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November 17, 1975

30th Parliament, 1st Session

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Hansard Transcripts

L016 - Mon 17 Nov 1975 / Lun 17 nov 1975

OIL AND GAS PRICES

TORONTO TEACHERS’ NEGOTIATIONS

MISSISSAUGA INQUIRY

FLOOD DAMAGE

SPADINA EXTENSION SUBSIDY

VIOLENCE IN HOCKEY

DARLINGTON GENERATING STATION

RONDEAU PROVINCIAL PARK HOME LEASES

METRO TORONTO HIGHWAY SIGNING

MINIMUM WAGE

WINTARIO FUNDS

MORTGAGE INTEREST TAX CREDIT

HEALTH STUDY OF ASBESTOS WORKERS

GREAT LAKES WATER LEVELS

YOUTH EMPLOYMENT OPPORTUNITIES

DAYCARE BUDGET

GRIFFITH ISLAND HUNTING LODGE

CORPORATIONS TAX ACT

INTERN STUDENT PAYMENTS

ESTIMATES, MINISTRY OF HEALTH (CONCLUDED)

PRIVATE MEMBERS’ HOUR: ELECTION ENUMERATION

The House met at 2 p.m.

Prayers.

Mr. Lawlor: Mr. Speaker, it is my pleasure to ask the House to welcome to the east gallery today, 28 students under the charge of Miss M. Doyle from St. Felix Separate School in my riding. Thank you.

Mr. Godfrey: Mr. Speaker, I would like to present to the House, through you, students from Whitby, Ajax and Pickering who attend the Denis O’Connor School and who are under the direction of their teacher, Mr. Joe Modeste, in the east gallery.

Mr. Warner: Mr. Speaker, I wish to introduce to the House 30 students from St. Richard’s Separate School in Scarborough with their teacher, Mrs. Storr.

Mr. Speaker: Statements by the ministry.

Oral questions.

Mr. Lewis: First of all, Mr. Speaker, may I ask the House leader if either the Premier (Mr. Davis) or the Minister of Education (Mr. Wells) is scheduled to come in for this question period?

Hon. Mr. Welch: I expect they will be here.

OIL AND GAS PRICES

Mr. Lewis: May I ask the Minister of Energy what steps he is taking to monitor scrupulously the increases in prices which the various companies and dealerships imposed on gasoline and home heating fuel, where, in some instances, those who imposed it on Saturday did so prior to the midnight deadline or the midnight entry, and the increase went beyond the amount the minister indicated?

Hon. Mr. Timbrell: Mr. Speaker, the monitoring at the retail end is being carried but by the Ministry of Consumer and Commercial Relations.

Mr. Nixon: That minister is not with us today.

Hon. Mr. Timbrell: I am not sure whether he is joining us later or not.

Over the last few weeks I Telexed all of the oil companies and repeated to them my statement of Oct. 24, making very clear the government’s intentions about pricing. All of the companies -- I believe we have heard from them all now -- have indicated they would follow the government’s wishes and not increase tank wagon postings more than the 5.4 cents maximum indicated in my Oct. 24 statement.

As I mentioned, the retail part of it is being monitored by my colleague’s ministry. I would only say this, that last night I was contacted by the Toronto Daily Star and they indicated that in their activities on the weekend they found one or two stations -- I have asked them, and I ask anyone who knows of specific locations, to let us know, because I suspect that in most of those cases, if not all, it would be stations where the retailers have been, or were, involved in pricing wars and that they were, as has happened over the last 140 days, adjusting their prices toward the prices which they were charging on June 24.

Mr. Nixon: Supplementary on that, Mr. Speaker: In the event the minister is informed of retail outlets that increase their prices beyond the limits of the freeze or the increase suggested by the minister, has he the power to roll them back? Without legislation, what can he do about it?

Hon. Mr. Timbrell: Mr. Speaker, as the hon. member for Brant-Oxford-Norfolk knows, the legislation which affected the freeze up until midnight Saturday is no longer operative. We can, either directly through the retail operators or through their companies, bring pressure to hear to adhere to the 5.4 cent gasoline.

Mr. Nixon: What pressures?

Mr. Makarchuk: Supplementary question to the same minister: Will the motorists who were forced into paying the inflated price prior to Saturday midnight be entitled to a rebate on the amount they spent?

Hon. Mr. Timbrell: Mr. Speaker, first of all I repeat again I suspect that in any case where that occurred, where there was an increase between some point in the middle of last week and Saturday, that it was an increase within the legislation, that is not exceeding the price that had been charged on June 24. If they were breaking the law, that is charging more than the June 24 price before midnight, then again if members would let me know we can take steps to try to assist those who have proof of purchase, gallonage and price paid.

Mr. Bullbrook: By way of one supplementary, if I may: With respect to the response to my leader, what pressures does the minister have in mind? Would he close them down, would he tell them they have been bad boys; or would he do something in between?

Hon. Mr. Timbrell: Mr. Speaker, I think it is clear to everyone in the industry, be they distributors or retailers, what the government wishes. It is also very clear that the government has indicated that if the wishes of the government are not met, and not met on a widespread basis, we are prepared to freeze the price again.

Based on the fact that the Ministry of Consumer and Commercial Relations in the whole 4½-month duration of the freeze had no more than I think about 20 or 24 complaints from the whole of the province, I have every reason to expect full co-operation from retailers and the industry based on the Telexes which they have sent to me. I also feel we can rely on the fact that the forces of competition will not allow them I to do that.

Mr. Lewis: Competition; of course.

Mr. Bullbrook: The minister has no pressure he can bring to bear; that is the deficiency.

TORONTO TEACHERS’ NEGOTIATIONS

Mr. Lewis: I would like to ask the Premier, if I may Mr. Speaker, would he join with me, or would he permit me to join with him depending on how the hierarchy of this minority government is observed, in bringing to the bargaining table the Metropolitan Toronto secondary school teachers and the boards, so that we may sit with them in a prolonged and determined fashion to attempt to achieve a settlement?

Mr. Breithaupt: The odd couple.

Mr. Haggerty: Has the Leader of the Opposition talked to Barrett?

Hon. Mr. Davis: Mr. Speaker, I, of course, am impressed by the enthusiastic response from the members opposite to that proposal. I would have to confess that I have not studied the protocol of such a suggestion as to who should join whom. My only thought at this moment, as far as the government is concerned --

Mr. Reid: They are in the same bed.

Mr. Breithaupt: They are both joined together.

Hon. Mr. Davis: No, I think it’s fair to state the two of us would not join together.

Mr. Nixon: Somebody is going to get in.

Mr. Singer: It’s holy deadlock.

Hon. Mr. Davis: My only observation would be that I have complete confidence in the ability of the Minister of Education (Mr. Wells) for this government to deal with the situation. He said to the House on Thursday, and I believe again on Friday, that from his standpoint he was more than prepared to meet with and discuss with the two parties any suggestions they might have toward the solution of this problem. As far as the government is concerned, we are completely confident of the minister’s ability to deal with this situation.

Mr. Lewis: I am sure that the minister has.

Hon. Mr. Davis: While I respect the suggestion made by the Leader of the Opposition, it is my view at this moment at least that that suggestion would not serve any practical or useful purpose.

Mr. Lewis: How does the Premier know that it won’t?

Hon. Mr. Davis: I reiterate that I have confidence in the capacity of the Minister of Education that, if intervention by a member of this government would be helpful, he is prepared to do so but I think it has to be within the context of one or both of the parties boing anxious to see some resolution or potential resolution to this problem where the government could be involved.

I will certainly keep the suggestion of the Leader of the Opposition in mind but at this moment it probably would not serve a useful purpose.

Mr. Lewis: I want to press with this because I don’t understand why this goes on and on. Why is it necessary to await the invitation of one of the two parties, both of whose positions now seem to be intransigent, rather than exercising the leadership role of government, either through the Minister of Education or the Premier, and asking the parties in to attempt to effect a settlement? Why must he ever await an invitation?

Hon. Mr. Davis: The minister has been in touch with both parties over the past three or four weeks and probably longer than that in an attempt to head off the strike that has taken place. He met with them, as I’m sore the Leader of the Opposition was informed, the day prior to the strike actually starting.

Mr. Lewis: For 20 minutes -- and two weeks too late.

Hon. Mr. Davis: The Leader of the Opposition can say it’s two weeks too late.

Mr. Lewis: The government is allowing the strike to be prolonged.

Mr. Speaker: Order, please.

Hon. Mr. Davis: It’s great to sit there as a person who voted in this House and who actively campaigned for the right to strike on the behalf of the teachers --

Mr. Bullbrook: The Premier is right.

Mr. Lewis: That’s right, and the Premier said that the government should attempt to see: a settlement.

Hon. Mr. Davis: -- who helped establish the Education Relations Commission --

Interjections.

Mr. Speaker: Order, please.

Hon. Mr. Davis: -- and then to come in here and say the government should sit down and with heavy hand resolve this problem.

Mr. Lewis: No, not with a heavy hand, but yes, if necessary.

Hon. Mr. Davis: I say this is one of the things the members of this House must have anticipated when the decision was made in Bill -- whatever the number was -- to give the teaching profession of this province the right to strike. They can’t have it both ways.

Mr. Lewis: You can have it both ways.

Hon. Mr. Davis: You cannot.

Mr. Lewis: The Premier is just allowing the strike to last for his own purposes.

Mr. Speaker: Order, please.

Mr. Lewis: Why doesn’t the government bring it to an end?

Mr. Speaker: This is not the place for a debate at this time.

Hon. Mr. Davis: What purposes?

Mr. Lewis: I don’t know.

Hon. Mr. Davis: Then don’t say we are allowing the strike to continue for our own purposes.

Mr. Nixon: A supplementary: I would like to ask the Premier if he feels the fact that his government brought forward legislation giving the teachers the right to strike precludes him from taking the action that has been put forward by the Leader of the Opposition and others in this House for the last two weeks? Surely, it’s not a question of having a --

Mr. Speaker: Order, please. The question has been asked.

Mr. Nixon: It’s a question of assuming responsibility.

Hon. Mr. Davis: Of course the legislation does not preclude that. The legislation brought by this government before the House was very enthusiastically supported by the third party in this House, who really would have extended some sections of that legislation. This is something the member forgets about on occasion and one on which he took a position some 1½ years before this government made that determination.

Mr. Nixon: The Premier is feeling badly today, isn’t he? He must be more vulnerable than he usually is.

Hon. Mr. Davis: That legislation was supported by all parties in this House. For the leader of the Liberal Party to say that by the waving of some magic wand, by the intervention of this government --

Mr. Nixon: There is no legislation preluding the Premier from involving himself.

Hon. Mr. Davis: -- we can solve a situation which the leader of that party helped, in terms of legislation, to create to me is a bit of hypocrisy in the process.

[2:15]

Mr. Nixon: Then you are trying to have it both ways.

Hon. Mr. Davis: You are trying to have it both ways.

Mr. Foulds: Supplementary: Does the Premier not think that this is the time for his government to take some initiative in bringing the parties together rather than merely sitting back and waiting passively for initiative from them?

Mr. Speaker: Order please, that’s the same question as the hon. Leader of the Opposition asked. Does the hon. Leader of the Opposition have further questions?

Mr. Lewis: It was, in fact, a perfect extension of the question that I asked.

Mr. Speaker: It seems to me it required the same answer.

Mr. Lewis: I’ll try to rephrase it: Is the Premier not aware -- I’m sure he is; he manufactured the system -- that the position is deteriorating in public terms and that the opposing forces in this dispute have locked themselves in, which can only have serious ultimate damage? Does he not think, therefore, that early on in the strike, just as he failed to do toward the end of the negotiating period, the Premier should personally take an initiative? Does he not think -- I’m putting it to the Premier directly -- that it is now time to take a political initiative and bring the sides back to the bargaining table?

Hon. Mr. Davis: Mr. Speaker, I think these matters are a question of judgement. I should feel complimented, but I really think the Leader of the Opposition is using a slight bit of exaggeration when I am being given credit for manufacturing the system.

Mr. Lewis: I know the system, because I suffered under it.

Hon. Mr. Davis: With great respect, while I recognize the Leader of the Opposition is somewhat younger than I am, I had no responsibility for the system when he was a part of it, or what was produced as a result of it.

Mr. Lewis: So the Premier is defaming either Frost or Robarts.

Hon. Mr. Davis: Mr. Speaker, I will not take responsibility for the Leader of the Opposition, not too many years ago, being one of those individuals who was, and with some success, exciting students at that time to take a very aggressive posture on certain matters that we will not refer to in this question period. Please do not give me that responsibility. He has to assume that entirely unto himself.

Mr. Lewis: Once you would have said inciting, not exciting.

Hon. Mr. Davis: Well, both.

Mr. Nixon: Go ahead and refer to them, it is all out of order anyway.

Hon. Mr. Davis: Mr. Speaker, to answer the question -- now that I have replied to the observation that was part of the question, because I want to conform to the rules like the hon. member -- it is not the time, in my judgement, for the Premier of this province to intervene personally. I would like to see a solution -- we would all like to see a solution -- to this problem, but I go back to some of the observations that were made prior to the introduction and the passage of that legislation, and it’s great for members opposite to come in here now and say the government should intervene and find a political solution to the problem.

Mr. Lewis: You never did.

Hon. Mr. Davis: The gentlemen opposite should be aware of the fact that before the legislation was even contemplated they adverted the right to strike on the part of the teaching profession, which this government accepted and introduced, so they must accept the fact of what has happened as being potentially there when that legislation was passed.

Mr. Lewis: Of course, in the application of your responsibilities.

Hon. Mr. Davis: There is no point coming here today and suggesting that we can, by some unknown procedure, bring a resolution to a very difficult problem.

Mr. Lewis: What do you mean, “unknown procedure”? --

Hon. Mr. Davis: The Leader of the Opposition says “bring them together.” They’ve been together, they’ve discussed this issue.

Mr. Lewis: You have known for weeks now.

Hon. Mr. Davis: I just say as a matter of policy, at this moment, Mr. Speaker, I don’t see any real practical result coming from such o meeting.

Mr. Lewis: Then the strike is on your conscience.

MISSISSAUGA INQUIRY

Mr. Singer: Mr. Speaker, I have a question for the Attorney General. In view of the fact that the Hon. Mr. Justice Donnelly adjourned four motions before him on consent, relating to, as the docket of the weekly court showed this morning, re Murray and Stortini, and relating to the municipality of Mississauga, could the Attorney General tell us what action, if any, he or his officials propose to take in relation to these matters, bearing in mind that one of the motions that was adjourned sine die to the divisional court relates to the possible punishment and imprisonment of a county court judge?

Hon. Mr. McMurtry: Mr. Speaker, we are aware of these motions which are returnable this morning. I was not aware of their disposition. I’ve discussed the matter with the senior county court judge and have been advised that Judge Stortini has very adequate legal counsel and that is where the matter stands at the present time.

Mr. Singer: By way of supplementary, could the Attorney General advise us whether he is prepared to intervene by himself or by his advisers as he did when the original motion was brought before the divisional court consisting of Chief Justice Estey, Mr. Justice Reid, and Mr. Justice Galligan, by using his counsel, Mr. Manning, and another solicitor from his office to argue that the inquiry had been improperly ordered?

Hon. Mr. McMurtry: No, Mr. Speaker, it is my view that it would be not proper for the Attorney General or his counsel to intervene at this point in time.

Mr. Nixon: Intervene again.

Mr. Singer: By way of further supplementary or a new question -- and I have a number of questions along this line, Mr. Speaker -- does the Attorney General intend to provide financial assistance for Judge Stortini, who is called upon now to defend himself “by very able counsel” because Judge Stortini was acting in what he at least thought was pursuance of his duty as a judge of the county court instructed to conduct the public inquiry?

Hon. Mr. McMurtry: It is a matter that is presently being considered. I am unable to give the member any more definite answer than that at this time but it is under consideration.

Mr. Singer: By way of further question, Mr. Speaker: Does the Attorney General intend to take action, as Judge Stortini suggested in his letter addressed to the council of the city of Mississauga, and order or recommend to the Lieutenant Governor in Council that an inquiry take place under the provisions of the Public Inquiries Act and use

part 3 of that statute?

Hon. Mr. McMurtry: The counsel for Judge Stortini at the inquiry, Mr. Bates, has been invited on a number of occasions to submit material or particulars to my department to justify the extending of these rather extraordinary powers under the Act my friend refers to. As of this moment, counsel for the inquiry either has been unable or is reluctant to provide any such particulars which would warrant any further investigation at this time.

Mr. Singer: By way of further question: Would the Attorney General not agree that it is unfair to put that burden on either Judge Stortini’s counsel or Judge Stortini and that there has been enough issue I raised in the public mind that there has to be a public presence started or initiated by the Attorney General under the provisions of the Public Inquiries Act so that the people of Ontario can find out what really happened in Mississauga, if anything?

Hon. Mr. McMurtry: As I indicated to this House, I believe last week, a complete police investigation has been made. Certainly from the information I have, no material or no evidence has been made available which would justify any further inquiry. I make this statement: Because souse persons -- I am not talking about Judge Stortini -- other people may have some interest in sort of creating a giant smokescreen, it is not my view, as Attorney General of this province, to waste the taxpayers’ money in Mississauga or in any other area unless we have some more solid information to go on.

Mr. Singer: Would the Attorney General not agree that it is a most unusual thing that a suggestion be made in the Supreme Court of Ontario that a judge should be imprisoned for contempt when he appears, at least, to have been carrying on his public duty as assigned to him? Wouldn’t he agree, in view of that fact, that all of the circumstances surrounding this deserve a full and complete public airing so the public can make up its mind whether the judge has acted properly or improperly?

Mr. Nixon: That is not a smokescreen.

Hon. Mr. McMurtry: I am, of course, concerned any time I hear of any such proceedings similar to those brought relating to Judge Stortini. I think it is most regrettable and it is certainly a matter that we intend to look into --

Mr. Singer: In a public way?

Hon. Mr. McMurtry: -- as completely as we can with respect to Judge Stortini’s involvement; and whether or not judges in the future can be or should be protected from this type of proceedings if they are, in fact, only carrying out their judicial responsibilities as given to them under the Act. In this case it was under, I think,

section 250 of the Municipal Act. I am very concerned about this and I can assure my hon. friend that we will continue to look into the matter to ensure that no judge is unfairly harassed if that is what is happening in this case.

FLOOD DAMAGE

Mr. Singer: A question for the Minister of Natural Resources: Could he tell us what steps, if any, the government is prepared to take in relation to damage caused to a number of properties along the Great Lakes as a result of the rather unusual and severe windstorm that took place last week?

Hon. Mr. Bernier: I am sure the hon. member is aware this question was asked of me in the House last week. I indicated at that time that my senior staff were meeting with the municipal officials along that particular area. There are three specific programmes they could apply for. We asked them to go back to their respective communities to assess collectively what the total damage would be. They estimated between $1 million and $2 million; our people said $200,000 to $300,000 so there was a wide discrepancy as to the amount of damage actually done. We are waiting for their response to that further survey and we will give it further consideration.

Mr. G. I. Miller: Has the minister made a direct survey of the area of Port Maitland, Port Dover, Long Point, Turkey Point, Low Bank and the general area of the Haldimand-Norfolk riding? Have his people done a survey and has he investigated it himself?

Hon. Mr. Bernier: Yes, I understand my senior staff were in the area for a full day looking at all the damage which occurred.

Mr. G. I. Miller: A further question: I had many telephone calls over the weekend --

Mr. Speaker: All right; that is not a question. Question?

Mr. G. I. Miller: Is the minister aware there are many people in the Port Maitland area who haven’t been contacted at this point in time; old age pensioners who haven’t been visited by his people?

Hon. Mr. Bernier: I don’t believe the staff intended to contact each individual individually. They looked at the general damage.

Mr. Haggerty: I would like to direct a supplementary question to the minister. Will he now initiate a study or inquiry into the high levels of water on Lake Erie?

Mr. Speaker: Order, please. That is not supplementary to the original question having to do with the storm damage last week. That’s a new question.

Mr. Haggerty: It is dealing with the high levels --

Mr. Speaker: Order, please. The member for Wilson Heights, does he have further questions?

SPADINA EXTENSION SUBSIDY

Mr. Singer: Yes, I have a question for the Minister of Transportation and Communications. Now that he has had an opportunity to speak to Mr. Godfrey, the chairman of Metropolitan Toronto council, has he, in writing, given to Metropolitan Toronto council advice that the province will pay the subsidy on the construction of that portion of the Spadina extension running from Lawrence to Eglinton Ave.?

Mr. Cunningham: On a point of information, Mr. Speaker.

Mr. Speaker: There has been a question asked and about to be answered.

Hon. Mr. Snow: No, not as of this date.

Mr. Singer: By way of supplementary, does he intend to do that?

Hon. Mr. Snow: Yes. Mr. Singer: When?

Hon. Mr. Snow: Very soon.

VIOLENCE IN HOCKEY

Mr. Eaton: A question of the Attorney General: Would the Attorney General inform us what investigation is taking place and if any charges will be laid following the violence at the London hockey game in which St. Catharines’ players entered the stands to fight with the crowd?

Hon. Mr. Henderson: The member for London North (Mr. Shore) was there; he refereed it.

Mr. Riddell: What position are you looking for, Bob?

Hon. Mr. McMurtry: I am advised that a complete investigation is under way in relation to this incident. There may very well be charges laid as a result of this investigation but it will not be completed for a few days.

Mr. Eaton: Would the Attorney General also consider asking for a meeting with officials of that league to see if something couldn’t be done to set regulations preventing players from entering the stands? Perhaps there could also be some regulation regarding fighting, such as ejecting players from the game at that point, because certainly that takes place in football and basketball.

Mr. Lewis: If only we could make hockey as civilized as football.

Mr. Lawlor: Ban them for life.

Hon. Mr. McMurtry: The local crown Attorney in London is arranging to discuss this matter with league officials in order to ensure that more adequate security be provided at future games.

[2:30]

Mr. Shore: Has the Attorney General received a report from the Crown attorney of London yet; and, if so, does he intend to lay any charges on this matter? Secondly, could the Attorney General advise this House if there is anything in the Criminal Code relating to hockey players and their coaches leaving the ice surface during a hockey game? If there isn’t, would he suggest that if the league itself is not going to take disciplinary action in this matter --

Mr. Speaker: Order, please. Much of that question was asked. Part of it may be a new supplementary. Does the hon. Attorney General wish to answer?

Mr. Shore: The supplementary specifically has not been answered, Mr. Speaker, as to whether he intends to take any action.

Mr. Speaker: All right. The hon. Attorney General will have the opportunity to answer the questions which have not been asked before.

Hon. Mr. McMurtry: Mr. Speaker, I have received a preliminary report from the local Crown attorney in London. It is not complete, but on the basis of the report, I think it is safe to say that there is a strong likelihood of some charges being laid. With respect to my friend’s questions in relation to the Criminal Code, our position is simply that the Criminal Code will be applied equally to all citizens whether they are on the ice or not.

DARLINGTON GENERATING STATION

Mr. Moffatt: A question of the Premier: Mr. Speaker, in view of the fad that the provincial government and Ontario Hydro are building the world’s largest nuclear generating station, in the Darlington area of the town of Newcastle, the town council of Newcastle wrote to the Premier on Aug. 20 and again in October asking for funds to prepare an environmental impact study with regard to that particular plant. They have received on reply. When does the Premier propose to reply to that council and what will the reply consist of?

Hon. Mr. Davis: Mr. Speaker, I think to set the record straight, there have been meetings with that municipality since that communication. I think the question as to what will be the ongoing procedure should properly be directed to the Minister of Energy. I understand there are further meetings yet to be held.

Hon. Mr. Timbrell: Mr. Speaker, there will be a meeting tomorrow afternoon with his worship the mayor, and I believe some members of council and staff of the town of Newcastle to discuss this project.

RONDEAU PROVINCIAL PARK HOME LEASES

Mr. Spence: Mr. Speaker, I have a question for the Minister of Natural Resources. Is the minister aware that some of the 21-year leases on cottages and houses in Rondeau Provincial Park will expire by the first of the year? The minister has stated that these leases will not be renewed, but the minister is well aware that there is a shortage of housing in this province and some of these leases are owned by senior citizens. Would the minister give consideration to extending some of those leases for those senior citizens whose leases will expire the first of the year?

Hon. Mr. Bernier: Mr. Speaker, the hon. member has clearly stated what the policy is and the policy was announced and formulated back in 1954 as it relates to 21-year leases in Rondeau Provincial Park and Algonquin Provincial Park. Now, these are fixed. They have been repeated on a number of occasions, but in view of the fact that some of these particular homes -- as the member has pointed out -- are held by senior citizens, I am prepared to meet with the Minister of Housing (Mr. Rhodes) to get his views on it and to consider your suggestions.

Mr. Good: Supplementary: Will the minister inform the House why no permanent resident within the park was included in the advisory committee when he was dealing with the long-term phasing-out of buildings in the park?

Hon. Mr. Bernier: Mr. Speaker, when the advisory committee was established on Rondeau park, I want to inform the House that a great deal of thought and effort and time went into picking the members of that particular committee. We have an excellent chairman from Chatham and with his assistance we went across the entire part of southwestern Ontario to select an excellent committee. I believe their report is scheduled to be in my hands very shortly.

METRO TORONTO HIGHWAY SIGNING

Mr. Williams: Mr. Speaker, I have a question for the Minister of Transportation end Communications. We are all aware of the large sums of money spent through our Ministry of Industry and Tourism to bring hundreds of thousands of visitors to Toronto every year. Is the minister aware of the frustrations being experienced by thousand; o these visitors by reason of the fact that there is inadequate signing of our major interchanges to direct the visitors into the central part of our city?

Hon. Mr. Snow: No, Mr. Speaker, I wasn’t aware of that.

Interjections.

Mr. Nixon: Are you aware now?

Mr. Williams: Supplementary question Mr. Speaker: Could the minister, through his good offices, work with his senior department heads --

Interjections.

Mr. Williams: -- and the Metropolitan Toronto transportation people to find ways and means of improving this situation?

Interjections.

An hon. member: Come on over and sit with the opposition! Sit right here.

Hon. Mr. Snow: I will certainly look into that matter. I really am at somewhat of a loss to understand why someone would have trouble finding this great city with the signs that we have on our expressways at this time.

Interjection.

Hon. Mr. Snow: The only problem that I am aware of is one that was evident during the construction period of Highway 401 at Malton airport, where there was some confusion as to where one left the main thoroughfare to go south on Highway 427. But that construction has been completed and the signage there has been completed, and that’s the only problem area I was aware of. I will look into it.

Mr. Williams: A further supplementary, Mr. Speaker --

Mr. Speaker: Order, please. I wonder if in the questions and the supplementaries we could have questions rather than suggestions. That’s not really the purpose of a question period.

Mr. Bullbrook: I think that’s a good suggestion.

Mr. Gaunt: Just write him a note.

Mr. Speaker: I think we’ll go on with the next question.

MINIMUM WAGE

Mr. Samis: A question of the Minister of Labour, Mr. Speaker. In view of the announcement on the weekend by her Quebec counterpart increasing the minimum wage to $2.80 an hour within the next two weeks, what definite assurance can the minister give the working poor of Ontario that the minimum wage in this province will be increased this year?

Hon. B. Stephenson: As I have said before publicly, the minimum wage in this province is under review at the moment. There will be an announcement made about it before the end of this year.

Mr. Samis: Supplementary, Mr. Speaker: Can the minister assure the working poor of Ontario that the minimum wage in this province will at least be equal to that of Quebec?

Hon. B. Stephenson: I think that we can probably assure the working poor of this province that the minimum wage will be adequate for the Province of Ontario. It may equal or surpass that of some other provinces.

Mr. Speaker: It seems to me that again was a further suggestion rather than a true question.

WINTARIO FUNDS

Mr. Kerrio: I will direct my question to the Minister of Culture and Recreation, my immediate neighbour from Brock. Can he justify the continued expenditure of millions of dollars of Wintario funds in the easy come, easy go manner of the policy that exists in his ministry in the face of a deficit budget, a need for restraint and a need for funds for tax relief?

Mr. Speaker: I think that question has been asked. Editorial comment during a question is really out of order and wastes the time of the House. The question has been asked.

Mr. Singer: Does that apply to the Premier (Mr. Davis), too?

Hon. Mr. Welch: Mr. Speaker, once you take the editorial content out of the question, there’s nothing left to be answered, is there? Except that --

Mr. Lewis: Except that you should choose your neighbours with more care.

Interjections.

An hon. member: You can count on that.

Mr. Speaker: Does the hon. member have a supplementary which is a question?

Mr. Kerrio: Yes, it has to do with the question. I would certainly like to know if wine stomping and four-part barbershop harmony is the kind of thing we’re going to pursue with the money we collect from this particular area.

Hon. Mr. Welch: Certainly both those activities are very important in Niagara Falls.

Mr. Nixon: You people grow a lot of grapes now.

Mr. Breithaupt: But surely not both activities at the same time.

Hon. Mr. Davis: The two go together.

Hon. Mr. Welch: Yes, I think you’re right.

Mr. Nixon: The Premier’s always right. The minister knows that,

Hon. Mr. Davis: The member should know that.

Hon. Mr. Welch: I hate to interfere here and interrupt.

Secondly, Mr. Speaker, this Legislature unanimously decided, by

section 9 of the Act creating the Ontario Lottery Corp., that these particular funds were to be spent in these ways over and above tax-supported programmes, and I think that’s important.

Mr. Singer: There is not one word about wine stomping in the statute. Not one word.

MORTGAGE INTEREST TAX CREDIT

Mr. Leluk: Mr. Speaker, I have a question of the Treasurer and Minister of Intergovernmental Affairs. Can the provincial Treasurer assure the members of this House that the mortgage interest tax credit proposed during the last provincial election will be introduced this session?

Hon. Mr. McKeough: Mr. Speaker, that is a matter which is still being assessed in terms of the announcements made by Mr. Danson a couple of weeks ago and our study of just what those announcements mean.

HEALTH STUDY OF ASBESTOS WORKERS

Mrs. Sandeman: A question of the Minister of Health: Could the minister tell me when he is going to institute a thorough study of the present and former long-term employees of Raybestos-Manhattan in Peterborough, and the families of those employees, for health symptoms related to asbestos?

Hon. F. S. Miller: Mr. Speaker, I can’t without checking to see what is being done in the ministry I think it would be wise for me to finish the one study started in the Scarborough area before instituting another, to make sure that the study is relevant.

Mrs. Sandeman: Supplementary, Mr. Speaker: In view of the minister’s recent announcement that studies are to be shine for former employees of the Reeves mine, does the minister not think it would be appropriate for all employees in this province who have been at risk to be tested as soon as humanly possible?

Hon. F. S. Miller: There are varying degrees of risk and I think I should look at those highest degrees of risk first.

Mr. Speaker: The member for Erie wanted to ask a question. He was on his feet a few minutes ago so I have had him in mind.

GREAT LAKES WATER LEVELS

Mr. Haggerty: Thank you, Mr. Speaker. I would like to direct my question again to the Minister of Natural Resources. Due to the high levels of water on Lake Erie will the minister now initiate a public inquiry as to the reasons the water hasn’t receded at all on Lake Erie?

Hon. Mr. Bernier: I am sure, Mr. Speaker, that the hon. member is very much aware that a few years ago we had a select committee of this Legislature looking at the low levels of the Great Lakes basin.

Interjections.

Hon. Mr. Bernier: A tremendous amount of information was gathered at that particular time and during the course of the last couple of years. We are working very closely with the federal government.

Interjections.

Mr. Speaker: Order, please. We can’t hear the answer.

Hon. Mr. Bernier: I really don’t see any need at this point in time for a committee or an inquiry to which the member refers.

Mr. Haggerty: Supplementary: Is the minister aware that one can see that the waters have receded in Lake Ontario? Why have they not in Lake Erie?

Hon. Mr. Bernier: It takes time. I don’t have the answers at my fingertips but I am sure the waters will recede in due course.

YOUTH EMPLOYMENT OPPORTUNITIES

Hon. Mr. Davis: The member for Wentworth (Mr. Deans) asked a question on Friday, I believe, and was anxious to have the response today although he suggested he didn’t expect it until tomorrow. It was to do with the Ontario careers action programme and it was announced during a certain contest that the government would be providing 1,000 jobs -- in fact, it will be 1,050 -- for unemployed young people, to give them useful and relevant work experience in ministries and agencies of the government throughout the province.

The ground rules are simply these: The programme will accept as trainees young people aged 16 to 24. They can be high school dropouts or people from high school as well as university graduates. The applicants must register with Canada Manpower centres. Trainees will be paid $100 a week for a maximum of 52 weeks and will work under special contracts. They will have not have status as civil servants and will not be eligible for employee benefits. They will be hired in at least two stages and the aim is to have the first pilot group under way by Jan. 12.

From the outset, the trainees will be encouraged to seek outside employment and to this end there has been close operation between the Ministry of Colleges and Universities, which is in charge of the programme, and Canada Manpower.

The programme offices will be at 880 Bay St. Each ministry will name a member of staff as co-ordinator to administer its part of the programme working in co-operation with the programme managers. Perhaps the Leader of the Opposition (Mr. Lewis) might convey this to the member for Wentworth so he will have that relevant information.

DAYCARE BUDGET

Mr. McClellan: Mr. Speaker, I would like to ask a question of the Minister of Community and Social Services. Since the need for day care in Ontario has been estimated by the Ministry of Labour to be in the vicinity of 400,000 places, as opposed to the 40,000 supervised places this ministry is responsible for would the minister advise the House why the daycare capital expansion budget was reduced from $5.75 million to $3.35 million in the revised estimates? Secondly, would he give the House a projection of the number of new supervised daycare placements that will be created by his ministry during the current fiscal year?

[2:45]

Hon. Mr. Taylor: I’ll take that question as notice and get the member the information he has requested.

GRIFFITH ISLAND HUNTING LODGE

Mr. B. Newman: Mr. Speaker, I have a question of the Minister of Natural Resources. Is the minister aware of the articles recently in the Windsor Daily Star concerning the exclusive hunting club on Griffith Island, and is he aware of the great public disgust over the wanton disregard for the hunting laws of the Province of Ontario by this select group? What action does the minister plan on takin so that Ontario hunting laws are not flouted by anyone?

Hon. Mr. Bernier: Mr. Speaker, I’m very much aware of the

article to which the member refers. I can’t agree with some of the comments he made as to the type of hunting that goes on on that particular island because I’ve been there myself. Just last week I asked for a full report from my conservation officers. They visited Griffith Island and laid three charges. I also indicated to the conservation officers of my ministry that they are to visit all other such private hunting areas and apply the same laws that apply to everybody else in this province.

CORPORATIONS TAX ACT

Mrs. Bryden: I have a question for the Minister of Revenue. Recently the director-general of audit for the Department of National Revenue in Ottawa is reported to have said that Canada was losing hundreds of millions of dollars in tax revenue because the multinational corporations were shuffling their profits out of the tax man’s reach to their foreign parents and to tax havens. He said the department was having difficulty checking this tax evasion because of a lack of staff and the high cost of pursuing such sophisticated tax evasion.

I’d like to ask the minister if he’s having similar difficulties in administering the Ontario Corporations Tax Act and if he has recently, since this statement, consulted with the Ottawa officials as to methods of preventing this kind of sophisticated tax evasion, which puts a heavier burden on small business and ordinary tax payers.

Mr. Speaker: Order, please.

Hon. Mr. Meen: If that is indeed the case, I would suppose that we would be experiencing the same sort of provincial corporations tax loss. I’ve not had a chance yet either to explore that problem or question my staff. I have intended to do so and I shall do so. I have also not had a chance as yet to discuss it with my counterpart in Ottawa which I also intend to do.

INTERN STUDENT PAYMENTS

Mr. S. Smith: A question, Mr. Speaker, of the Minister of Health: In view of the concerns that are being expressed in students in physio- and occupational therapy and dietetics that the interning stipend for students in those fields will be cut off in the same way they were cut off about three years ago, can the Minister of Health issue a statement clearly stating the government position on this matter so that students, universities and hospitals can plan accordingly?

Hon. F. S. Miller: I can’t make a statement myself. I think probably when one comes it will come from the Minister of Colleges and Universities (Mr. Parrott). I think the method of reimbursing some of these particular people is being reviewed at the moment and is subject to recommendation.

Mr. S. Smith: Supplementary: In view of the fact that from the health manpower

section of the ministry there has come confirmation that these stipends will be phased out, and in view of the tremendous --

Mr. Speaker: Ask your supplementary question.

Mr. S. Smith: -- can there not be a statement made by the ministry sooner so that planning can take place?

Hon. F. S. Miller: I’ll do my best to make sore there is one. I think the position is that they’re not going to lose a source of revenue, but it may be from a different source and in a different way.

Mr. Speaker: The oral question period has expired.

Petitions.

Presenting reports.

Motions.

Introduction of bills.

Orders of the day.

Clerk of the House: The 114th order,

House in committee of supply.

ESTIMATES, MINISTRY OF HEALTH (CONCLUDED)

Mr. Chairman: A little order, please. When we were last in committee of supply we were dealing with vote 2901, item 3. Any further comment on item 3? Carried. Item 4, finance and information services. Carried.

Vote 2901 agreed to.

On vote 2902:

Mr. Chairman: Item 1, health protection and disease prevention services.

Mrs. Sandeman: Mr. Chairman, I have always felt that in a time of restraint and cutting back of budgets, one cuts back on the thing in one’s budget which is the least important.

Mr. Chairman: Order, please. There are too many private conversations going on.

Mrs. Sandeman: I was particularly interested to notice in the estimates of the Ministry of Health, under the promotion and protection programme, that the vote for last year was 1.9 per cent of the total moneys voted. For this year, the amount under promotion and protection has been cut back to 1.8 per cent. I’m wondering if the Ministry of Health really feels that the necessity for preventive health services in this province is declining.

I’m wondering why, in a total ministry vote of nearly $3 billion, the ministry is busy cutting back expenditures, as indeed it probably feels it has to, in every possible area of health care; and yet at the same time the government cuts back on preventive health care, in a period when it would seem to most people it would make more sense to recognize the importance of primary prevention, which an many cases would make those expensive a secondary treatments unnecessary.

I think it would make snore sense to save money, not by cutting the quality or quantity of care to the already sick but by preventing, in very many cases, sicknesses from developing and thus improving the health standards in the community and saving money at one and the same time.

I would like, briefly if I may, to give three examples or three areas in which I believe preventive services are not properly used or funded in this province, areas in which I believe Ontario’s health care falls behind other jurisdictions, areas of preventive care which if they were given more attention, and if necessary more funding, would, I believe, result in our being able to cut back, as obviously the minister wishes to do, on expensive in-hospital services and things of that kind.

The three areas of prevention to which I wish to address myself are the areas of birth control and family planning services, the use of nurse-midwives in this province, and the whole field of care for pregnant women, particularly the nutritional needs of poor, pregnant women in this province. My colleague, the member for Parkdale (Mr. Dukszta) pointed out in his introductory remarks on these estimates that only $1.7 million has been allocated for birth control services, while the now Minister of Energy (Mr.

Timbrell) estimated that in the 1974-1975 fiscal year it cost the province $45.5 million for medical services, family benefits allowances and homes for unwed mothers for the 8,500 children born out of wedlock. I wonder, Mr. Chairman, if Mr. Timbrell realizes that there are many children horn in wedlock who are, in fact, unplanned children? The Minister of Health’s (Mr. F. S.

Miller) statement in December of last year stressed the importance of providing comprehensive birth control education and services across the province, and he promised we would see this programme in full operation in this fiscal year, starting in April, 1975. However, the experience so far raises some doubts that these services will be as readily available as the minister hopes.

The minister seems to be pinning very high hopes on the provision of clinics. He tells us that 25 clinics are now in operation and more are to come. Most of the developmental work in the family planning field seems to be going toward providing further clinics.

I would have to agree that a good clinic in an urban area cannot be bettered if it is truly accessible to all those who need its services, and especially those most at risk; within our community that is normally the young, the undereducated, native people and so forth. For the outlying areas and for those most at risk in the metropolitan areas, I think the minister must realize that we must develop outreach services, the clinics are not enough.

The outreach services must be in both education and the provision of birth control techniques and materials. If necessary we must send mobile clinics around the province. We must make sure there are enough public health nurses hired to do this very important work. We must make sure all maternity units in this country, as one of the services provided to women who have just been delivered of babies, give an opportunity for consultation and advice from an expert in the birth control field.

The second concern I have in this whole area of birth control in the province at the moment is that in the past planned parenthood, sex education and birth control have normally been not a government but a voluntary sector undertaking. The voluntary sector was the innovator and the initiator in this field.

The minister’s statement last winter assured us that services through the voluntary sector would continue; that the voluntary sector -- groups like Planned Parenthood of Ontario -- would continue to be funded through local health agencies. I feel this is not happening. Planned Parenthood of Ontario, which for so many years has given excellent service in this field and for Some years has felt itself to be alone in this very important preventative area, has real fears that the voluntary sector may be pushed out by what it sees as a government takeover in the birth control field. Planned Parenthood of Ontario recently has been getting what can only be described as a runaround from the ministry.

The member associations of Planned Parenthood are told they must go to the medical offices of health for funding, but when they do go to the medical offices of health for funding they discover that no funds are being disbursed to voluntary groups in that manner.

Planned Parenthood of Ontario met with the interministerial committee on family planning in July. Its members explained their problems about lack of funding. They reminded the interministerial committee of the service they are providing across this province in workshops, in educational activities in schools and for Children’s Aid Societies and so on. The committee listened and told them they could submit a budget to the committee. The Planned Parenthood people were pleased to hear this. They submitted a budget and were turned down.

It’s no wonder the voluntary sector feels it’s being abandoned. I find it particularly worrying when we remember that it was pressure from the voluntary sector and its in-depth knowledge and experience after 4.3 active years in this field which was one of the major causes of the minister’s policy statement last year.

I find it particularly worrying, at a time when we know more and more young people are enjoying sexual relations, that the government feels it must cut out part of the services, part of the contribution from people who could speak to these young people in term’s they understand, bring them services in the places where they are and continue to help in this very important preventive area of our medical services in Ontario.

The second area in which I believe the Ministry of Health is missing a real chance to do some exciting new work in preventive care and to improve the existing service and to save money is in the use of nurse-midwives. The present use of nurse-midwives in this province represents a vast misuse and underuse of our resources.

[3:00]

The trained nurse-midwives we have are only used in situations commensurate with their specialized training in remote northern areas. In metropolitan areas, nurses with that special training, nurses who are also midwives, are used hardly differently from other nurses. It is becoming more and more recognized that prenatal care for a healthy woman should be concentrated on the prevention of possible complications and on education. Both these functions a midwife is admirably suited for.

At present, far too much of the care in pregnancy is based on the medical, physical, doctor-centred approach. When a woman suspects that she might be pregnant, she goes to a doctor’s office. The whole of her care around pregnancy is centred in that doctor’s office. The baby is delivered in hospital and very often her perception of the whole process of pregnancy is one that is associated with places of sickness, the doctor’s office and the hospital.

It seems to me there are three major advantage of using nurse-midwives in this province. The first, and perhaps the one that is most important to the minister at this time, is the potential cost saving. The Ontario Committee on the Healing Arts presented a report in 1970, and Mr. Fraser’s study of obstetrical care in that report concluded that a trained midwife can relieve a physician of nearly 80 per cent of his responsibilities in terms of hours of work for a normal pregnancy. The report outlined methods by which midwives and physicians could combine in an obstetrical team. If I may read from the report, it concludes:

“If a government actually takes seriously its responsibilities under a universal medical care plan to provide a proper given level of obstetrical care to all mothers, it must surely be in the position of not being able to train the requisite number of obstetricians. More positively, it must be in the position of having to train midwives and to combine them in an obstetrical care team with an obstetrician.”

Even if it’s only as a cost-saving device, then I think in this province we should surely be training and using more midwives; but I don’t feel that the cost-saving argument is a sufficient argument for using nurse-midwives. There are to me equally important human reasons for using trained nurse-midwives.

Secondly, if you use a nurse-midwife, the doctor can be freed to do the work for which he or she was trained, namely the care of sickness.

This is closely connected, of course, with the third advantage of using a nurse-midwife: That the perspective of the midwife is that pregnancy is a natural, healthy process, it is not a sickness-oriented process, except in unfortunate rare and unavoidable cases. The emphasis of the nurse-midwife is on education and on support, and much of her work can and must be done in the home -- not in the doctor’s office, not in the hospital but in the home with the mother and with the rest of the family.

A good nurse-midwife can teach the mother about the enormous physiological changes she’s undergoing. Most doctors don’t have time to do that. A good nurse-midwife can prepare the mother for her delivery, prepare her thoroughly; prepare her psychologically and prepare her in a way which the woman understands and feels able to trust.

A good nurse-midwife will, of course, be with her patient during the birth process. She will also help the parents to cope with the changes in their psychological, their social and their economic environment that a new baby in the family inevitably produces. All these services for pregnant women come under the broad heading of prevention and we have ignored their importance in this province for far too long.

The third area of preventive health care I would like to speak to very briefly -- and another which is almost non-existent in Ontario -- is tied in closely with the services which I believe a nurse-midwife would provide. That is, the provision of proper and adequate nutrition during pregnancy.

At the moment we have doctors advising their patients to eat properly; doctors giving their pregnant patients’ diet sheets. That is fine for women who can afford to buy the foods -- milk, oranges, the vitamin supplements -- suggested on the diet sheets. It is not so good for poor women who cannot afford the kind of food they should properly be eating.

The documentation of the damage done to malnourished or undernourished children, both before and after birth, is being collected across the world. We have had a good report here in Canada. The report of the National Council of Welfare on Nutrition and the Children of the Poor, which was produced in 1973 -- members will probably remember it; the report was titled “One Child, One Chance” -- gave evidence no how physical and mental development of the fetus can be affected by the adequacy or inadequacy of the mother’s diet during pregnancy. The report pointed out in very cogent terms how such an adequate diet was often beyond the reach of poor mothers.

There was a very recent and very frightening report from the United States, and its implication for Canadians is very clear. A team of scientists in California has estimated that 1,000,000 infants in the United States have either already suffered stunting of their brains or risk that kind of damage because of malnutrition. When you add to that number the malnourished, pregnant women, there is probably another 1,000,000 unborn babies in the United States to be added to the total in jeopardy.

Of course, the number in Canada would be smaller than that and the number in Ontario would be even smaller, but we cannot afford to overlook the damage which is documented as being done to unborn children and to young children by inadequacies in their diet. We can’t afford to overlook it, partly because we spend millions of dollars trying to rectify that damage through special educational programmes -- programmes for the disabled and special remedial programmes, all of them expensive programmes -- during the lives of those children.

We can’t afford to ignore it on humane terms. It would be quite possible for the Minister of Health to prevent the problems caused by poor diet during pregnancy by a very simple and very obvious means, which does not involve handing out diet sheets indiscriminately to mothers, but envisages actually supplementing the diets of poor, pregnant women.

The experience at the Montreal diet dispensary is instructive. By supplementing the diets of poor mothers during pregnancy the diet dispensary had virtually been able to eliminate differences in birth weight and differences in prenatal mortality between infants of the poor and the non-poor by a method as simple as handing out milk and oranges and vitamin supplements to poor women. The preventive value of such a relatively cheap and easy programme cannot be overestimated.

May I remind members of the conclusions of the Department of National Health and Welfare in its submissions to the senate committee on poverty. The conclusion was that there is universal recognition that nutrition is a critical factor in poverty. Dietary inadequacies and undernutrition, combined with the other deprivations attendant on poverty, cause health deterioration. This sets up the cycle of decreased performance of all activities, mental apathy and incapacity for initiative or self-help. Medical research has linked malnutrition to anemia, low resistance to infectious diseases, mental retardation and mental illness.

Undernourishment may reduce the ability to acquire the education necessary for escape from the poverty cycle. Quite apart from impairment of mental development arising from deficiencies of nutrition during fetal life and early infancy, the complex of mental and physical latitude attendant on undernourishment, the distraction of attention caused by the distress of nagging hunger and unfitness because of recurring illness, all can stultify the education of a child of even normal mental endowment. I wonder if we’re ignoring such simple programmes as diet supplements because they are so simple and apparently so unsophisticated.

In conclusion, I would like to ask the minister to consider whether the provision of diet supplement, starting immediately, to poor, pregnant women in Ontario might not be one of the most useful weapons in his preventative medical care armoury? He’s waging a double battle; we all realize that. His double battle is against high costs and poor health in this province. I repeat that it’s short-sighted, it’s cruel and it’s ultimately prohibitively expensive to refuse such help.

Mr. Chairman, I want you to know that I’ve been guided in my remarks and in my thinking by the Treasurer’s (Mr. McKeough) remarks to the Ontario Hospital Association convention. The Treasurer spoke to the Ontario Hospital convention and concluded by, as he said, “giving a word to the wise and a warning too”. He said:

“Do not expect a return to the free-wheeling days of massively growing public expenditures. Do not expect that we shall be able to finance those expensive innovations and enrichments and expansions that are merely desirable. For the near future at least, we shall be able to afford only the necessary. This principle, I suspect, may have to apply to a number of existing services as well as to proposals for something new.”

We on this side of the House firmly believe that the programmes which come under the heading of promotion and prevention in today’s vote are necessary, must be provided and must not be cut back. Among these services I would include the improvement of birth control services, the provision of a proper and effective network of nurse-midwives and the immediate introduction of a diet supplement programme for poor, pregnant women.

Hon. F. S. Miller: I am philosophically not at much odds with the last speaker. I certainly do believe we should be spending as much money as we can put into the preventive programmes, and that’s never enough I have to say. Unlike the treatment programmes, they’re more discretionary and one discovers that discretionary decisions are amongst the few that are open to any management in the system. Those are the hard facts of life rather than the way we would like to see it.

I can only say that when I was faced with some of the decisions I’m going to be making in the next few weeks, I elected to take money out of some of the so-called open-ended treatment programmes and protect the programmes that I believe in, such as VD control, birth control programmes and so on. I feel it is important that we continue. You and I perhaps, though, would disagree in some of the methods of treatment.

As far as the birth control programme goes, we did get a fair amount of credit rather than criticism in the last year for the very fact we tried to implement a programme. I believe we’ve done reasonably well with the health units of Ontario, which we charged with the responsibility for actually producing and delivering the programme. In some areas they are actually financing the volunteer agencies you referred to.

I believe that two cities that were mentioned to me just now are North Bay and Hamilton, where the volunteer agencies either carry out the programme on behalf of the health unit or receive some funds from it. I stressed in the many times I was asked questions about this programme around the province that I am extremely anxious to make sure volunteer agencies remain within this field. I don’t want government to take them over, nor do I want us to become the only financial source for their moneys because this, in most instances, stops volunteer organizations from being volunteer.

In that very essence of being volunteer, they must retain certain distinct parts to their programmes that perhaps aren’t acceptable to the public at large. It’s for this reason that they’re best left as volunteer and best left financed to some degree by those people who believe in them.

[3:15]

The nurse-midwives proposal is one I profess quite a bit of interest in. I’ve talked on a number of occasions to those people who are considering expanding the European role of the nurse-midwife to Canada. If I recall some of the statistics I saw a long time ago I believe they are favourable; in other words, when births are looked after by nurse-midwives we have better rates of success than we do with births in hospitals under normal conditions. I’m not about to argue the validity of the points you have brought up. The member for Durham West doesn’t agree?

Mr. Godfrey: I’d like to see the figures.

Hon. F. S. Miller: I’m trying to recall some discussions I had a long while back. You may disagree but I think you may find that I am right.

Mr. Godfrey: In 1850.

Hon. F. S. Miller: In 1850? You may know more.

I’m pleased, though, with the overall progress we’ve had in Ontario in terms of the overall survival rate of mothers and babies over the last 10 years. I look Lack to 1965 and I think the death rate then for mothers was 3.1 per 1,000 births; it was down to 1.1 by 1973. The infant deaths were 20.5 per 1,000 births and it’s 14.1 now. I think in a relatively short time frame, that was eight years, significant improvements have been evidenced in those statistics. That’s not to say we’ve done all we should, but looking over world-wide statistics, I believe Canada and Ontario rank pretty well in this category.

We rank pretty poorly in some other categories, so I think there are some other things, let’s say, which are more deserving of management and management dollars on a priority basis in the future. We’ve achieved a pretty good level; wo don’t want to see it slip -- we’d like to improve it -- but if I had a choice of dollars in A or B, I think I could find there are a number of areas which deserve dollars perhaps more currently.

On nutrition -- I guess the chairman one day was listening to me extol my past and my upbringing; I suppose I should tell the little anecdote about him. I explained how I was born of a working-class family, grew up with a widowed mother on mother’s allowance and became a Conservative. His question was where did I go wrong along the way? That’s a fact, but it makes me particularly sensitive to some of the comments which always seem to indicate that all of our programmes are aimed at the well-to-do. I just have to say I don’t agree with this.

The hon. member talked about nutrition, about the poor mother not being able to afford the food; yes, but the sad thing is good food isn’t necessarily expensive food. People who are suffering from malnutrition are not necessarily poor. In fact, malnutrition is a national disease, I think, of affluence, not necessarily of poverty. We live in a nation, as far as I am concerned, which can afford too many things that taste good and do nothing for you.

Therefore, I’m not totally sold on the programmes in which we go into food supplements for people. Education of people to know what they should be feeding themselves and their children is perhaps more critical than the doling out of food which makes people forever dependent upon the state. People have to take responsibility for their own state of health, and that to my mind involves fairly wide-ranging education programmes which only have a --

Mrs. Sandeman: You can’t educate the baby in the womb.

Hon. F. S. Miller: I am not worried about educating the baby in the womb; I hope I’ll be able to educate the mother who has the baby in the womb. That, to me, is the critical issue, is it not? Later on, I’m going to get a crack at the baby.

Mrs. Sandeman: It may be too late by then.

Hon. F. S. Miller: I must say I took some exception to one phrase you used; you said young teenagers were enjoying sex more now. I just hope you’ll look at the phraseology there.

Mr. Moffatt: More than you.

Mrs. Sandeman: I should have said more young teenagers.

Hon. F. S. Miller: Hansard should be corrected; I’m sure you didn’t mean to imply what was said.

However, as far as the value of a nutrition education programme is concerned, you and I would not have any disagreement at all. I have talked to dietitians, and I have told them I think their work is exceptionally important. I have never promised, but I have implied, that we were very willing to consider them to be included in the Health Disciplines Act, something that up to date has not occurred, because of the critical importance of nutrition in the overall health of the people in this country.

I’m going back by memory, but I suppose that during the war when we would do almost anything we were ordered to do, we were at our healthiest. We were at our healthiest because they rationed a lot of the things that made us not too healthy -- excess sugar, excess coffee, fats. All of these things were the very commodities that were very hard to get; as a result we stuck with a number of staples that made, I am told, pretty good sound, nutritional sense. Therefore, the health of our people in Canada and in Great Britain was pretty good, I am told, from that point of view.

As I say, there is no argument on the need for better nutrition and education. It is a slow, painstaking, frustrating job, one which our ministry, in conjunction with others and other agencies, is willing to keep on trying to do.

Mr. Chairman: Item 1, of vote 2902 carried? Carried.

On item 2, development of health resources. Carried.

Vote 2902 agreed to.

On vote 2903:

Mr. Philip: Mr. Chairman, I would like to bring up a problem that is more than an irritant, I think it is a problem that perhaps should be seriously considered, and that is the problem of those people over 65 who are moving into this province. They are not eligible for premium-free insurance until they have completed 12 months residence, but my understanding is that temporary assistance is available to them on application. However, it has been brought to my attention by a number of people in my riding that they have discovered that their parents were not covered.

The parents, on seeing the cost of paying their own way for a year’s time, had actually decided to opt out. I wonder if you have spent any time trying to coordinate with the other Ministers of Health a more simple transfer of senior citizens’ insurance from one province to another.

Hon. F. S. Miller: Mr. Chairman, I think that wherever a programme is free, and services are not equal in the different jurisdictions, there is some need for a time factor to apply before automatic coverage is granted. I would say that if all the Canadian provinces offered the same kinds of programmes in health care, your arguments would be completely valid. But there are a couple of complicating factors.

Number one, we offer nursing home care in Ontario as an insured benefit. This is not offered in other provinces, or at least not in all other provinces. It is not federally-financed, I am sure you know that. The main clients are people over 65, the majority of them. We do have problems with people moving to Ontario from other jurisdictions to be basically qualified for that service after having lived and worked for many years in other jurisdictions; even other countries -- as Canadian citizens in many instances.

I think as long as we have these differences in programmes we have some need to put in a time deterrent. The federal government doesn’t automatically give the old age pension to people who have lived in Canada for a year -- I am sure you are aware of that -- for the same basic reason.

OHIP is a pretty generous programme; it covers you no matter where you go in the world. Many other health programmes do not. I feel, currently speaking, that the time deterrent can be justified. If the time arrives when all of Canada has the same basic insured services available so there wouldn’t be any reason for a person to skip from one place to another, I think I could safely say the need for a time deterrent would disappear.

Mr. Philip: Surely though, Mr. Minister, you are not talking about great numbers of people. What you are talking about are small numbers of people who are moving into the province, people to whom it doesn’t occur, since they are Canadians, that they are not covered. People who are at a certain age, then, go into a hospital and receive this letter from the hospital saying they are going to be financially responsible. It comes as a traumatic experience to many of them. Could there not be some way of covering them?

Hon. F. S. Miller: That assumes that, of course, we leave the entire responsibility upon the person to enrol before some disaster strikes.

I am keenly aware of the problem you are describing. My in-laws moved here from Quebec just last month and they are both over 65. This was their first question: “What do I have to do to have coverage?” At least they asked it.

I can only say that my experience with our health insurance group has boon that we have bent over backwards to do one of two things: Cover the person who pays his premium retroactively if, through honest mistake, he forgot to do it; or, secondly, we have been very willing to work with them if they didn’t have enough income to justify paying the premium on an income basis.

Mr. S. Smith: If I could just pick up the minister on this point: With regard to registering for OHIP, it certainly has been a problem in my medical experience, particularly with people who have passed the age of 19 and are no longer covered through their family, that many of these people simply do not make the premium payments necessary for OHIP.

What has tended to happen is they have received these rather staggering bills while they are being treated on the ward, which hasn’t contributed very much to their rehabilitation and recovery. In each instance, after a bit of paper work and six or seven phone calls, the cost has been absorbed by the government indirectly and things have been settled, but it did strike me an awful lot of bureaucracy was unnecessarily involved in forcing each and every person to register himself under the OHIP plan.

As long as you are going to have premiums I suppose it’s possible you used to have some type of registration mechanism, but I wonder if the minister wouldn’t agree this is just an awful lot of bureaucracy that accomplishes very little. This has happened at least five or six times a year on my own unit.

While I am speaking on the subject of OHIP, I wonder also if I might ask the minister what plans he has for OHIP to recover from automobile insurance companies automobile accident health costs. It seems to me that in law the province has every right to go after the perpetrator, the person who has caused an automobile accident, and demand the cost from that person via his insurance company.

I would like to know whether in point of fact the minister can give us a percentage of how many of these automobile accidents they have successfully prosecuted in this manner and successfully managed to get money back from the insurance companies. My understanding from someone within the insurance industry is that they have been able to obtain a very small percentage. I would like to stand corrected on that and I look forward to hearing about that percentage.

I also wonder if the minister would like to take this occasion to tell us what his plans are with regard to deterrent fees as related to OHIP premiums. I want him to know that the position of our party is absolutely dead set against these fees and I would like to have a statement from him --

Hon. F. S. Miller: Finally I have found a difference between a Liberal and a Conservative.

Mr. S. Smith: You will discover, to your disappointment Mr. Minister, that there are a great many differences, which you will find out about in the next few months.

Mr. Lewis: That’s true. You are much more right wing than they are.

An hon. member: Look at the halo.

Mr. Lewis: That is one of the most pronounced differences.

Mr. Ruston: Where did you get that tan, Stephen?

Mr. S. Smith: It is nice to see the Leader of the Opposition back participating in the --

Mr. Moffatt: He’s the only leader who is here right now.

Interjections.

Mr. S. Smith: We missed him.

Hon. F. S. Miller: We even noticed him.

Mr. S. Smith: I thought momentarily he had had his hair curled in an Afro hairdo and I didn’t realize he actually wasn’t here.

I wonder though if the minister could in fact reassure the population of Ontario about the question of deterrent fees, and I look forward to hearing his answer in this regard.

[3:30]

Mr. Lewis: Well you can put all the premiums on the income tax without telling the people where the initial money is coming from -- more Liberal policy.

Hon. F. S. Miller: The alternative to your suggestion is that in effect everyone should be automatically enrolled and that there should be no premiums. That’s the way I would read your comment about the 19-year-old entering the scheme. Is that what you’re saying?

Mr. S. Smith: You can have everyone automatically enrolled, despite the age question; and if you’re going to waive premiums -- as you frequently do in the case of those who are unemployed, waive them retroactively -- there’s no great problem. As it happens, all you do now is create work for an awful lot of people who have to check into whether these premiums have been paid when in fact they virtually never pay the premiums anyhow.

Hon. F. S. Miller: That

part isn’t the issue. Of course, we do help people, even though we have no obligation to help them if they have forgotten to enrol or did not enrol in OHIP when they stop being a dependant of the family. I think, technically, 21 is the age at which they must stop being a dependant, that’s the maximum age they can stay in the family under any circumstances; if they are working it’s earlier. By 21 they are dropped out of the scheme as a dependant and have to enrol as a student or have some other means OHIP support.

Surely, the issue isn’t how many we have to enrol retroactively, but how many did enrol and contribute toward those who did become ill, and who themselves didn’t draw upon the system. Unless there is some reason and effort to get them in, everybody could wait until the first accident. Everyone could simply say: “Why should I enrol in the OHIP Programme?” If it became that simple, I think that tendency would grow.

I have some reservations about always covering somebody retroactively. I think that far too many people profess ignorance at the time of an accident, whether it be an automobile accident or a health accident. They simply say, “Well I thought I was covered when I did so and so.”

Now our subrogated rights in the case of the automobile accident causing injury to the third party or other party -- the second party found guiltless -- have, of course, always applied. We collect, I’m told, between $6 million and $7 million dollars a year from insurance companies right now -- that’s a guess. We also collect from Workmen’s Compensation Board. But interestingly enough, at the present time we don’t pro-rate our costs or our subrogated amounts if the sum total of the charges levied against the guilty driver exceed the amount of insurance available.

Awards may be given to the person, to the individual. By law, it’s normal to take the total amount in the insurance package. Let’s say a driver had $100,000 insurance and there was $200,000 worth of damage caused; that may be ranked something like this: an amount of $125,000 damages to the person injured for personal problems, $75,000 for OHIP. Instead of us both getting a share of the $100,000 available, I agree last year that the individuals involved should get their money before we get ours.

You may or may not agree with that, but I think when a person’s been injured in an automobile accident and had health insurance, the least we can do is see that they have the right to this money before we have our share of it. That, of course, tends to cut down the amount of money we collect on behalf of OHIP, but we do collect from Workmen’s Compensation Board.

Now on deterrents, I’m not going to fall into the trap of making any comments about what government policy will be on deterrents in the future, because that is not determined. Most certainly I am going to have to review that area before long, because it is obvious to me the increase in the cost of the present system, allowing for inflation for 1976-1977, will exceed the moneys that will be allotted to run the Ministry of Health. For that reason I am going to have to look at ways of cutting, fairly dramatically, the costs of the present system.

In other words, the costs of running our hospitals and the costs of our present programmes next year are going to exceed the amount of money I am going to be given to run the Ministry of Health. Therefore, I have to look for ways to put the brakes on the open-ended programmes. Those are the alternatives open to me as I see it.

I haven’t as yet finalized that evaluation. It has been both painful and time-consuming. I am getting close to that point. Somewhere in that picture we will automatically look at the question of deterrents and probably pass them by, as we have in every other instance when we have looked at them.

Mr. Lewis: I should hope so.

Hon. F. S. Miller: I am not saying we will or we won’t. I am saying you don’t just discard it without reviewing it in the light of the other thing you have to do. I can’t really --

Mr. Lewis: You don’t create an election issue, either.

Hon. F. S. Miller: Strangely enough, it certainly wouldn’t be popular with either of the opposition parties. Now that I have established the fact I can tell a Conservative from a Liberal, but not a Liberal from an NDP --

Mr. Moffatt: Just keep watching; you’ll find out.

Mr. Chairman: Order, please. The minister has the floor.

Hon. F. S. Miller: Thank you, Mr. Chairman.

Mr. Chairman: Stay on the vote.

Hon. F. S. Miller: Please don’t show your biases.

We will get around to looking at it and probably discarding it. What I was going to say is, strangely enough, as I go round the province hundreds of people -- not all of them doctors -- have come to me and said: “It is about time you brought in a deterrent.” This is intriguing; hundreds of people --

Mr. Lewis: Hundreds of people? Hundreds of people don’t even talk to me.

Hon. F. S. Miller: That is understandable.

Mr. Lewis: Hundreds of people talk to you about deterrents?

Mr. Moffatt: Those are the voices you hear.

Hon. F. S. Miller: Yes, the voices from the back.

Mr. Lewis: They say, “Frank, bring in a deterrent.” My goodness, what a man can conjure up.

Hon. F. S. Miller: No, they say “Mr. Minister, bring in a deterrent.”

Mr. Moffatt: Or “exalted minister”?

Hon. F. S. Miller: I am sorry, Mr. Chairman.

Mr. Chairman: Is the minister finished?

Hon. F. S. Miller: This minister is only finished in one sense; which is I have stopped talking.

Mr. Angus: Mr. Minister, I would like to use a family reference, as you have, in terms of discussing your ministry. Coming from the north and having, by circumstance, been involved with the Hospital for Sick Children in Toronto, and going through a series of travel situations over a period of about a year and a half, I learned some of the frustrations that people from my riding and the riding of Port Arthur, for that matter all the ridings in northwestern Ontario, go through.

It is uneconomical, and I admit that, to have identical services in every part of the province -- and when I say identical I mean the specialist services in terms of those highly expensive or high expertise services found in Toronto or Winnipeg, Montreal or the major centres of Canada.

Mr. Chairman: I am advised that comes under item 2 of vote 2903, general hospitals and related activities.

Mr. Angus: It is considered under related activities, is it? It does not relate to transportation and OHIP?

Hon. F. S. Miller: If I can clarify it for the member, if I’m not wrong, I think under OHIP, the health insurance scheme, we are talking about the medical fees, the chiropractic fees and so on. In the next vote, for $1,552 billion, general hospitals and related activities, we will talk about the availability of services in institutions.

Mr. Angus: Yes, I was just using that as a

preamble. My comment is in terms of getting the people to those services which are available. Would you consider that under this vote?

Hon. F. S. Miller: Okay, carry on.

Mr. Angus: The situation is that because we don’t have those services in our areas people are required to come to the major centres, that is Toronto or Winnipeg, to get those services. Unless it is a hospital-to-hospital transfer -- in other words, such as in the case of an emergency -- OHIP does not provide the funding.

For instance, I met a family on the plane today which was coming down for a yearly checkup on their son. They had to come down here because the expertise wasn’t available and they had to pay the whole shot out of their pocket to get their child here for a 15-minute interview with the doctor. They are among the lucky people in terms of travel.

I have had personal situations where my wife has had to stay down here as long as three weeks with our daughter while she was in Sick Children’s. She had to pay for her own accommodation and her own transportation down, because it was important in terms of the welfare of our child and the healing process for the mother to be available. I think any physician will agree to that kind of concept. Whether it is a child or an adult, you still have to have that communication link to home.

What I am trying to tell the hon. minister is that it is important that money be made available through OHIP to provide transportation, because some families have to come down here every three weeks for an appointment for special medication or special services that they can’t get in Thunder Bay, Sioux Lookout or what have you.

I would really impress upon the hon. minister that if we are talking about a province of opportunity and talking about a province of equal opportunity in terms of medical care, then we have to begin to consider these kinds of realities when we talk about spending our OHIP premiums, of spending our tax dollars. I would implore the hon. minister to take a really new look at the whole consideration of transportation costs, and where necessary accommodation costs for the parents or spouses of those people who are so critically ill that they must come to Toronto for medical aid.

Hon. F. S. Miller: The hon. member for Cochrane North, I think, wrote me within the last couple of days about this very topic and I can appreciate the problem. I don’t have an easy solution to it or answer to it. Yes, I think almost all of us who live somewhere outside Metropolitan Toronto, at some time or other either are involved in or have a family relative who requires some of the specialized services of a major city hospital; not always Toronto, but the odds are very good if you live north of this area this is where you will head.

I guess we have only made inroads in one or two areas for some people who have a steady need to come to hospital and who otherwise would be patients. I am thinking now of those people with kidney problems. We have made a small attempt at keeping their transportation costs covered.

Of course you mentioned, at the other end, the emergency or the transfer of a person who requires an ambulance. It has been covered for a long time, and it is growing perhaps more than any other segment of my overall budget as a percentage.

Mr. Angus: If I could just interject for a second: One of the ironies about the hon. minister’s statement is that to get the transportation paid down they have to pay their own way back borne under the present situation.

Hon. F. S. Miller: I can only say this; as long as the comments made by the hon. member for Peterborough (Mrs. Sandeman) are valid, that I am not doing all I should in say preventive care, or that I am not doing all I should in children’s mental health services -- if you don’t get after me on that today I will be surprised -- then I have to say I rank the problem you discussed lower than that. I have the job of deciding which items I will spend money on first. Much as I would like to spend it on them all, those two would rank ahead of transportation, simply because in my opinion they are of greater need.

Mr. Sweeney: A question of the hon. minister, through you Mr. Chairman; a question of clarification on his explanation perhaps.

Hon. F. S. Miller: If anybody asks questions the hon. member can make statements.

Mr. Sweeney: My questions refer to two constituents who have brought them to my attention, and I have had some difficulty getting the answers. I am referring to OHIP coverage for Ontario residents who live outside of Ontario part-time; particularly those over 65 who probably go south. My understanding is that if they are out of the country for less than six months per year they continue to be covered. Let me just point out my understanding and then if the hon. minister would please clarify it, because there is probably an error somewhere. That is what they understood, that they were still covered.

In one particular case they received medical treatment outside the country but were only partially reimbursed for that. In the other case, the couple are outside the country for more than six months but are still Ontario residents. They still pay property taxes in Ontario because they have a home here. They still pay sales tax and other types of taxes when they’re here. Their understanding is that they don’t get any coverage at all, even when they come back to Ontario and need medical attention. Could the minister explain just what is happening here?

[3:45]

Hon. F. S. Miller: Yes, I can. Your general principles are right, but your details aren’t. I stand to be corrected by my staff if I’m wrong in my reply. Our requirements for Ontario health insurance coverage for persons outside of Canada, or in fact outside of the province I believe, is that they must reside in the province four consecutive months a year to retain eligibility. Therefore, they can be out of Ontario eight months a year and qualify for coverage.

The second thing, a person who is outside of Ontario and who requires emergency hospital treatment -- I don’t mean through an accident necessarily, but the kind of treatment that is not at the patient’s decision not elective -- will have all of his hospital costs paid for and his doctor’s costs will be paid for up to the Ontario tariff but not exceeding the actual dollars laid out. Have you got that?

Mr. Sweeney: Yes.

Hon. F. S. Miller: The only caveat I put in there is, don’t get sick in Florida.

Mr. Chairman: The member for Windsor-Walkerville.

Mr. Good: Don’t die in Florida.

Mr. B. Newman: I wanted to raise two issues with the minister. One concerns the OHIP number. Senior citizens are very confused with the series of numbers they receive. They have a Social Insurance number, an OHIP number and a drug number. Isn’t there some way of rationalizing all of that so the individual would have one and only one number rather than the conglomeration of numbers he has today?

Hon. F. S. Miller: Mr. Chairman, the speaker is touching a topic near and dear to my heart. I’m sure the general manager of OHIP is sitting here shivering now because he knows what I think.

When Dr. Potter got me foisted upon him as his parliamentary assistant I went in with exactly that philosophy. I really haven’t changed my mind. Some people say I never do.

The fact remains that I think the simplification of numbers would be a great step forward in terms of making life a little easier for any of us. It is not just a question of an OHIP number and a drug number -- I think the drug number is your SIN number as a matter of fact, if you have one -- it’s the multiplicity of numbers for all the special purpose requirements we have.

I can safely tell you it has been studied in such depth that no study is needed any more. The conclusion probably is that sooner or later it will happen. The reason for not implementing it isn’t, I would say, lack of belief that it’s the right thing to do; it is. It’s a combination of the practical problems involved in actually getting these numbers out in the time-frame therein, and the resulting co-operation required between all of those agencies which currently give numbers, federal, provincial, municipal and so forth. I think all those things can be overcome. It will just take a concerted effort and attempt to do so.

Of more importance has been the reaction of those people who look at the civil rights of the individual and who feel that by giving a person a single personal identifier, as we have chosen to call it, we will make possible access to too much personal information and in the process perhaps destroy the individual’s privacy. That really is the issue, not the technical issues involved.

Mr. B. Newman: I know the minister as a private member is aware of the problems you run into when a constituent tries to relay a series of numbers to you. He’ll give you the number of his cheque, he’ll give you any number that is on the cheque -- he doesn’t know whether it’s his old age security number, his social insurance number, his old age assistance number or his family benefits number; he quite often hasn’t a due at all. My thought is that if you can convince your own officials and possibly the government to come down with one number, you could resolve a lot of the problems.

I agree with you re the concern of the civil libertarians that we are going to come along and be put into Orwell’s “1984” a little earlier than we want to be, but for the sake of a lot of the elderly people, I think it would resolve some of the problems.

Hon. F. S. Miller: Mr. Chairman, first of all, I am firmly on your side. I think the question as to whether it happens or doesn’t happen depends not so much on the government side of the House, although I’m sure there would be a disagreement of opinion within our ranks, but general feelings on all sides of the House as to the feasibility and acceptability of that kind of a programme. But the one thing that was dear to me is that it doesn’t relate to my ministry alone. It relates to all of government, all at once.

Mr. B. Newman: Another point that I wanted to raise with the minister, Mr. Chairman, is that of the individual reaching the age of 19. May I suggest to the minister that when that does happen, in addition to sending a notice to the individual, or to the parent of that individual if it happens to be a son or a daughter, there also be attached an invoice for the individual to pay in case he is going to be required to pay his own OHIP premiums, because quite often the parent gets the notice and disregards it,

whereas if there were an invoice he wouldn’t disregard it as quickly at least. He may not wish to pay, but at least he would have been forewarned by the notice.

Hon. F. S. Miller: That presupposes something that isn’t so. That presupposes we know who is 19. You see, we don’t enrol the children in a family by any formal mechanism. I don’t know whether you are aware of that or not.

Mr. B. Newman: No, not at all.

Hon. F. S. Miller: If we went back to your first proposal and gave each person a unique personal identifier, which, as I see it, would be given at birth in place of the birth identification number, then, in fact, we would have a record of the age and birth of everybody at our central offices here in Toronto, on the assumption that in fact they stayed within the province. Obviously the records will not always be 100 per cent accurate, but they’d be pretty good because, in the same thinking, the number would be used to identify those who die and for a change we’d have an in and out department, if you want to put it that way.

Mr. Ruston: That will make a good headline.

Hon. F. S. Miller: Anyway, we’d have an inventory. I had better stop.

Mr. Moffatt: Quit while you’re behind.

Hon. F. S. Miller: Where was I?

Mr. Chairman: You’re off course.

Hon. F. S. Miller: Not really, I’m on course, Mr. Chairman. Currently, though, we give an OHIP number to the person who registers for the family unit or registers as an individual, and automatically, if somebody uses that number in the doctor’s office, such as a child or spouse, they’re added to our list. That explains to some degree why we have more people enrolled than there are in Ontario.

Mr. B. Newman: Another problem that I want to raise with the minister is the situation where the husband and wife don’t get along, so the husband decides that he is no longer going to carry his wife on his OHIP. All of a sudden she is dropped but he, in the meantime, finds someone else whom he would prefer to pay OHIP for.

Hon. F. S. Miller: That’s the in and out.

Mr. B. Newman: How does the wife find out that she is no longer covered? There is no way for her to find out at all, except when she goes to a doctor. She gives her old OHIP number there, and all of a sudden finds out she is not covered because her husband now is paying the OHIP for some other lady.

Hon. F. S. Miller: You have put a very sexist approach on all this. It is not the man who makes the determination, it is the person in whose name the policy is written. A woman can discard her husband just as easily as a man can discard his wife. The fact is, the person who registers to hold the policy decides who will be covered -- wife A, B, or C.

Mr. B. Newman: I don’t disagree there, Mr. Minister, but how then does wife A find out that she is no longer covered if the husband will not tell her?

Hon. F. S. Miller: A simple letter to the OHIP office will tell her -- or him.

Mr. B. Newman: It wasn’t that simple in the case that I had.

Hon. F. S. Miller: I recognize that it isn’t always.

Mr. Chairman: Shall item 1 carry? Item 1 agreed to.

On item 2 -- general hospitals and related activities.

Mr. Godfrey: I would like to speak to this vote and, unfortunately, if I may crave your indulgence, it may spread over into rehabilitation services. I view them as continuing from general hospitals, so with your permission I may be able to get a correct catharsis here.

I read the estimates which have been presented and I am struck immediately with the urgency of the situation of medical care in Ontario today. We see before us a ministry which is clearly out of control, incapable of doing business in the normally accepted manner and which basically lacks leadership. Indeed, having listened to the estimates for the Ministry of Education, I am struck by some of the amazing similarities between that department and this. They simply don’t know what is going on and have lost control of their ministries.

Let me cite some examples of this: We are told we are spending too much on health. Our Ministry of Health has accepted the strictures of the federal government -- with some mini-screams, but without question of their basic validity. In doing so, this government has surrendered to the federal government basic decisions as to the quality of medical care which would be given to the citizens of Ontario. This resignation of leadership is not new -- it is current. It may be seen more vividly in the current negotiations with regard to ceilings which have been put on the wages of those same workers who pay the taxes for our medical scheme.

In the words of our provincial Treasurer (Mr. McKeough), the record with the hospital insurance programme has been replete with rigidity and Confusion. He has stated that the federal government has shown a lack of imagination in dealing with the real problems of health financing. All this sounds very brave and forthright but where are we at present? We are in the middle of a medical morass where one thing comes through clearly -- the quality of medical care in this province is suffering and more is to come.

Our government, which has remained in office many years through having exploited the high quality of the educational and medical assistance which developed outside the government, has made the same basic mistake in both areas. In the school system, the brick-and-mortar ethic has prevailed, with the result that we see throughout the land, palaces of learning which house an inadequate number of staff who are restrained from bringing the best education to our citizens.

Similarly in the field of medicine, we see an over-construction of acute hospital beds with government approval. The result is the government is now involved in closing down these beds and pointing out that we need to open convalescent and chronic beds in their place. Surely, here is a giant system run by pygmies. There is nothing here but bureaucratic bed-doggling. But, let’s get back for a moment to the basic concept that the health dollar is taking too large a proportion of our budget.

[4:00]

How much money should be spent on health? As I said the other day, in commenting on the education budget when the minister was here, I think there are two budgets which should have priority in spending; these are education and health. Since 1960 there has been an escalation of costs in the hospital system which reached a peak last year.

Therefore, a much smaller hospital dollar has been expedited to meet vastly increased costs and the provincial government has been imposing a tighter and tighter squeeze on hospital budgets, with the result that budget increases allowed in all cases are less than the actual increase in the cost of hospital living. In structuring the budget of a hospital, the Ministry of Health is, in effect, controlling the quality of medical care using the dollar input rather than a basis which is founded on the need of the patient.

This restriction of dollars is felt in an industry which is labour-intensive. Only within the last year has the level of hospital wages been brought up to an approximate level of that in comparative industries and the catch-up has not been completed in some areas. The result of putting the lid on the hospital budget is obvious. Those catch-up wages will never arrive, and it will not be possible for the worker in the hospital industry to maintain his equity with those in a companion industry.

The Ministry of Health continues to think it can control medical care in this country simply by turning off the money tap. It sets the impossible task, which could be compared to a fireman asked to put out a forest blaze and told he had 392 gal. to do the job. Of course the medical system can be constrained, but at what a sacrifice? These attempts at rationing by freezing capital expenditures, limiting the number of beds, limiting the number and kinds of doctors and allowing a buildup of waiting lists can have one result: the demoralization of the system, uncertainty regarding objectives and serious inequities.

And who will feel the inequities most? The weak, the less privileged, and the poor, according to Dr. Deutsch. Thus we have the ironic paradox of a minister who presides over the most prestigious and well-heeled system of our time, allowing that system to bring back the very social evils which universally-available health control was supposed to overcome. But let’s come back to how many dollars should be spent. It is fashionable to state, and I’ve just heard it stated by the hon. minister in this House, that health care is an open-ended system which gobbles up an unjust portion of the GNP, or the GPP.

Hon. F. S. Miller: Just a second. I didn’t say those things.

Mr. Godfrey: I retract what I just said. The hon. minister implied them. However, if we look at the GPP over the past few years, we can see that the total health care expenditures and their major components, cost of physician’s services and the total cost of hospital insurance, have a stable trend if measured as a percentage of the GPP and actually the percentage is down over the last two years. I would quote: “In 1971 the Ministry of Health expenditure of the percentage of the GPP was 4.8 per cent. In 1972, 4.6; in 1973, 4.3; in 1974-5, 4.5; and 1975-1976, projected 4.5 per cent.”

I would point out too, that in structuring as he is, the hon. minister is going directly in the face of the recommendations of the Science Council of Canada report number 22 of October 1974, which states:

“So long as waste is eliminated, increasing operating costs should not be regarded with alarm. The objective of publicly supported health services has been to make good health care available to those who were deprived of it. Additional costs required to meet this objective are obviously justified where necessary.”

Let us look at the estimates and we see a preponderance of funds which are to be put into the acute care area. The ministry has for years encouraged doctors to close down their practices in the neighbourhood and to move them into the hospital department. Family practice units have sprung up in all hospitals throughout the country. Yet, suddenly, the ministry finds that this has caused a great increase in the hospital budget. Surprise. Suddenly the hon. minister has found that if you give a doctor unlimited facilities, he will use them in the interest of his patients. Now the ministry is balking at footing the bill for that proposition by reducing budgets.

We can see clearly, already, the results of this inaction in terms of patient care. St. Joseph’s Hospital in Toronto has already indicated it will be requiring everyone to take off 48 hours work without pay over the remainder of the year, which amounts to some 3,000 hospital days of care. Positions in various institutions have not been filled because of budget problems. Indeed, the hospitals have made a magnificent effort to restrain their budgets over the past few years.

Given the problem of remaining within the lower annual increment to the budget, the hospital system of Ontario has responded magnificently, I say again, to the challenge and has been able to reduce capital and operating costs to a significant degree in its attempt to stay within government guidelines. Yet this must now come to an end. It is impossible for these self-same hospitals, which have been built as a result of magnificent effort by Canadian medical teams, to further tighten their operations. If the ministry officials would take

part in hospital budget meetings, they would know what I am talking about.

Recently I was invited to sit in with the medical advisory committee of Wellesley Hospital in Toronto. For three hours, this group of doctors and administrators wrestled with a need for $1.2 million of new equipment for the coming year in order to reduce it to an allowable $300,000.

Time after time the statements were made as significant items of capital expense were turned down: “We will just have to manage another year even if it means reducing the service.” “The equipment is dangerous and should be replaced.” “A coroner’s jury in Sudbury has strongly recommended this item be placed on all gas machines.” It is impossible to continue our level of service and quality in this service with this piece of equipment.”

This group was honestly trying to reduce costs in the same manner they have been attempting to do so over the past few years. This attempt has led to the formation of cost control committees and other sincere efforts on the part of all staff, medical administrative and support services, to save a buck. It has been successful but this is the end of the line. These hospitals simply cannot function any longer on this type of budgeting. The Ministry of Health must realize there is little blood left in the stone walls.

The main criterion which guides the decision to purchase new machinery is: Does it replace an old piece which is now worn out? There is no scope for new ideas, new programmes or new presentations. The hospital system is just managing to carry on what it has done in the past.

One of the areas where we see a paradox in ministerial operations has been in the field of physiotherapy. There is a large core of well-trained physiotherapists in this province who treat patients on prescription from their physicians. At the initiation of the insurance scheme, a certain number of these were permitted to operate private clinics outside the hospital on a fee-for-service basis from the province. This has resulted in incalculable good. In the first place, it relieves the hospital of providing expensive facilities which do not justify the costs of treatment which has been given to the patient.

In addition, it enables the sporting around the community of areas where patients can receive the care given by the physiotherapist without having to travel great distances or in many instances wait in queues in the hospital.

Yet the government has seen fit to hold down the number of insured practices. The amount of service has been limited by refusing to insure the applicants who have asked that their practice be put on an insured basis. This is not a licensing on the part of the government. It amounts to a licence to practise privately. Many of the patients who are seen in these clinics have disabilities which give them difficulty in getting around and can come to a community clinic which can be closer to their home. There is no doubt that physiotherapy care can be given on an outpatient basis in a private area to a greater cost advantage than it can be given in the hospital.

I am aware of the argument that the federals put so much money into it and therefore we don’t have to put it in, but that type of cost accounting is fallacious. Yet in spite of the fact that physiotherapy can be obtained at private practitioners’ offices, the government recently saw fit to authorize the opening of a hospital out-patient clinic at Flemingdon Park in Toronto, which included a provision for physiotherapy services. This physiotherapy outlet was located half a mile from two pre-existing physiotherapy clinics.

Here we have an example of the inability of the government to do reasonable planning inasmuch as they have duplicated services which were already available, amid the duplication is at a much higher cost.

While it is politic for the Ministry of Health to state there are too many acute beds in Toronto, it is wise to look at the waiting list for patients who require that type of care. There are still waiting lists for urgent medical and surgical admissions at all hospitals. On many occasions acute conditions cannot be admitted to hospitals because of bed shortages. The minister fails to realize that an acute hospital system must be geared to take care of the greatest demands in order to protect the health and welfare of the insured. It is not possible to put off sickness or disastrous injury.

However, it is fashionable for him to say there are too many acute beds. Now we have several standing in this and other cities as monuments to that type of ministerial thinking. The Orthopaedic and Arthritic Hospital still has a wing in Toronto which remains unopened. The new Mount Sinai Hospital still cannot open beds. The hospitals in Scarborough still have boxed-in areas and I heard earlier from my colleague, the member for Grey-Bruce (Mr. Sargent) about the Hanover-Hilton.

This type of planning does indeed indicate some loss of direction. There is no point in telling me that we didn’t know this was going to happen. Surely, a Ministry of Health should be able to plan what is going on a few years in advance.

At the same time, the minister continues to permit massive building in other areas in other hospitals in the same area as those hospitals I just mentioned where beds cannot be opened. Sunnybrook Hospital continues a massive expansion as money is poured in, even though the hospital is barely rated at 300 beds. Not half a mile away, Lyndhurst Hospital, a world-famous centre for the care of spinal cord injuries, still cannot open 50 badly-needed beds because of a lack of money.

The result of this is that patients with spinal cord injuries, paraplegic and quadriplegic, cannot be serviced at this excellent centre and are shunted off to chronic homes or convalescent centres where the quality of care is not as good.

Let us now look at the convalescent and chronic bed situation. A survey in Toronto hospitals in 1974 showed hundreds of patients were inappropriately placed in acute beds, rather than chronic or convalescent beds which were required. I note with some pleasure that further chronic and extended care beds have been opened. I believe the total works out to 693 in the province over the past year. But, there is still a four-week waiting period for admission to Queen Elizabeth or Riverdale hospitals -- two of the major centres for convalescent care. This may be even longer, depending upon the type of illness.

Medical science is keeping patients alive for a longer period of time, but this science has not been matched by administrative science which could produce beds in which to nurse these patients.

If you are a patient in a convalescent home, and show improvement, then you are discharged to a nursing home. Nursing home beds are paid for by extended care to the amount of $18.50 a day, but the patient or his family, in some proud Ontario community, is responsible for $5.90 per day for a standard bed, $9.40 for a semi-private, or an additional $12.90 to pay for a private bed.

Thus, if a patient in a chronic centre makes the terrible mistake of showing improvement, then he is discharged to a nursing home with a great financial burden being placed upon his ability or his family’s ability to pay. In this topsy-turvy world of medicare, to show improvement is to be penalized.

In addition to the cost of beds, there are many problems associated with the placement of the patient. Many families are pressed to accept a second or third choice which is far removed from the home and produces subsequent transportation problems -- particularly for the mother of a young family.

But, more than that, there is no real provision in our medical scheme for a man to die with his family. There is an impropriety to a man dying in a chronic nursing care centre. Surely, in our society it would be possible to fund adequately those families who will agree to take the father home and die with the family. Oddly enough, this would constitute a saving if this were done properly. In addition, there are many ethnic groups where it is unconscionable for the family not to be present when a member passed on.

It seems strange that dignity and dying is not matched by the financial considerations which would make it possible. And I am not referring to Extendicare, the home visiting service, to the homemaker service -- I am talking about real help in the family which may simply involve a simple homemaker. This cannot be had -- and if it is had, there are financial strictures on it. You cannot have more than a certain amount of money. The budget is concentrated on acute care, yet has given lip service only to prevention and rehabilitation.

I was really uplifted when I read previous reports as to the emphasis which was going to be put on prevention and rehabilitation in our medical scheme. Let us look at the preventive aspects of our medical scheme. It is obvious that the health horrors of the industrial revolution of the early 19th century, which were conquered and put into proper perspective by a medical care system of that day, are being revisited on us in the 20th century.

Everywhere we see the results of the new industrialization, the contamination of atmosphere, the contamination of our food and drinking water and the breakdown of our psyche by the pressures of modern industrialism. Yet where is our Ministry of Health in the prevention of these problems?

[4:15]

I can tell you this, it’s still in the 19th century. I do not see in the Ministry of Health the employment of any epidemiologist who can look at the basic-core, distinctive knowledge which can be brought to bear in order to put into the practice the principles of preventive medicine. Nowhere is this more apparent than in the failure to prevent adolescent psychological breakdowns which we see in our school system.

This epidemiological approach is an area which the Ministry of Health has studiously ignored. Even the simple matter of gathering basic data or the vectors of disease is ignored. We still do not have occupations registered on a death certificate. There is still no coding of various employment type diseases on our death certificates. What we need is a life-long employment history so that we can look at the epidemiological facts and bring something to bear. In preventative medicine we have a clinical model where there is a doctor-patient relationship, and the art of medicine is applied to this. But there is a certain emphasis here which is not the practice of epidemiology.

The usual direction to the patient in such a situation is to “think clean.” Instead the emphasis should be “disease should never occur”. Epidemiological knowledge can apply to preventive medicine. It should look at each person as a bag-full of possibilities of development of different diseases. That is, to look at the job which has a high or a low risk of contact with this or that disease vector. Having determined that these factors are present, it is then possible for the epidemiologist to recommend the various measures necessary to prevent the disease from occurring.

This happy state of affairs does not exist in our government. Instead, we allow, for example, the asbestos fibre matter to continue; we fail to sell and convince of the tenets of good health. We allow the stultification of the production-line worker to continue, with loss of motivation and subsequent breakdown of mental health.

You will recall, I mentioned earlier that there was to be an emphasis on prevention and rehabilitation. I’ve already pointed out where prevention is inadequate; rehabilitation is equally bad. The same dismal record prevails. There is no prospect for betterment. With the advances in medical care, a shift in the patterns of morbidity has occurred with a pre-eminence of chronic degenerative-state diseases, frequently in older citizens. What has been done to help these citizens return to normal life, to rehabilitate them? I invite the minister to visit chronic centres with me to see the problems.

We won’t talk about cute little remarks made by nursing sisters who sold beds to clear out the corridors.

Let us walk hand in hand through the corridors, looking chronic illness in the eyes, and you tell me that enough is being done to rehabilitate these people. Lack of privacy, lack of care, lack of pride. How dare you reduce budgets to those areas? Oh, you can show me Baycrest in Toronto, an excellent example of the way things could be done in this province. But for every Baycrest, I can show you six homes or chronic institutions where patients are four or five to a room, crowded, degraded, bed-sored, smelly, distant from their friends, homes and families, spending their time in God’s waiting room with 200 or 300 other fellow sufferers.

Is this leadership in rehabilitation? Has the government freed funds to encourage young medical workers to go to these areas? Are those funds sufficient to do the job, or are they sufficient to paint a pleasant facade on these happy houses? And what is the status of the report of the project team on rehabilitation?

As you know, earlier this year it was recommended that the government of Ontario place new emphasis on the planned provision of comprehensive rehabilitation programmes, recognizing the rights of all residents of Ontario to achieve their maximum capacity for living, regardless of the