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October 5, 2017

41st Parliament, 2nd Session

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Hansard Transcripts

Votes and Proceedings

Orders and Notices

Hansard Transcript 2017-Oct-05 (PDF)

L103 - Thu 5 Oct 2017 / Jeu 5 oct 2017

LEGISLATIVE ASSEMBLY OF ONTARIO

ASSEMBLÉE LÉGISLATIVE DE L’ONTARIO

Thursday 5 October 2017 Jeudi 5 octobre 2017

Orders of the Day

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

Introduction of Visitors

Oral Questions

Energy policies

Fiscal accountability

Hospital funding

Long-term care

Manufacturing jobs

Children’s mental health services

Women’s health services

Workplace Safety and Insurance Board

Employment standards

Post-secondary education

Wind turbines

Poverty

Child care

Opioid abuse

Visitors

Norman Jamison

Legislative pages

Introduction of Visitors

Members’ Statements

Wasaga Beach

Commemoration of fallen soldiers

National Day of the People’s Republic of China

Conestoga College

World Teachers’ Day

Community Recognition Awards

PANDAS/PANS

Events in Ajax–Pickering

Oshawa’s Teaching City initiative

Introduction of Bills

Strengthening Protection for Ontario Consumers Act, 2017 / Loi de 2017 sur le renforcement de la protection des consommateurs ontariens

Statements by the Ministry and Responses

Ontario Agriculture Week

World Teachers’ Day

Ontario Agriculture Week

World Teachers’ Day

World Teachers’ Day

Ontario Agriculture Week

Visitor

Petitions

GO Transit

Pesticides

Public transit

School facilities

Water fluoridation

Long-term care

Hospital funding

Elevator maintenance

Hydro rates

Provincial truth and reconciliation day

Dental care

Private Members’ Public Business

Life Leases Act, 2017 / Loi de 2017 sur les baux viagers

Honouring our Veterans Act, 2017 / Loi de 2017 rendant hommage à nos anciens combattants

Nick’s Law (Opioid Abuse Awareness), 2017 / Loi Nick de 2017 Sur la sensibilisation à l’abus d’opioïdes

Life Leases Act, 2017 / Loi de 2017 sur les baux viagers

Honouring our Veterans Act, 2017 / Loi de 2017 rendant hommage à nos anciens combattants

Nick’s Law (Opioid Abuse Awareness), 2017 / Loi Nick de 2017 Sur la sensibilisation à l’abus d’opioïdes

The House met at 0900.

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

Prayers.

Orders of the Day

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

Resuming the debate adjourned on October 4, 2017, on the motion for second reading of the following bill:

Bill 160,

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

The Speaker (Hon. Dave Levac): Further debate?

Ms. Cindy Forster: I had about 10 minutes on this bill yesterday that I kind of spent on pieces of the act. Over the last few weeks—well, I’d say over the last seven years—I have had numerous patients come into my office with issues around their health care, but it seems increasingly so. I’m now getting them coming into my office every week.

I want to share a couple of emails from patients who have either been into my office or called my office. They want the legislators to know their health care stories, because they believe that if they don’t tell you their stories, nothing is ever going to change.

I got this one email, on September 24, from a woman. It’s around our home care system and, frankly, the lack of home care that is available to both our seniors and patients coming out of the hospital. This woman says, “I had a bilateral mastectomy on ... June 13. I was to spend one night in the St. Catharines hospital, but because I had an arterial line put in, due to safety in case I had a heart attack or stroke during surgery I ended up staying two nights” in the hospital—not very long, actually, having had a bilateral mastectomy.

“When home care came in before I left the hospital, the lady said I would have to go to the office to have my dressing changed. I was upset, but too tired and too sore to argue.

“So on Friday morning I had to get up and go to the other side of the city. I was in so much pain, every bump, railway track almost killed me. Then I sat in the waiting room for ... 20 minutes” in a dressing clinic in Welland. “There were seniors hacking and coughing in the waiting room. After surgery, I was worried about C. difficile or MRSA.

“The halls and the rooms were not clean. The floors were ... dirty. The rooms were messy. I honestly was worried about getting infection.” This was at a clinic, right? A clinic that is run by CarePartners, a for-profit provider that actually operates in 14 areas of the province.

She says she was also upset because she had a male nurse who came in to change her dressing. “There were female nurses there. I think it was ... tactless. I had just had a mastectomy, very insecure about myself. A female nurse should handle these types of cases.” I’m assuming this woman is an older woman as well. “Each room did not have supplies” so they had to keep going in and out of the room looking for things.

“I have severe osteoporosis, six herniated discs, one fractured disc. Fibromyalgia, MS, have had two heart attacks, two strokes, nine knee surgeries including knee replacements, both elbows done, three rotator cuffs and almost every other type of surgery. I have major chronic depression. I could write pages of health issues. I was so upset about having to try to get ready to go to have a dressing change. I called to speak to the lady who told me I could not have home care again, and told her I wanted home care” to come to my house, that “it was too much for me to go out.

She said no,” I would have to speak to a “supervisor. My husband and I were on a three-way chat with the supervisor for ... 20-25 minutes discussing this issue as she did not want to” give me home care “either. I finally said I was going to call the MP or MPP and things changed.

“Both men at the centre were nice”—the male nurses, she’s speaking about—“but it was very degrading to me.”

“They did not have the proper tube bandage so they took a pair of disposable underwear and cut the crotch out and used that” for a dressing for her mastectomy.

“If they cannot keep you in the hospital for proper post-surgery care” then at the very least “they should come to your house.”

“Very upset with the service I received.... I have so many complaints about the centre”—the dressing centre—“and the staff. Management were not pleasant at all. I was ill going through breast cancer and a mastectomy and they are arguing with you. Very frustrating.... I am too stressed still to remember everything except the service was terrible.”

We followed up with this woman after she sent the letter. She basically said that it was so difficult for her to focus after having that surgery, she was really put out mentally and physically by having to attend at a dressing the clinic on the other side of town so soon after her surgery. She was not placing any blame on the personal support workers or the health care workers, but on the bureaucracy of the LHIN and the CCAC. I want to thank her for actually bringing those concerns forward.

Then I got a letter about a fellow by the name of Doug. He is a veteran serving in the Canadian military for 20 years. He had surgery on his right knee after it went septic in December. He was in the hospital in Welland for almost a month. He got out on January 23. He says a cement block was inserted and now his knee is giving out. He has been told that the knee replacement surgery is not going to happen until July.

So I’m assuming we’re talking seven months that he’s having to wait to have his knee fixed. He probably already waited six months to have the first surgery, and now he’s being told that he has to wait seven months because they can’t get him in to do that surgery. He’s a veteran. He’s asking that, on behalf of himself and other veterans in the country, the surgery be undertaken sooner rather than later.

Once again, here’s somebody who cannot access the appropriate health care that they need in a timely way. We believe, as New Democrats, that this is because of the funding cuts that have happened in our hospital system and in our health care system: the frozen budgets that have happened, budgets that haven’t looked after the rising inflation, haven’t looked after the increase in population, haven’t even taken into account our aging population, right? The government needs to do something about this. When people are actually coming to your office and writing you letters about their issues, we need to do something.

I’ve got another one here. This is on long-term care. The member from London–Fanshawe has been talking about long-term care over the last few months here. This is actually about a man who is suffering from acute myeloid leukemia. His doctor says “his remaining time is measured in months.” The problem is, he lives in Welland and his wife is in a long-term-care bed in Niagara Falls because there are no long-term-care beds available in Welland for his wife to be transferred to.

Because he’s having chemotherapy, he is too ill to actually make that drive every day from Welland to the Falls—it’s probably 20 minutes to 25 minutes—so now he can’t see his wife. These people have lived together for many, many years, and she has been in Niagara Falls since September. Now it is almost the middle of October and he is not able to see his wife. That’s because we have 1,400 people on the wait-list in Niagara for a long-term-care bed, part of those 30,000 people who are on wait-lists across the province because this government has not had a plan to develop any new beds.

I think the last nursing home that was built in this province was probably in 2007 or 2008, around the time when a nursing home was built in my riding. That actually took nine years from the day it was announced to the day it was built. It was a nine-year period. That wasn’t adding any new beds; that was just putting back in place beds that had been cut when older nursing homes had closed in the Welland area.

Those are my comments for the moment. Thank you for the opportunity to share some stories with the legislators on people in my riding.

The Deputy Speaker (Ms. Soo Wong): Questions and comments? I recognize the member from Kitchener Centre.

Ms. Daiene Vernile: Good morning to you, Speaker, and good morning to our colleagues. I’d like to also say good morning to the folks who might be watching at home right now.

Just to give everyone a recap: We are talking about Bill 160. We’re a few hours into the second reading debate of the Strengthening Quality and Accountability for Patients Act. This is a very comprehensive bill with a number of parts to it. In fact, there are 10 pieces of legislation that are included in the bill. I just want to go over them quickly with you.

There’s the Health Sector Payment Transparency Act. This is going to make it mandatory for the medical industry—that includes pharmaceutical companies and medical device manufacturers—to publicly report payments they make to health care professionals and organizations: doctors, nurse practitioners, nurses and medical staff. If they are getting a meal or a trip or research grants or fees to make a speech from a medical company, it’s going to be mandatory for that information to be posted publicly to a database so the public can see who is getting what.

You might ask the question: How widespread is this practice today? Quite honestly, the answer is: We don’t know. But what we do know is that this practice has been going on for years, but because the medical industry has never had to report it, there’s no way for us to gauge the extent of the impact on our health care system. We want to bring transparency to our health care system and we want to ensure the public knows if their health care provider is getting freebies from a drug company. By the way, legislation like this has already been passed in France, Belgium, Denmark, Portugal, Slovakia and the US.

The next piece to this is the Health Protection and Promotion Act. This is going to allow the regulation of recreational facilities—and I see I’m out of time. I’ll continue afterwards.

The Deputy Speaker (Ms. Soo Wong): Questions and comments?

Mrs. Gila Martow: I’m rising to say a few words on Bill 160, the Strengthening Quality and Accountability for Patients Act.

Sometimes we end up repeating ourselves here a little bit, just a tiny bit, so just to say again that I used to practise as an optometrist. For many years, I was in a medical centre attached to a hospital, working with a lot of specialists. It was a very medical office. I understand a little bit about what we’re trying to achieve in terms of improving our health care, but there are going to be some changes. We do want to make sure that we’re going to be educating and consulting with the public health units, family council associations and long-term-care associations to make sure that everybody is clear on what the new legislation is going to mean for their sector.

The member opposite just mentioned legislation in terms of health care professionals, specifically doctors getting compensated by pharmaceutical companies. Nobody wants to think that their doctor is prescribing a medication or a treatment based on some kind of dinner or gift from a company. I’ve worked with medical professionals for three decades, and I can tell you, I can’t give even one example where I felt that that was the case.

I think we do have to recognize, though, that our health care professionals spend a lot of time and their own money travelling to get to meetings so they can educate themselves on new treatments, on new medication. I think this government is going to have to have that discussion some day on whether they’re going to make it more complicated, more difficult and more expensive for doctors to be educated. It is the pharmacare that normally does the education. Then we are going to have to come up with another system, because we certainly don’t want our doctors to not be cutting-edge and not know about new studies, new treatments and new medications that are out there.

The Deputy Speaker (Ms. Soo Wong): Questions and comments?

Mr. Gilles Bisson: Always listening to the stories that people have to write about their interactions with whatever is what this place is all about. I want to thank the member for Welland for bringing that forward.

The sad

part is that we’re getting all the same letters; we’re getting all the same phone calls. People are bumping across us at events and when we go shopping and telling us such stories. I was just the other day having a chat with somebody whose mother has been three years in an ALC unit at Timmins and District Hospital because she can’t get a long-term-care bed at one of the long-term-care institutions in Timmins.

That’s just not acceptable: having to wait three years in an ALC, an alternate-level-of-care bed in a hospital, which is vastly more expensive than paying to put that same individual in a long-term-care system. From an economic point of view, it doesn’t make sense, but also from a programming point of view.

I have a good friend of mine, Lucile Carrier, who is currently an ALC patient at the hospital. She has started to develop Alzheimer’s or some form of dementia. She’s been stuck almost about a year now in an ALC bed at Timmins and District Hospital. What has been frustrating is that the system and the CCAC and the LHIN, when it comes to assessing people, are moving people who are on the list directly from the community into the long-term-care bed and leaving those people who were unfortunate enough to end up in ALC beds there because they have a place to stay.

But that’s not fair, because in Lucile’s case, she needs programming; she needs stimulation in order to be able to deal with her condition. She is still very conscious, very coherent of what is going on around her, but leave her in that place long enough, it’s not going to be good for her.

Why are we not, instead, saying “first bed available”—because in Lucile’s case, I think she’s number one on the list to be transferred, or number two. Why don’t we transfer her into a long-term-care bed and then have somebody from the community replace her in the ALC bed? It shows to what degree we have a crisis in our system, and we need to respond to it.

The Deputy Speaker (Ms. Soo Wong): Questions and comments?

Hon. Liz Sandals: I’m pleased to be able to respond to the comments from the member for Welland on the Strengthening Quality and Accountability for Patients Act.

One of the things that falls under the purview of the Treasury Board Secretariat and the President of the Treasury Board is what we call open government. I’m responsible for our government’s open government project. That means, amongst other things, that we endeavour to have open data, open information. To put that in everyday words, that means that where possible, we’re trying to open up information and make it accessible to the public. It was the taxpayer dollar that collected that information. It should be available to the public.

Of course, with health care, our challenge usually is that a lot of the information we have is private. It’s about individuals and their health. You know that as a nurse, Speaker, that you can’t reveal that information. But in this very particular case, it isn’t information about patients; it’s information about doctors, and it’s information we don’t have. So the purpose of the legislation with respect to payments, meals, trips, meetings, events, that doctors receive from pharmaceutical companies—we don’t have that information. We’re perfectly willing to post it and make it public.

First of all, we have to be able to collect it, because we simply don’t know the magnitude of those payments. This legislation, if passed, will enable us to do that.

The Deputy Speaker (Ms. Soo Wong): I’ll return to the member from Welland to wrap up.

Ms. Cindy Forster: I’m going to tell you one more story in my two minutes because I think it’s really important to talk about the crisis that we actually have in health care and what happened to this young man, 59 years old. He went into the emergency department with pain in his toe. He already had an amputation done the year before. He was a diabetic. He went to the emergency department. He laid in the emergency for three days from Monday to Wednesday. He was supposed to have a surgical consult by an orthopedic surgeon. That consult never happened. He was transferred into a medical bed at the St.

Catharines site. An infectious disease specialist walked by his room, saw his leg sitting elevated on a pillow, and went to the nurse and said, “What is the matter with that man? Why isn’t anybody looking at his leg?” She said, “What are you talking about?”

It turns out the man had flesh-eating disease; he had necrotizing fasciitis. He ended up with a second above-the-knee amputation, because he lay in an emergency department for three days, where they’re not staffed to be looking after patients around the clock, 24 hours. If you’re in the emergency department, you’re supposed to be there looking after emergencies as they come through the door. They’re not staffed like they are on the units, for 24-hour care.

This is one of the issues that are happening in our system. Because of understaffing and underfunding, people are losing limbs.

There’s something wrong with this, Speaker. I raise the story because I know the family, and they asked me to raise the story here in the Legislature so that things would hopefully improve in health care for our family members.

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

Hon. Michael Gravelle: It’s great to be here this morning and to have an opportunity to speak on this important legislation. I’ll be sharing my time with the member for Kitchener Centre, the member for Davenport and the Minister of Housing.

Thank you very much for this Strengthening Quality and Accountability for Patients Act. This is an important piece of legislation; there’s no question about it. There are a number of aspects to it, and I want, in the brief time I have, to just speak about some of the key elements of the legislation.

What we all understand in this Legislature is that the people of Ontario deserve health care they can rely on, health care they can trust. What we are very clear about is that transparency itself allows the public to have access to information in order to be engaged and to make informed choices about their health and the health of their families, which is critical on a day-to-day basis.

Ensuring that there is transparency within Ontario’s publicly funded health system very much does increase public trust—there’s no question about that—as everyone really does deserve access to information that can support them in being confident that they are receiving the highest-quality health care. That is why our government is so strongly committed to strengthening transparency in health care in the province of Ontario.

We are introducing this new legislation that, if passed, would make information on payments from the medical industry to health care professionals and organizations available to the public. We think that is absolutely crucial. It would require the medical industry to annually report payments that are submitted to health care professionals and organizations. As has been mentioned before, this would include paid meals, travel, research grants, and fees for services such as consultations or sponsored speaking engagements.

If passed, this new legislation would allow for the payment information to be publicly posted on a database, which would give Ontarians insight into the extent of private sector funding in the health care system.

We do not yet know, if you ask the question, what the extent is of this. We don’t yet know the extent of industry transfers of value to health care. But if passed, these changes would allow us to have a better understanding of these transfers of value. This would arm patients with the knowledge that they want and deserve, to make informed decisions about their own health care. It is very, very crucial that people have the right to do that.

The province deserves openness. The people of Ontario deserve openness and accountability, and we are working to make that the norm. France, the United States, Belgium, Denmark, Portugal and Slovakia have all addressed these issues through legislation, so we are aligning ourselves with a growing movement. We are leaders nationwide, as it turns out, as we are the first jurisdiction in Canada to move forward on this.

But we’re not going to stop there; we don’t think that’s nearly enough. If this bill is passed, it will not only increase transparency but will strengthen health system accountability and enhance the quality of care for patients. It would guarantee, for example, that all long-term-care-home operators are providing safe and quality care for residents. My mother was in long-term care for seven years. I was very closely attached, in touch, in communication on a daily basis with the long-term-care operators. They did a magnificent job with my mother, but there still were challenges to make sure that everything went forward the way that we wanted it to.

We do need a stronger inspection program with more robust enforcement tools, including financial penalties and new provincial offences. That would give ambulances the ability to transfer patients to more appropriate care settings, such as mental health facilities, to best address their individual needs. It would reduce overcrowding in emergency departments and provide the best care for patients in the most appropriate settings when they call 911 for assistance. It would protect Ontarians in their day-to-day lives by regulating recreational water facilities like splash pads and wading pools, and personal service settings like barber shops and nail salons.

The proposed changes under the Strengthening Quality and Accountability for Patients Act will roll out important initiatives that will help Ontario’s health care system to continue serving all Ontarians today and into the future.

Just briefly back to the Long-Term Care Homes Act: The safety and the quality of life of Ontario’s 78,000 long-term-care residents remains one of our government’s top priorities. As I said, I referenced my own mother’s experience in long-term care. While we know that the vast majority of long-term-care homes are in compliance with provincial rules and regulations, those that have recurring issues certainly cannot be tolerated. These proposed changes would enhance our oversight system for long-term-care homes.

With those words, I will now pass my time off to the member for Kitchener Centre.

The Deputy Speaker (Ms. Soo Wong): I recognize the member from Kitchener Centre.

Ms. Daiene Vernile: I spoke a little earlier this morning on this particular bill, beginning with information on the transparency piece, and you just heard my colleague the Minister for Northern Development and Mines touch on this.

Speaker, there are 10 elements to this very important review of this legislation, and I’d like to move on to the next one. I want to go through all of them. It’s important to have some detail and background on how exactly this is going to work.

The Health Protection and Promotion Act is up for review. This is going to allow the regulation of recreational water facilities—as you heard my colleague say, things such as splash pads and wading pools—to protect the health and safety of young children. These changes are also going to include personal service businesses like barber shops, nail salons and tattoo parlours. We need to better inspect these locations and ensure they are free from infections. These changes are going to bring us in line with other jurisdictions across Canada that are already doing the same thing.

We’re also including the Long-Term Care Homes Act. We know that the vast majority of long-term-care facilities are in compliance with provincial rules and regulations, but we would like to strengthen that. The legislation proposes new enforcement tools such as financial penalties and new provincial offences.

The next point is the Retirement Homes Act. We know that Ontario has a very robust oversight system, and this is enforced by the Retirement Homes Regulatory Authority. After recent consultations, we know that we can improve the system by strengthening oversight powers. We want to increase transparency, accountability and governance.

The next item on the list is the Ambulance Act. We are proposing a change to the Ambulance Act to give paramedics increased flexibility so that they can deliver alternative care options on-scene to patients. This would allow them to avoid unnecessary visits to emergency departments. Currently, paramedics are bound by law to take patients only to hospitals, so if this legislation is passed, it’s going to help reduce overcrowding in ERs because paramedics would be able to redirect low-acuity patients who call 911 to non-hospital officials.

I have had this conversation at length with a friend of mine, a family friend, who is a paramedic. They find it very frustrating that when they have a patient who might not necessarily need to go to an ER, this is where they are directed to go; this is where they have to go. They are looking forward to this particular change. They might be able to take them to a mental health facility or a home or a community care resource.

Speaker, I’m working my way down the list here. The next item is the Oversight of Health Facilities and Devices Act. We are proposing to strengthen the safety and oversight of services delivered in health facilities with medical radiation devices like X-ray machines, CT scanners, ultrasound machines and MRIs. We want to modernize and ensure the safety and quality of these devices.

With the Medical Radiation and Imaging Technology Act, 2017, we’re proposing changes to strengthen transparency and oversight of diagnostic medical sonographers. This is going to replace the Medical Radiation Technology Act with new legislation to cover the entirety of the medical radiation and imaging technology profession.

I’m down to the last three items in this very comprehensive bill. The Excellent Care for All Act: This is going to allow the Patient Ombudsman to carry out investigations in private, away from the Freedom of Information and Protection of Privacy Act.

The Ontario Drug Benefit Act, 1990: This proposed amendment is going to remove the last outdated reference to physicians in the Ontario Drug Benefit Act. It recognizes that other health care professionals, like nurse practitioners, for instance, can prescribe medications in Ontario. They’ve already been doing this. We need to make sure the legislation reflects what they are doing.

Here is the last point: the Ontario Mental Health Foundation Act, 1990. The province is proposing to repeal the Ontario Mental Health Foundation Act. This decision is based on the results of the review that came to the conclusion that this work is currently being carried out by community-based organizations.

Like I said, this is a very comprehensive bill. It’s going to update our delivery of the health care system in Ontario and it’s going to ensure greater transparency for patients in our province. We were guided by 43 different organizations and 60 individuals on shaping this piece of legislation. We know that it’s going to give people the health care that they rely on and that they deserve in this great province.

I now pass on to my next colleague.

The Deputy Speaker (Ms. Soo Wong): I recognize the Minister of Housing and poverty reduction.

Hon. Peter Z. Milczyn: It’s a pleasure to rise in the House this morning to speak to the Strengthening Quality and Accountability for Patients Act. There can be nothing more important in our health care system than ensuring that all patients can have the confidence that when the health professional that they are interacting with, whatever procedures or medications are being prescribed or directed for them, that that patient can have confidence that that is being done truly in their best interest.

I have absolutely no doubt that the women and men in health professions in the province of Ontario are acting with the utmost integrity and always with the best interests of patients at heart. But we do know that some pharmaceutical companies and some other companies who sell medical products make payments to doctors, to other health professionals, to promote their devices, their prescription drugs, or what have you, to encourage those health professionals to learn more about that product and to prescribe that product, or to direct a particular device being used.

There’s nothing wrong with these companies promoting their products and providing education to doctors, to nurses, to other health care professionals, but it must be done in a transparent way. It must be done in a way where a patient will have the confidence that the doctor, the nurse, the health professional they’re interacting with, that what they’re doing is being done openly and transparently.

With this act, requiring that the payments, the sessions, the training sessions, the training dinners or lunches—whatever the case might be—that these companies put on, they have to be reported, that people can see that these companies are doing and what the individual health practitioners are receiving. I think that’s a very important reform. I believe Ontario is leading the way in this. It’s going to make a meaningful impact in the way these companies operate, because I have confidence our health professionals are already acting in a way with extreme integrity.

Another very important aspect of this bill is some of the changes to the long-term-care industry and ensuring that long-term-care-home operators are providing safe and quality care for residents, with a stronger inspection program, more robust enforcement and much stronger penalties for those few long-term-care operators that aren’t following the rules and the law.

Madam Speaker, any of us—and probably most of us in this chamber—at one point or another have had a loved one in long-term care. The peace of mind that you need to have to know that your mother, your father, your grandparents, your great-aunt or -uncle are receiving the care that they should be getting, that they deserve to get—that it’s being paid for them to receive in a safe environment—is extremely important.

I know that, day in and day out, across this province, long-term-care homes provide excellent care to patients, but there are some instances where there needs to be more enforcement and there need to be penalties for those who aren’t doing things the way they should. This act will strengthen that oversight system.

Another aspect of this bill is changes to the Ambulance Act and giving more power to paramedics and EMTs to direct patients to where they should be going, depending on what their medical needs are. This will reduce overcrowding in emergency rooms and will ensure that patients get the type of care and attention that they need. A cut on your leg perhaps doesn’t necessitate a trip to the emergency room; it can be treated a different way. If there is some kind of a mental health crisis going on, again, it doesn’t necessarily need to be dealt with in one of our acute care emergency rooms.

This will give that additional flexibility to EMTs and to the system to direct people to the care that they need when they need it and how they need it. That’s going to be good for all Ontarians.

I could speak all morning to this, but I will pass the time on to the member from Davenport to make some further comments.

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

Mrs. Cristina Martins: It’s a pleasure to rise today to speak about this important bill. The people of Ontario deserve a health care system that they can rely on, health care that they can trust, and that’s why this important bill speaks exactly to that. We know that ensuring there is transparency within Ontario’s publicly funded health care system increases public trust, as everyone deserves access to information that can support them in being confident that they are receiving the highest quality of care.

One piece of this bill that I think is truly great and of note, and I know it’s been mentioned here before, is the amendments to the Ambulance Act. I know that getting reliable emergency services quickly isn’t just important; it can be a matter of life and death. That is why it is so important that our emergency health services are operating effectively and efficiently. The amendments to the Ambulance Act will allow us to effectively allocate our resources and also help patients by getting them the resources that they actually need.

But first, a little background: Today in Ontario, there are approximately 8,788 paramedics and more than 1,730 ambulances and support vehicles. Last year they transported nearly one million patients, and that number is growing each and every year. We know that many of the 911 calls are not of life-threatening nature; in fact, some are individuals having a mental health crisis who need specialized supports in a welcoming environment; others are seniors who do not need medical transportation, but do need reassurances and support of a medical professional. Up until now, if a call was made to 911, those individuals would be transported to an emergency room no matter the issue.

We believe that a more flexible way of managing our 911 system is putting patients first or utilizing our existing resources in the best way. The proposed changes to the Ambulance Act would allow our EMS workers to treat and release low-acuity patients who do not need additional medical care. It would also allow them to treat and refer patients to a health setting more appropriate than an emergency room. These are changes that will help reduce offload delays at our hospitals. This means ambulances will be able to spend more time available to respond to those calls where every second counts.

These changes will also ensure our emergency departments and hospitals are not filled with individuals who could be receiving more timely care in a more appropriate setting.

It is important to remember that emergency health services—911—will continue to provide immediate response to serious emergencies, and, in fact, this bill would enable ambulance and emergency rooms to be more available for serious cases.

It is important that we pass this bill. It would give ambulances the ability to transport patients to more appropriate care settings, such as mental health facilities, to best address their individual needs. It would reduce overcrowding in emergency departments and provide the best care for patients in the most appropriate settings when they call 911 for assistance, including care for those in the most serious need.

These are changes that just make sense. These are changes that will allow us to better allocate our resources so that we can continue to reduce wait times for emergency care. It will help patients by getting them the resources they need instead of bringing them somewhere they may not need to go.

This is a fantastic piece of legislation. I commend the minister for his work on this piece of legislation and look forward to supporting it when it comes up for a vote in the House.

The Deputy Speaker (Ms. Soo Wong): Questions and comments?

Mr. Lorne Coe: I’m pleased to rise and debate Bill 160 and, in particular, the comments provided by the members from Thunder Bay–Superior North, Kitchener Centre, Etobicoke–Lakeshore and Davenport. I think they all struck important points in their narratives.

I come to the debate as someone who has worked as a civil servant at the Ministry of Health and Long-Term Care and also at the Ontario Seniors’ Secretariat, and that’s coupled with my 13 years as a regional councillor with the region of Durham, where I chaired the health and social services committee. So I’ve seen the perspective of EMS, and I’ve seen the perspective of long-term care up close and personal. I think together in this chamber we all want to work towards a health care system that upholds the safety and quality for the residents in long-term care.

I think the member from Kitchener Centre made an important point. She spoke about the breadth of consultation that has brought the legislation to this point. I would submit that that robust consultation needs to continue as we move through the stages, as you’re well familiar with, with this bill. That should include, as it has thus far, a continuum with the family councils of Ontario, with the public health units here in Ontario, and also with the long-term-care association so we can arrive at a point where we’re all comfortable with the direction that this legislation is taking.

At the same time, the stakeholders, as we move to the committee structure, have an opportunity to continue to provide their voice on ways in which we can strengthen the legislation going forward.

This is an omnibus bill, and I’ll be speaking in more detail about it for 20 minutes later.

The Deputy Speaker (Ms. Soo Wong): Questions and comments?

Mr. Wayne Gates: It’s always a pleasure to rise in the House. But I have to address one of the things that the Liberals talked about when they were talking about health care.

One of the biggest challenges that we have in health care isn’t the $50 billion that we’re spending on health care; it’s how we’re dividing the pie up. I’ve said this before in the House. What’s happening with that pie is, we’re giving it to the LHINs and they run their organization. CCACs have been brought in to the LHINs now, but it’s still there. They get their part of the pie, and then it goes to a private company called CarePartners.

So now that pie has been divided three times, and do you know how much money has gone to health care? Anybody? I know you’re all listening to me; you’re not on your BlackBerrys. Do you know how much? Nothing has gone to front-line workers. That’s the issue.

So then CarePartners now takes their profit. I think last year it was millions—$300 million. It was an incredible amount of money. Again, no money goes to front-line workers. We have a crisis in health care because we’re not publicly funding our health care. We’re not making sure our nurses are getting the tools they need to do their job, that they’re getting the resources they need in our hospitals.

When people say to me, “Gates, you’re making this up”—I went to Antica last week with my family. It was my birthday. Nobody sang Happy Birthday to me; I was very disappointed. But at the end of the day, the waitress came to me. Her father is in the hospital. He’s sick; very sick. Do you know what they said to that woman? “There’s no place for him to go, but we might be able to get you into a place for $3,500 a month. Have you considered talking to your dad about selling his house to get long-term care in the province of Ontario?” This is a senior who has given his entire life to make my life better, and we’re telling him to sell his house.

The Deputy Speaker (Ms. Soo Wong): Questions and comments?

Mr. Arthur Potts: It gives me great pleasure to have a chance to comment on some of the remarks of my colleagues on this side of the House on this very important Bill 160.

I want to start by saying how delighted I was to hear the comments from the Minister of Northern Development and Mines and for him to bring his acuity to this House and talk at length about what this bill is doing. It will help not just all the people in Ontario but the people in his riding of Thunder Bay–Superior North.

He talked about the transparency that’s evident in some of the provisions of this bill. The most important part, of course, is about protecting the safety of residents in long-term-care homes. He mentioned his mother. I thought it was incredibly sweet for him to do that and to talk a bit about the experience she had in the home. What’s important to realize is that not all residents of long-term-care homes have a dutiful son who can look after them and work closely with them and the staff.

We have to be sure that our system is accountable in a way that all residents—regardless of whether they have a son as competent as he is to assist—get the care, and that the transparency and accountability is there in the system.

That’s why the Auditor General will have an opportunity now, if this legislation is passed, to do a value-for-money audit of all the long-term-care homes, which she currently cannot do. I think that’s an incredibly important part.

Also, the member from Kitchener Centre and the Minister of Housing spoke. Most importantly, I liked the comment from the member from Davenport about how we are decentralizing care in this bill so that emergency workers have a chance to look after people on the street who don’t have huge injuries; they can patch up a bruise or a rash and then decentralize the care. Then they can go and not have to be tied up in waiting in emergency rooms, tying up staff and valuable resources. They’re actually out on the street, where they’re needed most.

The Deputy Speaker (Ms. Soo Wong): Questions and comments?

Mrs. Gila Martow: I’m pleased to say a few words on Bill 160, the Strengthening Quality and Accountability for Patients Act.

We’re hearing a lot about new legislation that relates to health care in terms of long-term care, in terms of oversight of diagnostic testing. I think that the public is getting a little tired of us having discussions about new rules, new regulations and new oversight when they feel that front-line health care is just suffering so much. We can’t just keep adding to the bureaucracy and not somehow look at ways to find more efficiencies.

We heard from the Minister of Housing, I believe it was, who said that a cut on the leg doesn’t necessarily need an emergency room, and he’s absolutely right. It doesn’t need an emergency room. The public is asking for more clinics that are open evenings and weekends. They are asking for that. What are they seeing? Not far from my riding of Thornhill, we saw the urgent care centre at Branson close. We don’t see another urgent care centre being opened in that area.

If there are problems with a property in one location, obviously, before we shut it down, we have to find a place to lease and ensure that the doctors and health care workers from that centre don’t just get dispersed. It’s so hard to put a team together, to get that up and going again.

I hear from people who say that other provinces are funding new cancer treatments and cancer medications, and Ontario has fallen behind. Lymphoma Canada specifically is having a lobby day coming up in a couple of weeks. They’re very concerned about health care for their patients and their clients in Ontario.

I think that overall there’s a lot more that needs to be done. And e-Health was a fiasco in this province. We can’t just talk about oversight and oversight and oversight and, in the meantime, we spend $1 billion getting an electronic health care system going in the province and completely fail. And it is a big failure.

The Deputy Speaker (Ms. Soo Wong): I return to the member from Davenport to wrap up.

Mrs. Cristina Martins: Thank you, Madam Speaker. I want to thank the member from Whitby–Oshawa, the member from Niagara Falls—a happy belated birthday to him—the member for Beaches–East York and the member for Thornhill for weighing in on this debate this morning.

I think we all agree—and what I’m hearing is that the people of Ontario deserve health care that they can rely on, health care that they can trust. It’s important that we ensure that there is transparency within this publicly funded health care system to increase public trust, as everyone deserves access to information so that they can be confident that they are receiving the highest-quality care.

Do I agree with the member from Whitby–Oshawa that we need to engage our stakeholders and that we need to consult on ensuring that we’re actually proceeding in the right direction with this legislation? Absolutely. We definitely need to engage all of our stakeholders to guarantee, for instance, that all long-term-care operators are providing safe and quality care for residents and that we do have a stronger inspection program with more robust enforcement tools, including financial penalties and new provincial offences.

We also want to make sure that the ambulances are provided with the appropriate ability to transport patients to more appropriate care settings, such as mental health facilities, to best address their individual needs.

Madam Speaker, we are committed to improving access to the right care at the right time and in the right place and to connecting health care partners and providers across the patient’s journey. That’s what this bill, this piece of legislation, speaks to.

If I can just read a quote from Chris Dennis, CEO of the Alzheimer Society of Ontario, on what he says about this piece of legislation: “We are supportive of transparency around private sector influence in the delivery of health care and commend Ontario’s leadership on this issue. Quality of patient care is paramount, and we think everyone in this sector has a role to play to ensure that Ontarians are well informed so they can make the right”—

The Deputy Speaker (Ms. Soo Wong): Thank you. Further debate?

Mr. Lorne Coe: I rise this morning to speak to Bill 160, the Strengthening Quality and Accountability for Patients Act, 2017.

If passed, Bill 160 would implement a number of significant changes within the health care system. For example,

schedule 5 to the bill includes amendments to the Long-Term Care Homes Act, the Health Care Consent Act, the Substitute Decisions Act and the Personal Health Information Protection Act. These proposed measures are related to the use of restraints, inspections and penalties that include, among others, the following provisions.

Inspectors would be able to issue penalties to force long-term-care homes into compliance with the act but would also have the power to reduce the penalty amount if it presented unnecessary hardship on the long-term-care home. On this aspect, I believe it’s important that the minister advise, as we move through the discussion of this legislation, how many additional inspectors will be needed in order to ensure that the requirements of this new framework are met.

Furthermore, the ministry will also charge a fee for inspections for recurring non-compliance in long-term-care homes. What’s not clear, Speaker, is if the number of inspections will be capped at any point and instead be moved up to a licence suspension for non-compliance. We need greater clarity in that particular area.

Inspectors will also be granted the ability to revoke or suspend licences and order an interim manager to step in to run a long-term-care home. Additionally, the ministry would have the ability to claw back funding or withhold funding from a long-term-care home under the new enforcement tools. This is to the point I made earlier in the response to the earlier comments about the need for greater consultation, over and above what has occurred thus far.

Other proposed amendments in

schedule 5 of Bill 160 include a change to allow the minister to suspend licences and issue orders. I would note here that due diligence cannot be used as a defence by a licensee, although they may appeal within 28 days of the order or notice. The minister may also issue additional policy and operational directives dealing with care levels, but not make them home-specific.

In addition, the fees associated with penalties will be increasing under the proposed measures, with the first offence costing $100,000 or 12 months in jail and the second offence costing $200,000 or 12 months in jail. The proposed penalty rates are a substantial increase from the current penalties, which are $25,000 for first-time offenders and $50,000 for repeat offenders.

Some of the other proposed measures in

schedule 5 will be of particular interest to families, those people watching today who have a loved one with dementia. In particular, the bill would amend the law regarding secure units in Ontario’s long-term-care homes. Secure units are areas within a long-term-care home that are often used to keep people with dementia safe. These units will frequently have locked doors to prevent wandering and alarms on exit doors in case a resident leaves.

To be clear, these are protective measures to ensure that those with dementia do not find themselves in a situation where they could potentially be injured. The sections of the Long-Term Care Homes Act dealing with secure units were previously drafted, but they were never brought into force, meaning that those sections in the Long-Term Care Homes Act are not currently law.

To address this oversight, the bill before us today, Bill 160, and in particular

schedule 5, proposes to address this gap by legislating what would be called “confinement” and outlining the qualifications for when this confinement would be applicable for a resident, and what restrictions would apply should a resident be confined.

There are few situations in which the government permits people to be detained against their will, the most primary of which is imprisoning criminals. In order to ensure that senior citizens with dementia across Ontario are not subject to similar provisions, this gap in the legislative framework is rightly being addressed.

The proposed legislation states that residents of long-term-care homes cannot be restrained or confined due to convenience or a disciplinary measure. Further, the bill introduces specific criteria that would have to be met in order to confine a resident. Consent would be required of the patient if they are mentally capable of making the decision. Otherwise a substitute decision-maker, usually a relative, would be responsible.

If the substitute decision-maker consents to a resident being confined, the long-term-care home would have additional responsibilities to the resident, such as giving the resident written notice, verbally explaining a notice and providing an opportunity to meet a rights adviser.

But there’s no clear definition of what a “rights adviser” is. Bill 160 offers no definition, so the bill only goes so far. The Retirement Homes Act states that it’s the person designated by, or in accordance with, the regulations as a rights adviser. However, there’s no mention of a rights adviser in the Retirement Homes Act’s current regulations. I think it’s clear, as a consequence, that this

section of Bill 160 requires additional clarity and review.

Should the resident choose to meet with the rights adviser as set out in the proposed bill, this adviser would have to tell the resident that he or she has a legal right to disagree with being confined and apply to the Consent and Capacity Board for a hearing. At that hearing, the resident could then appeal to the board for the right not to be confined. Interestingly, a substitute decision-maker would have to give or refuse consent to the confinement in accordance with the provincial rules that currently guide how substitute decision-makers must make treatment decisions.

This means that it is possible a resident may at an earlier time have expressed a clear wish not to be confined in a long-term-care home, and a substitute decision-maker would be required to follow that wish.

What is unique here is that a resident who has a prior capable wish to refuse a particular medical treatment runs the risk of harming themselves in the long term when a decision made at an earlier time must continue to be honoured. For example, a person may have a prior capable wish never to be treated with a blood transfusion, even if that is what is required to save their life years later.

But here, Speaker, respecting a prior capable wish not to be confined in long-term care could introduce a risk of harm to others, as some people with dementia are not only confused but can also become aggressive. How these individuals will be treated could prove very difficult for families who want their loved ones in locked units due to legitimate safety concerns, including a risk of harm to other vulnerable residents in the long-term-care home.

Fortunately, a substitute decision-maker would have the right to apply to the Consent and Capacity Board for a hearing for permission to deviate from the prior capable wish, and consent to confinement. Such permission from the Consent and Capacity Board might be granted if the Consent and Capacity Board is persuaded that the resident, if capable, would probably give consent because the likely result of the confinement is significantly better than would have been anticipated in comparable circumstances at the time the wish was expressed.

While it’s logical to offer legal protections to persons being involuntarily detained, mirroring the legislation will likely introduce some practical issues, some of which I’ve raised already, and could put some long-term-care home residents at risk. Hopefully, the government will seek feedback from stakeholders to refine the bill and ensure that it strikes an appropriate balance of the liberties of residents alongside the protection of other, more vulnerable persons in the same long-term-care home.

The Ontario Progressive Conservative caucus wants to see a long-term-care system that upholds safety and quality and one that is hailed as a success for all residents in long-term care. As builders of our communities, residents in Ontario’s long-term-care homes deserve no less. They deserve no less.

The government must ensure that it allows for adequate time to educate the long-term-care sector about their new legal obligations, of which there are many, as opposed to simply applying charges, penalties or, even worse, treating them as though they are a cash cow.

Meanwhile, through some of the amendments to the Ambulance Act set out in the proposed

schedule 1 of Bill 160, the government is seeking to provide paramedics with increased flexibility to deliver alternate care options on-scene to patients. If these legislative amendments are adopted, paramedics will have the ability and the authority to refer patients to destinations other than hospitals, as is currently required by law. Under the proposed legislative regime, persons with mental health issues, for example, could be taken to a facility more appropriate than a hospital, such as a primary care or community-based health care facility.

However, this proposed framework would require that these alternate facilities be able to operate 24 hours per day, seven days per week, similar to hospitals.

I’d like to turn now, Speaker, to the proposed legislative measures in Bill 160 that purport to address transparency, freedom of information, and privacy.

I want to be clear in discussing these aspects that the Ontario Progressive Conservative Party supports transparency and openness across the health care sector and, in fact, across all of government. Looking for ways to increase transparency and accountability for Ontario’s patients and their families is a goal we all strive for and want to accomplish.

It’s crucial that the private information of patients is kept secure and not used beyond the purpose for which the information was collected and intended.

With respect to

schedule 4, the Health Sector Payment Transparency Act, there are aspects in this

section which we support, in particular the requirement to report information about financial relationships that exist in Ontario’s health care system, including health care research and education, and to enable the collection, analysis and publication of that information in order to strengthen transparency and openness.

Encompassed in the proposed

schedule 4 of this bill are the reporting requirements of transfers of value paid to all regulated health care professionals and organizations. However, both the specific recipients and the threshold for reporting have been left to be determined by regulation. The proposed reporting requirements would be substantial, and to omit the specific details of the reporting requirements and the framework within Bill 160 is a significant oversight within this particular schedule. I would urge the government to look at that particular

section again and I hope that we’ll see some amendments.

Speaker, you will know that a national campaign called Open Pharma was launched in June 2017, calling on the federal government to mandate the public disclosure of all payments and transfers of value, such as gifts and meals, from pharmaceutical companies to physicians. In particular, the Open Pharma campaign called on the federal government to make drug companies more transparent by publicly disclosing clinical information on the safety and efficacy of drugs and medical devices, and making industry-funded research open access so that it’s available for re-analysis in academic journals and other platforms.

In a recent Globe and Mail article, the federal health minister at the time, the Honourable Jane Philpott, said that any move to force the disclosure of payments to individual doctors should be left to the provinces to decide. It’s clear, Speaker, as you read the omnibus bill, Bill 160, that the proposed legislation in

schedule 4 is the government’s response to that. But while on the one hand, the government has proposed greater levels of transparency in certain parts of the health care sector, they have also created an exemption from the application of the Freedom of Information and Protection of Privacy Act in Bill 160. This exemption would apply to records in the custody or control of the Ontario Health Quality Council that were prepared or obtained by the Patient Ombudsman in the course of conducting an investigation within the meaning of

section 13.3 of the Excellent Care for All Act, 2010.

While the proposed measure in Bill 160 is designed to keep the information of patients private, as it should, in the event that the Patient Ombudsman must conduct an investigation, there is concern that the government will treat these legislative measures as a precedent to keep other less sensitive pieces of information out of the hands of the public in order to preclude scrutiny. This is clearly unacceptable and contrary to the broad intent and purpose of the legislation in terms of transparency and openness. The Ontario Progressive Conservative caucus will ensure that the government upholds its commitment to openness and transparency in the totality of Bill 160.

Significant portions of this omnibus bill—it’s quite thick; it’s several hundred pages long—have been left to be determined by regulation, the timing of which is unknown and the content uncertain, very uncertain. The ability of MPPs in this chamber to determine law through regulations gives enormous power to the minister to enact the specific measures of Bill 160 when and how the government wishes.

Ultimately, ministers of the crown should be tabling complete bills in the Legislature to give all members of this Legislature an opportunity to participate in rigorous debate regarding the impact of the proposed new measures and amendments to existing legislation, of which there are many in this omnibus bill. The notion that ministers can table a bill and then determine substantial, specific portions through regulations at a time most convenient to the government clearly does not give other members of the Legislature the opportunity to properly scrutinize the bill in its entirety, the entire context of it all.

Speaker, it also suggests a hurried consultation pertaining to Bill 160. This legislation, as I have described earlier in my comments, will significantly alter the health and long-term-care sectors in Ontario for years to come. I believe it is incumbent on the government to conduct ongoing consultations with all sectors within the health care system impacted by this legislation, to ensure that the sector stakeholders continue to have an opportunity to have their voices heard. I would encourage the government to conduct this type of consultations with the people in groups impacted by these changes, in particular on educating the health and long-term sectors about their new legal obligation.

Education is going to be crucial, as there are significant proposed measures in the legislation, including new enforcement tools, financial penalties and new provincial offences for non-compliance. The worst that can happen here, Speaker, is to rush through major changes, create a culture of fear, make the sector even more vulnerable and, as a result, have unintended consequences within the long-term-care sector and other aspects of the health system.

In closing, Speaker, there are a variety of proposed measures included in Bill 160 that will benefit Ontario’s health and long-term-care sectors, but the government must put greater effort and thought into the design and consequences of legislation, particularly when they seek to include such a large number of legislative amendments in one bill. In closing, at the end of the day, we want to make the health care system more efficient and improve the health care experience and health outcomes for residents we have the privilege of representing. They deserve no less.

Second reading debate deemed adjourned.

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

The House recessed from 1012 to 1030.

Introduction of Visitors

Mrs. Julia Munro: I’d like to welcome the parents of Rachel Marshall and a family friend, Martha Drake. Thank you for visiting the Legislature to see the page in action.

Hon. Tracy MacCharles: I’m very pleased to introduce a number of people that a number of my colleagues and I joined this morning at the co-op breakfast. First we have Peter Cameron, acting executive director of the Ontario Co-operative Association; Luc Morin, director and government relations committee member for the Conseil de la coopération de l’Ontario; I think also here is Michelle Vieira, director of sales and member relations at Ag Energy Co-operative Ltd.

We have a number of people here from Brown and Cohen Communications and Public Affairs: Howard Brown, of course; Laura Casselman; and Blake Keidan. Welcome to Queen’s Park and thank you for this morning.

Mr. John Yakabuski: It’s my pleasure this morning to welcome Jennifer and Darwin Groskleg here to Queen’s Park. They are the parents of today’s page captain, Olivia. Welcome.

Ms. Cheri DiNovo: It’s my delight to introduce to the House Chad Murray and his daughter, Victoria Murray. Welcome to Queen’s Park.

Ms. Ann Hoggarth: On behalf of the Minister of Community and Social Services, who couldn’t be here this morning, I would like to welcome legislative page Adam Pariag’s mom, Rayanna Pariag, and his aunt, Jenny Foo, to Queen’s Park.

Ms. Sylvia Jones: Please join me in welcoming a great member of my team, Chelsea Goberdhan. She’s graduating from Ryerson next Thursday. Welcome, Chelsea.

Hon. Jeff Leal: On behalf of my good friend and colleague Lou Rinaldi from the great riding of Northumberland–Quinte West, I welcome Philip Thomas and his daughter, Jillian, here today.

Hon. Deborah Matthews: I am delighted to introduce three members from the Human Resources Professionals Association, who are here today for the annual awareness day reception. In the east members’ gallery we have Scott Allinson, Gary Monk and Claude Balthazard.

Speaker, there’s a reception immediately following question period in room 230, and we’re all invited to that.

Hon. Michael Gravelle: I’d like to introduce Mr. Norm Tollinsky, who is the editor of Sudbury Mining Solutions, who is here in the gallery somewhere. Thank you, Norm, for being here.

Hon. Liz Sandals: There may be some overlap here with the Minister of Government and Consumer Services, but given that we have a lot of co-ops in Guelph, I wanted to point out that a couple of the co-op reps are my constituents, located in Guelph: Michelle Vieira, who is the CEO of the Ag Energy Co-op, located in Guelph; and Peter Cameron, the acting executive director of On Co-op, the Ontario Co-operative Association, with its head office in Guelph.

Mr. Percy Hatfield: Speaker, not to be outdone, as one of the co-chairs of the co-op caucus, I’d like to welcome all of those who attended our morning breakfast this morning as part of the co-operative movement. On behalf of all of us, thank you to the co-op members who are here.

Mr. Han Dong: Joining us in the public gallery are two fantastic youth leaders from my riding, Allen Wang and Madeleine Wieler. They are accompanied by Robert Xu, international student and currently a Canadian governor on the University of Toronto governing council. Welcome to Queen’s Park.

Hon. Indira Naidoo-Harris: I’m pleased to welcome Lily Hamilton, who is joining us on behalf of Plan International today through a program called Girls Belong Here. She will be shadowing me today and is here to celebrate International Day of the Girl, which is on October 11. Speaker, it’s Women’s History Month. I’m honoured to share my day with her. Welcome to Queen’s Park, Lily.

Mr. Todd Smith: I’d like to welcome a part-time Prince Edward county resident. He’s the vice-president of the Human Resources Professionals Association: my good friend Scott Allinson.

Hon. Jeff Leal: In the west public gallery today, I’d like to introduce Scott Duff and the great OMAFRA ministry team from the rural policy branch. Welcome.

Mr. Victor Fedeli: I’d like to wish our MPP Lorne Coe a very happy birthday. I understand it’s his plenty-ninth.

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

Further introductions?

Mr. Bill Walker: Seeing as we’ll be away next week, I’d like to just acknowledge Sylvia Jones’s 10th anniversary serving the great people of Caledon and Ontario.

The Speaker (Hon. Dave Levac): I have some introductions to do. First and foremost: the page captain, Greg Bannister from Brant. His mother, Patricia Bannister, is with us in the gallery. Thank you for being here on the pages’ last day.

Also in the Speaker’s gallery we have with us, from the Republic of Congo, honorary consul general M. Jean-Michel Itoua and Mr. Brice Dimitri Bayendissa, member of Parliament for the National Assembly of Congo. Welcome.

We also have with us in the Speaker’s gallery today His Excellency the High Commissioner of the Republic of Cyprus to Canada, Mr. Pavlos Anastasiades, and his wife, Maria Antonopoulou-Anastasiades. Welcome to the Parliament. They’re also here to celebrate the 57th anniversary of independence of the Republic of Cyprus, and there is a flag-raising at noon. Welcome and thank you. Congratulations.

Mr. Bill Walker: I’d also like to acknowledge Randy Hillier and Bob Bailey, my colleagues, on their 10-year anniversary.

Mr. James J. Bradley: I don’t know whether this is a point of order or a point of privilege, Mr. Speaker, but I was denied entry to the Albany Club last night.

The Speaker (Hon. Dave Levac): That was neither.

The member from Nepean–Carleton on a point of order.

Ms. Lisa MacLeod: I am seeking unanimous consent to put forward a motion without notice to provide for the immediate passage of Bill 163,

An Act to—

The Speaker (Hon. Dave Levac): Excuse me. We do those after; the explanations come after. I have to ask this.

The member is seeking unanimous consent to put forward a motion without notice. Do we agree? I heard a no.

Interjections.

The Speaker (Hon. Dave Levac): Order, please.

Therefore, it is time for question period.

Oral Questions

Energy policies

Mr. Todd Smith: My question this morning is for the Acting Premier. We know that the opposition parties think that the $4.6-million compensation package for the Hydro One CEO is too high. We know that the Ontario public thinks that the $4.6 million in salary for the CEO at Hydro One is too high. We now know that the Ontario Energy Board—the OEB—thinks that the $4.6-million salary for the CEO of Hydro One is too high. But what we don’t know is: Do the Liberals think that the $4.6-million salary for the CEO of Hydro One is too high?

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

Hon. Brad Duguid: I’m not sure why the opposition have such a tough time understanding the role of the Ontario Energy Board. They seem to want to have it both ways. When the Ontario Energy Board makes a decision that, I think, we all believe is in the public interest and do their job, they want to criticize them then. Then they talk about the Ontario Energy Board not having any role whatsoever in trying to lead consumers into thinking—

Interjection: It’s about the salary, not the board.

The Speaker (Hon. Dave Levac): I’m not going to be accepting those kinds of interjections, so be warned—well, actually, I shouldn’t use that word until I want to do that. Be aware that I am not going to accept those interjections.

Hon. Brad Duguid: I think they’re trying to lead consumers into thinking, somehow or another, that the government sets energy rates and that it’s not the Ontario Energy Board.

The Ontario Energy Board has an important role to play. They’re doing that role. We’re proud of the role that they’re playing. They’re standing up for consumers, as this government did when we cut the energy rates by 25% for our consumers.

The Speaker (Hon. Dave Levac): Supplementary?

Mr. Todd Smith: Speaker, perhaps the minister didn’t understand the question, but the Ontario Energy Board has ruled that $4.6 million is too high a salary for the CEO at Hydro One. That salary was handed to the CEO by this Premier and this Liberal government.

Two years ago, the Premier tried to defend this outrageous salary by saying that this is what they pay in corporate America and that it’s actually less than American energy CEOs, so $4.6 million is acceptable. That’s what the Premier said.

But I don’t think the Premier can still spin it that way, given the decision by the OEB in the last week that we’re paying way too much for all of the executives at Hydro One. It doesn’t require spin.

Mr. Speaker, it’s really simple: Do the Liberals think that a $4.6-million salary for the CEO of Hydro One is too high?

Hon. Brad Duguid: It’s funny, Mr. Speaker: A party that used to understand the importance of putting private sector acumen into decision-making in some of our agencies now seems to want to go in the exact opposite direction.

Hydro One is now a publicly traded company. Our role is to ensure that they have the ability to provide the best possible level of service to the people of this province, taking advantage of that private sector acumen, improving the level of service and improving the return to the people of this province of that now publicly traded corporation.

We believe that’s going to be in the public interest. We believe that we’re going to see—and we’re seeing—improvements in our energy system as a result of that. We believe the Ontario Energy Board is doing their role and performing it very well in ensuring that that public interest continues to be served. I’m not sure where the member finds that there is some kind of a problem with—

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

Final supplementary?

Mr. Todd Smith: If I’m reading between the lines here, it seems like the minister believes that a $4.6-million salary for the CEO of Hydro One is acceptable, and this Liberal government believes that a $4.6-million salary for the CEO is acceptable. I can tell you that people across the province disagree with this Liberal government—vociferously disagree.

Bill Kelly from CHML in Hamilton put it pretty well, I thought. He said that the Ontario Energy Board’s recent decision “slapped down Hydro One” because they wanted ratepayers to “cover what they called ‘administrative costs,’ which is a sly way of saying that they wanted more money to give increases to their already overpaid executives.” In fact, in the OEB ruling, they decided that the budget needed to be cut by $30 million.

So why did it take the Ontario Energy Board, and not the Liberal government, to slap down these high-priced executives at Hydro One?

Hon. Brad Duguid: This is far from the first time that the Ontario Energy Board has asked one of the energy agencies to reduce their rate-increase asks. In fact it’s very, very normal; it has happened almost every single year in every single application. I can share with the member a list of dozens of times where this has happened.

The Ontario Energy Board is doing their job; they are looking out for consumers across this province. This government is doing our job by lowering energy rates across this province for those very consumers. I ask the member opposite to do his job and tell it like it is: that the energy board is simply doing what is in their job procedurally, to ensure that consumers’ interests are looked after, and, at the same time, we have an energy system that is being improved on a daily basis by this new publicly traded company.

I think that’s good news for the entire province.

Fiscal accountability

Mr. Victor Fedeli: My question is for the Minister of Finance. Last month, there were two legislative reports on the state of Ontario’s finances. They were described as blistering and scathing. Those descriptions, Speaker, are well deserved.

Both of the Legislature’s—

Interjections.

The Speaker (Hon. Dave Levac): Stop the clock, please. The member from Beaches–East York, come to order.

As I indicated to both sides, I’m not going to tolerate the interjections, and you’ll see how quickly I’ll deal with them if I have to.

Continue, please.

Mr. Victor Fedeli: Both of the Legislature’s independent officers openly challenged the ministry’s credibility. The Financial Accountability Officer said that the minister is using “unlikely assumptions” to make his debt claims. In fact, they said that if any of these wild assumptions fall short, the government’s targets would not be achieved. They particularly took issue with the government’s overly optimistic growth projections.

If the FAO doesn’t believe the minister’s numbers, why should the people of Ontario?

Hon. Charles Sousa: Economists independent of government across Canada have cited this: Ontario is leading the way in economic growth in our country. The Conference Board of Canada has cited that we’ve outperformed and had the most transparent levels of reporting than any other government in Canada.

This member opposite continuously degrades and talks down the outstanding achievements of Ontarians and businesses in our province that are creating wealth, creating greater prosperity, and hiring for more jobs. We have the lowest unemployment of any part of this country, and we are overachieving every single year that we put forward our budgets, to the benefit of Ontario.

We’ve reduced the deficit to under $900 million just last year, and we’re going for it: We’re balancing the budget this year, next year and the year after that.

The Speaker (Hon. Dave Levac): Supplementary?

Mr. Victor Fedeli: Back to the minister: The FAO’s comments were strong enough, but the Auditor General painted an even more damning picture of the minister’s financial reporting. For the second year in a row, the auditor wouldn’t sign off on the province’s books without a big asterisk.

The auditor went further, stating flat out that the statements are “significantly misstated.” She says our deficit last year was $1.4 billion higher than claimed, and our debt is a whopping $12.4 billion higher. She warned us and the markets and investors that we need to be able to rely on government figures being accurate, but “this year they cannot do so.” That’s her quote. You cannot rely on their numbers.

Again we ask—and I know they’re belittling the auditor; I can hear their comments again. But we ask: If the AG and the FAO don’t believe the minister’s numbers, why should we?

Hon. Charles Sousa: Investors around the world believe our numbers. The people of Ontario and throughout Canada who buy our bonds believe our numbers. We have the highest liquidity of trade in bonds of any government across this continent, in fact.

Our debt-to-GDP has been reduced—and it continues to reduce—below 37%, again overachieving our targets. Our accumulated deficit—which is a representation of the historical activity of Ontario’s budgets—today is at around 27%, the same as it was 25 years ago. Our interest on debt as a percentage of revenue today is 8%. When he was in power, when the Progressive Conservatives were in power, Mr. Speaker, it was 15% of our revenues.

We are overachieving, and we continue to do so. We are using the same standards as we’ve always done, including what the Auditor General has done even as recently as three years ago.

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

Mr. Victor Fedeli: Back to the minister: If the minister is comfortable using, “significant misstatements” and “unlikely assumptions,” then it should be no surprise to hear what else he continues to claim.

They continue to say, “We’re leading the G7 in economic growth.” But Ontario is not number one, Speaker. There are 27 US states ahead of us.

The minister continues to claim that manufacturing exports are up, but StatsCan just last week reported that Ontario manufacturing sales suffered their largest decline in eight years.

Here are some of the recent headings: “July Trade Deteriorates”; “Exports Languish”; “Ontario Residents Hit by Manufacturing Downturn”; “International merchandise exports fell”; “Manufacturing sales slip.”

Speaker, given all these examples, plus the Financial Accountability Officer’s and the Auditor General’s criticism, how can anyone trust anything this government says?

Interjections.

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

Minister.

Hon. Charles Sousa: Mr. Speaker, facts do matter, and that side of the House—

Interjections.

The Speaker (Hon. Dave Levac): Well, we’re there. From now on, we’re going into warnings for those interjections. The member from Renfrew–Nipissing–Pembroke, come to order. You brought us to this point. Warnings are on.

Finish.

Hon. Charles Sousa: Mr. Speaker, facts matter. This member opposite is citing sources—

Interjection.

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

Carry on.

Hon. Charles Sousa: He’s citing references from years past, recognizing that as of today, Ontario is ahead of the curve. Our unemployment rate is the lowest it has been in 16 years, at 5.7%.

That’s not to say that we’re not continuously looking at stimulating economic growth around all of Ontario, recognizing some regional disparities exist. That member opposite and that party voted against those measures that improve prosperity, stimulate new growth and continuously balance the books.

Hospital funding

Ms. Jennifer K. French: My question is to the Acting Premier. In my community of Oshawa, I have constituents come into my office all the time to tell me about their long wait times in the ER. Lakeridge Health Oshawa is no different than hospitals in Tillsonburg, Etobicoke, Brampton, Toronto or Peterborough, which just announced that it will open 24 beds, without help from this Liberal government, just to try to keep up with the number of people who need care.

In February 2017, the occupancy rate of Lakeridge Health Oshawa’s acute care beds reached 92%. Does the Premier have a plan to fix this unhealthy mess that she has helped create in Oshawa?

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

Hon. Eric Hoskins: Of course, unlike the party opposite, which simply opposes all of the plans that we have for addressing capacity and wait time challenges across this province, and different than the party who opposed our $500-million investments in hospitals earlier this spring, we do have a plan.

With Lakeridge specifically—and they are facing challenges, because as the member knows, it’s a rapidly growing area. We’ve given them a planning grant so that they can actually plan not just for today but also 20 and 30 years into the future for that entire region of Durham. In fact, we’re doing the same in Scarborough. But for Lakeridge itself, specifically, they’re working together with Ontario Shores to open up a brand new behavioural support unit which is specific. They’ll be providing 20 beds for ALC patients who have mental health needs so that they can decant those out of hospital to a more appropriate setting.

The Speaker (Hon. Dave Levac): Supplementary?

Ms. Jennifer K. French: Again to the Acting Premier: Lakeridge Health in Whitby is also over capacity. In February, it reached 102%. I would like to remind the Premier again that a maximum of 85% capacity is considered safe.

The Premier has said over and over again that she makes decisions based on evidence. The evidence that Ontario’s hospitals are facing an overcrowding and hallway medicine crisis is out there. The evidence is piling up, literally piling up in the hallways. Why is the Premier refusing to act on the facts?

Hon. Eric Hoskins: I’m gratified that the member opposite mentioned the Ajax-Pickering hospital, which is part of the Lakeridge Health corporation. Lakeridge Health received, this year alone, a $6.6-million increase in their operating budget to allow them to make modifications and continue to provide that high-quality care. But also, when it comes to Ajax-Pickering and staying in line with the discussion on mental health beds specifically, we’re opening 20 new acute care mental health beds at the Ajax-Pickering site as well, in addition to what we’re doing at Ontario Shores.

We’re listening to the local community, we’re listening to the hospital leadership, and we’re making those multi-million-dollar investments on the operating side and on the capital side to make sure that they are able to competently address, with the highest-quality service, those particular needs.

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

Ms. Jennifer K. French: Again to the Acting Premier: In Oshawa, as elsewhere, it’s not just acute care beds that are over capacity. Mental health beds are also locked in a constant state of gridlock. Both Lakeridge Health in Oshawa and the Lakeridge facility in Whitby registered capacity numbers in their mental health beds of 115% last winter.

The Premier cannot defend this, but can the Premier tell the people of my community when help from this Liberal government is coming?

Hon. Eric Hoskins: I would hope that the member opposite would understand and believe that 40 brand new beds for mental health, 20 of them for ALC patients who have specific mental health challenges, 20 acute—which is through Ontario Shores, in concert with the Lakeridge site in Oshawa, as well as 20 new acute beds at the Ajax site.

But the NDP, in a single year in 1994, announced a $53-million cut to 10 of Ontario’s psychiatric hospitals: in Hamilton, in Brockville, in Kingston, in Thunder Bay, in London, in North Bay, in Penetang, in Toronto, in St. Thomas and in Whitby. That represented up to a 17% cut in the operating budget of some hospitals—a $4.7-million cut in Hamilton alone; a $5-million cut in Whitby alone; $6.3 million in Kingston.

In the end, the NDP was forced to backtrack, so instead of $53 million, they only cut $20 million—in a single year, Mr. Speaker.

Long-term care

Ms. Teresa J. Armstrong: My question is to the Acting Premier. Yesterday, the Minister of Health said that the vast majority of long-term-care homes in Ontario are meeting the province’s minimum standards of care set out in the various acts that apply to them. But what the minister and the Premier failed to realize, it seems, is that this is not good enough.

Families with loved ones in care have been coming forward, speaking up for months to tell this Liberal government about the heartbreaking conditions in some of these care homes. Does the Premier not care what families are telling her, or is she just out of touch with what’s really going on in this province?

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

Hon. Eric Hoskins: The NDP continues to disparage not only our hard-working front-line workers in long-term cares across the province, but also does not understand that we are, in fact, listening to Ontarians and we are listening to residents of long-term-care homes who call long-term-care homes their home. We have an obligation and a responsibility, which I take very seriously, to ensure that we’re providing the highest quality of care.

Again, I need to ask the question of whether that party is going to vote for or against the new legislation that has just been proposed last week, which actually will increase our ability to further inspect homes, will increase the penalties and fines available to government to impose upon those non-compliers and give other powers to the government so we can ensure that not only is there compliance with the act, but that these homes are of the highest quality possible.

The Speaker (Hon. Dave Levac): Supplementary?

Ms. Teresa J. Armstrong: Speaker, this is what’s happening in long-term care: seniors are being left in beds for 18 hours, getting a bath just once a week, constant short-staffing and a lack of consistency in care. Vulnerable seniors are not even getting the basic help they need to make it to the bathroom on time. These are just a few of the thousands of stories described to me in the past few months by families with loved ones in care.

How can the Premier continue to claim that everything is fine in these homes when she hears from families themselves that there is a crisis happening right under her nose?

Hon. Eric Hoskins: That is precisely why this week I issued three “cease admissions” to long-term-care homes in this province, because they weren’t complying with the act and because there were director’s orders against those homes for issues such as a fall taking place and that fall not being reported to the proper clinical authorities, the physician who would then do the proper assessment. These are critically important activities that need to be taken, that need to be done in adherence with the act.

But, Mr. Speaker, it’s also important to recognize that we’re seeing that impact from our annual inspections of 100% of our long-term-care homes. We’re seeing that since 2014, the average number of compliance orders issued during an annual inspection has actually gone down by more than 50%.

We are seeing the improvement—the inspections are working—but we need to identify and act on those that are not in compliance.

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

Ms. Teresa J. Armstrong: The three cease-admission orders in London, Mississauga and Fergus are indicators that there are systemic problems in long-term care. Over and over again, we have told the Premier and her Minister of Health the heartbreaking stories of neglect, and even abuse, in long-term-care homes.

Over and over again, we have called for the Wettlaufer inquiry to be expanded, so that we can get an honest picture of what’s happening in the long-term-care system, identify the systemic issues and fix them. But over and over again, the Premier and her minister have ducked our questions and refused to expand the inquiry which would help thousands of people. They are content to ignore the problems in our long-term-care system.

Can the Premier tell us: When will there be enough evidence for her to take this issue seriously?

Hon. Eric Hoskins: We are taking it seriously—and we’ve been taking it seriously for a lot longer than the member opposite and her party have been raising this in a partisan fashion and fearmongering across this province.

People in their long-term-care homes don’t need to be afraid of the quality of care that they’re receiving—with a few exceptions, which we’re addressing effectively. They need to be afraid of what the NDP is doing in fearmongering and suggesting to Ontarians that their loved ones are not safe in long-term care homes.

I think it’s reprehensible. I think it’s completely inappropriate—

Interjection.

The Speaker (Hon. Dave Levac): The member from London–Fanshawe is warned.

Finish, please.

Hon. Eric Hoskins: I think it’s completely inappropriate to be elevating it to that level of conjecture and fearmongering across this province.

If they believe in supporting the long-term-care sector, why did they vote against our $80-million investment in this year’s—

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

New question.

Manufacturing jobs

Mr. Ernie Hardeman: My question is to the Acting Premier. Two weeks ago, I stood up in this Legislature and asked the Premier to change her policies that are driving jobs out of Ontario, including the 1,300 layoffs that have been announced in Oxford over the last 10 months.

Business after business warned this government that the high cost of operating in Ontario would force them to close their doors or move.

Yesterday, 200 more layoffs were added to that total, as Firestone announced that they are closing their doors after 81 years, and shifting their remaining production to North Carolina.

Will the government now finally admit that their policies are driving jobs out of Ontario, and take action today?

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

Hon. Brad Duguid: Let me respond to that question in two parts, Mr. Speaker.

I want to start off by saying that we share the member’s concerns for that community. They’ve been hit by a couple of significant layoffs in the last month or so, and we’re very aware of those challenges. In fact, we’ll continue to work with local authorities there. Our focus will be on helping those workers find other opportunities, and we’ll continue to ensure that our training, colleges and universities—now our MAESD—will be engaged in that as well. We’ll work—

Interjection.

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

I’ll keep doing it.

Hon. Brad Duguid: I’m not sure why he’d be heckling me at this time, Mr. Speaker. We’re talking about something very important to one of his colleagues.

I look forward to working with my colleague, as will my colleague minister, to help in any way we can.

In the supplementary, I’ll address the issues about Ontario’s competitiveness.

The Speaker (Hon. Dave Levac): Supplementary?

Mr. Ernie Hardeman: Mr. Speaker, 1,500 layoffs in Oxford in less than a year, and 2,800 CAMI employees on strike, trying to keep their jobs in Ontario—the government can try to spin this however they want, but that’s the impact of your policies.

The people of Oxford are doing everything we can to support our local businesses, but this government just adds more and more burdens until the companies are forced to close their doors. How many more people have to lose their jobs before you’re going to take real action and keep our businesses and our jobs in Ontario?

Hon. Brad Duguid: Mr. Speaker, now it’s time for me to bring the member into the real world, because that is not the real world in Ontario or even anything close to it.

This province is growing faster than the G7s on average. We have an unemployment rate in this province that’s at a 16-year low. We have created 760,000 net new jobs since the global recession. For the member to talk down the work that’s being done in this business community and in this province to create jobs is absolutely inappropriate and absolutely wrong.

I understand there are challenges in that particular community. There have been a couple of very significant layoffs. We will work with the member to help those workers, but the best thing we can do is stay on track—to keep building this strong economy in Ontario, keep leading the G7 and keep that unemployment rate at record lows. We’re determined to do that, and we—

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

New question.

Children’s mental health services

Mr. Michael Mantha: My question is to the Minister of Children and Youth Services.

In a letter you received from Chief Elaine Johnston from Serpent River First Nation, it said that if a family lives in Sault Ste. Marie, Blind River or Elliot Lake, they have direct access to Algoma Family Services children’s mental health services. However, if a family lives on a First Nations community, they receive no children’s mental health services from Algoma Family Services. Minister, why is this?

Hon. Michael Coteau: I’d like to thank the member for the question. I’ve been in this position now for just over a year and have had the opportunity to visit many of our indigenous communities across the province of Ontario. In fact, two weeks ago, I was at Treaty 3 and met with the chiefs in Kenora. I signed a historical document out there, moving toward an agreement between our indigenous partners and the government of Ontario to put the resources and the control back in the hands of the community, so that young people from the indigenous communities can get the services they need and they deserve where they live.

This is the first time in the history of this province—in fact, this country—that we’ve made a type of agreement that will put the responsibility and the ownership of the responsibility to look after children back into the hands of the communities, where it should be. I’m very proud of this government’s direction with regard to that policy.

The Speaker (Hon. Dave Levac): Supplementary?

Mr. Michael Mantha: Again to the Minister of Children and Youth Services: Algoma Family Services has indicated that they don’t have the expertise or resources to provide any services to First Nations in my area or to indigenous children who are in the care of Nogdawindamin Family and Community Services. This is why Nogdawindamin has submitted a proposal to your ministry to fund the delivery of culturally-appropriate children’s mental health services to my area’s First Nations communities. Your ministry simply answered that there is no money for this.

Minister, every child matters. Why is there no money for direct treatment of children’s mental health on First Nations in my area?

Hon. Michael Coteau: Mr. Speaker, we brought forward Bill 89 this year. Again, it was a historical document. It was the first document in the history of this country that acknowledges that a cultural approach to working with communities is necessary. It actually acknowledges that systemic racism does exist, and indigenous communities have been victims of colonialism here in the province of Ontario and across this country.

When we moved forward with that bill, the NDP supported it. The Conservatives did not support that bill, Bill 89. We still don’t know today why they didn’t support that bill that raised the age of protection and moved forward to build a framework to put those resources back in the hands of the community.

Mr. Speaker, you’ll see, as we go forward here in Ontario, that those resources will be put back in the hands of the community. It’s the first government in this country to do just that.

Women’s health services

Ms. Sophie Kiwala: My question is to the minister responsible for the status of women. This past week, I received a very concerning call from my daughter. She was walking down the street in Ottawa when she came across a protest. She was walking by the Morgentaler Clinic. We know, in recent months, protest activity outside of several abortion clinics across Ontario has escalated to the point of harassment and intimidation. My daughter, who was simply walking down the street, felt it, and she called me about it—let alone the women and health care providers who work in these clinics. This is not right. And we know that it is happening all across this province.

Mr. Speaker, as a woman, a mother and a member of this government—we have a responsibility to act. Yesterday, the government introduced legislation that would, if passed, do just that. Can the minister please tell us about our government’s plan to keep these women safe?

Hon. Indira Naidoo-Harris: I’d like to thank the member from Kingston and the Islands for raising a very important question.

Speaker, as a woman and a mother with a young daughter, I have an obligation to not only my daughter but to all women in this province and their daughters who make a difficult choice. It is my belief and our government’s belief that every woman in Ontario has the right to make decisions about her own health care and that they should be able to do so freely, without fear of bullying, intimidation or harassment.

In fact, that is why our government introduced safe-access-zone legislation yesterday that sends a very clear message that we will not tolerate any form of harassment against women exercising their fundamental right to choose. These proposed access zones would help ensure that women across Ontario have safe access to health care services and that their privacy and dignity are protected.

The Speaker (Hon. Dave Levac): Supplementary?

Ms. Sophie Kiwala: I know that the women across this province and the staff at these facilities are relieved to hear about this government’s actions and work towards this.

However, I would like some further information about the legislation.

The difficult decision that these women make is not one that is ever made easily. It’s a very difficult decision they live with for the rest of their lives. The reasons for making such a decision are deeply personal and are entirely up to them and no one else. We have a responsibility to ensure the privacy and emotional well-being of these women who make a choice about their own physical and emotional health. This responsibility, of course, also extends to health care providers.

Mr. Speaker, through you to the minister: How can we ensure that there is safety in every clinic, in every home and on the street?

Hon. Indira Naidoo-Harris: The member raises a very good point.

I can tell you that yesterday the health care professionals and advocates in the room were very supportive of the proposed changes we are making to protect their patients and themselves. In fact, they applauded. They were telling us how much this legislation was needed to stop women from being harassed, intimidated and bullied.

This legislation would, if passed, provide for the creation of safe access zones of 50 metres, which can be increased up to 150 metres, around abortion clinics.

We can’t just stop there. We also have a duty to protect the safety and security of the staff who offer women’s reproductive services, which is why this legislation would also implement safe access zones of 150 metres around the homes of the staff.

Speaker, we’re moving forward with this legislation because we take this seriously, because we have a responsibility to the women in this province.

Workplace Safety and Insurance Board

Mr. Robert Bailey: My question is to the Deputy Premier. Deputy Premier, the WSIB recently made significant changes to its hearing aid program without properly consulting audiologists and WSIB recipients. Before the summer, the Minister of Labour committed to looking at ways to fix the mess the WSIB has created. However, months later, the official opposition is still hearing from patients right across this province who cannot access the hearing aid that works best for them. We’ve heard stories of individuals limiting their time with loved ones because the hearing aid they are now forced to use is affecting their quality of life and hearing.

Deputy Premier, Ontario hearing aid patients are asking you to put them first and reverse the WSIB changes that are not benefiting anyone. I ask the Deputy Premier today: Will you act?

Hon. Deborah Matthews: Minister of Labour.

Hon. Kevin Daniel Flynn: Thank you to the member for that important question. I think a number of us in the chamber have been asked about exactly the same thing. What we need to ensure is that the WSIB is operating in the best interest of workers at all times. It’s an organization that was put in place to ensure that if somebody is hurt on the job—our preference is that the injury does not take place in the first place; we work hard on prevention.

Should that injury take place, and from time to time those injuries can include hearing loss, we need to ensure that the services that are provided to the worker are services that meet the needs of the worker, whether it’s a return to work, whether it’s a recovery from illness.

The information that the member has brought forward was a change in policy at the WSIB. It was an attempt to ensure that the services that are brought forward in terms of hearing aids are the ones that are best to meet the needs of the injured worker.

We have talked to the WSIB about this, we remain in conversation with them and we hope we can reach a resolution. I’ll address the rest in the supplementary.

The Speaker (Hon. Dave Levac): Supplementary?

Mr. Robert Bailey: To the Minister of Labour again: Just one single audiologist from my riding of Sarnia–Lambton alone has sent over 30 appeals to the WSIB in the last few months. It takes an average of three to six months to receive an answer. In my riding, I have met with more than a dozen affected constituents and received over 200 handwritten petitions on this issue. I can only imagine how many other patients and constituents are being impacted right across this province.

To the minister: Let’s do what is right and what’s fair, and make sure that injured workers in Ontario have access to the hearing aids that they need without further delay. Will the minister deal with this issue today?

Hon. Kevin Daniel Flynn: I appreciate the question from the member. He and I have had a number of exchanges about health and safety in his own riding. I have always found the member to be very sincere. He brings issues to me first. He doesn’t try to hijack the House when he brings these things forward.

I’m committed to continue to work on a variety of issues with the WSIB, because I know they’re brought forward sincerely. In this case, what I think you have is an organization, the WSIB, that thinks it’s doing the right thing; that has looked at what exists today in terms of hearing aids that are available to members of the public, to citizens of Ontario, who need to avail themselves of the services of the WSIB and have tried to provide that service in as effective and efficient a manner as they possibly could. However, you have a number of citizens who think that this is not working for them.

I believe that, working with the member, we can sort this out and everybody can get what they need at the end of the day.

Employment standards

Ms. Cindy Forster: My question is to the Deputy Premier. This morning, the Liberal government made it clear they don’t intend to support the NDP’s push for paid leave for victims of intimate partner violence, despite clear evidence that too many women are afraid to escape because they simply cannot afford to.

We heard from Unifor’s Sue McKinnon at the Bill 148 hearings this summer, who described one woman’s nightmare: She packed her life in a basket and fled with her three children. She was in constant fear of making sure her kids were fed, safe and had a roof over their heads, and she still had to make mortgage payments on a home that her partner destroyed.

Why is this government ignoring women who say paid leave will help them escape with their lives?

Hon. Deborah Matthews: Minister of Labour.

Hon. Kevin Daniel Flynn: I appreciate the question, but we are doing anything but ignoring women in the province of Ontario.

If you look at the impacts of Bill 148, a lot of the advantages that will be gained by the passage of that bill, should the House presume to do that, will be aimed directly at women who haven’t been treated in the past in the workplace the way they should. That’s the whole point of this.

I was in Hamilton this morning speaking at the YWCA. As a result of us taking Bill 148 out after first reading, we were able to hear from people around the province of Ontario. One thing they brought forward was something that the member is bringing forward again, and that is domestic violence. People need to know that when they need to take time off in the eventuality of that, their job is not in jeopardy and they’re not at risk of being fired. That’s exactly what we do with leaves in the province of Ontario.

I believe if we work together on Bill 148, we can bring forward a bill that will exactly meet the needs of these women.

The Speaker (Hon. Dave Levac): Supplementary?

Ms. Cindy Forster: Back to the Acting Premier: New Democrats have repeatedly called for paid leave for victims who need it. The member from London West introduced two pieces of legislation; your government is stalling it. New Democrats introduced amendments to Bill 148 during the clause-by-clause; the Liberal government voted against those amendments.

The NDP leader, last week, the member from Hamilton Centre, introduced a bill that would have 10 days’ paid leave for victims of sexual and domestic violence so that survivors can afford to take a leave, so they can afford to have time off to file police reports, and so they can have time off to testify in court proceedings against their abusers. But the Liberal government refuses to support this. Why is that?

Hon. Kevin Daniel Flynn: Once again, I appreciate the question, but the information being brought forward to the House simply is not accurate in this regard.

I was out in Hamilton this morning, talking publicly about the reason we took Bill 148 out in the first place; the way that we have listened to the people of the province of Ontario; and the way we are bringing forward up to 17 weeks of job-protected leave.

What we do in cases of compassionate leave, or these types of leaves, is that the province, under the Employment Standards Act, under the Labour Relations Act, under the Occupational Health and Safety Act, provides the job protection. It says to the individual, “Your job is not in jeopardy during this period of time.”

We then turn to our federal counterparts in Ottawa, which I have done, Speaker, and we ask them to provide the income during that period, under employment insurance.

We’re doing the right thing here; we’re doing right by women. With the support of the House, we’ll get to where we need to get to.

Post-secondary education

Ms. Ann Hoggarth: My question today is for the Minister of Advanced Education and Skills Development.

Ontario has one of the most highly skilled workforces in the world, and this is thanks in large part to the incredible transformation of our post-secondary system that we’ve undertaken in the last 14 years.

As I’m sure all of us will agree, increasing access to post-secondary education by removing unnecessary barriers is one of the best ways that we as a government can help improve the life outcomes of Ontarians.

As such, Mr. Speaker, can the minister please inform this House how we have removed barriers and increased access to post-secondary education in our province since 2003?

Hon. Deborah Matthews: It has been a remarkable 14 years for post-secondary education in Ontario.

Members of the opposition have said they don’t believe that cost and income are real barriers to post-secondary education. That couldn’t be further from the truth. We know that participation rates for kids from higher-income families are far, far greater than for lower-income families. That’s why we have moved forward with an extraordinary transformation of student assistance, of OSAP.

This year, over 200,000 students in Ontario are getting free tuition, and there’s help for hundreds of thousands more students. That’s almost one third of our students who are getting free tuition, and another third are getting help as well, Speaker.

The number of students attending has also gone up dramatically, by over 38%. We’ve made investments, and they’re paying results.

The Speaker (Hon. Dave Levac): Supplementary?

Ms. Ann Hoggarth: Thanks to the minister for her answer.

When our government was first elected, our post-secondary sector was in desperate need of significant investments to make sure that its institutions could continue to provide the world-class education our students expect and deserve. But we know that world-class education and instruction require world-class facilities and faculty.

Accordingly, Mr. Speaker, can the minister please share with this House and all Ontarians some examples of significant investments our government has made to improve Ontario’s colleges and universities in the last 14 years?

Hon. Deborah Matthews: As I said, enrolment has gone up by 38%, but grants to colleges and universities have almost doubled: They’ve gone up by 85%. That allows our colleges and universities to hire top-tier instructors and deliver state-of-the-art programming. We’ve invested heavily in the physical structure of their facilities as well.

Speaker, when the Conservatives were in power in 2003, their last year of power, they spent about $100 million in capital for colleges and universities. We have, on average, invested $300 million a year on colleges and universities. We’ve done that so that we’ve been able to build important projects such as the Software and Informatics Research Centre at UOIT in Durham and the Bata Library Research and Innovation Cluster at Trent. These are just two examples of the extraordinary investments we have made.

Wind turbines

Mr. Jim McDonell: To the Deputy Premier: The government is no stranger to the Nation Rise Wind project in the township of North Stormont. If it has been paying any attention, it would know that the municipality doesn’t want it and the local residents don’t want it. The minister has admitted that the province doesn’t need the power that Nation Rise or any other wind or solar contracts that are still being offered, signed and imposed on unwilling communities will generate. Nation Rise scored zero on all the IESO’s rated criteria, yet it was still offered a contract. It is unwanted, unneeded and unjustifiable.

What is this government waiting for? Why will it not cancel?

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

Hon. Brad Duguid: The Minister of Energy and the previous Minister of Energy have put in place a process now that very much takes into consideration the local concerns about these projects. But time and time again, the party opposite’s true colours come out. Any time there’s any resistance at all to any renewable project, they’re up on their feet talking about how they don’t support renewable, clean energy.

We do have to start thinking of the big picture here. We need to start thinking of our kids and the health of our population. That’s why, while local concerns are very, very important and we’ve taken measures to ensure that voice is heard, we’re very proud to be the first jurisdiction anywhere in the world to eliminate coal and move to cleaner sources of power. That is going to help our kids live longer. That’s going to save lives in this province. It’s helping to build a very strong clean-tech sector here in the province of Ontario.

The Speaker (Hon. Dave Levac): Supplementary?

Mr. Jim McDonell: Back to the Deputy Premier: It’s clear that we just don’t need the power. All the independent experts who have taken a look at this government’s energy record have gasped in dismay at the total mess that you’ve made. Only this government can force clean, green Bruce Power to vent steam to reduce generation, spill renewable water resources over dams, pay wind and solar companies more than the power is worth, cause an eight-terawatt surplus in generation, sell the surplus for a loss and then proclaim that everything is just fine.

We already have a surplus of power today before Nation Rise is even built. This province doesn’t owe the owners of Nation Rise a contract, but it does owe the citizens of North Stormont a duty to listen and to represent them.

North Stormont is an unwilling host. Which part of “unwilling” does this government not understand?

Hon. Brad Duguid: The Minister of the Environment.

Hon. Chris Ballard: Thank you for that important question and the ability to once again stand up and defend green energy in this province, because I’m not sure if the party opposite actually believes in green energy.

This government takes concerns regarding the environment and human health very seriously. Let me say that our ministry adheres to a very strict renewable energy approvals process. There’s not a single renewable energy project that the PCs have ever spoken in support of here in this House. They have no plan to help Ontario families and businesses make sustainable choices and lower—

Interjection.

The Speaker (Hon. Dave Levac): The member from Prince Edward–Hastings is warned.

Your time has expired. New question?

Poverty

Mrs. Lisa Gretzky: My question is to the Acting Premier. Last week, the Daily Bread Food Bank released their annual Who’s Hungry report, and Toronto families were shocked by how dire the situation has become. Food bank visits in Toronto are at the highest level since the 2008 recession, with seniors listed as the fastest-growing group of food bank users, up 27% from last year. The average length of dependence on food banks has gone from 12 months to 24 months, with Scarborough families seeing a 30% increase in food bank visits.

These figures are heartbreaking. People are skipping meals so they can pay the bills and keep a roof over their heads. When will this Premier take off her blinders and see that this province is in crisis?

Hon. Deborah Matthews: Minister responsible for poverty reduction.

Hon. Peter Z. Milczyn: I want to thank the member from Windsor West for the question. All Ontarians believe that no one should have to make the choice in this province between feeding themselves or their child or paying some other bill. We have a moral responsibility to ensure that all Ontarians have access to safe and good food.

We know, through the research we have done, that there’s a number of initiatives that need to be done. We’ve worked on improving income support programs. If approved, the increase in the minimum wage is going to provide Ontarians a better living wage so they can pay for those needs that they need to. We’re working on preventing homelessness in this province to ensure people have a safe place to stay, which includes supports that assist them with all their other daily needs.

I’m happy to answer more in the supplementary.

The Speaker (Hon. Dave Levac): Supplementary.

Mrs. Lisa Gretzky: Again to the Acting Premier: This government can say they are taking steps to address inequality with a $15-an-hour minimum wage and basic income, but the Liberals have had 14 years to make life better in Ontario and they have failed. In fact, the Daily Bread Food Bank explicitly states, “While on paper the economy may be doing well, in the real world, many people are not.”

We know what the Conservatives have said when times get tough. The last Conservative government told low-income families they could just buy dented cans and eat baloney sandwiches to save money. In eight years, they never once raised the minimum wage from $6.85.

New Democrats will not stop fighting to raise families up, even though this Liberal government keeps pushing them down. When will the Premier get her priorities in order and actually start fighting for Ontarians?

Hon. Peter Z. Milczyn: I want to thank the member from Windsor West for reminding the House about the damage the Conservatives did during their time.

I’m working in my ministry on the food security strategy which we’ll be consulting on later this fall. Last week, I met with the director of the Daily Bread Food Bank, which is actually in my riding. She said her number one ask on food security is affordable housing. We’ve extended rent control to all Ontario tenants to make sure all Ontario tenants are treated fairly. We’re investing in homelessness prevention initiatives across the province to make sure people have a place to stay, and the other supports, including access to food, to have a dignified life.

We’ve been taking action for 14 years, and we will continue to deliver on fairness for all Ontarians.

Child care

M me Nathalie Des Rosiers: Ma question est pour la ministre responsable de la Petite Enfance et de la Garde d’enfants.

For 14 years, our government has been a real champion of child care, taking action to make sure that we all have access to quality and affordable child care. We know there was a lot of work to do because this file was not a priority when the party opposite was in power. I know, as a working parent, how important it is to have good child care options, an