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November 1, 1989

34th Parliament, 2nd Session

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Hansard Transcripts

MEMBERS’ STATEMENTS

ROYAL ONTARIO MUSEUM LABOUR DISPUTE

SALE OF POPPIES

GORDON SANDERSON

CHRISTIE PARK NURSING HOME

HOSPITAL BEDS

RESTORATION OF LEGISLATIVE BUILDING

COURT FACILITIES

NEONATAL CARE

SUN LIFE SKATE CANADA INTERNATIONAL

STATEMENT BY THE MINISTRY

WIFE ASSAULT PREVENTION MONTH

RESPONSES

WIFE ASSAULT PREVENTION MONTH

ORAL QUESTIONS

CANCER TREATMENT

SALES TAX REBATE

CHRONIC CARE

ONTARIO SCIENCE CENTRE MAILING

INCOME TAX

ONTARIO SCIENCE CENTRE MAILING

COMMUNITY COLLEGE TEACHERS’ LABOUR DISPUTE

SALE OF DUTY-FREE LIQUOR

PASSENGER RAIL SERVICES

PUBLIC HOLIDAYS

WASTE MANAGEMENT

HOSPITAL FINANCING

SUSTAINABLE DEVELOPMENT

SALE OF POPPIES

CHILD CARE

PETITION

COMMUNITY COLLEGE TEACHERS’ LABOUR DISPUTE

ORDERS OF THE DAY

OPPOSITION DAY

HEALTH SERVICES

The House met at 1332.

Prayers.

MEMBERS’ STATEMENTS

ROYAL ONTARIO MUSEUM LABOUR DISPUTE

Mr Mackenzie: I would like to bring to the attention of the House an increasingly salient issue in labour-management relations today, and that is the issue of part-time workers. Only one month ago we saw this issue raised by the Toronto Transit Commission workers. Now we have a strike at the Royal Ontario Museum, where negotiations have been going on since April. Although the union has been in a legal strike position since July, the workers walked out only on 21 September.

One of the union’s key concerns relates to job security. Not only does ROM management want to allow work that is normally being carried out by union members to be taken over by nonunion employees, but it also wants to change a long-standing working arrangement to turn full-time jobs into part-time ones. Initially, management wanted to increase the number of part-time workers from under 30 per cent to 49 per cent of the bargaining unit. More important, it wants them to work with no fixed schedules for 20 to 24 hours per week, averaged over a three-month period.

No guarantee has been offered on the minimum number of full-time positions, and all newly hired full-timers would be hired into flexible, nonfixed schedules. Management contends the reason for this is the need to cut costs, and yet figures indicate that more than 70 per cent of overtime actually involved replacement of full-time positions which were vacant due to vacations, leaves of absence. and scheduling and hiring difficulties.

Why should the workers at the ROM have to pay for mismanagement on the part of the board at the ROM?

SALE OF POPPIES

Mr Wiseman: I was appalled, as I believe most Torontonians were, to wake up and hear on the radio this morning that the Toronto Transit Commission, with a lack of feeling for anything sacred, had banned our veterans from selling poppies at transit stations.

These men and women risked their lives for the freedom that we take for granted today. They have been denied access which they have always had and which the public has grown to expect because someone at the TTC says they are soliciting. One can buy candy, magazines, cigarettes and even lottery tickets at all or most of the stations, but God forbid we should help those who fought so that we can live our lives in peace and prosperity today.

Remembrance Day is just that: a day in which we can remember the debt we owe our veterans. Anything they make from the sale of poppies goes for their betterment and that of their families. One would have thought someone at the TTC would have been bright enough to understand that. Since they are not, I ask that the government, which heavily subsidizes the TTC, demand -- not suggest but demand -- that this policy be changed at once.

The people of Ontario want compassionate leadership and our veterans deserve it.

GORDON SANDERSON

Mrs E. J. Smith: In a short while, I would invite the members of the Legislature to cast their eyes to the south, but not as far south as the American border.

In the press gallery, we will have a member of the fourth estate whose job it is to report to the public of southwestern Ontario on the august activities of this chamber. Gordon Sanderson of the London Free Press yesterday celebrated his 40th anniversary with that organization.

Forty years will carry many members back to the stage in time before they had much interest in the role of the government or indeed before they had managed to make their own public debut in the form of a birth announcement. These 40 years have encompassed tremendous change and tremendous challenge. The role of the reporter in keeping these changes and these challenges before the public is essential to the democratic process.

Gordon Sanderson has served this role in an exemplary fashion, and on behalf of the people of southwestern Ontario I wish to thank him, to commend him to the Legislature and to wish him many more productive and exciting years with us.

CHRISTIE PARK NURSING HOME

Ms Bryden: Last month we were shocked to hear that Mary Dunn, an 81-year-old resident of Christie Park Nursing Home here in Toronto, had been brutally attacked by a fellow resident while reading in the lounge of the home on 3 October. She died in hospital next day from complications brought on by the attack.

I think everyone in the Legislature is appalled by such a tragic incident, but what is more appalling is that no one from the nursing home called the police to investigate a serious assault requiring hospitalization. The home’s administrator is quoted in the Toronto Star as calling it “a routine matter.”

Ministry of Health officials have said that neither the home administrators nor the ministry are obliged to call the police in such an incident. In fact, nursing homes branch officials have given the home a clean bill of health over the handling of the Mary Dunn incident. This is shocking in view of the fact that the Christie Park Nursing Home has a record of violating the Nursing Homes Act regulations 165 times between 1983 and 1988.

How can the ministry go on renewing the home’s licence year after year in view of these violations? When will the government keep its election promises to start enforcing the Nursing Homes Act regulations rigorously and bring in security requirements to protect the health and safety of the residents?

HOSPITAL BEDS

Mr McLean: My statement is directed to the Minister of Health (Mrs Caplan) and it concerns her government’s promise to allocate $850 million for 4,400 acute and chronic care beds in the province of Ontario. Some of those beds were promised for hospitals in the riding of Simcoe East, and her predecessor’s announcement that they would be in place by 1990 was greeted with a sigh of relief by hospital officials in Orillia and the Penetanguishene and Midland areas.

But the minister has since let it be known that her government is going to renege on the promise of more hospital beds. In a recent quotation in the Midland Free Press, the Minister of Health was quoted as saying: “Quite frankly. I don’t see any expansion on the institutional sector.... We’re focusing on service and on how we use these services.” The minister recently told the Legislature that beds are no longer the benchmark for services, and that up to 50 per cent of the services currently offered on an inpatient basis could be provided on an outpatient and ambulatory basis.

Even if we accept the minister’s rather doubtful assertion that one half of what is being done in hospitals can be done elsewhere and that community care is the answer to bed shortages, I think it would be reasonable to expect that community care services and the outpatient facilities be in place before any reductions in bed spaces occur. The minister knows as well as I do that these services and facilities are not in place, yet she persists in cutting the number of acute and chronic care beds in Ontario.

RESTORATION OF LEGISLATIVE BUILDING

Mr Adams: The buildings which house this Parliament easily measure up to those which house similar assemblies across North America in terms of history, tradition and atmosphere. Unfortunately, they lag behind many others in terms of their general appearance and standard of upkeep.

I have recently been able to visit the legislative buildings of our neighbouring provinces, Manitoba and Quebec. I was impressed by the state of upkeep of both of these and by the careful modernization which has been undertaken there. This building is both a museum and the hub of a modern, major government. It is a museum not because of the human specimens it contains, but because it is a working depository for the history of democracy in this part of Canada.

Its architecture and the plaques, statues, paintings and other treasures kept in it represent a heritage treasure of incalculable value. I submit that this treasure is not being cared for as it should be. This building is the base of a modern government of more than nine million people, with a budget of $40 billion. Piecemeal efforts have been made to upgrade the old building to its modern function, with limited success from the point of view of modern government and with detrimental impact on the museum aspects of the building’s functions.

We need a long-range strategy for the modernization, enhancement and upkeep of these historic buildings.

COURT FACILITIES

Mr Kormos: It has happened before and in all likelihood it will happen again. It happened today, right here in the city of Toronto, at the University Avenue courthouse.

Four persons charged with possession of cocaine and conspiracy to traffic in that same drug were dismissed, discharged by district court Judge Borins, not because they were innocent, not because the police had not done their work and collected the evidence, not because the prosecutor was not prepared to prosecute and seek convictions against people and put them in jail where they should be, but because the Attorney General (Mr Scott) does not provide court facilities here in this province and because the judge had no option since it took four and a half years for these people to come to trial because of the inadequate court space available.

It is absolutely outrageous that this should be happening at this point in our history, especially when we are all too aware of the impact that drug traffickers and drug trafficking are having on our community. We are told there is a war against drugs here in Ontario. The question is, what side is the government on? The government might as well be complicitous and be out there with these same folks on the streets peddling this stuff.

These people are walking free out of the courtrooms and not being dealt with because this government does not provide courtroom facilities for these trials to be conducted speedily. Indeed, the preliminary hearing itself took over six months to be reached and then four more years before court space was available to conduct the trial. That is why these people were discharged.

NEONATAL CARE

Mr Jackson: I hold in my hands a letter from Mrs Karla Evangelisto of Smithville, Ontario, in which she describes for me her shock and dismay when, after spending nine weeks in Chedoke McMaster Hospital prior to giving birth because of her high-risk pregnancy condition, she was told by doctors her baby daughter would have to be transferred to another hospital in Toronto because of a shortage of nurses at the neonatal intensive care unit.

Karla’s baby, Aleda Dawn, suffered from severe respiratory problems which, according to the attending physicians, could have developed complications should she have to be moved. The dedicated nurses at Chedoke McMaster, understanding the serious nature of Aleda Dawn’s condition, pushed and shoved to accommodate her so that she could stay at that hospital. Aleda Dawn almost died that night. That she is alive today is testimony to the caring commitment of the nurses who successfully overcame obstacles presented to them by a neonatal care unit suffering because of government underfunding.

Aleda Dawn should not have had to come that close to losing her life so soon after obtaining it. I say to the Minister of Health (Mrs Caplan) this is not the first such case brought before her nor, I fear, will it be the last. She has said she is committed to providing health care as close to home as possible, so the minister must agree that in the case of women who face the experience of high-risk pregnancies, intensive care must be provided for a child as close to the mother as possible. Those mothers and those children await her reply.

SUN LIFE SKATE CANADA INTERNATIONAL

Mr Cleary: Last week, the eyes and the ears of the world were on my riding. I am pleased to report on the success of the 1989 Sun Life Canada international figure-skating competition which was held in Cornwall, Ontario, during the past week. Some 75 competitors, 125 coaches and officials, and media from around the world attended this first-class event. Since its beginning in 1973, Skate Canada has developed into one of the most prestigious international skating events in the world.

The city of Cornwall was indeed proud to serve as the host to this event and the enthusiasm of capacity crowds made the participants feel very welcome. It is not surprising that the major sponsors and organizations of Skate Canada expressed high praise for the efficiency and co-operation received by the local organizing committee. Contributing to the success of this event were the outstanding facilities of the Cornwall Civic Complex and the countless hours provided by 300 local volunteers.

I know all members would want to join me in extending congratulations to all those who won medals and offer their best wishes to those in Cornwall who made the 1989 Sun Life Skate Canada International such a huge success.

STATEMENT BY THE MINISTRY

WIFE ASSAULT PREVENTION MONTH

Hon Mrs Wilson: I wish to inform the House that November is Wife Assault Prevention Month in Ontario.

Wife assault is a crime that inflicts horror upon our children and robs women of their physical and emotional wellbeing, of that security of the person which we believe to be an essential right of every citizen in this province. Wife assault is a crime that must be stopped.

As of last May, a new allocation of $5.4 million, plus a cost-of-living increase and wage compensation for shelter workers, brought the province’s financial commitment for wife assault prevention and services to $41 million, a 20 per cent increase over last year’s allocation and more than two and a half times the funds committed to family violence prevention in 1985.

At this moment the government maintains 23 programs through 15 ministries and agencies to address the issue of wife assault. I want to emphasize that this government is committed to a long-term wife assault prevention strategy, one which includes an integrated and co-ordinated approach to assaulted women’s needs and that very important component, public education, through our public awareness campaign. This year’s campaign will reach further into our communities, with newspaper advertisements in 10 languages, radio ads in Italian, Spanish, Portuguese and Greek, and mass distribution of an information brochure printed in seven languages.

Crucial to this campaign is the role played by our local communities. This year special grants targeting wife assault prevention efforts will go to 106 organizations carrying out local community education projects. In all, $200,000 has been approved to sponsor special projects that address the needs of Franco-Ontarian, northern, native and immigrant women, as well as women with disabilities, teens, racial minorities, rural and urban women.

We are aware, however, that education alone is not the solution to this problem. Women need support from a society that understands the truth about wife assault. This government’s message is clear: Wife assault is a crime; there is never an excuse; wife assault is never a private matter; and the prevention of wife assault is everyone’s responsibility. There is no place for violence against women in our society.

RESPONSES

WIFE ASSAULT PREVENTION MONTH

Mr R. F. Johnston: I join with the minister in this announcement today. I will start off with the last comment, which is that there is no place for violence against women in our society. If one looks at the situation today, one can see some progress since, for instance, 1982 when we first studied family violence and this matter in the Legislature and the standing committee on social development reported.

But if you look at the government’s actions since that time, Mr Speaker, whether it is to do with questions of public education or whether it is to do with actual action for women who are victims of violence, one would have to say we have not even addressed the recommendations of that report as yet, and I find that a very sad thing indeed.

It is important to do the kind of public education that has been discussed here and where groups around the province are using the funds, but it is also important to say what our public education system is doing these days around the questions of familial violence.

When you look at the fact that family studies, the very notion of using that as a format to give hands-on experience to children for nonviolent problem-solving, is diminishing as an element in the curriculum, when you look at using the day care centres that are now in the various schools of the province as a means of teaching people how to break some of those cycles of violence and how the relations between men and women as they are growing up are not supposed to be at varying degrees of power, but are between equals and are to be resolved peacefully, one would have to say we are not doing all we can.

In fact, there has been a loss in terms of the emphasis on that program in the schools in Ontario.

One of the things that has always concerned me about this education or public announcement program of the government is that it creates demand. Women who have been hidden victims for years, assaulted but afraid to leave their homes for economic reasons or fear of reprisal by the spouse, find themselves now saying: “Perhaps I should go. Perhaps I should go and present myself at a hostel. Perhaps I should take the children and leave the situation because it is becoming dangerous to all of us.”

What do they find when they go there? They find they cannot get in. Whether it is Ernestine’s in Etobicoke or the Emily Stowe Shelter for Women in Scarborough or any of the interval houses around Ontario, they find they are being turned away to more dangerous situations, turned out to lack of housing even when they have been in these facilities. They are creating a need, creating a demand, making women feel that perhaps society is supporting them and then providing no extra beds.

Having no expansion at all in our transition homes is a travesty. That this government, which promised major additions in spaces in 1985 during the election, still has added hardly any spaces at all in the intervening four years and then advertises, “We will not support violence against women and we are providing services to them,” in my view is a shame.

This has to be tied with the notion about women of disability, whom I notice are mentioned here. This government has asked for a new study on violence against women of disability. The Disabled Women’s Network indicated years ago that statistically women who are disabled are being beaten more and victimized more, and yet this government has not even taken the small step of making sure that each of our hostels and transition homes is actually accessible to disabled women, because most of them are not today.

The government can talk about public education, but what kind of message is it actually sending out to the people of Ontario when the infrastructure is not there to assist these very victims themselves?

Until we do an awful lot more about the stereotyping of women in our society, until we do something to change the image that is being put across time and time again on television about women as easy victims of violence, we are not going to address these concerns. A government like this can actually refuse to fund access programs for women like the Lakeshore Area Multi-Service Program in Etobicoke, women who are often in violent situations with their husbands before they split.

I say to the minister that this kind of education she is talking about is hollow indeed. It has to be added to by a plethora of programs that provide support to women who are victims of violence or it is in fact meaningless.

Mr Jackson: I am rather disappointed that the second announcement from this new Minister without Portfolio responsible for women’s issues -- the first dealt with Persons Day -- simply announces an advertising campaign based on what everybody now understands. Obviously, wife assault is a crime and society can no longer tolerate it, but I challenge the minister now that she has this responsibility.

To really try to understand this issue, to know this issue, to listen to the women who suffer from it, is to become very angry about this issue and to want to do something more than simply put out more buttons and more banners, and to put more advertising on the radio waves. If she would take the time to listen to the women who have been subjected to some of the decisions of our northern judges, such as Judge Vannini who says to a native woman in this province, “I know you have been beaten by your husband, but this time he went a little too far,” she would find that there is no place in Ontario for those kinds of attitudes in our judiciary.

What we need in this House is an announcement and a commitment from this government that it will look seriously at the necessary reforms in our judicial system, that it will look here in the city of Toronto at what the real meaning of wife assault is. Does the minister know that there is not a single reference in the Criminal Code to wife assault? It does not exist in the Criminal Code. It is assault, common assault, pure and simple. We should not be blinded by the notion that if you are doing it within the confines of your home, somehow the courts should look at that differently.

If Kirby lnwood had walked next door and beaten his next-door neighbour’s wife instead of his own wife, would he have got off with a suspended sentence? If he had gone next door and taken his next-door neighbour’s child and dropped that boy on his head, would the courts have said, “You get three months probation”? Of course not.

Do we tolerate, for example, that Franca Capretta, a woman in Ottawa, spent more time in the intensive care unit of a hospital because of her skull being crushed in by her husband than he spent in a police station or before our courts? That is where the commitment is required from this government, not more advertising. We all agree it is a crime, but it is a pervasive crime and it is becoming more apparent.

What are we doing about it? Are we empowering our police forces with the necessary sensitivity to understand domestic crime? No, we are not. Are we empowering our court system to enable a woman to go all the way through the court system, to receive necessary justice and receive access to criminal compensation, which in this province is one of the worst examples in Canada in terms of access for women who are subjected to violent crimes?

All the minister wants to do is advertise this. What happens when she advertises this problem? The phones starts ringing. She creates expectations on the part of women who are being abused and on behalf of their children who are being abused. That is why we need the additional funding now, not next year. Her own Premier (Mr Peterson) has indicated that the interministerial committee is not ready to report to this House or to the women of this province.

We need action now when we have a situation in Hamilton with waiting lists of 80 or 90 women who have now come to terms with the abuse in their lives. When they make a phone call they are told: “I am sorry. We don’t have the funding for those programs.”

Rape crisis centres, which deal extensively with cases of domestic assault, come to this government because there is no proper and formal funding mechanism for rape crisis centres. When they come on bended knee to this government begging for additional dollars, it does not just give them the funding; it says, “It will come as a reduction of next year’s funding.” They are just giving them a stay of execution.

Why do they force not only our interval houses but also our rape crisis centres to operate in such a fashion? All they can do is tell people: “I am sorry. We have to cancel our programs with our medical community. We have to cancel our counselling programs internally with all of the necessary privacy and support mechanisms for women coming to grips with this issue.”

I say to the minister that until her government stands on its feet and commits real dollars to this issue, she is only paying lipservice to the women of this province who are being subjected to these criminal activities. The women of this province need action. They do not need advertising. They need funding. They do not need more fanfare from the minister or her government. Let’s get the funding in place. Let’s respect the real tragedy of what is going on out there and start doing something about it.

ORAL QUESTIONS

CANCER TREATMENT

Mr B. Rae: I have my first question for the Minister of Health. I wonder if the minister can tell us when she was first aware of the shortage of radiation technologists at Princess Margaret Hospital.

Hon Mrs Caplan: The ministry some time ago identified the need for greater co-ordination and support of cancer care services. As the Leader of the Opposition knows, we appointed a cancer care co-ordinator last spring, Dr Aileen Clarke, who has been working with all the partners in delivering health services, particularly in the area of cancer.

Mr B. Rae: The reason I ask this question is that as the minister will know, back in 1985 there was a two-volume study on cancer care in the province, a comprehensive study. It was prepared on 30 August 1985. That document clearly sets out the crisis in cancer care in Ontario. It clearly sets out where there are shortages and problems in working conditions and it clearly sets out what needs to be done.

If I can quote from that report, in 1985 the government was told by a study which was commissioned by the Cancer Treatment and Research Foundation, “currently overtaxed resources will not meet future needs and will deteriorate beyond the point at which they can still be salvaged; and access to specialized care for cancer patients will correspondingly decrease.”

The government had that report on its desk in 1985. It allowed the situation to deteriorate for four years, to where patients were waiting for as long as seven and eight weeks to receive radiation treatment before the government announced its emergency measures. I want to ask the minister, when was she personally first made aware of the fact that there was a problem with respect to radiation care, and why did she not do something about it long before now?

Hon Mrs Caplan: I do not agree at all with the categorization of the Leader of the Opposition. The ministry took action immediately upon receipt of that report and announced the redevelopment of Princess Margaret Hospital, as well as working very closely with the Ontario Cancer Treatment and Research Foundation, Princess Margaret Hospital and the Ontario Cancer Institute to start to talk about how we could better take a specialty care approach and develop the kind of cancer network in the province.

Those discussions have been very fruitful. We have an action plan. We are massively recruiting for specialists from around the world. In fact, $1 million is going into recruitment efforts to make sure we have the staff we need in Ontario. We know the situation is not unique to Ontario. I can tell him that as much as we would all like to see these things in place yesterday, we are moving forward together actively.

Mr B. Rae: The fact of the matter is that there were more nurses working at Princess Margaret Hospital in 1985 and there were more beds open at that time than there are as I speak today. That is the reality. Why did the minister not act back then when her government was told that many of the concerns of radiotherapy technologists were in the area of working conditions, job responsibilities and staffing levels? The government was warned. It had a report on its desk that said cancer care was in disarray and that it stood at the crossroads. In particular, it pointed out the areas of radiation oncology and radiation technology as areas that needed focus from this government.

I want to ask the minister, why did it take a crisis where the waiting lists doubled and tripled, why did it take that long for this government to finally come to its senses with regard to the crisis that now exists in cancer care in Ontario?

Hon Mrs Caplan: As the Leader of the Opposition knows, we want to make sure that people have the services they need when they need them. He also knows we have developed an action plan so that we can ensure it is happening. I want him to know we have the assurance that is happening.

He knows as well that human resourcing issues are not unique just simply to Ontario, but that these issues are in fact worldwide in their scope. He knows as well that we have doubled the number of positions for training. We did that almost two years ago. We know that we are working very closely with the cancer care co-ordinator, the Ontario Cancer Treatment and Research Foundation, the Ontario Cancer Institute, the Canadian Cancer Society and Mission Air to do everything we possibly can to see that the people of this province have the care they need when they need it.

Mr Reville: It’s like talking to a telephone book.

Mr B. Rae: As my colleague the member for Riverdale says, it is like talking to a telephone book.

SALES TAX REBATE

Mr B. Rae: I have a question for the Minister of Revenue, who gave us some answers yesterday with regard to the rebates his government hands out to charitable organizations on the retail sales tax side, and in particular with respect to the costs of construction and other taxable costs that are not paid by charitable organizations under the law.

The minister yesterday told the House that nothing could be done. His Premier (Mr Peterson) went out and tried to bail him out of the large hole he had dug himself into when he said it could not be done. He said, well, maybe something should be done. Then I gather the minister said he thought maybe something ought to be done.

Tridel Corp. in addition to having an arrangement with Mrs Starr --

The Speaker: The question?

Mr B. Rae: -- also had an arrangement with two other charities, the Artisan Charitable Foundation and the Coral Charitable Foundation.

I would like to ask the minister if he is aware of transfers that took place far earlier with respect to the sales tax rebate. Is he seriously still saying today that there is nothing the government of Ontario can do to monitor the hundreds of thousands of dollars it gives to these organizations? Is he saying there is nothing he can do about that?

Hon Mr Mancini: Evidently the Leader of the Opposition does not want to understand the process that has been in place for a considerable period of time.

Interjections.

Hon Mr Mancini: The honourable Leader of the Opposition would rather have his colleagues heckle and shout than listen to the answer. I want to say to the Leader of the Opposition --

Mr Wildman: Life is tough, isn’t it, Remo?

Hon Mr Mancini: No, life is quite nice over here. You guys might want to try it some day, but I doubt if you will have the chance.

The Speaker: Order. Response?

Hon Mr Mancini: I want to say to the members opposite that the public trustee --

Interjections.

The Speaker: Order. If you do not want the minister to respond, I will ask for a supplementary.

Hon Mr Mancini: It was all those potential interim leaders who were heckling.

The Speaker: Does the minister have a response?

If they wish to undertake certain charitable works they must then propose these charitable works. They must complete these charitable works and they must prove that whatever they promised to have done is in fact done. Then they apply for the sales tax rebate and they qualify --

The Speaker: Thank you.

Mr B. Rae: I saw several clips of the minister outside this place in which he told the media that maybe the situation was not perfect and that maybe something more could be done to look at what happens after he hands over the cheque. Apart from the gobbledegook his bureaucrats have written for him, I wonder if he is prepared now to answer in this House a very simple question. Is he prepared to say inside this House what I heard him say outside this House with regard to whether future changes are going to be carried out by his government? Yes or no?

Hon Mr Mancini: When there are problems with charitable organizations, individuals such as the Ontario public trustee are called in to investigate the matter and to not only defend the government or the public purse but to defend the charity itself. We must realize that in this instance with the National Council of Jewish Women of Canada, Toronto section, it is their organization that has been hurt, an organization that has been in place for almost 100 years and that has done good works for almost 100 years. It is their organization that has been hurt and it is the responsibility of the public trustee to see if he can right the matter.

The Speaker: Thank you.

Mr B. S. Cooke: That’ll work. Remo goes to Ottawa.

Hon Mr Elston: He’s going to get there before Bob.

The Speaker: Order.

Mr B. Rae: I know the minister might be fantasizing about a draft.

The Speaker: It is now time for a final supplementary.

Interjections.

Mr B. Rae: I think the door just shut.

I want to ask the minister this question about his own responsibilities. He says that he does not want to hurt small unsophisticated organizations I am sure that Mrs Starr does not qualify under that title, neither does the party of which he is a member, nor does the Tridel Corp.

There is evidence now in the public record that two charitable organizations were effectively established by Tridel Corp; that those charitable organizations received a sales tax rebate and handed over that sales tax rebate directly to Tridel under an agreement signed by them and Tridel.

Now the question that I have for the minister is this: Is that the kind of charitable work which the taxpayers of Ontario are supposed to subsidize? And if not, when is he going to do something about it?

Hon Mr Mancini: When the charity involved applied for its sales tax rebate, a field audit was made, our auditor was out there for more than 27 hours. He conducted his job appropriately, he reviewed the files and the National Council of Jewish Women qualified for their sales tax rebate because they had completed the work they had promised they would do.

CHRONIC CARE

Mr Brandt: My question is for the Minister of Health. The president of the Ontario Hospital Association gave out some of the following facts regarding chronic care patients in hospital beds. He indicated in that statement that the average age of the patients is 86; that 92 per cent of them need feeding assistance, 95 per cent of those selfsame patients need help in moving and 65 per cent of the patients are either confused or have Alzheimer’s disease and are therefore in a difficult position in terms of the kind of care that they require.

The bottom line that I want to share with the minister is that with the best of intentions, seniors with those kinds of problems need chronic care facilities. They cannot be easily moved to the option that the minister proposes in this House frequently, as a community-based service. They cannot be easily moved into those kinds of services and they need chronic care beds. Is the minister prepared to live up to her commitment and the commitment made by her predecessor to construct the 3,000 chronic care beds that were contained in the former minister’s statement back in May 1986?

Hon Mrs Caplan: In fact, I would say to the leader of the third party that we are committed to meeting the needs, the real and changing needs, of the people of this province. I speak to seniors right across the province as I travel and does the member know what is unanimous? Not one person is telling me that they want to enter an institution before they absolutely have to. They know we have the highest rate of institutionalization in the western world. They are saying. “Help us to stay at home for as long as we possibly can.” We are listening and we are taking action to make sure that we can respond appropriately.

Mr Brandt: Along with others, I am getting rather tired of the pat response to some very serious questions.

I want the minister to know that at the Perley Hospital in Ottawa it is not a question of people remaining in their homes as long as they can before they are institutionalized. I want the minister to know that there is a two-year waiting list to get into the Perley Hospital for chronic care. And I want the minister to know that, as a result of the commitment made by her government to construct new facilities, she has put on hold a review of the Perley Hospital in Ottawa, which is causing that facility to go into debt by some $10,000 a week.

In addition, they have had to go to the bank to get a line of credit for some $800,000. The minister has not had the proper thinking with respect to the requests made by that hospital to even respond to its letters which were sent to her back in May.

When is the minister going to respond to the Perley Hospital’s immediate dilemma, which is its debt, and what is she going to do about the waiting list?

Hon Mrs Caplan: In fact, I have met personally with the chairman of the board of the Perley Hospital. I have met with all of the board chairmen in the Ottawa area. My colleagues in Ottawa have met with them. I spoke directly with the chairmen of the district health council and I assured them that the ministry is committed and determined to meet the real needs of the people and we have also asked the hospitals to submit their plans, which they now have.

We are reviewing them and I want to assure the member and the people of Ottawa that the ministry will ensure that essential services are maintained in the community and that hospitals work co-operatively with us to resolve the many issues during this transitional funding formula time as they arise.

Mr Brandt: The minister talks about reviewing the needs of the people. I want to advise her that of the three hospitals in the Ottawa area that look after chronic care patients, the lowest cost per patient bed is at the Perley Hospital, something in the range of $170 per day, which is about $60 to $70 per day less than other hospitals that provide a similar service. They are absolutely at capacity. They have no money.

They need a line of credit at the bank, which has been extended temporarily, with a very clear review that will be required by the bank and the hospital in order for it to continue to have the money that it needs to operate while the minister is casually reviewing the situation and deciding what she is going to do.

Can I ask the minister, when will she do one simple thing -- just a straight answer on one question, once in this House -- when will she send the Perley Hospital an answer to its request?

Hon Mrs Caplan: In fact, I am very aware of this situation. I want the member to know that ministry officials are meeting on an ongoing basis, reviewing the situation, and that we have said very, very clearly to those who have chronic hospitals across this province that we acknowledge that there are some interim steps that must be taken to address the funding formula changes but we are working with them on an individual basis and we will ensure that essential services are maintained in the community.

Mr Brandt: Mr Speaker, I realize it is not your responsibility to get a minister to answer a question in this House, but that answer was an insult to this House.

The Speaker: Maybe the member would adhere to the rules and ask the second question.

Mr Brandt: Yes, I do have a second question.

ONTARIO SCIENCE CENTRE MAILING

Mr Brandt: My second question is to the Premier. The Premier might be interested to know that a certain letter was mailed in the Toronto area recently in a plain brown envelope, such as the one I have in my hand, with no return address on the envelope. It contained information with respect to the Ontario Science Centre. As well as that same piece of material that was included in the plain brown envelope, there was a letter from the Minister of Culture and Communications (Ms Hart). It is not a constituency letter, but it went primarily to the minister’s own riding.

In my view, having read it, if the letter were to be sent across Ontario it would probably be acceptable. but in this particular instance, when it is included with advertising information from the Ontario Science Centre and some rather self-serving comments within the context of the minister’s letter, does the Premier think it is appropriate that money should be used from the science centre to distribute this kind of literature which is, in fact, self-serving to the minister?

Hon Mr Peterson: Frankly, I have no idea what the member is talking about. Obviously, I will look into it. I do not know who sent it, under what auspices.

Mr Brandt: It was sent by the Ontario Science Centre and in checking with the Ontario Science Centre I have found that in the postal routes in which this material was distributed -- seven in all -- six of them, either in whole or in part, happen to be in the minister’s riding. I would say that is rather serious. I ask the Premier, in investigating this, what steps does he plan to take to bring this to the attention of his minister as to the inappropriateness of using the Ontario Science Centre to distribute literature within the minister’s own riding, not in Mississauga, Scarborough, Etobicoke, Don Mills or anywhere else --

The Speaker: The Premier.

Mr Brandt: -- around the metropolitan area --

The Speaker: Order.

Mr Brandt: -- but in six of the seven postal routes.

Hon Mr Peterson: I can tell my honourable friend that I have never heard of the situation. I will look into it and share my views with the honourable member.

Mr Brandt: I want to say to the Premier that it is absolutely unbelievable that a minister would take these particular steps and use this method of distributing information, which is quite legitimate on the part of the Ontario Science Centre but quite inappropriate. I might add, on the part of the minister to use ministry letterhead to indicate what a wonderful experience this would be -- and I am sure it is -- to go to the Ontario Science Centre. Only one, I might add, with a very small, single exception, out of the seven distribution points was outside of the minister’s own riding.

I think it is inappropriate, it is self-serving and I ask the Premier to take the necessary steps with respect to the investigation of this matter. -

Hon Mr Peterson: I appreciate my honourable friend’s judgement on the matter. I have not seen it, but obviously I will look into it.

INCOME TAX

Mr Laughren: I have a question for the Treasurer. The Treasurer will know, I assume, that Revenue Canada now has compiled the tax data for Ontario for the 1987 taxation year, and that data shows that in Ontario there were 1,160 taxpayers who had incomes of more than $50,000 that year who paid absolutely no income taxes whatsoever, federal or provincial. At the same time, there were over 700,000 Ontario tax filers earning under $10,000 a year who paid provincial income taxes. Would the Treasurer tell us, how does he sleep at night?

Hon R. F. Nixon: I just think of the honourable member’s questions and I doze right off.

We have objected to this situation. We feel that the tax collection agreement is inadequate as far as it goes in that way and that we should have the right to levy our tax on taxable income, in which case we would, as members of this Legislature, have a bit more influence on the taxation system.

Mr Laughren: So the Treasurer is rejecting the one way that would resolve the problem. That is rather strange.

Could I ask the Treasurer how it is possible that he accepts a system that has the 700,000 people earning under $10,000 a year paying provincial income tax, while his preferential treatment of the capital gains costs the Treasury almost $500 million a year. At the same time, for only $150 million, everyone below the poverty level in the province of Ontario could be removed from Ontario’s provincial income tax rolls. Why does the Treasurer not take some of that forgone revenue and remove those people from the tax rolls in the province of Ontario?

Hon R. F. Nixon: We allocate our revenue in as fair and equitable a way as possible. The honourable member knows, as an efficient Treasury critic, that each budget has increased the number of citizens who have been exempted from paying provincial income tax by the program that we have been using, which he does not feel is rich enough. I have a lot of sympathy with his views and it would be nice to spend another $150 million in this connection.

What we have done, however, is put a surtax on higher incomes of the type that my honourable friend actually receives. Actually, perhaps not, because the honourable member is no longer a community college teacher. In this connection, the surtax is designed so that incomes above average are in fact subject to additional revenue.

ONTARIO SCIENCE CENTRE MAILING

Mr Brandt: I have a question to the Premier on the matter of the mailing from the Ontario Science Centre. When my office contacted the Ontario Science Centre to try to determine exactly what happened with respect to this mailing, we were advised at that time by the spokesperson from the science centre that any questions should be referred to the minister’s office because this was, and these are the exact words they used, “a joint venture between the ministry and the Ontario Science Centre.”

Again I want to point out that the mailing almost exclusively went to the minister’s riding. Now we are advised that we are to refer any questions to the minister’s office. Does this seem appropriate to the Premier under the circumstances?

Hon Mr Peterson: The member is saying a lot of allegations and I have told him I will look into the situation and I will give him the benefit of my judgement after I have looked into it. I do not know how I can be more fair than that.

Mr Brandt: I am trying to provide the Premier with all of the information that I have. I think the information with respect to the fact that a spokesperson for the Ontario Science Centre would indicate that this was a joint venture is rather important because it indicates that there was some kind of a relationship between the Ontario Science Centre and the minister with respect to this specific mailing.

I want to again put on the record that I feel the distribution of this is self-serving, inappropriate, and I am pleased to hear that the Premier is prepared to look into it. I ask him, will he then report back to the House?

Hon Mr Peterson: Let me say I am pleased that the member is pleased. I said at the beginning when he started that I would look into the matter and, of course, I will. The member has made a judgement on the matter. I do not know the facts attendant thereto. It is her responsibility. it is her riding, as I understand it, but as I said to my friend, I will look into the matter and I will give him the benefit of my advice as to whether it is appropriate or not.

COMMUNITY COLLEGE TEACHERS’ LABOUR DISPUTE

Mrs E. J. Smith: My question is to the Minister of Education. I have received more than one call from members of my constituency who suggest -- indeed insist -- that it is less than honest for the government to claim that it is in a neutral position in the present strike activities of the colleges of Ontario. They hold the view that since many issues are at the core of the strike, fiscal government restraint is responsible for the present situation. Would the minister care to comment on these questions?

Hon Mr Conway: Yes, I would, because like my friend the member for London South, I have heard that charge myself.

I would say in London what I said in Pembroke on Saturday last and what I will repeat now in this chamber. Five years ago in this province there were roughly 98,000 full-time students in the Ontario community college system, at which time the overall operating grants provided by the then Tory government approximated $463 million. Five years later, the overall enrolment is down somewhat to something in the neighbourhood of 97,000, so a slight decline in enrolment overall of full-time equivalent students, but the Peterson government has seen that operating support rise from $463 million to $698 million.

So I say that while the enrolment has remained stable -- in fact gone down slightly -- the overall operating grants have increased by over $235 million, an increase of over 50 per cent.

I have to believe that people in London and Pembroke, and yes, even in this Legislature, will understand that to be a very generous level of support. This government, under the leadership of this Premier (Mr Peterson), has done what it said it would do and that is substantially increase the financial support to the Ontario community college system.

Mrs E. J. Smith: The minister has previously assured us that there is a statutory committee that is looking into the students’ needs and making sure that no student is indeed at risk in the present situation. Is this committee also taking into account those particular courses that would be more adversely affected by the present work shortage?

Hon Mr Conway: As I indicated to the House the other day, under the Colleges Collective Bargaining Act, the whole responsibility for determining jeopardy rests with a body of individuals called the College Relations Commission. That group of people has the responsibility to monitor very carefully the whole question of jeopardy. They have a responsibility to report to the Minister of Colleges and Universities if, as and when, in their considered opinion, a state of jeopardy exists, and to this date they have not made that finding in this particular dispute.

SALE OF DUTY-FREE LIQUOR

Mr Philip: I have a question to the Minister of Consumer and Commercial Relations. Can the minister confirm that the Liquor Control Board of Ontario was approached by those freewheeling lobbyists and developers Huang and Danczkay, as well as the Department of Transport, and that the approach was that it not exercise its option, as of right, to operate the liquor store in Terminal 3? Can the minister confirm that it has given in to those lobbyists and can the minister give what justification can be given to giving up this option for the LCBO to operate a potentially lucrative business at Terminal 3?

Hon Mr Sorbara: Indeed I will not confirm that because that is not the case. My understanding is simply that the liquor control board, when confronted with the appropriate marketing of beverage alcohol in a duty-free context at Terminal 3, did an analysis of what the most appropriate method of marketing would be under the circumstances and, I tell the member for Etobicoke-Rexdale, looking at the nature of duty-free marketing around the world -- and it really is a global market -- opted for a model which would have one facility market all products, including cameras, tobacco products, perfumes and beverage alcohol as well.

Mr Philip: Is the minister not confirming then that in fact the LCBO will not be operating the store in Terminal 3, and would he further confirm that it is in fact the plan of the LCBO not to continue to operate its rather lucrative stores in both Terminals 1 and 2? Would the minister give us the detail that justifies his sellout of a rather lucrative business? What is the justification to the 50 employees presently working there and to the taxpayers of Ontario for giving up this lucrative business?

The Speaker: Thank you. You have already asked three supplementaries.

Hon Mr Sorbara: I am surprised and delighted to hear a member of the New Democratic Party arguing for a marketing model which generates significant profit.

I want to tell the member that the studies have been done and every indication is that the most effective -- read “profitable” -- method for marketing of beverage alcohol in duty-free stores is the model chosen for Terminal 3. I want to also tell him that currently the LCBO has contracts and leases which have it marketing beverage alcohol in a separate store at Terminal 1 and in a separate store at Terminal 2. But the fact is, as those leases are up for renewal, we will be looking at marketing in a one-stop shopping context.

The member is right that that raises a very important issue for employees at those stores. I want to tell him, I want to tell those employees and I want to tell this Parliament and the province that every single employee who will be affected by any change will be provided for in terms of alternative working arrangements within the Liquor Control Board of Ontario. I think that is a fair and effective way to do it and it represents the approach of a model employer. No one will lose his job.

PASSENGER RAIL SERVICES

Mr Harris: I want to talk about people losing their jobs to the Minister of Northern Development. I think he will be aware of the headline in yesterday’s paper, “140 Ontario Northland Workers To Go?” The headline in today’s paper is. “ONTC Confirms Job Losses.”

I am a little surprised that the minister did not have a statement on this today, given that we are talking numbers in excess of 10 per cent of the workforce of the Ontario Northland Railway and given the fact that this type of massive job loss will have a tremendous negative impact throughout all of northeastern Ontario. Some union representatives tell me that the worst is yet to come.

These cutbacks are the result of resource industry shutdowns, compounded substantially by the fears and the uncertainty created by the Peterson government with respect to the future of passenger rail services in northeastern Ontario.

I raised this question two weeks ago when I found out that the minister was sitting on the report that he did, that his government did on the future of passenger services in northeastern Ontario. He has had that report since August. Why will he not release that report and how many more jobs do we have to lose before we get that report?

Hon Mr Fontaine: First of all, the ONTC has not made an announcement on this matter and, as the member knows, I am fully aware of what is going on in that corridor with the closing of the mines. We are just starting to talk with the unions to see what we can do, if we cannot replace the freight that we are losing with those two mines. We have to do that in advance by the law, but that does not mean that they are going to lose all their jobs because ONTC is doing a marketing study to try to promote more freight in that corridor. Going back to Via, this is not the problem of the province; this is the problem of the federal government.

Second, the report is being translated into French and is going to be out. The report was done before Via decided to leave the north. The origin of the report was to see if the ONTC was doing a good job on the passenger side. The report will be out later on and the member will see. The Minister of Transportation (Mr Wrye) is negotiating. We are going to talk to Via and we will decide as a government what we are going to do with the Northlander or the other train.

Mr Harris: The minister will know that it is his government, it is the ONTC, that has the responsibility for passenger rail services in northeastern Ontario.

Second, I am asking about a report that his government commissioned, that was completed and finished in August, and he has had since August, that talked about the day train and the night train. As well, the minister has a petition from the United Transportation Union containing 28,000 signatures, people in northeastern Ontario saying loud and clear to the Ontario government that they want to continue both the day train and the night train.

The minister has that study, he has had it since August, he knows the uncertainty and the fears that that study created when it was under way. I would ask him again why he will not release the results of that study and why he will not give the people of northeastern Ontario a commitment that both the day train and the night train will remain in northeastern Ontario.

Hon Mr Fontaine: I would like to remind the member for Nipissing that his own government made a report under Margaret Scrivener and never acted on it either. We have waited since that time, since 1981, to see what they were going to do with it. I am telling the member the report will be made public when it is translated into French.

The onus for Via is federal. We asked, my ministry and the Ministry of Transportation, to meet with Mr Bouchard and he said no. That is not my fault. The member should write to Mr Bouchard and ask why did he meet with us in August last year. The report did not come in August. It came to me in Cochrane in the middle of September, and I gave the report to the ONTC to look at and to the Ministry of Transportation. That was my duty. Now I am telling the member that when it is translated it will be made public.

PUBLIC HOLIDAYS

Mr Fleet: My question is for the Minister of Labour. Two weeks ago, the Ontario Advisory Council on Women’s Issues issued an excellent report advocating progressive reforms of employment standards. In particular, the council recommends creating two additional public holidays each year, namely, the August Civic Holiday and a family day in February.

Public holidays are a basic standard which improve working and living conditions and contribute to improved family life and maybe to increased productivity. Ontario has only eight statutory holidays, yet a majority of private sector employees and three quarters of unionized employees have at least 11 paid holidays per year.

When will the government update the basic standard and quality of life of all workers in Ontario by acting on this report?

Hon Mr Phillips: We are doing two things. The first is that as a result primarily of the unemployment insurance changes planned for 1 January 1990, we are looking right now at some changes that were proposed in the report to maternity leave and family leave. As the member may recall, I issued a consultation paper just last week looking at that element of the report.

The second thing I would say is that we are planning quite a thorough review of what we call our Employment Standards Act, which will look at the other recommendations within that report. That review will take place next year, and so we will look at those two things: the consultation paper immediately and the Employment Standards Act in 1990.

Mr Fleet: The minister will recall that last May 1 introduced Bill 9 to create two new public holidays, the August Civic Holiday and a heritage day on the third Monday in February. The public response I have encountered about this proposal has, on balance, been highly favourable. In light of the review his ministry is currently conducting on the Employment Standards Act, will the minister undertake to have his ministry also examine Bill 9 for possible adoption by the government?

Hon Mr Phillips: The quick answer is yes, although I think we must recognize that this review includes some other extremely important matters, such as the family leave I talked about, the whole issue of overtime pay, the whole issue of severance and termination, which is extremely important.

We certainly will look at our paid holidays as part of that review, recognizing that it will be done within an overall review looking at some other quite important matters. Therefore, we will look at that, but I cannot guarantee that that will be one of our recommendations because we will be looking at several important matters that I think must be considered in a total context.

Certainly we will review Bill 9 as proposed by the member as part of it and we will look very carefully at whether it is of benefit to extend more paid holidays or whether there are higher priorities. We will consider it very carefully.

WASTE MANAGEMENT

Mrs Grier: My question is for the Treasurer and it concerns the disposal of garbage in the greater Toronto area. The Treasurer, I am sure, will agree with me that a great deal of expertise about the nature of garbage, the collection of garbage and the disposal of garbage lies with the public works commissioners in municipalities and that in the greater Toronto region there are five regional works commissioners and a number of local municipalities with works commissioners.

I wonder if the Treasurer could tell us, in the plans for the disposal of Toronto’s and the greater Toronto area’s garbage, what role he sees these public works departments and their commissioners playing in the future.

Hon R. F. Nixon: I think the honourable member may be under the impression that I am still the minister that the greater Toronto area reports to the House through. Is that correct?

Mrs Grier: Yes.

Hon R. F. Nixon: That has been changed, and I would like to refer the question to my colleague who has all the answers in this area, that is the honourable Minister of Municipal Affairs.

The Speaker: It is then referred to the Minister of Municipal Affairs.

Hon Mr Sweeney: I appreciate the confidence that the Treasurer has in my ability to have all the answers. I have had the opportunity to meet with each of the regional chairmen in the greater Toronto area, along with my colleague the Minister of the Environment (Mr Bradley), to discuss exactly how they were coming along with respect to waste disposal.

As the honourable member is probably aware, there is an agreement that each of the regional chairmen will name an interim site for waste disposal and then they are supposed to collectively come up with one or more sites of a more permanent nature. The other part of the agreement is that they will attempt over the short run to use recycling and reduction and reuse for roughly 25 per cent of that waste and over the longer run for 50 per cent of that waste. Third, they are looking at the possibility of some incinerator proposals, but that has not been defined too carefully.

I can only assume that the civic officials that the honourable member refers to are very much part of that process with respect to their own individual chairmen, but the two contacts we have within the ministry are with the CAOs, the chief administrative officers, and with the regional chairmen themselves. My ministry does not have any contact directly with the civic officials that the member mentions.

Mrs Grier: I apologize to the minister for having forgotten the fact that he had assumed responsibility for the greater Toronto area and I congratulate him on being given that responsibility.

My question, of course, was directed to the recent request for an expression of interest for the development of a comprehensive, long-term, solid-waste management system for the greater Toronto area and to my puzzlement at the fact that nowhere in this document is there any co-ordination of the expertise in the works departments of the various regional municipalities.

The expression of interest seems to be directed totally at the private sector, and I would like to hear from the minister how he expects the activities that he has described to us as now being carried on within the various regions to be carried on if the disposal fees that are presently at the disposition of the regional municipalities are in fact totally turned over to the private sector, as appears to be envisaged by the present plans for the GTA.

The Speaker: Minister.

Mrs Grier: There is a great deal of money going --

The Speaker: Minister.

Mrs Grier: -- into recycling and reduction as a result of those disposal --

The Speaker: I think there has been enough explanation.

Hon Mr Sweeney: I have a greater sense of the honourable member’s question. To the best of my ability, let me assure her that there is no attempt whatsoever, either on behalf of the government of Ontario or on behalf of the regional chairmen, to indicate that this task will be carried out by the private sector.

My best understanding is that they are looking very closely at their own ability to perform the task, and I understand that in some of the regions the civil service staff, the engineering staff, are making proposals in fact as to how they can do that. But the private sector certainly will be considered as one of the options.

The member is undoubtedly aware of the fact that there is an organizational structure set up -- the acronym is SWISC, the solid waste interim steering committee -- whereby they are looking at a number of options. I can also tell the honourable member that between last week and this week my deputy minister responsible for GTA, Gardner Church, and I have attended three seminars in three of the regions -- there is another one tomorrow night and I think the fifth one is next week -- whereby we are looking at a range of concerns from the regions as far as their co-operative efforts are concerned.

We are looking at transportation; we are looking at housing; we are looking at social services, and we looking at waste disposal. That kind of co-ordinated effort is going on at two different levels simultaneously and it most certainly will involve their own staffs --

The Speaker: Thank you. That seems like a fairly comprehensive response. The member for Wellington, new question.

HOSPITAL FINANCING

Mr J. M. Johnson: My question is to the Minister of Health. Almost three years ago the former Minister of Health, the member for Bruce (Mr Elston), gave his commitment for funding the redevelopment of the St Joseph’s Hospital in Guelph and for major renovation to the Guelph General Hospital. Does the minister intend to honour these commitments made by her government to the people of Guelph and Wellington county?

Hon Mrs Caplan: The member opposite should know that in fact I have been meeting with the communities. I had people from his riding in to meet with them, to talk about how we can make sure we are planning appropriately for the communities to meet the needs not only for today but also in the future.

He knows also that my colleague the member for Guelph (Mr Ferraro) has been a wonderful advocate on behalf of his community and wants to ensure that the new St Joseph’s Hospital, which is in the planning right now, will in fact meet the real needs of the people of Guelph in the future.

He knows also that there is some repair work that has to be done for the Guelph General Hospital and that we are working as part of our overall review of capital to make sure that, as we use capital dollars and as we put the shovel in the ground, we want to be certain that we are meeting those needs after the very best of planning processes, getting the very best of advice because we know that our only opportunity to do the right thing, which we all want to do, is before the shovel goes in the ground.

Mr J. M. Johnson: The minister should read the press release by her predecessor, the former Minister of Health. In a release dated 24 April 1987, the member for Bruce said: “The people of Guelph have been waiting almost 20 years for an answer to their medical needs. They deserve better. Their waiting is now at an end.”

Possibly the Minister of Health should talk to the former minister because apparently waiting is not at an end. When does she intend to honour the commitments? Not any more studies; 20 years is enough. Even the former minister admitted that.

Hon Mrs Caplan: The member opposite knows full well that we are gathering the very best of information and advice -- I am sharing that with colleagues in this House -- to make sure that, as we build for the future, we are building the right thing. We are committed to meeting the real and changing needs of the people of this province. I know that he is, and I want to assure him that my colleague the member for Guelph is ensuring we make the commitments that are necessary to meet the real needs of the people of Guelph.

SUSTAINABLE DEVELOPMENT

Mr Adams: My question is to the Chairman of Management Board in his capacity as chair of the Ontario Round Table on Environment and Economy. At the recent conference organized by the Peterborough round table on sustainable development, concern was expressed at a perceived shift in the balance between development and protection of our environment. The people in Peterborough look to the provincial round table for leadership. Can the minister bring the House up to date on the work of his round table’?

Hon Mr Elston: First of all, might I say that in terms of leadership, the municipality of Peterborough has taken a lead in setting up one of the first operating round tables, and it has gone a considerable way in the municipality to do several things which I think have been important advances with respect to taking stock of where its community is in relation to development and in ensuring the development is done in harmony with the environment there.

I think that, with respect to our own round table, our meetings have been productive to this stage and, in fact, we have had several interesting discussions surrounding the issues of planning for the future. Land use, energy and a whole series of other sectors of the economy have been visited to get a first sense of how we should approach the production and presentation publicly of an overall strategy.

The process around which that strategy will be brought forward is going to be the subject matter of an upcoming meeting, and I want to assure the people of the province not only that we support the local initiatives of each of the municipal and other round tables created but that we are working in harmony with the federal and other provincial round tables. In addition to that, we are providing ourselves with the best advice from the broadest public consultation that is possible.

Mr Adams: It seems to me that the Brundtland commission, which developed the round table concept, had in mind a grass-roots approach to sustainable development. Does the minister foresee that the provincial round table on the economy and the environment will be able to support, in concrete ways, the work of vital local round tables, such as the one in Peterborough?

Hon Mr Elston: In fact, what we expect from the process of the round table is not only the development of an overall umbrella strategy for sustainable development in Ontario but also the opportunity to examine ways in which local communities are making progress towards implementing programs in their own areas.

We have a portion of our round table which is dedicated and under the leadership of the honourable Minister of Citizenship (Mr Wong), items called demonstration projects, in which we are considering what we can do to show the people of the province how major advances can be made by making decisions in a wise fashion that take into account not only the business opportunities but also the opportunities we have as a society, to be able to preserve our environment in a way in which we would be proud, so that we can pass on the environment and our social order and structures in a way which our children and their children can be proud and take advantage of in future years.

SALE OF POPPIES

Ms Bryden: I have a question for the Minister without Portfolio responsible for senior citizens’ affairs. In view of the fact that Legions across the province rely on proceeds from the annual poppy fund drive to provide services to veterans in need, and in view of the fact that as veterans age and provincial services are cut back the needs are growing rapidly, can the minister tell us why the government and its Minister of Transportation (Mr Wrye) have chosen the day on which the two-week poppy fund starts for 1989 to announce that GO Transit and the Toronto Transit Commission will immediately ban poppy fund sales on the premises of these two provincially funded transit systems’?

Hon Mr Morin: Being a veteran myself, when I heard this decision was taken I was aghast. I have not yet done any inquiry about the issue. I will consult with my colleagues and get back to the member if that is agreeable to her.

Ms Bryden: I am absolutely stunned that the minister has not yet met with the Minister of Transportation, who was here earlier. I would have directed my question to him as well about this sudden death knell that has been dealt to the poppy fund drive, because the campaign is all geared up. The people will now not know where they can operate from and they will not reach their goal; their volunteers will not come out.

Will the minister ask the Minister of Transportation to sit down with all the groups that rely on sales and tag days to make up for their lack of funding from the provincial government and from other agencies and work out a fair policy for using government property to assist these groups in their fund-raising? We are using the Parliament buildings right now for poppy fund sales.

The Speaker: Thank you.

Hon Mr Morin: I am pleased to say to my honourable colleague that I have in my hand a letter that was addressed to the Minister of Transportation and it was signed by Lou Parsons. Permit me, Mr Speaker, to read the letter.

The Speaker: As long as it is not too long.

Hon Mr Morin: It is very short, but at least it is to the point and I want to satisfy my honourable colleague, because it is an important issue: “Mr Forbes confirmed to us that no one at either GO Transit or TTC has asked the Legion to refrain from offering poppies on either transit system.” To me that is clear, so obviously the problem, in my mind, seems to have been settled. I thank the member extremely for having brought this question on the floor.

CHILD CARE

Mrs Cunningham: I have a question for the Minister of Community and Social Services. On 6 February the minister’s predecessor stated in the House that he would do a complete review of the inspection and monitoring procedures in our child care centres. We expected that in August, and then we had a delay until October. It is now 1 November. This was a priority with the former minister. When should we see this document that will give us some direction around the necessary monitoring of child care centres across this province?

Hon Mr Beer: It is an issue on which my predecessor did note we were undertaking a review, and I hope very shortly to be coming back to the House with a statement. We have been undertaking a number of steps in the interim to deal with different issues. We want to conclude the review and, as I say, I will be reporting to the House shortly.

PETITION

COMMUNITY COLLEGE TEACHERS’ LABOUR DISPUTE

Mr Carrothers: I have a petition signed by some 33 individuals urging the government to do all it can to have community college instructors return to their classrooms.

ORDERS OF THE DAY

OPPOSITION DAY

HEALTH SERVICES

Mr Eves moved opposition day motion 2:

That this House condemns the government for its failure to address the deterioration of our health care system -- specifically its underfunding of hospital operating budgets resulting in the closing of hospital beds; its failure to keep its commitment to fund 4.400 new chronic and acute care hospital beds; its insensitivity to the increased waiting lists for health services forcing Ontarians to seek health care outside the province and resulting in the suffering of patients; its inability to foster a co-operative relationship and trust with health care providers; its inadequate support and funding for a more community-based approach to health care delivery, and its attempts to blame individual doctors and health care professionals for the problems in the health care system.

The Speaker: Mr Eves has moved a motion. I believe you all listened carefully; at least I noted that some did. Under standing order 41(f). members will have an opportunity to debate this motion. I would remind all members that the time will be divided equally among parties, and if the mover of the motion wishes to reserve any of that one third of the time until the end to respond, he certainly may.

Mr Eves: Addressing the many parts to the motion I moved in the Legislature this afternoon, land many colleagues, at least on this side of the House. feel that the health care system in Ontario is indeed in a state of crisis.

We understand on this side of the House, some of us having been where the minister sits, that there are no easy answers in many ministries in government, and probably the Ministry of Health is one of the most difficult, to say the least. But there has to be a definite improvement in co-operation between health care providers and the government in the province. Admittedly, the government mouths platitudes about co-operation, and it has many studies and reviews going on of various aspects of the health care system, but very little seems to be done in a concrete and real way to address some of the very real problems in our health care system today.

The difference would appear to be the priorities between health care providers and the government’s priorities. It would appear from the actions of both groups that doctors, nurses, hospitals, pharmacists, optometrists, physiotherapists, ambulance officers and nursing home operators all seem to share a common priority. That priority is treating the sick, caring for people and saving lives.

Look at how they treated physicians in the province when they were renegotiating the Ontario Medical Association fee schedule. Despite the fact that an independent fact-finder recommended to the government that the physician OHIP fee

schedule be increased by over three per cent, the government chose to unilaterally impose a 1 .75 per cent increase. It was the first time in the history of the province that a government has not recognized the findings of an independent fact-finder in such negotiations.

Now let us look at the nursing shortage in Ontario. We have over four funded studies or papers or documents with respect to the nurse shortage in the province, two of those by the profession itself -- the Ontario Nurses’ Association report and, of course, the Registered Nurses’ Association of Ontario report. They were remarkably similar in their findings. The 14 or 15 major findings in each were almost identical. Yet to date the government has addressed exactly one before this week, and that was to appoint nurses on hospital committees where they would have a real say and some real input into what is going on in the health care system.

In February 1989 the Minister of Health (Mrs Caplan) introduced regulation 83 for 1989, and by 30 September 1989 nurses were supposed to be established on these committees in all 223 public hospitals in the province. Hospitals were supposed to have passed bylaws. It was supposed to all be done. We are now at 1 November. When I asked the minister in the House last week exactly how many hospitals had complied, she did not refuse to answer the question, but she did not answer the question in giving her response. I suspect she did so because the answer is zero. If the answer is not zero, then why did the minister not give me the answer when I asked the question?

Some hospitals have been very co-operative in this regard. To say that others have been somewhat less than co-operative would probably be an understatement.

The minister knows she has received a draft bylaw, drafted in concert by the Ontario Hospital Association and the Ontario Medical Association. To date, it is my understanding that she has not responded to their submission.

Look at the way this ministry and this government have treated hospitals and their budget problems. Look at what they did to the administrator of Cambridge Memorial Hospital a few short months ago, I think. When the Deputy Minister of Health can stand up and say in a public forum that he is going to have a particular hospital administrator’s head on a platter if he goes public with some problems he is having in his hospital, it is a sad, sad day for health care in Ontario.

Optometrists were foolhardy enough to trust the government and put their faith, with respect to diagnostic fees under the OHIP fee schedule, into the hands of an independent fact-finder. Professor Rayner from the University of Western Ontario came to the inescapable conclusion that optometrists should receive exactly the same fees for their diagnostic procedures as ophthalmologists receive.

Despite the fact that his recommendation was that there was no excuse for the government giving them more, the government retroactively and unilaterally, again, dismissed this independent report and reduced the optometrists’ fee

schedule by 4.35 per cent. They did not give them the same; they cut their fee

schedule by 4.35 per cent.

If you want to talk about mismanagement in the health care system, all you have to do is look at an OHIP computer system that has over 25 million people registered as users. The population of the province is 9.5 million people. How can that possibly occur? We have asked this minister these questions. We asked her predecessor these questions. We have been asking the same questions for four years and the answers we have been receiving for four years are: “We are redoing. We are looking at changing the computer system.”

OHIP has been looking at changing its computer system, as far as I know, since at least 1984. It is now 1989. It is going to be a hell of a system when it comes out, I guess. They have been reviewing it for five years. When are they going to do something? It would only lead you to believe that they have been sitting on their hands for most of the time and perhaps seriously looking at the problem only recently.

We have no drug and alcohol rehabilitation centres in Ontario. The treatment centres we have are slim and none, and I think slim went fishing. We spent all kinds of Ontario taxpayers money to send these patients to the United States of America and other jurisdictions to be treated when it would be far more economical to treat them right here in Ontario.

Look at the issue of perinatal and neonatal care. Over the last several years, we have had mothers and newborns flown to Buffalo, Winnipeg and all kinds of other centres throughout Ontario because they could not receive treatment close to home. That situation simply did not exist only five short years ago in the health care system in Ontario.

Let’s look at the issue of lithotripsy. We have exactly one machine, still, in Ontario despite the fact that we have pointed this out to the ministry and the minister time and time again. We still do not have even a second unit. The city of Paris, France, alone has five. The province of Ontario has one. We have pointed this out time and time again to the minister. We send, on average, 12 to 15 patients a week, each and every week of the year -- we have been doing it for years -- to the United States of America for treatment at a cost to the Ontario taxpayer of anywhere from $2 million to $3 million a year. One machine costs $1.5 million. What are we waiting for?

We can stand up and announce study after study, as the minister did earlier this week. She is going to spend $600,000 a year reviewing nursing problems that have been reviewed to death. Spend the money on something concrete where it is going to help the people of Ontario and not delay resolving the problem for another year or two. “Hopefully, we will not be Minister of Health then, so we won’t have to worry about it.” Right? I guess that is the rationale.

Orthopaedic surgery: We have heard the minister say to some of my colleagues who have raised the problems of their constituents with respect to waiting times for orthopaedic surgery:

“Shop around. If you don’t like the answer some doctor gives you, find another one.” Great response.

Cardiovascular surgery: The waiting lists and the tragedies that have occurred in the field of cardiovascular surgery in this province since 1985 are really tragic. We have had individuals on waiting lists for literally months, if not years. We had the incident of one patient, who had his cardiovascular surgery postponed 11 times, who died.

We have, as recently as a couple of weeks ago. the incident of Pat Terry, which I raised in this Legislature at his and his cardiovascular surgeon’s request, because Mr Terry was literally on a waiting list for seven or eight months just to get an angiogram done; not to have surgery performed, just to have the diagnostic procedure done. This is an individual who had a history of heart problems and had a triple bypass in 1986. He had a heart attack while he was on the waiting list for an angiogram.

This is a problem the minister said she solved in June 1988. I do not think she solved it very well, because from talking to cardiovascular surgeons, the problem is just as bad, if not worse, late in 1989 as it was in June 1988 when she made her announcement.

The minister accuses members of the Legislature, including myself from time to time, of politicizing individual patients’ problems. I thought as an elected member of the Legislature that what I was sent here to do was to resolve individuals’ problems, both within my constituency and outside of it. If Mr Terry phones me and asks me to see if I can help him get lifesaving cardiovascular surgery, I regard that as my duty, obligation and responsibility.

The minister’s response, as I recall, was, “I would not interfere,” although miraculously, I might add. Mr Terry was scheduled for his surgery, or angioplasty in his case, the very next morning, by coincidence, after I asked my question of the minister in the Legislature.

We could go on to many different areas. I will look at the area of cancer treatment and the problems we are having now throughout Ontario with a lack of radiotherapy technologists. This is an issue that was raised by members of the opposition by way of questions to the minister many months ago. It is an issue, as the Leader of the Opposition (Mr B. Rae) pointed out in his first question this very afternoon in the Legislature, the Ministry of Health knew about in August 1985. The ministry knew there was going to be a problem with respect to an acute shortage of professionals required to operate cancer therapy treatment centres throughout Ontario. What did they do?

I would have liked to have thought that in the last four-plus years we could have addressed the problem before it hit us over the head and hundreds of Ontarians had to suffer and have radiation treatment postponed or they had to travel to other places in Ontario or other provinces in Canada for treatment. These things did not happen in this health care system four and a half short years ago. They are happening with alarming frequency now. Somebody has not got a grip on what the real problems and solutions to those problems are in the Ministry of Health.

There has been a tremendous destruction of morale in the health care system in this province since 1985. Health care professionals from all walks of the profession are becoming more and more disillusioned by the day with the health care system in Ontario. If the minister talks to any health care provider on the front lines out there, be it a nurse, a doctor, an ambulance officer, they will tell her that morale in the system has seriously deteriorated. They feel they cannot trust the government.

I have named a few instances where different health care professionals have placed their trust in the government, and the government, quite frankly, has not turned the other cheek, it has slapped them in the yap, quite frankly. That is what they get for trusting the government with independent fact-finders and arbitrators. Now the minister is asking them to trust her again with Bill 147. “Trust me,” the minister says.

Mr J. B. Nixon: Oh, come on. Take it easy. This is not melodrama.

Mr Eves: People are dying, Mr Nixon. If you do not care, leave. If you are here because you are on House duty, have a nice day and shut up.

Mr J. B. Nixon: I care, but I am not going to play with people’s lives, as you are doing.

The Deputy Speaker: Order, please. Would the members respect the standing orders, please.

Mr Eves: Perhaps the honourable member could do some bedtime reading about Patti Starr. I understand he has more than a passing interest in the matter.

Mr J. B. Nixon: You don’t have any interest in anything but your own, personal success.

The Deputy Speaker: Order, please. Would the member for York Mills (Mr J. B. Nixon) and other members respect the standing orders, please.

Mr J. B. Nixon: Mr Speaker, on a point of order: If the member is going to refer to me personally, I think he should be obliged to obey the same standing orders that you have asked me to obey.

Mr Eves: The first point I would like to make is that I would like restored on the clock the time that the member for York Mills has usurped.

I would like to conclude my statements about the state of health care in Ontario with a comment which is a direct quote from the report of the committee investigating cardiac surgery at St Michael’s Hospital. This is not an opposition member speaking, this is not a political dialogue, this is from a report of a committee that the minister herself set up. The report contains this very crucial statement of fact, near the end, “If Ontario does not devise a system to monitor and manage change, the province’s health care system will go from crisis to crisis and public confidence will continue to be eroded.”

I think that says it all. That is exactly what is happening today. The province’s health care system is going from crisis to crisis and public confidence is continuing to be eroded in this health care system.

I am asking the Minister of Health, the Deputy Minister of Health in particular, seeing as how he seems to run the Ministry of Health over there, and the government of Ontario to address these very serious problems in the health care system today. There are serious problems and people are literally dying while they are on waiting lists. These problems did not exist in 1985, they do exist now, and it is about time they were addressed.

Mrs Marland: In rising to speak to this motion, I would say at the outset that I would prefer that this motion was not necessary. I want to read into the record the motion, because in fact these words say it all as far as the situation of health care in Ontario in 1989 is concerned. The motion is as follows:

“That this House condemns the government for its failure to address the deterioration of our health system -- specifically its underfunding of hospital operating budgets resulting in the closing of hospital beds; its failure to keep its commitment to find 4,400 new chronic and acute care hospital beds; its insensitivity to the increased waiting lists for health services forcing Ontarians to seek health care outside the province and resulting in the suffering of patients; its inability to foster a co-operative relationship and trust with health care providers; its inadequate support and funding for a more community-based approach to health care delivery; and, its attempts to blame individual doctors and health care professionals for the problems in the health care system.”

I will try not to repeat the comments of our critic for Health, the member for Parry Sound (Mr Eves), who has very passionately and very accurately this afternoon tried, in a very short period of time, to outline some of the concerns of the Progressive Conservative Party in Ontario today.

When we discuss the situation of health care in Ontario, we are in fact speaking on behalf of a minority. Obviously the majority of people in Ontario today are healthy, fortunately, but it is on behalf of the minority who depend on government to provide the care that they need that we are speaking this afternoon. It is on their behalf that the Progressive Conservatives have placed this motion.

I have said a number of times in this House that any single member of the 130 ridings that people in this House are elected to represent could stand on any public platform in this province and defend spending money on health care over everything else, because the truth of the matter is that people who are ill would give everything they have in order to get better.

I can speak from a very personal basis. When our child developed leukaemia, we would have gone to the ends of the earth, we would have sold everything, mortgaged our house and done anything to find a cure to save that child. I only give that as a personal example because I think if you have been in that position and you have stood in those shoes, you understand. I do not expect other people who have not had a firsthand experience to understand, but I do expect them to listen to people who have had.

When I think of the people we have dealt with just in this last year, people like the Charles Coleman family in Mimico, the parents of baby Jessica in Mississauga, the cancer patient in my riding who just this week learned that she has to go to Ottawa for her treatment without the provision of transportation and meals and accommodation for her spouse to accompany her, when I give those names and those examples, that is all they are; they are examples of hundreds and hundreds of other cases.

When we talk about a person like a Dr Bill Rudd, who operates the Rudd Clinic in Toronto, where he does colonoscopies all day long and his particular examination technology is one that saves people from dying of cancer of the colon or the intestine, the irony is that this health care professional, Dr Rudd, has to provide his own equipment. In 1989, he is saving hundreds of lives and the government does not even provide him with the tools to render his diagnostic service.

Because of the time limitation, I cannot give more examples.

I do not have the opportunity to tell members of the major concerns of the people I represent and the people we have heard from around this province, but suffice it to say that when there is a remedy for a health care problem and all the help that patients can receive is to be on three different kinds of waiting lists, then I guess what begs the question with this Liberal government is, is its only goal to develop more confrontation and hostile relationships with the health care providers, the hospital boards of governors who are trying to provide the facilities and ultimately the public who cannot access their care?

Is that the only goal and is that the only way this Liberal government can prioritize in terms of spending?

There is no question that we have a $13-billion health care budget, but there is also no question that in terms of priority that is where the money has to be spent. There are areas where revisions can be made to the management of some of our facilities, but while we have people on waiting lists in excess of two years for an operation that enables them to work, to walk and to live normally, then we have to question the total irresponsibility of the attitude of this Liberal government and I guess in particular we have to name the Minister of Health.

I will look forward at another time when more time is available to enlarge on my personal concerns on this matter and to say that I feel it is depressing at best to look at the harassment of our health care professionals at all levels because of what exists today in the attitude to the health care system by the current Liberal government.

Mr Philip: It may seem to members to be somewhat parochial if I deal with conditions in the hospital of which I am a member of the board of governors, but I think it shows the real-life situation of the ineptitude of this government to deal with the crisis in our health care system.

Through the underfunding of hospital operating budgets, through the lack of initiatives in creating alternative care, through the lack of funding of proper home support services, through its failure to keep its commitment to fund the 4,400 new chronic and acute care beds it promised, and through its insensitivity to the situation facing people in the health professions, particularly those in the nursing profession, this government has failed the people of Ontario in the most grievous way possible.

As of 12 o’clock noon today, 1 November, Etobicoke General Hospital had absolutely no beds available, zero beds available. We have people on the waiting list.

If we look at this hospital, which has approval for a total of 413 beds, we see that at the present time it has 68 people occupying acute care beds who are waiting for chronic care placement, 12 people waiting for nursing home placement and 9 people waiting for rehabilitation placement, for a total of 89 people occupying active treatment beds who in fact do not belong in the hospital. But, because of a lack of initiative of this government and the Minister of Health and other ministries, there is no place else for them to go; 89 people occupying active treatment beds who should not be there in a hospital of only 413 approved beds.

Despite the fact that we have a highly efficient hospital which has developed some of the most advanced analyses of workload and work disbursement in the province, despite a highly sophisticated computerized system in which administration can keep track of exactly what is going on and where every cent is being spent in the hospital, we are faced with a situation where, even having been forced by this government to close beds, we will be able to balance our budget -- projecting to 31 March -- only by closing 18 beds.

Closing that number of beds in a hospital of this size, while on an average day about 90 people who are not in need of active treatment care are occupying beds, is certainly a serious matter. The beds that have been closed as a result of the deficit which the ministry has forced on this hospital are: 18 medical-surgical beds, 7 paediatric beds, 5 psychiatric beds and 4 gerontological beds, for a total of 34 beds.

The present shortage of nurses at the hospital is critical. Based on our present needs, we are short 17 full-time registered nurses, six full-time registered nursing assistants, 22 part-time RNs and four part-time RNAs. It is not as though our hospital has not tried to recruit, but we are losing nurses, nurses who have had very many years of experience, because they are simply getting burnt out.

In the House some time ago, I told about my touring each of the wards of Etobicoke General and talking to the nurses, the staff and the patients there. I can tell, if you have an active treatment ward in which you have to feed and bathe six stroke victims on a daily basis, you get burnout. The hospital is not equipped for the lifting, for the bathing and for the handling of that kind of patient; and indeed the 68 waiting for chronic care placement, and even the 12 waiting for nursing home placement, would be much better cared for in a facility that is properly equipped to handle those kinds of person.

At the time that we will reopen our beds, the beds that have been shut as a result of this government’s failure to adequately fund the hospital, in addition to the 17 full-time RNs we need today and the 22 part-time RNs, the six full-time RNAs and the four part-time RNAs, we will need an additional 10 full-time RNs.

Anybody who knows anything about the colleges that train nurses will tell you that, although people are going into the nursing profession, when they talk to their graduates three and four years later, the same people then have left the profession. My wife, for many years, was a teacher of nursing; she runs into her students in the shopping centre and so forth, and asks them: “Which hospital are you working for?

Where are you working?” It is quite tragic to think that the taxpayers of Ontario spend all of this money educating people for a profession and, because of the inadequate salary, because of inadequate working conditions and because of the burnout resulting from this, they end up leaving the profession after the taxpayers have paid for what amounts to a fairly expensive educational program.

The minister’s response of having one study after another simply is inadequate. This government has been in power for two terms now. It has had adequate studies. It knows what the problem is. It is about time that it stopped giving excuses, stopped blaming the professions, stopped passing the buck and got on with dealing with the very critical problem we are facing.

It is not the hospitals that are being run inefficiently. It is not the nurses who cannot do more. It is not the other professionals in the hospital who are not doing their jobs. The buck stops with the minister. She has not done her job. She has not dealt with the problems, and therefore this government must be condemned for its lack of initiative, lack of action and the breach of the promises it made in the last election.

Mr Jackson: I regret that the time restraints in this House prevent each and every one of us from presenting most of the concerns we have about the inadequate level of attention this government is giving to health care needs in this province.

To be a member of the Ontario Legislature in this day and age is to become a listener to a litany of medical treatments that go unattended and to become a person who has to listen to families who cry out, in futility almost, for the attention of someone in government to deal with the lack of access that has become the hallmark of this minister and her government.

On several occasions, I have raised concerns for my community specifically, but I have also expressed a specific concern for a constituency generally in this province. I am talking about newborn infants: children who are struggling for their first breath of life in this world; children who, we all hope, will find their transition in delivery to be uneventful in the sense that it will be without medical complication and difficulty for the mother.

Increasingly in this province we are finding that children can live longer, with less neurological damage and physiological damage, in spite of very difficult deliveries in high-risk, premature situations. Instead of reacting to that fact, instead of helping our hospitals cope with the increased incidence of these children, we have a government that refuses to take seriously the warnings of neonatal intensive care hospitals all across this province.

With a government that will not listen to this problem it was to be foreseen that we would start to see incidents where women going into labour, knowing full well that that child’s chances of success were minimal, were being asked to fly from the city of Hamilton with Chedoke McMaster, a world-class facility only several blocks away, all the way to Kingston or to London to other neonatal hospitals.

Why? Because this government said to Chedoke McMaster: “You will get a 4.6 per cent increase, period, end of sentence. You will not get an increase for your program because of its established demand as demonstrated in southwest region, because your government has said, ‘We’re sorry, but you have to cut the level of nursing in that program if you don’t have the funding.’” The minister knows it is true, because she has now been to the hospital to look at various incidents that we have raised in this House

I raised several cases -- John Glenn and Peter Samuel, the Sharpe twins, two young boys who had to be sent to a hospital in two different ambulances in anticipation of finding the necessary room for them, and it was not until after considerable time and fear and worry on the part of the family that these children’s medical needs were attended to at an intensive care hospital.

There have been backlogs in intensive care units across this province. We have had a young mother from Hagersville having to be told in the middle of the night, “We’re sorry, you’ve got to go the United States to have your baby because we cannot fly you to London, we cannot fly you to Kingston.”

In spite of all these questions, and our raising these points on the floor of the Legislature, the minister says to us: “You don’t understand the system. It is very complex. We have increased perinatal funding.” That may be all well and good, but the minister has not done that for neonatal services in this province, and the facts have borne out that.

She has suggested that there is a computerized telephone system, a network right through to a central office which deals with a bed registry for neonatal intensive beds. She defended that and in fact got headlines such as “Caplan Suggests MDs Ignorant of System.” Those are the kinds of headlines the minister invoked.

We all know her celebrated, most recent case of denying that she did not have an adequate system in place, but with the critical care neonatal bed registry she clearly stated she had a system in place until I uncovered in this House the fact that she had had meetings within her own ministry to discuss the fact that the system was not working. It was a manual system that, because of its reliability factors, was not being used by doctors. They could phone individual hospitals far faster than picking up a telephone and being told that somebody in Toronto is on their lunch break at the moment and will get back to you.

The minister knows she has to commit the necessary dollars to put in a computerized registry system that is current at all times in order for it to be effective. She still has not got approval from her government to implement that. Did the minister ever withdraw her statement that doctors in this province are ignorant of how poor a system she had in place? She never did. She allowed that image to persist around this province, which was inappropriate and offensive to the reality and the risk that these children are put through.

There have been countless cases. There was another one raised in the House today, the case of Karla Evangelisto from Smithville who, having spent nine weeks at Chedoke McMaster, was informed at the moment of delivery that her child may have to be taken from her and taken to another hospital many miles away because there are insufficient beds at Chedoke McMaster.

I say to the minister, this kind of crisis management, the bold front put on by her government that things are going well, the fact that these children will be continuously subjected to these kinds of risks and the mothers to that kind of uncertainty and unnecessary worry during a complicated, high-risk emergency delivery, that is unacceptable in this province in this day and age.

It is important that the ministry now becomes refocused in this area, because its failure to do so will have serious implications to the lives of these children and to the future wellbeing of the mothers who bring them into this world.

Hon Mrs Caplan: In rising to participate in today’s debate, I would say to members of this House that I understand how complex and difficult it sometimes is to understand the workings of our health care system. We often use the term “system” in a number of different ways. We know that members of this House would not want to make statements that were factually inadequate, factually incorrect or absolutely wrong, or in any way to mislead members of this House. I know that and I understand that.

However, I would want to dissociate myself from some of the statements that have been made, because health care is a supremely human activity, and we rely on the providers, the professionals, hospital boards and administrators, who are all working together, often under challenging circumstances, circumstances where we see within our society not only an ageing population but also rapidly changing technologies and enormous resources. This year almost $14 billion is being made available, a full third of the provincial budget.

As we establish our goals and are clear about our vision, we know how important it is for all of us to work together and also how important it is to understand how our system works. We know that we have 223 private, nonprofit corporations that we call hospitals. We know that the Ontario Hospital Association is the representative of those independent institutions which deliver the services to the people of this province.

We know that the physicians, the nurses and all of the other allied health professionals work both in those hospitals and in community-based facilities across the province, delivering a wide range of many services, and how those services have changed over the course of not only the past decade but since we began the journey on this very important road, which we call medicare, some 20 years ago. We know the many changes that have occurred within our society.

We know as well that, whether we are health care providers, patients, the government, consumers or professionals, we are all partners. We all have roles, very important roles. As partners, we have a responsibility to ensure that our system not only is vital and relevant for today but is responsive to the pressures and strains that every aspect of our society is experiencing.

Our health care system in Ontario is extremely popular. In fact, we know that an overwhelming percentage of our citizens consider that they should have every right to be proud; in fact, they are, so they continue to have a very high opinion of it. They know as well that this does not mean it is perfect. I assume they know that there is always room for improvement. In fact, I want to share with the members that we are always working to improve tomorrow to make tomorrow a little better than yesterday.

I want members to know that, although a recent poll suggested that 75 per cent of the people in this province were satisfied with the health care system, even if that poll number was 95 percent, I would still not be satisfied because, although 9.5 million people are served by this health care system, although thousands of people daily receive appropriate care in this province, if there is anyone who is dissatisfied then I am not satisfied until we make sure that we do everything possible to meet the needs of the people of this province so everyone will be satisfied in the future.

We know we can always do better. We also know that we are constantly striving to do that. This government has put enormous resources into our health care system and we know that the issues and challenges facing us are often ones of communication, ones of co-ordination and ones of accountability while also ensuring that what we do is meeting the needs.

As a society, our approach to health care is changing. It no longer involves only the treatment of illness, just medical treatment and services. More and more, the people of Ontario want, quite simply, a better quality of life. We also know that as a government it is our responsibility to create a climate in which our citizens can achieve their aspirations.

We are doing this, changing the direction of the health care system, to recognize that health is more than simply the treatment of illness. We also know that health is more than just the absence of disease. A new definition includes an emphasis on preventive care, promotion of healthy lifestyles as well as the creation of a healthy workplace.

Through the Premier’s Council on Health Strategy we have looked very carefully at the determinants of health and how we can respond more appropriately as we change the structures in our system to ensure that it is responsive to what people really need so we have the right incentives in place to assure that people are given priority on the basis of need within our very complex health care system.

The health care system is not simply a function of buildings we construct or the machines that we buy. It is really all about people caring for people. We are a prosperous society and we spend a great deal of our prosperity, our collective wealth, on health care.

We have also reached the stage, however, where it is not so much a case of what we have, as how to use those resources that we have to make sure that they give us the very best results for the people of this province.

So we have to ask ourselves constantly, are the people’s real needs being met? Do the outcomes to the patient justify what is being done? Are the people satisfied that they are getting the services they really need? Where and how can we direct our energies to ensure that the answer to these questions is yes most of the time?

I would like to take a few moments here to talk about some of the actions the government has recently undertaken to ensure that health care and health care services remain available and appropriate for all of our citizens.

As members know, the Independent Health Facilities Act is presently under consideration by the Legislature. This particular act will ensure and enable government to have the ability to properly plan for where services are needed so we can allocate our very precious health care resources effectively.

It will allow us to work with district health councils to determine the need for appropriate services and then to be responsive to those needs. But, most importantly, the Independent Health Facilities Act is about quality, ensuring that we have the appropriate standards and quality of care in community-based independent health facilities.

We know that we have quality assurance today in our hospitals. As these technologies are able to move outside of hospitals, we want to be certain that we can say to the people of this province that the services that they receive in an independent health facility are safe.

We want them to know that they can have confidence that the services they are receiving have been established in an environment where they can have the confidence that there is quality assurance on an ongoing basis and that that is being monitored, and that is what licensing is all about.

This legislation is a co-operative effort. We had a number of amendments proposed at committee, a number of amendments that were supported by the government. I want to thank the opposition for its praise of the committee process which was so responsive in assuring that the intent of the legislation was reflected in the final product.

I am looking forward to third reading discussion and debate in this Legislature so that we will have a new framework that will allow us to respond to changing technologies and that will allow us to say that there are a number of places where we can serve and improve our services to the people of this province. Today, services are provided in doctors’ offices and in the quality-assured environment of hospitals.

Through this piece of legislation, we want to make sure that we are also able to properly plan, to fund and to make sure that services provided in an independent health facility are safe and quality-assured as well.

We have addressed areas of specialty care. We have established our priorities. We want to make sure, as we plan these areas of highly specialized care, that we provide these services as close to home as possible while using provincial resources both efficiently and effectively and that we begin to build a network within our health care system, because right now, we know that what categorizes that system is that people have tended in the past to act quite independently, and there was no incentive for people to work together sharing information or data or planning together. So I think cardiovascular care is a very good example.

The challenge for the system, when you look at cardiovascular care, is partially because the indications for surgery were expanded. Surgery is now being done on older and sicker patients requiring more complex procedures and increased use of intensive care resources. We know that in May 1989 we took action. We said that not only were millions of additional dollars going to be made available to expand the capacity for cardiovascular care, we also looked at how we could best share information to make sure that people were appropriately referred to the services that were available as part of an overall network.

So we brought together the very best of expert advice to tell us how we could best develop a network within our system, how we could make sure that there were common

definitions and appropriate standards of care so that we could assure the best outcomes for people who are receiving this very important, highly specialized service in this province.

We did something else. We also said that while people today must get the service they need -- and we are all determined to see that that happens appropriately -- and we are relying on physicians to use their very best judgement to refer people to the service that they need, we are also concerned because we know that much of this can be prevented. So part of our program is to increase funding for heart-related, health promotion programs over the next five years. This is extremely significant because today we can prevent much of the heart disease which is affecting people.

Through healthy lifestyle and personal choices, they can in fact make sure that they never need this kind of surgery. We think that today we must start to do this kind of health promotion in our communities.

We have three community-based heart health pilot projects. That is just a beginning. There certainly is more to do, but we have to give people the information they need so that they can in fact be as healthy as possible for as long as possible.

We developed a cardiovascular triage registry system. That is a fancy word, but what it really means is that we want to make sure that the most urgent cases in Toronto are cared for first. We are looking at an expansion of this kind of registry program, the development of a network. We know the capacity, right around the province, of the eight cardiovascular centres has been expanded and expanded substantially.

We know that Sudbury has increased. We know that Ottawa, Hamilton -- a new centre at Sunnybrook Hospital is coming on stream. We have made a commitment to improve everything that we do, and I can tell the members that this is just one example.

Interjections.

The Deputy Speaker: Order.

Hon Mrs Caplan: Thank you very much, Mr Speaker.

Another very good example of how we are building an important network and working together with all our partners is in the area of cancer care. We know that there are eight regional referral centres, plus the Princess Margaret Hospital, which ensure quality of care for people requiring this specialized service.

I know the