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June 20, 1986

33rd Parliament, 2nd Session

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Hansard Transcripts

L036 - Fri 20 Jun 1986 / Ven 20 jun 1986

ROYAL ASSENT

BUSINESS OF THE HOUSE

12:43 a.m.

Debate on the motion for third reading of Bill 94,

An Act regulating the Amounts that Persons may Charge for rendering Services that are Insured Services that are Insured Services under the Health Insurance Act.

Individual doctors are aware of this. The values of caring are uppermost in most of their minds and yet they are faced with conflict presented to them by a group said to represent them. The Ontario Medical Association, as a professionally organized group, has become bigger than the membership and with a louder voice than the people it purports to serve. Professions should reflect the values and rules of their memberships. When professionalism becomes a power unto itself, it needs to be evaluated. The public, patients and doctors are right now evaluating the principles and philosophy of health care.

Some doctors are in a dilemma; some are in conflict. We are seeing the paradox of individual ethics versus professionalism. The health care professions are in conflict. The public, however, is caught in a bad position; the patient is in danger of losing access. We have a compassionate minister; a minister who has met with doctors and with the OMA and who has negotiated in good faith. Through a process of 11 formal bargaining sessions, the government made fair process to the doctors to address their concerns but would not put extra billing on the table. Throughout all those good bargaining sessions, no negotiated settlement was reached.

Actions by striking doctors will not force this government to withdraw the bill. We have gone through a lot of debate. The bill was introduced in December, debated in the Legislature and went before the standing committee on social development. The government is listening; we are open to consultation. People spoke to us about the issue before the election. We are now here in government and we are speaking for the people who asked us to speak.

The bill has received support from affiliated nursing organizations, labour, business and women's concerns. Doctors are not the only ones who care about the health of people; we in government do as well. I would also like to draw the attention of the House to the fact that three other provinces have banned extra billing.

We faced well into the myths and the people are behind us. We now know that extra billing will not improve access to health care but that our bill will cement the doctor-patient relationship and not deteriorate it.

Our minister has gone on record as showing the people of Ontario that he cares about shoring up and improving our health care system. We have entered into a review of the health professions. We have introduced assistive devices programs. We have put money into research and development of hospitals. We have taken a look at the function of district health councils and have listened to them. We have looked at drug pricing. We have looked at the needs and care of seniors. We have looked, through the Ministry of Colleges and Universities, at what geriatric schools are all about.

We have taken a good, hard look at the need for cancer research. We can go on and on. We are the social conscience of health care.

[Applause]

Hon. Ms. Munro: Thank you. At least I know you are awake.

The excellent health care system in this province is composed of nurses, cleaners, ward clerks, receptionists, nursing assistants, paramedics and many others. They are not striking. They are not trying to bring health care to an unhealthy stop.

At a town meeting I held in Hamilton last night -- or two nights ago, now -- I was expecting that there would be a real debate about this current problem. I had expected to be faced with doctors protesting or at least with representatives of the doctors. Of the 50 or so people there, there turned out to be two who supported the doctors and neither of them was talking about the end to extra billing. Rather, they talked about the process to end extra billing. It was not the end they were debating, but the means to the end.

I sometimes get the feeling from my colleagues opposite that they are not against the action of this government but against the way this government is acting. I challenge them to come up with a better way to bring health care back to the control of those who are really important: the people. I challenge them to recognize the reality of today's world, the reality of Canadian law and the predominance of Canadian government. I challenge them to end extra billing more equitably.

I do not mean to solve the problem in any other way, such as by negotiating in some form acceptable to the doctors rather than ending extra billing. That is not what the people of Ontario want. I do not mean to solve it by bowing to hardliners within the OMA but by ending extra billing, by not making patients face additional fees when they need treatment.

I have not heard a single reasonable argument from my colleagues opposite. I have heard lots of rhetoric, a good deal of issue-dodging and some rather obviously self-serving statements, but I have not heard an argument for a better way to end extra billing than that proposed in this bill.

12:50 a.m.

This issue is not about doctors' rights; it is about patients' rights. I hear the doctors say that it is not about money but about freedoms. Let me paraphrase one of the people at the town meeting I mentioned earlier. He asked what rights the doctors were giving up. He said that no one was telling them what hours they had to work, when to take a vacation or a day off, when to accept or reject a patient, how hard they can work or how much money they can make. He ended up by asking exactly what rights they are losing. I ask the same question.

Let me cite one example close to me. One member of my staff has just been informed that she has cataracts in both eyes. Her ophthalmologist made an appointment for her with another specialist and asked that she have some blood work done before that appointment. Her doctor and her husband's doctor are not working. Luckily, she has the resources of the health care system within Queen's Park available to her. But what about those who do not have this sort of resource available?

This is a just and reasonable bill. It proposes a just and reasonable end to what I consider an unjust and inequitable ability to bill patients beyond the OHIP benefit package. That package was worked out by previous governments and the medical profession. New packages will be worked out between new governments and new representatives of the medical profession.

I will be supporting this bill tomorrow afternoon or whenever the party opposite finally allows the majority of the members in this House to vote for the bill. I am not voting against doctors; I want to make that perfectly clear. I will be voting in favour of patients. I believe that is all we are talking about here this evening. When we finally vote, the Tories, in their own minds, will be voting for the rights of doctors. We will be voting for the rights of the patients and for the protection of our health care system.

Mr. Ashe: I rise to speak in this debate because I abhor this piece of legislation known as Bill 94. I feel frustrated and hurt about this legislation. Imagine how the doctors, the profession being directly attacked by Bill 94, feel. Imagine a profession, a group of people whose personal feelings are so much the opposite of what they have had to show in the past few days. Their upbringing, their education and even their oath are so foreign to what they have come to in the past number of days that they do not know what to do. As professionals, they are concerned about the future of the best health care system in the world here in Ontario.

We have a government that in the past let on it was one of the parties of the free enterprise system, a party of the people and a party of open government. Yet they come forward with this draconian, socialist legislation. That is what it is. It is down the path to socialism. The people to our left just put their hands together in glee because they have a few more cohorts to go down that path of destruction with them.

I find it unbelievable when I look, for example, in today's Globe and Mail, the Friday edition of the Globe and Mail, and see a few of the things that have happened and are going to happen. The Premier (Mr. Peterson) happened to be down in Ottawa.

Mr. Callahan: What happened?

Mr. Ashe: Some time on Thursday afternoon or whatever -- it must have been something to do with that -- he went down with all confidence that once he got away from Toronto there would be no militancy in the medical profession. They would not even know about it. Those things are unique to downtown Toronto and the greater metropolitan region. That is not the case.

Let me quote a few of the things the doctors have been forced to. Imagine "Screaming Doctors Surround Peterson at Ottawa Hospital." That is foreign to a doctor. That is foreign to his or her whole character. But they have been forced through frustration to get to that.

Imagine. "`You're wrong, David Peterson, you're dead wrong,' one doctor shouted, standing nose-to-nose with the Premier. `You're a tyrant, a gutless tyrant.'"

Mr. Epp: You have not heard your colleagues yet.

Mr. Ashe: We would never refer to one of our colleagues as that. I only quote that, Mr. Speaker, as I am sure you appreciate. I might call him a tyrant but I would not use the other word. I would not go that far.

Hon. Mr. Bradley: I heard "pigheaded" today.

Mr. Ashe: That is probably a good word too.

Mr. Stevenson: We are trying to think of the nicest things we can think of but it is difficult.

Mr. Ashe: Dr. Charles Shaver, the president of the Ottawa Academy of Medicine, was saying, "I feel the doctors have just been sledgehammered." Dr. Railton, the Ontario Medical Association president, "has already said the doctors will not end their strike just because the bill to ban extra billing is pursued." But the Minister of Health (Mr. Elston) "said yesterday that he does not believe the government will have to introduce back-to-work legislation and that passage of the law will `help end the stress on the system.'"

The stresses on the system are there but they have been caused exclusively by this government, supported by the little group on our left that has the indicated support -- at least it did in May of last year -- of 24 per cent of the population of Ontario. It is slipping quickly.

"Dr. Shaver said that if Mr. Peterson thinks doctors will call off the strike after the bill is passed, he and his government are dead wrong.

"`He's sadly mistaken,' confirmed Dr. John Kindle, a general practitioner at the Riverside Hospital," which is also in Ottawa. "The unity of this profession is so solid that the doctors won't return to work."

I think the Premier is getting a little edgy. Members heard me a few moments ago say what the Minister of Health is saying, that once the bill is passed it will "help end the stress on the system." But the Premier this afternoon "conceded that he was not confident that the strike would end with enactment of the legislation." Perhaps they should confer a little more often. I am speaking about the minister and the Premier.

Mr. Ward: The editorial is on page 6.

Mr. Reycraft: Turn to the editorial; page 6.

Mr. Callahan: Read the good stuff.

Mr. Ashe: That is all right. We will get to some others as well in the paper.

Mr. Callahan: Read to us from the Toronto Sun. That will be all bad.

Mr. Ashe: No, I happen to be going to page 13. To date, pretty well all the job action in the hospital context has been in nonteaching hospitals. What have we got now? What is the headline on "Doctors' Strike -- Day 9"? Mount Sinai, a very well respected and highly respected teaching hospital, associated of course with the University of Toronto -- and let me again point out something --

An hon. member: On a point of order, Mr. Speaker: The honourable member is reading a speech and I know that is an infraction of the rules.

Mr. O'Connor: You are not in your right seat.

Mr. Gillies: On a point of order, Mr. Speaker: The Attorney General (Mr. Scott) was clearly out of order with his interjection as he was not sitting in his seat, which is an infraction of the rules and customs of the House. The Attorney General was clearly out of order.

The Acting Speaker (Mr. Morin): I agree.

An hon. member: No, he is supposed to stand. I thought all members were supposed to stand, not sit in their seats.

Mr. Ward: On a point of order, Mr. Speaker: It is my understanding that all interjections are out of order. Is that not correct?

The Acting Speaker: Yes.

Mr. Ward: Then what difference does it make if one is in one's seat?

1 a.m.

Mr. Ashe: The impression is given by some of the members -- I think it is believed particularly by some of the members to the left when they put it out; I do not honestly think it is believed by many of the government members when they are forced to put it out -- that all doctors who extra bill, or all specialists, charge the system as much as it can handle.

Let me get back again to Mount Sinai, which is a highly respected teaching hospital. Because the majority of doctors in U of T teaching hospitals volunteer their teaching services, Dr. Lowy said the university is powerless if doctors decide to withdraw those services.

"Dr. Jack Brandes, a psychiatrist at Mount Sinai, said that the doctors at the hospital feel no dedication to a university that is `in the back pocket of the government.' He said that some doctors are paid as little as $108 a year to teach at U of T."

This is the major point: "If doctors are faced with sitting back while the entire medical system is being ruined, they will tell the dean and the assistant deans sitting in their ivory towers to take a flying hike."

It is hard to believe that a profession that is so well regarded and so professional can get to the kind of frustrating situation where they have to resort to this kind of change in ideology and this kind of verbiage. It is unbelievable, but it is happening.

Earlier today we heard the leader of the third party refer to a medical situation out in Durham. I have the honour to represent part of that region. Something in the order of one per cent of the doctors who practise in Durham region are opted out, which means --

Interjections.

The Acting Speaker: Please ignore the interjections.

Mr. Ashe: It happens to be a grand total of two, and I am guesstimating that we probably have something in the order of 200 doctors out there. I do not know if that is accurate. I am sure there are at least 200. We have an area where, if we go by some of the rhetoric that has been put out, it is only these doctors who are concerned about putting more dollars into their pockets and taking them out of everyone else's pockets. One per cent of the doctors in Durham extra bill; they are uptight. They are not uptight about their pocketbooks because it does not mean a thing.

They are concerned about the health care system in Ontario. They are concerned about the health care system in Durham. That is why they are extremely upset.

This morning doctors were speaking to people boarding the GO trains. They were giving literature to people getting on the GO train at Pickering. That is hard to believe but it is fact. We have all done that -- that is among the duties of a politician -- at certain times in our careers when we call elections, but doctors should not have to do it if they had any kind of communication with the government that supposedly reports back to the people, that supposedly represents the people.

It has let a situation that it perceived by its polling to be 80 to 90 per cent in its favour, back when it flip-flopped its position two years ago, slide to a minority position. Even at this time, unfortunately, an awful lot of people do not really understand the issue. They have let it slip, through mismanagement, down to the situation we are now in.

The leader of the third party again made reference to Dr. Atkinson out in Durham. I might quote further reference by that doctor, who happens to be the president of the OMA in Durham region. She is a highly respected medical doctor who operates in the town of Ajax, within my constituency.

"Dr. Atkinson added yesterday in an interview that the Durham Medical Society had presented and passed a resolution that if Bill 94 is passed by the Legislature, `we would withdraw all services.'"

I know this doctor. She is a very responsible doctor, but she and her colleagues are so frustrated, not about their own concerns but about how people can come forth with the diatribe that they have and create a situation that was not needed. There was a small problem, and they used a cannon to kill a fly. That is what Bill 94 is. The socialists have led the government down the path by the tail.

Mr. Foulds: Is the member calling the OMA a fly? Is he insulting the OMA? Shame on him.

The Acting Speaker: Order.

Mr. Ashe: The member would not know the difference anyway.

The whole presumption of Bill 94, and even going back to the well-conceived but poorly legislated Canada Health Act -- and I blame all political parties for that; so I say it in a nonpolitical sense. I would think we would agree that legislation drafted in haste is sometimes not the best legislation. We have all been party to that. Governments yesterday, today and tomorrow will introduce legislation that requires amendment. Sometimes they are able to amend it before it is passed and sometimes it is done afterward.

A few pieces come to mind that probably were passed in haste, which we now regret and where we see changes that should be made. Obviously, the Canada Health Act falls into that category, as does the Young Offenders Act and the spills bill. I could go on with examples of well-conceived and good-intentioned legislation that required change.

The presumption is that by banning the relationship of a patient with his doctor one makes the system more accessible. The presumption is that in the long run the quality of the health care system is raised and the cost of the system is lowered. The results of Bill 94 will be exactly the opposite. The system will ultimately become less accessible to many qualified doctors.

Mr. Foulds: The member could speak all night on what he does not know.

Mr. Ashe: I certainly can speak all night on what the member for Port Arthur does not know. There is no doubt about that. That would be very easy. As a matter of fact, we could carry on a filibuster to the end of the summer.

The Acting Speaker: Order. Please address your remarks to the chair and ignore the interjections.

Mr. Ashe: Anyone who has had occasion recently to go into most doctors' offices will have seen a sign that is very appropriate. I did not write down the exact words, so I paraphrase. Some of my words may be slightly different, but the idea is the same.

Mr. Foulds: What is wrong? Can the member not write?

Mr. Ashe: I did not write it down. I have other things to do.

Basically, it is asking whether people want the organization that runs the post office to run the health care system. Members should think about the organization that runs the efficient post office running the medical system. In that case, I sure would not want to be lying --

Mr. Eves: "If you like the post office, you'll love government health services."

Mr. Ashe: That is exactly it. If they like the post office, they will sure like the government running the health care system.

In closing -- I did not intend to be this long --

Mr. Foulds: Hear, hear.

Mr. Ashe: We know they are alive over there from time to time, and that is a step in the right direction. Sometimes I wonder, with their philosophy, whether they are alive or whether they are in a different century.

1:10 a.m.

I want to give members one other example of frustration. In this case, it is not a personal frustration of mine. It is not about a doctor or anybody working in the health care system. I had a legitimate call today, among one of many but this one frankly rather touched me. It was from a female constituent in my riding who phoned and indicated -- I was not in the office -- that she wanted to hear from me urgently.

Upon returning from the Legislature this afternoon, I called her back. This is a concerned citizen of Canada, a concerned citizen of Ontario and a concerned citizen who happens to live in the constituency of Durham West. She is not associated directly or indirectly with the medical profession. She is so personally frustrated and hurt by the implications of Bill 94 and the future, as she sees it, that she is threatening to leave the province.

Can members imagine anybody feeling that badly about the impending disaster being imposed upon a province and a great system by an uncaring, unfeeling government? That is exactly what is happening in Bill 94.

Interjections.

The Acting Speaker: Order.

Mr. Ashe: The last thing that leaves us all a little concerned is that numerous times over the past few weeks, and particularly over the past week, we have heard a series of questions over and over about why the Premier did not appoint a mediator. We know what his non-answer was all the time; that is not really my point right now.

My point is that if the government and Premier felt so secure about their position on Bill 94 and so confident they were doing the right thing, why would they be so concerned about having a mediator, a third party, someone remote from both systems, to look at it to confirm that they were right?

It is because of their concern that that mediator would say: "Hey, you guys, you are not going the right way. There is disaster at the end of this. We suggest you do this and this and this." They would be backed into the corner. At least they would try to get out of the corner they had backed themselves into.

Bill 94 is not conducive to the future health of members and myself, their children, my children and our grandchildren. Again, it is draconian legislation.

Mr. Breaugh: It has been my displeasure to know the member for Durham West (Mr. Ashe) for some 13 years now. He remains consistent. He has the uncanny ability to alienate people, even when there is a faint chance they might agree with him. I give him that much.

He mentioned a couple of things in his ramble tonight that I would like to comment on and perhaps hear a response from him later on. I do not know who has done it, but someone clearly has distorted the truth. Someone clearly has told doctors, who are normally reasonable people, some untruths about this bill. Doctors whom I have talked to are quite amazed to find the bill is about six sections long. Somehow they have been led to believe this is a very comprehensive piece of legislation. It is not; it is simple and straightforward. It talks about one item: extra billing.

The doctor my friend mentioned in his comments made the remark that she felt her job now would be to sit on the curb and watch the ambulance roll up to the front door and the funeral director roll out the back door. That is not the truth. I am sure that if that doctor were informed about the bill, she would not make comments such as that about this legislation. It has nothing to do with that and she would be aware of that if, in calmer moments, she would reflect on that.

Finally, I am saddened somewhat in that I thought by 12:30 tonight at the latest the member for Oxford (Mr. Treleaven) would be on. I have been misled. I am now here because I wanted to hear a six-hour speech by the member for Oxford. I do not know why his seatmates will not let him speak, but I want him freed now.

Hon. Mr. Scott: I want to join with the member who spoke last in expressing the disappointment of many on these benches that the member for Oxford has not begun. My duty here freed me at 11 o'clock. I was told that it would be only moments before he began and that I should stay.

The Acting Speaker: You must address your remarks --

Hon. Mr. Scott: Yes. I am coming to the honourable member who interrupted the potential for hearing the member for Oxford. I hope there will not be a moment's delay before the member for Oxford rises to his feet and entertains us.

As to the member who spoke last, he warned us about the dangers of socialism. Of course, it is a matter to which all right-thinking people must direct a great deal of attention and concern. The onset of creeping socialism in this province has been so slow that if we began to devote some mild interest to it in about the year 2020 it would not be too late to avert the risk the member referred to.

While we are on the subject of creeping socialism, it has been brought to my attention by the cabinet historian, the member for Renfrew North (Mr. Conway), that the member speaking was Minister of Energy during the time when the last government purchased Suncor shares. It is hard to imagine a more profound example of the evils of socialism and the evils of bad business management rolled into one. I want the member in his two-minute reply at least to begin a rationalization for what has to be one of the great mistakes of the past decade.

Mr. Charlton: I assure the Attorney General that I will not unduly delay the member for Oxford. I must make a few comments about the analogies used by the member for Durham West when he tried to compare the post office to this government running the health care system. This government also runs nuclear power stations in Ontario. If they are as inefficient as the member implies, the health care system is probably not going to make a whole lot of difference to us in the long run.

The government we are talking about also runs the ambulance services in the province. If they are as bad as the member for Durham West implies, then the health care system is going to have a very limited impact, at least in serious emergency cases, in dealing with the health care needs of the people of Ontario. That is if this government is as incapable of providing direction as the member for Durham West implies.

Mr. Callahan: I am waiting in great abeyance with the Attorney General. I rushed here from the beautiful city of Brampton to hear the member for Oxford speak, expecting to walk into the chamber and find all the material he had walked in with was being rhymed off.

To address the speech of the member for Durham West, when he referred to the New Democratic Party there was a real shrill in his voice. I got the impression a socialist was someone he could not possibly stand. Then he proceeded to do another thing that really angered me. He read from the Globe and Mail. He has deprived me of the opportunity to savour that paper tomorrow with my coffee. I would have thought, listening to what appears to be the very right-wing approach to this whole issue, he would have quoted from the Sun, not from the Globe and Mail.

1:20 a.m.

Mr. Foulds: It is not published yet. There is no early edition of the Sun.

Mr. Callahan: Is that right?

I must comment seriously on one item. The member does not seem to pick up on the issue that one cannot negotiate something when there is one person here and one person there and neither is prepared to change his position. Negotiation requires some type of accommodation.

I have watched the member and his revered leader on numerous occasions, constantly asking the same question from photostat copies of questions and getting the same answer, but for some strange reason they were not able to understand it; either that, or they were giving the doctors a false message. It has to be one or the other.

I figure we will hear in the next couple of speeches, particularly when we hear from that good, honest gentleman the member for Oxford, that the member was just fooling the doctors.

Mr. Ashe: The member and all those who have been waiting will be happy to know our next speaker is the member for Oxford.

There are a great number of points to cover, and I do not know whether I can do them all in the time. The first is the obviously incorrect reference to my capacity in the past cabinet as the Minister of Energy when the Suncor window-of-opportunity purchase was made.

Mr. Breaugh: You socialist dog, you.

Hon. Mr. Scott: You should have put curtains on it.

Mr. Ashe: No doubt many did not think it was the best investment at the time.

Mr. Breaugh: Name names.

Interjections.

The Acting Speaker: Order.

Mr. Ashe: Contrary to the belief of the present Minister of Education (Mr. Conway), I was not the Minister of Energy at the time. As I recall, the Deputy Premier at the time was also the Minister of Energy.

Mr. Foulds: You did not sell it when you were the minister, you socialist. You hung on to it.

The Acting Speaker: Order.

Mr. Ashe: The member for Hamilton Mountain (Mr. Charlton) made an analogy to nuclear power. I am being very consistent. He may recall that during our many deliberations over numerous years in the select committee, I always indicated one of the reasons Ontario Hydro has such a worldwide reputation was that the day-to-day operations are not controlled by the government, as another government tries to control the post office. That is probably why Ontario Hydro is efficient and the post office is not.

As for the member for Brampton (Mr. Callahan), if I had known he could read, I would have left him the full opportunity to read the first copy of the Globe and Mail tomorrow.

Mr. Gillies: Mr. Speaker, on a point of order: I wonder if I might have the pleasant duty of introducing our guest speaker this evening.

Hon. Mr. Scott: Mr. Speaker, on a point of order: We have reached the point in the program to which all members have been looking forward all evening and this morning. Bearing in mind the importance of this address, is it an infraction of the rules that the honourable member might be invited to speak from a seat other than his own so that we can all get the full benefit of his remarks? To speak from behind a pillar, as he is now doing, is very unfair.

Mr. Treleaven: No. I have prepared the table before me and will therefore speak from here.

Interjections.

The Acting Speaker: Order.

Hon. Mr. Sorbara: Mr. Speaker, on a point of order: I would like to take this opportunity to thank the member for Oxford for his speech.

Mr. Treleaven: After my initial comments, as an outline of what I am going to do, I think the people in this chamber should imagine a little man with a green eye-shade and shirtsleeves and garters on his biceps poring over

definitions in various statutes. If members picture that, they will not be disappointed in my comments. However, if they think of anything more exciting than that, they will be disappointed.

This is perhaps heresy. During the next little while, I may be castigating the Minister of Health (Mr. Elston) and the Minister of Community and Social Services (Mr. Sweeney).

Mr. Ramsay: And Bill 30, I will bet.

Mr. Treleaven: No; but I do want to say, and this is where the heresy comes in, that as I castigate a couple of ministries, this is one of those darts-and-laurels things. The darts go to those two ministries and their ministers, but at this point I do want to acknowledge publicly two ministers and their ministries who have been very helpful to me during the past year.

The first is the Minister of Transportation and Communications (Mr. Fulton) and his ministry. The second, I am glad to say, is the Attorney General (Mr. Scott). Both of these ministers have been extremely helpful to Oxford, just as the Ministry of Health and the Ministry of Community and Social Services have been unhelpful.

In fact, tonight the Attorney General personally delivered across the chamber a reply to my letter of June 3. The minister behind him, the Minister of Labour (Mr. Wrye), takes four months and six days to get the average reply just acknowledging a request. The Attorney General gives a reply in two weeks.

Mr. Martel: On a point of order, Mr. Speaker: Would you be prepared to tell me just what this has to do with the bill we are debating? To my knowledge, something about the Attorney General has nothing to do with the bill before the Legislature dealing with the Ministry of Health. If the member wants to talk about that bill, I am prepared to listen; but if he is going to talk about everything else, then we are in deep trouble, and I am not listening.

The Acting Speaker: Order. I appreciate that it is 1:30 in the morning and you must do something to keep yourselves awake. On the other hand, I am very much awake here. You must give the member for Oxford a chance.

Mr. Martel: He is not talking about the bill.

The Acting Speaker: Order.

Mr. Treleaven: I was down in my office trying to get a snooze from about 8:30 until 10:30. I was wrapped in a blanket that has dog hair on it; I got it from my car. It was all I could do to cover myself.

Mr. Sterling: On a point of order, Mr. Speaker: I have to agree with the member for Sudbury East (Mr. Martel). I do not know what a dog-haired blanket has to do with Bill 94.

Mr. Gillies: On a point of order, Mr. Speaker: By extension, what does a dog-hair-covered blanket have to do with the Attorney General?

Mr. Treleaven: I was listening on the squawk-box in my office. I listened to the member for Sarnia (Mr. Brandt) speaking on this bill. He was very noisy over the squawk-box, and I could not get to sleep while he was on. Then the member for Oshawa (Mr. Breaugh) took his two minutes just as I was nodding off, and I was awake again.

1:30 a.m.

Then the member for Brock (Mr. Partington) came along. I have never heard him so excited. On and on. The member for Lakeshore (Mrs. Grier) was upset with the member for Brock, who could not seem to understand. Then the member for Mississauga East (Mr. Gregory) got really cross with her because she could not understand him, and the member for Beaches-Woodbine (Ms. Bryden) was very disappointed in them both.

I hope my comments tonight are more erudite, as my friend the member for Wentworth (Mr. Dean) --

Hon. Mr. Scott: The member means more draconian.

Mr. Treleaven: No, later I also have "draconian" many times, but I believe "erudite" was a reference to the Attorney General. The member for St. David (Mr. Scott) had used some non sequiturs when he was talking about extra billing. I must deal with that. He was accused by one of the other members of talking about billing under legal aid. Perhaps the Attorney General has not and does not bill under legal aid. However, he was stating it is illegal to "extra bill" under legal aid.

Where the non sequitur comes in is that those who bill according to legal aid when a client has a legal aid certificate have to adhere to the law society's fee schedule. However, for those who bill outside the legal aid system, i.e. , virtually all the clients of the Attorney General in private practice, it would be at whatever fees they wish to charge those clients.

He mentioned in his speech a little while ago that be had the Ontario Medical Association as a client. I am sure the OMA does not qualify for a legal aid certificate. Therefore, I am certain the fee of the then solicitor for the OMA would have been "extra billed," i.e., not according to any tariff. Therefore, in the legal profession there is a two-tier system. I want to point out this two-tier legal fee system the Attorney General was trying to deflect.

He also asked various members, such as the member for Mississauga East, "Do you believe in extra billing?" He asked several others, who answered him very clearly, and I should anticipate that by saying that since doctors are small businessmen, as are solicitors, they should have the same rights as other small businessmen. They have businesses to run, employees to pay, rent, car expenses, black bags to buy and replace, etc. They are small businessmen. They should have the same rights as other small businessmen to bill on the free market in their offices.

I am not speaking about while they are in a hospital, which is a publicly owned and supported institution. In their offices they should be small businessmen the same as the shoe dealer, etc.

Mr. Breaugh: Are you saying a doctor is the same as a shoe dealer?

Mr. Treleaven: The same as a shoe dealer, a clothier or a lawyer, they are small businessmen, and they should be treated as such.

Hon. Mr. Sorbara: Can I sell the member a transplant?

Mr. Treleaven: They are businessmen. When he was in private practice, I am certain if his client had asked the member for St. David ahead of time, "What will your fee be?" he would have told them upon what basis he was going to charge his fee. If they did not ask, at the end he would still add up his time, etc., and would then charge a fair fee based upon his time, his experience and the overhead of his "business."

Hon. Mr. Sorbara: I think that is being very fair.

Mr. Treleaven: I am sure the Attorney General was most fair as he considered his account, as most solicitors are.

We are on third reading, and the third reading debate is why Bill 94 should not be read a third time. There are many reasons.

By the way, as the Attorney General is leaving, I mentioned the little man in the green eye-shade. The reason he should picture that in his mind is because approximately one third of my talk is a comparison of

definitions in different acts. He would like that. He would appreciate it, as the other solicitors here would, but it is not the highest form of entertainment. I know he intends to leave, and I just want to leave the word picture in his mind of why he is happy to escape, as is the Minister of Skills Development (Mr. Sorbara).

Hon. Mr. Scott: Actually, I am going to a meeting.

Hon. Mr. Sorbara: But this is very good.

Mr. Treleaven: Someone asked me if he had time to go home for a nap and he lives near Hamilton. Yes, and he can get back and I will still be here to greet him.

Bill 94 should not receive third reading because it has many inconsistencies in it. For example, let us look at the definition of "practitioner." This is just an example. I am going to give a few examples as I go through, a thumbnail sketch of what I will be dealing with in more detail later. I do not know why the place seems to be clearing out. Is it something I have said?

Hon. Mr. Bradley: John Williams used to do this.

The Acting Speaker: Relate to your topic, please.

Mr. Treleaven: Let us deal first with the definition of "practitioner" in

section 1 of Bill 94. That is an amendment that just got in under the wire. When we look at the other amendments that were made latterly by the Minister of Health today, in the

definitions added to

section 1, if we look under the definition of "board," it means "the Health Services Appeal Board under the Health Insurance Act."

Moving down to "general manager," it means "the general manager appointed under

section 4 of the Health Insurance Act." When you get down to "practitioner," it is defined as meaning "a physician, an optometrist or a dentist." The member for Kitchener (Mr. D. R. Cooke) is a solicitor. I thought he would find this enthralling.

Mr. D. R. Cooke: I was going to go and get my own glass of water because there are no pages here.

Mr. Treleaven: I can understand that. It may be dry and the member may be --

The Acting Speaker: Order.

Mr. Treleaven: Yes, Mr. Speaker. The definition of "practitioner" says it means "a physician, an optometrist or a dentist." Why does that definition not refer to the Health Insurance Act as do the

definitions of "board" and "general manager"? If we look at the Health Insurance Act for that definition, it is different.

This is one of the inconsistencies and a reason that this bill should not receive third reading and why it should be amended. Instead of this closure motion, we should have reverted back to committee of the whole House or back to the standing committee, so the people could come in and discuss the bill as we now have it amended, which makes it a tremendously different bill than it was originally.

Let us look at the definition of "practitioner" under the Health Insurance Act: "`practitioner' means a person other than a physician who is lawfully entitled to render insured services in a place where they are rendered." How can we have the Health Insurance Act governing Bill 94? How can one law control the other and have a different definition of the same word?

A practitioner includes a physician under one law and does not include a physician under the other. A physician is defined separately under the Health Insurance Act. That is one example. The Canada Health Act is also inconsistent. Bill 94 defines a practitioner differently from the Health Insurance Act and the Canada Health Act.

1:40 a.m.

If we look at the Canada Health Act which provides the entire reason for Bill 94, which is to try to get money from and through what is governed by the Canada Health Act, and then look for the definition of practitioner, we cannot find it. One finds "health care practitioner." It means "a person lawfully entitled under the laws of the province to provide health services in the place in which the services are provided to that person."

Mr. Polsinelli: Look up the definition of draconian.

Mr. Treleaven: Draconian comes later. I do not have the definition for that. I am sure it is in none of the statutes I have in front of me or that I have dealt with.

In coming to the definition of medical practitioner, which is contemplated by practitioner, one sees under the amendment to

section 1 of Bill 94, it means a physician, etc. Yet medical practitioner means "a person lawfully entitled to practice medicine in the place in which the practice is carried on by that person." That is not physician. That is under the Canada Health Act.

This will get much clearer as I proceed. Another example of where this act, Bill 94, is inconsistent and should be amended is the term "unauthorized payment." If one looks at the words "unauthorized payment" which is a new section, again brought in this afternoon into this act as one of the added

section 1 definition amendments, "`unauthorized payment' means the amount of money by which the amount a practitioner has charged and been paid for rendering an insured service to an insured person" -- the emphasis is on insured person -- "exceeds the amount payable under the plan for rendering that service to that insured person."

Mr. Sterling: I would like to ask the speaker a question and I believe it is permissible under the standing orders.

The Acting Speaker: Is it a point of order?

Mr. Treleaven: I think he is trying to ask if I will yield the floor for a question. I will yield the floor only for a question.

Mr. Martel: That is not in order.

Mr. Sterling: He can do that. He can yield the floor and allow me to ask a question.

He has to agree to yield the floor.

Mr. Polsinelli: On a point of order: I believe the rules of procedure of this House were changed a short while ago permitting members to ask questions after the previous speaker, particularly for this type of situation. I have read through the standing orders and I do not see any part of the standing orders that allow this type of procedure.

Mr. Harris: On a point of order: I believe it is in the standing orders. It is my understanding from my thorough examination of them, that if the speaker agrees to yield for a question, that is in order.

The Acting Speaker: Thank you for helping me.

Mr. Breaugh: On a point of order, Mr. Speaker: I think you will find as you go through our standing orders that precise rule is not written, but I am sure the Speaker will be aware that it is a long-standing tradition at Westminster for members to yield the floor briefly for a question. It is a great and venerable tradition and one that obviously should be done when a member is in real trouble. We have a member in real trouble. He should be prepared to yield for almost anything.

Mr. Sterling: I was going to ask the member for Oxford why he was reading all these

definitions and whether he could explain the thrust of what he is doing in a brief overview and then go into the particular

definitions.

Mr. Treleaven: The overall thrust of what I am doing to you is pretty obvious.

The overall thrust is to show a couple of brief examples -- I am just starting through --

Mr. Breaugh: Take your time. There is no need to rush.

Mr. Treleaven: Yes -- of the inconsistencies in the

definitions: improper draftsmanship, mistakes.

The member for Durham West (Mr. Ashe), who is yawning right now, stated that we in this chamber, being human, sometimes do act in haste. We do pass statutes in haste. That is what has happened here. Again, the member for Durham West was correct. We have passed this in haste. It has been drawn up in haste by the ministry, and therefore there are gaps in the

definitions.

When I was reading the definition of "unauthorized payment," as the addition which went into the bill yesterday afternoon, I emphasized with my voice the words "insured person." This is incomplete. There are people in this province who are not insured persons, who do not have the Ontario health insurance plan.

I can give you an example: the old order Mennonites. There are a good number of them in Oxford county. There are a good number in Huron-Bruce, the riding of the Minister of Health, around the Lucknow area. There are others in the Peterborough-Madoc area. They are all related, basically, to the people in Oxford county. Oxford, Elgin, the east side of Middlesex county, Norfolk -- all these areas have these people.

They pay taxes, but they do not vote. They do not have health insurance of any kind. They do not have fire insurance unless a mortgage requires it. They do not believe in that, and if someone is injured they pay cash at the hospital for the doctor, etc. Therefore, if one takes this "unauthorized payment" and looks at "insured person," one has a problem with Bill

Section 2, for example, the operative

section of Bill 94, deals with opted-out physicians, etc.

Section 2 of Bill 94

Mr. Sterling: On a point of order: The member for Yorkview (Mr. Polsinelli) was asking the speaker before the member for Oxford the definition of "draconian." Just to help the debate, I want him to know it is the colouring matter in a dragon's blood.

Mr. Polsinelli: It is what?

Mr. Sterling: The colouring matter in a dragon's blood.

Mr. Polsinelli: What piece of legislation does that refer to?

The Acting Speaker: Order.

Mr. Sterling: The member asked the question.

Mr. Treleaven: The opting-out section,

section 2 of Bill 94, states: "A physician or an optometrist who does not submit his or her accounts directly to the plan under

section 21 or 22 of the Health Insurance Act or a dentist shall not charge more or accept payment for more than the amount payable under the plan for rendering an insured service to an insured person."

1:50 a.m.

In other words, it says that a doctor who does not accept OHIP, who does not bill through OHIP; i.e., he bills his patients directly, cannot charge more than OHIP rates to an insured person. But what about a person who is not insured? A doctor can, therefore, render an account to a person who is not insured and he is not caught by

section 2. Therefore, we have a gap in this statute.

One can have at least three types of doctors: those who bill OHIP for insured persons under the act; those who are opted out and who bill insured persons; and the third kind of doctor, physician, optometrist or dentist who bills a non-insured person. He can bill any amount he wants. He is not governed and does not fall within

section 2, and this is a gap within the act.

The member for Yorkview is scrambling madly at his act, and I am sure he will find

section 2 of Bill 94

Mr. Polsinelli: The member is misinterpreting.

Mr. Treleaven: I am sure I am not misinterpreting it. An insured person is a person who is insured under OHIP.

Mr. Martel: On a point of order: I have listened for some time now to this diatribe. Erskine May, the authority on parliamentary procedure, on page 576 says:

"The amendments that may be moved to the question for the third reading of a bill follow the same pattern as those that may be moved on second reading; and the provisions of SO No. 41 concerning the questions to be proposed on such amendments apply equally to second and third reading. Debate on third reading, however, is more restricted than at the earlier stage, being limited to the contents of the bill;..."

It has nothing to do with the office of the Attorney General. It has nothing to do with the Mennonites. It has to do with the content of the bill which is before the Legislature.

I am not prepared to listen all night to this drivel which has nothing to do with Bill 94 unless he is going to deal with what it says in Erskine May: "Debate on third reading, however, is more restricted than at the earlier stage, being limited to the contents of the bill; and reasoned amendments" which might have arisen.

Mr. Speaker, I ask you to apply the rules as under Erskine May

The Acting Speaker: Order. The member's point is very well made. On the other hand, I wanted to give my honourable colleague a chance to warm up. I am sure that shortly he will direct his remarks towards the topic, which is Bill 94. He will.

Mr. Martel: On a point of order: I do not want to cause any kind of kerfuffle, but he has been warming up now for some half hour. It is drivel, it does not deal with the content of the bill and when we get to third reading, as Erskine May says, one must deal in a more restricted fashion than one does on second reading, which is pretty wide and free-wheeling.

Here it is very concise. One must deal with that sort of presentation that has been put forth by Erskine May. The member is dealing with everything else but the bill. I am tired of waiting for him to get to whatever you think he might get to some time in the near future, Mr. Speaker.

The Acting Speaker: The member has made his point.

Mr. Polsinelli: On the same point of order and in defence of my colleague the member for Oxford: The past few minutes when he was talking about the Mennonites related directly to the bill in the sense that the member was submitting that there is a gap in the bill. His proposition is that a doctor could bill a Mennonite more than he could bill an insured person. I submit that, while he was on topic, he was misinterpreting

section 2, and that is not the case.

The Acting Speaker: Would the member please resume his seat.

Mr. Martel: There is no clause-by-clause discussion on third reading. He may speak to the principle of the bill, but this is not a clause-by-clause, section-by-section debate. He should have done that in committee. This should deal with the principle and we should not have to listen to that drivel all night.

Mr. Gillies: On the point of order: In fairness to my colleague the member for Oxford, I think our

interpretation in this House has been that speeches on the principle of a bill are fairly wide-ranging. How can one tell after merely half an hour of a speech whether it is going to turn into drivel?

Mr. Treleaven: To assist, I must agree with the member for Yorkview that I am dealing directly with

section 2 of Bill 94. How can one possibly --

Mr. Martel: On a point of order: We are not dealing with a clause-by-clause debate on third reading. That is where my friend is wrong. That is why I ask that you bring him to order, Mr. Speaker. If he wants to talk about the principle of the bill, fine, but this is not a clause-by-clause debate.

Mr. Sterling: On a point of order: A few moments ago the member for Oxford yielded the floor to me to allow me to ask a question. I asked him for the thrust of his arguments in dealing with the

definitions of the bill. He answered that he was showing the inconsistencies involved in the

definitions of the bill. That has a large bearing on whether we should pass this on third reading.

Mr. Polsinelli: On the same point of order: The member for Oxford is dealing with a fundamental principle of this bill. The fundamental principle is that no one in Ontario should have to pay more for medical services than what is paid by OHIP. In his argument, he indicated that there was a possibility of a gap in the bill and that certain segments would have to pay more. In fact, he was mistaken.

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

Mr. Polsinelli: It was on the point.

Mr. Treleaven: With help like that, I do not need --

The Acting Speaker: Order.

Mr. Martel: May I quote Erskine May again?

The Acting Speaker: Please resume your seat. Will the member for Oxford make sure he sticks to Bill 94 and please stop raising the ire of his colleagues.

Mr. Treleaven: It takes very little to raise the ire of the member for Sudbury East. However, if the member for Sudbury East will read further on that page of Erskine May -- he may have a many years old edition. One cannot make amendments on third reading. Only in the House of Commons do they still make amendments on third readings.

2 a.m.

Mr. Martel: On a point of privilege: At no time did I talk about the member making amendments. I am talking about the debate. I quoted the entire paragraph, which in itself dealt partially with amendments. I am simply saying the member must deal with the principle of the bill.

On third reading, the debate is much more restricted than on second reading, which allows one to wander pretty freely and easily. The Speaker has ruled in this Legislature on more than one occasion that we cannot deal with clause-by-clause in second reading; that is done at the committee of the whole House stage. If my friend the new and learned member would only read Erskine May once in a while, he might understand it is not a clause-by-clause debate; it is a debate on the principle of the bill. He should try reading it. He is dealing with clause-by-clause and

definitions, and that is out.

Hon. Mr. Curling: On a point of privilege, Mr. Speaker: I was just getting the drift of the drivel, and this member interrupted me. I want to see where the drivel is going to lead. It is my privilege to let him continue so I can find out where the drivel is leading.

Mr. Treleaven: The member for Sudbury East is quite correct. It says we must be more closely restricted on third reading than on second reading. Second reading is on the principle of the bill. Third reading is on the bill as amended at this point. The question is, should the bill be given third reading? I am stating why Bill 94 should not receive third reading. That is straight out of Beauchesne and Erskine May. I am adhering strictly to the bill as amended.

Section 2 is part of the original bill.

Mr. Martel: On a point of order, Mr. Speaker: It is not a clause-by-clause debate, and you have to rule on that, sir. He is attempting to deal with the bill clause by clause, and that is not a third reading debate. I ask you to bring him back to order and make him talk about the principle of the bill. I am prepared to listen to that, but I am not prepared to listen to a clause-by-clause debate. That belongs in committee of the whole, even if my friend the member for Yorkview cannot read.

Mr. Sterling: In defence of the member for Oxford, he is not dealing with it on a clause-by-clause basis. He is comparing the clauses, how they interact with each other and how they interact with some federal legislation.

The

definitions in the Canada Health Act as opposed to those in Bill 94 are very important, because they interact with each other. If the member for Sudbury East had been here for the committee hearings and had heard some of the debate in relation to those

definitions, he would realize how important they are and how important the whole interrelationship between the different

definitions is.

It is one of the major principles that can be talked about in general on third reading. I am sure the member for Sudbury East has seen the reason and the logic behind my argument, will accept it and will no longer interject so we can hear the member for Oxford continue with his very good remarks.

The Acting Speaker: Order. The member for Oxford is entitled to discuss the clauses in the debate.

Mr. Martel: Mr. Speaker, he is allowed to debate the principle on third reading. It is not a clause-by-clause or definition-by-definition debate. That is finished. It is the bill on principle.

The Acting Speaker: Order. I have made the ruling.

Mr. Treleaven: On second reading we discuss the philosophies and the principle of the bill, and we can be wide-ranging. I am on third reading, and in Beauchesne and in Erskine May it states that third reading debate, as I said, must be narrower and more specific to the bill than second reading debate.

Mr. Martel: And it is not clause-by-clause.

Mr. Treleaven: It is not clause-by-clause examination.

Mr. Martel: Or definition-by-definition.

Mr. Treleaven: It certainly is on

definitions. The bill as it now exists, as amended, is what must be discussed on third reading. That is what third reading is for.

The Acting Speaker: We have agreed. I have made the ruling.

Mr. Treleaven: Thank you, Mr. Speaker. That is what I am doing. I am pointing out inconsistencies in this bill and why it should not be given third reading. There are inconsistencies with the Canada Health Act, which Bill 94 is trying to accommodate and adjust itself to.

Mr. Martel: That is not what third reading is about. And you are the Deputy Speaker; no wonder we are in trouble.

Mr. Treleaven: I am having a great deal of difficulty hearing even myself over the member for Sudbury East.

Mr. Martel: If the Deputy Speaker does not know the rules any better than that, we are in serious trouble.

The Acting Speaker: Order.

Mr. Treleaven: I am comparing it not only with the Canada Health Act but also with the Health Insurance Act and with the Health Disciplines Act, which are acts referred to specifically in this bill.

I talked about the amendments, the added

definitions, that were put in

section 1 today. I am pointing out inconsistencies. Those very

definitions refer to the Health Insurance Act --

Interjection.

Mr. Treleaven: Fine. May I continue, Mr. Speaker? I am right on point. I am right within the authorities --

Mr. Martel: Baloney, he is.

Mr. Treleaven: Thank you. Back to

section 2, which is an original

section of Bill 94: The member for Yorkview does not agree with me. However, I submit there is a third group of persons in Ontario who are not covered by

section 2 of Bill 94. I gave the members one example of these people. A physician, an optometrist or a dentist may extra bill them or charge what he wishes because they are not insured persons and do not come under

section 2.

The act is deficient under

section 2 as a result. That is one more reason why the bill should not be given third reading. It should be voted against on third reading and, quite frankly, sent back to the standing committee.

It has been very difficult. The member for Sudbury East is making this a lengthy debate. I hope he will not continue this kind of obstruction. It certainly does lengthen one's comments.

Mr. Martel: For a windbag like you, it does not take much.

Mr. Treleaven: With the interjections of the member for Sudbury East, I am only a fifth of the way through my preliminary comments of what I am going to discuss in my speech.

The Acting Speaker: The member for Oxford will please address his remarks to the chair.

Mr. Treleaven: Yes; thank you. I do hope the member for Sudbury East will restrain himself.

Mr. Martel: Will you get to the drivel?

Mr. Treleaven: I will show where it is leading. This bill is a different bill now from the one the witnesses addressed in the standing committee. One immediate example is the New Democratic Party amendment placed by the member for Windsor-Riverside (Mr. D. S. Cooke) on Tuesday, June 3. I believe it is the newly amended subsection 2(2)

Mr. D. R. Cooke: Does the member not have to go to the washroom?

Mr. Treleaven: That is no problem; I am not imbibing the water.

Remember that the original

section 2, which I just dealt with, became subsection 2(1) upon subsection (2) being passed; it was an automatic change of designation. Therefore, subsection 2(2) states:

"A practitioner referred to in subsection (1)" -- that is, an opted-out physician, etc. -- "shall not accept payment in respect of an insured service rendered to an insured person until after the practitioner receives notice that the patient has been reimbursed by the plan unless the insured person consents to make the payment on an earlier date."

2:10 a.m.

I will be dealing much later with how unfair that is from a straight business point of view; no other businessman in the world has that placed against him. We do not have the right when we buy shoes to say to the man who sells us shoes, "I do not have to pay you until I know you have paid your wholesaler and your wholesaler has sent me confirmation." I will get into that later. I am trying to point out that this

section is draconian; that is the dragon's blood, I think.

That was not in there when the witnesses appeared before the standing committee on social development to discuss this bill. It is a different bill. That is only one very small example. This bill should not go forward to third reading but should go back to the standing committee so the witnesses are able to review it in its present form, as amended. That seems fair; it should not go forward to third reading.

Mr. Polsinelli: Mr. Speaker, will the member permit a question?

Mr. Treleaven: Yes, I will permit one question.

Mr. Polsinelli: I refer the member for Oxford to

section 2. He is saying essentially that there are gaps in this bill. I submit that he is misinterpreting

section 2; perhaps he should reread it. It says effectively that a physician, an optometrist or a dentist cannot charge "more than the amount payable under the plan for rendering an insured service to an insured person." The maximum that can be charged is the amount the plan would pay for an insured service to an insured person, not that one has to be an insured person to be covered by the bill. The bill covers everybody.

Mr. Treleaven: Exactly; dead on. That is where the member for Yorkview and I come apart. Not everyone is covered. That is the very issue. How can a person be covered by the plan if he pays no OHIP premium and no one pays the OHIP premium for him? If he does not pay and no one pays for him, he is not an insured person. He is not under the plan; therefore this bill cannot cover him.

While

section 2 states that those physicians, optometrists or dentists who are opted out will not charge more to certain groups of people, it is silent on the others. The implication is that these care givers can charge more if a person is not an insured person under this act.

Mr. Polsinelli: No. It says the doctors cannot charge more than what OHIP would have paid. That is what it says.

Mr. Treleaven: It says, "to an insured person." The old order Mennonites in my riding are not insured persons.

Mr. Polsinelli: OHIP would pay nothing to an uninsured person.

Mr. Treleaven: At this point, I am in only my preliminary comments. I am not fully into

section 2. Perhaps later, when I get through my preliminary comments --

Mr. Polsinelli: What can we expect three hours later?

The Acting Speaker: Order.

Mr. Treleaven: I can then go at it more fully and try to explain more clearly. Obviously, I am not making myself clear enough so that the member for Yorkview can get the point. I will do more of that a little later.

My next comment in a preliminary way is that the bill is machiavellian.

Mr. Laughren: That is unparliamentary.

Mr. Treleaven: It is not unparliamentary.

The Acting Speaker: Address your remarks to the chair.

Mr. Treleaven: I will address you, Mr. Speaker, and look at you and ignore the interjectors.

The Acting Speaker: Ignore the interjectors.

Mr. Treleaven: Correct. The bill is machiavellian because the amendments deleted the heavy fines, which made the government look bad. The fines have been dropped from $10,000 to $250 and $1,000, but through its amendment, this bill beefs up the Health Services Appeal Board.

I do not want to get into the Health Services Appeal Board at this point in my preliminary comments, but I -- no.

Mr. Cordiano: The member should read us the note he just received. He should not be shy.

Mr. Treleaven: We would not want that on the record.

Mr. Ward: The member can sip his water and not think about it.

An hon. member: One knows it is Toronto water if one can smell it.

Mr. Treleaven: Toronto's water is heavily chlorinated, much more so than Oxford water, which comes from the Sweaburg swamp, right north of my house.

The Acting Speaker: Peace, and back to the debate.

Mr. Treleaven: The Health Services Appeal Board has inconsistencies. In a preliminary way, I will paraphrase this. Many times during his comments, the minister kept stating that a member -- singular, and it is in the act -- of this appeal board will constitute a panel by himself. However, if we look at

section 8 of the Health Insurance Act, which is the guiding act for Bill 94, it states that it shall be "not fewer than five and not more than nine."

Subsection 4b(1), as amended a couple of days ago, changed that and made it more open-ended. I remember the member for York Mills (Miss Stephenson) suggesting 30 or 36, and I think the minister concurred with 36. At the moment I do not have the exact number. It was increased by a great number so it would be not fewer than five and not more than 36 or whatever.

The act goes on to call for at least three to constitute a quorum. There is a chairman and a vice-chairman, and one of them is contemplated as being on that board. If we look at the table of contents of the document outlining the proceedings of the Health Services Appeal Board, which were put out by the Ministry of Health in 1984, we will see that the panels on various cases ran between three and eight. I could not find one where the full nine were on a panel.

Incidentally, during the debate, I remember the member for Lincoln (Mr. Andrewes) and the member for Oakville (Mr. O'Connor) stated they believed the board was two years behind in its case load. The member for Wentworth North (Mr. Ward) checked with the officials and found out "it was improving."

The first case that came with these proceedings of the Health Services Appeal Board, in the matter of a hearing under the Health Insurance Act, involved a Gordon Bissessar, MD, versus the general manager of OHIP and the medical review committee of the College of Physicians and Surgeons of Ontario. That one took almost three years. There was a decision of the general manager in November 1981. The matter came before the board in April 1984, and I think the final decision was on May 22, 1984. It took almost three years from the decision of the general manager in appealing it to the Health Services Appeal Board.

I will get to that in more detail. I was just going by that. That was just an aside regarding a problem with the act and a reason this act has to be changed further. I will get to that specific point in detail later.

2:20 a.m.

Right now, the point is why, under the act and under the amendment, we have a singular person constituting a panel,

whereas in the past and under the Health Insurance Act, there have been at least three. I therefore believe that with the beefed-up board -- now no less than three and up to 36 -- Bill 94 must be amended again; we must have a panel that is no less than three rather than a single panel, so the procedures are not changed and the act is consistent. Otherwise, we have real problems.

Because this bill is not reprinted, because we have the situation at hand now, because we are under the guillotine and because of the time allocation, we moved directly from committee of the whole House and the amendments right to third reading. Therefore, we set aside the standing orders that call for reprinting of the bill, as amended, before it goes to third reading. That is why we have to have unanimous consent to allow that.

I am sure all members debating on third reading up to this time have found a real handicap in that the bill has not been totally reprinted. One must go from the Hansards of the amendments, jump back and forth into the act itself and then back to the amendments. I am having a little difficulty right now laying my hands exactly on this singular reference to the members of the board.

Subsection 3b(4) says, "A member of the board conducting a review shall inquire into...." Subsection 3b(3) says, "The chairman of the board may from time to time appoint a member of the board to conduct a review under this act." That is, a single-man or single-woman panel, a one-person panel, is now an amendment to the act. It should not be. It is inconsistent with this. Of course, I am talking about the Health Services Appeal Board. It should not be, because the board was set up and is set up under the Health Insurance Act, which calls for no less than three and no more than 36.

How can one have a quorum of three and then have Bill 94 say a panel can be one? Bill 94 is wrong. The amendments have been hurried too much. Bill 94 should go back for amendment to make it consistent with the Health Insurance Act in that the quorum for a panel is no less than three.

Members will see that I am consistently on topic on why Bill 94 should not be read a third time. The overall thrust of the bill is different. It is now an anti-doctor bill. When it started out, it was not such an anti-doctor bill. We have, for example, subsection 2(2) of the act -- I am again under that handicap because the bill has not been reprinted. Even with the lack of reprinting, I believe it was on June 3.

The new subsection 2(2) states: "A practitioner referred to in subsection (1)" -- that is again an opted-out practitioner -- "shall not accept payment in respect of an insured service rendered to an insured person until after the practitioner receives notice that the patient has been reimbursed by the plan unless the insured person consents to make the payment on an earlier date." That says the practitioner has been singled out against all the laws of Ontario and Canada, particularly those of Ontario.

As I said before, civil law states -- and if the member for Carleton-Grenville (Mr. Sterling) were here, he would certainly know -- that if a man sells one a suit or a pair of shoes, the terms of his sale are cash at that point, cash on delivery. If he gives one 30 days, that is his choice, but without any specific arrangement for payment on a delayed basis, the terms of all such sales in the marketplace are cash at that time.

One does not buy a car from a dealer on the basis that one does not have to pay for it until General Motors, Chrysler, Honda or whomever sends notice that the wholesaler or manufacturing company has been paid. Of course not. However, that is what this amending subsection 2(2) does to the doctor, dentist or optometrist. Not only can he not bill but also he cannot even accept the money.

Let us say he has had a patient for years. As the patient leaves, he pays in cash, as happens reasonably often. As he walks out, he asks the nurse, "How much is that?" She says: "That will be $25. We will send you a bill." The patient says, "Never mind," pulls out the money and lays it down.

Where is he? The doctor is now in violation and subject to all the penalties of the act, because not only can he not bill but also he cannot accept the money, even if it is paid at his office. This is why it is an anti-doctor, anti-dentist or anti-optometrist bill. In commerce, this kind of law is placed on no one else.

I suspect that if some practitioner wants to take this thing to court on a constitutional basis, he will win, because this is discrimination against him as compared with all others who provide and sell goods or services in the commercial law field. That is why I call it an anti-doctor bill.

That amendment should not have been allowed, and it should not be there now. It is an extremely valid reason why Bill 94 should not be given a third reading.

I have a reprinted bill with arrows on it. That is very good. It does not contain all my notes, but it is helpful. Perhaps I will be able to use that instead of jumping back and forth into the Hansards.

2:30 a.m.

This bill is draconian now because of the hearings under the Health Insurance Act. Again, we are talking about the Health Services Appeal Board. This is another reason why the professionals -- I mentioned them a minute or two before -- are being discriminated against. I am sure the Charter of Rights and Freedoms would set aside various sections of Bill 94 as it is amended and throw it out as unconstitutional, because professionals do not get the same rights as ordinary citizens. These three professions are being discriminated against.

For example, in hearings before the Health Services Appeal Board under the Health Insurance Act,

section 5 says, "The chairman of the board may appoint a member of the board," etc. We have the two acts in conflict with each other. The professionals do not get the rights of ordinary citizens; for example, there is no specified right to counsel. Under these two acts, the professional who is charged and brought up before the Health Services Appeal Board not only does not have the right to counsel but also does not even have the right to appear. He has the right to make a submission in the same way as does the patient and the general manager. He does not have the legal, specified right either to appear in person or to have counsel.

I draw the attention of the members to the Statutory Powers Procedure Act, which deals with boards, commissions, etc., that, by statute, are given powers by this Legislature. That is exactly what we have here. We have a board. It is a tribunal, etc., for the sake of and under the Statutory Powers Procedure Act. Subsection 3(1) states that it "applies to proceedings by a tribunal in the exercise of a statutory power of decision conferred by or under

an act of the Legislature, where the tribunal is required by or under such act or otherwise by law to hold or to afford to the parties to the proceedings an opportunity for a hearing before making a decision." That is dead on here. In the Statutory Powers Procedure Act it is a hearing and it basically sets out the rights that anyone in Ontario gets when one comes up against an agency, board or commission of the government. They are guaranteed certain rights.

In the standing committee on procedural affairs I remember the then member for Wilson Heights, Mr. Rotenberg, was a strong advocate of this act. The member for Oshawa will remember Mr. Rotenberg going on strongly with regard to the Statutory Powers Procedure Act.

I read to members what subsection 3(1) applies to. Subsection 3(2) states, "This part does not apply to proceedings...(

h) of a tribunal empowered to make regulations, rules or bylaws, in so far as its power to make regulations, rules or bylaws is concerned." One would think at first blush it would include the Health Services Appeal Board but it does not, because that Health Services Appeal Board does not make its own rules, regulations and bylaws. Therefore, this act governs.

We now have another conflict. Being hastily drawn, incomplete, improper, Bill 94 is violating another act which guarantees the people of Ontario, including doctors, optometrists and dentists, fair hearings. This act, Bill 94, comes along and tries to set up more ferry-built rules that fly in the face of the Statutory Powers Procedure Act. For example, hearings are to be public under this act. That is guaranteed except in the case of public security or intimate or financial personal reasons, when it will be held in camera.

Hearings are to be public. Under the Statutory Powers Procedure Act, everyone in Ontario is guaranteed the right to a hearing and is guaranteed the right to counsel. That is

section 10. One is given the right to examine witnesses at hearings, etc. That is in particular. Everyone in this province is guaranteed the right under that act, to counsel at a hearing -- I am disappointed that the Minister of the Environment (Mr. Bradley) is not staying around. The night is early. The morning is young.

Hon. Mr. Bradley: I am around.

Mr. Treleaven: I know he is around.

Under

section 10, everyone in Ontario is guaranteed to "(

a) be represented by counsel or an agent; (

b) call and examine witnesses and present his arguments and submissions; (

c) conduct cross-examinations of witnesses at a hearing reasonably required for a full and fair disclosure of the facts in relation to which they have given evidence."

Under the procedures of the Health Services Appeal Board, a person does not have a counsel, cannot call and examine witnesses and cannot cross-examine. All he can do is to send in written submissions. How can one cross-examine --

Mr. Callahan: On a point of order, Mr. Speaker: The honourable member is talking about the Charter of Rights and Freedoms, which I do not believe is before this august body. According to standing order --

Mr. Shymko: Is the member the self-appointed expert on this?

Mr. Callahan: The member should listen and learn something. According to standing orders 19(2) and 19(3), he is not addressing his remarks to the question under discussion. We have no authority to deal with the Charter of Rights.

The Acting Speaker: We have gone through this before.

Mr. Treleaven: I suspect the member for Brampton (Mr. Callahan) is joshing us. He is a solicitor and he knows; he can read these better than I can.

The Acting Speaker: Would the member please bring his remarks back to the topic.

Mr. Treleaven: Mr. Speaker, to convince you that I am constantly on topic and never off Bill 94, the Health Services Appeal Board is referred to in the amendment to the act. I cannot possibly be off topic. I believe it was the new

section 4. This is difficult.

The new definition put in the board. It is the newly amended

section 1. The first definition says, "`Board' means the Health Services Appeal Board under the Health Insurance Act." How can I possibly be off topic when it is the very first definition, the first mention in

section 1ss of the act?

Therefore, the Statutory Powers Procedure Act, which is a guarantee --

Mr. Callahan: On a point of order: I refer to

section 19(11) of the standing orders. I suggest this member is using "abusive or insulting language of a nature likely to create disorder."

2:40 a.m.

Mr. Treleaven: I think the hour is getting to the member.

Mrs. Marland: I have news for you. He is like that first thing in the morning.

Mr. Treleaven: I would not know.

Interjections.

The Acting Speaker: Order.

Mr. Treleaven: I will not touch that one.

A guarantee is set out under

section 10 of the Statutory Powers Procedure Act, as I said. How can one conduct cross-examination? The member for Brampton certainly knows about cross-examination of witnesses. How can one do that when under the Health Services Appeal Board all one can do is send in a written submission?

Mr. Martel: On a point of order, Mr. Speaker: I went out for a while and allowed you to let this fellow have a lot of latitude. He went through a clause-by-clause debate. Let me read you another

section from Erskine May on the topic of third reading. I want you to get the import of what I am going to say, Mr. Speaker.

"The purpose of the third reading is to review a bill in its final form after the shaping it has received in the earlier stages. In the interests of brevity, debate at this stage is eliminated unless six members give notice of an amendment to the question for third reading....When debate takes place, it is confined strictly to the contents of a bill and cannot wander afield as on second reading."

That is according to Erskine May. Mr. Speaker, you have allowed this member to wander around and go through it clause by clause, and I have listened to the drivel for a while. This is third reading, according to the experts, and I ask you to get this member to refrain from clause-by-clause debate and deal, as Erskine May says, with the principle.

The Acting Speaker: Thank you again.

Mr. Martel: How long do you intend to listen to this sort of drivel before you enforce the procedures followed in this Legislature, Mr. Speaker?

The Acting Speaker: I made a previous ruling.

Mr. Martel: Yes, but the previous ruling was wrong.

The Acting Speaker: Are you challenging the chair?

Mr. Martel: I would not challenge your ruling at this hour of the morning, Mr. Speaker, but I suggest that based on what third readings are about, you might reconsider your previous decision.

Interjections.

The Acting Speaker: The member for Oxford will please stick to the topic.

Mr. Treleaven: I am, but in this democracy, we cannot give in to intimidation. I will and I am. It is just that the member for Sudbury East sometimes cannot understand things. I will stay on and I will go slower for him so he can understand me. As I stated, there is no specified right to counsel. I hope to get through this before the member for Sudbury East interrupts me again.

Mr. Martel: On a point of order: I understand quite well what the member is saying and doing, even if it contradicts the rules of this House. As the Deputy Speaker of this House the member should know that full well. For the Deputy Speaker to violate the rules of the House is questionable. I ask you, Mr. Speaker, to look at the discussion of third reading on page 528 of Erskine May and reconsider what you have allowed the member to get away with so far by being lenient this late in the morning. How long do you intend to allow him to contradict, to conflict, or whatever you want to call it, with what third reading debate is all about?

Hon. Mr. Sorbara: Mr. Speaker, on the point of order that my friend raises: The member for Sudbury East is eloquent in his arguments. He is a veteran of I do not know how many years in this House. He has this evening raised the same point of order on a number of occasions, and you have made your ruling. When you asked whether he was challenging the chair, he said, "No, I am not challenging the chair."

It would perhaps be incumbent upon you, Mr. Speaker, to call the member for Sudbury East to order so that we can get on with the drivel.

The Acting Speaker: For the attention of the member for Sudbury East, I have made a ruling. In my opinion, the member for Oxford is relating to the content of the bill.

Mr. Cousens: On a point of order, Mr. Speaker: If there are going to be continuing outbursts by the member for Sudbury East in the future, will you start dealing with his behaviour? At this point, if he is going to interrupt the stream of thought coming from --

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

Mr. Warner: The member would not know a rule if he fell over it.

Mr. Treleaven: It is very difficult to keep oneself on track with these interruptions.

Mr. Barlow: Why does the member not start over again?

Mr. Treleaven: No. That would be repetitious, and under standing order 19, the member for Brampton would be after me.

Section 5, which deals with the Health Services Appeal Board and its procedures, is incomplete. It does not give these practitioners -- the doctors, optometrists and dentists -- the ordinary rights and protection of every citizen of Ontario. Therefore, this Health Services Appeal Board and its procedures, as set forth in the newly-amended Bill 94, are unconstitutional.

The bill should not be passed. It should not get third reading. It does not provide for counsel or an agent. It does not allow the physician or the professional to examine witnesses and present his arguments. It does not permit him to cross-examine witnesses.

Under Bill 94 and the Health Services Appeal Board, under the Health Insurance Act, the patient, the general manager and the professional -- the practitioners -- have the right only to submit in writing the arguments of their case as to whether they extra billed, took more money than OHIP authorizes. How can one get one's rights under the Statutory Powers Procedure Act to examine and cross-examine the other witness, the accuser?

This is totally unconstitutional and against the laws of Ontario as in this act and many other acts. It is a basic principle of law in this province that one has a right to cross-examine one's accuser. That is fundamental to our system of justice. It is not in Bill

Section 11 of the Statutory Powers Procedure Act talks about the rights of witnesses to counsel. Again, that is not in Bill 94. Subsection 11(2) of the act says, "Where a hearing is in camera, a counsel or agent for a witness is not entitled to be present except when that witness is giving evidence." Again, the accused person's protection against what a witness is saying against him is not in Bill 94. For that additional reason, Bill 94 should not receive third reading.

2:50 a.m.

This is draconian. Here is another example of why the bill should not proceed to third reading. The professionals do not get the same rights as ordinary citizens. Bill 94 refers to the Provincial Offences Act. Members will remember virtually every other subsection in

section 4 was deleted by a new amending section, but subsections 4(1) and 4(3) remained.

Subsection 4(3) of Bill 94 states, "When a prosecution is conducted by a private prosecutor and the defendant is convicted, the court may determine the actual costs reasonably incurred in conducting the prosecution and, despite

section 61 of the Provincial Offences Act, may order those costs to be paid by the defendant to the prosecutor." I am quoting subsection 4(3) of Bill 94, which refers to

section 61 of the Provincial Offences Act.

Traffic tickets and so on are relatively minor provincial offences, and one still has protection. Everybody in Ontario gets protection under that act and yet under Bill 94, doctors, optometrists and dentists do not get those protections of the ordinary citizen.

Section 61 of the Provincial Offences Act, which is mentioned in subsection 4(3) of Bill 94, states in subsection 1, "Upon conviction, the defendant is liable to pay to the court an amount by way of costs that is fixed by the regulations." Subsection 61(2) deals with costs respecting witnesses. It says, "The court may, in its discretion, order costs towards fees" and so on. At the end it says, "shall not exceed $100."

Subsection 4(3) talks of when a prosecution is conducted by a private prosecutor. Presumably that would be a lawyer retained by the Ministry of Health to conduct the prosecution. We have his costs being added in against --

Mr. Callahan: On a point of order, Mr. Speaker: According to standing order 19(d)3 this honourable member is not speaking on the topic. He has included the Charter of Rights and Freedoms and the Provincial Offences Act. The next thing we will be into is the Warble Fly Control Act. I suggest he is out of order and should be so ruled.

The Acting Speaker (Mr. D. R. Cooke): He is speaking on those acts only in reference to Bill 94, to which he is speaking.

Mr. Martel: If I might speak to the same point of order, Mr. Speaker: Let me indicate what it says in "Proceedings in Passing Public Bills," on page 528 of Erskine May's Parliamentary Practice:

"The purpose of the third reading is to review a bill in its final form after the shaping it has received in the earlier stages. In the interests of brevity...when debate takes place, it is confined strictly to the contents of a bill."

There is a second section; please bear with me, Mr. Speaker, while I find the

section that further defines what should be done at third reading. On page 576, it says: "The amendments that may be moved to the question for the third reading of a bill follow the same pattern as those that may be moved on second reading; and the provisions of SO No. 41 concerning the questions to be proposed on such amendments apply equally to second and third reading.... Debate on third reading, however, is more restricted than at the earlier stage, being limited to the contents of the bill; and reasoned amendments which raise matters not included in the provisions of the bill are not permissible."

It says in Erskine May, which is the authority, that it is not a clause-by-clause --

The Acting Speaker: Order. I have heard the argument from the member for Sudbury East several times this morning. A ruling has already been made by the Speaker on that point. The speech we are hearing has not deviated substantially from the time that ruling was first made, and I do not accept the point of order.

Mr. Callahan: On a point of order, Mr. Speaker: I would like to move a motion to appeal the ruling of the chair.

Mr. Breaugh: You did it.

Mr. Martel: Ring the bells.

The Acting Speaker: Does the member for Brampton wish to appeal the ruling of the chair?

Mr. Breaugh: He did not mean to say that.

Mr. Callahan: Mr. Speaker, after obtaining advice from two members in front of me, I withdraw that motion.

Mr. Martel: Mr. Speaker, before we proceed --

The Acting Speaker: Is this a new point of order?

Mr. Martel: Yes. I ask the Speaker for his guidance in this matter. The definition of third reading is quite clear. It does not allow for clause-by-clause debate on third reading. Will you tell me what parliamentary procedure you are following, so that I will know in future just what --

The Acting Speaker: Order. We are following the rules. The chair has ruled that the member for Oxford is following the rules.

Mr. Martel: On a point of order, Mr. Speaker: Erskine May is the authority on the Legislature.

The Acting Speaker: I have ruled on that point. Will you sit down, please?

Mr. Martel: Mr. Speaker, may I ask for your assistance? What do you think it means? Maybe you will explain to me --

The Acting Speaker: Order. Will you take your seat, please?

Mr. Martel: Mr. Speaker, will you explain to me what the following passage from Erskine May means, so that I will know how you are interpreting Erskine May? Obviously, we are at loggerheads --

The Acting Speaker: Will the member take his seat, please? The chair has ruled that the member for Oxford is not in fact debating this clause by clause. He is following the rules. I am not going to hear any more on this.

Mr. Martel: Mr. Speaker, may I ask for your assistance?

The Acting Speaker: Will you take your seat, please?

Mr. Martel: On a point of order, Mr. Speaker: I ask the Speaker to assist me so that I will understand the ruling. What does it mean when it says, "Debate on third reading, however, is more restricted than at the earlier stage, being limited to the contents of the bill"? What does that mean?

Mr. Ward: Mr. Speaker, we do want to hear the member for Oxford. I would ask the member for Nickel Belt (Mr. Laughren) to restrain his colleague physically if necessary.

An hon. member: He is talking out of his seat.

3 a.m.

Mr. Martel: Mr. Speaker, how could he get your attention? He does not even know where he is supposed to be sitting and you recognized him. This has degenerated into a zoo.

The Acting Speaker: I believe the parliamentary assistant to the minister can take a seat in the front row.

Mr. Treleaven: It is difficult to keep one's train of thought. I am obviously on topic. Subsection 4(3) of Bill 94 makes reference to the Provincial Offences Act, so when I go to the Provincial Offences Act, following Bill 94, I cannot be off topic.

Mr. Cordiano: On a point of order, Mr. Speaker: I think the member for Oxford is following unparliamentary procedure. I just wanted to make that point. He can go ahead anyway.

Mr. Treleaven: As I have stated before, under Bill 94, the professionals do not get the same rights as every other citizen under many statutes. In particular, I am referring to the Provincial Offences Act that is referred to in subsection 4(3) of Bill 94. When we look at

section 61 and those following, such as

section 63 and

section 67, we see that the professionals do not get these rights. In

section 67, under the Provincial Offences Act, in which the offences are more important and more serious than overbilling by $10, the guilty parties --

Hon. Mr. Sorbara: Mr. Speaker, on a point of order: I am very sympathetic to the point my friend the member for Sudbury East has raised. I am not raising that point to you, Mr. Speaker, but I think there is merit in what he says. I am confident my friend would press that point, even perhaps to a challenge to the chair, were it not for the fact that he does not want to get thrown out, which is probably the appropriate course because he has raised that point on a number of occasions.

In that general area, on that point, regarding our friend the member for Oxford, who has been going on ad infinitum, referring to

section after section, perhaps you could direct or entreat him to take five or 10 minutes to explain to this House at 3:03 in the morning where his argument is going. If you were to direct him in that regard, we could get some sense of the general point he is trying to make. We could satisfy my friend the member for Sudbury East and the rest of the members who are in this House, now at 3:04 a.m., and who are trying to follow along.

The Acting Speaker: That is not a point of order. If you have a question for which you want the member to interrupt his speech --

Mr. Warner: On a point of order, Mr. Speaker: I think the member for Oxford rightly and properly has the floor. I ask that other members, including the member for Sudbury East, not interrupt. I have been listening intently to his speech. During the past three hours he has made two relevant points and that is above batting average for him. I wish to listen further.

The Acting Speaker: That is a good point of view and well taken.

Hon. Mr. Curling: On a point of order, Mr. Speaker: As you know, I am the most patient member in this House and I want to learn as much as possible. I gather that the member should speak on the principle of the bill. The point I am making is that he is so irrelevant that I cannot even get the relevance in his irrelevance. Where is the principle in what he is talking about? I cannot make any sense of what he is saying.

The Acting Speaker: The chair has already ruled on that point.

Mr. Epp: We are very concerned about the direction he has taken. Somebody has raised a point as to where he is going. I suggest if somebody had Ex-Lax, we would all know where he is going.

Mr. Ward: On a point of order, Mr. Speaker: I am getting concerned about the number of interjections as well. l have listened for two and a half hours and I think the member is speaking in support of the bill.

Mr. Treleaven: Actually, I have been going only an hour and three quarters, although it may seem like two and a half hours. In Erskine May and Beauchesne, from which my friend the member for Sudbury East likes to keep quoting, it also says -- I am sure if the Speaker checks with the clerks they will confirm it -- that on third reading debate the proper question is why third reading should be carried or why the bill should not proceed to third reading.

That is the whole purpose of speaking on it and that is where I am headed. Each of these points is right on as to why the bill should not proceed to third reading. I am dead on point. I hope I have clarified it for the member for Sudbury East.

Mr. Martel: Do not provoke me or I will not leave my chair.

Mr. Treleaven: Yes, I do not want to antagonize him.

In Bill 94, under the procedures of the Health Services Appeal Board, what happens if a doctor is found guilty? There is what is known as a writ of fieri facias, or fi. fa. The member for Brampton has now left. There is seizure, fi. fa., etc. There are many things under the Provincial Offences Act, which is referred to in subsection 4(3) of Bill 94, through which the ordinary person gets all kinds of benefits; i.e., if there is a fine, he can ask for an extension from the courts and he will get time to pay.

Mr. Speaker, you as a solicitor know that. I am sure in the past you have asked for extensions of fines many times in court. The physician, the optometrist and the dentist sure do not get that under Bill 94 or any of the acts flowing from it, but one does under the Provincial Offences Act and under any number of other acts. There is the granting of an extension and so on.

I can go on about

section 67 but I will not do that. There is also the suspension of fines in

section 71 of the Provincial Offences Act, again referred to in Bill 94. The

section states, "Where

an act provides that a fine may be suspended subject to the performance of a condition," the court may suspend the fine on conditions. Those are ordinary rights that every citizen of Ontario has under many acts, such as the Statutory Powers Procedure Act and the Provincial Offences Act but does not have under Bill 94 from the Health Services Appeal Board.

Perhaps I have made my point there. I could go on, but I have shown that the bill is draconian for all those reasons. It is probably unconstitutional and should not be given third reading. Bill 94 is imperfect, and I have dealt with the past, the draconian and machiavellian reasons it should be either amended or turned down.

3:10 a.m.

Now I will deal with the imperfections in it. It needs to be amended further. At least two areas immediately come to mind. Under certain circumstances this act will not qualify under the Canada Health Act. Anyone who has been here throughout second reading or in the debate in committee of the whole House will remember that the minister has continually stated -- and I believe through question period, questions to the Premier (Mr.

Peterson), etc. -- that the whole purpose in bringing in Bill 94 was to get the $53 million or $100 million or $25 million -- whatever the figure might be -- that the feds are holding in a pot up there until Ontario brings its legislation into line with the Canada Health Act. That, we understand, is the whole purpose of Bill 94.

Hon. Mr. Sorbara: Will my friend the member for Oxford yield the floor for a question? It will be very quick.

Mr. Treleaven: Yes, I will yield for one question.

Hon. Mr. Sorbara: My question to my friend from Oxford is this: After all the debate we have had in this House, does he really, honestly believe that the sole purpose of this bill is to recover $53 million? Is that the point of his argument? Is it his view, in

summary of all the things that have gone on here in the past months, that this is the sole purpose? I would be very surprised if his answer were yes, but I would be interested in hearing it.

Mr. Treleaven: It may not be the only purpose --

Hon. Mr. Sorbara: The member just said it was the only purpose.

Mr. Treleaven: No. There may be biases on the part of the third party and the government. They may have biases in philosophies.

Mr. Callahan: On a point of order, Mr. Speaker: In his statement, the member has obviously made an allegation against the third party and he was just about to make one against the government. I submit that this is unparliamentary. I ask that he retract this statement or be called to leave the House.

I will avoid the one about being called to order. Order him out of the House.

The Acting Speaker: It is not unparliamentary to make an allegation against the government.

Mr. Treleaven: It was just a bias, really. All I said was that the government and the third party may have a bias or a philosophy with regard to Bill 94, but the main purpose has been stated over and over in this House by the government. The main purpose for hurrying -- although various others say the government had until next April for the three years to be up -- is to get this money that the feds are holding in the pot.

Mr. Callahan: If we are hurrying, why are we here tonight?

Mr. Barlow: It is that party's idea. It is part of the closure motion.

Mr. Callahan: I had a better day than the member for Oxford did.

Mr. Treleaven: But I accepted the member for Brampton.

In the debate and in committee of the whole House the member for Lincoln, the member for Oakville, the member for Carleton-Grenville and the member for Dovercourt (Mr. Lupusella) each tried to ask the minister about the Canada Health Act. This is crucial. I did not understand his answers. The members kept trying to explain themselves in different ways and tried to get the minister to understand. Either he did not understand or they did not and I do not. It may well be that we do understand and that there is a fundamental gap here in this bill.

Take

section 12 of the Canada Health Act. I do not have to pull it out. Let us start with the assumption that one of the main purposes, or the main purpose, of going through with Bill 94 is that the province not be penalized by the holdback of moneys by the federal government under the transfer payments, established programs financing -- whatever you will -- under the Canada Health Act.

Incidentally, we are again on the point we were at a while ago about insured persons: "either directly or indirectly...made to insured persons or otherwise." One must take this to mean uninsured persons. I will deal with that again. I did before in a preliminary way; I will again, in a fuller way, get into "insured persons," which the member for Yorkview was so interested in.

Let us paraphrase paragraph 12(1)(a): The province must provide health services on uniform terms to everyone, with reasonable access to insured persons or otherwise.

Paragraph 12(1)(

b) says, "must provide for payment for insured health services in accordance with a tariff or system of payment authorized by the law of the province." That is OHIP.

Paragraph 12(1)(

c) says, "must provide for reasonable compensation for all insured health services rendered by medical practitioners or dentists." That is the key item.

Whenever the members for Lincoln, Carleton-Grenville, Oakville and Dovercourt kept asking the Minister of Health (Mr. Elston) about this, saying that something -- an agreement -- was missing, the Minister of Health kept giving them the answer that all a province has to do is provide reasonable compensation to these professionals.

He kept saying that. These members were not understanding. Frankly, I was not understanding. I just wonder if the Minister of Health is really understanding and all these other members are incorrect -- reasonable compensation to the practitioners.

In subsection 12(2), this "reasonable compensation" term is dealt with. There is a deeming clause which begins, "In respect of any province in which extra billing is not permitted." Bill 94 attempts to do that. It attempts to say, "No extra billing." Right? If it is passed, there will be no legal extra billing in Ontario. Ontario will then qualify under subsection 12(2).

3:20 a.m.

Again, "In respect of any province in which extra billing is not permitted" -- that is Ontario -- "paragraph 1(c)" -- the reasonable compensation clause -- "shall be deemed to be complied with if the province has chosen to enter into, and has entered into, an agreement with the medical practitioners or dentists of the province." It says if they have agreed to enter and have entered into an agreement for negotiation, this agreement has to provide, "(

a) for negotiations," etc., and "(

b) for the settlement of disputes...conciliation or binding arbitration by a panel...."

This is my point. There is no agreement. At this time we still have an agreement under OHIP. We will not have an agreement after April, 1987. The current agreement runs out in 1987. At that point, any agreement with the doctors is off. Therefore, there is no agreement after 1987.

There will be no agreement. It takes two to enter into an agreement, the OMA and the province. One cannot have a unilateral agreement. There must be at least two parties to an agreement; it is privity of contract, from my law school days. There must be two people in a contract. If the OMA does not willingly, voluntarily, come to an agreement at April 1, 1987, there will be no agreement. It will be in limbo.

One remembers the kerfuffle in the newspapers about whether the government had offered the OMA that, if no new agreement were entered into after the present one terminated by the passage of time next year, the doctors could extra bill. They would have that right to extra bill, opt out, etc. One remembers the discussion and claims over that. Therefore, there will be no agreement at that point unless the doctors agree.

Let me work back. If there is no agreement entered into under subsection 12(2), then it will not be deemed to fulfil paragraph 12(1)(c), which means reasonable compensation to the professionals. If it does not meet that test, it does not meet the test to get funding. As all those members were trying to say and I am trying to understand, unless it meets all the criteria of

section 12 of the Canada Health Act, how can Bill 94 do what the government wishes it to do to qualify for this money? If it falls down on any of the criteria, it does not get the money. One of the criteria is that there is and will be an agreement that has been entered into.

Bill 94 does not close that gap. I wonder whether the minister, in the hurry to amend and sort around this bill, has a lame-duck bill which will not do what he wants. Again, this should be clarified. Amendments should be put in. An agreement should be entered into to qualify for that.

There was an amendment which tried to get close. The member for Windsor-Riverside proposed an amendment, which was voted down, that tried to set out an agreement or a formula for these negotiations.

I did not read the whole thing, but this agreement that must be entered into to qualify for the money has to provide, under paragraph 12(2)(a), "for negotiations relating to compensation for insured health services between the province and provincial organizations which represent practising medical practitioners or dentists in the province;" i.e., this agreement has to provide for negotiations between the province and the OMA, the Ontario Dental Association or the Ontario Association of Optometrists. It already has to provide for negotiations in there.

There have to be clauses providing for settlement of disputes relating to compensation in there. This is paragraph 12(2)(

b) of the Canada Health Act. Right now, the present agreement does not set out provisions for negotiations and the method they are going to negotiate for compensation, ie. the fees. It does not set out the settlement, a formula for settlement or details or anything for the settlement of disputes relating to compensation; i.e., if they cannot agree, how do they determine the medical fees, the OHIP fees and the schedule?

Then it says, "for the settlement of disputes relating to compensation through, at the option of the appropriate provincial organizations referred to in paragraph (a)." Let us say the OMA --

Mr. Callahan: Could I inquire how long the member for Oxford is going to be, because I am trying to catch --

The Acting Speaker: I think the House should be excited and aware of the fact that the member for Oxford has just passed the two-hour mark.

Mr. Callahan: Is he wrapping up or what?

The Acting Speaker: Does the member for Oxford wish to yield the floor for a question?

Mr. Treleaven: No. I do not think there was a question. Well, there was a question asked.

Perhaps I can simply answer that I am now nearly halfway through my preliminary comments, the preliminary thumbnail sketch of what I will be discussing more fully.

Bill 94 is silent on this settlement of disputes that must be in the agreement for the province to get the money. It has nothing. There is no agreement with the OMA, for example, or any agreement for the settlement of dispute. It says at the option of the OMA, through "conciliation or binding arbitration by a panel that is equally representative of the provincial organizations and the province and that has an independent chairman." Then paragraph (

c) says, "A decision of a panel referred to in paragraph (

b) may not be altered except by

an act of the Legislature of the province."

In other words, the federal government is saying in

section 12 that it cannot just spring this panel, which has doctors well organized, equal OMA and equal province, on this panel. It cannot be altered without coming before this Legislature and receiving legislation.

The province cannot just by regulation or an add-on of some type simply amend, delete or cancel the decision of the panel. What has me puzzled -- and I think has other members puzzled -- is not there. I believe the minister has overlooked the fact that to qualify for the funds under the established programs financing legislation --

Interjection.

3:30 a.m.

Mr. Treleaven: Thank you, Mr. Speaker. Perhaps the smell of flowers will cover the smell of the chlorine in the drinking water.

There is no agreement in Bill 94, even though there were amendments that attempted to put it in and attempted to follow very much the wording of subsection 12(2). There is no agreement that provides for negotiations between the OMA and the government and that sets out a formula for settlement of dispute by conciliation or binding arbitration. Therefore, the bottom line is that Bill 94 can and will be passed and it still will not qualify for the funds from the federal government.

I started out by saying that the main purpose of this government in bringing down Bill 94 was to gain the federal money. The bill is going to fail in getting that. As a result, it should go back, be amended and examined again and more properly redrafted.

That was the one area where the bill is imperfect and where it will not qualify under the program criteria under the Canada Health Act. There will still be a withholding. Sections 18 and 20 of the Canada Health Act talk about withholding money if a province defaults and so on.

Section 18 of the Canada Health Act is the

section that deals with extra billing and user charges.

Section 18 reads as follows: "In order that a province may qualify for a full cash contribution referred to in

section 5 for a fiscal year, no payments may be permitted by the province for that fiscal year under the health care insurance plan of the province in respect of the insured health services that have been subject to extra billing by medical practitioners or dentists."

In other words, in order for the province to qualify there will not have been any extra billing during that fiscal year. Then

section 20 states that if "a province fails to comply with the conditions set out in

section 18, there shall be deducted from the cash contribution to the province" -- that is, they will deduct elsewhere from other transfer payments -- "an amount that the minister, on the basis of information provided in accordance with the regulations, determines to have been charged through extra billing by medical practitioners or dentists in that fiscal year," etc. It goes on to talk about the minister estimating how much has been charged through extra billing.

Sections 18 and 20 demonstrate what happens when the federal government finds out a province has not been playing the game. It may have allowed extra billing. We may also be back to a situation such as that of the old order Mennonites. A province has allowed a gap in the provincial act that does not catch everyone and is not fully encompassing of the entire population.

For these reasons the bill should not proceed. It should not be given third reading.

There is what I will call a neat point in

section 20 of the Canada Health Act. I suppose it is an aside in that section. The province does not need the permanence of Bill 94 to get this federal money.

Mr. Speaker, as a solicitor, you will remember that when people got behind in their taxes, a municipality could take action against the real property only when taxes were three years in arrears. There were various procedures under various acts specifying what a municipality could do: seize and sell, put liens on, etc. However, the time period was three years. You will remember that often when somebody was in rather dire straits, in the early part of year four or maybe at the end of December so that he was never quite three years in arrears, he would pay year one's taxes.

The ratepayer tried to go in to pay the first instalment of year one and pay nothing on the balance of year one and nothing on years two and three, but he was never quite three years in arrears. To get around that, municipalities started saying they would not accept less than the whole year's taxes.

This really is much the same under subsection 20(6) of the Canada Health Act, which is the main reason for Bill 94 being in existence. It is a refund to the province and it is on the same theory as the three-year payment of taxes.

Subsection 20(6) says, "Where, in any" -- emphasis on the word "any" -- "of the three fiscal years referred to in subsection 5..." Subsection 5 talks about separate accounting in public accounts and says, "Any amount deducted under subsections 1 and 2 from a cash contribution...." That is where they find they have not lived up to expectations and are withholding.

We now are in the middle of the third year of the present agreement with the federal government. It has withheld transfer payments pertaining to opted-out physicians, etc., for two years and we now are in the third year.

Subsection 20(6) says, "Where, in any of the three fiscal years referred to in subsection 5, extra billing or user charges have, in the opinion of the minister" -- the federal minister -- "been eliminated in a province, the total amount deducted in respect of extra billing or user charges, as the case may be, shall be paid to the province." Where it says, "in any of the three fiscal years," one has to read, "any one of the three fiscal years." I think the members will agree with that construction.

This is the analogy with the arrears of taxes on real property. "Where, in any of the three fiscal years...extra billing...has been eliminated," i.e. , in the last one, in the middle one, in the first, in any one, "the total amount deducted in respect of extra billing...as the case may be, shall be paid to the province."

It is strange but it means that all the province has to do is pay one year in three and it gets the money for all three years. Do away with extra billing and in one year you get all three years. Sign a one-year agreement. Work it along. If you ban extra billing in any one year, you get all three years. The way I read this is that by banning extra billing for one year on a one-year contract, you pick up the last three years' payments. Enter into an agreement only every third year and you will continually get the money from the federal government.

Under this system, Bill 94 could state that there will be no extra billing in year one, and it is a one-year agreement, and then away you go with extra billing in years two and three. Then there is another one-year agreement in year four, nothing in years five and six; you will get all six years -- one year in three. I believe that because "where, in any" year, you get the total.

Hon. Mr. Sorbara: Would the member yield for a question?

Mr. Treleaven: Yes, for one question.

Hon. Mr. Sorbara: Earlier in the member's remarks he referred to doctors as small businessmen. I presume he meant small businessmen trading in the health of the people of this province. If I follow the tenor of his remarks, he now is suggesting a different mechanism to infuse, by way of transfer payments, an additional $53 million, a way to get the money, perhaps for these small businessmen or perhaps just for the province. Is it the view of my friend the member for Oxford that the Canada Health Act and Bill 94 are simply economic measures or does he see in these bills some other, greater social objectives?

3:40 a.m.

Mr. Treleaven: Measures. I would not call them yardsticks. Perhaps the member is trying to refer to yardsticks. No; I am simply saying that Bill 94 is not necessary in its present form to get that money back. All it has to do is have an agreement that is effective one year out of every three to get back the money for all three years. Therefore, it is draconian. It is pushing on the doctors a three-year ban on extra billing when it needs to do only one year, according to my

interpretation of

section 20, the effective

section of the Canada Health Act.

Mr. Shymko: Mr. Speaker, to follow on this, with your permission, I want to have some clarification from the member.

Mr. Treleaven: I will yield for one question.

Mr. Shymko: I just want some clarification. It is my understanding that the famous Erik Nielsen report, recently tabled in the House of Commons, makes reference to a review of the Canada Health Act as passed originally by the Honourable Monique Bégin and supported by the present government concerning certain criteria and arguments that may verge on the concerns we have just heard from the government side of the House.

The suggestion from Erik Nielsen in his report simply and very clearly asks the government to review the present policy of penalizing provinces and -- correct me if I am wrong -- asks the government to review it. I wanted the members to clarify whether that review is --

Hon. Mr. Sorbara: On a point of order: My friend the member for High Park-Swansea (Mr. Shymko) asked the member for Oxford, who was making an argument, to yield the floor for a question. The member for Oxford kindly yielded the floor for a question. Now my friend from High Park-Swansea is standing up and making a speech about the Canada Health Act and Erik Nielsen. I simply ask you to rule him out of order.

The Acting Speaker: The point is well taken. I would ask the member for High Park-Swansea to get to his question.

Mr. Shymko: My question to my honourable colleague was for a clarification of the relationship of the Erik Nielsen report and its request of the present federal government to review its decision to penalize the provinces for allowing extra billing. He has specifically asked for a review. I want to know whether that review is being considered by the federal government, because it has a major impact on this bill, on the passage of this bill, on its implementation, on the effect the bill may have after its passage and on the possibility of the present federal policy being withdrawn or reviewed.

Is my honourable colleague aware of that and can he answer my question on the relationship of the Erik Nielsen report to what we are doing here today?

Mr. Treleaven: I thank the member for High Park-Swansea for his question. In fairness, I am not familiar with the Erik Nielsen report. It may well be that it tries to straighten out the problems in subsection 20(6), where it is possible to ban extra billing for one year only and collect money for all three years.

Mr. Cordiano: On a point of order: I would like to ask a question.

Mr. Treleaven: I will yield the floor for one que