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October 22, 1998

36th Parliament, 2nd Session

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Hansard Transcripts

vol. A

Hansard Transcripts

vol. B

Votes and Proceedings

Orders and Notices

L048A - Thu 22 Oct 1998 / Jeu 22 Oct 1998 1

PRIVATE MEMBERS' PUBLIC BUSINESS

MUNICIPAL RESTRUCTURING

RURAL AND NORTHERN HEALTH SERVICES

MUNICIPAL RESTRUCTURING

RURAL AND NORTHERN HEALTH SERVICES

MUNICIPAL RESTRUCTURING

RURAL AND NORTHERN HEALTH SERVICES

MEMBERS' STATEMENTS

DENTAL HYGIENE WEEK

COMMUNITIES IN BLOOM

LONG-TERM CARE

MEMBER FOR EGLINTON

HOSPITAL FUNDING

HIGHWAY SIGNS

INDUSTRY EDUCATION COUNCIL

REPORTS BY COMMITTEES

STANDING COMMITTEE ON GENERAL GOVERNMENT

MOTIONS

COMMITTEE SITTINGS

ORAL QUESTIONS

PROPERTY TAXATION

INCOME DISPARITY

LONG-TERM CARE

PROPERTY TAXATION

DOMESTIC ABUSE

YOUNG OFFENDERS

EDUCATION FUNDING

FRANCHISE BUSINESSES

SOCIAL ASSISTANCE

SCHOOL CLOSURES

APPOINTMENT OF JUSTICES OF THE PEACE

LINCOLN ALEXANDER EXPRESSWAY

BUSINESS OF THE HOUSE

PETITIONS

TRAFFIC CONTROL

PALLIATIVE CARE

HEALTH CARE

PRESCRIPTION DRUGS

PROTECTION FOR HEALTH CARE WORKERS

CHILD PROTECTION

HIGHWAY SIGNS

PROTECTION FOR HEALTH CARE WORKERS

GOVERNMENT ADVERTISING

ABORTION

HERITAGE CONSERVATION

YOUNG OFFENDERS

PRESCRIPTION DRUGS

PSYCHIATRIC HOSPITALS

ORDERS OF THE DAY

COURTS OF JUSTICE AMENDMENT ACT (IMPROVED FAMILY COURT), 1998 / LOI DE 1998 MODIFIANT LA

LOI SUR LES TRIBUNAUX JUDICIAIRES (AMÉLIORATION DE LA COUR DE LA FAMILLE)

The House met at 1000.

Prayers.

PRIVATE MEMBERS' PUBLIC BUSINESS

MUNICIPAL RESTRUCTURING

Mr David Christopherson (Hamilton Centre): I move that, in the opinion of this House, the Harris government be urged to acknowledge the downloading of services and expenditures to Hamilton and Hamilton-Wentworth is not revenue-neutral and has in fact created an unacceptable crisis in local property tax increases; and

That, in the opinion of this House, the Harris government be urged to acknowledge that:

Mike Harris and the Conservative Party of Ontario promised the citizens of Ontario fair and equitable taxation in the Common Sense Revolution, and property tax is an unfair and regressive form of taxation.

Mike Harris promised - in bold letters - on page 5 of the Common Sense Revolution, "We will work closely with municipalities to ensure that any actions we take will not result in increases to local property taxes."

Mike Harris also promised that the province's exchange of services and expenditures would be revenue-neutral.

The Harris downloading has shortchanged the citizens of Hamilton and Hamilton-Wentworth by $36.3 million per year, forcing dramatic property tax increases.

The Harris government's own figures confirm this $36.3-million shortfall.

The eight-year phase-in of the Harris government's business education tax has discriminated against Hamilton and Hamilton-Wentworth by putting an additional $17-million burden on to local taxpayers.

The province reneged on its original commitment to a three-year small business rebate program, and will now only fund the program for one year.

Many of our citizens may lose their homes, businesses and jobs as a result of the drastic property tax increases foisted on local taxpayers by the Mike Harris government.

Any further downturn in the economy could potentially bankrupt the municipalities who must now bear the brunt of increased social service costs and responsibilities.

City and regional councillors are being unfairly blamed and forced to explain these huge Harris tax hikes; and

That, in the opinion of this House, the Harris government be urged to immediately pay back to Hamilton and Hamilton-Wentworth the $36.3 million they have shortchanged our community; and

That, in the opinion of this House, the Harris government be urged to eliminate the $17-million cost of their business education tax by revoking the eight-year phase-in period and moving immediately to the provincial average, as well as reinstating their original three-year commitment to the small business rebate program.

The Acting Speaker (Mr Gilles E. Morin): Pursuant to standing order 95(c)(i), the member has 10 minutes for his presentation.

Mr Christopherson: The first thing I'd like to do with the 10 minutes of my opening comments is to recognize that in the members' gallery there are 13 members of regional council who are here because this issue is so crucial to us. I would also advise members of the House that there is a delegation of business people and citizens on their way who will be here in the public gallery.

Let me say at the outset that these regional councillors and the business people who are on their way aren't here because they suddenly woke up this morning, slapped themselves on the forehead and said: "Gee, I'm a social democrat and I better get down the highway and help Dave. That's what I've got to do today: I've got to get down there and help Dave." They are here from all political stripes, people who are non-aligned citizens who have no political agenda other than dealing with the crisis that we're faced with in Hamilton-Wentworth.

My hometown of Hamilton-Wentworth has been severely, tragically and undemocratically wronged. My resolution is here today to ask this House to help my community right this wrong. Lest anyone think that this is not a real issue, I read to you from a letter, September 25 of this year, two sentences:

First, "I write to you today regarding the local Hamilton-Wentworth property tax fiasco." Second, "The entire business and residential community is outraged and my city and region are being ravaged." That was written by the member for Hamilton Mountain, a member of the government's own backbenches.

Let me also quote from an editorial of October 9 in the Hamilton Spectator:

"What will be done about the property tax crisis in Hamilton-Wentworth this year? That's the number one issue for many taxpayers, business people and homeowners alike, who face skyrocketing tax bills.

"There is plenty of blame to assign, starting at Queen's Park. The provincial government created considerable strain for municipalities by implementing two historic changes, property tax reassessment and less-than-fair downloading of services to local government, in only one year. However, finger-pointing won't solve the taxpayers' problems. Municipal politicians and the region's MPPs must put their differences aside and co-operate to find desperately needed ways to cushion the blow."

That is why the resolution is here today; that is why it's worded the way it is. I agree that this is a time for us to set aside our party affiliation and scoring political points and deal with the wrong that's been done to our community and put it right.

I have not included - and deliberately so - the issue of CVA. I have not included the issue of transitional funding for the historic administrative merger that's taken place. That's a separate and complex debate in and of itself. I have deliberately confined my resolution to three key areas that I do not believe are open to political debate because they're facts; they're based on the actions of this government.

I'm going to deal with the issue of downloading and the fact that it's not revenue-neutral in our community. I want to deal with the issue of the small business rebate plan, where the government reneged on its promise, and also the business education tax, where my community is being discriminated against to the tune of $17 million a year. Those are the three issues that I'm putting before this House in asking my colleagues to support my community in climbing out of this crisis that we face.

First, the downloading. I want to state again that the Common Sense Revolution said, "We will work closely with municipalities to ensure that any actions we take will not result in increases to local property taxes." Mike Harris also promised that the exchange of services and expenditures would be revenue-neutral. In both those instances, that's not what happened, not by a long shot. This is straight-up dollars - and lack of common sense - but dollars and cents.

I want to point out to members of the House, particularly members of the government benches, two important factors as we enter into this debate today. First of all, if you're going to question the numbers that I'm about to read in terms of the downloading, I want you to remember something that's very important. The CAO of the region, Michael Fenn, who oversaw the compiling of these numbers, has one of the finest reputations in this province. His reputation, I would remind you, is so good that you just hired him as your Deputy Minister of Municipal Affairs.

So if you're going to question these numbers, you are questioning the integrity of the man you just hired to be the new Deputy Minister of Municipal Affairs for the province.

Secondly, I want to remind members that my community of Hamilton-Wentworth has already cut expenditures by over $50 million over two years. So to anyone who wants to stand here and suggest that our community hasn't done the job, first of all, you think about that $50 million and what that's meant to our community, and then I want you to look these councillors right in the eye and I want you to tell them that they didn't do the job. I want you to have the guts to do that, because that's what you're doing if you say that our community has not done the job that needs to be done in terms of putting our fiscal house in order.

In terms of the downloading, new costs that you've dumped down to our community such as public and social housing, ambulance services, community services, property assessment services, GO Transit - $102.8 million. You've increased costs for child care, public health services, provincial highways and assessment appeals to the tune of $12 million. You've cut revenue to such things as the municipal support grant, public health, transit and other important areas in our community to the tune of $55.6 million. In return, you gave us $134.1 million. When you do the math in terms of what you took away and what you gave us, we are $36.3 million in the hole. That's what this is about.

It is such a clear injustice, and that's why I'm asking my colleagues from all three parties to join with me in supporting this resolution. I'm calling on other members of the government back benches, because you've got the majority control. I'm asking you to support what is clearly in contradiction with the commitment you made in the Common Sense Revolution and the promise you made - remember the pinky swear? - that it would be revenue-neutral, that property tax wouldn't go up as a result of the downloading, and yet there it is, $36.3 million.

In my wrap-up comments, I'll point out to you that property taxes for Sandra Gray, the owner of Weeks Hardware, have gone from $55,000 to $132,000, a 140% increase. She employs 80 people. How many of those 80 people are going to be out of work because of the unfairness of your downloading? Roxy restaurant in Eastgate Mall: Taxes have gone from $5,000 a month to $9,000 a month. He says he has to sell a hamburger for $20 to cover off your property tax increase. Mike Ritovich, who operates Mountain Nissan and is a member of the Hamilton-Burlington car dealers' association: $1.3 million in increased taxes.

He has to sell 3,000 more cars to make up for the unfair downloading that you have foisted on to our community.

In the remaining seconds I want to touch briefly on the businesses education tax. This is pretty straightforward. Had you brought in a uniform application of taxes for the business education portion, we would be $17 million ahead in our community, but as it is we're losing that $17 million. You're taking eight years to phase it in. That's making our community uncompetitive with surrounding communities. You're supposed to believe in competitiveness. This hurts competitiveness.

Lastly, the small business rebate program: You promised a three-year program and you cut it back to one. Our business people need the assurance and stability of that three-year program.

I'm urging members to please be non-partisan about this. Support this resolution. My community needs your help.

Mr John R. Baird (Nepean): Taxpayers want the provincial government and all levels of government to deliver services efficiently and effectively. Previous governments have talked about sorting out who does what, about sorting out the relationship between the province and municipalities, but they lacked the courage to proceed and did not move forward with initiatives that they both talked about.

In the redivision and realignment of those responsibilities, Hamilton-Wentworth has benefited significantly from provincial funding to help the region take on new responsibilities under the realignment of local services. This year the region received $28.4 million through the community reinvestment fund, $3.6 million in special transition assistance, $3 million through the special circumstances fund, more than $8.3 million in transportation capital funding, and $5.3 million on highways funding, a total of more than $48 million.

This is part of a $600-million permanent funding support provided through the community reinvestment fund. Municipalities that are facing unique circumstances were able to apply for assistance from a $77-million special circumstances fund.

Changes to the Ontario municipal employees retirement system, the OMERS pension plan, have provided $4.5 million in savings to Hamilton-Wentworth alone. To help municipalities manage their cash flow requirements, the province remitted payments to school boards on their behalf and delayed the municipal repayments to October 30. For programs which the province continues to deliver during the transition period, municipalities were not required to make payments to the province before September 1, 1998, with an additional 30-day interest-free period.

The province has also taken over the cost of education, by far the fastest-increasing portion of the property tax bill, and that is after previous governments refused to take on this issue. In total, the commercial-industrial taxes, $512 million will be cut over the next eight years.

The member who just spoke, who I normally have a terrific amount of respect and regard for, didn't mention that he sat in cabinet for four years and they did nothing. They did absolutely nothing to cut -

Mr Christopherson: You are not going to compare what we did for Hamilton Centre -

The Acting Speaker: Order. The member for Hamilton Centre, please. You had your turn. Give him a chance.

Mr Baird: He was four years in cabinet and they allowed Hamilton businesses to be overtaxed and did nothing. In fact, before he went into cabinet, he was at the Ministry of Finance for a year and did nothing.

He complains about an eight-year phase-in. Had we started the eight-year phase-in the day he arrived at the Ministry of Finance, it would be complete and the $21-million tax cut that this government is bringing into Hamilton-Wentworth would be in place.

Now the member opposite and the colleagues in his party are saying that Mike Harris isn't cutting taxes for businesses fast enough. Well, you can't have it both ways. We have finally taken the initiative to cut those taxes, which have been overpaid for far too long. This government is taking it.

I can ask you who was fighting to get those taxes cut. There were four people who were fighting hard to fight taxes in Hamilton-Wentworth. They were the member for Hamilton West, the member for Wentworth North, the member for Wentworth East and the member for Hamilton Mountain, who finally got that decision made. If that had been done eight years ago, taxes would be $21 million closer. Do we think eight years is too long? You better believe we do. Would we like to cut taxes faster? You better believe we would. But at least we're moving forward. At least we brought in a $21-million tax cut to stop Hamilton businesses from overpaying.

Who set these tax rates? The member opposite wants to leave the impression that these tax rates were somehow set by Mike Harris. They were a result of big-spending councils over the years, which the member for Hamilton Centre and the member for Hamilton East participated in. We in this House -

Interruption.

The Acting Speaker: Order. Take your seat, please. I would remind the members in the gallery that you are here as our guests, and you should not participate in the debate.

Mr Christopherson: They are being provoked.

The Acting Speaker: Order. Member for Nepean.

Mr Baird: This government and these members on this side of the House are taking action to cut those taxes because they've been too high for too long and successive governments have refused to take action on it. But this government is taking action on it, this government is cutting those commercial-industrial taxes by a total of $21 million in Hamilton-Wentworth, and that's good news.

Mr John Gerretsen (Kingston and The Islands): I think the last member's display of total arrogance for local government is probably better shown this time than I've ever seen it in this House before.

Interjection.

The Acting Speaker: Member for Northumberland.

Mr Gerretsen: Rather than addressing the issue and working with these people on the $36 million that they are short, he brings out the regular kind of political rhetoric as to what former councils may or may not have done, about which he knows absolutely nothing and that's a pathetic display in this House.

Let me just say that I will take the local budgeting that is done at the municipal level in 99% of the municipalities across the province, if not 100% - they go over each and every item - I will take their approach and their numbers on any of these items before I would ever take numbers from anybody in this government.

This government has said over and over again that all of their downloading is revenue-neutral. Well, why is it that over 90% of the municipalities in this province, including AMO, the clerks and treasurers and every other organization, are saying: "It is not revenue-neutral. There's at least a $500-million shortfall throughout the province"? You can believe this or not, but it is absolute fact.

Initially AMO said there was a $1-billion difference between the downloading that you put on them and the number of services and taxes that you took back. You then met with them and somehow you were able to halve that amount to $500 million. The Minister of Finance and the Minister of Municipal Affairs then said, "We made a deal with AMO." Yes, of course. They would rather be $500 million short province-wide than the $1 billion you originally tried to download on them.

I'm not even going to touch the area of market value assessment, which has been in the news over the last two or three days, we'll talk about that later, but it is absolutely pathetic that the Minister of Municipal Affairs, the Premier and the Deputy Premier over the last 24 hours have done nothing but blame local municipalities for the property tax mess they created. They have had six different tax bills in front of this House over the last year or so and every time they've done it wrong. They have created the mess whereby municipalities couldn't even prepare a budget until August or September of this year.

Many of them couldn't get their tax bills out until maybe a month or so ago, and I understand some municipalities still don't have their final tax bill out. Most of them would normally like to set their budgets sometime between January and April of any given year. This government has created a mess, and every time it has done so it has blamed the local municipalities.

This isn't the only municipality where we've got these problems. In my own municipality of Kingston they are about $9 million to $10 million short. They made a similar appeal to the Minister of Municipal Affairs and he basically said: "Tough luck. That's it. That's all you're going to get."

This is not the way the province of Ontario ought to be run. This government likes to talk about partnerships with local municipalities. I've heard that at every AMO conference and, every time, the Minister of Municipal Affairs solemnly gets up and talks about a partnership. In a true partnership situation, you do not download services on the other level of government, making it an awful lot tougher for them to raise taxes.

What the people of Ontario should truly understand is that the costs the government has taken back under its wings are much more direct, much more predictable than the unpredictable costs they have downloaded on to the local municipalities. I would urge the people of Ontario to listen to the plight of council and taxpayers not just in the city of Hamilton, because this is going on throughout Ontario in many of our municipalities. People of Ontario, don't be fooled by this government trying to download the cost of extra services on other municipalities or on local taxpayers. It is simply not going to work.

You cannot blame the local councils for the kind of situation that this government has created through its own incompetence.

Mr Tony Silipo (Dovercourt): First of all, I want to thank my colleague and friend the member for Hamilton Centre, Mr Christopherson, for bringing this resolution to us today. I'm here to indicate clearly my support for this resolution.

I'm going to sit here during the rest of the debate and I hope the government members who are going to speak to this in addition to the member for Nepean will at least have the decency to speak to the resolution and to respond to the very issues the resolution raises, issues that deal with irrefutable facts about a shortfall, in this case, of $36.3 million to the Hamilton area in just the downloading costs alone, the difference of the $17 million in the way the government has chosen to apply the business education tax.

Yes, it is typical. What we are seeing happening in Hamilton is typical of what is going on throughout the province. But members aren't being asked today to fix the problem across the province, although I would say to my colleague from Nepean that he ought to get his script updated, because even his boss, the Minister of Finance, is now admitting it by promising yet another piece of legislation, which we will hear the details about tomorrow, I gather, to fix the ongoing property tax saga and scheme they have caused and the problems that come from that.

For him to stand up and say, "We've had the courage to make decisions" - you call it courage. We call it stupidity when you put small businesses in danger of having to close their doors, as is the case across the province and is certainly the case in many businesses in the Hamilton area, from what we are being told. Then you put municipalities and municipal councils - the regional councils and the local councils - in a position where the choices they have to make, if they want to try and help small businesses, as they do, are then to shift those costs on to the residential property taxpayers. What kind of a choice is that? What kind of fairness is that, when you ask people to do that?

The reality is that this is a problem the Mike Harris government has caused and it is irresponsible of them to now expect the municipalities to fix the problem for them. It is a problem that has to be fixed by acknowledging, as this resolution does, that in the Hamilton area there is a shortfall, that when the download is done, when the transfer of costs the government wants to take so much pride in between the provincial tax responsibility and the local tax responsibility is all done and settled, the numbers speak for themselves. There is a shortfall across the province of some $500 million, $550 million, depending on the numbers you look at, but there is a number here for Hamilton.

What this resolution is telling us is, acknowledge that which is true, that there is a shortfall of $36.3 million of additional costs that the property taxpayers in the Hamilton area are being asked to bear through no decision of their own but directly through the decision of the provincial government. It's inconceivable that people would stand here today and rail on about overspending and high-spending councils when councils throughout the province, and certainly this council, have been doing their utmost to maintain expenditures very close to last year's levels.

The issue is not the high-spending councils; the issue is that we have to acknowledge in this House - and we have the ability to do it through a private member's resolution that isn't binding on the government but is a way to send the message, as independent members of this House, which is what I remind members this process today is about, that says, "We acknowledge that there is a problem as it relates to Hamilton and we ask the government to take a look at that and to face up to its responsibilities."

Mr Toni Skarica (Wentworth North): Mr Christopherson asks the members to take a non-partisan approach. I think I am in a good position to do that and I will do that.

The Hamilton Spectator today indicates, "Local Taxpayers Must Have Help." I agree with that and all the Hamilton members here - Mr Pettit, Mr Doyle and Ms Ross - agree with that and that is why we lobbied our own government to get that $4-million subsidy. We have written a joint letter, all four of us, to help with restructuring of the Hamilton region for up to $27 million.

That's not what this resolution is about; that's maybe half of it at most. The other half of it says that yes, there are problems in Hamilton and they're basically all the fault of the Mike Harris government. I don't agree with that. In fact, even the regional chairman, Terry Cooke, doesn't agree with that.

In yesterday's paper, "Cooke Says Politicians Have `Failed' Taxpayers" - all politicians: federal politicians, provincial politicians and you people up there. Your own regional chairman says that.

Mr Gerretsen: How about you?

Mr Skarica: Me too; everybody. Moving forward: Who is to blame? What exactly did happen in Hamilton? I am so glad Mr Christopherson mentioned Mike Fenn because he was part of the bylaws. He participated in the bylaws. I met with him because I wanted to know what happened in Hamilton. They used the tools extensively. The download, yes, it's not revenue-neutral. I voted against it. But it's a 5% increase.

My business community is facing 100%, 200%, 1000% increases. That's not the download. How did that happen? The best way to visualize how the tax jungle happened is to imagine a gigantic garbage truck. That's not hard for us to do in Hamilton with all the hazardous waste that is flowing into Hamilton right now and has been for the last several years. This garbage truck stopped at Queen's Park and gathered the non-revenue-neutral download. That's 5% of the increase.

Then it went to the school boards. We had an amalgamation in our area. The Wentworth board where I'm at was cheaper, $1,000 per student, than the Hamilton board. The bylaw that the region passed, these gentlemen behind us, made my taxpayers pay the same amount as the Hamilton taxpayers. That resulted in a very substantial increase. My businesses are paying at least 25% more in taxes and Hamilton still has more programs than the students in my area.

Then the garbage truck next went to the Hamilton council itself. They did their own version of a download; it's called an upload. They have a number of programs that are losing money. They put them up on the region so that it could be spread around the whole region. That increased taxes by 0.5% to 1%.

Then the region itself: We asked them to cut costs by 2% to 3%. They instead increased expenses by 1%. They give a variety of reasons for it: "We can't reduce expenses. The province has been so unfair." Nobody has mentioned the fact that with our policies with reference to welfare, the welfare rolls in Hamilton are about 20%. In the last two years alone, the region saved $34 million. What happened to that money? Why did it have to increase taxes another per cent?

Then the truck keeps going. It's pretty full now. Mr Christopherson talks about a municipality going bankrupt. I'll tell you one that may go bankrupt whether there's an economic downturn or not, and that's the town of Flamborough. You want to talk about mismanagement. Go to the town of Flamborough, run by Liberal Mayor Ted McMeekin. Let's talk about that. The region people confirm they made money on the download. We gave them a $1.3-million cheque. They had $640,000 left over. What did McMeekin do with it? He put it in a reserve fund for a lawsuit. He could've reduced taxes.

Mr Christopherson: On a point of order, Mr Speaker: I don't think it's appropriate for the member to be raising personal names and casting aspersions against that name. I'd ask you to rule as such.

The Acting Speaker: This is not a point of order.

Mr Skarica: The Flamborough council could have reduced taxes by 5% if they had given the money we gave them back to the taxpayers. They used it for other purposes. They increased taxes 5% and blamed us. That's what's going on. The people of Flamborough are upset and they have started signing petitions. I've already filed 30 pages of these. What's McMeekin's response? Here it is in the Flamborough Review, "Council Spends Almost $1.4 Million in Buying Spree." I'm almost out of time.

It's everybody's fault. Our small businesses - in the Dundas Star, "Tax Hike Threatens Survival." What happened in Hamilton was, there has been a massive tax shift. It's come from outside the Hamilton core which has been devastated by too many taxes because of too many programs that have failed in Hamilton. Now their property values have been reduced. They can't pay their taxes. All of sudden, with all these increases, it has to go somewhere. It's gone out to the successful businesses on the Mountain, in Westdale and in my area.

That's why there are 100%, 200% and 1000% increases, even though there are all kinds of headlines like "Tax Hike Threatens Survival." I've had people come into my office crying that they've been wiped out by 200% tax increases and it has been a direct result of this bylaw structure that has done a massive shift outwards, and they're not going to do anything about it. Their only response is, "We want more money from the province." I'm telling them that we have all spoken to Ernie Eves and we want something done about it. We're going to do something about it. We're going to put on a cap so that our small businesses don't get wiped out. We're going to do that.

All responsible politicians should do what we do: Look at your expenses and cut those and don't wipe out taxpayers.

Mr Alvin Curling (Scarborough North): I want to just come to it from an objective point of view.

Interjections.

The Acting Speaker: Order. You each have the opportunity to voice your opinion. It's now his turn. Please. Member for Scarborough North.

Mr Curling: I know the Conservatives cannot look at anything objectively. What they have done all the time is divide and conquer. That's what they have done. The fact is that we know your program is not working. Your downloading aspect of it has hurt many municipalities. Hamilton is one of them. You see where the shortfall has come with them. When Toronto told you that your downloading aspect and your strategy wasn't working, and after Mel Lastman came in and really toe-to-toe bullied you all, you decided to bow to it, give some interest-free loans and help out in some respect.

The divide-and-conquer thing will not work. What has happened to Hamilton? Why don't you revisit your situation again and realize that you have to put in another proposal? Maybe you have. Your seventh tax bill may do that, but I don't think it will. You have always created a crisis and then turned around and tried to say, "Maybe now I'm going to become the captain and save it all." Just like you've done with the hospital situation and emergency rooms, now that you have created this crisis you're going to come in and try to resolve this.

That way you are blaming everybody else, when the blame lies right smack on your kind of strategy. Your divide-and-conquer and the discriminatory way in which you treat some of the municipalities are not working.

I just want to say to you, let's not look from a partisan point of view. Look at Hamilton as a growing area that needs support from the provincial government. It doesn't need the kind of bullying that you're doing and the kind of biased manner in which the previous member has just spoken. I just want to make those points and give my colleagues a chance.

Ms Marilyn Churley (Riverdale): I just want to take a couple of moments here to speak on this resolution this morning. First of all, I want to acknowledge the efforts made by my colleague David Christopherson today on behalf of not only his own riding but all Hamilton. I must say, sitting beside David in the House, sometimes I have to plug my ears because he speaks very loudly and passionately about many issues, but when I hear him talk about Hamilton he speaks passionately, he's well informed and he fights continually, on a day-to-day basis, for his hometown. I want to acknowledge that today.

I want to thank the members who are here today, different politicians from different political stripes, I assume, both male and female, for coming together united on this one issue, because it is so important that communities, no matter what the political stripe, come together and fight this kind of blatant downloading that we're seeing all across the province.

I cannot believe that once again here today we hear the Tory members come out with the same old set speech: "Let's blame it on the last 10 years," the governments before them. "Let's blame it on the municipal politicians; let's blame it on everybody, but it's not our responsibility." That's what they say day after day in this House.

You've got to wake up and smell the coffee. Hamilton people are here today and David Christopherson -

Interjection.

Ms Churley: There he goes again, the member for Etobicoke-Rexdale talking about what we did in power. We sure as hell didn't do the downloading that you guys did to Hamilton and all kinds of communities across this province. It is time that you woke up and smelled the coffee. You are hurting our communities. Take some responsibility.

Mike Harris promised on his pinky finger - wasn't it cute, and everybody stood up and applauded - that the downloading, the exchanges of services, would be revenue-neutral. We know that isn't so, and you won't admit it. He also promised Robert Fisher that there would be no hospital closings. Well, look what's happening across the province.

You have got to wake up and accept responsibility for what is happening here today in Hamilton. You can't just sit there and continue to blame it on everybody else but yourselves. This is a reality. You have to bring forward yet again another bill - is it the sixth bill or the seventh? - on your tax changes.

I plead with you today -

Mr John Hastings (Etobicoke-Rexdale): To go back to the old standards.

Ms Churley: Oh, no. Not to go back to the old standards; to go back to decency in this province, to go back to serving the people of this province the way they should be served. Government has a role to play in this society, and the role to play is equity and fairness for everybody. You have moved so far away from that concept. You read in the newspaper today that the rich are getting richer and the poor are getting poorer. We're seeing municipalities like Hamilton across the province practically unable to keep up with the services that they need to make sure there is equity in their communities.

I personally am sick and tired of this nonsense coming from you guys. I want to hear somebody stand up here today and tell what is real - I am choosing my words carefully here. I'd like to hear the member for Hamilton Mountain stand up and speak up for his community today and tell the people what's really going on.

Mr Baird: Tell us about the social contract.

The Acting Speaker: The member for Nepean.

Ms Churley: There he goes again, trying to place blame somewhere else. You're the government now, and you're hurting Hamilton and you're hurting communities across this province. It is so typical of you to blame other people. Be brave today. Stand up against your Premier. Just try it for a change. Support this resolution. Stop being so cocky and arrogant over there. Go to your Premier, go to your finance minister, and say, "Enough is enough." Get to the bottom of this and make sure the municipality of Hamilton has the money that they've been robbed of, frankly, and the other communities across the province as well.

Mr Ed Doyle (Wentworth East): A very impassioned speech over there from the new taxfighters: the new taxfighters from the NDP, the new taxfighters from the Liberal Party. That's what we've got, the new taxfighters. These are the people who raised taxes 65 times when they were in office. This is the party -

Interjections.

The Acting Speaker: Order. Take your seat for a minute. Order. Nice to hear you, member for Wentworth East. Please.

Mr Doyle: Do you need the microphone, Mr Speaker?

Yes, these are the new taxfighters. Let me tell you about the new taxfighters: 65 tax increases. Since we have been in office, taxes have been lowered over 60 times by this government. Every time they talk about the 30% tax cut that we gave, do you know what they call it? They call it "that stupid tax cut." These are the taxfighters: "that stupid taxfighter." This is incredible. I just don't believe what I'm hearing: the new taxfighters, the NDP and the Liberals.

Let's talk about something else here. Not too long ago, the New Democrats said to the Liberals and to us, "We would like the employment insurance money to be given back to workers and employers." Guess what the Liberals did? They said, "No, we're not going to do that." They didn't agree to that; they disagreed with it. When they wanted to do something about $2 billion in downloading to the province on health care issues and social issues, they said no. These are the new taxfighters, the new taxcutters.

I can't support this resolution. We care about our taxpayers in Hamilton-Wentworth more than they've ever demonstrated.

Mr Dominic Agostino (Hamilton East): I'm pleased to join the debate. I want to congratulate my colleague from Hamilton Centre for this well-thought-out resolution which makes a great deal of sense and addresses the issues of Hamilton-Wentworth.

I'm amazed at the arrogance, the cockiness and the insensitivity that the government members have shown to this issue. It's always blame someone else. In health care, it's not the government's fault; it's the hospitals, the doctors and the nurses. In education, it's not the government; it's the teachers and the trustees. In welfare, it's not the government; it's the welfare recipients. In municipal downloading and taxes, it's not the government; it's the municipal councils. That is typical of your arrogance. That is typical of your style of bullying, of your style of government.

Very clearly, the comments by the members for Wentworth East and Wentworth North are an insult to Mayor Morrow and Hamilton city council; an insult to Mayor Etherington, who is here, and regional council; an insult to every civic official.

I can tell this government that you can take some lessons in the spending and the cuts that have occurred and the budgets that have occurred in Hamilton and Hamilton-Wentworth. They don't need to take a back seat to and be lectured by any slash-and-burn members of this government who are totally insensitive to the needs of property taxpayers.

Hamilton-Wentworth sent four Tory members to the Legislature last time, and what did Mike Harris give them in return? The middle finger. They received Mike Harris's middle finger in return for sending four Tory members to Queen's Park.

The Acting Speaker: Order.

Mr Agostino: I don't think that's unparliamentary.

The Acting Speaker: There are words that you have to be very careful with. I would ask you just to withdraw that, please.

Mr Agostino: If it's unparliamentary, I'll withdraw it. I don't think it is, but -

Interjections.

The Acting Speaker: Order. I find that totally unacceptable.

Mr Agostino: I'll withdraw that. Withdrawn.

We're talking about Hamilton-Wentworth being shafted to the tune of almost $37 million. Those numbers are beyond dispute. As my colleague from Hamilton Centre mentioned, these numbers were not pulled out of the air, they weren't pulled out by opposition politicians; they were put together by the man you have hired as your Deputy Minister of Municipal Affairs, a man whose credibility and competence is beyond question. These numbers are accurate.

I find it amazing that the member from Wentworth spoke about all of this earlier. He was one of the most critical members of this government when the downloading exercise took place, and all of a sudden he's bought in. All of a sudden the whiz kids in the Premier's office have basically pulled his string and said: "Come back in line with us. Do what you're told."

Government members can't have it both ways. You have people like the member for Hamilton Mountain who will stand up and say, "We've been hurt by this." You have the member for Hamilton Mountain writing to the Minister of Finance, pleading for his political career, saying, "I did not leave my career to be a one-term MPP." I suggest to the member for Hamilton Mountain, start sending out your resumé, because you will be a one-term MPP as a result of this downloading exercise.

You can't have it both ways. You can't sit in the House and vote in favour of the downloading bill and then go back home and tell the Hamilton Spectator that maybe what the government did was wrong. You can't have it both ways. Have the courage and the integrity to either vote against the legislation or, if you don't agree and you believe they screwed your community, step out of the caucus and sit as an independent. You can't have it both ways.

The Acting Speaker: Order. Be careful with your language, please.

Mr Agostino: That's not unparliamentary.

The Acting Speaker: Just be careful.

Mr Agostino: I really expected a tone of co-operation from the government members, particularly from the Hamilton area. If anybody knows of the devastation the business community has seen, they know. They know of the increases of 50%, 100%, 500%, 900% in business taxes. They know of the devastation that homeowners, senior citizens, the disabled, working Hamiltonians are facing as a result of this massive downloading.

The region and the city can't cut any more. There just isn't anything left to cut unless you get into essential services. You simply can't come up with a solution the Premier put together on the back of a matchbox yesterday that suggests that somehow we're going to cap it, without any additional funding. Where's that money going to come from? Is it going to be from residential taxpayers? Is it then going to be put on to the business that had a bit of a decrease? Who is going to pay for that? You can't just come up with these solutions that don't work.

You've brought in seven bills to deal with property tax reform. Now you're going to be on to bill number eight. You talk about sheer incompetence, and who's paying the price? Homeowners, businesses in Hamilton-Wentworth. They are paying one hell of a price.

This resolution today addresses that. All it says is: "Treat us fairly. If you want to challenge our numbers, go ahead. Show us that our numbers are wrong. No one has done that yet. No one from the ministry has shown us that our numbers are wrong" - that the Hamilton-Wentworth numbers are wrong - "because they know that the numbers are right. They know that we've taken a beating of almost $37 million."

Think about that. Think about your communities. You can sit there with your arrogance and your cockiness if your community is not affected, but think if your taxpayers, Tory members, had been shafted to the tune of $37 million and have to pick that up through property taxes. If that happened, think about how you would react. Would you have the guts and the courage to stand up and support your community or would you simply allow the Premier and the Premier's office to pull your strings and tell you what to do?

Very clearly, the Hamilton members, the government members, have an opportunity here at least to undo some of the damage they've done. You can't undo the fact that you voted in favour of the downloading bill. You can't undo that, but you've got an opportunity now to send a message to Mike Harris to say: "You know what, Mike? We made a mistake. I made a mistake as a member who voted in favour of the downloading bill." If Tory members can say that, it is your opportunity to try to undo that damage. For a change, it is your opportunity to say, "I was elected to represent my constituents at Queen's Park, not Queen's Park in my constituency." It is an opportunity and people will be watching.

It is not a coincidence that 12, 13 members of city council and the mayor of Glanbrook have taken the time to come down here today. Can you not understand how important this is to our community? Can you not understand the devastation we're facing? If you're simply going to sit there and point fingers, it isn't good enough. It is not council's fault; it is your fault. I can tell the government members in the Hamilton-Wentworth area, you will pay a heavy political price for the beating you have laid upon our constituents. It isn't good enough to sit there and say, "Well, maybe we made a mistake." It isn't good enough.

You now have an opportunity to stand up. You now have an opportunity to cut the apron strings from the Premier's office. You now have an opportunity to vote with your hand, not the hand that is being pulled by Mike Harris. Say no to the whiz kids, say no to the Premier, say no to your caucus and say yes to the taxpayers of Hamilton-Wentworth.

Mrs Lillian Ross (Hamilton West): There's an old saying, "So much to say and so little time in which to say it." First of all, I want to welcome the members from Hamilton city council and regional council. I have some friends there and I hope I still do after my short little speech here.

I want to put on the record that I support very sincerely and strongly the homeowners and the business people in my community. I listen to their concerns all the time about the taxes they are facing and about the 1.97% tax rate they're looking at in the city of Hamilton. I share their concern that that tax rate is far too high.

In the resolution, the member has talked about the property tax system being unfair. He had an opportunity when he was in government, when he sat at the cabinet table, to look at that and to revise that system.

I have fought for my community. I've fought for funding for Red Hill Creek. I've fought for transitional dollars and I'm prepared to continue that fight for transitional dollars, the $27 million. I work with my community to try to get them the support they need.

Unfortunately, I've run out of time.

Mr Christopherson: Let me say at the outset that I recognized that there was going to be acrimony. It's impossible for us to deal with anything in this House, quite frankly, where at some point we don't touch open nerves and passions get ahead of us.

I drafted this resolution in a way that I sincerely had hopes for today during private members' public business, where there isn't the party discipline, where we don't whip the votes. It's the one time as backbenchers and individual members that we are not only expected but encouraged to come here, speak our minds and vote our conscience.

Had I loaded up this resolution with all kinds of political attacks, I can assure you that my colleagues on Hamilton city council and Hamilton-Wentworth council wouldn't have given it more than the 10 seconds it would take to move a motion to file the thing. But I dealt clearly and strictly with three key areas where, yes, the government is responsible. I'm not suggesting, and no one is, that all of Hamilton's problems and all of Hamilton-Wentworth's problems are solely the responsibility of Mike Harris. That is a ridiculous position to take.

But in the three areas that I've outlined in the resolution in terms of the downloading, in terms of the small business rebate program and in terms of the business education tax, those are your responsibilities.

My colleagues on local councils didn't take any initiatives that caused that problem. You initiated all three of those measures. I didn't get us into a whole debate about the other things that have happened in our community, what's happened to our health care system, what's happening to our school system.

By the way, you might be interested to know that tonight at the board of education, there are going to be recommendations about school closures. As many as 30 schools in my community are going to close. That's not in the resolution, and deliberately so.

When I heard the member for Wentworth North -

Mrs Ross: You didn't do it when you were there.

In terms of our downtown initiatives, we were beginning a program to look at a special taxation policy for downtown Hamilton that, had the election not come, quite frankly, and had the result not been what it was, we indeed would have had special legislation for downtown Hamilton and we wouldn't have half the problems that are facing us right now. You didn't do anything with that. Instead, you brought all these other problems on to us.

Interjection.

Mr Christopherson: The member for Wentworth East, I'm not sure exactly what that was all about, but it wasn't about the resolution; and the member for Hamilton Mountain didn't speak and I don't know why. He was in the House. He let another colleague speak, another backbencher from another community.

Ms Churley: From Ottawa.

Mr Christopherson: Which is fine, he's entitled to speak, but I thought that every member from Hamilton-Wentworth would have wanted an opportunity to speak to this important motion.

I want to put on the record that I think there are members in this House from Hamilton and from Nepean who owe my municipal colleagues an apology for what the members said and the things they said about them. It's fine to sit back there in the backbenches with all the protection of a majority government and the cabinet ministers out there and say, "You didn't do the job." I sat on that council for five years, city and region. That's a tough job, and our councillors and our aldermen have done the best job they possibly can in impossible circumstances. You ought to be standing up and applauding the job they've done rather than standing up and besmirching their reputations.

Let the record show that today in the gallery were Mayor Robert Morrow, Mayor Glen Etherington from Glanbrook, Councillors Dave Wilson, Mary Kiss, Marvin Caplan, Andrea Horwath, Ron Corsini, Bernie Morelli, Dennis Haining, Chad Collins, Bob Charters, Terry Anderson, Bill Kelly and Frank D'amico. They are here.

You know who else is here? Take a look up there. Go on, take a look, guys. Right up there is Mary Pocius, who is the executive director of the International Village BIA. She represents 8,000 businesses. She's here because this matters to her and her members. She's not here, quite frankly, to do harm to this government, and she's not here to do any great political favour for me. She's here because this is an important issue.

Members, members of the government because you have the control, and my colleagues the MPPs from Hamilton-Wentworth, I'm asking you to recognize the crucial negative impact of your downloading, of the business education tax and cutting back the small business rebate program from three years to one. Those are the three issues that I put forward in the motion and in my resolution. I'm asking you to recognize that this is not a political spin. These people are evidence of that.

Our community is hurting. We have work to do locally at the city council and the regional council, and these women and men are dedicated to do everything they can for those things that are in their power. But the three items I've put before you today are not in their power. They can't do anything about these injustices; we can.

We can't make a decision that's binding on the government, but collectively, as individual members from communities like mine in Hamilton-Wentworth, you can stand up and join with us and say, "It's not fair what happened to Hamilton-Wentworth in these three issues, and I'm going to give my support to them because this is legitimate and because I do want to be a fair-minded member of this Legislature." It's on that basis that I'm asking members of the government backbenches and Tory members from the government benches to please join with the rest of us in supporting and correcting the injustice that has happened to Hamilton-Wentworth. It's the only fair thing to do.

RURAL AND NORTHERN HEALTH SERVICES

Mr Tim Hudak (Niagara South): I move that, in the opinion of this House:

Whereas the Ontario government has shown the leadership to address access to health care in underserviced communities through the rural and northern health care framework, the $70 per hour sessional fees for emergency room physicians, and enhanced incentives for recruitment and retention of health professionals; and

Whereas the government's Bill 127 has legally recognized the important role and enabled greater participation of highly skilled nurse practitioners as part of a multi-disciplinary health care team;

Be it resolved that the government should act to further improve and expand the underserviced area program including the integration of nurse practitioners into primary care practices to make underserviced areas more attractive to physicians and other health care professionals.

The Acting Speaker (Mr Gilles E. Morin): Pursuant to standing order 95(c)(i), the member has 10 minutes for his presentation.

Mr Hudak: It's a pleasure to rise in the House on my resolution, which I see as a very important and emerging issue in my area, the Niagara Peninsula, other parts of southern Ontario, southwestern Ontario, as well as the long-standing challenges that the health care system has had getting health care professionals and doctors to rural and remote parts of northern Ontario.

I think the number of members who want to speak on this bill is a testament to their concern about ensuring that the citizens in their ridings have access to health care services. I'm joined today on this side of the House by my colleagues from Bruce, Durham-York and High Park-Swansea, three different areas of the province to address this issue today.

As a

preamble, I have to remark that this government has recognized the importance of access to health care in small-town Ontario. There are a number of things we've done already. I don't think we should lose sight of the fact that the underserviced area program has in fact been around for about three decades. I believe it was in 1968 that the program began, because there has always been that challenge for the rural, remote and northern parts of the province to make sure that they had health care professionals available to the citizens to deliver health care services.

In 1995 we came up with a number of new incentives to help recruit physicians to small-town Ontario. I'll give you some examples. For a number of emergency rooms that faced closure, quite frankly - if this government had not acted, about 70 emergency rooms in rural Ontario probably would have closed - we brought in what is often called the Scott sessional fee, a $70-an-hour fee to ensure that there are incentives for physicians to cover the rural emergency rooms. Seventy across the province have been kept open because of the actions of this government for access to health care in small-town Ontario. In fact, in my riding Fort Erie's Douglas Memorial Hospital is one of those hospitals.

Importantly too, coming from the backbench of this party, a number of MPPs, along with the health minister at that time, Jim Wilson, came up with the rural and northern health care framework. In fact, the member for Bruce speaking with me today played an important role in that as well. The rural and northern framework ensures that there is continued access to health care services in rural and northern parts of the province. I think the way it's going to unfold is the hospitals that are classified as rural will be staying open across the province and will be providing 24-hour access to emergency care.

It's another important step to make sure that citizens in small-town Ontario have access to health care services.

Just shortly after being appointed as the parliamentary assistant to the Minister of Health by the Premier, one of my first responsibilities was to bring in Bill 127, which legally recognized the important role of nurse practitioners in this province. Many other jurisdictions in North America had recognized these highly skilled and highly trained nurse practitioners, but Ontario had not yet passed legislation to legally recognize that. One of my first tasks, and it was a pleasure, was to carry that bill through debate in this House, which I would say was a very popular bill; in fact it received all-party support. Nurse practitioners now are legally recognized as a profession in the province.

It's my view, and through this resolution I'm trying to point out, that it's important now to take the next step. We've done the $70-an-hour emergency fee to keep those ERs open, we have the rural and northern health care framework to ensure access in rural and northern Ontario to health care services and we have the Bill 127 nurse practitioners. It's important to take the next step to improve the underserviced area program to make sure that we'll try some innovative ideas to attract physicians to small-town Ontario.

I should at this time speak about a good group that has been put together in the Niagara region. Dr Jeff Remington, a highly respected physician raised in Fort Erie and now practising in Port Colborne in my riding, is chairing this committee to come up with new ideas to attract physicians and health care professionals to the Niagara region. I have a quote from Dr Remington at the time I bounced this resolution around in his office. Dr Remington says, "The integration of nurse practitioners into the practices of family physicians in underserviced areas will greatly assist in our ability to provide increased care and necessary services to our patients and communities."

I think the goal through integrating the nurse practitioners is, first of all, to offer that important service to the people in the small communities, the additional services that an NP can provide. Some examples include performing general health assessments, well baby checks, periodic examinations and screenings, immunizations, some diagnoses that are permitted under the legislation and, importantly, health teaching, prevention, preventive medicine. One could argue that currently under the OHIP

schedule benefits there's not often that incentive for the doctors to work hand in hand in practice and in integration with the nurse practitioners. If we can find a method to try to integrate these services where they work together as a team, I think that will help enhance health care in the Niagara Peninsula and other parts of Ontario that could take advantage of this service.

Working as a team in that office would also help ease the doctors' workload. They often feel that the number of patients under their practices in small-town Ontario is growing. As more doctors are retiring, it seems in many areas that there are fewer moving from the schools in the big cities to come to small-town Ontario and, as a result, the doctors are picking up larger and larger practices. I think by having them work with the nurse practitioners and other health care professionals, we can look at ways of ensuring that that burden is eased, ultimately making small-town Ontario a more attractive place for family physicians and other health professionals to set up their practices.

We have a number of financial incentives that have been set up under the UAP, including the $15,000 financial incentive, and a disincentive in terms of limits on OHIP billing in the overserviced areas. If somebody is in a underserviced area program, they're part of that. They can get funds to help pay for doctors' visits to the communities so the doctors can see what a great place Port Colborne is, for example, or Fort Erie or Wainfleet or Smithville.

I know very well that those are great places to live, but often, in trying to reach the doctors in training in Toronto or Queen's or such, that little extra financial incentive to pull them into the community to see what a great place it is I think is important.

There have also been a series of community-sponsored contracts and other financial incentives; globally funded group practices. We have a number of financial incentives across the province that are having some success. But I would argue for going a step further and looking at ways of integrating - as one idea among many that I've heard from my colleagues here - to offer, in addition to the financial incentives, some lifestyle incentives to make practising in small-town Ontario that much more attractive.

I certainly look forward to the other ideas brought forward today to look at ways to enhance what is offered for underserviced areas. As I said, I believe that the financial incentives we have out there have been successful, but I'd like to see an additional array of services that will add that lifestyle component to make places like the Niagara region attractive for health care professionals.

Interestingly, a student who is a nurse practitioner, who lives in Fort Erie and attends school just across the border, came to me because part of her class project was to see if her congressman knew much about nurse practitioners. She came into my office as her member of the provincial Parliament and was pleased to hear that I was the member who helped bring this legislation through the House. Her name is Charlene Cormack.

Charlene said about this proposed idea, this resolution: "By working collaboratively with physicians, nurse practitioners will increase access to health care within a small community. Integrating nurse practitioners into the practices of family physicians would allow the physicians to concentrate on the more acute cases. It would be a benefit to" any community. That's a nurse practitioner student in my riding.

It's also interesting to hear what Linda Jones, the chair of the Nurse Practitioners Association of Ontario has to say about this resolution, this idea. "On behalf of the Nurse Practitioners Association of Ontario, I would like to express our full support for this resolution. It will allow underserviced areas access to the knowledge and skills of the primary health care nurse practitioner."

Also, working with PAIRO, I've had some very good conversations with some of the members of PAIRO on what some of their ideas are to help enhance the underserviced area approach of this government. They've been working very hard, as we all know, in approaching the government. They've spoken with me and the health minister. They believe as well that there are some opportunities in looking at ways of integrating nurse practitioners and trying some new approaches to this important issue.

I encourage all members of the House to support me in this idea, and I look forward to the comments of my colleagues.

Mr Gerard Kennedy (York South): It is a pleasure to talk about the subject, but not about this bill. This is propaganda brought into private members' hour. The member opposite, in introducing the resolution, the bill, talked about PAIRO, the association of interns and residents, which does not support this resolution. And why don't they? Because of the "whereases," because in here the government tries to claim that it has done a good job.

We heard the member opposite talking about nurse practitioners. Where, Mr Hudak, are the nurse practitioners? You haven't paid for them. We supported the bill. We went to your minister and offered to put the bill in, because you hung on to it for so long, and now there is no money yet to pay nurse practitioners. You announced $5 million and there's none of it available. Where are the nurse practitioners?

When you're talking about underserviced communities, you did bring in something called a rural health framework, but you're still closing hospital emergency rooms, still turning them into nurses' stations in most of those communities. Most of your members who represent rural communities know that. They know that in Grimsby, in places like Bruce and Huron, you are effectively going to be closing those hospital rooms because all you've done is put them off on a political basis. And why? Because the Harris government is treating every community like they're the same community.

You walk into those towns with a formula made in Toronto and you've cut out the funding. You've taken the funding away. How is Fort Erie going to be able to provide services?

Look what happened yesterday in Milton. Yesterday in Milton, a town of 34,000 people, they fired the obstetric nurses. They fired them because this government will not provide an adequate basis for medical practice and health services in the rural areas. Sadly, this is the real track record of this government. We have lost obstetric nurses in Milton; there is no effort being made to recruit obstetricians.

We see also that this government talks about setting up programs. They announced $36 million in December 1996 for underserviced areas; there should have been about $75 million spent. Only $4 million worth of contracts have been spent, $4 million out of $75 million, about a 7% or 8% batting average. That's about what this government deserves: a 8% mark on what it is doing or not doing for rural and underserviced areas.

We see what they've talked about in terms of doctors. What have they done to help people in rural areas have better access to doctors? What they have done is increased medical fees to $10,000 and $15,000, eliminating the possibility for good, talented doctors to arise from the communities that need them. This is the kind of thing that's happening under this government. This is the kind of thing that we should get excited about, because this is the government that's going to be hoisted by this.

We saw 7,000 people come out in Grimsby and hold a vigil for their hospital. We saw as many people sign letters from small communities in the Bruce and Huron. This is going to come back to haunt this government. They have not been there for the people who need them. They have not recognized the economics, the social value and potential that comes from communities because they have a hospital.

The bottom line is that under Mike Harris, rural health care has deteriorated. The people who live there know that, and hopefully, they'll make this government pay for that.

Ms Shelley Martel (Sudbury East): I'm pleased to participate, and since there are three of us participating, I'm going to get right to the point.

The member talks about integration of nurse practitioners into the health care system. I say to him, for goodness' sake, then your government had better start to find a way to pay them, because until your government finds a way to pay nurse practitioners to work in this province, all you have done is given them the scope of practice, allowed them legally to work, but not given them the means to finance themselves to do that.

All the members in this Legislature voted in June 1997 to allow nurse practitioners to legally work in the province of Ontario, but before that, during the debate on that bill and ever since that time, this government has consistently refused to find a broad-based scheme to remunerate nurse practitioners who want to use their skills, their expertise in providing health care to the citizens of Ontario, particularly to those citizens who live in underserviced areas. Your government has consistently refused to find a mechanism to pay these people to work in Ontario.

Our party has been trying to convince this government to do something about this serious issue. My first letter was to the first Minister of Health in this province under this government, Dave Johnson, in 1997, when I wrote to him and said, "Number one, you need to pass nurse practitioner legislation to allow them to practise legally, and you need to include in the legislation a scheme to pay NPs so that they can practise." I got a reply back from Dave Johnson thanking me for my concerns. He didn't say a word about how we were going to pay for NPs to work in the province.

I wrote to Minister Jim Wilson at the time the legislation was going through this House in June 1997. I said to him, "You have to come to terms with the fact that a funding mechanism is necessary to allow nurse practitioners to work independently or in partnership with physicians in underserviced areas, or we will never get the benefit of their skills and expertise." Jim Wilson wrote back in July 1997, saying: "It is not the intention of the government to have fee-for-service privileges for NPs.

It is not the position of the government to open up the community health centre program so that more nurse practitioners can be employed in community health centres in this province. The government will continue to look at what opportunities may exist as health care restructuring occurs."

We have a crisis now with respect to health care professionals in many, many underserviced areas in northern and rural Ontario. We can't wait until health restructuring continues to unfold. We need this government to show some leadership and to follow on with the second phase of Bill 127, a phase which in fact should have been included in Bill 127, which is, how do we pay nurse practitioners?

Then I wrote to the third health minister in this province under the Tories, to Elizabeth Witmer, and encouraged her to look at this very serious issue. I did it particularly in light of the announcement that was made in the May budget that $5 million was being set aside by this government to expand the role of nurse practitioners in Ontario. I received a letter back from Ms Witmer in September of this year which said that $5 million has been set aside. "We hope to announce the implementation plan for the $5 million in the early fall 1998."

This is the same sad scenario as the sad scenario we've been dealing with with respect to emergency room funding. The government makes an announcement that there's going to be emergency money, it's coming immediately, and six months later, because there's a huge crisis developing in the public again in emergency wards, the Premier finally trots off and presents the first of what we hope will be a number of cheques to come with respect to emergency funding. Six months it took this government to get the first cheques out the door.

We are sitting here five months after the announcement with respect to $5 million for nurse practitioners and this government has done nothing to get that $5 million out the door.

We have all kinds of needs for nurse practitioners in underserviced areas. We have 27 northern communities designated underserviced right now, and we have 45 communities in southern Ontario designated as underserviced right now. We have a proposal before the Minister of Health which calls on the Minister of Health to allow nurse practitioners to work with physicians in underserviced areas and to have a separate fund of money set aside to pay salaries for those nurse practitioners. It's called the nurse practitioner justification fund. This was put before the minister well over three months ago. There is still no reply to that good suggestion about how to get nurse practitioners working.

I say to the member, it's a joke that you bring this resolution here this morning. You talk a good line about integration. Why don't you lean over and talk to the Minister of Health and her cabinet colleagues on Management Board and tell them to get the $5 million out the door so that we in underserviced areas in particular can benefit from the expertise, the skills and the health care specialty that nurse practitioners can provide? Why don't you do that? We might be a whole lot further ahead.

Mrs Barbara Fisher (Bruce): I am very pleased this morning to have the opportunity to speak in support of Mr Hudak's resolution. I am supporting the improvement and expansion of the underserviced area program to include the integration of the nurse practitioners. I have special interest in this issue of rural health care as I represent the riding of Bruce, which obviously is predominantly rural. I appreciate the difficulties that rural communities face in attracting and recruiting physicians.

In the riding of Bruce, one area has already been designed as an underserviced area; two are looking at that possibility as well. The day I was elected, there were already two underserviced areas. It is not a new problem. It is something that must be dealt with, and politics need to be put aside. We are doing our best and moving forward to make that happen.

The rural and northern communities are obviously different from large urban centres and therefore must be considered differently. Distances between hospitals are greater. Weather conditions come into play. When patients are being transported to areas away from their homes, we have to think about what that does in terms of loved ones who want to visit those people in other locations. It does have a huge impact and it's obviously negative.

The rural health care policy has taken many of these problems into consideration, and the underserviced area program is one which is welcomed by communities in rural areas, including mine, although a previous speaker this morning implied that Huron and Bruce weren't supportive of this, much to his chagrin. If he'd checked the details, in fact we are very supportive, and that comes from those professional people, the doctors and nurses in the area, who want that support of assistance to them.

At the end of August, the southwestern Ontario rural medicine unit announced the hiring of Mr Jay Orchard as the community development officer. Jay is located in Goderich, in Huron county. He obviously services Bruce, Grey and the rest of southwestern Ontario. This new position, funded by the Ministry of Health, will focus on recruitment and retention of physicians for rural and underserviced communities throughout southwestern Ontario. Mr Orchard will help communities develop strategies and supports to recruit and to retain physicians. This is good news for communities in my riding.

We have progressed very well, by the way, with the restructuring of health services in Bruce, and I'm very proud of that because it was driven by the community, it was led by the community and the solution is being made by the community as to how to help themselves.

There have been many other innovative solutions found. I am particularly pleased that in Bruce and Grey a number of hospital administrations and boards have amalgamated. By the way, the health restructuring commission hasn't been there yet, and this has been done in a voluntary, progressive way. These amalgamations have reduced the size and cost of administration of hospitals, and as a result not one hospital has been closed.

Economic development in a small community is usually dependent upon its being able to provide such services as adequate health care, including hospitals. We in rural communities know that better than other people, in urban settings, might.

The expansion of the underserviced area program to include the integration of nurse practitioners into primary care practices will make underserviced areas more attractive to physicians and other health care professionals. Doctors have said that one of the reasons they hesitate going into practice in underserviced communities is lack of professional support. If doctor numbers are too few in a community, the workload is too heavy, and of course they won't come, nor can they be expected to come.

I have worked and lived in a small community for over 25 years and I can attest to the fact that the physicians are overworked and experience burnout. Nurse practitioners will help alleviate that workload.

The Society of Rural Physicians recently held a symposium in Newfoundland to discuss this very issue. I understand that the society, generally speaking, is supportive of nurse practitioners.

I had the pleasure last night of attending an OMA function and again it was expressed that they are supportive. Certain criteria have to be established and met. It is important that the nurse practitioner work within a defined role.

These health care professionals are not meant to replace physicians, but should be employed wherever possible to improve service in conjunction with physicians, health care boards and the people.

The society passed five resolutions with respect to the role of nurse practitioners. These include: There should be a national process to develop guidelines for the scope of practice of nurse practitioners; there is an enhanced skills set and specific education required by nurse practitioners; the activities within the role of nurse practitioners are location- and site-specific; funding models must be developed to enhance co-operative and collaborative care; innovative education is needed to provide core competency and an enhanced skills set.

However, Ontario has moved ahead. In 1997 amendments were made to the Nursing Act and other related acts. These amendments defined and established the role and responsibilities of the nurse practitioners in Ontario.

The nurse practitioner focuses on giving people the information, care, advice and support they need to be healthier and to prevent illness and injury. Patients can make the best choices with regard to their own health care if given the opportunity. That's why we want to move forward with this.

The nurse practitioner is now allowed to conduct certain and limited functions previously performed by physicians. These services include ordering certain X-rays, ultrasounds, basic lab tests, and the prescription of certain treatments and medications. These fall into the overlap of services between the nurse practitioner and the family physician. This overlap does not mean competitive practice, but can be and we look forward to having it be complementary practice.

The integration of nurse practitioners into the underserviced area program provides for a greater use of other primary health professionals and promotes access to primary health care in rural and northern communities. Nurse practitioners will function as part of a multidisciplinary team, in collaboration with other health care providers, including physicians. The adoption of this resolution will start this process.

I urge my colleagues to support this initiative and further assist northern and rural communities in their efforts to provide equitable and adequate health care to the residents of Ontario.

Mr Michael Gravelle (Port Arthur): I'm glad to have an opportunity to speak on the resolution by the member for Niagara South and also to comment on the comments by the member for Bruce. What we're hearing is the value of nurse practitioners and how important they are, yet we have a resolution that in some ways is almost insulting.

We have a government here - the member for Niagara South is parliamentary assistant to the Minister of Health - that after much delay actually has put through legislation supported by all members of the Legislature that we put the nurse practitioners act in place. We did that. We have a Minister of Health who has announced that there's $5 million to be accessed for nurse practitioners, but no way to access the actual funding. We have a

preamble in the resolution which I think is a problem as well, to put it politely, where the member talks about enhanced funding for recruitment and retention of physicians. We have had a three-year program of over $100 million to help recruit and retrain health care professionals in northern and rural Ontario, but almost no money of that has been spent: $3 million or $4 million of the $100 million that was committed.

So it's difficult to take him seriously when we have a resolution such as this which suggests that we should be supporting nurse practitioners, having them integrated into the underserviced area program when the funds that have been allocated are not accessible by the nurse practitioners.

The member for Bruce I think explained very well the value and the importance of nurse practitioners. Yet, what we have is a government that is basically doing everything they can to slow the process down. We know the minister in the House on September 29 said that she was ready to make an announcement, that the funding was going to be announced very soon. They announced the funding in the May 1998 budget: $5 million. The minister has confirmed that she's going to make her announcement, yet they've held off releasing that funding. As we know, an announcement of funds doesn't mean very much with this government because it's taken a very long time for that to be accessed.

I absolutely believe that the value of nurse practitioners in my part of the province cannot be overstated. I have worked very closely with the nurse practitioners in the Thunder Bay area to try and help move this process forward. We need to use today's opportunity - if we're grateful for anything, it's for the opportunity - to at least try and pressure this government to really move forward. This resolution will not in any great fashion improve the situation unless the government is absolutely serious about providing the funding which they've said they are going to provide.

The member for Niagara South knows that; the member for Bruce, who just spoke, knows that. What they should be doing is pressuring the minister to release the funding. Nurse practitioners are providing an extraordinarily important service. Right now, we have over 50 nurse practitioners in northern Ontario who are not working. We've got to find a way to access those funds, to use their services, to continue to fight on behalf of all of them and make sure that this government finally listens and releases the funding and lets them get to work.

Mr Blain K. Morin (Nickel Belt): It's indeed a privilege to rise in the House today and get to speak on such an important issue as it affects my northern rural riding of Nickel Belt, particularly around the value of nurse practitioners.

In Nickel Belt, being such a vast riding where we have rural communities such as Foleyet, Gogama, Shining Tree, it becomes especially important to fund nurse practitioners when we look at those remote rural communities which depend on the nurse care practitioners and nurse practitioners to meet those needs. An example of this is when we start looking geographically at a centre such as Gogama, where it takes the constituents of my riding two hours to receive emergency treatment at the nearest hospital, which is in Timmins, or another two and a half hours to get into Sudbury to receive emergency treatment.

Therefore, nurse practitioners become more of a value than ever, especially in northern communities.

I would like to start by saying that nurse practitioners have written; on September 19 in the Sudbury Star, and in the by-election in Nickel Belt, they asked us to continue putting pressure on the government to expand the use of nurse practitioners to alleviate the underserviced problems in northern Ontario. The government announced $5 million for community nursing, nurse practitioners, in provincially funded settings in the budget. None of that money was spent. That has created a real crisis in my community.

The nurse practitioners who wrote the original letter were Marilyn Butcher, Monique Richer, Ann Palomar, Joanne Przystawka, Roger Pilon, Annette Hoop, Brenda Taylor, Karen Hourtovenko and Claire Warren. The important thing to remember, and one of the beefs that the nurse care practitioners have about being underutilized, is that the nurse practitioners association estimates that there are 50 qualified nurse practitioners in underserviced areas in northern Ontario who are either unemployed or underemployed because of the limits on their ability to be paid.

That's quite serious when we're dealing with northern rural areas. We're not talking about building a new arena. We're talking about the basic right of people in Ontario to receive health care. It's health care, and that's what we need to do in those rural northern areas. We have to release the funding. It's great for this government to continue opening and making announcements on funding and spending, but you actually have to start spending the money. The lives of people in Gogama, Foleyet and Sultan depend on it. Their lives depend on it.

Last year, the government committed $36.4 million for global funding of group practices in underserviced areas, which could include nurse practitioners. So far, only $4 million of that $36 million has been spent. In May, the government announced its primary care reform, which consisted of five pilot projects for rostering and capital funding. The reform is extremely limited and does not address the issue of remuneration for health care professionals and other family physicians.

I ask the government to release that funding and help me service our constituents with the basic rights of health care.

Mrs Julia Munro (Durham-York): I'm pleased to be able to rise this morning to speak on Mr Hudak's private member's resolution calling for the government to improve and enhance the underserviced area program to support the recruitment of health care professionals to small-town Ontario.

Hospitals in my riding of Durham-York continue to face significant growth pressures of at least twice the provincial average.

I've had a number of meetings with constituents in my riding where they have raised their concerns about funding for our hospitals and the very real problem of attracting doctors to the more remote areas. When I say "remote areas," I'm not talking about communities which are hours of driving time from each other. My riding is considered part of the 905 GTA, and while this might not appear to be particularly isolated, it has special problems that are addressed by this member's resolution.

We're talking about areas such as Mount Albert, no more than hour from downtown Toronto, or Sunderland, which is no more than an hour and a half from Toronto. You would question why a physician would hesitate to set up a practice in one of these areas, which naturally I believe to be one of the most beautiful areas in Ontario. With Lake Simcoe close by, I suggest that these areas are perfect places to live, work, raise a family or, for that matter, retire.

The rural and northern framework was developed in recognition of the importance of ensuring access to health care services for residents of rural and northern municipalities. It was the first step in addressing the health care needs of small-town Ontario.

Naturally I question why it is so hard to attract qualified health care professionals to areas within my riding.

I know for a fact that Sunderland in Brock township has worked very hard to create a package that is very attractive. They have been working in this area for years. This is not a new issue. Mount Albert is also in constant contact with my office regarding their difficulties in trying to replace Dr Charles Bill, who has provided medical services to the residents of this area for many years and has finally taken his long-awaited full retirement. I am aware that the municipality and Mrs Peggy Bill have gone to considerable lengths with the district health council, PAIRO and the College of Physicians and Surgeons to find a replacement for Dr Bill.

There is significant concern surrounding this issue. York region is expanding rapidly, and the lack of access to public transit in the area makes it extremely difficult for residents to travel to Newmarket for medical services.

This government recognizes the special and unique workload and responsibilities of physicians practising in northern and rural areas. Health care professionals hesitate to set up a practice in small-town rural areas because it usually means working long hours and working nights, weekends and holidays. But there are solutions to these problems.

More and more, we recognize the need to provide a variety of health care services, integrated in such a way as to allow people to move from one health care provider to another, along with a history of their records. This would allow patients to get involved in their own wellness and their own care.

One solution is to hire a nurse practitioner. As part of a new health care initiative, the Ontario government announced a plan for the education and employment of nurse practitioners in primary care. In February 1998, the Minister of Health welcomed proclamation of the Expanded Nursing Services for Patients Act, legislation that solidifies the role of nurse practitioners. This act will improve access to health services for Ontarians, particularly community-based health services.

Nurse practitioners focus on giving people the information, care, advice and support they need to be healthier, prevent illness and injury and to make the best choices with regard to their own health care.

These qualified individuals have the training and qualifications to take a more active role, alleviating some of the pressures put on the physician. The physician would then be able to focus on treating the patient.

It's really important to recognize the importance of this resolution. It recognizes the growth, it recognizes the long-standing issue of underserviced areas and it recognizes the initiatives that have already been put in place by this government through the framework for rural and northern health services and the legislation for nurse practitioners. It's a testament to the ongoing support of this government to matching needs of the community with health care.

This resolution serves to focus on our continuing commitment to provide health care for all Ontarians.

Mr Pat Hoy (Essex-Kent): The doctor shortages are a matter of grave importance. I've received thousands of calls and letters begging for meaningful incentives to attract doctors to underserviced communities.

When I was elected, I sent a letter to Jim Wilson, urging him to take action on the doctor shortage problem and the UAP application of the village of Thamesville. We spent many hours with the UAP office. I asked Minister Witmer repeatedly why it had not been approved. Quite frankly, the government's own bureaucrats were embarrassed by the interference coming out of the minister's office and the blatant, partisan, political influence that was used to block it.

Finally, in 1998, after open letters to the press, the approval was announced, but it was a matter of shame to the government how that announcement was made. I was not notified, and Doris Swain of the Thamesville committee was not notified. The announcement was made by Jack Carroll, the government member from Chatham, who does not represent Thamesville, who had never met Doris Swain and who never worked on the application. This is the kind of blatant political action of the Harris government, and I say shame.

Shame, Minister. Your government has done nothing to introduce meaningful incentives, and that is the key: incentives, not a big stick, not punitive measures.

I held four public meetings in my riding on doctor shortages. I met with local doctors struggling with enormous caseloads. I sent both ministers of health ideas from the local medical community and the public. I have asked for the freeze on CHCs to be lifted. They can and should be part of the solution in underserviced areas.

The town of Tilbury has had a DHC-approved application waiting since the Tories announced the freeze in 1995. I have asked for funding for nurse practitioners to help doctors like Dr Button, Dr Klein and Dr Clendenning in my riding. I have asked for a pilot project that would pay for young doctors and nurse practitioners to rotate through designated UAP communities in my area. The government's emergency care pilot project does nothing to help rural doctors. But we get no response and we certainly get no action from the Harris government.

Dr John Button is one of those valiant county doctors, and a country doctor at that, in my riding who is struggling to provide quality medical care in the village of Ridgetown and beyond. When the government passed Bill 197, Dr Button called me immediately to ask how he could hire a nurse practitioner. He was bitterly disappointed when he discovered that there was no funding mechanism for nurse practitioners. Dr Button has 7,000 patients. That's correct - 7,000 patients. Dr Button has told me that we are 300 doctors short in southwestern Ontario.

He says there are 300 underutilized nurse practitioners waiting to help. Why is the Harris government introducing a private member's resolution? Why haven't you already made this law? Why aren't nurse practitioners already working to help solve this emergency? All of us in this House understand where a private member's resolution will go. Even with the full endorsement of the legislature, we in the opposition are limited to private members' bills, but the government can introduce whatever legislation it wants. Yet Mike Harris has refused to address the critical problem of doctor shortages.

I understand and appreciate the stand taken by PAIRO in not supporting this resolution. They cannot stomach its arrogance and misleading language, the part that talks about the government's leadership - leadership that has been totally absent on this problem since the Tories took office, and now with this gutless attempt to address funding for nurse practitioners. I'm going to hold my nose and vote for the resolution, because it is the only pitiful response from the members opposite.

I'm going to read a statement that I made in the Legislature in May 1998. It refers briefly to hepatitis C patients in Ontario who cannot get the drugs or programs they need without the bureaucratic delays this government is famous for, unless they qualify for the Ontario drug benefit program or the Trillium drug benefit plan. That leaves a lot of people out.

"I am delighted by the Premier's dramatic flip-flop on hepatitis C. I have many constituents," who need justice. "The Premier has finally learned that he is vulnerable. Self-interest," and the Dionnes, have "taught him how to do the right thing.

"I'm calling on the Premier to do the right thing for rural and northern communities which are seriously short of physicians.... A year and a half ago, the Premier pledged $36.4 million per year for three years. That money has not been spent." It sounds familiar. "The quality of health care...is being threatened by the lack of doctors.

"Keep your promise, Premier.... Find the money in your budget," to fund nurse practitioners. "Lift the freeze on community health care funding.... Find the money... Premier. We need doctors now."

Mr Derwyn Shea (High Park-Swansea): I am pleased to rise and speak on behalf of this resolution, but I would like to preface my comments by indicating that I do associate myself with many of the comments raised by the member for Sudbury East. I think she represented a point of view which many of us in the House can share, regardless of party affiliation. Certainly for my

part I recognize the importance of the nurse practitioner legislation that was approved by this House. I'm pleased that the midwife legislation went through before and I applaud that. I'd now like to see that vision of health care expanded, and I think the member is beginning to try to move this House in that direction. I would hope it would reflect an attitude among the ministry that there's a need to begin to see the enhancement of interprofessional co-operation across the province.

I represent a riding in the city of Toronto. We have access to 911. In the case of a heart attack, for example, there's a three-tiered response: ambulance within seven minutes, the police and the fire departments. Frankly, in large parts of our province there is not a 911. There isn't a three-tiered response. One would be pleased if there was a one-tiered response.

We have some interprofessional debates going on between medicine and nursing. I think much of that is beginning to be dissipated, particularly with the new members of the profession, both in nursing and in medicine. But we're going to have to deal with those structural differences. We're going to have to come to grips with the issues of who controls whom, and get past all of that to recognize there is collegiality. There has to be co-operation in the provision of services and that has to be effective.

Part of that, I have to say, involves billing rights. We talk about the nurse practitioners being seen in the pay scale of $60,000 to $80,000 per year. I want to tell the parliamentary assistant that to my knowledge there is not yet at this point one nurse practitioner in this province currently at that level. Those particularly being hired by MDs are not at that level, and that's not good enough. We have to begin to break that mould, and we have to begin to ensure that those nurse practitioners are beginning to get out into the field and are beginning to access the people desperately in need.

Frankly, if you don't have an MD - take a look yourself, Mr Speaker, at the scope of operations that nurse practitioners can now perform. We would be able to take tremendous burdens off the health care system, not only in the rural areas but, I put it to you, in the urban areas as well, where hospital emergency rooms are overstretched, where our MD offices are overtaxed. The fact is nurse practitioners, dare I say doing home visits, might very well begin to bring us back to the kind of health care system we truly and desperately want.

In spite of all the financial cuts we've faced from all levels of government, let's get past that and begin to develop a vision of health care that serves the people of this province. I think this resolution begins to move us beyond where we were a year or so ago and I hope the parliamentary assistant is reflecting the new nuances within his ministry that would give us some hope. I am pleased that he has brought it forward and I am pleased to support it.

Mrs Sandra Pupatello (Windsor-Sandwich): Let me say at the outset that I will be voting in favour of this resolution. Nonetheless, I still find it galling to listen to the kind of propaganda that has to precede an issue that is so serious for the majority of Ontario. Most of Ontario is underserviced. If we look at the map of Ontario, the bulk of Ontario is underserviced.

What surprises me as well is that the member who is advancing this resolution, as part of his job of being interested in this issue, has not applied for the underserviced designation in his own region. I find it interesting that you haven't applied for the designation in the area of Niagara. There will be a report out soon that will show clearly that this area of Niagara South, and the whole region of Niagara, is one of the most short of doctors in all of Ontario. To me, that says that the program itself does not have the value that the government, when it chooses to, wants to put the emphasis on in the underserviced designation.

I remember very well, the first year we were in this House, we could not bring forward the issue of doctor shortages without the minister saying, "You haven't even applied for the program." So we went through the hoops. We went through the bureaucracy and the administration required to fill in an application form; interestingly enough, a northern and rural application form for underservice. We come from Windsor, which is hardly northern and certainly not that rural, so it was quite interesting that there was no program for us as a mid-sized city in Ontario, but we applied nonetheless.

As the member for Essex-Kent also mentioned, the politicizing of this process was incredible. The minister himself waited until we held a town hall in Windsor at an emergency room that was closing, to announce that we got our designation for being underserviced. When we followed up with bureaucrats the Monday following, none of the bureaucrats in the system was aware that a designation had even been given to Windsor. The minister just chose to politicize that, throwing a bit of a bone: "Here it is. Here's your underserviced designation."

Unfortunately that was in 1996. Now here in Windsor in 1998 we have fewer doctors than we had in 1996, and that's after the designation. That speaks, members of the House, to the value of the program. We question, why force us to apply to a program that doesn't seem to have worked in all of the other areas where it has been designated? We still have chronic problems of doctor shortages.

Is the nurse practitioner the answer? I believe that is an integral part of the answer, and every member of the House, regardless of party, is supporting the concept of allowing nurse practitioners to play a greater role in primary care. Isn't that great? All the nurse practitioners may be listening today. Isn't it nice that we're having a love-in at Queen's Park today for nurse practitioners? The irony is not lost on this group, the irony that this is the same government that in the May 1998 budget set aside $5 million and never spent a dime.

Mrs Marion Boyd (London Centre): I share the indignation of my colleague from Windsor-Sandwich. Obviously the words of the resolution itself urging the government to act to "improve and expand the underserviced area program" to include nurse practitioners is something we support. There's no question about that. But how can we possibly allow this to go unremarked, that the parliamentary assistant has brought forward a resolution that clearly has been turned down by ministers of health, turned down by the Ministry of Health.

I would like to interpret it as the parliamentary assistant attempting to move things along, as the member for High Park-Swansea suggested, but I suspect it's more window dressing.

One of the reasons I suspect it's more window dressing is the "whereases" that accompany this resolution. The first "whereas" indicating that the "government has shown leadership" in resolving some of these problems is absolutely disgusting. The rural and northern framework for which the member praises the government didn't come about as a prerequisite for looking at hospital restructuring.

The rural and northern framework was an afterthought when it became very clear that the restructuring commission's benchmarks were going to close dozens of small hospitals and the political warning sign went up and the government said, "Oh, oh, we didn't expect to do this," and then they scrambled to come up with the rural and northern framework.

That rural and northern framework is not yet in place. The framework was publicized and then handed over to the district health councils to apply, but the district health councils of course have been completely restructured themselves, covering huge areas of the province for each one and with very little capacity to make the judgments that are required to put the rural and northern framework into place in a good health planning way.

Second, this is a government that signed an agreement with the Ontario Medical Association that restricted severely the ability of the government to form alternative payment plans for physicians.

For the whole course of that agreement it made it impossible to take dollars out of the OHIP pool that was there for fee-for-service for physicians and move them into alternative payment plans, and it's quite clear that they agreed with the doctors' union to restrict that because the doctors' union is well aware that physicians who are attempting to practise primary care in this province understand that there needs to be a different way of paying physicians, a different way of enabling them to co-operate with partners like nurse practitioners.

It isn't there under the fee-for-service system and that whole issue needs to be done.

The member is also well aware that the global group practice which could have provided some of the answers in rural areas, not just in northern areas but in rural areas, as PAIRO has suggested, is not real because the government will not allow sufficient numbers of physicians to look after the patients for 24 hours a day, seven days a week, without physicians being on call every weekend, most evenings, not being able to get away on vacation, not being able to do education.

As far as the nurse practitioners go, I would like to think that the parliamentary assistant thinks he can move the ministry and the minister, but the nurse practitioners my colleague from Nickel Belt mentioned met recently with Sheila Rene of the Ministry of Health and they raised this issue about payment for nurse practitioners and the officials in the Ministry of Health made it quite clear that the nurse practitioners would not fit into the underserviced area program - very clear. In addition to the Ministry of Health saying: "No, we don't have any intention to increase the community health centres.

We don't have any intention to introduce fee-for-service for nurse practitioners. We don't allow sufficient money to have them in global group practices," now we hear that the Ministry of Health is totally opposed to this resolution. What does it mean? It's window dressing.

The Acting Speaker: Mr Hudak, you have two minutes to reply.

Mr Hudak: I thank my colleagues for their comments. Just to put this whole thing in perspective and stepping aside from the partisan rhetoric, for 30 years the UAP has been around. We had the Peterson-McGuinty government which did nothing to change the program.

Interjection: Who?

Mr Hudak: They're trying to forget the Peterson-McGuinty government, but it's going to be around to haunt them for some time. We had the Rae-Martel-Boyd government that did nothing to improve underserviced areas. Finally, we elected a government that has taken leadership on this issue and is bringing about important changes. In the last six months alone, 34 GPs have been recruited to underserviced areas across the province. In Port Colborne, I hope - very good news soon - to attract a new doctor. Jeff Remington has done an excellent job there. Mayor Badawey is going to Ottawa to try to get some doctors for that area. There have been successes, and I'm just adding one more idea to that array.

I brought this forward to put forward an idea for change for some thoughtful debate in the House. I will from time to time get some thoughtful response from the third party, but I have to tell you that the comments I received from the Liberal Party are so disappointing, just so typical. At some time, there must have been a brain debt in policy in that party. I did not hear one good idea. The member for Windsor-Sandwich says that Niagara hasn't applied and I somehow - I brought the package to the Port Colborne hospital. I pushed for that.

The reason they haven't applied is because they're going to do it as a region, or something to that effect, which I've been helping with in my job. Once again, Windsor-Sandwich, long on mouth, long on criticism, very short on research. I think she should try to do her homework.

It's disappointing to see the opposition party simply sit and dissemble, trying to take a Jerry Springer approach to politics. If they want to continue as some sort of new age rat pack, then I think they're going to languish as the opposition party for some time to come. I beg of them, one time, please, from you guys, one good idea. This is the party of change, here to fix government. It's the party that's going to bring about that change for small-town Ontario.

MUNICIPAL RESTRUCTURING

The Acting Speaker (Mr Gilles E. Morin): We will deal first with ballot item number 27, standing in the name of Mr Christopherson.

Mr Christopherson has moved private member's notice of motion number 24.

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

All those in favour, say "aye."

All those opposed, say "nay."

In my opinion, the nays have it.

Thank you. Take your seats.

RURAL AND NORTHERN HEALTH SERVICES

The Acting Speaker (Mr Gilles E. Morin): We will now deal with ballot item number 28, standing in the name of Mr Hudak.

Mr Hudak has moved private member's notice of motion number 22.

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

All those in favour, say "aye."

All those opposed, say "nay."

In my opinion, the ayes have it.

Call in the members. This will be a five-minute bell.

The division bells rang from 1202 to 1207.

MUNICIPAL RESTRUCTURING

The Acting Speaker (Mr Gilles E. Morin): All those in favour of the motion will please rise and remain standing.

Ayes

Agostino, Dominic

Bisson, Gilles

Boyd, Marion

Caplan, David

Christopherson, David

Churley, Marilyn

Colle, Mike

Conway, Sean G.

Curling, Alvin

Gerretsen, John

Grandmaître, Bernard

Gravelle, Michael

Hoy, Pat

Kwinter, Monte

Lankin, Frances

Lessard, Wayne

Marchese, Rosario

Martel, Shelley

Martin, Tony

Morin, Blain K.

Patten, Richard

Phillips, Gerry

Pupatello, Sandra

Ruprecht, Tony

Silipo, Tony

Wildman, Bud

The Acting Speaker: All those opposed will please rise and remain standing.

Nays

Arnott, Ted

Baird, John R.

Beaubien, Marcel

Boushy, Dave

Carroll, Jack

Chudleigh, Ted

Danford, Harry

Doyle, Ed

Elliott, Brenda

Fisher, Barbara

Ford, Douglas B.

Fox, Gary

Galt, Doug

Gilchrist, Steve

Grimmett, Bill

Hardeman, Ernie

Hastings, John

Hudak, Tim

Johnson, Bert

Jordan, W. Leo

Kells, Morley

Leadston, Gary L.

Martiniuk, Gerry

Munro, Julia

Newman, Dan

O'Toole, John

Parker, John L.

Pettit, Trevor

Preston, Peter

Rollins, E.J. Douglas

Ross, Lillian

Shea, Derwyn

Sheehan, Frank

Skarica, Toni

Spina, Joseph

Sterling, Norman W.

Stewart, R. Gary

Tilson, David

Turnbull, David

Wood, Bob

Young, Terence H.

The Acting Speaker: Order. The members ion the gallery, please take your seats.

Clerk of the House (Mr Claude L. DesRosiers): The ayes are 26; the nays are 41.

The Acting Speaker: I declare the motion lost. The doors will now be open for 30 seconds.

RURAL AND NORTHERN HEALTH SERVICES

The Acting Speaker (Mr Gilles E. Morin): All those in favour of the motion will please rise and remain standing.

Ayes

Agostino, Dominic

Arnott, Ted

Baird, John R.

Beaubien, Marcel

Bisson, Gilles

Boushy, Dave

Boyd, Marion

Carroll, Jack

Christopherson, David

Chudleigh, Ted

Churley, Marilyn

Colle, Mike

Conway, Sean G.

Curling, Alvin

Danford, Harry

Doyle, Ed

Elliott, Brenda

Fisher, Barbara

Ford, Douglas B.

Fox, Gary

Galt, Doug

Gerretsen, John

Gilchrist, Steve

Grandmaître, Bernard

Gravelle, Michael

Grimmett, Bill

Hardeman, Ernie

Hastings, John

Hoy, Pat

Hudak, Tim

Johnson, Bert

Jordan, W. Leo

Kells, Morley

Lankin, Frances

Leadston, Gary L.

Lessard, Wayne

Marchese, Rosario

Martel, Shelley

Martin, Tony

Martiniuk, Gerry

Morin, Blain K.

Munro, Julia

Newman, Dan

O'Toole, John

Parker, John L.

Patten, Richard

Pettit, Trevor

Phillips, Gerry

Preston, Peter

Pupatello, Sandra

Rollins, E.J. Douglas

Ross, Lillian

Ruprecht, Tony

Shea, Derwyn

Sheehan, Frank

Silipo, Tony

Skarica, Toni

Spina, Joseph

Stewart, R. Gary

Tilson, David

Turnbull, David

Wood, Bob

Young, Terence H.

The Acting Speaker: All those opposed will please rise and remain standing.

Clerk of the House (Mr Claude L. DesRosiers): The ayes are 63; the nays are 0.

The Acting Speaker: I declare the motion carried.

All matters relating to private members' public business having been completed, I will now leave the chair and the House will resume at 1:30 pm.

The House recessed from 1214 to 1332.

MEMBERS' STATEMENTS

DENTAL HYGIENE WEEK

Mr Gerard Kennedy (York South): I am delighted to stand today to announce Dental Hygiene Week, which began on October 18 and runs through to the end of this week.

Dental hygiene is an important contributor to overall health, oral care in particular. There are some facts we would like to relay on behalf of the dental hygiene profession:

Oral bacteria causes about 10% of community-acquired pneumonia and 25% of hospital-acquired pneumonia;

Patients with periodontal disease have 150% to 200% greater risk of incurring fatal heart disease than patients without periodontal disease;

Those with periodontal disease suffer strokes twice as often as those with good oral health; and

While diabetes can lead to periodontal disease, seven out of nine diabetics who are successfully treated for gum disease reduce their need for insulin.

A dental hygienist's job is to prevent gum disease and tooth decay. With each visit to your dental hygienist, you are contributing to your overall health. Dental hygienists are not just teeth cleaners; they also assess, plan and implement treatments and evaluate individual oral care needs.

Currently there are 6,000 dental hygienists practising in Ontario. This makes dental hygiene one of the largest of the regulated health professions. As we begin Dental Hygiene Week, it's important to acknowledge the vital role they play in our health care system. It's extremely important to recognize this underrated profession in the context of the whole health care system that we have to have in our purview. We wish great success to dental hygienists as they work this week to make people aware of the contribution they make.

M. Gilles Bisson (Cochrane-Sud) : Encore une victoire de la part du caucus NPD.

On sait que les trois derniers ans, le gouvernement conservateur à beaucoup de reprises a commencé à éroder les droits des francophones quand on transfère des services aux municipalités. Vous savez que, à beaucoup de reprises, on a eu des amendements dans cette Chambre, et même mon projet de loi 17, pour essayer d'éviter ce transfert de services et de protéger les services pour les francophones quand ça vient aux droits linguistiques.

Vous savez aussi, en ce qui concerne la Loi 12, dont on vient juste de faire les débats au comité, qu'on avait demandé un amendement garantissant les droits linguistiques. Le gouvernement n'est pas allé aussi loin qu'on aurait voulu. Ils ne nous ont pas donné une garantie législative, mais il faut dire qu'ils nous ont donné une manière de garantie avec les mots du ministre dans une lettre qu'il m'a donnée, que j'aimerais lire :

On est fiers, Blain Morin et d'autres néo-démocrates, d'avoir eu cette garantie, et on continue la lutte pour les communautés francophones.

COMMUNITIES IN BLOOM

Mr John Hastings (Etobicoke-Rexdale): I'd like to rise today to inform the House about an important event celebrating the beauty of the city of Etobicoke in the new city of Toronto which occurred last month. It involved a celebration of the national Communities in Bloom competition, for which Etobicoke-York was awarded the distinction of being the most beautiful community of its size in Canada.

Advisory board chairperson Fiona Campbell, co-chairperson Barbara Clarke, and the parks and forestry division of the city of Toronto representative, Murray Cameron, received this honourable distinction on September 26 at the national awards ceremonies in Winnipeg.

This friendly competition involved municipalities which are undergoing beautification and naturalization projects. The communities were judged on their effort in management planning, maintenance, improvement and innovation in tidiness, environment, history, heritage, urban forestry and the like.

What makes this award so significant is that it attests to the spirit of environmental restoration and volunteerism within our community. People from all walks of life joined together to make the community of Etobicoke-York the most desirable community in which to live.

In celebration of Etobicoke-York's and the city of Toronto's latest award, the committee plans to plant 2,000 trees along Highway 427 in the year 1999 for the Millennium Project.

This is the award they won that day.

LONG-TERM CARE

Mr Michael Gravelle (Port Arthur): While the Minister of Long-Term Care pathetically scrambles to announce the opening of more long-term-care beds throughout the province, I want to use this opportunity to ask him to recognize and deal with a situation in Thunder Bay that, if he does the right thing, will move all of us a step closer to meeting this growing need.

The facts are straightforward. In April of last year, the hospital restructuring commission closed down Hogarth Westmount Hospital in Thunder Bay and asked the St Joseph's Care Group to take over responsibility for the long-term-care needs of those people who had been resident there. However, within a relatively short period of time, the Ministry of Health recognized that this move was wrong, as there were not enough beds to accommodate those people at Hogarth Westmount.

The solution: As bizarre as it may seem, the ministry authorized the reopening of 127 beds at Westmount under the auspices of St Joseph's Care. The problem is that the ministry only authorized this reopening on a temporary basis, almost as if they felt the need was going to go away.

The minister knows, as does the Premier, that there is an overwhelming need for more long-term-care beds in our community and that people there have nowhere else to go. These beds must be funded on a permanent basis. Not to do so will continue to cause a great deal of anxiety among the patients, as well as the staff who care for them.

Minister, I'm calling on you today to permanently fund these long-term-care beds in my community. By the stroke of a pen, you can improve the health care situation in Thunder Bay and, in doing so, allow St Joseph's Care Group to do the huge job they have agreed to take on in our community.

Mrs Marion Boyd (London Centre): Yesterday, the Minister of Long-Term Care suggested that New Democrats somehow opposed the change to the standards on long-term care in terms of patients who have been in chronic care hospitals moving to a more residential centre. He tried to suggest that we had done nothing to forward that dream.

In fact, we did a number of things, and I'll give you a very good example. The Perley-Rideau home in Ottawa was one of those projects that we undertook. It brought together three different long-term-care facilities under one roof. It was to be a long-term-care facility to be operated as a red-circled long-term-care facility. It included both very complex care and less complex care in a residential setting, with congregate dining and all of the recreational and activation kinds of activities that he talked about yesterday.

And what did this government d