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April 6, 2011

39th Parliament, 2nd Session

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Hansard Transcripts

Votes and Proceedings

Orders and Notices

Hansard Transcripts 2011-Apr-06 (PDF)

L104 - Wed 6 Apr 2011 / Mer 6 avr 2011

LEGISLATIVE ASSEMBLY OF ONTARIO

ASSEMBLÉE LÉGISLATIVE DE L’ONTARIO

Wednesday 6 April 2011 Mercredi 6 avril 2011

ORDERS OF THE DAY

HEALTH PROTECTION

AND PROMOTION

AMENDMENT ACT, 2011 /

LOI DE 2011 MODIFIANT

LA

LOI SUR LA PROTECTION

ET LA PROMOTION DE LA SANTÉ

INTRODUCTION OF VISITORS

ORAL QUESTIONS

EXECUTIVE COMPENSATION

EXECUTIVE COMPENSATION

EXECUTIVE COMPENSATION

TAXATION

EXECUTIVE COMPENSATION

GOVERNMENT APPOINTMENTS

ENERGY POLICIES

EXECUTIVE COMPENSATION

FREEDOM OF INFORMATION

IMMIGRANT SERVICES

GOVERNMENT REGULATIONS

SCHOOL TRANSPORTATION

TOURISM

CORRECTIONAL FACILITIES

HOSPITAL FUNDING

DEFERRED VOTES

2011 ONTARIO BUDGET

MEMBERS’ STATEMENTS

TARTAN DAY

EVA’S PHOENIX

CORNWALL COLLEGIATE

AND VOCATIONAL SCHOOL

LLOYD VAN DUSEN

SEARCH COMMUNITY MENTAL HEALTH SERVICES

MENTAL HEALTH

AND ADDICTIONS SERVICES

POST-SECONDARY EDUCATION

HEALTHY LIVING

CANCER SCREENING

MOTIONS

PRIVATE MEMBERS’ PUBLIC BUSINESS

IVAN THRASHER

STATEMENTS BY THE MINISTRY

AND RESPONSES

WORLD AUTISM AWARENESS DAY /

JOURNÉE MONDIALE

DE SENSIBILISATION À L’AUTISME

INTERNATIONAL ADULT LEARNERS’ WEEK /

SEMAINE INTERNATIONALE

DES APPRENANTS ADULTES

WORLD AUTISM AWARENESS DAY

INTERNATIONAL ADULT LEARNERS’ WEEK

WORLD AUTISM AWARENESS DAY

INTERNATIONAL ADULT LEARNERS’ WEEK

NOTICE OF DISSATISFACTION

PETITIONS

PROTECTION FOR PEOPLE

WITH DISABILITIES

PARAMEDICS

OAK RIDGES MORAINE

PARAMEDICS

WIND TURBINES

BRITISH HOME CHILDREN

GASOLINE PRICES

PARAMEDICS

DOG OWNERSHIP

PARAMEDICS

WIND TURBINES

PARAMEDICS

HYDRO RATES

PARAMEDICS

ORDERS OF THE DAY

BETTER TOMORROW

FOR ONTARIO ACT

(BUDGET MEASURES), 2011 /

LOI DE 2011 SUR DES LENDEMAINS

MEILLEURS POUR L’ONTARIO

(MESURES BUDGÉTAIRES)

ADJOURNMENT DEBATE

HOSPITAL SERVICES

HEALTH CARE FUNDING

SOCIAL SERVICES

The House met at 0900.

The Speaker (Hon. Steve Peters): Good morning. Please remain standing for the Lord’s Prayer, followed by the Islamic prayer.

Prayers.

ORDERS OF THE DAY

HEALTH PROTECTION

AND PROMOTION

AMENDMENT ACT, 2011 /

LOI DE 2011 MODIFIANT

LA

LOI SUR LA PROTECTION

ET LA PROMOTION DE LA SANTÉ

Resuming the debate adjourned on April 5, 2011, on the motion for third reading of Bill 141,

An Act to amend the Health Protection and Promotion Act / Projet de loi 141, Loi modifiant la

Loi sur la protection et la promotion de la santé.

The Speaker (Hon. Steve Peters): Further debate?

M me France Gélinas: It was just yesterday morning when I was in full flight and I was interrupted by the clock, so I will try to rebuild the momentum that was going on at the time.

I would like to start by acknowledging what a pleasure it is to see Dr. King, our chief medical officer of health, in the assembly this morning to take in the proceedings. It is truly appreciated, and certainly shows your commitment to the improvement of public health throughout Ontario. I thank you for being here.

Yesterday, I had started to talk about some of the concerns I have with the bill. Bill 141, the Health Protection and Promotion Amendment Act, is focused on one initiative: It is focused on bringing central control of public health units. As I said, I can see why, in certain very narrow circumstances, this extra power of the chief medical officer of health could be needed. I have full confidence in Dr. King, in her judgment to use those new powers wisely.

The issue is that this bill will be there way past when I won’t be here anymore, and way past when any of us won’t be here anymore, and only the words will remain—the words on a piece of paper that describe the bill. This is where the worries start.

The worries start because some of the words that we have used in this bill have not been defined, and some of them could be defined in broad terms. That brings me worries because we have, right now in Ontario, a system of 36 public health units. Each of them serves a geographical area, and the entire province is covered. No matter where you live in Ontario, you’re always within the district of one of the 36 health units. This being said, those health units have been there for a long time and have worked with their communities for a long time. They know them inside and out.

Because of the work they have to do with the environment, they know all of the health care providers. They know each and every one that has a fridge and keeps vaccines. They know where they are. They know the ones that work well and the ones that have broken-down fridges. They know where all of the restaurants are, the ones that, here again, keep the food. They know their districts. They are there in their communities, day in and day out. They have a relationship with the people in their community, and this is part of their strength: their knowledge, their linkages to the community, because Ontario is very vast.

Ontario is a land of opportunity and Ontario has a beautiful diversity.

If you look at the little communities that make up Nickel Belt and you compare this to where I work in Toronto, it’s like we’re on two different planets, but yet we are all Ontarians and we all belong. The strategies that my health unit has put forward to make sure that they stay in contact with the people in Nickel Belt are very different from the strategies that the Toronto health unit puts forward to make sure that they reach out to their diverse population. So I continue to have some worries about this.

What I had started doing yesterday is, I had started to quote from some of the deputants who had come in front of the committee and shared some of those worries. Yesterday, I had quoted from the Association of Local Public Health Agencies, and their quote was pretty clear. This bill had come without any consultation with them, and they thought that if we all put our heads together, all the resources in 36 health units and the office of our chief medical officer of health, we may come up with something better.

But they never had an opportunity to put their heads together, because they were presented with a fait accompli. They were presented with a bill where the decision had already been made that the chief medical officer of health would be given those extra powers, and all that we asked their input on was on wordsmithing: Would they like to see changes after the fact?

This is not the way we traditionally work in the public health units. In the public health units, work is usually done from the ground up. That is, everybody is involved, whether the medical officers of health of the 36 health units or their boards of health; they all put their shoulder to the wheels. They move things forward together, making sure that the diversity of all of the health units is taken into account.

But this was not done by this minister. This minister brought forward a bill that she said is based on the recommendations of what we’ve learned from H1N1. Unfortunately, she brought the bill forward before the report was released, and when the report was finally released we looked at all 60 pages of it and nowhere in the report did we see that, had we had central control by the chief medical officer of health, better public health outcomes would have come out of this. We don’t see this at all.

I also quoted yesterday, before my time was up, the Toronto Public Health unit. The Toronto Public Health unit is huge. It covers a very dense urban area of our province, and they are in charge of public health for many, many Ontarians.

And there again, they have shown in what they’ve presented that—and I will quote again: “Directive-making power would not have altered the problems with vaccine supply and distribution, would not have clarified the role and function of local health integration networks ... in the response, or alleviated the need for local modification to address specific community needs.” So, had we had this new bill, had Bill 141 been there before H1N1 hit the province of Ontario, it wouldn’t have changed the outcome.

I would like now to quote from another agency, and this is the Association of Municipalities of Ontario. It goes as follows: “We also do not see the relationship between the proposed HPPA amendments of

section 69 respecting the appointments of acting medical officers of health and the pandemic response. It was not an issue referenced in Dr. King’s H1N1 pandemic report. The proposed amendment is again an example of the increasing provincial involvement in local board of health governance and administrative responsibilities.”

If you look at this from the association of municipalities, you have to understand that every health unit has members of their local municipality appointed to it, and their municipality has to foot some of the bill. They share in the expense of the health unit.

I would ask a page for a glass of water, if any of them is not too busy.

The municipality has an interest in what goes on in the public health unit. Not only do they have a pecuniary interest, as in, they pay a part of what goes on, but they also have an influence. Because here again, the municipality works at the local level to try to improve public health. They are also closely connected to the people.

In the brief that they presented, they really show that if the power now is not even going to be with the local health unit, where they share a geographical area, they share constituents because of where they live—now it’s going to be the chief medical officer of health who directs what goes on. They look at this as, “Why are we there? If we’re not going to have a say in it but we’re still going to have to pay, how is this going to be beneficial to our municipality?” They have some issues with that.

The member from Whitby–Oshawa did make reference yesterday to a couple of changes that were made to Bill 141, but some of them remain. One of the big ones is the term “public health event.” It is a term that is used in Bill 141 but is not defined anywhere. A public health event would be something that would trigger and justify the chief medical officer of health exerting her power over health units and more or less issuing directives that tell the health units, “It doesn’t matter how you want to do things; you’re going to do things the way I tell you to,” which is what a directive is all about.

Not only can she issue directives to the medical officer of health, but to the board of health and to one or many or all of the health units. This extra power is triggered by a public health event, but we have a bill that doesn’t describe what a public health event is. This is worrisome to me, because a reasonable person could see a public health event in many different ways.

My health unit is organizing a smoking cessation seminar. To me, this is a public health event. It’s an event of the health unit. They’re also organizing all sorts of training for new moms and expectant pregnant women. This is also a public health event, but that certainly would not form the basis of triggering the chief medical officer of health to take over, to issue directives to my local health unit. So I would have liked this term to be described, and to be described in really, really narrow terms. Because when the good Dr.

King is not there anymore and when all of us are not here anymore, those words in that bill will continue to be there, and we don’t know how they’re going to be used. Way back when they drafted the bill—the name escapes me right now—nobody thought that it would be used during the G20 to justify a perimeter while the world leaders were having their little chat here in Toronto. So we have to think in those terms. We have to think that those words are going to stay way, way longer than we will.

Stakeholders were very concerned with the generality of this term, and nothing was done to define it or to constrain when the chief medical officer of health has power to act in the event of a public health event. I don’t know why we refuse to make the bill clearer. Why do we refuse to define a term that hasn’t been defined and that can be interpreted in such broad terms by reasonable people?

The bill could have a significant impact, including a significant financial impact, on public health in municipalities. But here again, there is nothing in Bill 141 that acknowledges this or provides support for public health or municipalities. What that means is that the chief medical officer of health can issue a directive. That means that local public health units have to carry out whatever the chief medical officer of health decides is in the best interests of the public health of Ontarians. But in the action of carrying this out, they may incur significant costs.

Those significant costs will be borne by the local health unit and by the municipality, which has to chip in their share, but they have no control over what they do.

What if it makes sense to do this in some health units, but in your health unit you look at your resources and say, “Frankly, I would have done things differently”? But you don’t have an opportunity to do things differently, because a directive was issued by the chief medical officer of health, so you have no choice but to spend all that money with no guarantees that somebody will help you pay the bill.

You’re on the hook to spend a whole bunch of money whether you agree with spending that money or not and, frankly, with whether or not it’s the best strategy to achieve quality public health in your geographical area. You’re on the hook for the money, and there’s nothing in the bill that will guarantee that you will ever recoup part or all of those expenditures.

This is worrisome to health units, but it is especially worrisome to municipalities. Municipalities are partners once removed, yet they are on the hook for the payment. It doesn’t make for a very good relationship. A more trusting relationship would be to have the municipalities at the table and make sure they have a say as to how we will respond to this public health emergency or pandemic or whatever else is going on. But this is not it. The directive could be issued and the municipality would have to pay their fair share, and there’s nothing in the bill that addresses this. It’s always worrisome.

From the start we know there are people who have everything to lose and nothing to gain. This win-lose situation is never the right one. The win-win situation is what we should be aiming for, and the win-win situation is to make sure we get all the partners in public health at the local level to have a say.

Toronto Public Health talked about issues with the protection of personal liability for boards of health and medical officers of health who are following a directive from the chief medical officer of health. Local authority may have to act on a chief medical officer of health directive, but they have no protection for their action. You have to understand that not everyone who works in public at the local level health is an employee of public health. In the example of Toronto Public Health, some of their employees who do the work of public health, and who would be directed by a directive from the chief medical officer of health, are actually employees of the city of Toronto.

So, while the chief medical officer of health, through a directive, will direct public health workers to do certain things, we haven’t really settled the issue of protection and personal liability. You are no longer doing what your employer has asked you to do; you’re now answering to what a third person once removed has directed you to do, and nobody has figured out what would happen to the personal liability of those workers who, in all truthfulness, are not following the directive of their employer anymore. This is something that needs to be looked into. This is something that needs to be addressed and needs to be settled.

It is there in the bill that we can issue directives, but we leave this loose end out there. Thousands of workers who do public health work will now find themselves in this weird situation where they won’t be answering to their employer anymore—they will be answering to the chief medical officer of health—and we have no idea if their personal liability would cover them if, God forbid, something happens. And we all know that something will happen, because something always happens. Life is like this. Life goes on. Life happens.

It makes me uncomfortable to put forward pieces of legislation where we have loose ends like this and the minister won’t even acknowledge, “We will deal with this,” even were to say, “We will address this in regulation. We will make sure we consult. We have a task force in place that is looking into this.” But to simply leave it out there with no follow-up—it’s just something we have uncovered, and we won’t do anything until a worker gets in trouble. That would be a little bit too late for me.

I would like this bill to be tighter, to have fewer loose ends and have fewer words that have not been defined and could be interpreted in different ways. The government did nothing to address this problem.

The problem is that this bill is moving on an issue—that is, the issue of centralized control—which, now that we have both the Ministry of Health and Long-Term Care’s and Dr. King’s reports on H1N1, was certainly not a priority for either one of those reports. There are pressing issues. There are best practices that we have gotten from those reports. H1N1 was a big, big practice for public health units. I’m really proud to say that our public health units rose to the challenge and did a fantastic job. But they were also lucky that although the virus seemed to spread really easily, it was not as, I’d call it, virulent. It did not make people as sick as other viruses could.

So in a sense, we had a good opportunity to put our health units to the test at the max in a real-life situation, with a collective agreement that needed to be negotiated in Sudbury while all of this was going on. This was a real-life event, and we’ve learned an awful lot from it, for the good of everybody in Ontario. But nowhere in this learning does it say that having centralized power for the chief medical officer of health would have saved the day, would have made the long lineup go away, would have made the jumping of the queues better, would have made the private school that went ahead of everybody else better. None of this would have been changed by Bill 141.

The pressing issues were things like a lack of coordination between the local health integration networks, public health and primary care. That was a real issue. Who was responsible for what? Who was to do what, and when? The local health integration networks had not been there for that long. Their role in that particular instance was, let’s just say, not defined. Nobody knew exactly, and different local health integration networks responded in very different ways.

The same thing with primary care: Primary care had been the main delivery system for all the flu vaccines in the past. They were the one. Health units hold their clinics and everything, but the primary care sector had certainly played a huge role in delivering flu vaccine in the past, and for long periods of time during H1N1 they were held at bay. That was a pressing issue that needs to be looked at and needs to be defined, so that we can move forward with best practices.

There are no easy answers when it comes to issues of local control versus provincial coordination. If it was clear-cut for everybody that, “Had we had provincial coordination of power, things would have been way better; here’s how it would have changed everything; here’s how everybody in Ontario would have been happy with the H1N1 rollout,” then I would be the first one to say, “Please, let’s go ahead and move.” But nobody is saying this. We are saying that the balance between local control and provincial coordination is something that needs to be thought through carefully.

It’s something that needs to be defined carefully. It’s something that will forever change the way public health units work in Ontario.

I would say that Ontario is really privileged to have developed, over the years, a system of health units that have worked together, that have coordinated their efforts and that have always worked in this way that everybody had a say, everybody came to some kind of agreement and then rolled them out in the way that made the most sense in the geographical area that they serve. We’re changing this. The page is turned; we are changing this forever. But I’m not ready to say that we are changing this for the better. There could be areas where it would be for the better, but they’re not defined in the bill. So it’s worrisome.

In 2003, when Ontario was battling SARS and the SARS pandemic shook the confidence that Ontario had in its health care system—we learned from SARS. Things were supposed to change. Dozens of recommendations were issued to make things better. Yet seven years later—almost eight, actually—we are left asking many of the same questions: How could there have been such poor coordination? How come our health units fell short in some areas? And why was the communication plan such a disaster? Those are all questions that are valid.

Those are all practices that we can improve on and that I know we will improve on; we have learned. The willingness to change is there. But out of all of this that happened during H1N1, the minister comes out with Bill 141, focused on one thing: taking away local control in favour of central coordination. This falls way short of my expectation and this falls way short of what we could do to improve our health units.

I must say that following H1N1, Ontarians’ confidence in their public health system was shaken yet again. I will always remember the first weekend that the vaccine was available. The vaccination point was at the new Sudbury shopping mall. It was a horrifyingly bad-weather day in Sudbury. We had sleet and wind and snow and it was just awful out there. The roads were awful to get to the mall, and there was this long, long lineup outside the mall of pregnant women and families pushing strollers, waiting to get in to get their H1N1.

I remember looking at this—it is tattooed in my brain—and thinking, “We are failing those people. Those pregnant women and those young families with strollers should not be out in that sleet and wind and snow,” that we had that Saturday morning at the new Sudbury shopping mall, yet they were. We failed them. We have to do better; everybody agrees. We did improve, and we will continue to improve. But all of those issues that we’ve learned—none of them are addressed in Bill 141. Bill 141 has one narrow mandate: Take away public accountability, public control, in favour of centralization.

I think I have made my point.

I come from northeastern Ontario. I spent 25 years of my life in health care in northeastern Ontario, and I have seen the results of decisions that are made in Toronto, that are Torontocentric and that do not respect the reality of what it is to deliver health care and to deliver public health in northeastern Ontario, where the distances are different, where the temperature is different and where the diversity is different. We’ve had many a good laugh at provincial initiatives that would come to Nickel Belt. We would look at this and say, “My God, those people must be on Mars. This has nothing to do with good-quality care,” and we would all laugh.

We are setting up a system against the proven good-quality public health that we have, where we have this decentralized system in public health. We’ve had local controls for many, many years. We are now putting forward a bill that takes this away and that focuses on central control, and it is worrisome to me. It is not defined well enough in the bill and it leads to many loose ends.

Ça me fait plaisir de vous parler du projet de loi 141. Le projet de loi 141 est un projet de loi à portée assez limitée. Le projet de loi, en lui-même, sert à donner des pouvoirs supplémentaires à notre médecin hygiéniste pour pouvoir donner des directives à tous les services de santé publique de la province.

En Ontario, nous avons 36 services de santé publique qui couvrent toute la province. Peu importe où vous vous trouvez en Ontario, vous êtes toujours dans une des 36 régions géographiques des 36 services de santé publique. Les médecins hygiénistes qui sont en charge des services de santé publique sont là et ont une bonne relation avec la région géographique qu’ils desservent. Ils connaissent tous ceux qui offrent des services de soins primaires.

Si vous avez un frigidaire pour conserver des vaccins, vous pouvez être sûr que le service de santé publique vient vous visiter pour vérifier que votre frigidaire est en bon état et pour vérifier que vous conservez les vaccins. Ils ont une relation avec tous ceux qui offrent des soins primaires. Ils ont une relation avec pas mal tous ceux qui servent de la nourriture également, parce qu’ils vont vérifier que la nourriture est gardée dans les frigidaires à la bonne température, etc. Du côté de l’environnement, c’est la même chose.

Donc, on a cette richesse dans 36 services de santé publique en Ontario qui ont une relation directe et qui connaissent leur région en profondeur. Ils connaissent la diversité des régions qu’ils desservent. Ils connaissent la diversité des personnes qu’ils desservent. Ils connaissent leurs habitudes, ce qui fonctionne bien et ce qui ne fonctionne pas, et c’est une richesse qui a bien servi la province de l’Ontario pendant des années de temps.

Maintenant, on se base sur ce qui est arrivé avec la grippe H1N1 pour motiver des changements. Après la pandémie de H1N1, on a eu plusieurs rapports, des rapports qui nous ont démontré où on aurait pu mieux faire certaines choses. Aucun de ces rapports-là nous dit que les choses auraient été mieux ou qu’on aurait eu une meilleure qualité de soins si on avait eu la centralisation des pouvoirs par le médecin hygiéniste en chef. Il n’y a aucun rapport qui nous dit ça.

Par contre, on a un projet de loi qui, je dois dire, est sorti avant même que les rapports nous soient disponibles et qui nous dit que tout ce qu’on a appris de la pandémie de H1N1, c’est qu’on aurait besoin de concentrer les pouvoirs de notre médecin hygiéniste en chef pour qu’elle puisse donner des directives.

Maintenant, je dois dire que j’ai plein de confiance en la D re King. C’est une femme de confiance qui a beaucoup d’expérience, qui s’y connaît en santé publique et qui veut améliorer la qualité des soins en santé publique. Je fais confiance à son jugement, et dans le court terme, je n’ai aucun doute que les choses vont bien aller.

Le problème, c’est qu’un projet de loi va être là beaucoup plus longtemps que moi et vous, monsieur le Président. Le projet de loi va être là quand chacun de nous ne sera plus là; quand la D re King aura été remplacée par quelqu’un d’autre, le projet de loi va être encore là. Et là, tout ce que tu as, c’est des mots en noir sur blanc pour te dire quoi faire. Dans les mots en noir sur blanc, il y en a qui n’ont pas été définis; on les a laissés très larges.

« Un événement de santé publique » peut être n’importe quoi. Ça peut être mon service de santé publique qui nous offre une session sur comment arrêter de fumer. Ça, c’est un événement de santé publique; c’est un événement. Le service de santé publique nous invite—il invite les fumeurs, en tout cas—au service de santé publique. Ça, c’est un événement, mais pour moi, pourquoi est-ce qu’on ne prend pas le temps de définir dans notre projet de loi ce qui sera considéré un événement?

Même chose : il y a des travailleurs qui offrent des services de santé publique, mais qui ne travaillent pas pour le service de santé publique. Toronto est un exemple où il y a plusieurs travailleurs qui offrent des services de santé publique, mais qui travaillent pour la ville de Toronto. Ces travailleurs-là, qu’est-ce qui va arriver à leur assurance lorsqu’ils ne font plus le travail de leur employeur, mais commencent à faire du travail de notre médecin hygiéniste en chef? C’est dans la loi; c’est dans le projet de loi qu’ils devront faire ça, mais on ne définit pas comment on va s’assurer que ces travailleurs-là sont toujours couverts par leur police d’assurance.

Je vois que je n’ai plus grand temps.

Bill 141: In the short term, there’s no danger to it. I have full confidence in the judgment of Dr. King and I know that she will listen to the public health units and do, in the long run, what is best for the people of Ontario. But I am worried when a bill goes out with terms that are not defined and with loose ends that have not been tied.

The Deputy Speaker (Mr. Bruce Crozier): Questions and comments?

Mr. Phil McNeely: It’s a pleasure for me to speak to Bill 141 this morning. I just recall back to when the H1N1 epidemic was on; what I remember most was the inability to get the vaccine. The second thing was the long lineups of parents with their kids outside of a public building in the cold. So this is very pertinent to that.

I’d like to say that I read parts of the report of the Ontario chief medical officer of health. Dr. Arlene King is here today. Really, what we’re doing is much in line with what came out of that report. I’m sure that there was a lot of study of the epidemic here and in other jurisdictions. What came out of it was that basically, the chief medical officer of health must have the authority to direct public health units in real time. I think that, without doubt, is extremely important.

We have an opportunity now to use the lessons we have just learned to build on the spirit of collaboration that currently exists; to make changes that are necessary so that we will continue to be ready, no matter how grave the threat. To think that the member who has just spoken sees 36 separate public health units as the way to go on something so serious, where best practices have to be looked at, have to be adopted, and the plans have to be integrated and have to be right.

When we give that authority to the chief medical officer of health, that is the right thing to do. Those plans that will no doubt be made, or are made now, based on our last experience, that the medical chief medical officer of health has the authority to look at those public buildings—it would have been nice to have that all set up so that these families weren’t out in the cold for three or four hours waiting for the vaccine. That would be quite important.

All in all, I think this is a good bill. That’s what we should be supporting.

The Deputy Speaker (Mr. Bruce Crozier): Questions and comments?

Mr. John O’Toole: I did listen, as I usually do, to the member from Nickel Belt, who put forward a very strong position. She probably has very good reasons, with her experience in the health care field.

I’m very pleased to say that Dr. King is here this morning, which is important. In most bills that I’ve spoken on—I try to speak on every single bill—very seldom are the civil servants here. They’re probably watching from their plush offices somewhere.

Respectfully, I think it’s important, because this is important. This is about protecting public health.

Mr. Lou Rinaldi: That’s your office.

Mr. John O’Toole: My office is fairly plush too, but it’s not mine, actually. I’m just a temporary resident there.

But I would say that when you look at H1N1—I believe that a couple of the very first people identified, when they arrived from, I believe, Mexico or wherever they were coming from, were actually from Port Perry, in my riding. It was quite an interesting event. If I look back in the history—and I might even get a chance to speak on it this morning—it did cause some concern.

Then you get down to the whole argument of command and control. In many respects I think the report that Dr. King issued said very clearly that there’s a certain time where there’s almost a declaration of war, as she put it, where there would need to be a central Churchillian war room response to these pandemics. You can’t have 500 decision-makers and make very prompt and efficient decisions. That’s really the problem I have.

But you know, when I heard Dr. Low and those people who would be on television, I think it often—they urged the public to panic, almost. I’m not sure how effective—but the communication strategy itself needs to be coordinated as well to give proper information at the proper time and not raise the alarm before it’s appropriate. Otherwise—

The Deputy Speaker (Mr. Bruce Crozier): Thank you. Questions and comments?

Mrs. Maria Van Bommel: I am also very pleased to be able to speak to the comments that were made by the member for Nickel Belt. I want to first of all say thank you very much to Dr. Arlene King for being here. It gives me an opportunity to personally say thank you for the work that you have done on the health impacts of wind turbines. It has been very important for me to follow all of this along.

When I hear the member from Nickel Belt talk about the concerns she has around the centralization of all of this, I’m going to speak to this from a slightly different perspective, and that is from the perspective of the farmers. When I see things such as H1N1, which is also transferred to animals and to birds, we have a situation there where our commodity groups are working very hard to make sure that we isolate those situations, and the commodity groups are doing their part to make sure that we do that and make sure that it doesn’t spread.

But we also need the ability, as farmers and those commodity groups, to have the opportunity to make contact with one central point. That is how we can manage to contain this, not only in our own particular farms, but in order to protect the public health. For a farmer to have to concern himself about where he’s going to make that contact, who he’s going to talk to—is that the local level? Does he talk to his commodity group first? And that is actually what we’re told to do as farmers; we’re told to contact our commodity group. Our commodity group will then ensure that everything is taken care of.

The commodity organizations then need to be able to make contact with that one point, and I believe that we need to do that through the chief medical officer of health for the province—not the local one, but for the province—because it’s something that can easily spread. Those are the situations where I see that centralization is critical to ensuring that we protect public health.

The Deputy Speaker (Mr. Bruce Crozier): Member for Nickel Belt, you have up to two minutes to respond.

M me France Gélinas: I would like to thank the member from Ottawa–Orléans. Certainly I agree with him that the spirit of collaboration that exists in our public health system is something to be cherished and something that has served us well. I recognize that we have to be ready for a pandemic, and like what he remembered—I guess they had bad weather out his way, same as we had out our way, when the flu vaccination centres were open.

I don’t want to lose sight that there are best practices that have been recommended. If you look at the medical officer of health’s recommendations, she makes recommendations regarding the roles and responsibilities of different agencies, including the LHINs. She makes recommendations about the designation of flu assessment centres and the need for a real-time surveillance system. I don’t want Bill 141 to be our only response to H1N1. We’ve learned way more than this.

I thank the member from Durham and the member from Lambton–Kent–Middlesex. Certainly the farming analogy still works, because animals get sick just as much as humans do and public health could extend beyond humans into birds and farm animals.

I’m not against having clear lines of communication. This is also one of the recommendations that Dr. King does in her report: having a clear line of communication. Where you draw the line is this local-control-versus directive. To me, those would only happen when they are at odds, and it should happen very, very rarely because locally, people should realize that it’s better for them to—

The Deputy Speaker (Mr. Bruce Crozier): Thank you. Further debate?

Mr. John O’Toole: Briefly, because this is such an important topic and perhaps there are a few things that haven’t been said—or at least said twice, because there has been more said than has actually been done. I just wanted to put a few things on the record. I did speak on this in second reading, so I’m not unfamiliar.

I want to give credit to, certainly, our critic Christine Elliott, the member from Whitby–Oshawa. She has been most thoughtful in her observations and her recommendations to caucus position on this. It’s my understanding that we’d be supporting the bill. Nothing is perfect, I suppose. I guess there were some amendments that had been moved.

But I also look at it from a personal perspective. I would guess, as I said in my response to the member from Nickel Belt, that the first four people who were identified with H1N1 on April 28, 2009, originated in Durham region. In that respect, Durham region saw 92 hospitalized due to the seasonal flu in 2009-10, nearly three quarters of those attributed to H1N1. The number of infections was so large: A number of at least 292, these being only those cases that were confirmed in the laboratory. At least five of these people did not survive their illness. I guess that’s a kind way of saying they died.

This illness did not affect the usual numbers. In fact, this strain was especially aggressive amongst younger-aged cohorts, and this is one of the surprises that I found. Normally, they always talk about vulnerable groups. This is kind of what I said earlier, too, that often it’s the frail elderly who are most affected and, most obviously, treated. Then it comes down to prioritizing those people who receive the vaccination, or whatever the treatment modality is.

This is why I kind of think that—I’m not second-guessing. I do support, sort of, the recommendation, and I want to quote this, because in the report, How Ontario Fared, by Dr. King, I think she makes quite a good argument. The way Christine Elliott has summarized it for us, she recommended that we need to “extend our chain of command to the local level,” i.e., Durham or Halton or other parts of southwestern Ontario—all of Ontario. There are 36 different public health authorities. They’re not aligned totally municipally, so there are some overlapping jurisdictions.

“The system as it is presently constructed does many things well in what I will refer to as ‘peace time.’” That’s the point I think the member from Nickel Belt is making, that autonomy in the local health authorities is a long-standing discussion: How well they’re funded or not; how many of them actually have a doctor, a medical officer of health. Many of them don’t. I don’t know what the status is at the present time, but it’s always a problem with getting doctors to fill those positions in remote or hard-to-service areas.

But it goes on here to say, “In ‘war time’”—this is where I think of the war room in the Second World War in London—“however, when people are getting sick and people are getting scared, the health system needs to accommodate the kind of strong central oversight and management that currently doesn’t exist. The chief medical officer of health must have the authority to direct public health units”—the word “direct” is very instructive—“in real time as he or she sees fit.” Well, there will probably be a panel of people.

If I look back prior to that: When we were government, at that time, I had the privilege of being parliamentary assistant in health for Tony Clement and, for some time Elizabeth Witmer, and saw just how complex the organization really is. It’s amazing. It’s half the budget, but it’s a huge organization with lots of pressures.

I guess that’s the whole point. I don’t think any one person, as I saw it—I remember listening and watching CNN and all the various media outlets. It was absolutely—some of these news outlets actually feed on events, or tragedies really, and exacerbate the command and control model. That’s what I’m saying. Now, when you’ve got all the social networking interactions alarming—and raising up, even, some of these young children who are singing a song and all of a sudden there are five million hits. This is a significant communications challenge; we’ll just leave it at that.

I worked in systems for about 15 years, I guess, or 13 years, and I see this as being the large issue. It ties primarily into how well and how well informed—and the World Health Organization, I thought, was completely over the top, and I’m not qualified. When they came on from the United Nations, they were just inflammatory. People who were getting sick were becoming sick because they were frightened, and they had what I call resonance. They felt sick.

When I talk, I don’t want to be an alarmist here; I just feel that given today’s—what’s missing? This is not hypercritical, because I sat for a short length of time on the first version, under Premier Mike Harris: the Smart Systems for Health board. I was there. I’m a systems guy; I know. In fact, I was quite surprised how much of it was kind of modularized back then.

I reported back to the minister—I think Tony Clement was the minister at the time—and I said, “Jeez, how are they going to glue this thing together?” Because there are really nine modules: there’s long-term care; the OLIS, the Ontario lab information—there are several different modules that feed in, and who can see what information, when and where? It’s a layered-access security, because when you log in with a health card, they shouldn’t know that you’ve been on mental health medication or lifestyle medication. Who can see what, when? Can the anaesthesiologist see?

They only need to know certain information for giving you a needle to put you to sleep. The general surgeon on orthopaedics might need to know your bone density, but who needs to see what? It’s a very important, fundamental question to this whole issue. And who puts that information in? Who interprets it?

Why is eHealth not working? Nobody can read a doctor’s handwriting. Honest to God, when they transcribe those patient records, good luck to you. “Will,” “may,” “shall,” “must”—all these key operative words become very instructive to what the next procedural medical personnel would do.

Now, eHealth is still not working. In fact, here is the real issue on this: This is the question that Christine Elliott mentioned yesterday. It makes eminently important sense. Yes, we must be able to know who’s been treated. They must be able to identify homogenous groups that should receive it. It could be a cultural kind of thing; it could be a whole bunch of things. You need to manage the data, for sure. If you’ve got all these health records, and you can almost tell where they live and all the rest of it, and these age groups, young, old, whatever, and people with native backgrounds or whatever it is that you might want to be treating, it’s very important to manage it properly.

Giving it to everyone? Some people may have risks with it. They may find there are other things. So there is a management component to it.

I want to spend a bit of time on the whole eHealth thing, in a way. There’s already one in operation. It’s the children’s health information. What the hell is going on here? Why aren’t we using it? It’s already in place. Dr. King, give me the nod. Well, it’s true. It is in place.

There’s also the whole—I forget, but there is a pan-Canadian system in place, too. Canada Health Infoway, I think it’s called. If I happen to be on vacation and I’m in Nova Scotia, where my son-in-law’s family is—and they’re good friends of ours—and there’s this alert, I want to be told that I’m one of those exposed. It should be pan-Canadian. It’s hideous. Developing a system that isn’t pan-Canadian is completely unproductive. What about the visitors here? I find that the design has to be national. In fact, there is a federal—it’s the Panorama system.

I know nothing about this in technical detail but I know how systems work and I can tell you that this is a case to make where, if you want command and control, it’s not just Ontario.

You’ve got the health quality council federally. They can’t make it work on anything: on what drugs are available to who or to what age group. So it’s not a system that glues together as easily as people think.

I commend Ontario for this report. I believe that, like anything, it’s a first step. It’s not going to solve all the problems; it’s going to give some authority to do things. Responding to public health emergencies is important. I think we all agree with that. If you look at the history of this topic we’re talking about—in my brief review here, it says that there have been three pandemics in the last century, with the most severe being in 1918-19—there weren’t many systems around then; they had smoke signals, I think—the Spanish flu, where 20 million to 40 million deaths occurred worldwide.

Many experts believe that a pandemic is certain to happen. The question is when, and it’s not known when.

It becomes critical that all of these health experts—I think it must be very difficult now to be a doctor. I was at a lecture at the University of Toronto on nanotechnology and how they’re going to treat things differently in the future using nanotechnology to get the medications to the actual organs or part of the body where it’s really needed, as opposed to radiation, which goes through all the organs. If I look in the future, I think there will be new solutions that certainly weren’t available then.

This

article goes on that the World Health Organization and other international agencies, including Health Canada, “have recommended the development of pandemic plans to help reduce the impact of the next pandemic on the world’s population.”

If I can legitimize the argument of Ontario having control, I have no problem with that. I could also use the same arguments to legitimize having a pan-Canadian response and have no problem, because I’ve already suggested that I’d support that in certain conditions, which the civil servants can figure out. But I could also say, “I guess the United Nations are going to run the whole show.” I don’t think so. So where did that break down—or “those darned Americans. Or some pharmaceutical company trying to make millions of dollars out of this.” So you’ve get into the whole idea of cultural trust and respect.

When I’ve got the UN telling me something, I get very afraid. I’m not sure they know what’s going on in Libya. They have an idea of what they want to go on.

When I think I’m off topic here, I say that the command and control—

The Deputy Speaker (Mr. Bruce Crozier): It would be nice to come back to it, yes.

Mr. John O’Toole: Yes, I am getting back eventually. I like to roam around this landscape because there are so many important and interesting things.

I’m going to agree that the final result here is to say that Ontario needs to have a plan. The biggest single thing is to have well-qualified people in those positions of decision-making, and it’s a team; it’s never one person. Nobody knows everything about anything. Einstein died, and it’s unfortunate, but he didn’t know everything about everything either.

I think we need to have panels of people, panels of experts, and we need a stronger communication strategy during these pandemics so that the public are engaged and informed. It’s better, in this public safety thing, to give everybody a paintbrush. Then you say, “Doesn’t that dilute the legitimacy of it? They’re saying it’s impossible.” I don’t think they know who is until it’s all done—“Oh, gee, you know what happens? All kids five and under already had enough natural immunity to whatever, or didn’t have any or whatever.”

Then there’s the adjuvanted version of the vaccine. What is all that about? Too much information—it’s a very difficult job; I’m not being critical. Thank God you’re the doctor, is all I can say.

It is a fascinating topic from the point of view of purely management; managing the communication, managing and regulating the distribution and managing who knows what about what. Because these things are invasive, and there’s no real response to it. They start to develop these vaccines or whatever in a lab that says, “I think we have the solution.” I remember them talking; I think it was, “We’re trying to develop the vaccine.” You know, it’s tough. I really don’t know, but you have to have some confidence that there are organizations, like Dr. King’s organization, that can manage these things in difficult times.

That probably, to a civilized society, is very reassuring to be able to say, “I have a lot of respect for that function being well performed.”

I would hope that these things do move forward in a fashion where there is a system tying the lab information, the testing information and the actual science together. This is sorely needed, absolutely critically needed. In fact, when you start to model health outcomes without systems, it’s just somebody’s guess, really, and there’s random data that is used to do these forecasts. I would think we’d have to talk to Dr. Cavoukian, the privacy commissioner, to find out if she has any aversions to who knows what about who.

Because that becomes the bottom line: the privacy issue and the personal right to be informed—and how they’re informed. Is it informed consent? Is it implied consent? What kind of consent is it? Because you live here you’re going to get it?

I don’t like medication myself. I don’t take any of this stuff. I don’t take any of it because I feel my own immunity system has allowed me to arrive at 68 and still function reasonably effectively. Some people have no immune system and they need it; they need all this stuff every day. In fact, they have no immunity systems because they’ve all been sort of overcome by having replacements injected into their body. Those are my own opinions, and those are totally off topic.

I guess my point being is, when it did affect Durham, it affected me because I have the responsibility and the privilege to represent the area, and I hope to do it effectively for another five or 10 years at least. I would only say that—I was reading some of the stuff that was prepared here. This whole chain of events—when I look at the people involved, they were some of the most respected health people who were doing the very best they could do under an emerging emergency situation.

It’s almost like looking at what is going on in Japan. Japan has probably some of the most focused, productive people—it’s sort of a generalization here—but they haven’t got the foggiest idea of what is going on in those poor nuclear reactors. They have some idea, and they say they’re going to put sawdust in there to make the—I mean, even the brightest and the best have difficulty.

But when I think of Dr. Margaret Chan, who is the World Health Organization director and—in my own region, when I was a regional councillor in Durham, Dr. Robert Kyle was a very, very pleasant man to work with. He always had people’s interests first. He was very professional without being overarching, opinionated. He always brought very well-informed reports to council and let council make those decisions—and, of course, Dr. Arlene King as well. I believe these people need the tools, and it’s up to the government, and in our case now, Premier McGuinty’s government.

I hope this bill doesn’t get lost in the election, you know, because we need its third reading. We need it to get in. I guess there is a whole regulatory framework to it here. That is how bills are constructed nowadays; there is a kind of a framework, and then they hang onto it a bunch of modules called regulatory opportunities to bring it into effect. There’s not too much that I found in this very small bill that was glaring in any way. I would only say that in the

preamble

section I guess is the point that would have to be reasoned out with the member from Nickel Belt. I think her point was very good about when and where and why these pandemic or overarching command-and-control procedures would be put in place.

The other

part is, what happened to the $1 billion in eHealth? I want the eHealth system delivered. I want a date it’s going to be delivered, and let’s get it operational. Let’s say right now that OLIS, the lab system, works already; the pharmacists already use it in their own system. So in that case, let’s get going with eHealth. What’s causing all the trouble? In fact, they’re paying Sarah Kramer, I see in the disclosure, $100,000. She’s still getting paid. What’s that all about?

The Deputy Speaker (Mr. Bruce Crozier): Questions and comments?

M me France Gélinas: Sorry; I wasn’t sure if it was my turn or not.

The member for Durham makes for interesting listening, to say the least. Sometimes we are not sure exactly if we’re still on Bill 141, but nevertheless it is interesting. One piece of what he’s talking about—the need for electronic health records—is certainly something that the critic had talked about and something that is addressed in the report from the lessons we’ve learned in the pandemic: The fact that we had no opportunity to share in real time what was happening on the ground was truly, truly worrisome.

It would have made things a whole lot easier had we known how many vaccines had been rolled out, to whom and where, and to be able to report back on that. I think that would have gone a long way to alleviating fears that the distribution system was inequitable. Because when you don’t have the right information, then anybody’s best guess is just as good as the next one. The need for an electronic health record that allows the right providers to have the right set of information to be able to do their jobs is something that we should all work for.

It is mentioned in the report that came after H1N1, but it is certainly nowhere near Bill 141. Bill 141 has this narrow focus on local control versus central coordination, and it doesn’t address some of the serious issues that we’ve learned with H1N1.

The Deputy Speaker (Mr. Bruce Crozier): Questions and comments?

Mr. Khalil Ramal: I listened to the member from Durham for quite some time. He spoke about many different things, and I get the sense he’s supporting this bill. Even though he travelled to many different topics, he came back and went off and back. Anyway, I think the most important thing is, from what I sense, he is going to support the bill and his party can support the bill.

This is a great, important bill for all of us across the province of Ontario to coordinate all the medical health units across the province if a pandemic or a natural disaster or a provincial or national or international issue happened in the province. It would be very important to have all the medical units respond in the same way, with the same method.

The third party—I listened to the member from Nickel Belt talking about many different things, and I think she is not supporting the bill, for different reasons. One of the reasons is, she thinks the chief medical officer of health would have all the power and would ignore regional and local input. But I don’t think so. This would give flexibility to the chief medical officer to choose and alter, and to accommodate all the people across Ontario, to make sure the medical health units perform in the best way in order to protect our population in Ontario.

I think it’s a great bill, and I hope the third party will change their minds, because in the end it’s the aim of the bill to coordinate all the efforts, to create a way to look after the people of the province of Ontario in a professional manner in order to protect them and to be able to respond quickly, fast, in the right time. It’s important. In the past, we witnessed so many different chaotic situations: Every unit, every place responded differently. So that’s why the aim for Bill 141 is to coordinate those efforts.

The Deputy Speaker (Mr. Bruce Crozier): Questions and comments?

Mrs. Julia Munro: I’m pleased to be able to offer a couple of comments in the time available on the remarks made by my colleague from Durham. I think there are a couple of things that we need to focus on in the remarks he made.

Obviously, a pandemic is something that is very serious, generally life-threatening and highly contagious. If you put it in that kind of a context, then a response has to be unified, coordinated and timely. It seems to me that that’s the essence of the bill that we’re discussing here.

The issues that we’re concerned about are, of course, the question of the leadership between the province as a whole and individual areas across the province. It seems to me that everyone agrees that there has to be one person at the top, one person who has to have that ability to provide overall direction.

Many members have identified certain circumstances where their experience differs from that which has been centrally envisioned. I think the important thing here is to see that central voice as one that is interested in outcomes and responsible for providing appropriate resources, not micromanaging.

Finally, I’d like to draw attention to a point I don’t think has been emphasized enough, and that is the important role of the media. When I think back to the H1N1 pandemic, I think the media was caught between the sense of urgency that they had and making it into a media circus. I think they created a lot of angst within the community at large by constantly showing long lineups and focusing on that. People who weren’t even in the areas of prime concern were busily lining up because there had been so much pressure put on them. I think we have to—

The Deputy Speaker (Mr. Bruce Crozier): Thank you. Questions and comments?

Mr. Phil McNeely: I appreciate this opportunity to respond to the member from Durham on the small amount of time that was referenced to Bill 141.

But I’d just like to correct the record on eHealth: There are five million Ontarians with electronic health records now. All hospital imaging now is electronic: MRIs, X-rays, etc. It can be shared with and diagnosed by physicians no matter where they are in Ontario, so we can get the best treatment for people. That is coming along very well. It started in 2002, and I think that 2015 was always the original date for completion. It’s on track; it’s going to help, and will certainly help with pandemics.

I’d like to address issues that are more relevant to what has been said by the third party. We’re broadening

section 95.1 of the HPPA, the Health Protection and Promotion Act, to cover municipally employed public health workers; so the issues raised there are looked after.

The whole issue of centralized command: That kind of terminology is not proper terminology here. The public space aspect still bothers me. Right beside the lineup of people outside waiting to get into 255 Centrum, which was the old town hall in Cumberland, was a public building, yet it wasn’t being used. Those plans are all going to be made now. Those mistakes aren’t going to be made, and the authority is at the right place to make sure that we’re prepared for the next pandemic that’s going to come, that we’re ready and that we have a good plan.

Having the chief medical officer of health looking after that: I feel very confident in Ontario.

The Deputy Speaker (Mr. Bruce Crozier): The member for Durham, you have up to two minutes to respond.

Mr. John O’Toole: I’d like to thank the member from London–Fanshawe; the member from Nickel Belt, who has participated in this very thoroughly; the member from York–Simcoe—I believe the idea of context and media are very important observations; and the member from Ottawa–Orléans: Thank you for bringing us up to date on the status of eHealth; it’s important.

I’m kind of disappointed that Dr. Helena Jaczek, who’s here this morning, wasn’t able to respond to this, because she was a medical officer of health and, I think, probably should still be a medical officer of health. She’d have a more demanding role in life.

I also want to thank Dr. Robert Kyle. This is the report that I got most of my information from, so I want to give him full credit as a footnote here.

I believe that moving forward on this bill would be the appropriate thing. As I said, even in my review of remarks, I want to make sure that I make it clear that Dr. King did say she suggests that the province make full use of Panorama, a program developed to track and manage immunization jurisdictions across Canada. That commitment there shows that she has a sense of duty to the national response to pandemics.

I think that really, Bill 141 should have that put in there: to try and develop a national plan. Not just Panorama, but the whole eHealth system should be. I should know that if I happen to move, that I’m possibly allergic to something or whatever else that system—because I’ll tell you; that is the future. Can you imagine modelling human health by age and subsets of all that? There are some real, valuable efficiencies in health care that aren’t being made use of. I’ve never understood why, but again, this bill may help that develop.

I think the debate is over now, and I will have a coffee in another minute or two.

Third reading debate deemed adjourned.

The Deputy Speaker (Mr. Bruce Crozier): Thank you to all. Pursuant to standing order 8, this House will recess until 10:30 of the clock.

The House recessed from 1016 to 1030.

INTRODUCTION OF VISITORS

Mr. Khalil Ramal: I’d like to welcome John Winston from Tourism London, who’s here in the west gallery. Welcome, sir.

Mr. Peter Shurman: In the west members’ gallery, I’d like to introduce two constituents: Mr. Hanif Ebrahim and Mrs. Samina Ebrahim, who are the parents of our page Fatemah Ebrahim.

Mr. Yasir Naqvi: I’ve got quite a few guests here today, so bear with me.

With us here today is Nancy Kirby, who is the president of the Ontario Catholic School Trustees’ Association. Welcome, Nancy.

Gord Butler, the chair of the Ottawa Catholic School Board, is with the Catholic schools’ delegation today.

Also I’ve got quite a few student leaders who are visiting Queen’s Park for some meetings. For the Canadian Federation of Students, we have Sandy Hudson and Nora Loreto; for the Ontario undergraduate students’ association, we have Meaghan Coker, Alexi White and Sam Andrey; and for the College Student Alliance, we have Heather Brekelmans, Tamara Popovic and Jim Robeson. Welcome, all, to Queen’s Park.

Hon. Michael Chan: Today is Tourism Industry Association of Ontario Tourism Day at Queen’s Park, and I want to welcome the members and also my ministry’s partners: Beth Potter, Emily Harper-Hawkins, Tim West, Gary Masters, Phil Casey, Troy Young, Don Braden, Bruce Gravel, John Winston, Gerry Ginsberg, Tony Elenis, Grace Sammut and William Swan. Welcome to Queen’s Park.

Mr. Gerry Martiniuk: I’d like to introduce my niece Kristianna Martiniuk-Kingdom and her children Morgan, Bradley, Avery and Blair.

The Speaker (Hon. Steve Peters): Further introductions?

I’d like to take this opportunity to welcome to the Speaker’s gallery today my brother Joe Peters and my nephew Nicholas Peters.

ORAL QUESTIONS

EXECUTIVE COMPENSATION

Mr. Tim Hudak: My question is to the Minister of Health. Minister, in October 2009—

Interjection: There’s Norm.

The Speaker (Hon. Steve Peters): Please continue.

Mr. Tim Hudak: Minister, in October 2009, a committee of the Legislature grilled then-Deputy Minister of Health Ron Sapsford over his role in the billion-dollar eHealth boondoggle. According to media reports, on November 13, 2009, just a few weeks later, Sapsford suddenly quit as your deputy minister. Yet, Minister, strangely, the sunshine list of bureaucrats paid over six figures shows that you handed Sapsford three quarters of a million dollars in 2010, despite the fact that they say he quit in 2009. A simple question, Minister: Did Mr. Sapsford actually leave employment with the government of Ontario?

Hon. Deborah Matthews: I understand that the Leader of the Opposition is concerned. I have to tell you that I am concerned, too. I think that all of us want every penny possible going to improve front-line health care. That is what I think the people of Ontario expect of us.

The question is, how are we improving health care? I do want to take a moment and talk about some of the successes related to eHealth. I’m going to give you one example of a telemedicine success story. The diagnostic imaging department at Weeneebayko General Hospital, in Moose Factory, is a great example how eHealth’s success is leading to better patient care. This department is connected with the Timmins and District Hospital—

The Speaker (Hon. Steve Peters): Thank you. Supplementary?

Mr. Tim Hudak: Minister, with all due respect, that wasn’t even close to addressing a legitimate question from the Ontario PCs and the people of Ontario. We appreciate the minister’s concern, but families want to see answers, and they want to see action. I asked you a very simple question: Did Mr. Sapsford actually quit government, or did he continue to be employed by the province in 2010?

Six days have passed since the sunshine list came out. For six days, you continued to dodge, to duck, to weave—straight answers to straight questions. We find out in 2010 that Mr. Sapsford’s salary went from $500,000 in 2009 to $762,000 after he allegedly quit.

Minister, why did the McGuinty government give Ron Sapsford a raise in 2010 after he quit?

Hon. Deborah Matthews: What I think the people of Ontario want to know is, is health care getting better? Are we getting value for money?

I can tell you that the women along the James Bay coast would say, yes, they are, because the department at Weeneebayko is connected with Timmins general hospital via a dedicated T1 line. It gives people in the region access to imaging specialists in Timmins 24 hours a day, seven days a week, in many cases preventing the need for them to be transported. Weeneebayko was the first hospital in North America to use this connectivity directly as a result of investments in eHealth, the first hospital to use it for a telemammography program, where mammograms done in one hospital can be read in another.

This is just one of many examples—

The Speaker (Hon. Steve Peters): Thank you. Final supplementary.

Mr. Tim Hudak: Well, with all due respect, Minister, Ontario families simply want to know why they continue to pay for the eHealth boondoggle now, two years later. You gave Mr. Sapsford a raise in 2010. You refused to answer any basic questions about when he actually left government and why he was continued to be paid in 2010.

If anything, Minister, you’ve led the media and members to believe it was a severance payment. But yesterday, a Ministry of Finance spokesperson confirmed that severance payments are not reported on the sunshine list. This clearly is not severance; it’s something else altogether.

I’ll ask the minister again: What exactly was the three quarters of a million dollars that you handed Sapsford for? Secondly, did he actually get severance on top of all that?

Hon. Deborah Matthews: The member opposite knows that I have answered the questions to the extent that I am permitted to do so under legislation.

But since the member opposite seems interested in knowing how eHealth is going, I’m more than happy to share another success story. Digital diagnostics: Every hospital in this province has now gone filmless. That means they’re using digital diagnostic scans; whether it is a CT, an ultrasound, an MRI or a mammogram, it’s all digital.

Then under the diagnostic imaging/picture archiving and communications system, DI/PACS, a program led by eHealth Ontario, diagnostic imaging is connected to all other hospitals. What that means is that diagnostic imaging can happen in one hospital, in Owen Sound, for—

The Speaker (Hon. Steve Peters): Thank you. New question.

EXECUTIVE COMPENSATION

Mr. Tim Hudak: Back to the Minister of Health: Minister, you’re not even making an attempt to answer these straightforward questions on behalf of families. It’s actually breathtaking, the level at which you’re trying to avoid simple, straightforward questions.

Let me try a different tack. It’s not only the mysterious salary and raise that you gave to the deputy minister implicated in the eHealth scandal, but it goes beyond that.

Let me tell you about Angela Tibando. Angela was a consultant at the Liberal-friendly Courtyard Group. After a scathing auditor’s report and grilling here in the Legislature because of Courtyard’s friendly relationship with the Ontario Liberal Party and the sweetheart deals, the Liberal-friendly Courtyard Group was forced to close its door, but Tibando found new life as a bureaucrat at none other than eHealth Ontario, making $134,000 a year—

The Speaker (Hon. Steve Peters): Thank you. Minister?

Hon. Deborah Matthews: It is becoming increasingly apparent to me, through this line of questioning and other comments, that the party opposite opposes initiatives when it comes to eHealth. I think this is a big step backwards, and I’m—

Interjections.

The Speaker (Hon. Steve Peters): I’d remind honourable members that your leader just asked a question. It is important for him to be able to listen to the Minister of Health, and you’re not helping with your interjections.

Minister?

Hon. Deborah Matthews: Make no mistake about it; if we want to have a universal health care system that is here not just for us and our generation but for our children and our children’s children, we must embrace electronic health records. That is why we are determined to keep moving forward, despite the ongoing opposition of the party opposite.

When we took office, only a handful of physicians had electronic medical records. Now, five million Ontarians are seen by doctors—

The Speaker (Hon. Steve Peters): Thank you. Supplementary?

Mr. Tim Hudak: Ontario families are rightly concerned about the incestuous relationship between the eHealth figures and the McGuinty government. You’ve made some sort of secret backroom deal with the Deputy Minister of Health implicated in the eHealth boondoggle, Mr. Sapsford. You refuse to answer questions about that.

We find out that Angela Tibando, a former Courtyard consultant, has now found a happy home at eHealth, the very place where Courtyard received millions and millions of dollars in sweetheart deals, and it goes beyond that. Another member of the Liberal-friendly Courtyard Group by the name of Ian Fish, a former Courtyard consultant, is now another eHealth bureaucrat, making more than $100,000 a year.

What’s with this incestuous relationship between Liberal-friendly Courtyard Group and the McGuinty government?

Hon. Deborah Matthews: What’s important to me, and what I think is important to the people of Ontario, is that we’re getting results when it comes to eHealth, and we are getting those results.

Let me share yet another eHealth success story. I was very pleased to be at St. Joseph’s hospital in Toronto just recently to celebrate the 100th and final hospital to connect with the emergency neuro trauma—

Interjection.

The Speaker (Hon. Steve Peters): The member from Renfrew will please come to order.

Minister?

Hon. Deborah Matthews: The ENITS program is designed for people with neurological trauma, so an accident, perhaps a stroke. Thanks to the good work of the people at eHealth Ontario, we now have every acute care hospital in this province hooked up, so that 24 hours a day, seven days a week, there is a neurosurgeon who can read that—

The Speaker (Hon. Steve Peters): Thank you. Final supplementary.

Mr. Tim Hudak: You’re getting results all right. It’s too bad it’s for the wrong people.

What we’re seeing here are consultants from the disgraced Courtyard Group, which had to close its doors, now getting a very soft landing on the public payroll. We think that’s wrong, and it doesn’t end there.

Karli Farrow, your former health policy adviser and architect of the Liberal health care platform, did a turn as a Courtyard consultant. While at Courtyard, Ms. Farrow was billing over $10,000 for less than a week of work as part of the eHealth boondoggle. But once again after Courtyard closed its doors in disgrace, Karli Farrow was handed a lifeline. She’s now a health bureaucrat at Trillium Health Centre, making over $150,000 a year.

Why is it that the only Ontario family you care about—

The Speaker (Hon. Steve Peters): Thank you. Minister?

Hon. Deborah Matthews: Quite to the contrary: On our side we are determined to continue to improve health care. Unlike the party opposite, we are committed to spending more when it comes to health care year over year. Their approach is to turn the clock back, to go back to the days before the computer. We are determined to keep using technology to provide better health care.

Let me share a quote from Dr. Ron Charach: “Let’s hope the endless buzzing around the cost of the ambitious eHealth initiative doesn’t end up sidelining the project. There are far greater costs to the public of not having centralized medical data, in terms of tests being frequently re-ordered, and specialists asking questions for which patients have no answers.”

We are determined to continue to make progress when it comes to eHealth.

EXECUTIVE COMPENSATION

Ms. Andrea Horwath: My question is to the Premier. For two days, this Premier has stonewalled on the compensation pay to Ron Sapsford. I’m hoping today is the day that we get some clarity on this issue.

Mr. Sapsford quit his Ministry of Health position in late 2009. Will the Premier finally explain to Ontarians why Mr. Sapsford still received $762,000 in wages and benefits in 2010?

Hon. Dalton McGuinty: To the Minister of Health.

Hon. Deborah Matthews: The member opposite does know that I answered the question yesterday to the extent that I am able to under FIPPA. We had that conversation yesterday.

Section 42 of FIPPA limits what I can say about personnel issues.

But let me tell you, we are absolutely committed to getting better value for health care dollars to improve health care for the people of Ontario. Our record speaks for itself—

Interjections.

The Speaker (Hon. Steve Peters): I would just say to the members of Her Majesty’s loyal opposition that during the rotation of questions, you have two opportunities to ask questions and the third party has an opportunity to ask questions. I would appreciate it if you would give some consideration to the leader of the third party as she asks her questions and requires to be able to listen to the answers to those questions, and not interject on behalf of the third party.

Minister?

Hon. Deborah Matthews: We are getting results for the people of Ontario. That is what matters for me.

When it comes to access to primary care, the fundamental health care request of the people of Ontario, we’ve made tremendous progress. Over a million—1.2 million—more Ontarians have access to primary care than when we took office. That’s 94% of Ontarians. We know where the other 6% are—

The Speaker (Hon. Steve Peters): Thank you. Supplementary?

Ms. Andrea Horwath: Let’s face it: What we are talking about here is the mother of all golden handshakes, yet this government refuses to reveal the details. Here is one detail they’d probably prefer not to tell Ontarians: In 2009, an order in council lists the maximum annual base salary for a deputy minister, like Mr. Sapsford, as $220,000. Even with allowable incentives, this would add up to about $266,000. Why did Mr. Sapsford pocket half a million dollars more than he should have according to the government’s own rules?

Hon. Deborah Matthews: I want to make this very clear—

Interjections.

The Speaker (Hon. Steve Peters): Minister?

Hon. Deborah Matthews: On this side of the House, we are determined to continue getting better and better value for our health care dollars. We have taken steps to demonstrate that commitment. One of the elements in the most recent budget was that hospital executive expenditures are required to be reduced by 10% over the next two years. Every penny of those savings will go into front-line care. We are determined to continue getting better value.

One of the ways that we’re getting better value for taxpayer dollars when it comes to health care is moving people from very expensive hospital care into care in the community. We are determined to continue—

The Speaker (Hon. Steve Peters): Thank you. Final supplementary.

Ms. Andrea Horwath: Ontarians who have contacted my office are livid about the Sapsford affair, as well they should be. We have someone who quit his job amidst a cloud of controversy, who then received half a million dollars more than he should have, according to the government’s own rules. Clearly, there’s something rotten here.

When will the Minister of Health and the Premier of this province come clean on the details? Or will they continue to show complete contempt for the people of this province?

Hon. Deborah Matthews: What is important to the people of Ontario is that we continue getting better results. Our aging at home strategy is just one example of how we are getting better results and better value for taxpayer dollars: a $1.1-billion strategy designed to help people stay in their home as long as possible, to come home from the hospital and stay at home rather than moving into long-term care. These are the innovations in health care that I think the people of Ontario are very interested in.

TAXATION

Ms. Andrea Horwath: My question is to the Premier. In this morning’s Globe and Mail, an independent analysis of Statistics Canada data proves beyond a doubt what New Democrats have been saying all along: Corporate tax cuts don’t create jobs, period.

When the Premier read the front page of the Globe and Mail this morning, did he stop for even one minute to ask himself what $4 billion could have meant in relief to Ontario families struggling to pay the bills?

Hon. Dalton McGuinty: I’m pleased to receive the question. As I’ve said a number of times before, everybody is entitled to their own opinions but not their own facts. Here are the facts.

So far, we’ve recovered 91% of the jobs lost during the recession. My colleagues opposite take issue with that. I would suggest that they contact Stats Canada and dispute it with that particular authority. By way of contrast, the United States has recovered less than 17% of their jobs, and the United Kingdom has recovered fewer than 40% of their jobs.

In the supplementary, I’ll also talk about a few more facts to speak to just how strong our recovery has been.

The Speaker (Hon. Steve Peters): Supplementary?

Ms. Andrea Horwath: Well, here are the facts: In 2000, the combined provincial-federal corporate tax rate was 42%. In Ontario, the combined rate is 28% and will soon fall to 25% because of the Premier’s corporate tax giveaways. At the same time, business investment in plant and machinery has fallen from 7.7% of the GDP to 5%. Ontario still hasn’t, by this Premier’s own admission, made up the jobs lost during the recession.

Has the Premier ever thought, couldn’t the $4 billion that this government dolled out to corporations have better been used to help struggling Ontario families?

Hon. Dalton McGuinty: As I said, one fact, of course, is that we’ve recovered 91% of our jobs. Here are a few more that are specific to our economy here in Ontario.

Private sector investment in building machinery and equipment rose 10% in the third quarter of 2010; that is the strongest gain since 1998. Manufacturing sales are up 24% compared to 2009. Let’s take a look at the auto sector, comparing March of this year to March of last year: For GM, sales are up 26%; for Chrysler, they recorded their 16th consecutive month of year-over-year sales growth; and Ford has had the best March in a decade. Those are facts.

The fact is, our economy is turning the corner, and our tax reforms are helping that.

The Speaker (Hon. Steve Peters): Final supplementary.

Ms. Andrea Horwath: Well, this is how things look to me: Statistics Canada data proves that corporate tax cuts don’t create jobs. Even the federal Liberal leader says, “Make me Prime Minister because I don’t believe corporate tax cuts create jobs.” Ontario families worried about jobs, about reduced incomes and about soaring household bills don’t believe corporate tax cuts create jobs either.

Why won’t the Premier do the right thing and redirect at least some of his $4 billion of corporate tax giveaways to things that make life affordable for Ontario’s families?

Hon. Dalton McGuinty: Again, I want to remind my honourable colleague of a few of the facts. We now know that we’ve recovered 91% of our jobs. We now know that, when it comes to specific indicators like the auto sector, manufacturing and year-over-year growth, Ontario is doing better than any of the other provinces.

I would also encourage my honourable colleague to heed the advice offered by former Prime Minister Tony Blair, who said this: “In the past, social democrats became identified with high taxes, especially on business. Modern social democrats recognize that in the right circumstances, tax reform” and reducing the tax burden “can play a critical

part in meeting their wider social objectives.”

We are reducing the tax burden on businesses and families to strengthen the economy so we can have better education, better health care and better social supports.

EXECUTIVE COMPENSATION

Ms. Lisa MacLeod: My question is again to the Minister of Health. In June 2009, Sarah Kramer left eHealth Ontario in disgrace, just as the billion-dollar boondoggle was unfolding. It was well reported in the media at the time that the former CEO, who was hand-picked by the Premier of Ontario himself, was handed a $317,000 severance. Yet the sunshine list last week shows that you paid Kramer another $106,000.

Since the Ontario PC caucus and the government’s own ministry have confirmed it was not a severance, why did Ontario families have to pay another $106,000 on top of the $317,000 she was given as a gift on the way out?

Hon. Deborah Matthews: I’m thankful for the question. What I want to say is that I am restricted in what I can say, as the member opposite well knows, about those arrangements.

What I can reiterate is our commitment to keep on moving forward when it comes to eHealth, because eHealth is making a real difference for people. And we are not alone in advocating a continuation with eHealth. Let me read from the Toronto Star—

Interjections.

Mr. John Yakabuski: Release yourself from the chains.

The Speaker (Hon. Steve Peters): If the member from Renfrew wants to be released so badly, I do have the power to set you free.

Minister?

Hon. Deborah Matthews: Let me read a quote from Dr. Suzanne Strasberg, the former president of the Ontario Medical Association, in speaking about electronic health records. She says, “This is a grand task and one that requires a long-term commitment. The expectations are both promising and exciting, and it is imperative the government and physicians get on with the job.”

The Speaker (Hon. Steve Peters): Supplementary?

Ms. Lisa MacLeod: Ontario families have no idea why they keep paying for Sarah Kramer, Ron Sapsford and so many others for not doing a day’s worth of work on their behalf, particularly in the health care system.

You paid Sarah Kramer over $100,000 after she had been given a quarter-million-dollar severance, after she had presided over the billion-dollar eHealth boondoggle. Now she’s fled to the United States to take another job. So we want to know: Why did you continue to pay Sarah Kramer after the severance was out? Is it because you cut the same deal that you cut Gérald Savoie from the Montfort Hospital, who, after two years of not doing a thing, will actually be paid over $1 million? Will Sarah Kramer be on the sunshine list, just like Gérald Savoie is, next year?

Hon. Deborah Matthews: I know the party opposite is having great fun with this. What is important to me—

Interjections.

The Speaker (Hon. Steve Peters): Members will please come to order. I would just ask that they be conscious of these desks; they are antiques and we do not want to damage them permanently.

Please continue.

Hon. Deborah Matthews: On this side of the House, we’re determined to continue to get results for people, and that includes the people of Nepean–Carleton riding. We now have two family health teams in Nepean–Carleton with 28 doctors and 15 health care professionals providing care to over 30,000 patients, 8,000 of them previously unattached under your watch.

Under their watch, Speaker, it was a different story. They cut funding to hospitals. At the Children’s Hospital of Eastern Ontario, for example, they cut $6.3 million. Almost 11% of the budget was slashed when they took office. Ottawa—

The Speaker (Hon. Steve Peters): Thank you. New question.

GOVERNMENT APPOINTMENTS

Ms. Andrea Horwath: My question is to the Premier. Under the watch of CEO Rosemarie Leclair, Hydro Ottawa spent tens of thousands of dollars last year hosting corporate clients in luxury boxes at Ottawa Senators games even as they were hiking hydro rates paid by residents and businesses.

Why won’t the Premier condemn the former Hydro Ottawa CEO’s waste of taxpayers’ money instead of condoning her actions by appointing her as chair to the Ontario Energy Board?

Hon. Dalton McGuinty: Minister of Energy.

Hon. Brad Duguid: As the member knows, Hydro Ottawa is registered as a private company, and it is indeed wholly owned by the city of Ottawa. I want to commend the mayor of Ottawa today for his prompt response on this matter. It’s always good to see our municipal partners working hard to ensure good value for ratepayers.

That’s very much in sync with the approach that we’re taking and the culture that we’re building in our own energy agencies. Over the last year, we’ve worked very hard with our energy agencies to save over $1 billion. Hydro One is reducing its operational costs by $170 million this year. In fact, all of our energy agencies are bringing down their operating budgets this year. They recognize that we need to get value for money, and this government remains committed to working with our agencies to ensure that we indeed do that.

The Speaker (Hon. Steve Peters): Supplementary?

Ms. Andrea Horwath: Well, excuse me and the rest of Ontarians who think the culture that you’re building is a culture of entitlement.

The Premier is appointing as head of the OEB a hydro executive who is unapologetic about spending $30,000 on luxury suites at hockey games. The OEB chair pulls down approximately $500,000 a year in salary. Is this what the Premier looks for when he’s deciding who gets the plum promotions and pay raises in this province: the ability to spend taxpayers’ dollars on wining and dining at NHL hockey games?

Hon. Brad Duguid: Once again, this is the smear-a-day NDP campaign that goes on day after day in this place. I’ll tell you, though, what we look for when we’re looking for people who are going to lead our energy agencies. We look for women who make the top 100 most powerful women, hosted by the Women’s Executive Network. We look for people who in 2010 won the quality of life award by St. Joseph’s Women’s Centre. We look for people who in 2009 were honoured champions of the United Nations Association in Canada.

We look for people like Rosemarie Leclair, who was a member of the University of Ottawa’s board of governors, who sat on the board of directors for the United Way of Ottawa, who was a member of the Ottawa Chamber of Commerce, who has more credentials in energy than you can shake a stick at. This is a very qualified person, and we’re looking forward to her serving very—

The Speaker (Hon. Steve Peters): New question.

ENERGY POLICIES

Mr. Wayne Arthurs: My question is for the Minister of Energy. Minister, Ontario’s long-term energy plan lays out for Ontario families the investments needed to turn the inherited Tories’ dirty, unreliable and outdated energy system into one that is clean, reliable and modern. It lays out the cost of these critical investments in full transparency and stands in stark contrast to the approach taken by the Leader of the Opposition, who is afraid to share his energy plan with Ontario families.

Over 20 years, energy plans indicate that these investments will result in an average increase of 3.5% per year for those 20 years, but many of these investments are needed early on, so the next five years may see increases in the range of 7% to 8%. Can the minister outline how the government will help Ontario families adjust through this period of investment?

Hon. Brad Duguid: I want to thank the member for Pickering–Scarborough East for that question. The opposition leaders are indeed trying to convince Ontario families that somehow they can build a clean, reliable, modern energy system without increasing energy costs. Ontario families will see right through that. These investments are crucial, and the fact of the matter is, these costs are unavoidable. So we’re helping Ontario families. We’re providing them with a clean energy benefit that’s taking 10% off the bills of Ontario families, small businesses and farmers. We’re also helping Ontario energy consumers with our energy property tax credit.

Let me tell you: If Stephen Harper were to provide a similar amount of assistance to Ontario that he’s committing to providing other provinces across Canada with our money, that would surely go a long way to help us bring down the price and cost of energy in this province.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Wayne Arthurs: Minister, you’ve said in the past that the work done over the past seven years to turn around the rather ugly energy legacy left by the PC Party has been successful to date. But it hasn’t been easy. We’ve had to make significant investments in our transmission system that have been neglected under previous governments.

You’ve indicated that making those transmission upgrades at the same pace as the expansion of clean energy projects has been quite challenging. While I’m pleased efforts are being made to overcome that challenge, would the minister tell this House what other potential obstacles stand in the way of making our global-leading clean energy economy even more successful?

Hon. Brad Duguid: I agree with the member. Our efforts to transform our energy system from the mess we inherited under the Tories into a modern, reliable and clean energy system have been extraordinary, but it hasn’t been easy. We’re seen globally as trailblazers in building a clean energy economy and transforming our energy system. We’ve overcome every obstacle in our way, and we’ve done this despite the continual opposition from the members opposite, who have opposed our efforts every step of the way.

What I can’t understand is why the Leader of the Opposition simply refuses to stand up for Ontario families when it comes to Prime Minister Harper’s commitment to spend our money subsidizing clean energy projects in other provinces. Harper’s slogan is, “Here for Canada.” The Leader of the Opposition’s slogan should be, “Here for Harper, not Ontario.”

The Speaker (Hon. Steve Peters): I just remind the honourable members that we need to deal with provincial issues.

New question.

EXECUTIVE COMPENSATION

Mrs. Christine Elliott: My question is to the Minister of Health.

The minister is not answering simple, straightforward questions. She is behaving as though she does not need to account to Ontario families for the obscene amounts of money that are still being handed to the people implicated in the $1-billion eHealth boondoggle.

The three quarters of a million dollars that was paid to Ron Sapsford is not severance. The Ministry of Finance’s guide for the preparation of the sunshine list indicates that severance is not reported. So the question is: Why have you implied that it is severance and what are you hiding?

Hon. Deborah Matthews: Just to be clear, I have not implied anything. I am not permitted to speak to the particular issue. What I am absolutely committed to and able to speak to is how health care is improving right across this province, including in Whitby–Oshawa.

Let’s just talk about one thing that is very important to the people of this province, and that’s wait times. When we came to office, people were waiting an outrageous length of time to get the care they or their loved one needed. We went to work. At Lakeridge Health, serving the people of Whitby–Oshawa, hip replacement wait times are down by 272 days, a 58% reduction. Outpatient CT scan wait times are down by 60%—

The Speaker (Hon. Steve Peters): Thank you. Supplementary?

Mrs. Christine Elliott: Minister, there’s no hiding the three quarters of a million dollars that you paid to Ron Sapsford; it’s simply too large. His $80,000 in expenses alone is more than the average income of a typical Ontario family for a year. These are very straightforward questions, but you’re refusing to answer them. It’s like you have something to hide.

What is Ron Sapsford being paid for, and why did you give him a raise? Simple question.

Hon. Deborah Matthews: As I have said repeatedly, I cannot speak to that particular arrangement. But I sure can speak to improvements that we have made, in Whitby–Oshawa, for example.

The member opposite and I together were at the opening of Lakeridge Health Whitby just last week. It was a splendid day. People were worried that that hospital would never reopen—

Interjection.

The Speaker (Hon. Steve Peters): The Minister of Community Safety will withdraw the comment that he just made, please.

Hon. James J. Bradley: I withdraw.

Hon. Deborah Matthews: People who were at that event—the nurses, the doctors, the volunteers at that particular hospital—told me they were worried the hospital would never open. Thanks to the good work of my colleagues in the Legislature, that hospital has reopened. It is now fully occupied. People are getting excellent care close to home. Jobs have been provided right in the riding of the member opposite.

FREEDOM OF INFORMATION

M me France Gélinas: My question is for the Minister of Health and Long-Term Care. Life-changing events, life-and-death events, take place in Ontario hospitals each and every day. Sometimes a family is worried and wants answers and information. But now, buried on page 31 of the 146-page budget, we see that the government has included an amendment that will block public access to freedom-of-information requests in hospitals. The NDP stood up against that same amendment back in November in order to protect the accountability and transparency that Ontarians fought so hard to secure in their health care system.

Why is the minister trying to curtail hospital accountability by sneaking in this defeated amendment in the budget bill?

Hon. Deborah Matthews: I’m very pleased to have the opportunity to speak to that question. I am delighted that we are moving forward on bringing hospitals under freedom of information, expanding transparency and accountability in our health care system.

We are at a very important time in our health care system because we are now starting to turn our attention to quality improvement. I think the member opposite understands how important it is that we take a good hard look at quality in our hospitals throughout our health care sector. Part of the process of improving quality requires that, within hospitals, they’re able to have very open and frank conversations about where quality was not what it should have been. After consultation with the hospital sector, we have made this change that will allow improvements in quality to continue.

The Speaker (Hon. Steve Peters): Supplementary?

M me France Gélinas: Let me tell you something about trust: Trust is a pillar of quality. If the minister wants to talk about quality care, she has to take into account trust.

New Democrats have been working hard to restore trust and accountability in our health care system. On the heels of a damning report from the Auditor General on hospital consultants and lobbyists, the McGuinty Liberals had hoped to change the channel by introducing Bill 122, that you refer to. But now, without anyone looking, they are trying to retreat from transparency, from accountability measures that they more or less wanted to take credit for and that Ontarians have been demanding for years.

Will the minister explain to Ontarians why our government is trumping the public right to health care information?

Hon. Deborah Matthews: Let me tell you that patient safety and patient quality of care is paramount for us. After very careful consideration and very in-depth conversation with the hospital sector, I was persuaded that we simply must make this amendment to allow that very, very important job of quality improvement to continue. I do not want hospitals—

Interjections.

The Speaker (Hon. Steve Peters): I can’t believe it either, the number of times that I’ve warned the honourable member. I would just remind him that if he is going to choose to sit in that front row, he needs to do so silently.

Minister?

Hon. Deborah Matthews: I think it’s important that people understand that we are talking patient safety. We are talking life and death. We know we can reduce deaths by focusing on quality. I want the hospitals to be able to do that in the way they know how. I want to encourage the work on quality improvement.

IMMIGRANT SERVICES

Mrs. Laura Albanese: My question is for the Minister of Citizenship and Immigration. Last December, the federal government announced it was cutting $44 million in funding to 35 Ontario newcomer settlement agencies. These agencies help new Canadians get employment and language training to get settled and find good jobs. In my riding of York South–Weston, organizations such as the York Weston Community Services Centre and the Community Action Resource Centre have been devastated by the unilateral federal cuts.

The federal government’s reckless cuts have hurt thousands of newcomers. Ottawa now wants to repossess the assets from agencies whose funding was cut. This will make it even more difficult for these agencies to continue helping newcomers get settled in Ontario.

To the Minister: What is Ontario doing to help these agencies keep the basic equipment they need to serve newcomers?

Hon. Eric Hoskins: As you can appreciate, I was extremely disappointed that Ottawa unilaterally cut $44 million in funding to immigrant settlement agencies in Ontario. I’ve spoken with the impacted agencies and they tell me that Ottawa’s cuts will absolutely devastate the agencies, the employees and the newcomers that rely on their vital settlement services. To make matters even worse, these same agencies have been told that they may have to hand over their equipment and their furniture.

I’ve written to federal Minister Jason Kenney to strongly urge him to allow our settlement agencies to keep the assets that they purchased using federal funds, as their contracts allow them the discretion to do. These assets include desks, chairs, phones, computers and even child care and child-minding equipment. I call on Minister Kenney to immediately—

The Speaker (Hon. Steve Peters): Thank you. Supplementary?

Mrs. Laura Albanese: In February, the minister announced that the government created a one-time stabilization fund to help stabilize the operations of settlement agencies whose funding was cut by Ottawa. Many settlement agencies, including agencies in my community, were extremely happy to hear that Ontario was doing what it could to help. At the stabilization fund announcement, one agency told me that every bit helps when it comes to supporting newcomers.

Some agencies have applied for this funding to help them get through in the wake of Ottawa’s unilateral cuts. They desperately need that funding now to continue to help newcomers get settled and get job-ready.

Can the minister tell us if his ministry has completed its funding application process so that settlement agencies can continue to provide important services to newcomers?

Hon. Eric Hoskins: First of all, I’d like to thank the member from York South–Weston for her tireless advocacy on behalf of newcomers in her community.

Minister Kenney and the federal Conservatives may not respect the important work of our front-line settlement agencies, but the McGuinty government respects their tireless efforts. That’s why we’ve created a stabilization fund to help eligible settlement agencies whose funding was completely slashed by Ottawa. These agencies have an outstanding record of service in their communities, and we are supporting them through this very challenging time.

I can tell the member from York South–Weston that the Community Action Resource Centre, in her riding, whose funding was totally cut by Ottawa, is receiving stabilization funding.

Ontario remains absolutely committed to getting the best immigration agreement from the federal government. We will continue to fight for fairness for Ontario and for Ontario’s newcomers.

GOVERNMENT REGULATIONS

Mr. Ernie Hardeman: My question is to the Minister of Agriculture, Food and Rural Affairs. I just want to say that we’re having a little trouble getting answers to the question, Minister, so I’m going to make it very simple.

I have a multiple-choice question for you. I’m going to give you some examples of ridiculous red tape that would restrict people and hurt business. Can you tell me which one of these apply to your ministry: limit who a business can sell their product to or which door they may sell it through, tell a business what colour they can paint the interior of their facility, or tell a business person what colour they can paint the inside of their vehicle?

Minister, which one of these red tape rules are you going to force onto Ontario farmers?

Hon. Carol Mitchell: I do sincerely want to thank you for the question. One of the things that I wanted to share with the members from across the way is that we have been working very hard with our businesses within the agricultural community. We recognize the challenges that have been facing our local abattoirs, so we provided $1.5 million to assist. I can tell you that we have seen many success stories, and the investments we have made in red tape are turning things around.

But I say to the members from across the way: We’re talking about red tape. We’re quite proud of our record at OMAFRA of reduction of red tape. But I think that farmers and rural communities want to know: Why won’t you pick up the phone and call Harper about risk management? That—

Interjections.

The Speaker (Hon. Steve Peters): Members will please come to order. I just remind the honourable members once again that, notwithstanding the fact that there is a federal election going on, we have issues that we need to deal with here in the province of Ontario.

Supplementary?

Mr. Ernie Hardeman: Minister, they all apply to your ministry, and I thought you might have known that. When you are restricting the colour that a farmer can paint the inside of their vehicle, you have a red tape problem.

A month ago, I asked the Premier about an internal memo that your ministry produced which made it clear that you are hiding red tape, not cutting it. From what we’ve seen, the only action taken in response was to remind your staff to keep documents confidential.

Minister, your problem isn’t the brown envelopes; your problem is your red tape. Will you finally apologize to farmers and tell us how many of your regulations you claim to have cut are actually a sham?

Hon. Carol Mitchell: I’ve got to say that supporting risk management—

Interjections.

The Speaker (Hon. Steve Peters): Members will please come to order.

Minister?

Hon. Carol Mitchell: I want to say that the work of our local abattoirs—do they understand, from across the way, the local product, where that comes from? That comes from down on the farm. By supporting risk management, it’s strengthening the value chain. On this side, we get that.

But I’ll tell you this: Farmers want to know how they’re going to vote on the budget—

Interjections.

The Speaker (Hon. Steve Peters): Members will please come to order. It never ceases to amaze me, when certain members ask questions and certain members respond to questions, how it just gets the juices flowing in this chamber.

Interjection.

The Speaker (Hon. Steve Peters): Minister of Agriculture, I might have been referring to you.

Interjections.

The Speaker (Hon. Steve Peters): The members will please come to order. We want to ensure that everyone has an opportunity to ask their questions.

New question.

SCHOOL TRANSPORTATION

Mr. Gilles Bisson: My question is to the Minister of Education. Minister, as a result of your new busing policy, 80% of the bus contracts for this fall on Highway 11 east is going to be going to two large multinationals—one from London, England and the other one from Sudbury. As a result of that, a company like Schumacher Bus Lines, which has been around for 96 years, is at a risk of closing their doors; and a company like Kamiskotia Bus Lines, the former Silver’s bus lines, which has been there for better than 50 years, is closing its doors.

My question to you is as simple as this: Why did you put forward a busing policy that favours large multinationals at the expense of long-serving local businesses?

Hon. Leona Dombrowsky: I think it’s important that I take this opportunity to correct what the honourable member has presented. In fact, it’s not a government policy, but what we have said to school boards, because the Provincial Auditor identified for us that we needed to be more competitive in terms of how we engage those services.

So we have been working with school bus operators from across Ontario to put in place models that meet the needs of the school board and the students that they serve, as well as ensure that the industry is able to participate in a fair way.

We have pilots under way. We did in southern Ontario last year; we are now doing pilots in northern Ontario this year. We look forward to hearing from boards their results—

The Speaker (Hon. Steve Peters): Thank you. Supplementary?

Mr. Gilles Bisson: Minister, don’t try to pass the buck on to the school board. It just happens to be that Colleen Landers from one of our boards is here now, and she knows well that this is not a school board policy; this is an Ontario Ministry of Education policy. For you to try to pass this on to the school board, I think, just flies in the face of reality.

I’ll ask you again. There are business owners across my riding and Mr. Ramsay’s riding who have been in business for 50 and 100 years. Their bus companies are about to close—some of them will close—because of this policy. I ask you one more time: Why do you favour a policy that puts long-standing businesses in our community at risk of closing down in favour of larger multinationals?

Hon. Leona Dombrowsky: I again remind the honourable member that it is not the Ministry of Education that engages school bus operators in local boards; it is local boards that do that.

What the Ministry of Education has asked of our school boards, because the Provincial Auditor—and I would just remind the honourable member: They like to talk about the Provincial Auditor and refer to the auditor’s recommendations. I say to the honourable member that the Provincial Auditor has made it very clear that we need to improve the way we engage transportation services in school boards. We are working with boards and we are working with local operators to determine a process that is fair and equitable and ensures the people of Ontario that the dollars we are spending on student transportation have been determined in a manner that is open and transparent—

The Speaker (Hon. Steve Peters): Thank you. New question.

TOURISM

Mr. Dave Levac: My question is for the Minister of Tourism and Culture. As Ontario’s economy recovers from the recession, tourists from near and far are starting to travel and visit again. Visitors are coming from national and international destinations. In 2008, visitors spent $22 billion in Ontario. That is why it’s important for the government to make strategic investments and have significant economic impact across the province. This will attract even more visitors, keeping them coming back, creating jobs and supporting the economic growth of our regions.

Minister, effective investment is critical to making Ontario’s tourism industry competitive. Can the minister please tell us what the government is doing to make Ontario’s tourism industry competitive?

Hon. Michael Chan: I want to thank the honourable member from Brant for his question and also for his wonderful advocacy in promoting tourism in Ontario. Again, I want to, one more time, welcome some of our tourism partners to the House today.

In 2010, more than 104 million Canadians travelled to Ontario, more than any other province or territory. Our government has made significant investments to develop a competitive tourism industry in Ontario. We have invested $130 million to support the 13 newly developed tourism organizations. This year, through Celebrate Ontario, we are also investing $20 million to support 232 festivals and events—

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Dave Levac: I’m pleased that the government is building a competitive tourism industry in Ontario. However, short-term investment is not enough for long-term competitiveness in Ontario’s tourism sector. As a former principal and educator, I know that long-term planning is an extremely important commitment to make a success.

Several local events come to my mind in building premier events: the International Villages in Brantford, Telephone City Car Show, Applefest in St. George, Springtime in Paris, Hockeyfest, the Brantford International Jazz Festival, Frosty Fest and, of course, Six Nations Pow Wow. That’s why we need the government to continue to invest beyond just one year. This helps strengthen Ontario’s tourism industry for today and tomorrow. Supporting economic growth is important. I want to know what the minister is going to do to support long-term sustainability for the tourism industry in Ontario.

Hon. Michael Chan: Families in Ontario stand to benefit from our investment in tourism. It is a key economic driver to job creation. This is why, in our recent budget, our government has committed an additional $18.75 million to support the regional tourism organizations for 2012. This is in addition to the $40 million in ongoing funding.

If passed, our budget will help tourism regions attract more visitors, strengthening, of course, our economy. The budget will also make our $20 million in Celebrate Ontario permanent.

We are on the right track with our investment. It is helping families, attracting visitors, creating jobs and supporting economic growth.

CORRECTIONAL FACILITIES

Mr. Robert Bailey: My question is to the Minister of Finance. Last Tuesday, your government released a budget that included a provision to close the so-called underutilized jails in Sarnia, Owen Sound and Walkerton.

Minister, if you had bothered to pick up the phone and call the mayor of Sarnia, you would have found out that in fact the Sarnia jail is over their maximum capacity. I understand, however, that just minutes ago your Minister of Public Safety has agreed to meet with the mayor of Sarnia on this issue. I say: too little, too late.

In fact, a report by your own government says that the Sarnia jail is at 105% capacity. If you had bothered to call the mayors of Owen Sound and Sarnia, you would have discovered that those prisoners are actually sleeping on the floor because the beds are full.

Why did you say these jails are underutilized when they’re not?

Hon. Dwight Duncan: The Minister of Community Safety and Correctional Services.

Hon. James J. Bradley: In the supplementary, I’ll mention the 25 jails the Conservatives closed, but not now.

As you know, the ministry is modernizing the jail system in Ontario. The Sarnia jail was built some 50 years ago and requires more than $1 million in capital investments. I’m surprised you didn’t ask this earlier, by the way. It costs $180 a day to house an inmate in the Sarnia jail and $125 per day to house those inmates in the new Windsor jail.

Decommissioning the Sarnia jail is consistent with the government’s commitment to modernizing the corrections system and closing some of the older, less efficient jails to ensure we have a correctional system that is safe—

The Speaker (Hon. Steve Peters): Thank you. Supplementary?

Mr. Robert Bailey: Minister, that’s all well and good, but you’re closing the jail in Sarnia and moving those prisoners to a new superjail in Windsor, which happens to be in the finance minister’s riding. It must be a coincidence. You claim that this is the best choice, but it seems that you are alone in that assumption. Unlike you, I have spoken to the mayor of Sarnia, the OPP, the police chief of Sarnia, the Canadian border services, the two native police forces, and the president of OPSEU, who represents all the workers. Frankly, this is becoming a hallmark of your government, and my constituents want answers.

Minister, is it your opinion that you always know best and it’s simply not worth you or your ministry’s time to speak to those on the ground who have to live with your decisions?

Hon. James J. Bradley: This is very interesting.

Interjections.

The Speaker (Hon. Steve Peters): Stop the clock.

Minister?

Hon. James J. Bradley: This is very interesting. The members had a chance for several days to ask this. I know why he hasn’t—because the government of which he is now

part closed jails in Cobourg, Haileybury, Waterloo, Wellington, Parry Sound, Barrie, Peterborough, Guelph, Cornwall, Lindsay, Whitby, Brampton and Sault Ste. Marie.

I remember the member for Wellington–Halton Hills saying the following: “I think the people of Ontario would expect us to look at how we’re operating the system of provincial jails and find ways to do it better and cheaper.” I happen to agree with my friend from Wellington–Halton Hills on that issue, as with Senator Runciman, who indicated that it’s the “oldest infrastructure in Canada” we have out there.

We have to make these difficult decisions. The first half of—

The Speaker (Hon. Steve Peters): Thank you. New question.

HOSPITAL FUNDING

Mr. Michael Prue: My question is to the Premier. Toronto East General Hospital has a long and proud history as a caring, innovative and accountable hospital. Now it faces major challenges. A number of its buildings are no longer up to standard. There is a lack of accessible facilities, and in some wards six patients share a room. There are plumbing and electrical disruptions because the systems are out of date. The Toronto Star reported that a full ward of patients were moved due to sewage breaks.

This budget that has just been introduced said the government will invest up to $35 billion in infrastructure over the next three years. My question to the Premier: Will the redevelopment of Toronto East General be one of these priority infrastructure projects?

Hon. Dalton McGuinty: The Minister of Health.

Hon. Deborah Matthews: I welcome the opportunity to talk about the great work that’s being done at Toronto East General. I will let the Minister of Infrastructure take the supplementary, but I cannot resist the opportunity to congratulate the CEO, Rob Devitt, and the extraordinarily fine people who are working there.

I actually had the opportunity to visit Toronto East General just a couple of weeks ago, where they showed me all of the quality initiatives that they are pursuing. It is a model of health care. I am very, very proud of the work that is happening at Toronto East General Hospital.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Michael Prue: Well, thank you very much, but it didn’t answer the question. I, too, am proud of Toronto East General Hospital. It’s of great value to our community. It’s a great teaching hospital. They provide excellent care. The CEO, Rob Devitt, has been acknowledged by this government as a health care leader. He’s given 10 years of balanced budgets. That’s one of the things he’s done. But despite the fact that the staff does an excellent job treating patients, the hospital facilities are so dated they lack privacy and challenge today’s infection control practices.

For the last six years, the hospital has been working with ministry staff on plans for the redevelopment. My question is: Will Toronto East General Hospital get approval from the province to move ahead with the redevelopment and commence construction now, or do they have to wait for the election period to hear the news?

Hon. Deborah Matthews: To the Minister of Infrastructure.

Hon. Bob Chiarelli: Thank you for the question. We’re very pleased to talk about building hospitals in Ontario. We know that the previous government closed them; they closed them by the dozen. What we’re doing here is building 18 new hospitals, under construction or having been completed. We’re also in the process of extending or expanding 100 hospitals in Ontario.

We are very proud of our infrastructure program. We are very proud of the fact that the previous government, having averaged $2.5 billion a year for the last three years in infrastructure, has to be compared to our record of $10 billion per year investing in infrastructure in the province of Ontario.

We are rebuilding Ontario. We’re rebuilding our health care system and every other piece of infrastructure in this province. We’re very proud of our record and we have done three times more infrastructure than the opposite government did—

The Speaker (Hon. Steve Peters): Thank you. The time for question period has ended.

DEFERRED VOTES

2011 ONTARIO BUDGET

The Speaker (Hon. Steve Peters): We have a deferred vote on the amendment by Mr. Miller to the motion that this House approves in general the budgetary policy of the government.

Call in the members. This will be a five-minute bell.

The division bells rang from 1136 to 1137.

The Speaker (Hon. Steve Peters): Members please take their seats.

Mr. Miller has moved the amendment to the budgetary policy of the government. All those in favour of the amendment will rise one at a time and be recognized by the Clerk.

Ayes

Arnott, Ted

Bailey, Robert

Chudleigh, Ted

Clark, Steve

Dunlop, Garfield

Elliott, Christine

Hardeman, Ernie

Hillier, Randy

Hudak, Tim

Jones, Sylvia

MacLeod, Lisa

Miller, Norm

Munro, Julia

Murdoch, Bill

O’Toole, John

Ouellette, Jerry J.

Savoline, Joyce

Shurman, Peter

Wilson, Jim

Yakabuski, John

The Speaker (Hon. Steve Peters): Those opposed?

Nays

Aggelonitis, Sophia

Albanese, Laura

Art