Ontario Hansard — 9 March 2023 (43rd Parliament, 1st Session)

2023-03-09

Ontario — Debates (Hansard)

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March 9, 2023

43rd Parliament, 1st Session

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Hansard Transcripts

vol. A

Hansard Transcripts

vol. B

Votes and Proceedings

Orders and Notices

Hansard Transcript 2023-Mar-09 vol. A (PDF)

L052A - Thu 9 Mar 2023 / Jeu 9 mar 2023

LEGISLATIVE ASSEMBLY OF ONTARIO

ASSEMBLÉE LÉGISLATIVE DE L’ONTARIO

Thursday 9 March 2023 Jeudi 9 mars 2023

Orders of the Day

Concurrence in supply

Members’ Statements

Scarborough Somaliland Community Association

Arts and cultural funding

Skills training

Health care

Autism treatment

Explosion in Orléans

Greater Napanee Pride committee

International Women’s Day

Legislative pages

House sittings

Introduction of Visitors

Question Period

Indigenous relations

Health care

Autism treatment

Manufacturing industry

Consumer protection

Skills training

Climate change

Health care funding

Mining industry

Government’s record

Tourism and hospitality industry

Mental health and addiction services

Hunting and fishing

Nurses

Seniors

Member’s comments

Franco-Ontarian flag

Notice of dissatisfaction

Visitor

Business of the House

Deferred Votes

Building More Mines Act, 2023 / Loi de 2023 visant l’aménagement de davantage de mines

Farmland and Arable Land Strategy Act, 2023 / Loi de 2023 sur la stratégie en matière de terres agricoles et de terres arables

Legislative pages

Reports by Committees

Standing Committee on Government Agencies

Introduction of Government Bills

Supply Act, 2023 / Loi de crédits de 2023

Introduction of Bills

Group of Seven Day Act, 2023 / Loi de 2023 sur le Jour du Groupe des Sept

2253697 Ontario Inc. Act, 2023

Motions

Committee sittings

Petitions

Gender-based violence

Volunteer service awards

Social assistance

Tenant protection

Affordable housing

Access to health care

Social assistance

Tenant protection

The House met at 0900.

The Speaker (Hon. Ted Arnott): Good morning. Let us pray.

Prières / Prayers.

Orders of the Day

Concurrence in supply

Hon.

Paul Calandra: I move concurrence in supply for the Ministry of the Attorney General; the Ministry of Indigenous Affairs; the Ministry of Energy; the Ministry of Northern Development, Mines, Natural Resources and Forestry; the Ministry of the Environment, Conservation and Parks; the Ministry of Agriculture, Food and Rural Affairs; the Ministry of Health; the Ministry of Colleges and Universities; the Ministry of Finance; the Ministry of Economic Development, Job Creation and Trade; the Ministry of Labour, Training and Skills Development; the Office of the Premier; the Cabinet Office; the Treasury Board Secretariat; the Ministry of Transportation; the Ministry of Infrastructure; the Ministry of Municipal Affairs and Housing; the Ministry of Heritage, Sport, Tourism and Culture Industries; the Ministry of Government and Consumer Services; the Ministry of Francophone Affairs; the Ministry of the Solicitor General; the Ministry of Education; and the Ministry of Long-Term Care.

The Speaker (Hon. Ted Arnott): The government House leader has moved government orders numbers 4 through 26, inclusive.

I recognize the member for Durham.

Mr. Todd J. McCarthy: I am pleased to rise this morning to discuss the importance of the procedural process specific to concurrence in supply and how it relates to the government’s estimates for the 2022-23 fiscal year.

Mr. Speaker, I think it is useful for all members of this House and the public in general to appreciate what concurrence is and how the estimates process works. It is so very important because every dollar spent throughout the fiscal year comes out of the pockets of this province’s hard-working taxpayers, those same citizens who are facing very challenging economic times and who have entrusted us to deliver on the priorities of the people of Ontario.

It is true that the economic climate right now is challenging. Interest rates are higher than they have been for years and inflation remains high presently. There are also geopolitical conflicts that are adding to the general feeling of unease and economic pressure. As well, Mr. Speaker, supply chains have not yet had the time to be fully recovered from the global pandemic.

Now, when seen in this context, it is easy to understand the additional importance of the government’s fiscal responsibility and transparency and the essential importance for all members and for the public to understand the full fiscal process. To explain and clarify this process is exactly what I will endeavour to do today.

On September 8, 2022, volume 1 of the 2022-23 expenditure estimates was tabled. A few months later, on December 5, 2022, volume 2 of the 2022-23 expenditure estimates was tabled. This second set detailed the spending plans of the legislative offices. Seen as a whole, the expenditure estimates provide details of the operating and capital spending needs of ministries and the legislative offices for the fiscal year. This constitutes the government’s formal request to the Legislature to approve spending requirements.

Mr. Speaker, this is an annual process that every Ontario government must complete. This process constitutes the government’s annual formal request to the Legislature to approve spending requirements. Should it pass, the estimates provide each ministry with the legal authority to spend their operating and capital budgets.

Once expenditure estimates were introduced, they were then referred to the relevant standing committee for review. The standing committees then select ministries to appear and answer specific questions as to their respective expenditure estimates. This was the first time that we used this new approach and it resulted in a comprehensive review of almost all ministry estimates. This general oversight is invaluable.

Should the Supply Act pass, it signifies the final approval by this House of expenditures proposed by the government in the expenditure estimates. It is important to note that our government is not proposing any new spending today, but rather the government is simply looking to approve the spending already outlined in the 2022-23 estimates.

As a brief reminder for all members of this House, the latest projection as per the quarter 3 finances is that overall program expenses in 2022-23 were projected to be $188.6 billion. That is money that is going into building an Ontario that is prepared for the future, an Ontario that embraces innovation and prioritizes health and safety, an Ontario that is fiscally secure and ready to take the next step forward.

Mr. Speaker, in the face of hard economic times, the people of Ontario have proven their resilience and strength, and it is the government’s duty as stewards of the public purse to support the families, the workers and the businesses of this entire province. It is an awesome responsibility to be entrusted with their hard-earned tax dollars, the hard-earned tax dollars of the citizens of Ontario. It is not to be taken lightly.

Our government made a promise to be responsible and to be transparent with the province’s economic and fiscal realities. We have made a promise to the people of Ontario to deliver better jobs and bigger paycheques; to build highways, transit and hospitals; and to lower the cost of living for families. Mr. Speaker, that is exactly what we are doing.

The Speaker (Hon. Ted Arnott): Further debate?

Ms. Catherine Fife: It’s a pleasure to join the House this morning to talk about this particular motion before the House. It was interesting to hear the member talk about the process that the finance committee goes through with regard to estimates. He did leave out the part where we only got 20 minutes to review the Ministry of Finance expenditures. The entire estimates process this year was truncated.

My colleague and myself, who sit on the finance committee, tried to make the case to the finance committee Chair and to my colleagues across the aisle that our due diligence as parliamentarians includes exposing and honouring those words that he just said, which primarily revolve around transparency. Unfortunately, receiving 20 minutes to review the Ministry of Finance numbers proved to be very challenging. This was a very public debate at finance committee.

We did, however, get the opportunity to question the Minister of Finance, which is always an opportunity that I value, I would say, and I appreciate the Minister of Finance coming to that committee. He and I had a disagreement in that committee, I think it would be fair to say, in that I raised the issue around Bill 124. Now, for those of you who are watching at home—which is probably just Peter Tabuns’s mother and my mom and dad—Bill 124 has had a humiliating and devastating impact on our health care human resources.

I asked the minister straight up: “What is your resistance to removing this piece of legislation, which now for three years has demoralized the health care workers in Ontario, has pushed them out of the province of Ontario, has compromised the health and well-being of the people who we’re all elected to serve?”

In fact, we usually say a prayer saying that we are going to bring the best of ourselves to this place and that we are going to work to the benefit of the people of this province, for the greater good. Bill 124 is a piece of legislation which is compromising, ironically, even the goals of the government. The government has put forward a plan around health care; you are actually working against yourself and the interests of the people of this province by keeping this piece of legislation on the books.

In fact, it’s worth noting that this piece of legislation has already been deemed unconstitutional in the courts—that it violates the charter rights of Ontarians—and yet, having lost that case on Bill 124, you maintain, in the most stubborn and callous manner, this piece of legislation, and you’re wasting more tax dollars fighting and appealing that decision in the courts of Ontario.

I do want to be fair to the Minister of Finance.

Maybe we’ll get into this a little bit later on, but during that committee meeting I said, “How is it fiscally responsible to undermine the health care workers who are currently working in our hospitals by having Bill 124 still on the books and then forcing hospitals—including the entire caring sector, including long-term care—to have to go to outside agencies, which are private companies, and pay those agency nurses sometimes two, three or four times as much?” In fact, we heard in Kenora that this has an incredibly demoralizing impact on the work environment, and let’s remember, the work environment is the health care environment, where the well-being of patients is supposed to come first.

In that exchange with the finance minister, I said, “Why are you willing to pay so much money for an agency nurse?” And then the private company also skims off the top of that somewhere between $200 and $400 per hour—and then not honour the nurse who is working alongside that agency nurse, coming to work every day, who went to work during the pandemic, who showed up for the people of Ontario. You called them health care heroes.

I do want to say, the finance minister said, “You and Bill 124”—yes, Bill 124 is what we will fight day in and day out in Ontario.

The fiscal irresponsibility of it is at the core of this, really. The government received a devastating report from the Financial Accountability Officer yesterday. You have a plan for health care—yes, it is a plan, but it is a plan to fail the people of Ontario. The shortfall is $21.3 billion. You will not meet your own targets. The important piece with the Financial Accountability Officer is that they are measuring you against your plan, your budget targets, and to find this large a discrepancy is—even I was surprised, and you have surprised me a few times; I will admit to that.

The process by which the budget this year, the estimates this year—it has been incredibly truncated. I’ve always said, for the last 10 years that I’ve been in this House, that when you have a flawed process, you will have a flawed product, and that has certainly been true of multiple pieces of legislation that have come before this House.

The high-level piece on health care—and of course we’re going to talk about health care for a fair amount of time today, because it is very topical to the people of this province, particularly to the 107,000 people who are called “long waiters,” who are waiting for surgery.

We know that the surgical ORs in the province of Ontario are underutilized. We know that on Thursday at 3 o’clock when the money runs out, the hospital is not allowed to run a deficit, so that OR closes. Instead of funding that OR, instead of funding the nurses and the doctors who are required to open that OR more fully, to its full capacity—in our 100 public hospitals—the government is proposing a little sideline on the surgical units. I think that our health critic, later on, is going to be exposing some of those sidelines and how devastating and how damaging they can be to the entire fabric of our universal health care system.

I will say that out of the 107,000 people who are long waiters—just to be clear, these are people who have been waiting so long that the original surgery they were booked for—they are past that point of optimal health care outcomes. This number has never been this high—107,000 people. I have asked the FAO to pull out some of the demographics on that, because we also know that there are 12,000 children waiting for surgery in Ontario. The Children’s Health Coalition has asked this government for $371 million to close that gap.

When the chamber of commerce was here on Monday—it has been a very full week, a really good week. One of their concerns is health care, because they, as a chamber—as their members from across this province have said, “When health outcomes are compromised, that impacts our work environments, and it impacts the economy.”

So those parents whose children are still waiting, those 12,000 children and their parents—you can imagine that when parents go to work and they’ve been waiting one or two years for spinal surgery, they’re not working at their optimal. We heard this story from our leader last week. When your child is sick, you are well past distracted; it is hard to focus.

I don’t think that this government fully comprehends the impact of not honouring that $371 million.

Now, the plan that the government has also put forward on health care will leave a shortfall of 30,000 nurses. The Ontario Nurses’ Association yesterday responded in a very strong manner to the FAO report, as you would imagine. They’ve experienced the brunt, really, of Bill 124, as have personal support workers.

At the end of the day, the plan that you have put forward for people in this province is already failing. We know that. We know that because there are 107,000 people—long waiters—waiting for surgery. There are 12,000 children who are left in the lurch for surgery. Unless you have a serious course correction—which hopefully happens on March 23. Listen, I’m looking forward to coming back to this House for budget week. I’m looking forward to seeing how this government acknowledges the pain of the people of this province on housing, on health care and on home care.

I just want to really talk quickly about home care because the member talked about transparency. Thank goodness we do have an independent budget officer in the province of Ontario who has an expenditure monitor, who tracks what the government said they were going to spend and what they actually did, in the end, spend. The discrepancies tell a story. They tell a very powerful story. We see the press releases, we see the announcements, we see the re-announcements on the same funding allocations, but you know what we’re not seeing? The money get out the door and invested into the communities.

Home care is really one of the pillars that actually would support and alleviate the pressures on the health care system, particularly on the hospital system, but also on long-term care.

So on home care, you’ll remember that there were several announcements made about a $1-billion investment. We welcomed that investment. The agencies across the province, home care and the helping agencies, like Meals on Wheels, for instance, and Independent Living Centre, welcomed it. They’ve never seen a number like that. And it’s an impressive number: $1 billion is nothing to ignore.

But at the end of the day—and this just came out in February: “Almost a year after the Ontario government announced a historic $1-billion investment in home care and $100 million in community support services, just a fraction of that funding has been paid out, leaving the faltering system that provides care to people in their homes and in the community teetering on the brink of collapse, officials say.”

This is coming from Steve Perry, who is an Ottawa-based home care owner, Carefor, and he said, “‘We are going to run the risk of collapse, or at a minimum of service rationalization,’ if the province doesn’t quickly put enough money into home and community care to stabilize the system.... His is among the home and community care agencies and organizations pleading with the province to fast-track funding.”

Now, one could ask the question, why is the money not getting out there? It’s not like these not-for-profit and community agencies haven’t proven their worth. If you’ve ever gone on a visit or a tour with Meals on Wheels and you’ve gone from house to house to house, that agency, Meals on Wheels, has a strong volunteer base, but obviously really good leadership. They have eyes on seniors. They have eyes on vulnerable people who are isolated, who are lonely. And loneliness kills. We know that from the pandemic.

Meals on Wheels, and we heard this at budget committee at every stop, are looking at a reduction of services by 30%—30%. Who cuts home care? Especially when we know that these upstream investments actually save the health care system money down the line, so a senior doesn’t find themselves dehydrated or undernourished and then in an emergency room.

God willing they can get into an emergency room, because 145 emergency rooms were closed last year. Never in the history of the province have we seen so many—they’re called unplanned emergency rooms. That means they didn’t have the staff—I see I’m losing my audience here—they didn’t have the resources to stay open.

Does anybody remember when the Premier himself said, “You know what? We’re going to get rid of those Liberals and hallway medicine?” There are people in the province who would be happy to have a hallway to go to right now; they don’t even have an emergency room. For the love of humanity, when you make a promise to invest in a community, have the decency to follow through, or at least look into why the money is not getting out into the community, because this is a definite lack of transparency.

Just to continue on with the money that hasn’t got out there, this is, again, Steve Perry: “‘At the end of the day, these are people we’re talking about. These are people who need care and services not getting care and services.... It is really big deal that we get this right. ‘”

The promise was actually $1 billion over three years to shore up the home and community care services. They talked about how significant this investment was. It was, as I said, welcomed by agencies, but, obviously, what happened during the pandemic—and making no excuses; if there was ever a time to invest in keeping people healthy, that’s one of the big, I hope, lessons that we learned through the pandemic: that those investments are worthwhile. But the situation did worsen during this pandemic because home and community care workers are underpaid compared to their counterparts in hospitals and long-term care.

I know that the member from Timiskaming–Cochrane actually understands this is as well.

“Since the province’s announcement, less than $130 million of the $1 billion promised has flowed to home care agencies, according to those who receive it. Only $32 million of the $100 million for community support services has been distributed....

“Agencies have received no word”—this is a real breach trust, I think—“on when more money is coming or how much, forcing most of them who planned to cut services in the upcoming fiscal year. Perry says that they have only been told that the province is continuing to examine how best to spend the money as part of its plan for health care transformation. The struggling home and community care systems can’t wait, he said.”

So you’re holding on to the money, trying to decide who should get the money. These agencies have been in business in communities for years now. They have proven track records, and yet you don’t trust them? It makes no sense whatsoever.

“Sixty-six per cent of the community support service agencies across Ontario are planning to reduce service volumes as part of their budget planning process with Ontario Health, and 22% say their wait lists for care will get longer. Planned cuts in service average about 27%, which officials say translates” to 874,000 hours.

“Carefor, meanwhile, has already had to cut services because of worsening staff shortages ... between health workers in the home and community care system....”

This is the biggest piece, this is the biggest lesson from this one example: that the government of the day does not value health care human resources—people. You talk a lot about funding beds. A bed does not take care of people. In fact, we heard through the budget delegations that if you’re just talking about a bed and funding a bed then you’re really funding furniture, not the services. This is a serious disconnect that this government has. At the end of the day, even when you make grandiose promises around services, we’re seeing a huge disconnect between the words and press releases and the announcements, and the money that does not get out there.

“In a statement ... Home Care Ontario warned that the Ontario government’s plan to modernize the health system could be upended unless it first stabilizes home care staffing.” Once again, this is the theme: You are actively working against yourself by not acknowledging how important it is to value the people who are in the health care and caring sector.

I did want to also talk a little bit about education, because we are starting to track the education cuts across Ontario. We’re hearing from our communities of people leaving, and we heard this at budget committee here in Toronto. OSSTF and ETFO all came to the committee and said, “Listen, we have a huge human resources issue. We can’t keep the people working in the profession that they trained for. They’re moving to other competitive fields and sectors primarily because of wages.”

Also, we do know that in the child care and education sector—elementary—that there is a disproportionately higher level of women who work in the fields. They’re leaving because they can’t afford to do the work they were trained for. Educational assistants and all of the support staff that help make a school a real community are actually in crisis. And the government of the day has said, “Listen, we’re putting in historic levels of funding.” But that funding is actually not translating down into the classroom. And the classroom, in the funding model for education, should come first and then work up to the administration, and I think that’s a key part of getting education right.

I have been in the education sector for a number of years, back in 2003 when I first was elected as a trustee, and then I became the president of the Ontario Public School Boards’ Association and worked with those 71 school boards from across the province, and then at the national level. As I was moving and learning as a trustee, I also had the opportunity to chair the province’s mental health round table. And because of this, educators recognized that mental health was having a devastating impact on education outcomes.

At the time, the government of the day, the Liberals, had also legislated student well-being as well and gave that to the boards. So mental health became central to some of the work we were doing as school boards. At the national level, it also was really encouraging because our interaction and exchanges with Indigenous communities also weighed in on that as well, and we became genuine allies through that process.

But I wanted to talk about the education dollars, because our critic from Ottawa has challenged the minister on several occasions. She said, “Listen, you say this, but what we’re hearing from school boards, classrooms, classroom teachers and principals is a very different story.” This is from a Mississauga newspaper that came out February 27, so this is like two and a half weeks ago.

The title of it is, “‘The Kids Aren’t All Right’: Mental Health Supports Needed in More Than 90% of Ontario Schools, Report Finds.” This was an annual survey done by People for Education, which is an excellent organization that I worked with for many years—Annie Kidder. And this is a survey of principals from across the province to get a sense on the culture. It’s basically an environmental scan, if you will, of our education system.

It goes on to say, “The percentage of Ontario schools with no access to a psychologist has nearly doubled over the last decade. A symptom of a system ‘under severe stress,’ according to the report published Monday by People for Education.

“It comes as young Canadians report declining mental health, leaving overburdened education workers trapped in a ‘downward spiral’ as they confront COVID-19’s ripple effects, the report said.”

This is something that we have said to the government: We have to plan to address what happened during the pandemic. We just can’t say, “Okay, you know what? It’s over. Everybody resume as you were.” because there was some real damage that happened during that pandemic. There were learning gaps. There was learning loss. There were social skills that were compromised. Our youngest learners who learn visually by watching people’s faces looked at people wearing a mask for two-plus years.

So you have to acknowledge, and you need a long-term strategy to build back stronger and to address the vulnerabilities that exist in the system. And I will say that system was already strained prior to the pandemic.

This is a quote: “‘What principals are saying—and what so many are saying—is that the kids aren’t all right.’” We need the government to hear this. It’s a genuine call to engage in an authentic conversation on what is happening in our education system.

“The survey of principals at more than a thousand elementary and secondary institutions across the province found 91% of the schools were in need of mental health supports from psychologists, social workers and other specialists.” Child and youth workers are a key part of that as well.

Some of you know that my husband does teach in a rural secondary school, and those child and youth workers are sometimes the main connection that a student has within the community. They pull those students in, they make them feel connected to the community, and we’re losing those child and youth workers. They’re moving to other jurisdictions because they are also stuck under Bill 124, which is the theme of the day.

This is a stat that I found very sobering: “In 2011, just 14% of elementary schools reported having no access to a psychologist. But by 2022, the report notes, that figure jumped to 28%.” It doubled. So over a quarter of our schools in Ontario have no access to a publicly funded resources around helping children navigate through a mental health crisis or duress.

The research and the evidence are so clear: It absolutely impacts academic outcomes and student well-being, Madam Speaker. All of us, every MPP, all 124 of us have experienced having to attend a funeral for someone who has died by suicide. In the 10 years I have been an MPP, I have attended three of these funerals. The emotional labour of doing that is one thing, but having known that with early intervention and the appropriate resources—when people have the courage to actually ask for help, that help should be there.

“Meanwhile, just 9% of Ontario schools have regular access to other kinds of mental health specialists. Some 46% of schools reported having no access at all.”

This is what a teacher has said from the Halton District School Board. She sees a system “teetering on the verge of collapse.” That’s a direct quote from her. Her name is Nicolle Kuiper. She says, “You can’t teach kids algebra when they feel their whole world is crumbling.”

We know this, and we know where the mental health supports need to be. They need to be where the students are, because navigating the mental health system in the province of Ontario—it’s almost like it was designed never to be easily navigated. If you don’t have cash, you don’t have benefits, you don’t have resources and you don’t have a natural advocate in your family, it’s a very challenging system.

That is definitely not a knock against the community agencies who have stretched those dollars as far as they can. When I meet with the Kitchener Downtown Community Health Centre or, really, any health care professional, they are literally making those dollars stretch as far as possible.

So we’re really hoping, all of us on this side of the House, that on March 23, the finance minister recognizes that by not investing in accessible mental health resources, this is a lost opportunity for a whole generation. The stakes are high on this one. One could argue that they are also life and death.

This teacher goes on to say that “the most support she’s seen in her workplace is a child and youth counsellor split between two schools—a resource that ‘barely scratches the surface.’” In fact, she just made my point. These resources are stretched as far as they possibly can.

One other stat says, “Some 82% of schools surveyed in the report said they needed more support staff like educational assistants, administrators and,” yes, “custodians.” Custodians play an important

part in the education system.

You can see there is such an obvious disconnect between the words that we hear from the Minister of Education and from the Minister of Finance and the reality that’s playing itself out in our schools.

The supply motion covers a number of ministries. As I mentioned, we didn’t really get to ask too many questions on this because it was a very truncated process. I believe it was about 20 minutes that we got to ask the government questions on what you’re planning to spend. But we do have, as I said, a good benchmark for where the funding is going and where it’s not.

Really, the theme that I’ve become more and more engaged in is this so-called transparency that the government says that they’re all about. When you do follow the money, you actually learn a lot, and the numbers certainly tell a different story. The province started off the 2022-23 fiscal year with $4.6 billion in contingency funds. The reason why the contingency fund component is very interesting—this is separate from the surplus, and you’ll remember inflationary costs, the costs of services and costs of goods, have gone up so much that the government cleared their deficit three quarters ago because so much tax revenue came into the province of Ontario.

So the government benefited from a high inflationary rate. Did they pass on those savings to the people of Ontario? No, they did not. What they did, though, was put it into an unallocated contingency fund. The reason why this is so important—I believe the FAO has said the same thing in various public settings—is that it removes the transparency and the accountability over this funding allocation. Every dollar that comes through this place on behalf of the people of the province is allocated. Sometimes, as I’ve just told you with home care, you can allocate it, but you don’t necessarily get it out the door.

But in the instance of a massive contingency fund—and Ontario is an outlier in this regard—by underspending on home care, by not getting the appropriate amount of money out that you targeted for education, all of this money goes into this unallocated contingency fund—a slush fund, if you will. This removes our responsibilities as MPPs—it actually removes our rights as legislators—to oversee those expenditures and that amount of money.

This is something that is a new practice, I would say, for any government. The Liberals couldn’t do it because they ran regular operational deficits. But this money should be in the system. That’s the key

part I want to say. This money should be in the court system, for instance. There’s a young person in my riding who was assaulted. She has been waiting three years for her day in court. That is justice denied.

We would support a more streamlined funding system into the court system. We would obviously support more funding into mental health—and I want to thank the minister for coming to Carizon in the fall and talking about the importance of community. Help us help you, is what I want to say. We want the minister who is responsible for mental health to receive the resources that he needs to get that money out the door and into communities—all communities across the province.

But when you have this much money—the last quarter came out, so now it’s $2.9 billion, ahead of a massive budget—and knowing that organizations like the Children’s Hospital Coalition are asking for $371 million, this money could have got to those hospitals to alleviate that surgical backlog back in the fall. So the question that the people of Ontario should be asking of this government is, what are you waiting for? How bad does it have to get before you spend the money that you actually said you would invest in health care, in education, in transportation, in infrastructure and in mental health?

And so we see this unallocated contingency fund as fairly detrimental from a financial transparency perspective, because we don’t even know—if we started the year off with $4.6 billion and now we’re at $2.9 billion, we don’t know where that money went to. The government is, one could argue, actively preventing us from doing our job, and that doesn’t serve the people of this province very well.

I did want to—this came up, actually, in budget delegation. You’ll know that the finance committee hasn’t travelled for the last few years because of the pandemic. We did go to 11 different cities. It was an interesting selection of cities, I might add, though. We missed all of the London area, all of the Kitchener-Waterloo-Cam-bridge area. We didn’t go to Niagara. It’s not like tourism is a big thing, I guess, in Ontario. We tried to go to Sioux Lookout. We had Red Lake. We ended up in Kenora. We went to Sault Ste. Marie, to Sudbury, to Timmins. We went to Ottawa. We went to Kingston.

We went to a fair number of places but we missed a good part of south-central and southwestern Ontario. We also travelled Bill 46, the red tape reduction bill, but not too many people showed up to that. I just wanted to give a few of the perspectives of what we heard on this committee.

In Red Lake, one of the nurses who spoke to us, her name is Meghan Gilbart and she is the chief nursing executive. She said that to have an agency nurse working alongside you making four times as much as you impacts morale, work culture, patient satisfaction and patient safety. It depresses the caring environment because it speaks to how the government values nurses and health care workers. This is where Bill 124 was called “humiliating.” If you want to build up a health care system, you have to support the people that are in that system.

If they feel that the government is actively working against them, that obviously will impact productivity and work outcomes. She went on to connect wage suppression with morale suppression.

This was also around the time that we found out that the Minister of Health actually had received a briefing note from her own ministry saying how Bill 124 would negatively impact the health care sector. So even the ministry—the minister’s own ministry—has told her how negative Bill 124 is for the entire sector. And still, they press on and are fighting and appealing the decision in court which found the legislation to be a violation of our charter rights.

We also heard from—I want to say, the Alzheimer Society showed up in a big way this year, because they have warned this government of the negative impact of not investing in those supports. We heard from caregivers as well. The province of Ontario definitely needs to understand and to support the people who are caring for their partners who are experiencing Alzheimer’s. This is one of the cruellest diseases that we see in Ontario right now and across the world.

This is what we heard from Stéphanie Leclair, and this was in northeastern Ontario: It currently takes, on average, 18 months for people in Ontario to get an official dementia diagnosis, some patients often waiting years to complete diagnostic testing. More than half of the patients suspected of having dementia in Ontario never got a full diagnosis. Research confirms that early diagnosis saves lives and reduces care partner stress.

They said, and this is a direct quote, if we don’t act now and invest, “Ontario’s hospitals will exist solely to house/care for those who have dementia or Alzheimer’s.” The sector is warning you that if you don’t plan now, if you don’t invest now, there will be greater costs down the line.

I’m sure that we all know somebody who is going through this journey. It is a cruel journey for the entire family. If you don’t want the further pressures on the health care system the plan that you have, if you’re not willing to course-correct—I hope that the government recognizes that keeping people out of hospital by those community supports is one of the main pillars of trying to rebuild the health care system. The demographics of this province are also well known. They were well known before the pandemic. We have an aging demographic and the population has certain needs; we need to plan for those needs.

That’s what a responsible government does. It’s not like you don’t have the money. The money is in an unallocated contingency fund.

Really good organizations like L’Arche Sudbury came. They came with solutions. That’s what was so impressive about this budgetary process: People are not just asking for a handout, they’re not just asking for cash. They’ve come to the table saying, “We want to partner in a very real and genuine way. We’ll do our part, we’ll fundraise on our part, but we need a financial partner, a willing partner to come to the table.” L’Arche Sudbury did an amazing job on that.

I want to say, the post-secondary institutions, like Algoma University, came forward and they’ve identified one of the key issues around the health care human resources crisis, which is that people in that sector are not being supported. Bill 124—a humiliating piece of legislation—aside, they’ve recognized that certain training needs to be incorporated to deal with the complex mental health and societal issues that people are facing. They want to be part of the solution, and they want to train people to deal with people who are incredibly vulnerable.

We did hear from the Ontario Public School Boards’ Association. This started some time ago, but they have an Indigenous Trustees’ Council, which has made a recommendation to the government of Ontario and the Minister of Education to create a compulsory course that deals with reconciliation and the residential school history of this country—basically just to tell the truth about what happened in Canada. They see this as a true path to reconciliation.

One of the quotes that I heard, which really resonated with me through this, is that the Honourable Justice Murray Sinclair, chair of the Truth and Reconciliation Commission, points to education as key to reconciliation: “Education got us into this ... and education will get us out” of it. It was powerful presentation because education really is the great equalizer for so many communities, if it’s done right and if you build those supports for student well-being and make the school really the hub of the community.

Doug Gruner of the Ontario College of Family Physicians came to us, I believe it was in Ottawa, and he expressed a great deal of frustration with the system that surrounds the hospitals. He said they can’t get patients into specialist appointments. Over two million Ontarians don’t have a family doctor, 150,000 have no family provider whatsoever and 75% of family physicians do not work in family health teams—and that supportive work environment actually retains those health care professionals.

He referenced the underutilized surgical suites across Ontario. Why aren’t we making the most of our publicly funded hospitals and the investments that have been made in those surgical suites? We should be opening them as much as we can to alleviate that devastating wait-list.

They had a solution for the Minister of Health around time allocation. They said that by providing some technology and some technical supports by way of a medical scribe, doctors could spend more time with patients and less on paperwork.

These were solutions that came from the sector. They were informed, they’re research-based, they’re evidence-based and they’re looking for solutions.

I could go on at length about some of the great people who came and who took the time to come to these budget selections. I feel like the government members weren’t so keen on the Bill 124 conversation, to say the least. But not one delegation—not one—said anything good about Bill 124, because there really isn’t anything to say that is good about Bill 124. The only good thing that we can say is that at least the courts have upheld the law of this province, and they did so again earlier this week, which—thank goodness we have the court system in Ontario, although the government really should just call the last 15 court cases a lawyer employment strategy, in my view.

Earlier this week, the third-party election guidelines that the government brought in prior to 2022 were struck down in the courts, as well—and deemed it null and void and a violation of charter rights, and also a piece of legislation which prevented Ontarians from participating in their own election.

I wish people were paying attention to this kind of thing, because it’s a whittling away of our democratic institutions in some regard. When legislation is brought in by a government which undermines the rights of the people we serve, everybody should be paying attention. The court system obviously has been focused on this for some time, as well.

There are a number of other ministries that the estimates capture—certainly, the Ministry of Indigenous Affairs is timely, given our discussion around Bill 71 yesterday and some of the comments that were made by some government members about indicating what’s good for Indigenous communities. I think that our critics and our speakers yesterday were quite strong on this. Reconciliation only happens when you actually engage in an authentic and honest conversation and when you include Indigenous communities in that conversation, particularly as it relates to treaty rights and the fact that it’s their land.

One would think that would be a core principle of any kind of consultation process. As is already indicated with the building mines faster act, Indigenous communities are already gearing up to go to court. I suspect that you’ll lose that court case, as well. So it actually makes fiscally responsible sense to engage with those communities sooner, at the very beginning—because consultation after the fact is called disrespect. Those are certainly our concerns with Bill 71.

On the transportation funding: The FAO also identified a $656-million discrepancy in funding that’s supposed to be going out for transportation and for transit. This is particularly impactful on the people of Toronto, with the Eglinton Crosstown and Metrolinx—the lack of transparency as it relates to the Ottawa LRT and the Eglinton Crosstown. The people of this province have the right to know where that money is going and how much money is actually going to profits versus infrastructure. The transparency language that we heard earlier, quite honestly, doesn’t resonate on this side because we’re still looking for answers.

But I will say, at the very least, we do have a very good understanding now of how poorly prepared the health care sector is for the changing demographics, as indicated by the FAO yesterday.

I do want to say, just because I’ve been consistent on the Bill 124 conversation and the question arose yesterday—if the government of the day loses the court case, the appeal of Bill 124, which the government is actively appealing right now, the cost to Ontario just in hospitals—60% of the funding around hospitals goes to wages because you need people to deliver health care. Beds do not deliver health care. If the government of the day loses that case, the—what is it called?

Interjection.

Ms. Catherine Fife: Back pay. Thank you. The back pay will be $3.6 billion.

Instead of doing the right thing, accepting the court ruling that it’s unconstitutional and violates charter rights; instead of actually valuing health care workers, nurses, PSWs and everyone that works in a hospital, who have been capped at 1% now—and during the pandemic, also, collective bargaining rights were violated during that process around sick days and benefits and what have you, because if you work in the health care sector, apparently you’re not allowed to get sick.

But if the province actually loses the court case, the financial repercussions are monumental, and it will have to happen in a massive way. You can’t just keep fighting and fighting and fighting in court—although you have done that with the mandate letters; now you’ve lost four times. It’s just a common practice. It’s a transparency and accountability thing that the government is not so keen on, but cabinet ministers usually release their mandate letters, indicating their priorities, their directions, their vision for the ministry.

I’m really interested in reading the mandate letter for the Minister of Health, I have to say. I am. Because when you are actively underutilizing the operating rooms that exist and the surgical suites in Ontario, you are actively underfunding that particular pressure point that exists in the province of Ontario, and at the same time you’re proposing this parallel system of private profit-driven surgical suites, then I’m sure that mandate letter says this is the intentional goal: to create this two-tier system.

I see I’m running out of time, which can’t be real.

I think I just want to say, on the so-called transparency of the money, clearly there are some significant issues. The $2.9 billion that’s currently unallocated right now should be out there in the health care system. It should be part of the retention of the experienced, talented people that are working in the health care system right now.

The fact that we heard so clearly—and all the government members heard the same message. That’s the value of having a budgetary process which is open, public and transparent: that we all hear the same thing, and it’s captured in Hansard. What doesn’t work very well is the other parallel system that the Minister of Finance does, where they have their invite-only—and we ran into this issue in Niagara, right?—where the government has their own consultations that are not public and that are by invite only and you get three minutes, somebody rings a bell and you’re done. And we don’t have any documentation from those consultations, which would be valuable, don’t you think?

Mr. Jeff Burch: Yes.

Ms. Catherine Fife: I do. It actually caused some confusion too, because some people were like, “Well, we got invited to this budget consultation, and the member who represents that area wasn’t invited,” which is a whole other level of disrespect, but sometimes you’ve just got to get used to that stuff.

Fortunately, we have such good working relationships with the people of this province that they call us and they say, “Why weren’t you there?” And I said, “That’s because that’s the government’s system.” If you want to come to the public, transparent, open budget consultation, then by all means, come to it and try to get into it. Of course, the government conveniently forgot London and Niagara and K-W, and so people had to travel. If you’re putting up barriers to people engaging in their budget—just like this is their House—it doesn’t instill trust and it doesn’t instill confidence, I would say.

I just want to finish on the FAO report from yesterday, because there were five areas that the FAO focused on: long-term care; hospital capacity; emergency rooms, which we already heard about; home care; and I think most importantly, key provincial workforce measures and the impact on the people who work in those systems. There is a desperate need also, and this is just a clarification. When they’re focused on the health care human professionals, it was not comprehensive of all professionals. It certainly didn’t engage the issue of the doctor shortage as well. Perhaps there may be a separate report on that.

But it did make me think though that where so few people have access to a primary care provider—two million to be in the area—because the system is still designed as the doctor being the gatekeeper for the entire health care system. If you don’t have a family doctor, it’s really hard to access a specialist, to have a health care contingency care plan where you see a very clear guideline as to how you can get better again.

With so many Ontarians not having access to a doctor, it does raise the issue of what is the strategy? Our health critic has been so strong on the nurse practitioner-led clinics, because a nurse practitioner, if you did so choose to invest—once again, we hope that it’s in the budget—a single nurse practitioner can alleviate a wait-list of 900 patients because they’re funded differently. It’s a very holistic model of care. I believe there are nine current applications into the government to address northern and rural communities and to address key areas where people do not have family practitioners.

The chamber has also advocated—I mentioned they were here earlier—that accelerating the registration of internationally educated medical professionals should be happening right now. The government says that they’re doing this on nursing, but I just want to leave the government with this one key piece: You can’t recruit nurses from other provinces into a broken system. It doesn’t work. The smart investment, the fiscally responsible investment is to respect the people who are currently working in the system, because they’re experienced and they’re connected to those communities.

That in and of itself will help you recruit health care professionals into those sectors, be it into the mental health field or into home care or into the hospital system.

We also have to provide an opportunity for internationally trained medical doctors to access the system in Ontario. Our critic on this from Scarborough has been incredibly strong. This was a topic that I was talking with my concierge last week. His name is Mohammad; he’s from Pakistan. He’s a renal specialist. He’s a doctor, and he’s working as the concierge in my building. He has four children. He took the medical exam. He failed by one point, so now he’s a concierge.

I’m working with him because I think the Ontario College of Family Physicians has recognized that there have to be opportunities where trained medical professionals can reach their potential in Ontario. We’re desperate for doctors. We’re desperate. What a missed opportunity. Ontario should be a province where you come to this province and you get the opportunity to reach your potential, because Ontario needs you. This actually was interesting because the same day, one of our northern members was talking about how much it costs to fly and house folks who need to travel for dialysis.

The smart investment is on recruiting and retaining those medical professionals in communities that desperately need those talented people. I’m certainly hoping that the government can make some progress on that as well.

With that, I just want to conclude by saying we are going to be respectful of the people’s voices that we heard during the budget consultation, we are going to continue to fight for greater transparency in the funding and we’re going to push the government to actually acknowledge that the plan that they have for health care right now is a plan that will fail. We need that acknowledgement to be made by this government, because having a $21.3-billion discrepancy is basically setting up the health care system in Ontario to not be successful, and I would hope that none of us want that to happen

With that, Madam Speaker, I just want to say thank you for your undivided attention. I look forward to budget 2023.

The Deputy Speaker (Ms. Donna Skelly): Further debate? Further debate?

Mr. Calandra has moved concurrence in supply for the Ministry of the Attorney General. Is it the pleasure of the House that the motion carry? I heard a no.

All those in favour of the motion will please say “aye.”

All those opposed to the motion will please say “nay.”