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December 7, 2017

41st Parliament, 2nd Session

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Hansard Transcripts

Votes and Proceedings

Orders and Notices

Hansard Transcripts 2017-Dec-07 (PDF)

L133 - Thu 7 Dec 2017 / Jeu 7 déc 2017

LEGISLATIVE ASSEMBLY OF ONTARIO

ASSEMBLÉE LÉGISLATIVE DE L’ONTARIO

Thursday 7 December 2017 Jeudi 7 décembre 2017

Standing Committee on General Government

Orders of the Day

Strengthening Quality and Accountability for Patients Act, 2017 / Loi de 2017 renforçant la qualité et la responsabilité pour les patients

Introduction of Visitors

Oral Questions

Energy policies

Energy policies

Energy policies

Energy policies

Government advertising

Hospital funding

Climate change / Changement climatique

Emergency preparedness

Affordable housing

Senior citizens

Health care funding

Government advertising

Immigration policy

Road safety

Visitors

Correction of record

Visitors

Correction of record

Visitor

Members’ Statements

Environmental protection

Gasoline prices

Cycling

Their Opportunity

Power outages

Insurance coverage

School closures

Trinity–Spadina Outstanding Business Awards

Wind turbines

Private Members’ Public Business

GO Transit

Liquor Licence Amendment Act (Maple Wine and Mead), 2017 / Loi de 2017 modifiant la

Loi sur les permis d’alcool (vin d’érable et hydromel)

GO Transit

Liquor Licence Amendment Act (Maple Wine and Mead), 2017 / Loi de 2017 modifiant la

Loi sur les permis d’alcool (vin d’érable et hydromel)

Order of business

Garrett’s Legacy Act (Requirements for Movable Soccer Goals), 2017 / Loi de 2017 sur le legs de Garrett (exigences relatives aux buts de soccer mobiles)

The House met at 0900.

The Speaker (Hon. Dave Levac): Good morning. Please join me in prayer.

Prayers.

Standing Committee on General Government

Mr. John Fraser: I beg leave to present a report from the Standing Committee on General Government and move its adoption.

The Clerk-at-the-Table (Ms. Valerie Quioc Lim): Your committee begs leave to report the following bill, as amended:

Bill 160,

An Act to amend, repeal and enact various Acts in the interest of strengthening quality and accountability for patients / Projet de loi 160, Loi visant à modifier, à abroger et à édicter diverses lois dans le souci de renforcer la qualité et la responsabilité pour les patients.

The Speaker (Hon. Dave Levac): Shall the report be received and adopted? Agree? Agreed. Carried.

Report adopted.

The Speaker (Hon. Dave Levac): The bill is therefore ordered for third reading.

Orders of the Day

Strengthening Quality and Accountability for Patients Act, 2017 / Loi de 2017 renforçant la qualité et la responsabilité pour les patients

Mr. Ballard, on behalf of Mr. Hoskins, moved third reading of the following bill:

Bill 160,

An Act to amend, repeal and enact various Acts in the interest of strengthening quality and accountability for patients / Projet de loi 160, Loi visant à modifier, à abroger et à édicter diverses lois dans le souci de renforcer la qualité et la responsabilité pour les patients.

The Speaker (Hon. Dave Levac): Mr. Ballard.

Hon. Chris Ballard: I will be sharing my time with the member for Ottawa South and the Minister of Health and Long-Term Care.

The Speaker (Hon. Dave Levac): Minister of Health and Long-Term Care.

Hon. Eric Hoskins: I’m pleased to rise in the House this morning to lead off third reading of Bill 160, the Strengthening Quality and Accountability for Patients Act, 2017. This bill includes 10 pieces of legislation that align with our government’s Patients First: Action Plan for Health Care and our open government initiative.

If passed, this bill would increase transparency, strengthen oversight and regulate some health programs and services to ensure quality control. With the bill, our government is working on progress already made to increase access to care, to reduce wait times and improve the patient experience.

We believe that an open, transparent, accountable health system that puts patients first is the best way for Ontarians to make informed decisions about their own care. Bill 160 covers a great deal of ground. Today I want to touch on several aspects of the bill. As was mentioned, my parliamentary assistant, the member for Ottawa South, will continue third reading discussion to discuss other elements of the bill.

Ontario is becoming a leader in the health care sector by being the first province to introduce certain pieces of legislation.

Under the Health Protection and Promotion Act, this bill will ban eye tattooing and the implantation of eye jewellery unless performed by a member of a regulated health profession.

Speaker, we’re committed to protect the safety of patients. Bill 160 proposes new transparency legislation, the Health Sector Payment Transparency Act. If passed, this act would require the reporting of information about financial relationships that exist within Ontario’s health care system. Ontario’s medical industry would be required to disclose annually all payments, cash and in kind, above a set value to prescribed recipients. The medical industry includes manufacturers of pharmaceuticals, biologicals, medical devices and other medical supplies.

Those receiving payments could be regulated health professionals, health care organizations, patient advocacy groups, professional associations, pharmacies, researchers and academic institutions. Referred to as a transfer of value, these payments could include things like paid meals, travel, research grants and fees for consulting or speaking engagements, to name a few.

There is plenty of evidence that these relationships exist in our province, across Canada and in other jurisdictions, but we just don’t yet know to what extent here in Ontario. That’s not to say that these transfers of value or payments are in any way improper, but this government believes and many of our partners in the health care system believe it’s important that those transfers of value occur in a transparent environment.

So why is disclosure so important? Because we know that payments from private industry can influence, and do influence from time to time, professional judgment and decisions. So these transfers can lead to real or perceived conflicts of interest for health professionals and can lead in some cases to inappropriate prescribing or biased decision-making within the health sector. Those examples are definitely not in the best interest of patients.

Ontarians want and deserve health care that they can rely on and trust. If passed, this legislation would include appropriate enforcement measures that will enable my ministry to address non-compliance by the medical industry. It’s important to state that the onus for reporting will not be on the recipient of those transfers of value; the onus of reporting will be on the medical industry itself.

The powers that the ministry would have under this legislation would include inspection and audit powers and the authority for the ministry to issue compliance orders to the industry. It would also allow for the data collected annually to be made available to the public through a searchable database similar to a database that has existed for many years in the United States called the Sunshine Act, which reflects transparently similar transfers of value between the medical industry and health care professionals and other entities in the United States.

As a province, we’re not alone in seeking increased transparency between the medical industry and our health care system. I mentioned the United States, but many other countries, including in Europe and Asia, have similar levels of transparency and databases to see if their health care professionals and health care organizations have received funding from the medical industry, and the nature of that funding. But with this legislation, if passed, Ontario would be the first jurisdiction in Canada to increase transparency and allay any concerns about real or perceived conflicts of interest in that important area of marketing and prescription of drugs, medical devices and other medical services.

My colleagues may recall that this form of transparency and disclosure is what the national Open Pharma campaign, led by prominent Ontario physicians, researchers and academics, was calling for earlier this year. In fact, the Open Pharma campaign served as an inspiration for our government to pursue further transparency and disclosure beyond the drug sector.

This past summer, we consulted widely with both the medical industry and the health care sector. I have to say, the vast majority of stakeholders were supportive of improving transparency in the health care sector and said that they would find the disclosure of information on transfers of value highly useful.

This positive reaction includes many in the medical industry themselves—that industry that plays such an important role in terms of being an economic driver and an employer in this province. It plays in so many ways such an important role in the province’s health care system. In fact, that industry, by supporting research, by funding services and equipment in health facilities and partnering with consumer groups on health awareness initiatives—we truly appreciate their contributions.

If passed, this legislation would strengthen transparency and accountability in Ontario’s health care system. It would increase public trust and confidence and allow the Ministry of Health and Long-Term Care and the public to better understand the financial relationships within our health care system.

It would also provide access to information that Ontarians need, want and deserve in order to make the best health care choices, and increase safety for the people of Ontario. By doing so, it would then help make the patient experience the very best possible.

The Deputy Speaker (Ms. Soo Wong): I recognize the member from Ottawa South.

Mr. John Fraser: I’m pleased to rise today for third reading in support of Bill 160, the Strengthening Quality and Accountability for Patients Act, 2017.

As you know, the bill before us covers a great deal of territory across a broad range of health care sectors. It’s an ambitious bill that, if passed, would benefit Ontario patients now and well into the future.

It would support Ontario’s Patients First: Action Plan for Health Care by ensuring that patients receive quality, accountable, transparent health care that is in their best interest.

The Minister of Health and Long-Term Care has already addressed one of the 10 pieces of legislation included in this bill, the Health Sector Payment Transparency Act, 2017. This new legislation would, if passed, help patients and our government better understand the financial relationships between the medical industry and our broader health care sector.

Speaker, I can’t underscore enough how important I believe this is. The transfers of value that exist inside our health care system are important, definitely, for patients and families and all Ontarians to know, but as the health care system operator, I think it’s a critical piece for us to be able to better understand and better manage the system.

It represents a major step forward in strengthening transparency and accountability in our health care system. It would increase public trust and confidence and provide patients with the knowledge and support they need and deserve to make informed decisions about their own care.

In my time today, I will focus on other key aspects of this important bill, starting with amendments to the Long-Term Care Homes Act, 2007. These amendments respond to the Auditor General’s recommendations and public concerns related to care in long-term-care homes. As well, they provide transparency on the circumstances under which a resident can be confined.

While the vast majority of long-term-care homes are substantially compliant with provincial rules and regulations, the proposed amendments would strengthen and expand the strong enforcement system already in place. If passed, these legislative amendments would enhance the enforcement tools by including new financial penalties to ensure that homes with repeated non-compliance issues are promptly dealt with.

The delivery of safe, quality, resident-centred care is a top priority for our government. Ontario has about 630 long-term-care homes serving 78,000 residents. These homes serve adults of all ages who need help with daily living and access to 24-hour nursing and personal care. We want to ensure that they are receiving the safe quality care they need and deserve.

Many of us have or currently know someone in a long-term-care home. I have family in a long-term-care home as well, and both of my in-laws are in long-term care. Most of our experiences—as is our experience in our family with the care—have been positive, because, generally speaking, the majority of these homes operate with extreme integrity. However, Speaker, as you know, there are always those on the outside who aren’t operating in that way.

Many stakeholders have consistently been calling for a more stringent approach to long-term-care home inspections, especially around resident care and safety. These legislative amendments, if passed, would send a clear message to operators that ongoing care and safety of the residents they serve cannot be compromised. In addition to financial penalties, there are also new provincial offence amounts and re-inspection fees for home operators with reoccurring non-compliance.

All long-term-care homes in Ontario already undergo annual inspections. The changes would give the minister authority to issue directives in critical areas, including medication management and to suspend a licence if necessary. These measures would build on key investments we are making in long-term care to improve resident experience so it is comfortable, safe and home-like as possible.

Another aspect of these amendments relates to confinement. Some residents in long-term-care homes may need to be confined to the home or an area of the home to ensure their safety or the safety of others. A resident with severe dementia, for example, is at risk of getting lost if left unsupervised. Currently, long-term-care homes can only confine residents when immediate action is necessary to prevent serious bodily harm to the resident or others. The consent of the resident, or, if the resident is incapable, their substitute decision-maker, is not required.

I want to be clear: Right now consent is not required. There is no legislative framework under which a resident may be confined for their own safety.

The proposed legislative amendments, if passed, would introduce a consent-based framework outlining when and how a resident maybe confined. This framework would serve to uphold residents’ rights and better meets residents’ safety and security needs by providing transparency on the circumstances under which a resident can be confined on an ongoing basis.

The need for confinement would be determined by the long-term-care home operator based on such factors as significant risk of harm. It would require the consent of the resident or their substitute decision-maker. A rights adviser would meet with the resident if she or he disagreed with the confinement or asked for a meeting. These due measures would meet the safety and security needs of long-term-care-home residents in a way that respects their rights. They, their family members, substitute decision-makers and long-term-care-home operators would have a clear framework that sets out exactly when, why and how a resident may be confined.

Speaker, I want to turn your attention to measures proposed under this bill to further enhance the safety and welfare of seniors living in retirement homes. Again, I have some experience as well with this in my own family. My in-laws were in a retirement home for a number of years, so I have a personal concern with the legislative amendments that we’re proposing here in terms of how important they are, I believe, given—I guess I would say—the similar circumstances that we find residents have in long-term care.

Across our province, there are 59,000 seniors living in over 744 homes licensed under the Ontario Retirement Homes Act. An arm’s-length Retirement Homes Regulatory Authority overseen by the Ministry of Seniors Affairs is responsible for identifying, registering and licensing homes. The authority also conducts regular inspections, investigates concerns and serves as an enforcement body, including issuing fines or ordering closures if necessary.

As Ontario’s population continues to grow, the number of retirement homes and seniors living in them will continue to increase. We want to enhance these homes so that they serve the best interest of our seniors, so they can live the safe, dignified lives they’ve worked hard for and deserve. The retirement home sector is diverse. Retirement homes cater to seniors with varying needs, ranging from independent living to more dependent seniors, who may require extensive personal support and care.

The proposed legislative amendments, if passed, would increase resident safety in these homes by strengthening the Retirement Homes Regulatory Authority’s ability to deal with licensed non-compliant and unlicensed operators.

The authority would have increased powers to inspect and investigate retirement homes; it would stipulate requirements related to ceasing operations as a retirement home; it would issue orders to cease operating without an opportunity for a licence; and current confinement provisions for retirement homes would be aligned with the proposed amendments to confinement provisions in the Long-Term Care Homes Act. This would further protect seniors living in retirement homes and improve their care through increased transparency and accountability.

We had some debate about this when we were in committee. Again, what we have right now is a situation where there is no legislative framework. The reality is, in retirement homes, people make a choice to live there. Often you can have couples that are living there because one spouse requires no or very little care and the other spouse requires a great deal of care. In order to have safety of that resident, they may need to be confined to the home, to the residence or a certain area of the residence. But those families choose to live together. That’s their choice. That’s where they want to be. Living in a retirement home and living in a long-term-care home is different.

We have to make sure that there is a legislative framework under which residents’ rights can be protected. That’s why I’m pleased that this is also included the bill. As Ontarians, we owe a great deal to our seniors population. These amendments, if passed, would enhance our retirement homes so that seniors can live safely with dignity, respect and the knowledge to make informed choices.

I would like to focus on some areas of the bill that, if passed, would help improve Ontario’s ambulance services and ensure patients receive the right care at the right time. As my colleagues may recall, last June our government announced plans to modernize and enhance Ontario’s emergency services system. The proposed changes would enable paramedics to provide appropriate, safe, and effective care to low-acuity patients who call 911 by providing on-scene treatment and releasing them or referring them to other health care providers, or transporting them to a non-hospital setting such as a community care clinic or a mental health facility.

In consultations with stakeholders this past summer, there has been a general support with the direction we are taking to expand the scope of paramedics in Ontario. Right now, paramedics can only transport patients to hospital emergency departments, but there may be better places than an emergency department for some patients. In a case where a person is in mental distress, for example, many communities have facilities that would better serve the individual.

It would also get them to the right place at the right time when they need it. A person with a minor injury could be taken to an urgent care clinic where they might be able to see a doctor sooner than waiting in an emergency department. A senior who needs urgent assistance for a medical ailment may not need medical transportation. They may be treated and released by a qualified paramedic without leaving their home.

Legislative amendments to the Ambulance Act, 1990, if passed, would provide patients with increased flexibility and more care and transportation options. This would also help emergency departments continue to focus on higher-acuity patients and improve availability of ambulances to respond to higher-acuity calls. For paramedics, it would mean less time in emergency departments waiting to hand patients over and more time on the road responding to urgent calls.

As a bit of background, there are more than 8,000 paramedics working for certified ambulance services across this province. Last year, about 1.7 million ambulances were dispatched and about 1.1 million patients were transported in Ontario.

Ontario’s aging and growing population is fuelled by a steady rise in calls for ambulance service and visits to our emergency departments. This is driving costs upward and putting unnecessary pressure on the system. At the same time, only a small number of patients transported to emergency departments are deemed of high acuity, requiring more urgent, critical care. Many low-acuity patients with minor ailments are not admitted to hospital treatment. They may benefit from care delivered in a different health care setting. The proposed amendments would enable the ministry to develop new patient care and transportation standards for critically ill patients.

As you may recall, this past June, the government also announced a commitment to provide funding for pilots in two interested municipalities that would enable firefighters who are certified paramedics to provide on-scene treatment to low-acuity patients. Currently, fire departments are situated across the province to respond to calls quickly. The proximity of a fire department to a low-acuity call may provide opportunities to firefighters certified as paramedics to provide appropriate care in a timelier manner while allowing ambulances to focus on higher-acuity calls.

In order to develop a common understanding of the scope and breadth of the firefighter-paramedic pilot, the ministry is planning to consult with targeted partners and providers, as well as patients and families, over the course of the next three months.

The Ambulance Act has not been changed in almost 20 years. Given the scope and skills that paramedics have today, the proposed amendments, if passed, would bring our emergency medical services into the 21st century. Wait times and overcrowding would be reduced in our emergency departments, and paramedics would have more flexibility to deliver alternative care options on-scene to patients, thereby avoiding unnecessary emergency department visits. These changes make a lot of sense. These are changes that would help us allocate our resources better and will help patients get the right health care at the right time, when and where they need it.

With this bill, our government is taking action to deliver a better patient experience across broad sectors of the health care system. This is the driving force behind our Patients First action plan to provide patients with faster access to the right care, better home and community care, and the information they need to stay healthy. Our goal is to build a health care system that is sustainable for generations to come.

Together, as Ontarians, we have made enormous progress, but there is always room for improvement. We can always do better. We can find smarter ways to deliver services, to protect public health and safety, to enhance enforcement, to increase transparency and accountability, and to see everything from the point of view of the patient.

The bill before us contains measures that would, if passed, enable us to move forward quickly with several other much-needed changes. Amendments to the Health Protection and Promotion Act would allow for the regulation of recreational water settings not currently covered under this act. This would include unregulated recreational water facilities like splash pads and wading pools. No one wants their child running around in a contaminated pool. We need to better inspect these locations so we can be confident that they are free of infections. This is a long-needed measure that will protect the health and safety of infants and young children.

Similarly, these changes would also allow the regulation of what we refer to as personal service settings. These include barbershops, hair and nail salons, tattoo and body-piercing parlours, and providers of electrolysis and various other aesthetic services.

When you have a pedicure or a manicure or decide to get a tattoo you’ve always wanted—not that I’ve ever really wanted a tattoo. I don’t know. Can I get a show of hands here? Maybe I should ask: Who’s got a tattoo?

Ms. Sylvia Jones: Maybe you don’t want to know.

Mr. John Fraser: I don’t want to know. Okay. All right. Sorry; I just thought I would break it up there, folks.

Hon. Yasir Naqvi: We’re paying attention.

Mr. John Fraser: You’re paying attention. That’s good. I don’t know how you are with my voice droning on.

These amendments, if passed, would also clarify how the current act applies to food premises that operate out of a home.

Interjections.

The Deputy Speaker (Ms. Soo Wong): Order.

Mr. John Fraser: Okay, now I’ve got you going.

It would make clear that the act applies only to the part of the home used to operate a food business and not the entire dwelling that is used as a home.

Speaker, the ministry has engaged extensively with public health units and municipalities to modernize and transform the work of public health. Stakeholders have told us that our current public health framework is somewhat outdated and does not reflect the evidence of best practices. These amendments to the Health Protection and Promotion Act would bring it in line with the modernized state of public health and strengthen this important sector in our province.

Our government is also strengthening health and safety in a number of other ways. A few years ago, there were reports that a number of patients acquired infections after receiving services at out-of-hospital premises, such as pain and endoscopy clinics. To address concerns, the minister sought the advice of Health Quality Ontario on the quality of oversight in out-of-hospital health facilities.

In 2015, Health Quality Ontario submitted its report to the minister. This report contains 12 recommendations, including the creation of new legislation to consolidate under one roof out-of-hospital and independent health facilities. These non-hospital facilities would be known as “community health facilities.” The new legislation proposed under this bill, if passed, would strengthen the safety and oversight of other key services. In this case, the focus is on services delivered in the community health facilities, including diagnostic imaging, pulmonary function tests, sleep studies and some surgical procedures.

A new act, the Oversight of Health Facilities and Devices Act, 2017, if passed, would accomplish a number of things: It would modernize and expand the regulation of medical devices in all settings to ensure safety and quality when using these devices; it would strengthen the accountability in the system for providing high-quality care in community health facilities; and, through public reporting, it would ensure that patients and caregivers have access to critical information about the quality of care provided.

This new act, if passed, would in future also allow private hospitals or other health facilities to be designated as community health facilities. This means that oversight would be consistent through detailed reporting and enhanced inspection programs. It would also prohibit the creation of new private hospitals and allow for the Private Hospitals Act to eventually be repealed.

There’s an increased need to ensure that the number and range of services and procedures being performed outside of public hospitals are delivered in a way that protects patient safety and informs patients when there is a safety or a quality issue. The regulatory regime to oversee these services and procedures must require compliance with consistent evidence-based safety and quality standards and include effective and progressive enforcement tools to address instances of noncompliance.

When there is a safety or quality issue in services provided, patients need to know that they will be informed. The new act, if passed, would require community health facilities to post in a prominent place, visible to the public, inspection reports, compliance and cessation orders. The procedure for the public to allow for the making of complaints, with contact information, would also be posted. To accomplish this, the new Oversight of Health Facilities and Devices Act, 2017, if passed, would repeal the Independent Health Facilities Act and consolidate oversight of non-hospital facilities.

Another act that would be repealed under the Oversight of Health Facilities and Devices Act, 2017, if passed, is the Healing Arts Radiation Protection Act or HARPA. HARPA regulates x-ray machines across the province.

Let me tell you: A lot of things have changed since 1980—I think we all know that—including our hairstyles.

Interjections.

Mr. John Fraser: Just making sure you’re awake.

Technologies and the landscape have changed significantly. HARPA no longer meets the needs of this high-tech and evolving sector. It has not kept pace with advances to ensure quality control and has permitted the potentially unsafe use of these technologies, which may harm the patient, the provider and the public if not properly operated.

Two years ago, Health Quality Ontario established an expert panel to provide the government with recommendations on how to modernize HARPA. The expert panel’s final report made six key, broad recommendations, including replacing HARPA with new legislation. The new legislation would expand the current scope of regulated devices to all existing and emerging technologies beyond x-ray machines. The Oversight of Health Facilities and Devices Act, if passed, would provide the reassurance that services delivered in non-hospital facilities or with medical radiation devices are safe and up to date.

The new act would improve the quality of care that patients receive through more rigorous oversight and a stronger governance, accountability and enforcement structure. The scope of the regulation would also be expanded to include MRIs, ultrasound, nuclear medicine, and new technologies to be added in the future.

Speaker, under Bill 160, we are proposing another new act which, if passed, would strengthen the safety and oversight of diagnostic medical sonographers. These are individuals qualified to apply sound waves to produce images for physicians, midwives and nurses. The new Medical Radiation and Imaging Technology Act, 2017, if passed, would replace the current Medical Radiation Technology Act, 1991. It would apply to the entire medical radiation and imaging technology profession, including diagnostic medical sonographers.

There is good reason to bring sonographers into the fold: A new years ago, the Health Professions Regulatory Advisory Council found that inconsistent quality assurance and education requirements in the unregulated sonographers’ profession raised patient risk. The council recommended that the profession be regulated by the College of Medical Radiation Technologists of Ontario. It also recommended that the Medical Radiation Technology Act, 1991, be amended to reflect the full membership of the college.

Last year, the minister’s task force on sexual abuse of patients also recommended that unregulated professionals such as sonographers need to be identified and assigned to an existing college for regulation in the interest of public safety. As recommended by the council and the task force, the Medical Radiation and Imaging Technology Act, 2017, if passed, would fully reflect the inclusion of diagnostic medical sonographers as a new specialty within the College of Medical Radiation Technologists of Ontario.

The new legislation maintains the vast majority of existing provisions in the former act. Key changes are intended to make the act more representative of the regulatory college’s expanded membership. The bill before us, if passed, would also update the name of the health regulatory college overseeing the profession. The name would change from the College of Medical Radiation Technologists of Ontario to the College of Medical Radiation and Imaging Technologists of Ontario.

The name of the profession would also change from “medical radiation technology” to “medical radiation and imaging technology,” and the scope-of-practice statement would include a reference to the application of sound waves. The titles used by the radiation and imaging professionals that make up the college’s membership would also be appropriately reflected in the new act.

There would be some implementation costs: registering approximately 3,000 new members; rebranding; updating the standards of practice and bylaws; and updating the public register, to name a few. These costs would be supported by college revenue from new and existing membership fees. There would be no significant additional costs or other impacts to regulated health professionals’ practice or to the facilities where they practise as a result of the proposed legislation.

If the new act is approved, the ministry would work with the college and other partners to ensure the smooth transition of both the newly regulated diagnostic medical stenographer specialty and the college.

I’d like to turn to a number of other key aspects to the bill before us. They’re very important to all of us. First are proposed amendments to the Excellent Care for All Act. If passed, they would enable the Patient Ombudsman to conduct investigations in private by excluding records from the Freedom of Information and Protection of Privacy Act, also referred to as FIPPA. The Patient Ombudsman’s mandate is to help resolve complaints about health care sector organizations from patients and caregivers.

Her office oversees the province’s public hospitals, long-term-care homes and services delivered by local health integration networks. It may initiate investigations in response to complaints and, on its own initiative, make recommendations to other health sector organizations following those investigations.

The proposed amendment to exclude the Patient Ombudsman records from FIPPA would help build on the progress already made to improve the health care experiences of all patients across Ontario. Fear that their records would be disclosed under a FIPPA request may prevent some patients and caregivers from bringing forward their concerns or complaints. Patients, caregivers and others who come forward with concerns about their health care need to feel they can speak freely without fear of retaliation or discontinuation of services because their information has been disclosed.

This measure would ensure that when patients and caregivers come forward with complaints, their information will remain confidential. Knowing that your information will remain confidential is an important part of enabling effective investigations by ombudsperson bodies, such as the Patient Ombudsman.

In addition to these changes, the proposed amendments, if passed, would enable Health Quality Ontario to lease reasonably necessarily office space without requiring Lieutenant Governor in Council approval, as is now the case. The agency would also have greater operational flexibility, and its administrative cost would be reduced.

This change is also in line with the modern approach commonly found with other crown agencies, which are allowed to enter into lease agreements for reasonably required office space without Lieutenant Governor in Council approval.

If passed, the proposed amendments would help fulfill our government’s objectives in the Patients First: Action Plan for Health Care and the ministry’s commitment to patient-centred care. They would build on the progress already made in improving the health care experiences of all patients across Ontario. Indeed, we have much to be proud of. But the fact is, we can always do better, because better has no limits.

We want to ensure that all Ontarians, regardless of who they are or where they live, are receiving the high-quality care they need and deserve. Protecting the privacy of the Patient Ombudsman’s investigative records would give patients and caregivers the peace of mind they need to move forward with their complaints. This, in turn, would help ensure the integrity and effectiveness of investigations and the quality of health care Ontarians receive.

Some stakeholders have expressed concerns with the proposed exemption of the Patient Ombudsman’s investigative records from FIPPA, including the Office of the Information and Privacy Commissioner. If the proposed amendment is passed, the ministry is committed to continuing discussions with these key stakeholders to ensure that all concerns are addressed.

There is another proposed amendment in the bill before us that deals with disclosure of personal information in a housekeeping amendment to the Ontario Drug Benefit Act that, if passed, would clarify the ministry’s authority to disclose personal information for purposes related to the administration of the act. The proposed amendment would clarify the ministry’s authority to disclose personal information to effectively administer the act. This would be a strictly technical amendment that is not intended to affect the current operations, if passed.

The bill also includes another proposed amendment to the Ontario Drug Benefit Act. If passed, it would remove the last outdated reference to “physicians” in the act to reflect that other health care professionals, such as nurse practitioners, can now prescribe certain drugs covered under the Ontario Drug Benefit Program where deemed within their professional scope of practice.

As you may recall, the Protecting Patients Act, 2017, included amendments to the Ontario Drug Benefit Act to include a nurse practitioner as an authorized prescriber under the Ontario Drug Benefit Program. The amendments in the Protecting Patients Act, 2017, came into effect this past July and allow the ministry to fund non-drug therapeutic products, such as diabetes testing strips and nutritional products, prescribed by nurse practitioners. Nurse practitioners can also submit a funding application to have a drug product funded through the Exceptional Access Program for a specific patient.

These changes are benefiting Ontarians by improving access to drug benefits for patients who receive their primary care from nurse practitioners. They are helping to reducing delays caused by nurse practitioners having to seek a co-signature from a physician to ensure that their patients receive coverage for certain products.

Under this bill, the ministry is proposing a complementary amendment to the Ontario Drug Benefit Act relating to the reimbursement criteria for what are referred to as “limited use” drugs. Limited-use drugs are products found under the Ontario Drug Benefit Program for patients who meet certain clinical criteria. This ensures that the drugs are funded in clinically effective and appropriate situations. In some cases, this may involve specifying that the drug is only funded if prescribed by a physician or a certain class of physicians.

A drug may be recommended for limited use for a number of reasons; for instance, when it has potential for widespread use outside conditions for which the benefit and cost-effectiveness have been demonstrated, where it has been proven clinically useful but is recommended for use only after other alternatives have been tried, or if the drug is very costly and a more cost-effective alternative is available with the same benefits.

The proposed amendment, if passed, would clarify that the clinical criteria may be established requiring a drug to be prescribed by any class of prescriber, including nurse practitioners, in order to be funded under the Ontario Drug Benefit Program. The proposed measure would further align the Ontario Drug Benefit Program with nurse practitioners’ current scope of practice and help increase patient access to the medications that they need.

Overall, stakeholders, including the College of Nurses of Ontario and physician groups, were supportive when nurse practitioners were designated as an authorized prescriber under the Protecting Patients Act, 2017. The proposed amendment, if passed, would complement these changes. It also addresses concerns raised by the College of Nurses that current restrictions under the Ontario Drug Benefit Act may create a barrier to nurse practitioners providing effective and comprehensive care to Ontario drug benefit recipients.

Before I reach the end of my allotted time, there’s one last piece of the legislation that I’d like to talk about. This is the proposal under this bill to repeal the Ontario Mental Health Foundation Act and dissolve the foundation. If passed, this bill includes related amendments to the Pay Equity Act, the Substitute Decisions Act, and the Social Contract Act, which make reference to the Ontario Mental Health Foundation Act and “the foundation.”

The intent is to repeal the Ontario Mental Health Foundation Act in its entirety. This includes both

part I, which relates to the Ontario Mental Health Foundation, and

part II, which relates to the Clarke Institute of Psychiatry. The Clarke Institute no longer exists and was amalgamated with two other corporations to form the Centre for Addiction and Mental Health. While it is not necessary to repeal

part II of the act to dissolve the foundation, this is an opportunity to repeal the second part of the act, which has now been obsolete for some time.

The decision to dissolve the foundation was based on the results of a very thorough mandate review. The review found that the bulk of the foundation’s mandate—diagnosis and treatment—is very out of date and currently being delivered by community-based organizations. It also found that by directly funding research through the ministry’s existing Health System Research Fund, we would be operating much more efficiently.

Let me be clear that, in dissolving the foundation, our government is not cutting back on our mental health funding commitments. The foundation’s funding allocation of up to $1.86 million annually would remain within the ministry to directly support mental health research. This better aligns with our government’s and ministry’s priorities and with the goals of Open Minds, Healthy Minds: Ontario’s Comprehensive Mental Health and Addictions Strategy. If the repeal of the act and the dissolution of the foundation are approved through passage of the bill, the foundation would be dissolved by March of this coming year.

The Ontario Mental Health Foundation has a history of supporting emerging and existing researchers. Their accomplishments have contributed to Ontario’s strong mental health research environment. I want to assure my colleagues that our government remains committed to supporting mental health through Ontario’s Health System Research Fund. We would also remain committed to Ontario’s comprehensive mental health and addictions strategy, which is helping to improve the lives of all Ontarians with mental health challenges.

All of the proposed changes and amendments I have spoken about today move us forward on our shared commitment to put Ontario patients first.

I do want to mention that there are a couple of things that aren’t in my speech here that I think we accomplished as a committee. Not to go back onto tattooing—but I was very pleased to see in the bill that we had all-party agreement, through unanimous consent, to restrict this practice. I think there’s a certain “ick” factor in the pictures that we all saw. It is incredible, the kind of damage that was potentially being done to Ontarians. I think that we’re all pleased that we were able to work together on that.

I know there were also some changes that related to public health, particularly in Oxford county. We made some changes there as well, too.

I believe there were also some changes with regard to long-term-care homes and municipal long-term-care homes that we all agreed on and brought forward.

I think those things were really important things in the bill. It’s a really big bill. I’m glad we were able to do those things as well.

While I have this opportunity, I’d just like to thank all the members of the committee. It was great to work with you. It was a lot of work over a few days. I’d also like to thank the ministry staff who were there, especially the counsel, who were routinely and regularly called upon to clarify some things for us. They did a lot of great work, and we appreciate very much them being there for the duration of committee.

Speaker, we want to enhance the quality and transparency in health care services. We want to make our health care system more accountable and cost-efficient. Some key pieces of legislation in this bill are aimed directly at strengthening oversight and safeguarding the quality of care that patients receive across our province each and every day.

Some amendments aim for better care and safety for residents in long-term-care and retirement homes. Others are targeted at building patient trust and public confidence in Ontario’s health care system and service providers. Still others would arm patients, families and caregivers with the knowledge they need to make informed health care choices. One, the requirement for the medical industry to report payments to health care professionals or organizations, would set Ontario apart as the first jurisdiction in Canada to take such a leap forward.

We’re all taking these steps because we want Ontarians to know that we have their best interests at heart, and that their need for quality health care comes first, always first.

The proposed amendments in this bill would build on the progress we have already made and on what we have heard from extensive consultations with stakeholders across our health care system.

Again, if passed, this bill will continue the transformation of health care delivery in Ontario and for many years to come.

The Deputy Speaker (Ms. Soo Wong): Questions and comments? Questions and comments? Last call for questions and comments. I recognize the member from Elgin–Middlesex–London.

Mr. Jeff Yurek: Thank you, Speaker. I didn’t realize we had an opportunity for questions and comments. Or is this my hour of debate?

The Deputy Speaker (Ms. Soo Wong): This is questions and comments.

Mr. Jeff Yurek: It’s just that my time is ticking away here.

The Deputy Speaker (Ms. Soo Wong): Okay. Further debate then? Further debate?

Mr. Jeff Yurek: I wanted to do the two-minute questions and comments.

Interjections.

The Deputy Speaker (Ms. Soo Wong): Order. I have asked twice for questions and comments, and no one stood up. So I will recognize the member from Elgin–Middlesex–London for further debate.

Mr. Jeff Yurek: Further debate—thank you, Madam Speaker. I’m proud to stand up today and rise on behalf of the PC Party and our leader, Patrick Brown, to begin our debate on third reading of Bill 160,

An Act to amend, repeal and enact various Acts in the interest of strengthening quality and accountability for patients.

Once again, I’ll commend this government on titling bills. They are experts at making all their legislation sound wonderful. However, it’s usually the details beyond the title that we have to piece away at to bring out the problems that may arise from many of their pieces of legislation.

Madam Speaker, this bill, in essence, is an omnibus piece of legislation. It contains 10 separate schedules, or 10 separate bills, that could come to this Legislature on their own for debate, input from stakeholders and proper proceedings. However, this government has decided to bundle that all together and rush it through this House, all in an effort to be perceived to be effectively changing health care in our province.

Unfortunately, we’ve heard from many stakeholders, particularly patients, that there was a lack of consultation in this process. This bill was rushed in piecing together—if you followed my initial debate in second reading, there were many questions and concerns raised that we had hoped would be addressed through the committee process, and fixed through amendments.

I’d like to note that the member from Nickel Belt from the third party mentioned yesterday in committee that

schedule 9 of this bill had over 62 amendments on the government side alone. The amendment deadline was over a week and a half ago, and it was still on this past weekend that we received the majority of amendments to

schedule 9. I think that clearly shows that this government was ill prepared for this bill. It was rushed, and unfortunately, they rewrote almost the whole

schedule because of the confusion and the misdirection it showed with regard to the creation of this bill. I think

schedule 9 should have been pulled from this bill at that time, when they realized that they had critically messed up this piece of legislation. They should have pulled this bill out and brought it back as a separate piece of legislation to have proper consultation and proper debate, so that the people of this province really understand the effects and what is going to happen with regard to

schedule 9. The questions that were raised—we still don’t have a clear understanding of the effects of the amendments to this piece of legislation.

Many times in committee, the third party and myself would ask the question to the government, “What specifically does this amendment mean?”, and they couldn’t answer it. Their response was either to bring staff to try to answer it, or, “It’s up to regulation what’s going to happen.” To have the changes that this bill is incorporating in all 10 schedules—and the majority of the responses were, “It’s up to regulation. We’ll figure it out in regulation”—that’s a concern.

I think it’s a concern not only for this side of the House; I’m sure it’s a concern for some of the backbenchers on the government side of the House and for Ontarians—the fact that we’re passing an omnibus piece of legislation with large changes to our health care system and we really don’t have a clear vision of what is going to occur in our health care system.

Again, there was too little consultation with stakeholders, but the main ones who were missed out on were patients. Time and time again, this government fails to include patients in the development of health care legislation that is going to affect their care. We even heard from ministry staff during my technical briefing months ago that some sections of this bill had zero consultation with patients.

When you’re creating pieces of legislation that are affecting the service and delivery of health care and that are also affecting access to the personal, private medical information of patients in Ontario, it’s critical that the government consult with those patients who will be affected, patients who should be the centre of our health care system. But unfortunately, after 14 years with this government, the focus isn’t on the patient; it’s on the failed experiments of increased bureaucracy that have moved precious dollars away from patient care.

This government has moved the protection of private health information over its many bills over the last two years—has deteriorated the protection, and it has been outlined numerous times, again, by our privacy commissioner.

This government has moved to a top-down-directive bureaucratic health care system which is leading to poor outcomes for patients, increased gaps in the system and unintended consequences from the many health bills this government has passed.

Not since the days of the NDP government of Bob Rae have we seen a government that has mismanaged the files of health care in government. Under the NDP, not only were hospital beds cut, particularly 25% of our mental health beds, but the NDP also cut spaces in our medical school system, which led to the shortage of doctors that we have had over the past 20 years.

Also, during that mismanagement of time, the NDP government created their social contract, which was created through legislation outside of the contract agreement with their public sector workers. The government, unfortunately, made workers take time off, unpaid. Because they mismanaged the system so much, they had to make those cuts outside of contract negotiations to the workers of this province. Unfortunately, the NDP did realize their mistake of mismanagement and prorogued. At least they walked away, but this government continues to progress ahead with many pieces of legislation, which is totally a mismanagement.

Madam Speaker, the mismanagement of this government again was highlighted yesterday in the Auditor General’s report that showed this government not only cost patients access to timely and needed care, but it also spent our precious health care dollars outside of our jurisdiction instead of in Ontario. Patients have had to seek life-saving treatment outside of our province at a cost not only to themselves but to the Ontario taxpayer.

This government has a history of ignoring our Legislative Assembly independent officers. They have repeatedly ignored the reports of our Auditor General. In fact, in volume 2 of the Auditor General’s report yesterday—mind you, yesterday’s report was the largest I’ve ever seen from the Auditor General, and in a conversation the member from Nepean–Carleton, Lisa MacLeod, mentioned that it was the largest she has seen in the 12 years she has been here.

Anyway, the report yesterday showed that the government failed to act on any of the recommendations on palliative care from a report two years ago. I’ve spoken to many doctors in this province regarding access to palliative care and how it’s falling apart or it’s inaccessible in many parts of this province. This has forced many patients and families to suffer or made them utilize emergency room departments for their support and care. This is part of the reason why our emergency departments are overrun, in addition to the record number of ALC patients in our system.

The Auditor General referred to that part about people having to utilize ER departments in yesterday’s volume 1 of her massive report.

Thankfully, our colleague Sam Oosterhoff from Niagara West–Glanbrook has a private member’s bill coming forward next week which will help create some structure to palliative care, and I’m hopeful the government will be supportive of that piece of legislation.

However, back to my original point and back to the bill: As I said before, this government has a history of ignoring the wisdom of our independent officers of the Legislative Assembly, not only the Auditor General but the Information and Privacy Commissioner. The Information and Privacy Commissioner submitted numerous amendments to this piece of legislation to protect the personal, confidential health records of patients in this province. We submitted those amendments to committee. The third party supported those amendments. However, the government voted down every single amendment put forward by the privacy commissioner and the PC Party.

This government continually has opened access to personal health information in every single piece of health legislation in the past two years. They’re eroding the trust and security patients feel when discussing their personal health matters with their health care professionals. Government staff, bureaucrats, LHIN staff and ministry staff can now access your personal health information. Too many people have their fingers in the pot, and the privacy commissioner has warned this government of this concern time and time again.

During this process, the PC Party submitted dozens of amendments to this omnibus piece of legislation. Every single amendment was defeated by this government save one. These amendments came from stakeholders such as the privacy commissioner and the CPSO. Just to note, the CPSO’s amendments were based on their experience of having oversight of independent facilities. Their amendments were put forward to ensure there were no gaps in oversight in the system that is going to be created in this piece of legislation. It’s unfortunate that the government voted against them.

However, I was so excited when the government voted in support of one of our amendments that I actually had it recorded for posterity’s sake, so there is proof so they can say they actually supported something of ours. However, it’s one, and I believe it’s only about the second or third amendment in the entire past two years that they have supported at committee in a health bill.

I find it unfortunate that this government continually opposes not only our amendments but the third party’s amendments time and time again. I’m quite uncertain as to why they feel that, through consultation at committee time, the amendments brought forward by stakeholders and patients—why they feel it’s only the government that is supportive of amendments. I don’t know if they’re fearful of supporting our amendments—that we’d use it against them. However, to strengthen a bill and strengthen democracy, it’s working together to strengthen a piece of legislation.

The one amendment they did support was to ensure that compliance and cessation orders from inspectors of community health facilities are posted for public view. It would provide an incentive for licensees to address the issues identified in an inspection. It was interesting that in drafting this piece of legislation—which was rushed—this was missed.

You can go just about anywhere in this province to any restaurant and view compliance orders before choosing to eat at that restaurant. They’re either posted or they’re online. You could walk up to the door and see—they’re red, yellow or green. You can download with your Internet what the report actually said and you can make an informed decision on whether or not to eat at that restaurant.

Mind you, too many people still eat at the yellow-warning restaurants. My wife’s job is as a public health inspector. When she tells me what a yellow warning means—I would not want to eat at those facilities. I’d be concerned. Eat at the green ones.

What was missing in this legislation was that, when choosing your health care facility to get some treatment, the orders wouldn’t be posted. You could walk in blindly and not know what had been posted for that particular centre. I’m glad the amendment was accepted, because it’s important. If there is an order outstanding, you can then judge whether or not it’s something you want to take into consideration for your health before utilizing that service, to ensure whether it’s something minor and you go, “Okay, it’s fine,” or it’s something like, “I’ll look elsewhere.

I’ll work with my health care professional and find somewhere else to go.” I think it’s important that that is posted—and again, it also brings an incentive through the fact that, because it’s now public and posted, the person operating that facility will make amends in a quick, effective and efficient way to ensure that they’re delivering the health care we expect.

I mentioned earlier but I want to reiterate that the critical flaw in this piece of legislation is that so much has been left to regulation. It raises the concern that the government hasn’t done due diligence in drafting this piece of legislation. It was rushed. Consultation was minimal. Going forward, the public, opposition members and in fact government members have no clear idea of what the consequences of this bill will be. Regulations are not debated in this chamber. The opposition parties have little to no say.

This omnibus bill gives the government immense power without the ability of sober second thought from the opposition. I note the government members during committee had no idea of how this bill will affect the health care system. Continually throughout the process, the government members repeatedly answered our questions on amendments, saying that everything is left up to regulations. They hope it’s going to be found out during regulations. There’s hope that costs could be controlled. We all know how cost containment works with this Liberal Party.

In

schedule 4 of the bill, Health Sector Payment Transparency Act, we are no further along on how the publication of financial relationships will proceed. We have no idea of the costs to create the system. As I mentioned in second reading, in the United States it’s $300 million to $400 million a year to create their system. Who is going to pay for that? We have no idea what threshold this government used to post the information. Is it going to be $10, as in other jurisdictions? Is it $5? Is it $100?

We heard at committee that these postings, if done incorrectly—if implemented wrong—will have negative consequences for clinical trials and research in our province. Unfortunately, this government doesn’t know how they are going to post it. We put forward amendments to put context to those postings, because numbers on a website can be misconstrued in many, many ways; however, if there’s context linked to that transparency, then people will have a better understanding of why that transaction occurred.

We are all for increased transparency and accountability. I don’t think you could question any member in this House that they are not supportive of that. However, it has to be implemented correctly, or unintended consequences will occur. We see these unintended consequences in every Auditor General report released every year over the last 14 years. Unfortunately, we’re no further ahead at finding out what the answers are with respect to the reporting of the transparency payment act.

Just because I only have a few minutes, I’ll give a positive before I go.

Mr. James J. Bradley: This is good news.

Mr. Jeff Yurek: I think it’s great that we are able to work together as all three parties to bring eye tattoos to an end in this province. I’m glad we all agreed it had to be added in the bill, and I’m glad the minister mentioned it in the speech. However, it wasn’t part of Bill 160 at all, and it’s one of the main things the minister focused on, but I am glad that we were able to listen to the Eye Physicians and Surgeons of Ontario for their advocacy. We thank Dr. Jordan Cheskes and Dr. McReelis, who was also there—we thank that organization for bringing this to the forefront.

This works, this way. We know it’s a government bill. The government has a majority. It’s as good as passed, this bill. We understand that. I know they always say, “If this bill passes.” Yes. It’s a government bill. They are not going to defeat themselves on this piece of legislation.

So I am very, very glad to see that all three parties worked together to ban eye tattoos, which is a dangerous activity, causing blindness—eye jewellery—putting it in our eyes.

Hon. Eric Hoskins: Keep going. Stay happy. More positive.

Mr. Jeff Yurek: One more positive for the minister: I am happy that we got together to—

Interjections.

The Deputy Speaker (Ms. Soo Wong): Order.

Interjections.

Mr. Jeff Yurek: I got that one.

What I’m going to talk about is the changes to the county of Oxford’s health unit, which will enable the municipalities between the county of Oxford and the county of Elgin to look to merge their health units to better utilize their money.

The Oxford CEO and medical officer of health are retiring. This is a perfect opportunity, considering Oxford and Elgin have the same demographics. The geographic—they have Woodstock; we have St. Thomas; we have a farming community. It’s a good match, and it’s something that, I think, will utilize our health care dollars more efficiently. It’s something both municipalities want. They of course have to do their due diligence in consultation with members of the public to ensure that they’re supportive of it, but I’m glad the ministry worked with the opposition members to ensure that this change will occur, or to remove the barriers so that the change has the possibility to occur.

Third reading debate deemed adjourned.

The Deputy Speaker (Ms. Soo Wong): Seeing as it’s 10:15, I will be recessing the House until 10:30.

The House recessed from 1015 to 1030.

Introduction of Visitors

Mr. Lou Rinaldi: I would like to recognize here at Queen’s Park today, from the city of Belleville, Mayor Taso Christopher; Karen Poste, the economic development director; Rick Kester, CAO; and Mark Fluhrer, director of recreation, culture and community services.

Two other guests, Gail Rayment and Tony Rayment, are here to have lunch with their MPP. Welcome to Queen’s Park.

Mr. Michael Harris: I’ve got a couple of introductions. I would like to welcome Glen Cleasby, a friend of mine from the Waterloo region, as well as Chandra and Dave Kudsia from Kitchener-Waterloo. Welcome, gentlemen, to Queen’s Park.

Hon. Reza Moridi: It’s a great pleasure to welcome Mrs. Fakhrieh Afshari and Mr. Kambiz Afshari, sitting in the members’ gallery.

Mr. Todd Smith: I too would like to welcome the delegation from Belleville that’s here: His Worship Mayor Taso Christopher; and from economic development, we have Karen Sharp; also the CAO, Rick Kester, is joining us; and from the city of Belleville, my good friend Mark Fluhrer is here as well. Welcome, folks.

Mr. Arthur Potts: It gives me great pleasure to introduce my good friend Sharon Kiff, who is the spouse of Stewart Kiff, and their lovely daughter Elizabeth Kiff, who are in the members’ gallery. They’re here with some students: Nathalia Scofild, Aaron Sheppard, Anna Chudakov and four students from Japan who are visiting—a special welcome to Hina Itoh, Rina Seno, Inori Yamata and Masahiro Iida. Konnichi wa. Welcome to Queen’s Park.

Mr. John Vanthof: On behalf of the member from Welland and one of our pages, Allan Buri, I would like to welcome his aunt Rita Smith, his aunt Diana Hutton and his uncle Bruce to the Legislature today.

Hon. David Zimmer: There is a group of students from Centennial College in the government relations program here observing the machinations of government. They’re here with their instructor, Phyllis Bennett.

Hon. Deborah Matthews: I am delighted to introduce Ananya Nair and Kathy Huang. They’re both health sciences students at McMaster University who are benefiting from the new OSAP and happy to tell that story.

Mr. Michael Harris: Today, Davis Gates will be our page captain. His mother, Jacqueline Armstrong-Gates, is with us, as well as Jeff and Victoria, in the public gallery. Welcome to Queen’s Park.

M. Grant Crack: Je veux souhaiter la bienvenue au président du conseil scolaire franco-ontarien catholique de l’est de l’Ontario, M. Jean Lemay, et aussi au directeur général, M. Benoit Mercier. Ils sont avec nous ce matin.

The Speaker (Hon. Dave Levac): The member from Prince Edward–Hastings on a point of order.

Mr. Todd Smith: Point of order: I’d like to correct my record. I introduced Karen Poste as Karen Sharp this morning. Karen Poste is with economic development.

The Speaker (Hon. Dave Levac): Members are always allowed to correct their own record.

Ms. Lisa MacLeod: I know we’re going to talk a lot about raccoons here today but I see there’s an old badger that just arrived here. I’d like to introduce Richard Brennan.

The Speaker (Hon. Dave Levac): By tradition, I never speak to the press, but I will take responsibility and I apologize for bringing Badger back.

Minister of Education.

Hon. Mitzie Hunter: Speaker, I have an introduction that I would like to make.

Bonjour et bienvenue à Jean Lemay, Benoit Mercier et Helen Vigneault : le président, le directeur général et la directrice des communications de l’Association franco-ontarienne des conseils scolaires catholiques.

Le Président (L’hon. Dave Levac): Merci. Bienvenue.

I’m sure that you’ll join me in my introduction. In the Speaker’s gallery today, someone who has worked in the Legislature for over 45 years, now retired: our friend, the wonderful Gloria Richards, is here today.

As a footnote, she worked for over 15 Speakers in the Legislature. I think she has a favourite, but I’m not going to say anything.

The member from Mississauga–Streetsville.

Mr. Bob Delaney: Our legislative page captain for today hails from the riding of Mississauga–Streetsville. That’s Devon Kisob. His mom, Winnifred, is here. Previously, his sister, Massoma Kisob, was a legislative page from our riding as well. Please acknowledge his mom, who is back again to watch yet another of her children as a page captain.

Oral Questions

Energy policies

Ms. Lisa MacLeod: Speaker, merry Christmas and thank you for your wonderful party last night for all of our deserving staff.

My question is to the President of the Treasury Board. There were some astonishing details in yesterday’s Auditor General’s report. Nine companies billed ratepayers $260 million in ineligible expenses. Only $160 million was recovered. Ratepayers are still on the hook for an astonishing $80 million. That’s unacceptable. The money must be returned.

To the Treasury Board president: Will the Liberals guarantee every cent is repaid by the end of the year, by December 31?

Hon. Liz Sandals: Minister of Economic Development and Growth.

Hon. Brad Duguid: I’m happy to respond again to this issue. The fact is, Mr. Speaker, the IESO caught on to what looked like some form of exploitation happening to their program. They did some in-depth work over a number of years. They’ve recovered, I believe, two thirds in total of the dollars that they deemed to be ineligible. Many of these ineligible costs were in dispute with the companies, so it wasn’t a case where the companies agreed that all of these costs were ineligible.

There was a negotiation that took place. The IESO had, I believe, $168 million that was repaid, because that’s the amount they thought appropriate, given the discussions they had with the companies.

Interjections.

The Speaker (Hon. Dave Levac): We’re working on warnings.

Supplementary?

Ms. Lisa MacLeod: The IESO didn’t catch on; they got caught. What were these companies using ratepayer money for? Wealthy executives and Liberal insiders were expensing raccoon traps and scuba gear.

Mr. Speaker, only this Liberal government would let wealthy executives expense raccoon traps while ratepayers are afraid to open their bills. When will the money be paid back—by December 31?

Hon. Brad Duguid: As I said, the money has been reimbursed. There were some dollars that were in dispute. There were ineligible costs that were identified. The IESO did what they ought to do: They investigated. One of the companies was fined $10 million. They take this seriously.

There is no excuse for any company to try to exploit any system that’s in place. But I do say—and I say this sincerely—when a company has the ability to exploit a system, it means there are issues with the system. That’s why the IESO has also strengthened the system, in particular the definition of what eligible and ineligible costs are, to ensure that this can never happen again.

The Speaker (Hon. Dave Levac): Supplementary?

Ms. Lisa MacLeod: This scandal started out four ministers and two Premiers ago, and it’s still ongoing and we’re still looking for $80 million. I’ve seen a lot over my time at Queen’s Park—billions wasted here, billions wasted there—but yesterday was different. Yesterday was something else. The auditor revealed that, while seniors saw their power disconnected in the dead of winter, wealthy executives were expensing thousands of dollars’ worth of luxuries. I am not sure which was worse, if it was the car washes, the raccoon traps, the landscaping, the coveralls, the overalls, the parkas or scuba gear, all expensed by wealthy executives and Liberal insiders out of the wallets of ratepayers.

Mr. Speaker, the egregious abuse of taxpayer dollars is astonishing. How long was the Liberal government going to allow their insider friends to expense gear like scuba gear and raccoon traps? Answer me that.

Interjections.

The Speaker (Hon. Dave Levac): Be seated, please. Minister?

Hon. Brad Duguid: The so-called Liberal insiders that the member is referring to have donated to that party well over $100,000, so if anything, they’re PC insiders. Maybe we should be more concerned, Mr. Speaker, because they are certainly more PC insiders than they are Liberal insiders. The fact of the matter is, if the member wants to politicize this, so be it. I’ll go there too.

That party knows a thing or two about gaming. They know a thing or two about exploiting. When you look at their tabloid document that looks more like a Teen Beat magazine than it does a platform, Mr. Speaker, you see on the front of that document a claim that they’re cutting income tax by 22-point-something per cent. They are doing nothing of the sort. It’s a bogus tax cut they’re promising. That’s what I call exploitation.

Interjections.

The Speaker (Hon. Dave Levac): Stop the clock, please. Be seated, please. As I suspected, we’re in warnings. Somebody might have already gotten one. Clearly, we’re in warnings.

Supplementary?

Mr. Todd Smith: New question.

The Speaker (Hon. Dave Levac): Correct. New question.

Energy policies

Mr. Todd Smith: My question this morning is for the Acting Premier. The government’s panel to write new rules for the electricity system is seriously compromised. We know from the auditor’s report yesterday that no fewer than five members of the panel put together by the government either broke existing market rules or were under investigation while they were helping write the new rules for the electricity system. We know that only two members, including one of the co-chairs, were identified by name. Three more companies who gamed the system for a combined $78 million remain unnamed.

How is it that five government insiders were able to game the system for hundreds of millions of dollars, and this government then rewards them by putting them in charge of writing new rules for the electricity system?

Hon. Deborah Matthews: The Minister of Economic Development and Growth.

Hon. Brad Duguid: For the life of me, I don’t know why the PCs always want to refer to PC insiders as Liberal insiders, because they continue to do that. The folks whom they’re frivolously referring to actually donate over $100,000 to the PC Party, Mr. Speaker. If they want to get political with this, so be it.

This panel is a very important panel. Two members have resigned from the panel who were involved with some of the companies that were deemed to have been exploitive of the previous system. The fact is, though, a number of these costs are in dispute with these companies, and that’s fair enough.

What’s important are this panel’s recommendations and the market renewal system that this panel is working on that’s going to ensure that we have an even more efficient system put into place by 2019, which is the work that’s being done to ensure that we continue to have not only a strong, reliable system, but an affordable system as well.

The Speaker (Hon. Dave Levac): Supplementary?

Mr. Todd Smith: Back to the minister: All we know from the auditor’s report is that one of the three unnamed companies is a generator. It sounds like the minister knows who we’re talking about, so why won’t he share these names with us this morning? That company that filed $51 million in inappropriate expenses that ratepayers ended up paying for—this is a serious, serious issue, Speaker. We know that these companies are fighting to keep some of the expenses they claimed, but we don’t know who they are. We want to know who they are. Again, the minister knows who they are.

We don’t even know if they’re still helping to write the new rules or if there’s another convenient resignation on the way, like we saw Friday.

Interjection.

The Speaker (Hon. Dave Levac): The President of the Treasury Board is warned.

Were you finished?

Mr. Todd Smith: No.

The Speaker (Hon. Dave Levac): Do you have a wrap-up?

Mr. Todd Smith: Yes, I do have a wrap-up. Thank you, Speaker.

The IESO’s website has been changed this week, so we no longer know who the current members are.

Why is the government hiding its own incompetence? If you know who they are, Minister, please tell us who they are.

Interjections.

The Speaker (Hon. Dave Levac): Be seated, please. Thank you.

Minister?

Hon. Brad Duguid: Two members have resigned from the panel who were part of companies that were indeed considered to have been exploitative of the system. The members of the panel are public knowledge, so the member—it’s all public knowledge.

But there’s an additional member who has been appointed to the panel, and this comes out of the Auditor General’s recommendations. We’ve now appointed a consumer advocate to the panel who’s actually an energy low-income-consumer advocate who will help ensure that that voice is also heard on this panel.

This is a strong panel with very good expertise on it that’s providing good advice. The Ontario Energy Board has indicated that the work that’s being done by this panel has been very, very valuable.

The PCs may not care about the work that goes into building a clean, reliable, affordable energy system because they know nothing about that, Mr. Speaker, but we do.

The Speaker (Hon. Dave Levac): Final supplementary?

Mr. Todd Smith: Speaker, I don’t think the minister understands the seriousness of this issue. Hundreds of millions of dollars ended up on the bills of hydro customers in Ontario. This is the second Liberal gas plant scandal. It’s not just the second Liberal gas plant scandal; it’s the second Liberal parkas scandal that we’ve seen in the last couple of months here at Queen’s Park.

Four ministers, including this one, and two Premiers received no fewer than 10 warnings from the OEB since 2009 on this issue, and they did nothing about it. No one did anything. Two of the ministers are still in cabinet, including the one who is taking the questions this morning. He knew these companies were under investigation. If he didn’t, he should have known. And somehow these same people who were gaming the system are writing the government’s new rules on market renewal anyway.

Will the government finally show some accountability, come clean and tell us who these insiders are who are creating the new rules that they broke?

Hon. Brad Duguid: The PC insiders are public knowledge. Their donations to the PC Party—

Ms. Lisa MacLeod: Say their names.

The Speaker (Hon. Dave Levac): The member from Nepean–Carleton is warned.

Finish, please.

Hon. Brad Duguid: The donations to the PC Party of over $116,149 are right on their website. It’s public knowledge, Mr. Speaker. I don’t know why the member is too lazy to go to the website to get the names of the folks on that committee. They’re right there. They’re not hidden.

There’s a new member who has just been appointed who is going to be a voice for those residents that this government has spoken to in many, many ways—

Interjection.

The Speaker (Hon. Dave Levac): The member from Lanark–Frontenac–Lennox and Addington is warned.

Finish, please.

Hon. Brad Duguid: Thank you, Mr. Speaker.

This new member of the panel, who will speak for low-income ratepayers across this province, speaks to the folks who we’re giving a voice to as government with our minimum wage policy, with our 25% off energy rates and with our work in workplaces to ensure that they’ve got a—

The Speaker (Hon. Dave Levac): Thank you. New question.

Energy policies

Mr. John Vanthof: My question is to the Acting Premier. Yesterday, the AG confirmed that the Premier has allowed private power companies to rip off Ontario families to the tune of hundreds of millions of dollars. From the privatization of power generation by the Conservatives to the sell-off of Hydro One by Kathleen Wynne, the system now seems to be set up to make cash cows of ordinary Ontario families—cash cows for private energy companies.

When will this Liberal government wake up, realize that our electricity system is broken and actually do something to stop private power companies from stealing from the families of Ontario?

The Speaker (Hon. Dave Levac): Again, another reminder: We use titles and ridings in the House. Thank you.

Hon. Brad Duguid: Mr. Speaker, I think I’ve been incredibly forthright about this over the last two days in my answers to the members opposite, so I think I need to go beyond that.

I believe that that party just can’t help but speak about—they have to mention the word “privatization” 20 times a day. I think what they want to bring to the energy system is an arcane philosophical perspective. What they want to do, what they’re saying and what their policy is for us to socialize the entire energy system in the province of Ontario. Imagine what it would cost for the government to buy out Bruce nuclear—tens of billions of dollars that that party wants to cost ratepayers or taxpayers across this province, and that’s on top of their wacky scheme to buy back shares of Hydro One that will also cost at least $10 billion, maybe more.

We’re talking $10 billion, $20 billion, $30 billion of costs on the taxpayers of this province, on the ratepayers of this province, and to businesses in this province. That would—

The Speaker (Hon. Dave Levac): Thank you.

Supplementary?

Mr. John Vanthof: Under the Liberal government, Ontario’s electricity system contains programs that are paying gas-generating hydro companies $30 million more than necessary each and every year.

People are suffering in Ontario. Hydro rates have gone up by more than 300% under the Liberals, and some families are being forced to choose whether to heat or eat. Why is this government allowing private power companies to defraud hard-working families who are already struggling?

Hon. Brad Duguid: Seriously, Mr. Speaker? This party is talking about rising energy rates? Imagine what’s going to happen to our energy rates when you waste $10 billion with zero public benefit, zero savings, just to fulfill your philosophical ideas—

Interjections.

Hon. Brad Duguid: Mr. Speaker, they would waste tens of billions of dollars—$10 billion to fulfill their philosophical idea to buy back Hydro One, with zero benefit to the people of this province and the ratepayers of this province—as well as spend tens of billions of dollars to purchase energy projects that are currently private across this province, again with no benefit to taxpayers.

They would destroy our fiscal situation and they would destroy our economy.

The Speaker (Hon. Dave Levac): Final supplementary.

Mr. John Vanthof: The Auditor General identified another government program that cost families and businesses $19 million over just one year. For most families who are struggling, that money is the difference between having heat this winter or not.

Why has this Liberal government repeatedly ignored the warnings about private hydro companies gaming the system and leaving the people of Ontario to pay the price?

Hon. Brad Duguid: I’m not sure what other program the member is referring to, Mr. Speaker, but it’s a fairly general question. I’ll go back to where I went in my first response.

It’s one thing to ask questions—and this is Auditor General day, so we know it’s a good day for the opposition. There is lots of material for them to come at us on, as there always is, and that’s part of the accountability of the system that we have here, Mr. Speaker.

But they also have to be accountable for what they stand for. And right now, this party has a policy that will cost this province $10 billion of waste, to buy back shares of Hydro One with no benefit to the people of this province—

Interjection.

The Speaker (Hon. Dave Levac): The member from Essex is warned.

Hon. Brad Duguid: Meanwhile, Mr. Speaker, we are working diligently to do everything we can to bring down the costs of energy in this province. We’re providing people with a 25% cut in their energy rates, which is in part because we’re working hard to bring down the costs. We’ve also built a clean and reliable system that is the envy of North America, something everybody in this province can be very, very proud of.

Energy policies

Mr. John Vanthof: To the Acting Premier: Earlier this week, we learned about a private gas plant in Brampton that stole over $100 million from Ontarians. Yesterday, the AG said that there are eight other power producers that could be gaming the Liberal system, at a cost of $260 million to the province of Ontario. Only $168 million of that has been recovered from these companies.

What is the government doing to force private gas companies to pay the full amount back to the people of Ontario, who are actually overpaying their hydro bills because you’re failing to regulate the private power system?

Hon. Deborah Matthews: To the Minister of Economic Development and Growth.

Hon. Brad Duguid: I understand that question, Mr. Speaker, and I think I’ve explained it, but I’ll explain it once again. The fact is that there were some companies that were exploiting the system that was in place. The IESO did a very thorough investigation of that. They have determined one that the member mentioned, Goreway. It has been fined $10 million. The vast majority of the funds have been repaid.

Some of those funds were in dispute. They were deemed ineligible by the folks at IESO, but the companies were in disagreement with them. There were some cases where some of those costs may not have been as clear as they needed to be. That’s why the IESO strengthened the system and the definition of what eligible costs are. They negotiated a settlement with those companies that they deemed to be fair to, first off, ratepayers, but also fair to the companies.

The Speaker (Hon. Dave Levac): Supplementary?

Mr. John Vanthof: I wonder if the raccoon traps are in dispute.

The $260 million consists of claims for things like staff car washes, carpet cleaning, scuba gear and raccoon traps. That $260 million represents 40% of the claims paid out by this one government program between 2009 and 2015. That means that nearly half of the claims okayed by electricity regulators under this Liberal government program could be fraudulent and had nothing to do with the generation of electricity at all.

When will this government finally realize that the privatization of our energy system is hurting, is penalizing, the people of Ontario?

Hon. Brad Duguid: Mr. Speaker, some of the costs, like the costs that the member referred to, were pretty obviously not eligible costs. They are the ones that would have been paid back, and rightfully so. Goreway, of course, was fined $10 million on top of that because there was a very obvious example of exploiting the system that was in place.

The key is, when these things are identified, that government agencies like the IESO identify the problem, investigate thoroughly, as they did, and recover the dollars that ought to have been recovered. The IESO has done that. They’ve negotiated with these companies to ensure the funds that they deem should be recovered have been recovered, and they have changed the system—in fact, strengthened the system—to ensure this won’t happen again. I think on the surface that’s a good approach. It’s unfortunate that this has happened, but I think the IESO has learned from it.

The Speaker (Hon. Dave Levac): Final supplementary.

Mr. John Vanthof: New Democrats put out a detailed plan almost a year ago that would require the electricity system to work in favour of Ontario families. Now we have the PC hydro plan, which has basically slapped some blue paint on the $40-billion Liberal borrowing plan. Only New Democrats are ready to tackle this problem and bring down rates. Why isn’t the government?

Hon. Brad Duguid: Mr. Speaker, I’m not going to defend the PC hydro plan. Certainly we have a plan to build a clean, reliable, affordable energy system in this province. By contrast, what the NDP are putting on the table for people is to waste $10 billion—maybe more—to buy back shares of Hydro One, with absolutely no benefit whatsoever to the people of this province and absolutely no benefit whatsoever to the energy system.

At the same time, they want to buy out all the private suppliers in Ontario that have been here, many of them, a very long time. That’s going to cost tens of billions of dollars. We’re talking $30 billion or $40 billion that’s either going to come off the tax base or they’re going to hit hydro ratepayers with incredible rate hikes. Families, businesses—they would destroy our economy.

Government advertising

Ms. Sylvia Jones: My question is to the Deputy Premier. The Auditor General has reported that the Wynne Liberals have spent $17.4 million on government advertising. The auditor said that the primary goal of these ads was to “foster a positive impression of the governing party.” These include a $3-million infrastructure campaign which the auditor said was “self-congratulatory and aimed at ensuring the government gets credit for its potential future spending plans.”

So $17.4 million is a 33% jump in advertising in a single year. Are Ontarians to take it as a coincidence that the government has increased its advertising budget by 33% the year before an election?

Hon. Deborah Matthews: President of the Treasury Board.

Hon. Liz Sandals: I’m very pleased to respond to the question and to the report from the Auditor General. I’d like to begin by noting that of course we are, and continue to be, the only province in Canada that actually has government advertising legislation.

I also want to talk a little bit about the numbers. It is true that the numbers increased from last year’s estimate, but that’s primarily because there was—

Mr. John Yakabuski: There’s an election.

The Speaker (Hon. Dave Levac): The member from Renfrew–Nipissing–Pembroke is warned.

Carry on.

Hon. Liz Sandals: That’s primarily because money that had previously been in ministry advertising lines was consolidated into the central advertising line. When you actually compare apples to apples, then you find out that in fact there was only a $6-million increase in the advertising budget, and I’d be happy to explain that.

The Speaker (Hon. Dave Levac): Supplementary?

Ms. Sylvia Jones: I think you need to explain it to the auditor.

The government continues to claim that they are complying with the legislation, but they neglect to mention that they were the ones who watered down the legislation and it actually weakens the Auditor General’s oversight.

Interjections.

The Speaker (Hon. Dave Levac): Be seated, please. Thank you.

President of the Treasury Board.

Hon. Liz Sandals: If we could just sort out some accurate information about the legislation, the original legislation, which they support, did not give the Auditor General—

Interjection.

The Speaker (Hon. Dave Levac): The member from Leeds–Grenville is warned.

Hon. Liz Sandals: —did not give the auditor the authority to review. The legislation which does give the auditor the authority to review digital advertising is our revised legislation, which currently exists.

So to go back to what I was saying before: It is true that there is a $6-million increase in the bulk media buy line this year. That is related to the fact that we are translating into more languages. It is related to the fact that we insist that all government advertising be compliant with the Ontario disabilities act. In fact, the cost of digital advertising has gone up, not so much because the volume has gone up, but just that the cost of placing an ad in digital media has gone up because it’s a more popular—

The Speaker (Hon. Dave Levac): Thank you. New question?

Hospital funding

M me France Gélinas: My question is for the Acting Premier. Yesterday, the Auditor General revealed that 16 P3 hospitals where the ongoing maintenance and repairs have been privatized by this Liberal government and the Conservatives before them—those hospitals are being forced to take money from nursing and front-line care to cover millions of dollars in maintenance costs that the private contractor refuses to cover. Every hospital the Auditor General contacted told her the exact same thing. They are not seeing the benefits that were promised under this privatized model.

How can this government force our hospitals to take money away from nursing and front-line care just to mask the failure of this health care privatization scheme?

Hon. Deborah Matthews: To the Minister of Health and Long-Term Care.

Hon. Eric Hoskins: I appreciate the Auditor General’s report. I said yesterday that I accept all of her recommendations as they pertain to health care. But I want to talk about another report, Mr. Speaker, that came out this morning from the Fraser Institute.

Interjections.

Hon. Eric Hoskins: You’ve got to love the Fraser Institute. So the Fraser Institute just came out this morning and finds that Ontario has the best wait times in the country once again; in fact, four weeks better than the next closest province and one of only two provinces in Canada to actually improve wait times from 2016 to 2017.

We have the shortest wait times from GP to specialist. We have the shortest wait times from specialist to treatment. We have the shortest wait times for CT scans. We have the shortest wait times for MRIs. I’m really happy I have a supplementary, because it’s a long list, Mr. Speaker.

The Speaker (Hon. Dave Levac): Supplementary?

M me France Gélinas: Back to the Acting Premier: Those P3 contracts were supposed to cover all hospital maintenance costs. That was the entire point of signing those contracts. But now, hospitals are being forced to divert their operating funds, funds that this Liberal government froze for four years straight. Money meant to hire nurses, open up new beds, cut wait times, provide quality care—that money is instead being diverted to pay private companies that won’t hold up their end of the deal, that refuse to do the work.

Why is this government forcing people to wait longer in our hospital system and forcing nurses to work without the proper staffing levels instead of stopping this massive failure of this health care privatization scheme?

Hon. Eric Hoskins: Mr. Speaker, again, I appreciate the report. We invested over $1 billion over the last two years in our hospitals for their operating budgets. We’ve invested 1.3 billion additional dollars over the next three years for wait times. The member opposite spoke about wait times twice in that supplementary.

We have, according to the Fraser Institute just this morning, the shortest wait times in the country for ultrasounds, the shortest wait times in the country for radiation oncology, the shortest wait times in the country for general surgery, the shortest wait times for gynecological procedures, the shortest wait times for ears, nose and throat, the shortest wait times for a colonoscopy, the shortest wait times for treatment for breast cancer, and the shortest wait times for treatment for lung cancer, cancer of the cervix, cancer of the larynx and prostate cancer. Congratulations to Ontario.

Interjections.

The Speaker (Hon. Dave Levac): Stop the clock. Be seated, please.

New question.

Climate change / Changement climatique

M. Shafiq Qaadri: Ma question est pour le ministre de l’Environnement et de l’Action en matière de changement climatique, the Honourable Chris Ballard.

Yesterday we announced the results of our fourth carbon market auction. The auction generated more than $420 million, bringing the total proceeds for this year to $1.9 billion. Speaker, you will be pleased to know that our government guarantees that 100% of these proceeds will be reinvested in programs that will help Ontarians make more sustainable and affordable choices: funding for projects like the GO regional express rail, repairs to schools, hospitals and social housing, new bike lanes and energy-efficient home retrofits.

Can the minister please explain to this chamber more about the green investments that we’re able to make through the proceeds of our cap on pollution?

Hon. Chris Ballard: Thank you to the member from Etobicoke North for that important question. As a medical doctor, I know that he really understands the importance of making sure that the province fights for clean air, clean water and clean land.

Mr. Speaker, the results of the latest auction show that our plan is functioning as designed. Businesses across the province are engaged in the market. As the member mentioned, the auctions from our carbon market have generated a total of $1.9 billion this year alone. By legislation, every dollar collected is being reinvested into projects that fight climate change. Earlier this week, the Minister of Transportation announced that we’re providing $93 million of cycling infrastructure to municipalities across the province. Last week, I announced $64 million for hospital energy efficiency.

Our plan is focused on investing in Ontario’s future and creating a more fair society where we all benefit from clean air.

The Speaker (Hon. Dave Levac): Supplementary?

Mr. Shafiq Qaadri: Thank you, Minister. Third parties, in fact, recognize that our plan is creating fairness and opportunity for Ontarians by investing in a greener future for our province. Earlier this week, we saw expert analysis that reveals that the Leader of the Opposition’s new carbon tax scheme would in fact cost more but do less for Ontario families than our current plan.

The EnviroEconomics analysis shows that our plan will reduce greenhouse gases by 82.2 megatonnes by 2022. The PC leader’s new carbon tax would in fact do far less, reducing emissions by just 28.8 megatonnes. The difference is equivalent to taking more than 11 million cars off the road. The new report of EnviroEconomics reveals that our current plan to cap emissions from business is almost three times as effective and comes at half the cost.

Est-ce que vous pouvez élaborer sur le travail et les mesures que notre gouvernement fait, in particular regarding guaranteeing emission reductions for the cheapest price?

Hon. Chris Ballard: Thank you again to the member for that question.

Speaker, I’d like to take a moment to speak about real guarantees, not flip-flop guarantees. Our cap on pollution guarantees real emissions reductions that will improve the air quality and reduce Ontario’s carbon footprint, and it guarantees that this will come at the cheapest price possible for families and businesses.

The same economist the PCs cited a few weeks ago in their glossy magazine said our cap-and-trade program would drive down emissions nearly three times more than their carbon tax scheme would. It appears the Conservatives have cherry-picked the numbers in their schemes.

This same expert analysis shows that the Conservative carbon tax is also more expensive, costing Ontario families and businesses a total of $15.1 billion. Meanwhile, our plan guarantees three times more savings.

Emergency preparedness

Ms. Laurie Scott: My question is to the Minister of Community Safety. Yesterday, we learned from the Auditor General that the Cabinet Committee on Emergency Management has not met for several years and that the last provincial risk assessment was done six years ago, based on data from 2009. The AG says that as a result, Ontario is simply not prepared to deal with large-scale emergencies. Emergency management staff are untrained. They have large turnover, and a major IT project has been bungled. What an unbelievable failure on the part of this Premier and this government.

Protecting the safety and security of its citizens is the first and most important responsibility of any government. Why does it take an Auditor General’s report for this government to realize that they have no emergency plan to keep 14 million Ontarians safe?

Hon. Marie-France Lalonde: Thank you very much to the member opposite for the question, because I want to reassure Ontarians. Let me be very clear: We can respond to emergencies, and we have responded to emergencies, and the Auditor General agreed with that.

Could our emergency response be more efficient? Yes. This is why we recently launched our new emergency management action plan. Our plan is based on an earlier independent review, and we were actually very pleased to see that the findings of our review are consistent with the Auditor General’s comments and recommendations.

We know that emergencies and disasters are happening with greater frequency around the world, and while they are maybe rare in Ontario, we know we must be more proactive and prepared.

For the member opposite to know, we are recruiting our new first chief of emergency management to champion the changes that we’re making.

The Speaker (Hon. Dave Levac): Supplementary?

Ms. Laurie Scott: Back to the minister: When this same question was asked of the minister by a reporter yesterday, she responded by talking about climate change. What about terrorism? What about cyber threats? What about disaster prevention, mitigation and recovery?

The shocking thing is, this government’s cabinet committee didn’t even meet to prepare for the Pan Am Games or the G20. They sat on their hands for more than five years, and now they claim that they are working on it. It’s ridiculous.

Given the dangers in the world today, when will the government finally get around to fixing these huge holes in our province’s emergency management system?

Hon. Marie-France Lalonde: I’m very happy again for the chance to talk about the comments raised by the member opposite.

Over the past five years, our Cabinet Committee on Emergency Management has been engaged on a number of emergencies. These include the 2012 forest fires in northern Ontario, the 2013 ice storm, the 2015 Pan Am/Parapan Am Games and the 2017 southern Ontario flooding. These engagements ensured that members were prepared if a committee meeting were required.

The Cabinet Committee on Emergency Management, as I said yesterday, actually met earlier this week. We will be reconvening this committee regularly as we implement our emergency management action plan. We know that while emergencies may be rare in Ontario, we must be more proactive, prepared and ready for anything.

Affordable housing

Mrs. Lisa Gretzky: My question is to the Acting Premier. Yesterday, the Auditor General reported that this Liberal government has neglected social housing for so long that there are now more people waiting for social housing than actually living in social housing.

The wait-list in Ontario has grown by 36% since the Liberals have been in power. That’s 185,000 families. In my riding in Windsor, we have 4,000 people—families—on our wait-list, yet the number of social housing units mandated under the Housing Services Act has grown by zero. Some families have to wait close to 10 years before they are provided with a place to live. Imagine their lives in those 10 years. Could anyone in this House hold on that long before their family had a safe, secure place to live?

Why has this Liberal government refused to ensure there is enough social housing to meet the needs of struggling Ontario families?

Hon. Deborah Matthews: Minister of Housing.

Hon. Peter Z. Milczyn: I’m very pleased with the question from the member opposite.

Mr. Speaker, let me tell you what we have been doing for social housing. During our period in government, 20,000 units of affordable housing have been built in this province. Specifically to the member opposite, during that period of time, 320 new units of affordable housing in Windsor have been created; almost 6,000 affordable housing units have been repaired in Windsor; 307 households in Windsor received down payment assistance; and thousands of evictions have been prevented.

In addition, through our programs, we’re assisting with the refurbishment of our social housing stock, thanks to funds from the cap-and-trade program, which will be in jeopardy if another party comes into power.

We are active on this file. We are creating more housing and creating more affordable housing for Ontarians.

The Speaker (Hon. Dave Levac): Supplementary?

Mrs. Lisa Gretzky: Back to the Acting Premier: What this Liberal government has done is increased the wait-list for social housing by 36% and put 185,000 families at risk of homelessness.

In the late 1990s, the Conservative government downloaded social housing onto municipalities without providing a way to pay for it. The Liberal government clearly liked the Conservative policy, because they have refused to reverse that ill-conceived decision.

Then in 2013, this Liberal government went even further. They cut provincial funding for municipal social housing by $150 million a year. Now about a third of all social housing in Ontario is at risk of being lost forever due to the expiry of contracts, which will allow private landlords to convert social housing into condos.

What will this Liberal government do to save these social housing units? And will they commit to building enough new units to meet the needs of Ontario families?

Hon. Peter Z. Milczyn: Our government this year announced an investment of $657 million to repair our existing social housing stock. We announced $200 million in investments for affordable housing to ensure that our most vulnerable populations—the homeless, victims of domestic violence, victims of human trafficking—get homes we can build with appropriate supports.

Mr. Speaker, the member opposite is correct in noting, as the Auditor General does on page 730, that between 1996 and 2002 there was no affordable housing built in this province. That was by the Ontario PC Party, the Ontario party of cuts. Because their platform once again is silent on the issue of housing, we can only assume the $6 billion of cuts will come out of the housing budget. We are increasing—

The Speaker (Hon. Dave Levac): Thank you.

New question.

Senior citizens

Mr. John Fraser: My question is for the Minister of Seniors Affairs. Minister, I read yesterday that you were at the Activity Haven centre in Peterborough to announce the Ontario Age-Friendly Community Recognition Award.

In 2015, Ontario launched the age-friendly community grant program, providing $1.5 million in funding to 56 projects which help local governments and organizations transform their communities to become more physically and socially inclusive for seniors. I know that this program has already benefited seniors in my riding of Ottawa South through places like the Council on Aging and the Heron Seniors Centre, and I know that it is continuing to impact more and more ridings across the province.

Will the Minister of Seniors Affairs inform the House about the Ontario Age-Friendly Community Recognition Award, please?

Hon. Dipika Damerla: I want to thank the member from Ottawa South for that question and also for his advocacy for seniors. Indeed, he is right, Mr. Speaker: I was in Peterborough yesterday with the member for Peterborough, and I was there to make an important announcement.

Just to give some background, Mr. Speaker: Earlier this year, in the summer, my ministry announced the Age-Friendly Community Recognition Award program. What this program does is that it’s going to recognize communities, municipalities and towns across Ontario that make an effort to make their communities age-friendly.

What I announced yesterday is that nominations are now open. Communities and municipalities can apply online, so I’m going to urge all of my colleagues here: Go back to your ridings and make sure your municipalities apply.

The Speaker (Hon. Dave Levac): Supplementary?

Mr. John Fraser: I want to thank the minister for her answer. It’s important that we recognize the work that’s being done for Ontario’s seniors by countless communities and organizations across the province. This new program will encourage collaboration among communities and promote grassroots action to meet the needs of Ontario’s growing senior population.

I’m also aware that this government will be expanding the successful age-friendly community grant program. Could the Minister of Seniors Affairs please explain to this House about the expansion of the age-friendly community grant program?

Hon. Dipika Damerla: The member from Ottawa South is absolutely right. As some of you may remember, earlier in November I joined the Premier in announcing Ontario’s action plan for seniors, an action plan that we are calling Aging with Confidence. It’s a 20-point program, and one of the centerpieces of that is that we are going to be increasing our investments in age-friendly communities. In fact, we will be investing $7 million more in providing municipalities and community organizations with funding that they can go ahead and implement to make their communities more age-friendly.

This builds on the fact that in the past we have funded 56 communities across Ontario with the age-friendly planning grant. The communities went ahead and did their planning, and now this money will help them implement that plan.

Health care funding

Mr. Jeff Yurek: My question is to the Minister of Health and Long-Term Care. Yesterday’s annual report released by the Auditor General focused primarily on the government’s failures in the province’s health sector. Her report included chapters on out-of-date lab fees, cancer patients not having access to the drugs and services that they need, and rampant government waste.

What’s worse, this government was warned about these issues years in advance. Take, for instance, the 2009 warning to expand stem cell transplant projects. This government ignored these warnings, resulting in millions of dollars and unneeded lives lost. Can the minister explain to the House why they chose to ignore these warnings?

Hon. Eric Hoskins: I appreciate the question. In fact, we’ve increased our stem cell funding in this province by 600% over the past five years. In fact, earlier this year, I announced an additional $31 million to expand capacity here at University Health Network, Sunnybrook and Hamilton Health Sciences.

But Mr. Speaker, I think it’s important for us to imagine for a moment what an AG report would look like under a PC government, with the $12 billion of cuts. I want to talk about their so-called historic investment in mental health. We all agree how vitally important that is, but their proposed investment is a mere one fifth of the investment that we’ve made over the previous 10 years. They’re describing it as the largest mental health commitment in Canadian provincial history; it is anything but.

Look at our record over the last 10 years compared to what they’re proposing. They’re proposing one fifth of what we have ourselves invested.

The Speaker (Hon. Dave Levac): Supplementary?

Mr. Jeff Yurek: I speak of waste and incompetence and mismanagement, and the government delivers Liberal spin and mistruths.

Interjections.

The Speaker (Hon. Dave Levac): The member will withdraw.

Mr. Jeff Yurek: I withdraw.

The Speaker (Hon. Dave Levac): Carry on.

Mr. Jeff Yurek: To the minister: Speaker, 65 patients have travelled to the US for stem cell transplants, and it’s estimated that another 106 will seek treatment over the border before Ontario brings up their standards. Had the government listened to the capacity warnings in 2009, they could have saved the taxpayer over $90 million. Unfortunately, it took a few high-profile cases of people dying waiting for treatment before this government deemed it a priority.

Speaker, will the minister apologize to the Ontarians who have had to seek life-saving treatment outside of the province because of this government’s mismanagement?

Hon. Eric Hoskins: I will never apologize for funding and providing life-saving treatment, whether that treatment is required in Ontario or whether it’s required in another part of this world. We’ve increased the funding. We’re increasing our capacity. Wait-lists are going down. More and more Ontarians are having that stem cell treatment here in the province.

But, Mr. Speaker, I have to go back to the fact that if we just compare the first year of the proposed Conservative spending on mental health with our record of our first year of that 10-year period, they’re proposing to invest $151 million in their first year. Our first year, we invested 600 million new dollars. Their second year, they’re proposing $190 million. We invested $650 million. Third year, $215 million; ours, $800 million. Over their first four years, they would invest 814 million new dollars. We invested in our first four years more than $3 billion.

Interjections.

The Speaker (Hon. Dave Levac): Be seated, please. New question.

Government advertising

Ms. Catherine Fife: My question is to the Acting Premier. Liberal government advertising has hit a 10-year high, and I’m sure it’s coincidental how its advertising has peaked in an election year. Ontario’s auditor has reported that 30% of those ads are what she would call partisan ads, but because of the legislative changes made by the Liberal government, the Auditor General now has no choice but to approve those partisan ads. That means public dollars are being used to promote this Liberal government and this Liberal Party. This is just one of the reasons, Mr. Speaker, why the people of this province no longer trust this government.

Will the government stop running partisan ads today?

Hon. Deborah Matthews: President of the Treasury Board.

Hon. Liz Sandals: As I noted earlier, Speaker, Ontario does remain the only province in Canada that actually has rules around government advertising. In fact, when we look at government advertising, we have a definition of partisan advertising, which says that you can’t advertise a party and you can’t have political figures from cabinet in the ads. In fact, there are very tight rules about what is and is not allowed.

The Speaker (Hon. Dave Levac): Supplementary?

Ms. Catherine Fife: Again to the Acting Premier: I do not understand, nor do the people of this province understand, how you can justify defending this program. It is indefensible. Public advertising should serve the public good, not help a desperate government hold on to seats.

It wasn’t just that the Premier was using public dollars to promote their hydro scheme or ads for programs that didn’t actually exist, but they actually used public dollars to try and target opposition MPPs. Ontarians have every reason to feel let down by this Premier and by this government.

Will the Acting Premier stop these advertising campaigns today, or is she going to keep using public dollars for partisan Liberal ads?

Do you know what, Speaker? I’ve heard lots of complaints from members opposite about how we don’t spend enough money advertising in small-town media. We do advertise in small-town media, and what do they do? They complain.

Immigration policy

Ms. Soo Wong: My question is for the Minister of Citizenship and Immigration. Diversity has always been one of Ontario’s greatest assets, and in my riding of Scarborough–Agincourt. This diversity makes us a stronger and more successful province. I’m pleased to learn that last year, our province welcomed over 110,000 newcomers, including the many thousands of Syrian refugees living in my riding of Scarborough–Agincourt.

We need to ensure all our newcomers are successful in this province. It is vitally important that we work with our federal partners to ensure our immigration system is working effectively to keep this province prosperous. It is my understanding that our province has developed formal agreements with our federal partners since the last agreement expired in 2011.

Speaker, through you to the minister: Can she please inform the House how her ministry is working with the federal government to enhance our shared goals of harnessing the contributions immigrants are making in our province?

Hon. Laura Albanese: I’d like to thank the member for Scarborough–Agincourt for her question and her continued interest towards immigrant communities. Ontario’s relationship with the federal government continues to grow and improve. On November 24, I welcomed here at the Legislature the federal Minister of Immigration, Refugees and Citizenship, the Honourable Ahmed Hussen, to officially sign the Canada-Ontario immigration agreement.

The Canada-Ontario immigration agreement, or COIA, sets a new path of co-operation between our province and the federal government, which will allow us to effectively lead and manage immigration policy and to welcome newcomers. The agreement includes commitments to bilateral collaboration on selection policy as well as increasing and improving economic immigration. COIA will help Canada and Ontario fulfill our shared goals of maximizing the contributions immigrants make to the economic, social and cultural life of our country.

The Speaker (Hon. Dave Levac): Supplementary.

Ms. Soo Wong: Thank you to the minister for her response. It is encouraging to hear that we are doing more collaboration with our federal partners.

Statistics Canada projections show that immigration will continue to be the key driver of population growth in our country in the coming decades, and I’m sure the minister would agree with me that immigration is especially crucial to Ontario’s future to mitigate the impact of our aging population. In my riding alone, 21% of my constituents are seniors.

To address the labour shortages and to continue to draw the benefits of diversity, immigration is essential to ensure a stable and consistent population to balance the needs of the labour market and to keep our economy moving in the right direction.

Speaker, through you to the minister: Can she please inform the House the steps taken on specific aspects of immigration in the province, ensuring fairness and opportunity for all?

Hon. Laura Albanese: Once again, I would like to thank the member for her question. Our ministry has been working closely with the federal government. In the months ahead, additional annexes to COIA will be signed to formalize federal and provincial coordination on French-speaking immigrants, international students and the role of municipal governments as partners in immigration.

COIA will also help Canada and Ontario share information and data more effectively, to inform policy as well as program planning and evaluation.

Also announced at the signing was a commitment from the federal government to provide $21 million over the next three years to Ontario’s bridge training programs, to go along with approximately $70 million from the province. This investment will help reduce the barriers that skilled immigrants face when