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October 10, 2013

40th Parliament, 2nd Session

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Hansard Transcripts

Votes and Proceedings

Orders and Notices

Hansard Transcripts 2013-Oct-10 (PDF)

L072 - Thu 10 Oct 2013 / Jeu 10 oct 2013

LEGISLATIVE ASSEMBLY OF ONTARIO

ASSEMBLÉE LÉGISLATIVE DE L’ONTARIO

Thursday 10 October 2013 Jeudi 10 octobre 2013

ORDERS OF THE DAY

ELECTRONIC PERSONAL HEALTH INFORMATION PROTECTION ACT, 2013 /

LOI DE 2013 SUR LA PROTECTION

DES RENSEIGNEMENTS PERSONNELS

SUR LA SANTÉ FIGURANT DANS

UN DOSSIER DE SANTÉ ÉLECTRONIQUE

INTRODUCTION OF VISITORS

ORAL QUESTIONS

POWER PLANTS

TEACHERS

POWER PLANTS

POWER PLANTS

GOVERNMENT’S RECORD

POWER PLANTS

STUDENT MENTAL HEALTH SERVICES

PAN AM GAMES

ONTARIO NORTHLAND

TRANSPORTATION COMMISSION

SMALL BUSINESS

HOSPITAL SERVICES

HORSE RACING INDUSTRY

AFFORDABLE HOUSING

WIND TURBINES

ANNUAL REPORT,

ENVIRONMENTAL COMMISSIONER

OF ONTARIO

LEGISLATIVE PAGES

INTRODUCTION OF VISITORS

MEMBERS’ STATEMENTS

KITCHENER GIRLS’ SOCCER

GREENPEACE SHIP

EID AL-ADHA

ALICE MUNRO

SOCIAL ASSISTANCE

ALICE MUNRO

HIGHWAY FUNDING

DENTURISTS

LOW WATER LEVELS

VISITORS

INTRODUCTION OF BILLS

ENHANCING PATIENT CARE

AND PHARMACY SAFETY

(STATUTE LAW

AMENDMENT) ACT, 2013 /

LOI DE 2013 MODIFIANT DES LOIS

AFIN D’AMÉLIORER LES SOINS

AUX MALADES ET LA SÉCURITÉ

DES PHARMACIES

MOTIONS

PRIVATE MEMBERS’

PUBLIC BUSINESS

COMMITTEE MEMBERSHIP

STATEMENTS BY THE MINISTRY

AND RESPONSES

HOSPITAL PHARMACIES

WOMEN’S HISTORY MONTH

HOSPITAL PHARMACIES

WOMEN’S HISTORY MONTH

WOMEN’S HISTORY MONTH

HOSPITAL PHARMACIES

PETITIONS

TIRE DISPOSAL

LONG-TERM CARE

PUBLIC TRANSIT

RURAL SCHOOLS

AIR-RAIL LINK

CASINOS

CHRONIC OBSTRUCTIVE

PULMONARY DISEASE

HOME CARE

ONTARIO COLLEGE OF TRADES

DOG OWNERSHIP

AIR QUALITY

TAXATION

AIR QUALITY

PRIVATE MEMBERS’

PUBLIC BUSINESS

TECHNICAL STANDARDS

AND SAFETY AMENDMENT ACT, 2013 /

LOI DE 2013 MODIFIANT LA LOI

SUR LES NORMES TECHNIQUES

ET LA SÉCURITÉ

TRANSPARENCY IN MEMBERS’ EXPENSES ACT, 2013 /

LOI DE 2013 SUR LA TRANSPARENCE

EN MATIÈRE DES DÉPENSES

DES DÉPUTÉS

FAIR HIRING TO SUPPORT TEACHERS, PARENTS AND STUDENTS ACT, 2013 /

LOI DE 2013 SUR LES PRATIQUES

D’ENGAGEMENT ÉQUITABLES

À L’APPUI DES ENSEIGNANTS,

DES PARENTS ET DES ÉLÈVES

TECHNICAL STANDARDS

AND SAFETY AMENDMENT ACT, 2013 /

LOI DE 2013 MODIFIANT LA LOI

SUR LES NORMES TECHNIQUES

ET LA SÉCURITÉ

TRANSPARENCY IN MEMBERS’

EXPENSES ACT, 2013 /

LOI DE 2013 SUR LA TRANSPARENCE

EN MATIÈRE DES DÉPENSES

DES DÉPUTÉS

FAIR HIRING TO SUPPORT TEACHERS,

PARENTS AND STUDENTS ACT, 2013 /

LOI DE 2013 SUR LES PRATIQUES

D’ENGAGEMENT ÉQUITABLES

À L’APPUI DES ENSEIGNANTS,

DES PARENTS ET DES ÉLÈVES

TECHNICAL STANDARDS

AND SAFETY AMENDMENT ACT, 2013 /

LOI DE 2013 MODIFIANT LA LOI

SUR LES NORMES TECHNIQUES

ET LA SÉCURITÉ

FAIR HIRING TO SUPPORT TEACHERS,

PARENTS AND STUDENTS ACT, 2013 /

LOI DE 2013 SUR LES PRATIQUES

D’ENGAGEMENT ÉQUITABLES

À L’APPUI DES ENSEIGNANTS,

DES PARENTS ET DES ÉLÈVES

The House met at 0900.

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

Prayers.

ORDERS OF THE DAY

ELECTRONIC PERSONAL HEALTH INFORMATION PROTECTION ACT, 2013 /

LOI DE 2013 SUR LA PROTECTION

DES RENSEIGNEMENTS PERSONNELS

SUR LA SANTÉ FIGURANT DANS

UN DOSSIER DE SANTÉ ÉLECTRONIQUE

Mr. Milloy, on behalf of Ms. Matthews, moved second reading of the following bill:

Bill 78,

An Act to amend certain Acts with respect to electronic health records / Projet de loi 78, Loi modifiant certaines lois en ce qui concerne les dossiers de santé électroniques.

The Speaker (Hon. Dave Levac): Mr. Milloy?

Hon. John Milloy: At the outset, I want to just point out that I’ll be speaking only for a brief moment and then turning it over to the Minister of Health as well as the minister’s parliamentary assistant, the member from Oak Ridges–Markham.

The bill, and I know the minister will go into some detail, obviously deals with the issue of electronic health records.

I can certainly say, from my experience as an MPP, I have had the opportunity to work with local physicians, with hospitals, with health care providers and to attend numerous demonstrations of the strides that we are making in terms of electronic health records, in terms of the dollars that it’s saving in making sure that we don’t have to duplicate tests, but more importantly, the way in which it’s benefiting patient care in that physicians and health care providers have access to a whole history, as I mentioned, of tests, of pharmaceuticals a person is taking, of their whole medical history, which helps them provide better care, faster care—and as I say, Mr.

Speaker, you always have to look at the whole issue of efficiency and cost. It means that we don’t duplicate tests, it means that we’re able to make the best decisions at that moment and in the best interests of the patient.

So I look forward to the debate on this bill. I think it’s a very important bill in establishing a framework around this very important headway that we’re making in terms of health care. With that, I will turn it over to the Minister of Health.

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

Hon. Deborah Matthews: I rise in the Legislature today to speak to the Electronic Personal Health Information Protection Act, 2013, that I introduced on May 29, 2013. This legislation, if passed, would protect the personal health information of patients to ensure that their electronic health records can be safely and securely shared by health providers within a patient’s circle of care. The proposed legislation would amend the Personal Health Information Protection Act, 2004, known as PHIPA, the Drug Interchangeability and Dispensing Fee Act and the Regulated Health Professions Act, 1991.

Until now, our existing privacy laws have done a great job of protecting patient privacy. But as technology progresses and we enable the sharing of electronic health records between health providers in a patient’s circle of care, we need new rules in place to further safeguard patients’ privacy. I think we can all agree that patients have a right to have their privacy protected when it comes to their personal health information. This includes the right to choose what information may be shared with other providers.

To give effect to these rights and support patient privacy, we need rigorous privacy rules in place for patient records. That’s what these proposed amendments seek to achieve. They are as much about giving patients greater control over how and with whom their electronic medical histories are shared as they are about enabling providers to better work together on a shared system of electronic health.

Mr. Speaker, comprehensive consultations about this proposed legislation were held with more than 50 health system organizations, and the proposed legislation was developed in close collaboration with our health care partners, including eHealth Ontario, Ontario’s nursing and medical associations, and our health professional regulatory colleges. But most importantly, we relied on the advice of the Information and Privacy Commissioner. We could not have developed this important legislation without the crucial and valued input of her and her office.

I am very pleased to say that the Information and Privacy Commissioner has expressed her full support for the proposed amendments on the grounds that they will support shared electronic health record development, while also protecting patients’ personal privacy.

The proposed Electronic Personal Health Information Protection Act would:

—establish privacy and security requirements for the shared electronic health record;

—clarify the authority under which health information custodians may collect, use and disclose personal health information in the electronic health record;

—establish a committee to advise the minister on electronic health record-related matters;

—establish rules protecting an individual’s right to make a consent directive to mask their personal health information; and

—describe limited occasions for which consent overrides may be permissible.

These proposed amendments would, if passed, also seek to double the existing penalties for privacy violations for those responsible for handling personal health information.

The amendments to the Drug Interchangeability and Dispensing Fee Act, if passed, would allow prescribers to use electronic means to provide an instruction on a prescription, which will help enable electronic prescribing.

Mr. Speaker, technological advances have resulted in better quality care and have added greater value to our system through productivity gains. They have also reduced wait times, given providers better diagnostic tools that are saving lives and are helping patients better manage their own health and well-being.

Virtual health initiatives are eliminating the barrier of distance, increasing access to care, and electronic health records are enabling a more patient-centred system. Each day, more and more clinicians are able to share lab, diagnostic and other patient information through projects like hospital reporting systems, which allow community-based physicians to view reports on patients who have been discharged from hospital.

The Ontario laboratories information system, or OLIS, which collects information from the province’s community, hospital and public health labs to create a centralized record of a patient’s lab test results, can be accessed by authorized providers across the province. And the emergency neurosurgery image transfer system, or ENITS, is ensuring that head trauma patients and those with other neurological disorders, regardless of where they are in the province, have access to the guidance and expertise of a neurosurgeon 24 hours a day, seven days a week.

We’re also advancing virtual health initiatives like telemedicine, which allows providers to use video conferencing and other advanced information and communication technologies to provide care to Ontario’s widely dispersed population, and e-consultation, which will make it easier for providers to communicate with each other and with their patients.

Speaker, these amendments, if passed, would enable our government to fulfill our commitment to provide a safe and secure electronic health record for all the people of Ontario by 2015, while at the same time protecting the privacy of their personal health information. I’m pleased to say that we are on track to reach that goal. Our work will continue beyond 2015 to better support provincial transformation priorities, improve the quality and safety of patient care and leverage further efficiencies in the health care system.

Secure, shared electronic health records that protect the privacy of every patient’s personal health information are a key driver of health system transformation. Electronic health records are known to improve the quality, safety and integration of patient care, as well as convenience for patients.

Electronic health records will also play an important role in community health links, which were created to provide better, more coordinated care to meet the needs of our most complex patients, many of them seniors. These are patients in our health care system who typically need the most from our health care spending. They use the system most frequently, yet their conditions aren’t improving. In fact, these high users of the system, who account for around 5% of our patient population, consume more than two thirds of our health care dollars.

Community health links are a truly innovative model of care, one that will improve patient outcomes, first for our most complex patients, but eventually extended beyond that. Community health links are the next step in the transformation of Ontario’s health system and flow naturally from other recent reforms. Health links strengthen the link between all of the health care providers in a given geographic area who are providing care to individuals with high needs.

That network of linked health care providers works as a team to collectively manage the needs of those patients with the greatest needs, in partnership with the patient, the family and the community, so they move smoothly through the system. In addition, health links can potentially have an enormous impact on our health care costs by making the care of multiple chronic patients, many of them seniors, more efficient as well as more effective. Health links will help us improve care and will lead to better use of taxpayer dollars.

The electronic sharing of information by health link partners will support better coordination and will bring better value by saving time and reducing duplication. Our community health links will seek to leverage provincial e-health initiatives to support more effective, high-quality care by enabling the consistent maintenance and sharing of a patient’s record. They will enable effective, timely communication and collaboration within the patient’s circle of care and between the provider and the patient, and they will enable the removal of physical barriers to care delivery through the virtualization of care.

Key to our efforts to support community health links with technology is the planned development of a care coordination tool which will meet the health links core business requirements for enabling care coordination.

Throughout the health care system, with the help of electronic health records, health care providers are able to make better clinical decisions by having complete and up-to-date patient information literally at their fingertips. The risk of negative drug events is being reduced thanks to more complete personal health information available to a provider for treatment. And the health care system itself, along with Ontario taxpayers, is benefiting through evidence-based funding, planning, delivery and monitoring by the ministry.

In order for electronic health records to realize their full potential, a wide variety of complex health information systems must be connected to each other. Care providers must be able to electronically share patient data for patients to move seamlessly through various parts of the health care system, for example, from a checkup to a lab result to a hospital procedure to rehabilitation.

Ontario’s health care system is highly complex and geographically widespread. We have the largest population of any province and the second-largest land area. There’s no doubt that linking electronic health systems within the province will support efficient, timely and high-quality patient care.

Electronic health care is critical if we are to improve access to quality patient care and foster greater innovation across our province. It will help us transform our health care system from using mostly paper-based records to fast and efficient electronic sharing of data among authorized health care providers anywhere in the province. But being fast and efficient is only part of the picture. Electronic sharing of information must also be secure, and it must be designed in a way to protect the patient’s privacy.

Electronic health records contain information from a variety of health care providers, including lab results, medication history and information from the electronic medical records used by physicians and nurse practitioners.

Eventually, shared electronic health records will include data from hospital information systems, community care clinics and other providers as well; in other words, from all the health care settings and health care professionals involved in a person’s circle of care. Over time, these electronic health records would be connected to each and every patient across Ontario. They would be their guide to their personal health and well-being, connecting all of their health providers under one system of care. The result will have a positive impact on health care delivery and on outcomes.

Over 10,000 Ontario providers, providing health care for two out of three Ontarians, have or are in the process of implementing electronic health records. We need to take the next step in integrating our health care system. We need to ensure that the personal health information of every patient is safe, secure and private. These proposed amendments would, if passed, support better information sharing and coordination among all the health care providers and organizations a patient may come into contact with, while protecting each patient’s personal information. Better, more complete information, leads to better, more integrated and coordinated care so that no one falls through the cracks.

I want to thank Ontario’s physicians, eHealth Ontario and everyone who has helped to make this progress possible. I also want to extend a special thank you again to the Information and Privacy Commissioner and her staff for their collaboration on this important bill.

Speaker, let me assure the members of this chamber, as well as each and every person in Ontario, that the privacy of everyone’s personal health information is critically important to our government, which is why we need to move forward on these proposed amendments. I urge all members to support this legislation.

The Deputy Speaker (Mr. Bas Balkissoon): The member for Oak Ridges–Markham.

Ms. Helena Jaczek: It gives me great pleasure to speak further to our government’s proposed Electronic Personal Health Information Protection Act, 2013. I’d like to start off by setting the context for this proposed legislation.

The launch of our government’s action plan for health care in January 2012 signaled the most radical transformation of the province’s health care system since the introduction of medicare. When medicare was founded in the 1960s, acute conditions such as heart attack or injury and infectious disease were the primary health concerns of Canadians. As a result, health care systems across the country were designed to focus on acute, episodic care delivered by highly trained, dedicated doctors and nurses in hospitals.

Over the past several decades, the health care landscape has shifted dramatically. New technology, drugs and procedures have increased life expectancy and greatly improved patient care and safety. While those medical miracles have allowed people to live longer, our aging and growing population is increasingly putting pressure on the health care system. Now many people live with one or more complex chronic conditions and would prefer to remain in their homes and communities to receive appropriate care.

As hospitals remain an essential part of the system, the level of care they provide is less than ideal for those living with chronic conditions. Moreover, the global financial meltdown in 2008 put Ontario’s economy through a few very turbulent years, and the global situation remains uncertain to this day.

In the current constrained fiscal environment, health care spending can no longer be allowed to grow at the previous annual levels of 6% to 7%. If this rate of spending were to continue, government spending on health care would balloon to 70 cents per dollar a dozen years from now, leaving only 30 cents to be shared among four other public programs, including education. The challenge and the opportunity for Ontario is to build a quality health care system that meets people’s needs at the right time and in the right place, a system that is accountable and financially sustainable.

There is strong consensus that the system needs to change and is ready, indeed eager, for reform. A transformed health care system requires much better integration of all sectors. There needs to be better links between primary care, the hospital and community- and home-based providers. That’s where electronic health care comes in.

Much of the transformation in our health care sector requires the tremendous innovations in technology already in place, which includes virtual health initiatives like telemedicine and the implementation of electronic health records for all the people of Ontario. Electronic health care is becoming an increasingly important tool and enabler for better access to quality patient care and health system integration across Ontario. A health care system built around paper-based records is transforming into one that allows fast, efficient and secure electronic data sharing among authorized health care providers, regardless of their location in the province.

A health care system based on electronic data sharing means better and more coordinated care for patients, which is especially vital for older Ontarians and those with chronic or complex conditions. Shared electronic health records, or EHRs, will allow laboratory results, medication histories, diagnostic images and patient information from electronic medical records to be shared between multiple health care providers within a patient’s circle of care. The result will be improved quality, safety and integration of patient care.

That’s why investing in eHealth is such an important part of our government’s action plan for health care and our commitment to provide Ontarians with the right care at the right time in the right place.

EHealth also serves as a vital part of ensuring that health care dollars are invested in the most efficient and effective manner possible. The action plan is the blueprint that will help Ontario realize its vision of being the healthiest place in North America to grow up and grow old.

With this shift, we are improving the quality of patient care, freeing up valuable acute care resources for those who need them most and increasing value for taxpayers’ dollars. Higher quality care that is driven by evidence and delivered properly the first time is better for patients and better for taxpayers.

EHealth initiatives enable this health system modernization and lead to better, safer and more cost-effective care. To further this, the government has introduced legislation to ensure that this information is safe, secure and private.

Speaker, this proposed legislation is an important milestone. It shows how far we’ve come in implementing electronic health care for all Ontarians.

I will speak at greater length later in my remarks on eHealth Ontario’s many accomplishments. But before we talk about where we are going, I think it’s important to look over our shoulder at just how far we’ve come.

In 2007, only 770,000 Ontarians were benefiting from electronic medical records. Today, nearly 70% of all Ontarians have electronic medical records. That’s about 9 million people in our province whose family doctors are able to call up their electronic medical records when they come in for an appointment or a checkup. In fact, more than 69% of primary care physicians and more than half of all specialists in communities across the province now use electronic medical records.

All of the province’s 154 hospital systems and more than 9,400 community-based clinicians have made electronic medical records an integral part of their approach to health care. Just to give perspective on the size of what we’ve achieved, that’s more doctors in Ontario than all other Canadian provinces combined.

Over a quarter of a million hospital reports are now sent to doctors’ electronic medical systems every month. What does this mean for patients? Well, it used to take 12 days to transfer hospital records by mail. Today, it takes 30 minutes. Not only does that reduce patient wait times, but it also aids with transitions in health care to help patients to avoid unnecessary hospital readmissions. In addition, the medication history of Ontario’s seniors is now accessible to health care providers in all hospitals and emergency rooms, to ensure they get the proper care.

Additionally, the Ontario laboratories information system is right now storing more than one billion lab results for 9.5 million Ontarians.

It is clear that electronic health care helps health professionals deliver the best care for their patients. But it also helps by connecting patients with health professionals across great distances. It quite literally brings care closer to home, which is particularly vital for Ontarians in rural and northern Ontario. There were 236,000 remote clinical consultations through the Ontario Telemedicine Network last year alone. And neurotrauma patients now have access to a neurosurgeon 24 hours a day, seven days a week. That’s better and faster care for Ontarians in their greatest hour of need.

And it’s saving millions of dollars, helping to protect the sustainability of our health care system for future generations.

Clearly, Speaker, eHealth Ontario has made remarkable progress in bringing better care closer to patients. We have come a long way in just a few years. But now it’s time to take the next step. That’s why the government has introduced the proposed legislation before us today. This proposed legislation, if passed, would advance the health system transformation. It would help us realize better quality of care for patients, and better value for taxpayers. And it would ensure that our cherished health care system continues to be there for future generations of Ontarians.

Most importantly, the legislative changes we propose would enable our government to move on with the next phase of developing an electronic health record, or EHR, for the people of Ontario by 2015. Without these legislative changes, the implementation of EHRs cannot proceed, and the full benefits of this technology will not be realized.

At the same time, we’re absolutely committed to ensuring that the safety and security of electronic health records and the privacy of Ontario patients are protected. Ontarians agree that this is a critical element of implementing modern technological tools like electronic health records. Research has indicated that the Ontario public strongly supports EHRs. Ontarians agree that the use of EHR data for decision-making and planning by the ministry is a good use of health information and will result in better health care for those who need it and a more efficient health care system in Ontario.

Ontarians can also see the positive impacts for health care providers and the health care system. They understand the potential benefits for themselves and their families.

Our research shows that the public does have some concerns about privacy. However, these concerns ranked lower than for other frequent online activities such as shopping, networking and banking. When asked about the extent of their concern around specific online services and personal privacy and security, Ontarians are most likely to be concerned about the privacy and security of social networking, followed by online banking, online shopping and then EHRs.

Fifty-five per cent of Ontarians were concerned or very concerned with their personal privacy and security with EHR services, compared to 57% with online shopping, 59% with online banking and 67% with social networking. I was gratified to learn that about 68% of Ontario residents surveyed probably or definitely think that the provincial government will ensure that appropriate measures are in place to safeguard the privacy and confidentiality of personal health information contained in EHRs—a vote of confidence, clearly.

This proposed legislation both satisfies the public’s expectations and fulfills public trust. It’s important to note that Ontario’s Information and Privacy Commissioner, Dr. Ann Cavoukian, commended our government for introducing these proposed amendments to Ontario’s health privacy legislation, the Personal Health Information Protection Act, or PHIPA. As a former custodian of personal health information, wearing actually five hats, as commissioner of health services and medical officer of health for York region, the importance of protection of this information is of huge importance to me.

Indeed, the commissioner has been advocating for a legislative framework to address the privacy and security issues associated with electronic health records for some time.

While PHIPA has served as a model for health privacy legislation across Canada and abroad since its introduction in 2004, it didn’t adequately address the rights of individuals and the duties of health care providers in a shared electronic health record environment. According to the commissioner, “These amendments are necessary to foster public trust and confidence, as the health sector transitions from paper-based records to electronic health records.”

The amendments to PHIPA will clarify the rights of Ontarians to limit the collection, use and disclosure of their personal health information in their electronic health record. It will be achieved through a variety of means, such as the application of consent directives to reflect the wishes of all patients. The amendments will also clarify the right of patients to access and request correction of their information and to find out who has accessed their health records.

The amendments will also assure patients that only their authorized health care providers and those acting on their behalf may directly access personal health information in their electronic health record and will limit the purposes for which such information may be accessed. Additionally, there will be a requirement to log and monitor all accesses to electronic health records to help curtail any unauthorized collection, use and disclosure of personal health information, thus strengthening the safeguards.

The modernization of PHIPA will facilitate the introduction of electronic health records throughout the province. Such records have the potential to greatly improve diagnosis and treatment; to enhance patient safety; and to facilitate the coordination and integration of services—resulting in a more efficient and effective health system.

We deeply appreciate the contributions of the Information and Privacy Commissioner and her office in the development of this proposed legislation. I want to assure all the members of this House that our government will continue to work closely with her and the health care sector to ensure a smooth and seamless transition into the digital era, while strongly protecting the privacy of Ontarians and the confidentiality of their personal health information.

I’m pleased to say that with the help of eHealth Ontario our government has already made significant progress toward implementing elements of an electronic health record and toward moving related priorities forward. We are very proud of eHealth Ontario’s accomplishments, and I’m pleased to outline them for you in greater detail.

First, I’d like to speak about the diagnostic imaging and picture archiving communications system, or DI and PACS. For the first time in the province’s history, every hospital in Ontario is now able to produce and share filmless diagnostic images, including X-rays, CT scans, ultrasounds and MRIs, within their facilities, resulting in faster test results. Clinicians are able to make more timely and accurate diagnoses, and radiologists can access, read and report on digital images in an hour or less, rather than in 48 to 60 hours.

For the patient, diagnostic imaging and picture archiving communications systems avoid duplication of tests and needless exposure to radiation. As DI and PACS are more fully integrated, test results can be accessible across the province.

Next, the drug profile viewer, or DPV, is saving lives in emergency departments every day. In every one of the province’s emergency rooms, hospital wards, in-patient pharmacies and clinics, the individual drug profiles of Ontario’s seniors can now be accessed by hospital staff. The viewer displays information for Ontario drug benefit and Trillium Drug Program recipients, who make up roughly 18% of the population of Ontario and account for 43% of all prescriptions written in the province.

The drug profile viewer allows the electronic sharing of medication information between authorized health care providers. DPV helps physicians to quickly identify the potential for harmful drug interactions or lethal combinations of drugs, saving lives every day.

I’d also like to speak about the Ontario Telemedicine Network. Ontario now has a globally recognized telemedicine network, with more than 1,600 sites across the province using the Ontario Telemedicine Network to deliver remote care to patients. The Telestroke program provides stroke patients in remote areas of the province with 24/7 access to life-saving emergency care that they might not receive without this real-time, expert neurological assessment. Last year, OTN supported more than 236,000 clinical consultations.

The emergency neurosurgery image transfer system, or ENITS, is also helping to save lives. Brain CT scans of patients suffering head trauma are now transmitted and viewed within minutes by a 24/7 on-call neurosurgeon who consults with medical staff at any of Ontario’s 97 acute care centres.

Instead of moving patients to neurosurgeons, neurosurgeons can access reliable, time-sensitive patient information remotely, enabling them to determine quickly if patients need to be transferred to receive acute care. Patients avoid unnecessary risky travel and are able to receive specialized care faster and closer to home. Families are saved from the trauma of having their loved one being physically moved away.

Transferring neurosurgery patients to other hospitals, particularly out of country, can cost as much as $100,000 per transfer, and in the past, 49% of emergency neurosurgery consults were referred to neurosurgical units. In 2012-13, however, only 34% of these patients were transferred after an ENITS consultation, and, to date, this service has saved the Ontario health system tens of millions of dollars.

ENITS is managed through CritiCall Ontario, a 24/7 emergency referral service that uses sophisticated referral logic software to calculate the distance between the calling physician and potential sites that can provide the necessary expertise.

Next, let’s look at the Ontario laboratories information system, also known as OLIS. OLIS collects information from the province’s hospital community and public health labs to create a centralized record of a patient’s lab test results that can be accessed by authorized practitioners across the province. Earlier last year, the first clinical use of OLIS was deployed at the Ottawa Hospital. We’ve heard from doctors there who have said that this technology has revolutionized their practice.

EHealth Ontario has been rolling OLIS data out to clinicians since then, and the feedback has been overwhelmingly positive. OLIS has more than 1.25 billion individual test results in its database, representing 9.5 million Ontarians. For providers, this means information is at their fingertips within minutes or even seconds, helping them to make faster and more informed clinical decisions. Faster access to information means more time dedicated to patient care and less time spent on administrative paper chasing.

For our young patients and their families, the wait time for lab test results will be shorter, so treatment can start that much sooner. As for the health care system, it means fewer duplicate tests because the patient’s lab test history will be right there for the health care providers to access, and there will better integration of care between family providers and hospital providers. This initiative is part of our e-health strategy to put valuable patient lab data into the hands of clinicians throughout Ontario.

Lastly, let’s talk about electronic medical records, EMRs. An EMR is the computer software physicians use to electronically collect, manage and store a patient’s medical data. It’s the digital equivalent of the old paper files and charts that your doctor used to use and keep in an office cabinet.

Over 10,000 providers providing health care to more than nine million Ontarians have or are in the process of implementing EMR systems. Approximately 69% of Ontario’s primary care physicians are moving forward with an EMR. In fact, Ontario has the largest number of physicians using an EMR in Canada. The latest EMRs collect over 30 diabetes-related data elements, 25 chronic heart failure-related data elements, and more than 45 asthma, hypertension and chronic obstructive pulmonary disease-related data elements.

Physician records are increasingly connected to regional health care institutions. Each month, more than 375,000 hospital reports, such as patient discharge summaries—which are critical to avoiding expensive hospital readmissions—are sent electronically to clinicians so patients can get better and timelier care from their primary care provider. Approximately 3,000 types of lab results are currently being accessed through EMRs.

Electronic medical records are more comprehensive and support access to Ontario laboratories information systems—the provincial database I mentioned earlier—that contain approximately 69% of community hospital and public health lab tests.

Speaker, my colleagues across the aisle may each have an EMR in their physician’s office. That means details about the care they receive from a family doctor, specialist, nurse, dietitian or other health provider is captured electronically using EMR software. This makes it possible for all members of their health care team, like specialists, nurse practitioners, emergency rooms, home care and long-term-care homes, to share accurate, clear and concise information about their health care status.

For example, the Association of Ontario Health Centres, the AOHC: All of these member sites which provide community-governed primary care to so many of the province’s most vulnerable groups are installing electronic medical record systems so that 800 ordering clinicians, nurses and doctors can provide better care to their patients, including those who may not have a family physician. AOHC member sites include all of the province’s community health centres and aboriginal health access centres, as well as several nurse practitioner-led clinics.

EMRs help in managing chronic conditions and in preventing drug interactions. These are just some of our many e-health achievements, and I’m proud to highlight all the progress we’ve made in e-health.

Electronic health records, or EHRs, are the next stage of e-health. EHRs bring together an individual’s health information from health care providers, like your family doctor or specialist, as well as other information like lab test results, prescription drug information and diagnostic images like X-rays, CT scans and MRIs. Our proposed legislation would support better information sharing and coordination, resulting in improved health care, particularly for those with complex health care needs.

For example, the diverse partners in a community health link, from hospitals to primary care providers to community care, would have appropriate access to patient health information, enabling greater collaboration and better care for their patients. Better, more complete information leads to more integrated and coordinated care so that no one falls through the cracks.

Speaker, let me assure the members of this chamber, as well as each and every person in Ontario, that the privacy of everyone’s personal health information is critically important to our government. These proposed legislative amendments are part of our plan to protect privacy and security of personal health information in EHRs. I urge all members to support them so that we can keep our commitment to provide every Ontarian with an EHR by 2015.

The Deputy Speaker (Mr. Bas Balkissoon): Questions and comments?

Mrs. Christine Elliott: I am pleased to comment briefly on the remarks made by the Minister of Health and by the member from Oak Ridges–Markham with respect to Bill 78. I will be speaking on it further—I think I’m the next speaker in the lineup here—and will have some further comments.

But I think, overall, we have to take a look at this government’s record on delivering eHealth, and I think that by all accounts it’s been a pretty abysmal failure. That’s not just us saying it. We’ve certainly heard from the Auditor General on that, who commented that up to $2 billion has pretty much been wasted without a functioning electronic medical records system to show for it.

We don’t really know where we are in the great scheme of things, but I would say the fact that this legislation, which sets up the basic framework for an electronic health records system, is only being passed now—surely you would think that this would have been done some years ago in order to be able to even develop the system. So it certainly begs the question of where we are in the development of the system overall, and I suspect we’re still many years away from having a functioning system.

That is a great shame for a number of reasons, one of them being economically. We have all kinds of tests and medical procedures that have to be duplicated because health professionals aren’t able to communicate in real time with each other, and so they have to duplicate them or else have people continue to carry around things like X-rays and so on. That shouldn’t be happening in the province of Ontario, not at the state that we’re at now.

But I think, more tellingly, there’s a human component to this that we can’t discount. I’ve heard from many, many people who have spouses with terminal illnesses that every time they go and see a different medical professional that they are involved with, they have to recount their story time and time again. This is very wearing on people, but it also means that every time they tell it, they get further away from what has happened. Information falls between the cracks. So it’s really essential, both in human and economic terms, that we get moving with this.

We will be supporting this legislation because it’s essential for the framework, but whether this government gets this done or not, I’m not holding my breath.

The Deputy Speaker (Mr. Bas Balkissoon): Questions and comments?

Mr. Michael Mantha: It’s a pleasure to rise to speak about Bill 78,

An Act to amend certain Acts with respect to electronic health records.

We’re going to be doing a lot of homework on this bill, Mr. Speaker; I need to tell you this. There are a lot of items that we need to go through in this bill to make sure that the integrity, the confidentiality and the sharing of information are going to be upheld, which is first and foremost the concern of constituents and people across the province. It’s going to be a tedious process.

We’re going to be looking at supporting this bill. However, we’re going to be looking at having many discussions over the committee stage, because Ontarians expect more and they want more. I don’t mean to throw stones across to this government, but essentially there has been some legislation that has come forward in this House in the past where, as we go through the discussions, issues are highlighted, but again they are not really dissected, they are not really analyzed, and we don’t learn from the mistakes that we’ve done in the past.

This is something that is very concerning. We really need to look at making sure of the integrity and that the individuals across this province—because now we’re going from a paper to an electronic copy, and there are a lot of discrepancies. There are a lot of red flags that raise in my mind right now that could happen through this entire process.

So we’re going to analyze this, along with our colleague from Nickel Belt, our critic for health and long-term care, and we’re going to be extremely diligent in holding this government to account in regard to how this act actually gets implemented.

The Deputy Speaker (Mr. Bas Balkissoon): Questions and comments?

Hon. Madeleine Meilleur: I’m very pleased to add my comments in support of Bill 78, the Electronic Personal Health Information Protection Act.

Yes, indeed, as previous speakers have said, your personal information about your health—it’s very important to be private and to be secure. But let me say to you, as a health care professional for part of my life, how it used to be. Okay?

So if you needed a consultation or if you needed to be transferred to another hospital or something like this, then they would take the paper file, they would print it, and they would send it by mail or send a nurse or a health care professional with the patient for the transfer. Sometimes the file was lost, and sometimes the file was left on the printing machine. This was not the perfect world, and it had been like this for a long time.

Thanks to eHealth and all this system—because we hear all the negative part about eHealth—I have the privilege to be a patient in a family health team where eHealth is there. When you need to see a specialist, you can go the next day, if it’s possible, because then he can open his computer and he sees your file. He sees all your results and everything.

Yes, we need to be sure that all the information is kept confidential and that only people who need to see it will see it, but let’s say we’re not in the age of the stone. We have made a lot of progress, and this is the continuation of the improvement of health care in Ontario. I’m very pleased to support it.

The Deputy Speaker (Mr. Bas Balkissoon): Questions and comments?

Mr. John O’Toole: It’s a pleasure to listen to the important discussion this morning on eHealth. I think our critic, Christine Elliott, summed it up when she said, “How’s it working today?” They’ve been at it for 10 years; it’s an absolute disaster, on any measure at all.

I don’t blame the minister personally. The parliamentary assistant—I have a lot of respect. She was a medical officer of health; she should probably be the Minister of Health, actually, and no disrespect at all.

Here’s what I’m saying: They’ve had 10 years to get it right. Most of the world is automated. This province is completely mismanaged. I’m not even going to talk about the bill because I was the PA to health for about two or three years in this system and there should have been a lot of work done in the last 10 years, and nothing has happened.

Here’s a good example right here. There’s an

article in the Toronto Star on October 3. It’s entitled, “Fundraisers an Increasing Necessity for Sick Ontarians.” This is a human story. Lisa Glennie spent some time in the hospital. “After she suffered her stroke, Glennie spent months in hospital receiving” rehab. “She still can’t walk on her own, has difficulty talking” and it affects her memory. “Now the hospital wants her out and is charging her $1,700 a month to stay,” because she has nowhere to go. “Meanwhile, OHIP refuses to pay for Glennie’s rehab sessions....” Sick and ignored: That’s how it is in Ontario today.

This isn’t me; this is a Toronto Star article, October 3. That’s a report card on how Ontario’s health care system is working today.

I have constituents of mine who can’t get the proper treatment—medication. They are spending half of the budget now, basically, on health care. I understand that the system is part of this—I, at one time, worked for IBM; I was a COBOL programmer. I get it. Why isn’t it up and working today? It’s shameful, the disregard that they have for Ontarians.

The Deputy Speaker (Mr. Bas Balkissoon): The member for Oak Ridges–Markham, you have two minutes for a response.

Ms. Helena Jaczek: I’m certainly extremely disappointed at the comments by my colleagues the member for Whitby–Oshawa, the member for Durham—the two from the official opposition. I would have thought that after listening the last 45 minutes, you would have seen the incredible strides that we’ve made with electronic medical records, which were detailed in so many different aspects.

In addition, the member for Durham doesn’t seem to understand the meaning of the word “respect”; however, I’ll leave that piece.

To the member for Algoma–Manitoulin: Yes, of course, we share your concerns around the protection of personal health information. I did mention in my remarks that I was a custodian of five different health records. I had to make sure, whenever there was a request for information from one of those five datasets, that we didn’t confuse which dataset was which. There was a great deal of precision necessary for this because many patients actually appeared in all five datasets. This is an incredibly complicated issue in terms of the protection of privacy. It’s now being done electronically.

It certainly has been done in a very thoughtful way, and we have made real progress in a very complicated area. It’s benefiting patients across the province.

To the Minister of Community Safety and Correctional Services: Yes, indeed, I remember meeting her for the very first time when she was chair of the health committee in the region of Ottawa-Carleton many, many years ago. In her long experience as a nurse, she knows of what she speaks when it comes to patient care and personal health information security. I am so glad that, at least on this side of the House, we are absolutely committed to putting this legislation through.

The Deputy Speaker (Mr. Bas Balkissoon): Further debate?

Mrs. Christine Elliott: I am very pleased to rise today to speak about Bill 78 on behalf of the PC caucus. Bill 78 is, of course,

An Act to amend certain Acts with respect to electronic health records, commonly known as the Electronic Personal Health Information Protection Act, or EPHIPA.

The acts that are affected by Bill 78 are the Drug Interchangeability and Dispensing Fee Act, the Regulated Health Professions Act and the Personal Health Information Protection Act, 2004. Of course, it is the latter act which is the most affected by Bill 78. I will be discussing these changes in due course, but first I would like to comment on the state of development of electronic medical records in Ontario generally. I think we really need to set the record straight here.

By all accounts, this Liberal government’s handling of this file has been abysmal. Ontarians found out from the Auditor General about the stunning waste of up to two billion taxpayer dollars with little to show for it in terms of a fully functioning electronic medical records system. We have heard a lot today from the Minister of Health and the member for Oak Ridges–Markham about the amazing progress that has been made in the development of e-health, with nine million Ontarians having access to electronic medical records, but the fact of the matter is, that doesn’t really mean very much.

All it means is that more physicians have digitized their records, so instead of having paper files, they now have their clients’ or patients’ medical records on a computer. But the whole point of having an electronic medical record system is to have the health care providers that are involved in a patient’s care, and increasingly people have more people involved than just their own family doctor, able to communicate with each other in real time. That is not even close to happening yet in Ontario, and that is a real tragedy.

There are numerous systems out there, all over the place. The government continues to fund new systems that don’t connect to each other. We are years and years away from having a system that is actually going to work. That is a tragedy because so much money has been spent for so little, but it is a tragedy in human terms, too.

A functioning electronic health record could go a long way toward eliminating patient death through toxic drug interactions, which do happen in Ontario each and every year. Working electronic health records would also reduce the need for clients and patients to verbally recount their medical history to each health care provider they see. As I mentioned before, I’ve heard from terminally ill cancer patients, and they have told me how devastating it is to have to recount their personal history every time they see a different health care provider.

Even if you’re prepared to ignore the human costs of not having electronic health records, it’s hard to ignore the economic costs. Diagnostic tests and procedures often need to be repeated because results cannot be easily shared, and skilled health care practitioners are still required to take medical histories repeatedly and to use phone calls and faxes to communicate information. I’ve heard from numerous health care providers in the home care area, particularly nursing organizations, that routinely have to use fax machines to communicate information.

I used to think that it was lawyers, like myself, who were dinosaurs in the digital age, but this is still happening in health care in Ontario. It’s certainly not by choice, I can tell you that.

Time after time, in my capacity as health critic for the official opposition, I hear from health care providers, from doctors to nurses to pharmacists and many others, that it is essential that Ontario develop a functioning electronic health records system in order to transition to a 21st-century model of health care. Clearly, we need to get on with it, and I hope that with the passage of this act, if it does come to pass, this Liberal government will take this to heart and move forward, but I am certainly not going to hold my breath at this point.

Bill 78 deals with the protection of personal health information in the context of an electronic health record, so of course, it is essential before e-health can move forward. The question, however, is, why wasn’t this essential component dealt with before now? Surely this is one of the most important building blocks in developing e-health, so shouldn’t it have been developed years ago?

The fact that these standards are only now being developed is quite troubling, and begs the question of where we are now in e-health development without having this basic framework in place. So that remains to be seen. I hope we’ll get that information soon, but that’s a question for another day.

I’d like now to turn to Bill 78, but before I speak about the specific aspects of the bill I’d like to spend a few minutes discussing the history of health information privacy legislation in Ontario, and I hope that it will help to place Bill 78 in the appropriate context.

The concept of confidentiality with respect to health information is relatively new. Prior to 1977, it was relatively easy for insurance companies, investigation agencies, police and lawyers to obtain access to patients’ medical records. I can certainly say that when I started off as a young lawyer many years ago this was the case, and it was just in the early years of my practice that this began to change—and I certainly would say for the better, because confidentiality of health information is absolutely essential for patients in our province.

In December 1977, the Ontario government, under Premier Bill Davis, appointed a commission headed by Mr. Justice Horace Krever to conduct an inquiry into the issue following allegations of police access to patient records in OHIP and health care facilities without obtaining their consent. There was, at that time, no overarching legislation for the protection of privacy and health information, and each health care facility was on its own in terms of developing its own policies and procedures. The commission began its work in April 1978.

The report of the Commission of Inquiry into the Confidentiality of Health Information was released in 1980, a three-volume, 1,626-page report—very comprehensive, and it contained a number of key elements that we still rely on today with our privacy legislation.

An excellent

article on the history of health information privacy legislation in Ontario, written by Andrea Anna Guerin and Christian David Fortin in 2008, said this about the work of the Krever commission:

“The Krever report identifies for the first time the discrepancies in the practices of health care institutions, health care professionals and the ambiguity in the legislation governing privacy and health information. It also recognized that the implementation of legislation to provide a universal provincial framework for privacy and health information should not be so cumbersome to impede the effective and timely delivery of health care.”

So it is important to recognize, as was noted, that there is a need to achieve a balance between the protection of an individual’s health information versus the need for health professionals to access this information under certain circumstances.

In any event, the Ontario government then attempted to implement the essential recommendations of the Krever report. The Ministry of Health attempted to initiate reforms in June 1996 with its paper entitled A Legal Framework for Health Information. This was followed in 1997 with the Personal Health Information Protection Act. Although it contained most of the essential elements necessary for protection of health information, it was not successful, nor was its successor act,

An Act respecting Personal Health Information and Related Matters, in 2000. The work continued.

In 2002, the Ministry of Consumer and Business Services and the Ministry of Health and Long-Term Care released a draft document entitled Privacy of Personal Information Act, 2002, known as POPIA. We love these acronyms. It too failed to pass, and it was not until November 1, 2004, that Ontario passed the personal health information privacy act, known as PHIPA. PHIPA succeeded in providing an overarching framework for the protection of personal health information. It was met with approval by the Office of the Information and Privacy Commissioner of Ontario, Dr. Ann Cavoukian.

In her submission to the Standing Committee on General Government on January 27, 2004—before the act was passed—the Information and Privacy Commissioner stated with respect to Bill 31, the Health Information Protection Act, “We are pleased that this government has moved promptly to introduce a comprehensive legal framework to protect personal health information. Our office has advocated the need for such legislation for many years.

Members of the public, health care providers and other stakeholder groups have anticipated introduction of legislation of this nature since the Report of the Royal Commission on Confidentiality of Health Information in Ontario (the Krever commission report) in 1980.”

The commissioner then went on to say: “We also are pleased that this office has been identified as the oversight body for this legislation. This provides the public with a single point of contact for both public sector and health sector privacy matters. This will facilitate implementation of the legislation and minimize confusion on the part of the public.”

So, in essence, Mr. Speaker, health information and privacy legislation was long overdue in Ontario and, certainly, while we believe that PHIPA is far from perfect, particularly with mental health issues, there is at least a basic framework in place to protect an individual’s right to privacy with respect to their health records. Bill 78 is in many ways the next logical step to be taken in continuing to protect privacy.

As we move to an electronic medical records system with multiple health care providers having access to individual medical records, it’s essential to establish a framework and protocols for the sharing of this information and to ensure that it is only used for prescribed purposes.

As was mentioned earlier, Bill 78 amends PHIPA in several key respects. First,

section 34 of the act is amended to permit prescribed persons who are not health information custodians to collect and use health numbers for the purpose of creating or maintaining the electronic health record.

Section 51 of the act is also amended to make

part V of the act apply to a prescribed organization as if it were a health information custodian with respect to the specified records and as if the organization has custody or control of the records.

Part V.1 adds a whole new

section to deal with electronic health records because they weren’t contemplated in 2004 with the passage of PHIPA.

The Minister of Health is required to establish an advisory committee for the purpose of making recommendations to the minister concerning specified matters related to the electronic health record and can make directives to a prescribed organization with respect to carrying out its responsibilities. The minister would be required to take the recommendations of the advisory committee and the Information and Privacy Commissioner into account before so directing a prescribed organization.

The effect of the above amendments would be to recognize that there will necessarily be an entity or organization that will be responsible for the operation and maintenance of the electronic health record other than the original health care provider and to provide that the same rules that apply to the health care provider will also apply to the prescribed organization.

The rules around the use of this confidential information are specifically spelled out.

Part V.1 prohibits the health information custodian from collecting personal health information from the electronic health record maintained by a prescribed organization except for the purpose of providing or assisting in the provision of health care to an individual or eliminating or reducing a significant risk of serious bodily harm to a person or group of persons where the health information custodian believes on reasonable grounds that the collection is necessary for this purpose.

Individuals may withhold their consent to the collection or disclosure of his or her personal health information in the electronic health record, subject to certain exceptions. This directive can only be overridden if there would otherwise be a risk of serious bodily harm, if it was not possible to obtain consent in a timely manner or if there was a risk of potentially harmful medication interactions.

That, Mr. Speaker, is the essence of Bill 78. In her introduction of Bill 78, the Electronic Personal Health Information Protection Act, or EPHIPA, on May 29, the minister indicated that the Information and Privacy Commissioner had indicated her support for the bill. I subsequently wrote to the commissioner myself to obtain her view of Bill 78, and I would like to take this opportunity to read the letter which I received from Ms. Cavoukian in answer to my inquiry. I would like to take a few minutes to do that now, Mr. Speaker.

In her letter to me dated August 23, 2013, Ms. Cavoukian indicated: “I would first like to clarify the provisions in the bill related to ‘prescribed organizations.’ A ‘prescribed organization’ will not be appointed by the Minister of Health and Long-Term Care but rather will be prescribed in a regulation by the Lieutenant Governor in Council.

Section 55.12 of the bill requires that these regulations be subject to the public consultation requirements in

section 74 of the Personal Health Information Protection Act.

“A ‘prescribed organization’ will also be required to comply with detailed requirements found in

section 55.3 of the bill. These are similar to the requirements imposed on an entity currently responsible for creating or maintaining electronic health records in the province of Ontario under a regulation to the Personal Health Information Protection Act.

These detailed requirements include an obligation on the ‘prescribed organization’ to take reasonable steps to limit the personal health information it receives to that which is reasonably necessary for the purpose of creating or maintaining the electronic health record, and to perform privacy impact assessments and threat risk assessments in respect of each system that retrieves, processes or integrates personal health information in the electronic health record.

“The failure by a ‘prescribed organization’ to comply with these detailed requirements is subject to an investigation by my office and, if my office determines that the Personal Health Information Protection Act or its regulation have been contravened, my office has the power to issue an order which is enforceable as a judgment or order of the court.

“Section 55.3 of the bill also requires a ‘prescribed organization’ to have in place and comply with practices and procedures to protect the privacy of individuals whose personal health information it receives, and to maintain the confidentiality of that information. These practices and procedures must further be reviewed and approved by my office every three years. Over the past 10 years, we have developed a rigorous process for organizations whose practices and procedures must be reviewed by my office.

Such organizations are required to implement policies, procedures, agreements and other documents that comply with a comprehensive manual, that my office developed (exceeding 100 pages) entitled the Manual for the Review and Approval of Prescribed Persons and Prescribed Entities. A similar manual is being developed for ‘prescribed organizations.’

“With respect to the concern you raised in relation to third parties retained to assist ‘prescribed organizations’ in creating or maintaining the electronic health record, it should be noted that

section 55.3 of the bill requires a ‘prescribed organization’ to ensure that employees and any other person acting on its behalf comply with the restrictions that apply to the ‘prescribed organization,’ detailed in

section 55.3 of the bill. It also requires persons acting on behalf of a ‘prescribed organization’ to comply with the restrictions and conditions that are necessary to enable the ‘prescribed organization’ to comply with the requirements in

section 55.3 of the bill. Once again, this is similar to the provisions that currently exist under the regulation to the Personal Health Information Protection Act.

“It should also be noted that a ‘prescribed organization’ is required to immediately notify me, in writing, if personal health information in the electronic health record has been viewed, handled, made available, released or otherwise dealt with by a ‘prescribed organization’ or a person acting on its behalf in a manner that contravenes the Personal Health Information Protection Act or its regulation.

“Finally, you requested my views about the bill more generally. I have been advocating for a legislative framework to address privacy and security issues associated with electronic health records for many years. While the Personal Health Information Protection Act has served as a model for health privacy legislation across Canada and abroad since its introduction in 2004, it did not adequately address the rights of individuals and the duties and obligations of health care providers in a shared electronic health record environment.

“This bill will clarify the rights of Ontarians to limit the collection, use and disclosure of their personal health information for health care purposes in the shared electronic health record, to access and request a correction of their information and find out who has accessed their information. It will also set out the purposes for which personal health information may be collected, used or disclosed and require the auditing and monitoring of all accesses to prevent unauthorized collections, uses and disclosures.

As a result, I welcome the introduction of this bill, which will serve to enhance the privacy of individuals while facilitating the efficient and effective delivery of health care services.

“This bill, if passed, will modernize the Personal Health Information Protection Act and facilitate the introduction of electronic health records in the province of Ontario, which already lags far behind other jurisdictions in Canada. Electronic health records have the potential”—

The Deputy Speaker (Mr. Bas Balkissoon): Excuse me. Thank you.

Second reading debate deemed adjourned.

The Deputy Speaker (Mr. Bas Balkissoon): Seeing the time on the clock, this House stands recessed until 10:30.

The House recessed from 1015 to 1030.

INTRODUCTION OF VISITORS

Mr. Bob Delaney: I have two distinguished guests to recognize today. First of all, in the public gallery this morning is Winnifred Kisob, who is the mother of page Massoma Kisob, here to observe her daughter on her last day with us as a page. Please welcome her.

Finally, I’d like to introduce my overlapping member of Parliament, seated in the members’ east gallery. I’d like members to recognize Mississauga–Streetsville member of Parliament Brad Butt, who is joining us today.

Mr. John O’Toole: It’s a real honour today to stand and recognize the federal member of Parliament for the riding of Durham, and my son, Erin O’Toole. Welcome to Queen’s Park, Erin.

The Speaker (Hon. Dave Levac): The one-liners write themselves, but I’m going to resist.

Ms. Cheri DiNovo: It’s a delight to recognize a volunteer of ours from Parkdale–High Park, Amina Sheikh, in the members’ gallery.

Hon. Deborah Matthews: I would like to recognize someone who is not here with us in body but is most definitely here with us in spirit, and that is the great author Alice Munro, who has just been awarded the Nobel Prize for literature.

Mr. Monte McNaughton: It’s my pleasure to introduce my friend from London West, Ali Chabar, to the Legislature today. Ali is a lifelong London resident. He has committed himself to serving the community. He is the past and current PC candidate for London West. Welcome, Ali.

Miss Monique Taylor: It’s my pleasure to once again welcome the father of our page Gabrielle Le Donne, Mr. Dino Le Donne. Welcome again to Queen’s Park.

Mrs. Amrit Mangat: I’m pleased to welcome the proud parents of page Aly Muhammad from my great riding of Mississauga–Brampton South: Mrs. Nadia Mithani and Mr. Amin Mithani. They are in the east members’ gallery. Welcome to Queen’s Park.

Mr. Todd Smith: It’s a pleasure to welcome for the first time to the Legislature my mom and dad, Ray and Sharon Smith from New Brunswick, who are here for Thanksgiving weekend. Also, my daughters for the first time are going to be taking in question period today: Payton and Reagan are there as well.

Mr. Monte Kwinter: I’d like to welcome a group from the Kenton Adult Learning Centre, up in the gallery, to Queen’s Park.

Ms. Catherine Fife: It’s my pleasure to welcome Chris Galloway all the way from Alberta—first time visiting Queen’s Park.

Mrs. Laura Albanese: I would like to welcome to the Legislature Nancy Tomkins, president of the Denturist Association of Ontario, and Mr. Frank Ordorico, vice-president of the Denturist Association of Ontario. They are in the members’ east gallery. Welcome to Queen’s Park.

Mr. Jim McDonell: It’s my pleasure to welcome to the House the relatives of our great page from Stormont–Dundas–South Glengarry, Jasper Ross: his mother, Lisa Sizeland-Ross; his uncle Brett Sizeland; and friend Marie Mugahid. They are here in the west gallery. As well, I want to welcome the parents of my LA, Olga and Mauro Manfredi, the mother and father of Luca Manfredi, who works in my office.

Ms. Dipika Damerla: It is my pleasure today to introduce two Buddhist monks: Bhante Saranapala from the West End Buddhist Temple and Jue Qian from the Fo Guang Shan Temple. Both of them are here along with monks from 10 temples. We’re having a Buddhist heritage day, and I invite everybody to rooms 228 and 230 after question period.

Mr. Frank Klees: I want to welcome to the Legislature Mr. Rob Anderson, Mr. David Rae and Mr. David Gallagher, who are here to have a discussion with the Minister of Finance concerning some very important issues affecting their company, AIC.

Hon. Eric Hoskins: I’d like to introduce three constituents from my riding of St. Paul’s: Kathleen, Bob and Adam Garner, who are here to see Sean Garner, a page from my riding, serving as page captain on this last day for our pages.

ORAL QUESTIONS

POWER PLANTS

Ms. Lisa MacLeod: My question is to the Acting Premier. Earlier this morning, my colleagues and I sat through the justice committee with the Auditor General while the member from Mississauga–Streetsville decided that he would question the integrity and the professionalism of the Auditor General and her findings.

In that committee, the auditor confirmed that your decision surrounding the power plants and the cancellation were favourable to TCE and not to the taxpayer, that political interference from the Premier’s office to make TCE whole hamstrung the OPA and cost us more money, that the OPA said that Napanee was not a good replacement location and that, as a result of that, your government spent an extra $513 million for the relocation of the power plant—

The Speaker (Hon. Dave Levac): Question.

Ms. Lisa MacLeod: —GTA.

We also know the government has known since December 2010 that the number was far greater than $33 million.

You have proven inept. Will you resign?

Interjections.

The Speaker (Hon. Dave Levac): Stop the clock.

Be seated, please. Be seated, please. Thank you.

Deputy Premier.

Hon. Deborah Matthews: As has been repeated many times in this House, the Premier is the one who wrote to the Auditor General to examine the Oakville relocation. We thank the auditor, and we accept her findings.

Speaker, I think, as has been said repeatedly in this House, this was a decision of this party, also the PC Party, also the NDP. It was something on which we had found common ground. This was a plant that had to be relocated.

I have to tell you, Speaker, as you know, the Auditor General has credited the Premier for taking action. She said, “I did have the opportunity to meet with the Premier ... it was good to hear that they are taking the report seriously and that they are taking ... actions and changing the way things are going to be done in the future.”

The Speaker (Hon. Dave Levac): Supplementary?

Ms. Lisa MacLeod: That was a pretty good Richard Nixon impression, Speaker, but I can tell you something: The Auditor General earlier today confirmed that there was political interference by this government—not by the Progressive Conservative Party, not by the New Democrats, but by the Liberal Party of Ontario and the Liberal Party of Ontario alone.

Your Premier was the campaign chair of the last election. She signed the document that handed over all of the bargaining rights to TCE to make them “whole.” Okay? That is quite significant, and it proves what the auditor also would say: that the cost taxpayers ended up having had nothing more to do than your own political future.

She said that had you sited those plants somewhere else in the GTA, you would have saved the taxpayers $513 million. She also said if we had waited it out, it would have cost us nothing at all.

My question, again, for this Deputy Premier: Will she resign?

Interjections.

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

Hon. Deborah Matthews: Well, the answer to that question is “No,” but I can tell you what we will do, and that is that we will fix the system so that this does not happen again. There is widespread agreement that the original siting was not appropriate. That’s why we’re improving the siting of large energy infrastructure projects by implementing the recommendations of the OPA and the IESO. Communities will have a say right from the beginning. We will get the siting decisions right from the start, so this will not happen again.

We’re also introducing new rules that are limiting political staff involvement in commercial third-party transactions. I believe that the staff in the then Premier’s office acted in good faith, but we are acting on lessons learned.

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

Ms. Lisa MacLeod: If ever there was proof that it’s time to change the team that leads the province, it was that answer. It is that answer that proves that Tim Hudak and the Ontario Progressive Conservatives should assume this government, because we wouldn’t have done what they did. They created the OPA to remove political interference from energy decisions, and then they ignored the OPA.

It was the OPA who told your government that it wasn’t the appropriate location to go to Napanee. You ignored them. You cost us $513 million more. You knew that if you did nothing, if you let it wait out, we wouldn’t have had to pay one red cent.

We have a motion of want of confidence on the order paper. I am asking you today, Deputy Premier: Will you call that for a confidence vote? Will you allow members of this assembly to debate that, and will you allow us to vote against this government and make sure that we can have an election for the people of Ontario?

Interjections.

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

Hon. Deborah Matthews: Well, Speaker, I think it might be time for a walk down memory lane. I think the member opposite needs to be reminded of their record when it comes to energy. They might remember the attempt to privatize Hydro One; that led to a $19.5-billion debt charge that Ontarians are still paying off to this day.

They might remember that their failed privatization caused electricity prices to rise a whopping 30%—

Interjections.

Hon. Deborah Matthews: —that’s a 30% increase in 30 weeks. In 30 weeks, electricity prices went up 30% under their watch. They artificially capped prices, and that resulted in a $1-billion additional figure being tacked on to the stranded debt.

Interjections.

The Speaker (Hon. Dave Levac): Bad timing. The member from Renfrew will come to order and, to the government members, when an answer is being given, I need to hear it as well.

Wrap up, please.

Interjection.

The Speaker (Hon. Dave Levac): The member from Halton does not help himself either. Now he has been told.

Hon. Deborah Matthews: And if that’s not bad enough, they more than doubled the use of dirty coal.

TEACHERS

Mr. Rob Leone: My question is for the education minister. We all agree in this Legislature that education is vitally important to the future prosperity of this country.

Interjections.

The Speaker (Hon. Dave Levac): The Minister of Citizenship and Immigration will come to order. Please.

Mr. Rob Leone: We agree that we have the best teachers, the most caring teachers and the hardest-working teachers right here in the province of Ontario. The only difference is, our party wants to see those teachers in front of the classroom, while it appears that the Premier would rather see some of our youngest teachers unemployed and at home.

The member from Nepean–Carleton has brought forward a thoughtful piece of legislation that brings parents, students and teachers together in support. It allows teachers to be hired based on their skill, ensuring that the best and the brightest are in front of the next generation of students. Parents support this bill, teachers support this bill, and students will benefit greatly from this bill.

Minister, will you support the bill and give Ontario teachers the respect that they deserve?

Hon. Liz Sandals: I’m very pleased to answer this question. First of all, let me make it perfectly clear that we have said to all our partners in the education sector that we are perfectly willing to work with them to find improvements to the regulation. We admit that there are some problems with this regulation.

But what we will not do, Speaker, is rip up collective agreements, unlike the folks opposite, who think that—

Interjections.

The Speaker (Hon. Dave Levac): The member from Durham is dangerously close to being asked to withdraw.

Finish, please.

Hon. Liz Sandals: Thank you, Speaker. We don’t have a white paper policy document that says to lay off 10,000 teachers to balance the books. They do.

We think that we have a collective agreement, and we agree that we need some improvements to this regulation. In fact, I’ve just announced the appointment of some people to look into this, and I’d be happy to follow up within the supplementary.

The Speaker (Hon. Dave Levac): Supplementary?

Mr. Rob Leone: What the minister is telling us is that she doesn’t want the best teachers teaching our kids in our classrooms.

Let me tell you about Jason Trinh. Jason is a talented teacher with a master’s degree in molecular biology. After filling in at two of Toronto’s top high schools, he was honoured with the Premier’s New Teacher of the Year award. He was also hand-picked to design a summer math camp and was so successful that he was credited for boosting grade 9 math scores.

But Jason can’t find a job. He can’t even get an interview because he sits 800th on a seniority list of more than 2,000 teachers. Under regulation 274, principals are forced to hire whatever names happen to be at the top of their seniority list.

Jason Trinh is the type of teacher we need in front of our classrooms. I would hope and would like to think that his award actually means something. Minister, why don’t you think that our children deserve the best teachers in front of our classrooms?

Interjections.

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

Carry on.

Hon. Liz Sandals: You know, it’s really interesting that they want to talk about the best teachers. We actually—

Interjection.

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

Interjection.

The Speaker (Hon. Dave Levac): The member from Leeds–Grenville, come to order.

Carry on.

Hon. Liz Sandals: We actually happen to think that when school boards have hired people to be occasional teachers, when they’ve interviewed and hired people to be long-term occasional teachers, that that is in fact a pool of really great teachers. We think that school boards have been responsible in choosing long-term occasional teachers. Apparently, they don’t.

But, Speaker, we are not ripping up collective agreements. We have a different approach about how to deal with unions than they do. We have said from the beginning, both the Premier and I, that we will—

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

Mr. Rob Leone: Minister, this is about fixing an unfortunate mistake to ensure fairness for teachers, and nothing else. I urge this government to support this bill and send it to committee so we can have an open conversation about what to do about this situation.

We know the NDP tried to shut down debate on this bill, as we know where their interests lie, and that’s what we have come to expect from them. But being in government means that you have to do what’s best for the people of the province of Ontario, not just what’s best for the special interests that helped get you elected.

We are on the side of parents. The PC caucus is on the side of principals, we are on the side of students and we are on the side of teachers. Why is the government, the NDP and the special interests the only ones left standing on the other side?

Support this member’s bill. Repeal regulation 274. Let’s get the best teachers in front of our students.

Interjections.

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

Hon. Liz Sandals: I think we’d better have a little bit of perspective here on recent history. We are the people who said, “We’re not ripping up collective agreements. We’re going to sit down with our partners. We’re going to have some conversations and reach memorandums of understanding with each and every one of our partners.” As a result of those conversations, working together, we have a school system this year that is calm and has extracurriculars, and that is a result of working with people, not just saying, “We’re going to rip up the collective agreement.”

We will continue to work with people to look for solutions, but we’re not laying people off, we’re not ripping up collective agreements and we’re not repealing regulation; we’re working to improve it.

POWER PLANTS

Mr. Peter Tabuns: My question is to the Minister of Energy. The Auditor General said that the cabinet minute that the Premier signed on arbitration tied the OPA’s hands. Why did the Premier tie the OPA’s hands when it was dealing with TransCanada?

Hon. Bob Chiarelli: I thank the member for the question. The auditor said a number of things in her report. Included in that report was the following quote: “Making assumptions about future events and their effects involves considerable uncertainty. Accordingly, readers should be cautioned that while our estimates differ from estimates previously announced by the Ontario Power Authority (OPA), they will also likely differ from the actual costs and savings that will be known only in the future.”

The people on the government side, including the OPA, throughout these conversations dealt in good faith. Any documents that were produced with respect to the negotiations were done in good faith. There were different perspectives on the facts; the auditor has referred to that. But we have accepted the auditor’s report. The Premier has accepted it; I have accepted it. We’ve taken strong action to ensure that power plants are properly sited in the future.

The Speaker (Hon. Dave Levac): Supplementary?

Mr. Peter Tabuns: I guess the minister didn’t like the question and didn’t want to answer the question. The Premier signed a cabinet minute that tied the OPA’s hands. The Auditor General said there was nothing that gave the OPA any strength in their dealings with TransCanada. She signed a deal that took all the protections for Ontarians and cut them off at the knees. She sold us down the river. Why did the Premier sign this arbitration agreement? Did she not understand or did she not care?

Hon. Bob Chiarelli: On October 7, 2010, the government publicly committed to relocating the Oakville plant and the OPA sent a termination letter to TransCanada Energy. The arbitration agreement reflected promises that had already been made in the OPA’s termination letter to TCE on October 7, 2010. As per the Auditor General just this morning, the arbitration agreement just reiterated the original letter sent from the OPA to TransCanada.

Even MPP Peter Tabuns—I should say the member for Toronto–Danforth—agrees there was nothing extraordinary about this cabinet directive. On April 11, he said, “I don’t see it as a smoking gun. We knew that the cabinet was approving this process. So this does not surprise me.”

He’s reinventing history, Mr. Speaker.

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

Mr. Peter Tabuns: There is no history to reinvent. The auditor said that when people sign deals, they should know what they mean. Did the Premier realize she signed a cabinet minute that left Ontarians guaranteeing profits for a private power company? Why would the Premier ask Ontarians to back up TransCanada and not themselves?

Hon. Bob Chiarelli: I believe the Auditor General also said at committee this morning that she had received a number of legal opinions. Those legal opinions indicated that had this been litigated, it would not have been in the interests of the province. The costs would likely have been higher. So there are different perspectives.

I read the quote from the Auditor General that said we should look at these facts cautiously and from different perspectives. She has been very objective, she’s been very fair, she’s been very neutral in her findings, particularly when she says that the arbitration agreement just reiterated the original letter sent from the OPA to TransCanada. Mr. Speaker, I believe that answers the question.

POWER PLANTS

Mr. Gilles Bisson: To the Minister of Finance—to the Minister of Energy: The auditor is quite objective. She’s saying you guys wrestled yourselves to the ceiling. You took—

The Speaker (Hon. Dave Levac): I’m sorry, I do need clarification. You said two ministers. Energy? Thank you.

Mr. Gilles Bisson: Let me do this all over again. It’s pretty clear what the auditor was saying this morning. She was saying that this government wrestled itself to the ceiling when it came to a settlement with TCE. You took the most expensive route in order to settle this thing where you could have got out for absolutely nothing.

The question is, why did the Premier, the current Premier today, sign a cabinet document back then that led to us having to pay these people over $685 million?

Hon. Bob Chiarelli: Mr. Speaker, I think he just asked the same question. It had to do with the Premier signing with respect to the arbitration agreement.

I want to repeat the answer. The arbitration agreement reflected promises that had already been made in the OPA’s termination letter to TransCanada Energy on October 7, 2010. The Auditor General this morning said that the agreement just reiterated the original letter sent from the OPA to TransCanada. As I said, the energy critic for the NDP said, “I don’t see a smoking gun.”

The Speaker (Hon. Dave Levac): Supplementary?

Mr. Gilles Bisson: The fact is your Premier, Kathleen Wynne, signed an arbitration agreement on behalf of cabinet. That is what led to the settlement. If the government had chosen to do nothing and allowed force majeure, or allowed that contract to end as it naturally would have in 2016, you would not have had to pay what you did.

I ask you again: How can you stand in this House today and say that you guys did what was best for the people of the province of Ontario when it came to the settlement of this contract?

The Speaker (Hon. Dave Levac): Just a minute. I remind the member and all members to use either the title or their riding, please.

Carry on.

Hon. Bob Chiarelli: Mr. Speaker, the question is directed to the activities of the Premier. This Premier, at the first opportunity, when she returned to the Legislature, reconvened the committee. Secondly, she directed all of her ministries—which had never been asked for before—to make documents available that were asked for by the committee. That resulted in well over 160,000 documents coming to the committee. The unprecedented offer from the Premier was to open up the documents and papers in the Premier’s office; I believe it was the first time in the history of this Parliament: 30,000 pages of documents from the Premier’s office.

She was open, she was transparent, she was upfront, she was honest and she showed tremendous leadership on this issue.

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

Mr. Gilles Bisson: Some leadership. It cost us $685 million.

The point is, your member from Mississauga–Streetsville this morning at committee was trying to say that the auditor based all of her findings on her assumptions. The auditor, being a very clever person, knowing her job, said that was not the fact. In fact, her findings are based on facts. So it’s clear that your Premier and you as Minister of Energy, along with the rest of this government, are trying to basically not accept what the auditor had to say.

Why are you fighting what the auditor had to say and trying to say that these are all assumptions when, in fact, they’re all fact?

Hon. Bob Chiarelli: In the premise of his question he said that this cost us a lot of money. It did: $675 million. The Premier accepted responsibility for that and apologized for that.

But I will say, Mr. Speaker, that that $675 million should be compared to several other decisions that were taken several months ago. Number one: The decision to renegotiate the Samsung contract removed $3.7 billion from the rate base, compared to this number. The decision to remove domestic content removed $1.9 billion from the rate base. That’s $5.6 billion that we’ve taken out of the rate base, and that more than covers that number, but it doesn’t excuse that number.

GOVERNMENT’S RECORD

Mr. Todd Smith: My question this morning is for the Acting Premier. I’m sure the next Liberal election campaign ad came to me last night after the bombshell that was dropped this week. It goes something like this: The eHealth scandal, $2 billion; the Ornge scandal, hundreds of millions of dollars; the gas plants scandal, $1.1 billion; the Pan Am Games, priceless. There are some things in life that money can’t buy, but if you are a Liberal in Ontario, there’s always the taxpayer.

Minister, when are you going to stop making Ontario people pay for your scandals and your incompetence? Will you call the non-confidence motion? Get a mandate from the people of Ontario before you misappropriate any more of taxpayers’ money.

Interjections.

The Speaker (Hon. Dave Levac): Before I go, I’m going to caution everyone that if we’re going to dangerously go down a slippery slope of trying to say something indirectly that you can’t say directly, I’ll nail it right away. So let’s be very cautious, please.

Interjection.

The Speaker (Hon. Dave Levac): No, I don’t need any editorials.

Deputy Premier.

Hon. Deborah Matthews: Well, thank you, Speaker. The member opposite maybe wasn’t around when his party was in power, so I think he needs to be reminded of some of the extraordinary legacy his party, when they were in power, left for the people of Ontario. The attempt to privatize Hydro One led to a $19.5-billion—

Mr. John Yakabuski: We went to the people and we paid the price. End of story.

The Speaker (Hon. Dave Levac): I don’t need armchair quarterbacks. The member from Renfrew–Nipissing–Pembroke is warned.

Finish, please.

Hon. Deborah Matthews: The Hydro One attempt to privatize cost Ontario taxpayers and ratepayers $19.5 billion. We are still paying that off. Every time an Ontarian opens their hydro bill, they’re paying for the follies of the PC Party. When they tried to privatize electricity, prices rose 30% in just 30 weeks. The record is crystal clear. To make it worse, some of us remember that they hid from the people of this province—

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

Mr. Todd Smith: Minister, let me tell you the difference between what you are talking about and what we’re talking about here. You’ve clearly lost the moral authority to govern in Ontario. Your government misappropriated $1.1 billion—and here’s the key—for partisan, political purposes. You treated the Ontario taxpayer like they were your own slush fund, like they were your own ATM.

Just because the NDP is prepared to prop you up and just because the NDP will support that kind of behaviour doesn’t mean we will here. Just because the NDP is prepared to let you throw good money after bad at the Pan Am Games—they haven’t learned their lesson; we have. We won’t let it continue.

Minister, you shouldn’t be allowed to spend one more red cent in this province. Will you call a non-confidence motion? Let the Ontario taxpayer decide once and for all if they’re going to support this corrupt government.

Interjections.

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

Interjections.

The Speaker (Hon. Dave Levac): The member from Cambridge will come to order. The member from Hamilton East–Stoney Creek will come to order. And if he goes to his seat, I’ll say it again.

Answer, please.

Hon. Deborah Matthews: The testosterone here is a bit in overdrive, but let’s try to reflect on the history of this province. When the PCs were in power, they hid a deficit from the people of this province of $5.6 billion. You talk about moral authority. They sold the 407 at a fire sale price.

But more importantly for me, Speaker, under their watch, one third of students dropped out of high school before they completed it. We had the longest surgical wait times in the country. We’ve gone from the worst to the first. When it comes to high school dropout rates, our kids are thriving. People are coming from around the world to find out how Ontario transformed their education system in one short decade.

POWER PLANTS

Mr. Peter Tabuns: My question is to the Minister of Energy. The Premier has said over and over that mistakes were made; it’s a shame about Oakville and Mississauga—and then you bungled the cost of the cancellation.

But an apology isn’t much good if you turn around and do the same thing over again. Has the Premier learned those lessons, or is she currently repeating those same mistakes in St. Clair with the replacement for the Mississauga plant?

Hon. Bob Chiarelli: Mr. Speaker, reference is made to the Auditor General’s report again, and I want to make reference to an Auditor General’s report, but not the one that she just released. I want to talk about the public accounts that she released several weeks ago. The same Auditor General confirmed that the public accounts for Ontario—for the first time in 12 years, the costs of provincial government declined, and we continue to be the only province that is bettering our deficit reduction targets. We have acted responsibly. We’re continuing to act responsibly.

Mr. Speaker, if they’re prepared to go to an election, let them start talking about their policy. Let them start talking about their leader, who in one week says he’s going to cancel the wind contracts, and in the next week he says he’s not going to cancel them. We don’t know where he stands, Mr. Speaker, and I defy him—

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

Mr. Peter Tabuns: It appears the minister isn’t following this file.

Interjection.

The Speaker (Hon. Dave Levac): Minister for Rural Affairs, come to order.

Mr. Peter Tabuns: The Premier said the government would start consulting before siting power plants, but Sarnia mayor Mike Bradley is quoted as saying, “This ... decision, we were not consulted on. They simply made the announcement, and we were told it was coming to Lambton county.”

Local residents are starting to raise health issues. It’s sort of like déjà vu all over again. The Premier seems to be making the same mistake—

Interjections.

The Speaker (Hon. Dave Levac): Excuse me. Come to order.

Interjections.

The Speaker (Hon. Dave Levac): The member from Eglinton–Lawrence, you’re not helping, and if you go to your seat, I’ll tell you the same thing.

Finish, please.

Mr. Peter Tabuns: Does the minister realize that apologies don’t count for much if you keep making the same mistake over and over?

Hon. Bob Chiarelli: The critic for the NDP wants to get into the quote game. I have a few quotes.

Mayor Hazel McCallion: “We have been opposing this power plant since 2004.”

Sarnia Observer: “‘Our area accepts and welcomes these kinds of projects.’”

Sarnia Observer re St. Clair township mayor: “‘I told the minister the community would view it as a very positive thing for us all.’” That’s the mayor, Mr. Speaker.

“Local tradespeople are glad to learn a natural gas plant will be constructed at the” Lennox generating station.

“‘It’s been a slow summer for us.... This is very good news.’” That’s the Sarnia Observer.

Mr. Speaker—a unanimous vote on the part of the Napanee council, accepting the plant. We have two communities, Mississauga and Oakville, who are happy that these plants have been moved, and we have two willing host communities who are happy to have them.

STUDENT MENTAL HEALTH SERVICES

Mr. John Fraser: My question is to the Minister of Training, Colleges and Universities. As you may be aware, today is World Mental Health Day. Mental health is a growing concern amongst our young people in my riding of Ottawa South, especially our post-secondary students. With psychiatric disorders comprising 16% of all identified disabilities at our post-secondary institutions, we cannot sit idly by. As exams and the essay season heat up, the parents in our communities want to be sure that their kids have the support they need to succeed.

Can the minister please tell the House what the government is doing to provide support for post-secondary students struggling with mental health issues?

Hon. Brad Duguid: The member is right: This is an incredibly important issue. One in five Ontarians, which means one in five of our young students, experience some form of mental illness, such as anxiety, eating disorders, schizophrenia and depression, and 70% of mental illness is identified during the teenage years.

Imagine dealing not only with the stresses of day-to-day school life, not only with maybe being away from home for the first time in your life, but also having to deal with some form of mental illness.

We’ve rolled out a number of supports. In fact, our $27-million youth mental health innovation fund has already announced over 20 new programs right across the province with our colleges and universities.

That’s also why we recently announced our Good2Talk helpline, a free, confidential, anonymous service that offers professional counselling, mental health information and connections to local resources 24 hours a day, seven days a week, 365 days a year—a very, very important service for our students.

The Speaker (Hon. Dave Levac): Supplementary?

Mr. John Fraser: It’s great to hear that the province is tackling mental health and investing in programs that will help our young people get access to the help they need to succeed. It is especially important to hear that students will have access to the Good2Talk helpline 24 hours a day and seven days a week. We must do everything we can to support our young people in all the ways they need and deserve.

However, I’ve also heard that the government is investing in 10 projects across the province that will provide further on-campus assistance and mental health programs. Parents and students alike can agree that these programs are just as necessary in the east as they are in Toronto, and they would like to be assured that institutions across the province are being considered.

Speaker, through you to the minister, has the government committed to any of these projects at the post-secondary institutions in Ottawa?

Hon. Brad Duguid: I think it’s an excellent question. Absolutely, these projects are rolling out right across the province; I can assure the member of that. In fact, there have been two rounds, so far, of approval, so it’s actually 20 projects: 10 announced last week and 10 announced in the spring. A total of $6.5 million so far has been invested.

One of my favourite projects, in fact, is at Carleton University, in partnership with the University of Ottawa, in the member’s region, as well as in partnership with the Ottawa-Carleton District School Board. Carleton University and its partners have received $640,000 over two years to work with and identify students who are at risk at the high school level, and then provide wraparound support services as they transfer into university. It’s a groundbreaking program.

It’s very innovative, and I think that what it’s going to lead to is better results for those students, right through to ensuring that those students, if they do suffer from some form of mental illness, don’t lose a school year or worse.

This is a program we’re very excited about. I’d like to thank all members from all parties—because I know that they all support these kinds of initiatives—for their support, and I’d particularly like to thank our partners in the colleges and universities for the work they’re doing to roll them out.

PAN AM GAMES

Mr. Rod Jackson: It must have been a pretty good Pan Am party last night, so I guess my question is to the Deputy Premier. Minister, all those foreign dignitaries you treated this week to your $500,000 parties want to know if they will be safe for the TO2015 games. Your current one-line budget item for essential services, at $235 million, is supposed to include the total security costs, but here are some comparative security costs for the last few multinational sporting events: London, $1.6 billion; Vancouver, $1 billion; and Turin, $1.4 billion.

Minister, I hope you’re not depending on cutting corners by granting special police powers to security guards to save your budget and keep Ontarians safe. Minister, what is the exact amount of the total security plan for the Pan Am Games? The total amount.

Hon. Deborah Matthews: To the Minister of Finance.

Hon. Charles Sousa: I appreciate the question. The member opposite has been apprised of the ongoing deliberations regarding budgeting of the Pan Am Games for the last two years. He’s well aware, from the outset, as to what is taking place and how it is going to be costed. He knows fully well—and I put it in the budget; I’ve also put it in our first-quarter results—some of the issues we have with regard to transportation and security.

More importantly, what was really shameful was that the members opposite chose not to receive delegations from across South America, people who came to our country. We are displaying Canada at its best—and Ontario—and they chose to dismiss them and to neglect them. These are people who are coming to invest in our province. We’re hosting the games that we would want all of the world to recognize. They chose not to support Ontario.

The Speaker (Hon. Dave Levac): Supplementary?

Mr. Rod Jackson: It seems to me that the most investment is coming from the Ontario taxpayer, not from the delegates that got paid thousands of dollars to fly here and be put up here in Toronto.

Several weeks ago, the TO2015 CEO met with our party leader and me, and, when pressed, he threw out another number about security: $113 million for security. It wasn’t clear if that was the total security budget embedded in the $235 million for the essential services item, or if that is another one of your surprise budget items hidden off the Pan Am books somewhere. Either way, a Pan Am security source indicated that your security budget, whatever it is, has been well overblown already.

Your lack of planning is the biggest security risk to date, Minister. Have you buried extra money outside the games budget again, and how much exactly is the total security cost? Can you give me the number in the budget of the security costs—flat out, yes or no? Can you do it? What is it?

Hon. Charles Sousa: We have recognized the complexity of these games; that’s why we’re working in tandem with TO2015. It’s also why we have taken the extra step to ensure that security is installed as necessary by hiring a number of security and other groups to support these games.

Let’s also recognize the influx of the tremendous amount of tourism that’s coming to this province, the 10,000 athletes and officials who are going to attend, the extraordinary amount of celebrations and enthusiasm and the pickup that is going to have for our province. It’s tremendous.

More important than that is the legacy that is going to be created by all of the community centres, the athletes’ villages, the athlete venues across southern Ontario for the benefit of future generations. They should be supporting that, Mr. Speaker. They should be standing for Ontario.

ONTARIO NORTHLAND

TRANSPORTATION COMMISSION

Mr. John Vanthof: My question is to the Acting Premier. I think it has been pretty well established that the Liberal government wasted over $1 billion to guarantee the profits of a private gas company and to save a few seats around Mississauga and Oakville.

While they were doing that, they also decided to dump the ONTC infrastructure on which northerners rely. A year later, due to the united northern front, we’ve put a hold on that. But imagine our surprise when we come to find out that jobs that could be done in North Bay at the shops are still being outsourced to other countries, and our own shops aren’t being allowed to bid.

Are private contracts, private companies, still more important to this government than good jobs in northern Ontario?

Hon. Deborah Matthews: To the Minister of Natural Resources.

Hon. David Orazietti: I appreciate the question from member opposite. The member opposite knows full well that the minister’s advisory committee has been set up and recognizes that the status quo was no longer an option. I think everybody agrees with that, and they recognize that there needs to be a new plan to help strengthen transportation infrastructure in northern Ontario, something that has been an incredible challenge in this region. I want to assure the member opposite that we are committed to investing in transportation infrastructure in northern Ontario and in the region to ensure that northerners who need service and access to transportation get that service.

I’m working with the Minister of Northern Development and Mines. He is very acutely aware of these challenges and these issues, and he will continue to work with the local community to ensure the most effective solution for the region.

The Speaker (Hon. Dave Levac): Supplementary?

Mr. John Vanthof: Once again, my question is to the Acting Premier. I think everyone is aware, especially northerners, that the minister’s advisory committees are charged with the job of advising the minister of how to restructure and how to come up with a plan for the ONTC. I think we’re all in agreement on that, but how can they come up with a plan when you tie the ONTC’s hands and you don’t allow them to bid on contracts to actually make money for the company?

You’re spending money on lawyers—you’re lawyering up—but you’re not letting northerners actually try to rebuild their company. You are trying to save your reputations while we lose our jobs.

Hon. David Orazietti: The member knows full well that the Minister of Northern Development and Mines is very committed to addressing this issue in a way that meets the objectives and the realities of northern transportation challenges, and is committed to working with these communities. That’s why this advisory group was set up. So while the member opposite is making some claims, there is an advisory group that we’re going to be taking our advice from and working with to ensure the most effective solution is reached in this area.

This is an acknowledgment that everyone recognizes that the status quo is not an option in this area. There has been a significant financial loss in the area with respect to the operation of the ONTC, and we’re going to continue to work with the communities to find the best result.

SMALL BUSINESS

Mrs. Laura Albanese: My question is for the Minister of Economic Development, Trade and Employment. Minister, this week marks Small Business Month across Canada, and it’s a chance to highlight small businesses and the hard-working people who run them.

There are many small businesses in my riding of York South–Weston, such as Cristina’s Antiques, Caplan’s Appliances and the Golden Wheat Bakery, just to name a few, who are small business owners who are working to make it work for themselves and working to create local jobs in Ontario.

There is always great fulfillment in running a successful small business, and it coincides with the government’s commitment to creating the right business climate to attract and support business.

Mr. Speaker, through you to the minister: How is our government supporting small businesses across Ontario?

Hon. Eric Hoskins: Thanks to the member from York South–Weston for her question. She’s a great advocate for small businesses in her community as well as in Ontario.

We’ve recently introduced Bill 105, the Supporting Small Businesses Act which, if passed, will ensure that 60,000 small businesses will pay less employer health tax and will eliminate that tax all together for 12,000 small businesses right across the province.

We’ve made funding commitments of over $88 million to support businesses through our two regional economic development funds. Our work to cut red tape has eliminated over 80,000 regulatory burdens in the last five years, savings of more than $265 million for businesses in Ontario. Of course, we’ve permanently cut the small business corporate income tax rate from 5.5% to 4.5% and eliminated the small business deduction surtax.

The Speaker (Hon. Dave Levac): Supplementary?

Mrs. Laura Albanese: Thank you, Minister, for the update.

Small businesses contribute so much to Ontario’s economy. They are important partners for Ontario. They help build vibrant and strong communities, communities such as the Portuguese, the Spanish, the Vietnamese, the Somali and the Italian community. All of these communities have a strong presence in my riding, and, obviously, I continue to actively participate as much as I can in them.

I continue to receive, although, many questions from constituents about jobs created by small businesses, as well as broader questions about job creation as a whole across our province. Mr. Speaker, could the minister please provide me with an answer to take back to these communities about what our government is doing to help small business create good, meaningful jobs in my riding and in the rest of the province?

Hon. Eric Hoskins: I thank the member again for the follow-up question and the opportunity to speak to the employment component of this.

Mr. Speaker, small and medium-sized businesses represent over 99% of all businesses in our province, which means, of course, they are a highly significant source of employment for the people of Ontario. Communities across the province—rural, small-town and urban—benefit from these important jobs. As jobs minister, I know how important having a good, meaningful job is.

Making it easier for small businesses to create jobs is an important element of the investments and supports we provide, supports like the Ontario Network of Entrepreneurs, helping to bridge knowledge and experience to help entrepreneurs start new businesses, and our 57 small business enterprise centres right across the province helping to support small businesses and entrepreneurs as well.

We’re also looking forward to the official launch of our youth jobs strategy in the coming weeks, which will obviously support young people and create more jobs.

HOSPITAL SERVICES

Mr. Peter Shurman: Thank you very much, Speaker—

Interjections.

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

Interjections.

The Speaker (Hon. Dave Levac): No, no, no.

Member from Thornhill.

Mr. Peter Shurman: If I’d only known they cared.

Speaker, my question is for the Minister of Health and Long-Term Care. Minister, over the course of my time here and well before that, your government has been promising the residents of Thornhill and Vaughan a hospital. We have yet to see a hole in the ground, and the sign at the corner of Major Mackenzie and Jane is starting to look, well, tired and rusty and battered—sort of like your party.

Now, to further complicate matters, there appears to be a gaping hole in this story. Who has title to the 80 acres of land where the hospital is to be built? Both the city of Vaughan and a private corporation seem to have an interest.

My question is this: Does your ministry or the city of Vaughan hold clear title to construct a hospital on this 80-acre tract of land or have you left this or any part of it in the hands of a private corporation?

Interjections.

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

Minister of Health and Long-Term Care.

Hon. Deborah Matthews: Vaughan is a growing, thriving community, and the people of Vaughan and Thornhill deserve a hospital, and we’re going to deliver a hospital to the people of Vaughan.

I want to thank the member from Vaughan, who, since before he was elected to this Legislature, has been a tireless advocate of that new hospital. And in fairness, I want to thank the member from Thornhill, who also has stood up and supported this infrastructure project, even though the party, I’m afraid, does not support hospital infrastructure. But nonetheless, the member opposite I think should drive by the site. There is a new sign that went up this week, celebrating the site of the future hospital, and I am very pleased that the largest single health care investment ever in Vaughan is the $49.7-million—

Interjections.

The Speaker (Hon. Dave Levac): Thank you. And while her answer is finished, I want to be able to hear the rest of the answer, and the member from Lambton–Kent–Middlesex is not helping.

Supplementary, please.

Mr. Peter Shurman: If only a sign could offer dialysis.

There are few things more important to a community than a hospital, and the residents of Thornhill and Vaughan are restless, Minister. For the past five years, Vaughan residents have been paying additional taxes to the tune of $16 million that have been collected since 2012, and yet no date to break ground or start construction. This is just wrong.

A previous health minister and a previous finance minister, in fact, turned taxpayer dollars over to a private corporation in aid of future hospital activities. Where did that go? There is a lack of clarity and a lack of transparency and oversight here, and we both know that.

Now it is unclear who the land belongs to. Minister, you know as well as I do that a hospital cannot be built on private land. So, Minister, please end the ambiguity. Who owns the land and when will the hospital be built?

Interjections.

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

I’m going to ask—because I wanted him to put the question, but I’m going to ask the member from Bruce–Grey–Owen Sound not to heckle when he’s asking the question.

Answer, please.

Hon. Deborah Matthews: Speaker, I’m feeling this might be a—

Interjection.

The Speaker (Hon. Dave Levac): So now I’ll stand up and tell the member from Bruce–Grey–Owen Sound: You’re warned.

Interjection.

The Speaker (Hon. Dave Levac): Ask the member from Halton about that.

Hon. Deborah Matthews: Speaker, I’m so happy to have this question, because I’m happy to assure the member opposite and the people of Vaughan that the construction is scheduled to begin in 2015. We are working with all partners to make sure we proceed with this site, and let’s imagine what’s going to be there, Speaker. We will have emergency and surgical services; operating rooms; acute, in-patient, intensive-care beds; diagnostic imaging; specialized ambulatory clinics.

The people of Vaughan deserve this hospital. The member from Vaughan has been a fearless advocate for this hospital. Construction will begin in 2015, and we’re moving ahead.

HORSE RACING INDUSTRY

Ms. Cindy Forster: This Liberal government is notorious for making bad bets and losing big. But it’s easy to wager when you’re not playing with your own money. When—

The Speaker (Hon. Dave Levac): Sorry, I need to ask the member to put the question—to who?

Ms. Cindy Forster: The Acting Premier.

I’ll start again. This Liberal government is notorious for making bad bets and losing big, but it’s easy to wager when you’re not playing with your own money.

This week, the Auditor General confirmed that this government gambled away $1 billion to save a few Liberal seats in Oakville and Mississauga. But by scrapping the racetrack slots in Fort Erie, you gambled with the livelihoods of many people in Fort Erie and track communities across this province.

The Premier says she’s sticking up for rural Ontario, but what is she doing to make sure the final race of the season isn’t the last race in the 116-year history of the Fort Erie tracks?

Hon. Deborah Matthews: Minister of Rural Affairs.

Hon. Jeff Leal: Mr. Speaker, this government put in place a panel of three very distinguished former cabinet ministers of the province of Ontario: Mr. Snobelen, Mr. Buchanan, Mr. Wilkinson. The Premier, over a month ago, issued a letter to the panel to come up with a five-year plan to make sure that horse racing in Ontario is sustainable and transparent, and to get fans to the tracks.

We’re moving forward with that plan. The plan is going to be complete in the next little while, and we’ll have