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October 19, 2016

41st Parliament, 2nd Session

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Hansard Transcripts

Votes and Proceedings

Orders and Notices

Hansard Transcripts 2016-Oct-19 (PDF)

L017 - Wed 19 Oct 2016 / Mer 19 oct 2016

LEGISLATIVE ASSEMBLY OF ONTARIO

ASSEMBLÉE LÉGISLATIVE DE L’ONTARIO

Wednesday 19 October 2016 Mercredi 19 octobre 2016

Patients First Act, 2016 / Loi de 2016 donnant la priorité aux patients

Introduction of Visitors

Cindy Nicholas

Oral Questions

Hydro rebates

Health care funding

Electronic health information

Privatization of public assets

Health care funding

Automobile insurance

Health care funding

Health care

Health care funding

Small business

Heath care funding

Child care

Municipal government

Health care funding

Deferred Votes

Ontario Rebate for Electricity Consumers Act, 2016 / Loi de 2016 sur la remise de l’Ontario pour les consommateurs d’électricité

Introduction of Visitors

Members’ Statements

Hydro rates

Disaster relief

Advanced manufacturing and design technologies

Child Abuse Prevention Month

Autism treatment

Sanctuary Refugee Health Centre

Assistance to farmers

Small business

Dick Watts

Introduction of Bills

Election Statute Law Amendment Act, 2016 / Loi de 2016 modifiant des lois en ce qui concerne les élections

Statements by the Ministry and Responses

Women’s History Month / Mois de l’histoire des femmes

Access to justice

Women’s History Month

Access to justice

Access to justice

Women’s History Month

Motions

Private members’ public business

Private members’ public business

Petitions

Hydro rates

Post-secondary sector employees

Hydro rates

Privatization of public assets

Green power generation

Logements pour personnes âgées

Hydro rates

Lyme disease

Hospital funding

Hydro rates

Agri-food industry

Privatization of public assets

Landfill

Orders of the Day

Protecting Students Act, 2016 / Loi de 2016 protégeant les élèves

Promoting Affordable Housing Act, 2016 / Loi de 2016 sur la promotion du logement abordable

The House met at 0900.

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

Prayers.

ORDERS OF THE DAY

Patients First Act, 2016 / Loi de 2016 donnant la priorité aux patients

Mr. Naqvi, on behalf of Mr. Hoskins, moved second reading of the following bill:

Bill 41,

An Act to amend various Acts in the interests of patient-centred care / Projet de loi 41, Loi modifiant diverses lois dans l’intérêt des soins axés sur les patients.

The Speaker (Hon. Dave Levac): Point of order, the member from London–Fanshawe.

Ms. Teresa J. Armstrong: Speaker, I believe we do not have a quorum.

The Speaker (Hon. Dave Levac): A quorum call.

The Deputy Clerk (Mr. Todd Decker): A quorum is present, Speaker.

The Speaker (Hon. Dave Levac): Government House leader?

Hon. Yasir Naqvi: Thank you very much, Speaker, for recognizing me to speak on Bill 41. I will be sharing my time with the member from Ottawa South.

I feel very privileged on this extremely important piece of legislation because it sets up the future direction of our publicly funded health care system. As an Ontarian and as a Canadian, I am extremely proud of the fact that we have a publicly funded, universally accessible health care system that really ensures that all of us have the most important tenet of ensuring that we have good-quality lives in terms of a health care system available to us all.

Speaker, as you know, I have the great honour and privilege of serving the great community of Ottawa Centre. In my community, I have amazing examples of incredible health care institutions that provide very important care in my community.

I will highlight a few: places like the Centretown Community Health Centre, where I had the great honour of serving as a member of the board; or the Somerset West Community Health Centre, which serves the areas of Hintonburg, Mechanicsville, Westboro and Wellington Village; not to mention the Carlington Community Health Centre, serving the neighbourhood of Carlington and other surrounding areas. These three community health centres provide incredible, community-centred, locally focused health care.

Through this important legislation, their role will be further enhanced as a strong front-line deliverer of health care.

Other important institutions in my community in the great riding of Ottawa Centre are places like the Ottawa Hospital Civic Campus, which is almost 100 years old and has been serving the entire city of Ottawa—in fact, the entire region—for some time. It is the hub, the key trauma centre in our city, serving many, many people. In fact, my daughter, Elliana, was born at the civic hospital right in the riding, so I know the amazing health care professionals—the doctors, the nurses, the other medical staff—who do just an incredible job in serving our community.

The other great institution in my community that is going to benefit tremendously through this legislation is the University of Ottawa Heart Institute, perhaps one of the best cardiac centres in the world, with world-class research taking place and care being provided. The heart institute, in fact, at this time, is going through a tremendous expansion. We’re investing almost $200 million in expanding the heart institute with new, state-of-the-art surgery rooms that are going to ensure better care.

What Bill 41 does is it ensures the coordination of care in our communities, be it our community health centres or our hospitals or our family health teams, so that it all takes place in a manner that puts patients in the middle of it all. So instead of our patients, residents in my community, going from one health care service or facility to the other, they actually get health care built around them, making sure that the services they need are really focused on their needs as opposed to them trying to figure out what those services are.

The last point I will make before I pass it on to the member from Ottawa South, and I’m sure that the Minister of Health will be speaking on this bill as well, is the focus on our seniors, making sure that our seniors have the important home care available to them.

One of the biggest things I hear in my community when I’m going door to door to door every weekend is that seniors want to continue to live in their homes. They don’t want to live in a retirement home or long-term residence, and they want to get those important services delivered to them at home. I think this bill takes a very important step by making sure that that care coordination for seniors and the care they receive all gets coordinated at a local level through the local health integration network.

Lastly, I just want to give a big shout-out and a thank you to the Champlain LHIN, the CEO at Champlain LHIN, Chantale LeClerc, and her entire team and staff who do an amazing job in our region in providing quality delivery of care. I’m very fortunate to come from Ottawa and represent the community of Ottawa Centre, which is a beneficiary of a very, very good, publicly funded, universally accessible health care system. I look forward to working along with the Minister of Health and our government and all members in this House in making sure that those types of health care services are available.

The Acting Speaker (Mr. Paul Miller): The Minister of Health.

Applause.

Hon. Eric Hoskins: Thank you, Mr. Speaker. I appreciate the applause. I think it’s for my arrival. I want to thank the member for Ottawa South.

The Acting Speaker (Mr. Paul Miller): The member from Windsor–Tecumseh on a point of order.

Mr. Percy Hatfield: Thank you, Speaker. I could be wrong. With all due respect, I don’t believe the House leader said he would be sharing his time when he stood up this morning.

The Acting Speaker (Mr. Paul Miller): He did not initially start off with that but during his speech he did mention he would be sharing his time.

Mr. Percy Hatfield: No, sir, he said he would be passing it—

The Acting Speaker (Mr. Paul Miller): The member will sit down.

Continue.

Hon. Eric Hoskins: Thank you again, Mr. Speaker. I want to express my gratitude to the member from Ottawa South for beginning this important conversation, which I’ll continue, of course. As always, I appreciate the affection that’s coming from the other side.

I’m of course pleased to rise today to speak to the second reading of the proposed Patients First Act, 2016, which I think, as we all know, is

an act that, if passed, will further the commitments of our government to transform our health care system into one that puts the needs of patients at its absolute centre.

I should add that yesterday and the day before I chaired and co-chaired a provincial-territorial meeting of health ministers, a meeting which included federal health minister Jane Philpott at her federal-provincial-territorial meeting. It was absolutely clear throughout the discussion how we all share the perspective that we need to ensure, as those responsible and accountable for providing health services in our provinces and territories, that we keep patients at the centre of all of our activities and the objectives, the goals that we set, the outcomes that we’re looking to achieve.

It was gratifying to hear that strong consensus emerging from that gathering. It reinforces the object of this bill, which, by the title itself, but certainly through its contents, has as its core the patient-centred, patient-focused effort.

I have already acknowledged the member for Ottawa South. I thank him for sharing his time with me on this important subject matter. I also want to thank him for his strong assistance and support with this important piece of legislation. I also know that we’ll be hearing from the member from Ottawa—

Hon. Glen R. Murray: Centre. Centre is over there, and this is south.

Hon. Eric Hoskins: Centre. It’s south over here, centre over there. And it is hard; you would think after eight years I would have my bearings in this Legislature.

But regardless of where they sit, Mr. Speaker, I have to say that both members from Ottawa, Ottawa South and Ottawa Centre, have done an extraordinary job in supporting this piece of legislation, providing strong advice and good advice to make sure that it delivers on its promise of delivering better patient-centred health care, better coordinated and collaborative health care in this province. I want to thank them and I want to thank, indeed, all of our government’s partners in health care that have participated in this process.

Mr. Speaker, it’s true that every day across this province, in countless different ways, dedicated health care professionals are making a difference in the lives of Ontario patients, whether that’s in our hospitals, in our health care centres, our long-term-care homes or in our communities. These are the people responding to the needs of our families and our friends in their times of need. Together I believe we share one common goal, and that’s to do our very best for the people of Ontario.

That’s why I want to thank all of our health care partners for all of their help in moving forward with our government’s plan to transform our health care system into one that puts patients first. I want to thank them for working with us on our proposal to help improve its structure.

Mr. Speaker, if we are to move effectively ahead with our government’s proposal to improve the structure of our health care system, we must continue to be able to work together as true partners, with a shared interest in providing the best possible care for patients. Our history is proof that when we work together there is much that we can accomplish. Together, we’ve already made great strides in strengthening our health care system. Thanks to our ability to work together, we can say that 94% of Ontarians now have a regular family health care provider. More patients have access to care closer to home.

We’re seeing shorter wait times for most surgical procedures, improved emergency department wait times, and more support for people to stay healthy through a greater focus on disease prevention and health promotion.

It’s taken a lot of planning and a lot of hard work, but together we have made a difference in the lives of patients across this province. Consider the case of Linda, a patient with complex needs who has been benefiting from the services of the North Simcoe Community Health Link. Since connecting with her care coordinator, Linda says she now has access to so many agencies that she didn’t even know were available to her. That gives her a lot of comfort. She says some people just want someone who will listen, and through meeting with her care coordinator, Linda has said that she has built a relationship of trust.

As a result, she has become more trusting and honest with her doctor as well. Today, Linda is leading a better quality of life because she’s better informed and our health care system is better integrated.

But we have more work to do. Despite our successes, we know that, too often, the services that we deliver are, and remain, fragmented. Our system could be better coordinated, and the services that people rely on can be better distributed across this province.

While the work we’ve done to date has made a tremendous difference for patients in Ontario, we need to ensure that our health care system is benefiting all patients equally right across the province. So my ministry and I are actively working, for example, with indigenous leadership and organizations to look at how we can improve health outcomes for indigenous peoples and their families and their communities. Many, as we know, are located in remote areas of this province.

We know that newcomers to our country and our province are dealing with a health care system that doesn’t always fully recognize their challenges or perhaps doesn’t deliver culturally appropriate care. We also know that some Franco-Ontarians find it challenging to access the services that they need, and that we have a responsibility to provide, in French. We need to look at how we provide services to those faced with mental health and addictions issues to ensure that they have the care they need when and where they need it.

Ontarians deserve to have a health care system that provides them with seamless, consistent and compassionate care. In order to strengthen our health care system, we must address the challenges that are preventing us from delivering fully integrated, patient-centred care. We know that, at their root, these challenges stem from the differences in how our health services are both planned and managed.

Currently, the way our health care system is structured, our LHINs—our local health integration networks—are responsible for our hospitals, our long-term-care homes, community services and our mental health and addiction services. Yet, surprisingly, primary care, home and community care, and population and public health services are all being planned and managed in a distinctly different way. While CCACs—community care access centres—are accountable to LHINs for their performance and look to our LHINs for funding, they have their own boards that operate and function independently.

Similarly, the work of our public health system in local communities operates separately from other health sectors—our primary care system.

We have all the pieces of the puzzle, yet those individual pieces are not yet forming a cohesive picture, so we need to better integrate our health care system. That’s the structure I was talking about earlier. We need to get everyone working toward the same goal of providing easily accessible, fully integrated services, working in coordination for the benefit of all Ontarians.

For all of these reasons, our government is proposing the legislation that’s before us today. This legislation builds on the commitments that we made through the Patients First action plan. That plan aims to improve the patients’ experience, make our system more transparent and even more accountable, and ensure that our universal health care system will be there when we need it for generations to come. These aren’t simply lofty ideals but principles worth striving for and worth defending—always.

If we believe that everybody has a right to good health and good health care services, then we need to be asking ourselves how we can ensure universality, how we can improve access and how we can deliver the highest quality of care. The choices we make must be rooted in evidence and in the patient experience.

To improve the health care experience for Ontarians, we need to move away from the status quo. We need to understand what our patients need in order to support the models that serve them best. In fact, every decision I make as Ontario’s Minister of Health and Long-Term Care is fully centred on these principles. I’m committed to providing Ontarians with faster access to the right care and to delivering better-coordinated and better-integrated care in their communities. I want to make sure that people and patients are getting the education, the information and the transparency they need to make the right decisions about their health.

Just as important, I am committed to doing all of this while protecting our universal health care system. I’m committed to making decisions based on value and based on quality. This will help to ensure that the health care system that we enjoy today will continue to be there tomorrow for our children, our grandchildren and the generations beyond them.

In order to deliver on that promise, that promise of equitable access to health care for all, we have to reorganize our system in a bold and transformational way. The Patients First Act proposes to do just that.

If passed, the legislation before us today would help us to build a system that best meets the needs of Ontarians, a system that closes the gaps that exist and one that would help bring health care services to the people who truly need them most. A system that best meets the needs of patients in an equitable way is one that is truly population-focused and deeply integrated at the local level. To do that, we need strong local health system planning and strong management.

About a decade ago, in April 2006, our government created the LHINs with the goal of improving local health care system planning, integration and service delivery to better meet the needs of patients. We did that because we understood that the best way to meet a local population’s needs was not by managing everything from an office here in Toronto, but by allowing local experts to control and implement care, care that best reflects the needs of the community.

Mr. Speaker, as I have travelled across the province in my role as minister, I have had the opportunity to meet with all of our LHINs and their boards. Those opportunities demonstrated to me the depth of local knowledge and the capacity that each of our LHINs has to be true local managers of our health care system. Not only do they know the needs of the local population, but they also know the partners and the service providers who care for that population.

I want to see the LHINs continue to evolve. I believe that they should play a more central role in our health care system, one that better acknowledges the true importance of local decision-making and local management. Part of that evolution includes primary care.

Working alongside our partners in health care, our government is constantly engaging in discussions about the future of our health care system. Throughout that process, we’ve been fortunate to have benefited immeasurably from the work of a number of highly skilled experts, not the least of which were recommendations put forward by Dr. David Price, Elizabeth Baker and the panel members of the Primary Health Care Expert Advisory Committee.

In their report on reforming primary care, a report that came from the experts, the front-line clinicians in primary care across this province itself, the panel called for primary care providers to be better integrated not just among themselves, but also within the health care system at the local level.

The recommendations of the panel, a panel that emerged from those front-line expert and experienced clinicians in primary care themselves, have only served to reinforce what we already know about primary care: that it is an absolutely essential and important part of the bedrock of our health care system.

Yet it needs to be better organized around the needs of patients and around the needs of the local population that it serves. That’s why we’re working to establish sub-regions within LHINs to serve as that focal point for population-based planning, for service alignment, integration and performance improvement—precisely the recommendation, the strongest recommendation, that came from that Primary Health Care Expert Advisory Committee.

It’s important that we all understand that sub-regions aren’t boundaries. They will be geographic units that will enable planners and providers to better identify and respond to the health care needs of local communities in Ontario.

Now, transforming our health care system into one that is focused on population health and equitable access requires greater and better local governance. We need our LHINs and local clinicians to play a much greater role in championing key activities at the community level, including population-based health care planning, health care services integration, clinical change management, and performance and quality improvement.

But perhaps the single most important quality of a truly patient-centred health care system is that quality of being integrated. That includes further integrating our home and community care sector as well.

For some time now, we have been working hard to transform our home and community care system so that it delivers better and more consistent care for the patients who rely on it. We followed explicitly the advice of Dr. Gail Donner and her expert group on home and community care, who told us that we needed to focus first on consistent services that meet the needs of local populations before we considered making changes to the structure and to the governance of that aspect of our health care system. We have done that.

Last year, we launched our home and community care road map that outlined 10 concrete steps that we’re taking to improve the home care experience for both patients and caregivers. We are now taking steps to provide more consistent services across the province.

What the Baker-Price report, and the report of Dr. Donner and her panel, and so many other expert reports have in common goes back to what I was speaking about earlier. It goes back to the belief that each and every Ontarian deserves to have a health care system that provides them with integrated, consistent and high-quality care. But it’s also about providing equity.

We know that LHINs are uniquely positioned to help us deliver greater equity in health care. They have already demonstrated what they can do in terms of improving regional planning and the integration of services. Yet as the Auditor General has pointed out, LHINs have neither the mandate nor the tools to integrate all of the health services being offered.

That is where the proposed Patients First Act would come in. What our government is proposing with this legislation is to give LHINs the tools they need to better integrate our health care system. It’s in their name—local health integration network—yet they need to have the tools and the resources to fully integrate what often can be a fractured health care system.

We’re proposing to give LHINs the responsibility for the management and service delivery of home and community care, for primary care, planning and performance management, and, importantly, for building stronger links with public health.

Mr. Speaker, I’m a public health physician myself. By forging those stronger links between our public health units, our medical offices of health and our LHINs, that is to the benefit of all of us. The experts—not the only experts, but truly experts—in population health, in health equity, in the social determinants of health are our public health workers, our medical officers of health, our RNs, our managers, those who work in that public health system.

What we need is the benefit of their expertise, of their experience throughout our health care system as we continue to push further towards a wellness approach to the delivery of health services. We need to know that we’re doing that in an equitable way, in a way which reflects population health needs and impacts social determinants of health.

We also intend to make our LHINs more accountable to the public. By focusing on a local approach, we expect to reduce bureaucracy and administration in home and community care to remove overlap and duplication and to make it easier for patients to find a doctor or to find home care when they need it.

With the support and oversight of the Ministry of Health and Long-Term Care, LHINs would be able to build new connections between primary care providers, hospitals, home and community care, and public health to improve health care for Ontarians across the province, no matter where they live.

Those are those missing pieces. Our LHINs are already responsible for long-term-care homes, for community services, for our hospitals, for mental health services; we are bringing those other elements, those remaining elements of our health care system, into the fold. That coordination is most important to the patient and the patient experience. They’re not interested in the structure or the governance. Patients and Ontarians are interested in receiving the highest quality of care in a timely fashion and in a way that is as seamless and coordinated as possible. It all comes back to the patient.

One thing we need to keep in mind about this proposed legislation is that a patient’s primary concern, as I mentioned, is not the structure of our health care system; they rely on us for that. The patient’s principal concern is whether they get the care they need and whether it’s going to be there when they need it.

What we’re proposing to do with this legislation is to create an easier way to access the health care system that respects a patient’s right to choice. What we’re proposing to do will provide patients with one point of contact to access primary care and the other services that they need, with better access to same-day, next-day, after-hours and weekend care.

For our doctors, our nurses, our care providers, this proposed legislation would provide them with a structure that supports greater integration, while still maintaining their clinical autonomy.

If passed, this bill would enable our specialists to benefit from stronger local planning that would enhance their access to services and promote the use of technology and telemedicine to provide better service to complex patients, regardless of where they live. For hospitals, this new structure would help with high rates of hospital readmission, alternate level of care days and the inappropriate use of emergency services. The essential work that our CCAC employees are doing would continue under the proposed legislation, but under this new vision, the CCACs would be working directly within our LHINs.

Public health practitioners would continue the important work that they’re doing, but they would be more connected to the rest of our health care system. For those in the long-term-care sector, it would mean better support in managing transitions for clients between acute and home and community care, with better service planning in the home and community care sector.

The proposed legislation before us today would make for a more efficient health care system, reducing the duplication of services and resulting in a better sharing of information. It would help us build connections across the health care system, across that full continuum of care.

Now, it’s important to point out that the proposed legislation was built through the hard work of our government in consultation with all of our health care partners, all of our stakeholders and, most importantly, Ontario patients.

That consultation began last December when I put forward a discussion paper for all to consider. We heard from all of our stakeholders. We heard from and interacted with more than 6,000 individuals. We consulted numerous times with the Ontario Medical Association. We received direct consultative feedback from our doctors from the OMA. We consulted with our nurses. We consulted with virtually every one of our stakeholders; those that represent them were made aware and invited to participate.

We took many, many months to ensure that we were able to benefit from their expertise and their perspective and incorporate that into this act. In fact, by introducing it just before the summer and then reintroducing it recently, we had the benefit of that entire summer period to go back, with this specific proposed legislation, to our partners, to go back to the OMA, to go back to the nurses, to go back to other health care providers and stakeholders—those that provide home and community care, those in our long-term-care homes, those in our hospitals—to benefit from their experience through a consultative process and incorporate their good ideas to make this legislation even stronger.

We spoke with patients, with caregivers, with francophones, with indigenous peoples, health care partners, staff, clinicians, municipal and other community and government partners to gather feedback on our proposal.

When the ministry first released the Patients First discussion document back in December, I made a commitment at that time to meaningfully engage with indigenous partners. We’re following through on that commitment through a parallel process that will collaboratively identify specifically what is needed for responsive and transformational change, especially with respect to equitable access to services that meet their unique needs. Of course, we will also continue to work with First Nations, Métis, Inuit and urban indigenous partners to foster positive relationships and ensure that any changes in the proposed legislation will not negatively impact their current or future access to care.

I was gratified on my initiative yesterday. We had a two-hour meeting as part of the federal-provincial-territorial ministers of health meeting, a two-hour meeting specifically with indigenous leadership from across this country: First Nations, Métis and Inuit. We spent more than two hours listening to them, hearing from them about the challenges that they face, about the bold and concrete proposals they have to move forward to reduce and eventually eliminate those negative health outcomes that we know are so pervasive through those communities across this nation.

We’ve also taken steps to ensure that one of the key planning objectives of the LHINs is to encourage access and better integrate the health needs of the francophone community at the local level. This was a key objective that the French Language Health Services Advisory Council asked us to consider, and I fully supported this objective.

We have gathered feedback from across the province. Most of those consulted agreed that there is a need to focus on achieving better system integration, improved performance, needs-based planning and delivery, greater health equity, and continuity in home and community care as well as in primary care. The vast majority of the feedback we received was supportive of the strategies proposed, so we knew we were headed in the right direction with the legislation that we were developing.

We also received feedback that suggested additional priorities needed to be addressed, including the need for strong collaboration between the LHINs and primary care providers, and removing the LHIN directive over hospitals so that directive powers—for operations and new policies—and supervisory powers are only at the minister’s direction. You will see from the proposed legislation that we’ve taken steps to respond effectively to that feedback.

Further, Mr. Speaker, you may note that the proposed legislation here today has, in fact, continued to evolve from the earlier Bill 210 which, as I mentioned, was first introduced back in June. This bill is the result of ongoing conversations, conversations with our health care partners, conversations that continued throughout the summer, have continued into the fall and continue as we move forward with this bill.

Speaker, I can say with confidence that we have left no stone unturned in our effort to create the best possible legislation and, if passed, our government will continue to rely on our partners in health care for their input and additional feedback. It’s important that if we undertake any changes to our health care system, we must do so carefully and in partnership with all of our health care partners to make sure that patients have ongoing, smooth, coordinated access to the health services that they depend on, that they need to rely on and that we have the responsibility to provide.

The goal here is to make changes to the structure and governance of our health care system as seamlessly as possible, so that Ontarians can continue to enjoy the high-quality care that they have come to expect. Our government remains as committed as ever to the goal of putting patients at the centre of all we do in health care. The proposed Patients First Act is the next step in ensuring a system that is best able to deliver on that commitment.

Before I wrap up and hand things over to the MPP for Ottawa South—I got it right that time—I just want to take a moment to, once again, thank all of our partners in health care, to thank them for their continuing contribution to the legislation we are considering here today. This truly is their legislation. It emerged and has grown from the advice that we have received through expert panels, through task forces, through consultation and through regular engagement of our health partners.

They will be able to see themselves in the evolution of this important piece of legislation, so I want to thank them for that contribution and the continuing contribution that they make every day to serving the people of Ontario.

Mr. Speaker, in closing, we want to ensure that patients in Ontario have equitable access to care, that their needs are being met and that their choices are being respected. We look forward to continuing to build on those relationships with our partners as we move forward, and not just with our health care partners but with patients, with clients, with Ontarians, with caregivers who are critically important participants. Thank you all.

I know I have spoken at length about why our government would like to see the proposed Patients First Act enacted into law and why it’s necessary for the future of our health care system. I would now like to turn things over to my colleague the member from Ottawa South, who will walk us through some details of the proposed legislation.

The Acting Speaker (Mr. Paul Miller): The member from Ottawa South.

Mr. John Fraser: I am extremely proud to rise today in support of the proposed Patients First Act, 2016, and equally proud to rise after the comments from the Minister of Health and from the Attorney General, who I know is also a champion for health care in our region of Ottawa.

I’m in support of the bill that, if passed, would improve access to care for patients and their families. The proposed Patients First Act is, of course, the next step forward made in Patients First: Action Plan for Health Care, which Minister Hoskins released last year. I would like to thank the minister for his leadership on this file and congratulate him on the action plan and this piece of legislation. I’m proud to be associated with both.

We’ve just heard from the minister about why this legislation is so critical and about why it is so important to move ahead and plan to transform our health care system into one that puts the needs of patients at its centre. What I would like to do now is demonstrate to all of my colleagues in this House how we are going to achieve this.

Bill 41, if passed by the Ontario Legislature, would help us fulfill our action plan to provide patients with faster access to the right care, to better home and community care, to the information they need to live healthy lives, and a health care system that’s sustainable for generations to come.

It starts with a clear objective. Our government is committed to improving the patient experience in Ontario and to provide better care for Ontarians no matter where they live. What does this mean? It means improving the communication and connections between primary health care providers such as family doctors, nurse practitioners, interprofessional health care teams, hospitals, and home and community care for a smoother patient experience.

It means making it easier for patients to try to find a family doctor or nurse practitioner when they need one, to see the provider quickly when they are sick, and to find the care they need closer to home. It means making it easier for doctors, nurses and other primary care providers to connect their patients to the health care that they need. It means ensuring that there’s local planning so that health care providers are available to patients where and when they are needed.

It means strengthening indigenous and francophone involvement in the planning, design and delivery of health programs and services being provided to their communities.

What’s key is that all of this depends on expanding the mandates of the local health integration networks. Fundamentally, this is all about better integration of services across our health care system. That is what LHINs were created to do, and with this bill, if passed, LHINs will be able to plan, fund and integrate health services at the local and sub-regional levels.

I’d like to point out to my colleagues that this legislation is comprehensive; it touches on so many different pieces of existing legislation but is built upon some very basic principles. The first is a more effective integration of services and greater equity. When you look at the heart of what we’re doing with this proposed legislation, this is all about better integration of health care services across the system. If your key goal is patient-centred care that puts patients first, then, by definition, all other components of the system need to be working towards that together.

Mr. Hoskins believes and I believe that what patients need and what Ontarians need and deserve is a health care system that is seamless. What does this mean? It means more consistent care for the patients who rely on it. It means good, compassionate care whoever you are, whatever your ethnicity, wherever you live and however much you earn. Nobody disagrees with that; in fact, it is what everybody strives for.

Even though we’ve built a health care system we can be proud of, there still exist some challenges to the full delivery of integrated, patient-centred care. These challenges, more often than not, boil down to the separation of our various health care services—separation not in what these health services want to accomplish, which is better patient outcomes, but separation in how our health care services are planned and managed.

Right now, LHINs have responsibility for hospitals, long-term-care homes, community services and our mental health and addiction services. They manage all of these locally across their regions, but primary care services are planned and managed in a distinctly different way, and home and community care services and public health services as well—again, planned and managed in different ways. We can’t get to where we want to go with everyone trying to move forward at times in a disconnected way. We need to have somebody lead the integration of services.

You have to have somebody who takes responsibility for ensuring that the partners are working together and collaborating. If we have this, we can make sure that we’re moving together in the right direction. We can ensure that the various health services we offer are working in coordination with one another, for the specific benefit of Ontario patients.

We all know the disconnect that we hear in our communities between different health services and people being able to access services in another area, transferring and transitioning between different types of care. What we’re proposing is to expand the mandate of our 14 LHINs so that they can be the ones who help to coordinate and foster the collaboration that’s needed to make sure those services are connected together, that people have access, and that there’s a focus on outcomes.

This bill, if passed, would give LHINs responsibility for overseeing primary care planning. It would put them in charge of home and community care delivery and would give them responsibility for developing formal linkages with public health to improve population health planning.

This bill, if passed, would make LHINs the central hubs of our local health care systems, responsible for planning, managing and improving the performance of virtually every aspect of health care in their respective regions. LHINs would be responsible for working with providers across the care continuum to improve access to high-quality and consistent care and to make the system easier to navigate for all Ontarians.

Ontario LHINs have been moving in this direction for years now. They have a mandate to make health care more integrated and responsive to local needs, and they have made some tremendous progress.

I know that in the Champlain region of Ottawa, we’ve made tremendous progress on wait times in terms of our hips and knees. We’ve made tremendous progress on youth mental health and addiction and suicide prevention for our young people. This is all a result of local planning, local collaboration and local leadership that has made that very effective and helped to serve the patients of the Champlain region very well.

LHINs have a mandate to make health care more integrated and responsive to local needs. They have run up against the fact that they neither have the official mandate nor tools to integrate all the local health services Ontario offers. If you can’t integrate all of your health care services, you can’t fully integrate your health care system. We’re proposing to give them the mandate and the tools that they need.

If passed, the Patients First Act would give Ontario LHINs responsibility for local health care and make them more accountable to the Minister of Health and Long-Term Care for their performance.

As part of this process, the LHINs are working to fully establish sub-regions, which would become the focal point for local planning, service management and delivery. These sub-regions would be places where primary care would be better integrated with home and community care and other local, community-based health services to ensure—

Interjections.

The Acting Speaker (Mr. Paul Miller): I thought the health minister would be really interested in this. There are five discussions going on on your side when your gentleman is talking. All of the noise is mostly coming from over there. I’d appreciate it if you’d cut it back. If you want to have your little conferences, you know where to go: outside. Thank you.

Continue.

Mr. John Fraser: Thank you Speaker.

The point, as I’m sure my colleagues understand, is that if you can localize planning, management and delivery within smaller geographic areas, you can more effectively respond to the health care needs of local communities. That means, across the province, that patients are going to get equitable access to services.

Another principle of this bill is focused on our goal of providing timely access to primary care and seamless links to other services. This is an area where a great deal of work remains to be done in this province. We must work to deliver even more effective primary care, and, because this is integral to the notion of primary care being the gateway to the entire system, that includes delivering primary care that in turn links patients to the other services that they need.

If this bill is passed, LHINs would, in partnership with local clinical leaders, take responsibility for primary care planning and performance management. The ministry would continue to negotiate physician compensation and primary care contracts, but the LHINs would work closely with primary care providers to plan services, undertake human health resources planning, improve access to interprofessional teams for those who need it most and link patients with primary care services.

Mr. Speaker, I think this measure in the proposed legislation will be able to enhance things like advance care planning. We have a challenge in our communities in terms of how people access palliative and end-of-life care, and a lot of that has to do with how our primary care is approaching advance care planning. From my perspective, I think that this measure in the bill will be a very effective tool in working in collaboration with primary care to make sure that people are prepared and understand how to access the system—that the system understand what’s important to them.

I think this is a really critical part of the bill. I want to stress that this part of the bill is about working in collaboration and partnership, because I think that’s what our patients need and deserve from both our physicians and other primary health care providers and the government.

Effectively, LHINs would be the focal point for care planning and care management. We would bring primary care planning much closer to communities where the services are being delivered and to the patients who are receiving those services. Think about how effective this would be for patients. The LHINs or LHIN sub-regions would engage local clinical leaders. They would monitor performance, identify performance challenges and implement targeted improvements. They would be perfectly placed to improve patient access to interprofessional teams.

They would also be responsible for recruitment planning in partnership with local clinician leaders, and each LHIN sub-region would have a process to match unattached patients with a primary care provider.

This isn’t about telling patients which doctor they can see or taking patients away from doctors. Quite the contrary, it’s about ensuring that every patient who wants a family doctor or a nurse practitioner can have one. Our government takes a great deal of pride in the progress that we’ve made to help ensure that patients have access to primary care services.

The Patients First Act is also focused on delivering more consistent and accessible home and community care. What we propose to do is to give LHINs responsibility for the management and service delivery of home and community care. We would transfer direct responsibility for service management and delivery from the community care access centres, which currently undertake work for the LHINs. These LHINs would govern and manage the delivery of home and community care.

This would mean that CCAC boards would cease to exist and that all CCAC functions, as well as those CCAC employees who provide client support, would be transferred over to the LHINs. This also means the transition would be seamless for the patient. Former CCAC employees would continue to provide care coordination, and home care services would still be provided by current service providers. Continuity of care is a top priority.

What this transition would do is allow the LHINs to further integrate home and community care with our hospitals and primary care providers. Our home and community care workers are going to be better connected with doctors, nurse practitioners, nurses and other health professionals, working together to put patients first.

And, Speaker, I need to be very clear. The decision to transfer our CCACs into the LHINs is not a reflection on their work, because they have done some great work. In 2015-16, over 646,000 Ontarians received home care from CCACs. CCACs have delivered home care in this province to tens of thousands of people in tens of thousands of places every day. And, in that year, 2015-16, approximately 210,000 people were able to return home from hospital with CCAC care. That year, Ontario CCACs delivered 28.7 million hours in personal support and homemaking visits, 6.9 million hours in nursing visits and 1.7 million hours in therapy visits.

CCAC employees have worked hard to provide services to Ontarians for many, many years, and we look forward to those employees continuing to work with the LHINs to improve home and community care, which includes implementing the Roadmap to Strengthen Home and Community Care.

Another way the Patients First Act, if passed, would help improve our health care system is by strengthening the links between population and public health, and other health services. Again, it’s a question of bringing forward all of our health services together on the same team, with patients the main focus.

This bill, if passed, would integrate local population and public health planning with other services by formalizing the linkages between LHINs and public health units. This would create a formal relationship between the medical officers of health and each LHIN, so that they can engage with each other and work on planning together.

I know that in my community of Ottawa, we’re very fortunate. Our Chief Medical Officer of Health has actually worked quite closely with many of the health partners to address things like youth addiction and teen suicide, and understood that that was a population health problem. We need to do that across Ontario. We need to have that kind of system collaboration and co-operation. I want to thank Dr. Isra Levy for his leadership in that regard.

By engaging the medical officers of health, it would allow us to ensure that public health services are being directed to the people who need them most. Because right now, unfortunately, the people who need them most are those who experience the most significant barriers to access.

Linkages between LHINs, public health and other health services would allow for joint planning activities and greater consistency of service. We know there are disparities in the capacity of some of the local public health units, and further integrating local health care systems would allow us to reduce and even eliminate those gaps.

Speaker, those are the four areas of focus. I want to make it clear that in all of these areas, our goal is to simplify and improve the patient experience. Through this plan, there would be no added bureaucracy, and any financial savings would go to improving patient care.

We would undertake any changes carefully and in collaboration with our health care partners to make sure that patients have ongoing, smooth access to the health care services they depend on, and we would update patients, caregivers and partners all along the way.

I also want to add that our government will continue working with First Nations, Métis, Inuit and urban indigenous partners and health providers to ensure that their voices are heard, in particular with respect to equitable access to services that meet their unique needs. Our indigenous partners have been very clear for some time that there’s a real need for a respectful engagement process to help address the unique relationships between indigenous peoples and the health care system.

I would like to echo the comments made by Minister Hoskins, that we’re committed to meaningful engagement with our indigenous partners and we’re following through on that commitment through parallel processes that will collaboratively identify what is needed for responsive and transformative change.

Should this legislation pass, we would be moving forward with the meaningful and productive engagement that is geared to achieving results and improving patient outcomes.

It might also interest my colleagues, as the minister said, that we had some considerable time over the summer to take a look at the direction of the bill and take the input of stakeholders. With some of the changes that we have made and incorporated into this bill that has been put forward, it would be very clear that the proposed directive powers over hospitals for operations and new policies, and the proposed power to appoint a supervisor over a hospital, would only be at the minister’s discretion.

It would be clear that the LHIN oversight of primary care providers, including physicians, would be to support collaboration between the LHINs and primary care providers.

And it is extremely important that it would recognize the importance of French-language services provision and enhance more equitably access to health care services for the francophone community.

Speaker, I don’t have much time left. I simply want to say that this bill proposes a great many benefits for health care in Ontario. I’m very proud to support it, and thank my colleagues for their time and attention.

The Acting Speaker (Mr. Paul Miller): Questions and comments?

Mr. Jim McDonell: I’m proud to rise today to represent my constituents in Stormont–Dundas–South Glengarry.

We talk about the bill resulting in a much larger bureaucracy. We’re not seeing the dollars get to the patients. This year, we hear about the 1% increase in hospital funding. It sounds great, but when it gets to the actual hospitals, they’re seeing in many cases an actual reduction in funding. At one of my hospitals in particular, it’s almost a million-dollar cut, when you look at the whole funding envelope. Money is not getting to the hospitals.

When I look at some of the increases they have had, of course, salaries—hydro has not had as big an impact in the city of Cornwall, because at Cornwall Electric, we’re somewhat insulated. But out in the rural areas—we’re serviced by two hospitals, one in Alexandria and one in Winchester—they’re not so lucky. They’re seeing significant increases in energy costs that has to come out of that million-dollar loss.

You can see the challenges. Wages are up. What we’re seeing, in talking to various doctors, is actually a cut in hours. In operating rooms, the lights are turned off. Doctors who are working somewhat close to the US border are crossing the border into the States. They’re providing hours of office time in the States, in Massena. One orthopedic surgeon says he won’t take any more knee surgeries because there’s such a long wait.

We’re not seeing these actions on the ground. We’re seeing more delays. I see residents in my riding coming to Toronto because the wait times are shorter. These are problems right across the province, and we need to see some results.

The Acting Speaker (Mr. Paul Miller): The member from Essex.

Mr. Taras Natyshak: I listened intently to the presentation by the various ministers. The last speaker, the member from Ottawa Centre, did a pretty good job in getting into some of the specifics. I think he did the best job, actually. Unfortunately, the minister was really vague in his presentation. I didn’t hear any specifics—a lot of platitudes, a lot of integration- and collaboration-type words. We’ve heard these all before when it comes to the LHIN and we haven’t seen the net benefit in our communities.

I’ll tell you about some of the challenges that we have at our local hospitals: nurses that have been laid off, front-line-care workers that aren’t able to deliver the care that’s needed in our emergency hospitals. We’ve got a resurgence of nurses coming back to Windsor for work from all parts. They’re coming back to Windsor for jobs. Guess where they’re working? At Beaumont Hospital in Michigan and at Henry Ford hospital in Michigan because there have been such drastic cuts to our health care system in Ontario that they can’t get a job.

These are nurses that have been educated here in Ontario, are fully certified and fully ready to contribute to our health care system but can’t get a job due to the cuts—juxtaposed with a federal government that is now going to slash even more than the Harper government did.

We need a Minister of Health that is going to advocate for true support from the federal level—true accountability. Undoubtedly, this bill comes on the heels of an Auditor General report where we saw that the CCACs spent 40% of their budget on administrative costs, nearly $1 billion a year. We know that’s why this is coming forward, but it does nothing to support front-line care. We’ve got home care workers who are barely making minimum wage. You can’t provide quality service to people in this province if you’re not going to pay the people correctly and you’re relying on private care providers.

There are systems out there that are better than this, and we expect better than this from the government of Ontario.

The Acting Speaker (Mr. Paul Miller): Questions and comments?

Hon. Glen R. Murray: It’s interesting, Mr. Speaker, following the other member. We have seen very robust salary increases for physicians and for nurses—I live with a nurse who’s rather remarkable—and we’re now lifting up the wages of PSWs at an unprecedented level. It’s interesting because my partner, Rick, served in the Canadian Armed Forces, so he’s seen some pretty difficult work situations and been on the front lines in some fairly ugly situations in his life. But he’s worked in a number of provincial health care systems. He’s an operating room nurse and describes this system here as phenomenal.

My mother has had several battles with cancer in this system, and she has lived in three provinces. I have never seen this standard of care. Our health care workers are extraordinary—the capacity. Her drug costs, from Manitoba and Quebec, are a fraction of what they are as a senior. She lives two blocks away. She’s 89 years old—in about two weeks—and she lives independently. That says something. For all the carping about that, I can tell you the health care system in this province, I think, is, if not the best in the world, one of the best in the world.

I have had the privilege of living in a few other places. I also know, in Manitoba—I was mayor of the city of Winnipeg—my partner had a heavier work

schedule as a nurse because of the amount of overtime. I almost never saw him. He was working mayor’s hours—and I worked seven days a week, one of the big stresses in our lives. It’s great, now, that I’m here. We actually get to take vacations together again because his workload here is so much more reasonable, and since he works in neurosurgery—you really don’t want someone who’s working in spine and neuro not to be well rested.

So I think we have good conditions. It’s not perfect. We’ve still got huge challenges. Our nurses, particularly—I’m overwhelmed—are amazing. I used to do AIDS education in fly-in communities. If you have ever seen—in northern remote communities, nurses do everything. Those nurses—I take my hat off to them. They are a remarkable group of professionals. I think we should be thankful for—

The Acting Speaker (Mr. Paul Miller): Thank you. The member from Chatham–Kent–Essex.

Mr. Rick Nicholls: Thank you, Speaker. I’m pleased to add my comments to the debate this morning with regard to this particular bill. I have some questions on it because I always get a little nervous when I take a look at a bill that—this particular bill affects 19 other acts. I heard the minister talk about consultation—19 other acts. Sometimes I often think that there may be poison pills in there because it’s a case where there might be some components, several components, that we may agree with, but there may be some other elements of it that we don’t agree with, as an opposition.

Having said that, then suddenly we’re the bad guys because, of the 19 acts, there may be one or two that we’ve got some issues on; the others, well, good for the government. So I do have a concern with that.

The title of this bill is maybe somewhat misleading. I understand what the Minister of Health and Long-Term Care wants to do; hence, a nice title: “Patients First.” I always have concerns in our health care because we need to take a lot of the money and flatten some of the organizations. When I say flatten, I’m not talking about job elimination, but in flattening an organization, we need to put more money down to the front line. I’m sure that that’s what the minister’s intentions are, but, again, I’m concerned about that.

We’ve even had discussions about hospitals and what I would call “empire building” and how, again, we need to take those dollars that are maybe rich at the top and push them down to the front line where we can hire more front-line workers, because health care, obviously, is the biggest expenditure in our government this day.

Again, we have some serious concerns and hopefully that can get sorted out in committee.

The Acting Speaker (Mr. Paul Miller): One of the three speakers has two minutes.

The member from Ottawa South.

Mr. John Fraser: It’s a pleasure to respond to the member from Stormont–Dundas–South Glengarry, the member from Essex, the Minister of the Environment and the member from Chatham–Kent–Essex. I appreciate the member from Essex and his comments. I do think the minister did a good job, though. I don’t think it was vague. I just want to add my two cents. I couldn’t have made it more clear myself.

We all know in our offices about the health care system. We all know about its successes and its shortcomings. We all know that. The thing that we have to focus on is what we know is a challenge, and that is the connectedness that patients feel to the services that they need. Right now we have a health care organization, LHINs, which have had success. They still have some challenges, but they’ve had, in different areas, different successes—in my area, successes with hips and knees, success around mental health and around palliative care, because they’ve brought a focus and leadership to integrating those services.

It’s critical that it’s local. We all represent local areas, and to say that we should not give more power or more responsibility—maybe that’s a better way of putting it—to those local entities for taking care of those things that are most important to people—I think in this Legislature I would be surprised if everybody said, “Let’s just put it all in downtown Toronto.” I don’t think I could find too many people, except maybe a few people from downtown Toronto—

Interjection.

Mr. John Fraser: Even the people from downtown Toronto.

I look forward to the debate on this bill. I think it’s a critical piece of legislation. It does change 19 acts; I do take the member’s—when we’re changing a lot of acts, that’s something that takes some time; you want to be able to debate. This is the second time this bill has been introduced, and I think that we’ll have a healthy debate on this. I look forward to it, and I thank all of the members for their comments.

Second reading debate deemed adjourned.

The Acting Speaker (Mr. Paul Miller): It being 10:15, this House stands recessed until 10:30 this morning.

The House recessed from 1013 to 1030.

Introduction of Visitors

Mr. Rick Nicholls: In the west members’ gallery this morning, it’s my pleasure to introduce Mr. Tom Madden, senior vice-president of Young America, located in Minneapolis. Just last week, they opened up a new office in my hometown of Chatham, Ontario, called YA Canada, employing over 140 people.

Mr. Percy Hatfield: I see up in the east gallery this morning Barbara Higgins, from my riding. She’s the mother of page Elisabeth Lawton. Welcome to Queen’s Park.

Hon. Helena Jaczek: Please help me welcome students from St. Augustine Catholic High School in Markham, on both sides of the public gallery.

Mrs. Julia Munro: I’d like to introduce to the assembly today Elizabeth Drummond and her daughter, Margaret Sands, from my riding, here to visit for question period. Please welcome them.

Mr. Joe Dickson: I’m pleased to introduce, in the east gallery this morning, on the far right, the gentleman with his cowboy boots on, who is the horse trainer and owner and president of the quarter horse racing association of Ontario, who race at Ajax Downs in my constituency.

Ms. Laurie Scott: Today being Breast Reconstruction Awareness Day, I’m pleased to welcome staff and volunteers from Rethink Breast Cancer to the gallery. They’re up there. Thank you, ladies. Rethink’s mission is to empower young people worldwide who are concerned about and affected by breast cancer. Welcome.

From my office at Treasury Board, joining her this morning, are Aisling MacKnight, my scheduler, and Ben Charlebois, our MPP liaison.

The Speaker (Hon. Dave Levac): Thank you. The member from Thornhill.

Interjections.

The Speaker (Hon. Dave Levac): Thornhill. I did say Thornhill.

Mrs. Gila Martow: Oh, sorry. I just want to say that on their way today are Rabbi Yirmi Cohen, his son, Mendy, and his daughter, Chaya. They’re here to celebrate the holiday of Sukkot, to do the blessing, the bracha, the lulav and the etrog. Chag sameach, everybody. It’s Sukkot this week.

Hon. Michael Gravelle: I have two members of my family here in the Legislature today who I would like to introduce: my sister, Susan Houghton, who has been here before, and my dear cousin Stewart Goodings, from British Columbia. Welcome to both of you.

Mr. Todd Smith: After a record-setting summer for tourism in Prince Edward county, I’d like to welcome the mayor of Prince Edward county, Robert Quaiff, who joins us today in the west members’ gallery.

The Speaker (Hon. Dave Levac): Thank you, and welcome.

Hon. Deborah Matthews: I am delighted that we’re joined today by the president of Lakehead University, Dr. Brian Stevenson, and Richard Longtin is here too. Welcome to Queen’s Park.

Hon. Glen R. Murray: I’d like to introduce Brock Wunderlich, who is a co-op student—we were speaking of students earlier—working in the government caucus. He has a particular interest in the environment and is an environment and business major from Wilfrid Laurier University. Welcome, Brock. Good to have you with us here.

Hon. Indira Naidoo-Harris: I am pleased to rise today and to let you know that a page from my riding of Halton, Riya Karumanchi, is page captain today. I want to welcome her mother, Radhika Daggubati, to Queen’s Park and to the Legislature.

Hon. Yasir Naqvi: It is a great honour for me to introduce the family of page captain Suryakant Jain, on behalf of the member from Etobicoke North. Please welcome Suryakant’s mother, Sonali Verma, and uncle, Anant Sagar, who are visiting Queen’s Park.

The Speaker (Hon. Dave Levac): Further introductions? If not, I have some.

I’m not sure he’s here yet, but I am welcoming a personal guest of mine: in the Speaker’s gallery, Mr. James Muir, the wine master and maître d’ at the CN Tower. We’re glad he’s with us. He will give anyone lessons on wine if you want them.

Also in the Speaker’s gallery we have with us a delegation from the National People’s Congress of China, led by the chairman of the Canada-China Legislative Association, Mr. Chi Wanchun. Accompanying them is the Honourable Victor Oh, Senator in Ottawa. Victor, welcome. We warmly welcome the entire delegation from China. Thank you for being here.

I could also like to introduce, and please join me in welcoming, the family and friends of the late Cynthia Maria Nicholas, MPP for Scarborough Centre during the 34th Parliament, who are seated in the Speaker’s gallery: her daughter, Leahanne LeGrow, her former husband, Ray LeGrow, and family and friends. We welcome our guests today.

Accompanying that delegation we have with us Mr. Steven Mahoney, MPP for Mississauga West during the 35th Parliament. Welcome, Steven.

Cindy Nicholas

The Speaker (Hon. Dave Levac): Point of order, the government House leader.

Hon. Yasir Naqvi: Thank you very much, Speaker. I believe you will find we have unanimous consent to recognize the former member for Scarborough Centre, Cynthia Maria Nicholas, with a representative from each caucus speaking for up to five minutes.

The Speaker (Hon. Dave Levac): The government House leader is seeking unanimous consent to pay tribute to a former member. Do we agree? Agreed.

Mr. Lorne Coe: I’m honoured today, on behalf of the Ontario Progressive Conservative Party, to pay tribute to the late Cindy Nicholas.

Cindy served as a Liberal member of the Legislative Assembly, representing the riding of Scarborough Centre from 1987 to 1990. She also served as the parliamentary assistant to the Solicitor General from 1989 to 1990. This was a time, Speaker, when debates centred on victims’ rights, children and families within the justice system, and the Special Investigations Unit.

I’m not certain what sparked her interest in politics, but it might have happened in 1983. That year, she was named as special adviser to the late Supreme Court Justice John Sopinka, who chaired the William Davis government’s Task Force on Equal Opportunity in Athletics. The report was an analysis of physical activities for boys and girls in Ontario’s public school system, noting that boys were more advantaged than girls in sports and exercise in Ontario and concluding that there should be greater equality. Her contributions to that task force helped set the tone for the changes that would come in the decades ahead.

Before politics, she made her mark in competitive marathon swimming—first, at the young age of 16 years old. In 1974, she matched Marilyn Bell’s 1954 crossing of a wind-swept Lake Ontario, and she did it in a record time of 15 hours and 10 minutes. Her little group, which included her father and a Globe and Mail reporter, departed from Youngstown, New York, at 2 a.m. on the morning of August 16. Except for family and friends and, of course, the intrepid Globe reporter, no one knew of the attempt.

They were armed only with a 10-foot wooden dinghy, a compass, a 10-horsepower outboard motor and some leftovers from the refrigerator. It wasn’t until they were spotted the next morning by a passing pilot that news spread and she was accompanied by a flotilla to Exhibition Place in Toronto.

Cindy became a lawyer in Scarborough after obtaining her degrees at the universities of Toronto and Windsor. She received numerous awards, including being made a member of the Order of Canada in 1979, inducted into the sports hall of fame in 2003 and the swimming hall of fame in 2005.

In addition, Cindy was the first recipient of the Scarborough Award of Merit and was honoured with a star on the Scarborough Walk of Fame in 2006. Now, each year, the local community recognizes her contributions with the annual Cindy Nicholas Swim Classic, marking 40 years in 2017. And her dream of an Olympic pool at the University of Toronto’s Scarborough campus was finally realized in 2015.

She loved her community and the people there who sought her help. She was a member of the youth employment project advisory committee and the sports head injury inquiry, and she also served on many other community and charitable boards, overall improving the lives of so many residents, Speaker, so many residents. Michael Read, the Channel Swimming Association president, said, “She was an incredible swimmer, her achievements were seemingly endless and well-deserved, a lovely and charming person and a great inspiration to all who were lucky enough to meet her.”

Cindy Nicholas was a national and local hero. She was a passionate champion for sport and for Scarborough, always proud of her roots. To Cindy’s family, Cindy leaves a tremendous legacy to the province as well as to Canada, and for that we’re extremely grateful.

The Speaker (Hon. Dave Levac): Further tribute.

Ms. Jennifer K. French: It is always our honour to stand in this proud Legislature and talk about issues that matter to the people of Ontario. Sometimes, like today, we have the opportunity to stand and speak about individuals who have mattered to us provincially and personally. I am honoured to stand and pay tribute and remember Cindy Nicholas.

First, I would like to welcome her family and friends to the Legislature today. Welcome to Leahanne LeGrow and her father, Raymond LeGrow. They are joined today by Cindy’s cousins Gail Wheeler and Pam Dornan, and friends Marsha Simmonds and Shoshana Teitelman. Welcome to Queen’s Park.

When we pay tribute to former MPPs, it is a chance to remember them, to recognize their work and celebrate their lasting impact. It is also a special chance to connect with their loved ones. Thank you to Cindy’s only daughter, Leahanne, for sharing some of her very special memories.

Cindy was well-recognized for her athletic achievement, being named top female athlete of the year in 1977 and given the Bobbie Rosenfeld Award. She was made a member of the Order of Canada in 1979 and was inducted into Canada’s Sports Hall of Fame in 1993, inducted into the Ontario Sports Hall of Fame in 2003, and into the International Swimming Hall of Fame in 2005.

She always liked to swim, and was a very competitive person and wanted to be good at everything. She was always encouraged by her father, Jim, and her parents were wonderful supporters and made sure she had all the opportunities she could. Throughout Cindy’s life, whenever she was in the water, they were right alongside her in the boat.

It seemed that her father also really enjoyed Cindy’s opportunities. She was in law school and her father said, “Cindy, there is an opportunity for a race in Egypt.” But Cindy said, “Daddy, I don’t really want to swim in the Nile.” But Dad thought Egypt was a pretty neat opportunity, and she did end up swimming in the Nile, with him alongside her, which does sound like a pretty special adventure.

Cindy was very close to her parents. She grew up in Scarborough, in Cliffcrest. She grew up there, made lifelong friends there, worked there and knew she wanted to represent it. She was elected to the Ontario Legislature in 1987, to serve her neighbours and constituents in the riding of Scarborough Centre. She was a Liberal MPP who served as parliamentary assistant to the Solicitor General from 1989 to 1990.

Cindy was elected in 1987, and Leahanne was born in 1988. While she doesn’t remember much from that time, her very first family picture was proudly taken on the steps of Queen’s Park. Cindy remembered fondly that she used to tote Leahanne around with her. When the bells would ring and she would have to come into the chamber, she would have to hand Leahanne off to whoever was closest, and afterwards come out of the chamber and have to ask, “Who’s got Leahanne?”

Apparently, even back in the late 1980s, traffic was a challenge. Cindy and Leahanne spent a lot of time sitting on the DVP, singing songs in the car.

Cindy loved her community. There were about four blocks between her home and constituency office, and another block to her parents’. She actively and wholeheartedly represented her riding. She was always proud of her time at Queen’s Park, and at the end of her term in 1990, she continued to be an active participant in her community. She was a lawyer, and her office was right around the corner from the grocery store and her church, and she couldn’t go anywhere without connecting with someone. She was well known and well respected by her clients and neighbours. She inspired others. Scarborough thought so much of her, and she thought so much of her community.

Cindy became a member of the Scarborough Walk of Fame at the Scarborough Town Centre in 2006, as one of the first people recognized for sports achievement. She was later on the nomination committee, because she grew up there. She knew the community, and she wanted to be active in recognizing the good folks from the area who deserved recognition for making Scarborough great.

She was so proud of the community and wanted big things for it. In fact, she always said they needed a bigger pool in the east end. She was so excited to finally see that happen with the Pan Am centre.

Cindy always had big goals, a big heart, but also a big pool. Generally, people have about a 30-foot pool, but their family pool in Cliffcrest was a 52-footer. She never lost her love of swimming, and in her retirement, she still swam a couple of miles a day.

She continued to give back and connect. She dedicated much of her time to her dear mother, Victoria, and to volunteering across Scarborough, appreciating the needs and strengths across the community she knew so well and loved so much.

Cindy Nicholas was sadly lost to her family, community and to the province too soon, at the age of 58, after a battle with cancer. Thank you to her family and friends for sharing her with us. We offer our sincerest condolences.

Those who knew Cindy in real life are richer for knowing her, and those who knew Cindy as larger than life were inspired by her. Cindy Nicholas dived into our hearts at 16, made waves throughout her life, and her love, strength and authentic spirit will forever send ripples throughout our province.

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

Hon. Brad Duguid: I am very, very honoured to have the privilege to rise today to speak and pay tribute to a Canadian hero, a good, long-time friend of mine, a former legislator and somebody who I can only describe as an incredibly, incredibly nice person.

On these occasions, our Legislature comes together in mutual respect and admiration for those who have contributed so much to our society, to us and to future generations. For the most part, we tend to acknowledge those that have left public life and have often gone on to some form of retirement prior to their passing. Unfortunately, today we’re here to pay tribute to Cindy Nicholas, former MPP for Scarborough Centre, who left us far too young.

I would like to acknowledge those—they’ve already been acknowledged—who are in the audience today: her daughter, Leahanne LeGrow; her former husband, Ray LeGrow; her cousins Gail and Michael Wheeler, Pam Dornan, Ryan Wheeler; and some of her close friends who are here; as well as a friend and former colleague in this Legislature, Steve Mahoney. I want to thank them for being here as well.

I had the privilege and opportunity to connect with Cindy’s mother, Victoria, at Cindy’s memorial earlier this summer. I was actually somewhat surprised to learn that she remembered this young kid from Scarborough in her living room with a number of my political friends, on behalf of the then opposition leader David Peterson, trying to convince Cindy and her family that running for a provincial seat in Scarborough would actually be a good idea.

I’ve got to tell you that while that first try was unsuccessful at getting Cindy to run, I recall that there was no doubt in our minds whatsoever that Cindy had a very strong desire to serve the public. Three years later, indeed, she did answer that call.

In many ways, she had been serving in public life for her entire adult life—and really her teenage life as well when you think about it. Public office was really just the next step in what I would call a lifetime of service to Scarborough, to Ontario, to Canada, and, frankly, to the world.

We all know that Cindy Nicholas was a truly accomplished long-distance swimmer, and my colleagues have spoken about some of her incredible feats. Her accomplishments in the water are frankly unrivalled, and they’re unrivalled to this day. She defied the impossible. At age 16, as was mentioned, she swam Lake Ontario in just over 15 hours. I think that was a record at the time.

She was unsurprisingly named the top Canadian athlete in 1977 and she earned that Bobbie Rosenfeld Award. She was named a member of the Order of Canada, as was mentioned, in 1979. She is, of course, in both Canada’s and the Ontario Sports Halls of Fame, and of course she’s in the International Swimming Hall of Fame. I don’t think there was ever a doubt, probably from the time she was 16, that she wouldn’t be getting those honours.

Two of the honours that were mentioned by my colleague from Whitby–Oshawa were the honour of the Scarborough Award of Merit and the Scarborough Walk of Fame. I was with her during those ceremonies. I know how proud she was of those as well because she really was a true champion of her home community in Scarborough.

When I think about it, Cindy’s real accomplishments didn’t just come in the pool, in the lake or in the Channel. They went far beyond that. Cindy was an inspiration to generations of Canadians of what could be achieved through perseverance, through training and determination.

At the same time, Cindy was unique for a sports celebrity. She never, ever lost her humble Scarborough youthful innocence. To call her “Scarborough’s Sweetheart” nowadays might be considered borderline sexist, but that’s what she was referred to, back in the 1970s and 1980s, often in the media. Really, that was in response to the fact that this great athlete and this strong and determined role model was an incredibly kind and caring human being at the very inner core of her being.

Yes, she worked here at Queen’s Park between 1987 and 1990, and she served on many committees and as a parliamentary assistant to a couple of ministers during her time here. But again, what made Cindy stand out at Queen’s Park wasn’t her legislative achievements as much as it was the fact that she always maintained her Cindy Nicholas kind and sweet personality. The cut and thrust of partisan debate simply never had a place with Cindy Nicholas. Her ability to come across as “just Cindy” was always noted by her constituents, Ontarians and her colleagues—Steve Mahoney would remember—and I think all of us in this Legislature, many of whom had very close connections with Cindy.

And so, I say on behalf of all of us today, on this side of the House and on all sides of the House, Cindy Nicholas is missed and will always be missed by all who knew her. We thank and acknowledge her loved ones—many of them are here today; some of them couldn’t be here.

I hope that today’s celebration of Cindy’s life brings you comfort in her premature loss, and I hope that the reflections that you’ve heard in this Legislature today that we’ve all had the opportunity and the privilege to share with you—reflections of Cindy’s huge accomplishments and of her as the person that she was—bring smiles to your faces as well today, along with pride in having been such an important part of her life, as she was an important part of all of ours: all Ontarians, all Canadians.

Applause.

The Speaker (Hon. Dave Levac): I would like to thank all members for their thoughtful, kind and heartfelt comments regarding the life of Cindy. We would also like to thank the family for the gift of Cindy. Knowing that it always is a sacrifice, and that we would make sure that our tributes today are felt for you in times to come, we will provide you with a DVD and a copy of the Hansard for this testimonial. Thank you very much.

Oral Questions

Hydro rebates

Mr. John Yakabuski: My question is for the Premier. It was revealed yesterday that the government spent nearly $12 million on contracts to friends and self-promotion through the Ontario Electricity Support Program. They doled out over $9 million to high-priced consultants and another $2.5 million to their ad man. That money was supposed to go to low-income families struggling to pay their hydro bills.

Speaker, can the Premier please justify spending nearly $12 million on consultants and self-promotional ads when families are struggling to make a choice between putting food on the table and heating their homes?

Interjections.

The Speaker (Hon. Dave Levac): Just as an indicator, I’m going to deal with this as quickly as possible. The Minister of Children and Youth Services will come to order.

Carry on.

Hon. Kathleen O. Wynne: We created the Ontario energy support program to help people who were struggling with their electricity bills, people who live on low incomes. We wanted to make sure and we want to make sure that everyone in the province who’s eligible for this program will know about it and will understand how to access it.

Right now, there are 145,000 families who, since the program was launched 10 months ago, have signed up for the program and are receiving support and are therefore paying lower electricity bills. It’s beyond me why the Conservatives would attack a program that is actually designed to help people with their electricity bills. This is a—

Interjections.

The Speaker (Hon. Dave Levac): I’ve made it clear that I will be seeking attention for both questions and answers. If it starts up as soon as I sit down, I’ll get whoever decided to challenge.

Premier?

Hon. Kathleen O. Wynne: This is a $225 million program, Mr. Speaker, and $12 million to do the public education is a small fraction of that amount.

The Speaker (Hon. Dave Levac): Supplementary?

Mr. John Yakabuski: Well, 145,000 is less than a third of those eligible. The people are waiting, but your friends have done very well.

Interjections.

The Speaker (Hon. Dave Levac): The member from Glengarry–Prescott–Russell, the Minister of Education, the President of the Treasury Board and the Deputy Premier will come to order. And the list will grow.

Please finish.

Mr. John Yakabuski: There’s not a day goes by where I don’t hear another hydro horror story: another family struggling to keep the lights on, a senior who can’t afford their medications or to pay their bills. We hear all of those stories over and over again, and this government has the gall, the audacity, to spend $12 million on high-priced consultants and self-promotional ads. This government knows no bounds.

Can the Premier tell every senior struggling to pay their hydro bills or for their medication that paying consultants was more important than their welfare?

Hon. Kathleen O. Wynne: I thank the member for the question. He makes the point that it is very important that people who are struggling with their electricity bills have access to support.

There are some 300,000 people in the province who still would qualify for the Ontario energy support program—

Interjection.

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

Hon. Kathleen O. Wynne: —and we need to make sure that they know about that program. So what we have done is we have put advertisements in print and radio and bus shelters—

Interjections.

The Speaker (Hon. Dave Levac): Next time I stand, we’ll go to warnings. The member from Leeds–Grenville: second time.

Finish, please.

Hon. Kathleen O. Wynne: We have put notices in ODSP and Ontario Works cheques; inserts from local utilities with their bills; partnerships with food banks and libraries, and MPP offices. So I hope that the MPP has a poster in his office and helps people in his constituency to find out about the program.

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

Mr. John Yakabuski: The inserts cost next to nothing. The ads of $2.5 million were for your self-promotion. What I can’t understand is why this rebate wasn’t automatically given to those in need. Why were they forced to apply? Why waste $12 million? But the Premier and minister think this $12 million was worth it, or, as the minister said yesterday, that it was “money well spent.”

If the Liberals think that it was better to spend on consultants and ads, they should have no problem releasing the details. Speaker, will the Premier commit today to release every contract and the details—disclose all the details—of how this $12 million was spent?

Hon. Kathleen O. Wynne: As I said, the money that was spent to put in place a public education campaign was very necessary because there are 500,000 families in the province who would be eligible. About 145,000 families are now in the program, so that means there are still more families who would qualify.

Mr. Speaker, the member opposite knows perfectly well that utilities do not have personal income information, so it was necessary to set in place a program approach that allowed people to apply. I hope that the member opposite is letting his constituents know about this program. It’s very important. The opposition has said—

Interjections.

The Speaker (Hon. Dave Levac): We’re now moving to warnings. The member from Huron–Bruce and the member from Haliburton–Kawartha Lakes–Brock, come to order. You’re in before the warnings; you’re lucky.

Hon. Kathleen O. Wynne: The opposition has been more than clear that there are people who are struggling with electricity bills. I hope that they are pointing people who come into their constituency offices in the direction of this program so that those people can get help.

Health care funding

Mr. Jeff Yurek: My question is to the Premier. Due to the rationed health care system, wait times in southwestern Ontario are increasing and patients are suffering. Last year, I informed the House that hip and knee replacement surgeries were completely cancelled during the months of January to April due to lack of funds.

Constituents like Ruby and Betty in my riding need to travel over an hour to Strathroy for knee replacement surgery. However, they both received letters from their surgeons this past week: “Our funding that we received for this fiscal year of April 2016 through till March of 2017 has reached its maximum, and therefore, we are not able to book any further patients for total knee or total hip replacements for this fiscal year.”

Speaker, we’re only six months into this fiscal year and they’ve already run out of money. Constituents like Ruby and Betty are suffering because of this rationed care. When will the Premier step in and ensure that health care funding lasts year-round?

Hon. Kathleen O. Wynne: Minister of Health and Long-Term Care.

Hon. Eric Hoskins: I appreciate the question. We know that when it comes to surgical procedures in this province, for most surgeries we have the shortest wait time, or among the shortest wait times, in all of Canada. But there are areas—we have to be frank about this—where we need to continue to make further improvements. Also, we need to make sure that that success is well distributed across the province.

We do expect our hospitals, when they are provided with an allocation, to manage that allocation responsibly and actually spread it over the course of the year, because there are many surgical procedures that demand those OR times. We expect and look to our hospital officials and leadership to be able to manage those allocations appropriately. We do that using an evidence-based approach and a scientific approach to make sure that people do have access when they do need that access.

The Speaker (Hon. Dave Levac): Supplementary? The member from Bruce–Grey–Owen Sound.

Mr. Bill Walker: My question is to the Premier. Life is getting harder for Doug Price. The frail 73-year-old needs replacement surgery on his knee today. Sadly, he can’t have it and he won’t get it for at least another year. His wife, Doris, faced the same predicament when she was told to wait a year for her cataract surgery.

Delayed and cancelled surgeries are skyrocketing across our province as a result of this Liberal government’s scandal, waste and mismanagement. Mr. Speaker, it’s unacceptable that this government can’t fund surgeries for patients, like Doug Price, who are in constant pain and unable to leave their home.

Why haven’t the Premier and the minister acted on this crisis situation and found a solution so that patients can get the needed surgeries as soon as possible?

Hon. Eric Hoskins: We increased the budgets of our hospitals this year by more than 2%, and we continue to make investments, and we often do that. So there’s the base funding that we provide hospitals, but also, to reduce wait times, we specifically allocate funds across this province. We do that generally through what’s called a quality-based procedure, where we provide that funding to hospitals that have proven their efficiency, their effectiveness in delivering these services as well.

It’s a system that has actually seen pretty dramatic improvements over just a number of years, so we can be proud of how we’re situated vis-à-vis the rest of the country. But we know that there’s more work to be done.

In fact, for the South West LHIN, as an example, we provided them with significant new funding specifically for hip and knee surgery this fiscal year.

We’re working closely with the LHIN in South West and in other parts of the province to be able to manage those challenges—

The Speaker (Hon. Dave Levac): Thank you. Final supplementary, the member for Haliburton–Kawartha Lakes–Brock.

Ms. Laurie Scott: My question is to the Premier. We are joined today by Rethink Breast Cancer, which is a national non-profit organization whose mission is to empower those who are concerned about and affected by breast cancer. They have been advocating for improved access to breast reconstruction for women who have been diagnosed with breast cancer and those who are at high risk of getting it.

According to a report they published earlier this year, Ontario currently has a one- to two-year wait-list for breast reconstruction surgery. This is simply unacceptable and harmful to breast cancer survivors. Manitoba, by contrast, has wait times of only up to six months for the same procedure. Fully half of physicians in Ontario surveyed say they are dissatisfied with the patient wait times for breast reconstruction, and 80% of those surveyed felt a lack of operating room time was the biggest contributor to the long wait times.

Will the Premier commit to immediately increasing surgical resources in the province, such as OR time, so that women suffering from breast cancer can get back to living their lives normally?

Hon. Eric Hoskins: I particularly appreciate this question. I want to thank—I know we have individuals in the gallery—Rethink Breast Cancer for their recent paper which highlights the challenges that are faced.

This is such an important issue, Mr. Speaker, that we need to make further progress on this. In April of this year—and I think this was one of the problems: The reconstruction, whether it’s prophylactic or whether it’s following surgery for cancer, wasn’t governed or managed by Cancer Care Ontario. In April of this year, we made that change as a result. So we’ve had an expert panel looking at precisely this challenge, because it is unacceptably long for women who have to go through this traumatic physical and mental procedure—the challenges that they’re facing.

We’re obligated to make sure that we’re providing a better system and better support for them, and we’re making the changes to deliver just that.

Electronic health information

Ms. Andrea Horwath: It’s particularly my pleasure to direct my question to the Premier today, on Persons Day, the day that, 87 years ago, women were actually included in the definition of being a “person” in this country.

I’ll continue with the actual question, Speaker.

Ontarians are very proud of our health care system and they want to know that it’s going to be there for their kids and for the next generations, but they’re very, very worried about privatization.

The Premier has made some comments, and I just need to be firmly sure of where this Liberal government is going, and so I’m going to ask the Premier to tell us clearly: Is privatization of any or all of our eHealth assets on the table for this Liberal government?

Hon. Kathleen O. Wynne: Let me just acknowledge that the leader of the third party was at the LEAF Persons Day breakfast this morning with a number of her colleagues and a number of mine, and thank her and thank everyone who has supported LEAF over the years as they work to make sure that the law works for women and not against women. Happy Persons Day, everyone.

Mr. Speaker, as I have said, as the Deputy Premier has said, personal health information—eHealth—is not for sale, not now and not ever.

The Speaker (Hon. Dave Levac): Supplementary?

Ms. Andrea Horwath: Last week, the government asked Ed Clark to figure out how much money our eHealth assets are worth. Now they insist that all they want to do is strengthen health care. But you don’t improve health care by asking how much you can get to sell off a hospital, and you don’t need to know the sale price of eHealth in order to be able to improve it.

Why should Ontarians trust this Premier that she isn’t privatizing our eHealth assets?

Hon. Kathleen O. Wynne: Minister of Health and Long-Term Care.

Hon. Eric Hoskins: To reiterate, there is no possibility of a sale or the commercialization of people’s health information. In fact, what I asked Ed Clark to do last week was to value the assets, to actually take an inventory of what has being created by eHealth over roughly the past decade—

Interjections.

The Speaker (Hon. Dave Levac): I’m trying to remember. Did I say we’re into warnings?

Interjections: Yes.

The Speaker (Hon. Dave Levac): Thank you. I just needed that reminder.

Carry on.

Hon. Eric Hoskins: Given that the current mandate of eHealth is due to conclude at December of next year, I think it’s prudent to do an inventory of the assets, to value those assets, to understand what assets have been created across this province. We know that others, like Canada Health Infoway, have done this. We want to do that to leverage those assets going forward, to build an even stronger digital health strategy and system.

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

Ms. Andrea Horwath: Speaker, I’m more worried than I was when I got up to ask these questions in the first place. That’s the same language this government used when they talked about selling off Hydro One: “leveraging the assets.”

Look, it wasn’t that long ago that this Premier refused to admit that Hydro One was even for sale in the province of Ontario. In fact, she still insists that Hydro One isn’t being sold. She calls it “broadening the ownership,” even though everybody knows what the truth is.

When the Liberals ask Ed Clark to figure out the sale price of our eHealth assets, and then turn around and say they won’t sell anything, it doesn’t pass the smell test, especially when they’re now talking about leveraging that very asset.

We’ve seen more than 10 years of privatization by this Liberal government in the health care sector, and we cannot take any more. Why is this Premier so interested in how much money she can get for our public eHealth assets?

Interjections.

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

Minister.

Hon. Eric Hoskins: It doesn’t matter how many times she tries to say it. eHealth is not for sale. eHealth is not for sale.

What we’re doing is we’re actually looking at what has been created over roughly the past decade. We’re moving into a new phase of a strategy where we’re going to be able to provide better support for consumer-facing eHealth and digital health systems. We’re going to build on the fact that 80% of family doctors across this province are already using eHealth and that most diagnostic procedures are already digitized. We’re going to look at that. It’s the prudent thing to do.

The mandate is coming to a conclusion at the end of next year. It’s prudent to actually look at what we’ve got, so we can build an even stronger system going forward.

We will not be selling eHealth.

Privatization of public assets

Ms. Andrea Horwath: My next question is also for the Premier. But I’ve got to say that in October 2014, this Premier said she wasn’t selling off Hydro One, and look where we are now.

On Monday, I sat down with a woman named Maryse Gareau. Maryse lives in Sudbury with her husband, Chad, and her two beautiful young daughters. Maryse has watched her hydro bills go up by nearly $100 since the same time last year. The cost of hydro means that they cannot save for their kids’ future, and she’s concerned about whether she can afford even entering them in before- and after-school programs, like sports, for example.

Like people all across Ontario, the sell-off of Hydro One means life is getting tougher for folks like Maryse, her husband, Chad, and their daughters, and it means it’s harder for them to give the future that they want to give to their children. She’s actually not putting money away in their RESPs because she’s taking that money and using it for her hydro bills.

Will the Premier stop the sell-off of Hydro One so that it doesn’t get worse, instead of better, for this family?

Hon. Kathleen O. Wynne: I thank the leader of the third party for the question. I know that it serves the leader of the third party’s interests to conflate these subjects. I know that she’s trying to make a link between electricity prices and the changes with Hydro One.

The reality is that we have made massive investments in the electricity system in Ontario. We have shut down the coal-fired plants. We have built over 10,000 kilometres of line. We’ve done that so that we could have a clean grid in this province, a reliable grid. There’s a cost associated with that, and we’ve recognized that, so we are working to take costs off of people’s bills and help people like Maryse and her family.

We are also working to help a family like that so that they have the supports that they need, whether it’s child care—100,000 new child care spaces—or whether it’s tuition, making sure that by the time those two kids get to post-secondary, they have the support that they need, whether it’s free tuition, if they’re low-income, or supports that they need. Those are the kinds of things we’re doing to support families in the province.

The Speaker (Hon. Dave Levac): Supplementary.

Ms. Andrea Horwath: The Minister of Energy, the MPP for Sudbury, stood right here in this House and said, “A 20% reduction for families in rural, remote and northern communities, like in my part of the province, will actually be a significant savings for many families.” But people in Sudbury, people in the minister’s own riding, people like Maryse and Chad, are not getting those savings. Instead, they’re watching their bills go up, and turning Hydro One into a private, for-profit monopoly is only going to make it worse, regardless of what the Premier claims.

We’ve seen it happen over and over and over in virtually every jurisdiction across North America: When you privatize your electricity system, the costs go up for the public. That’s what happens, whether she likes to admit it or not. The question is, will this Premier stop any further sell-off of Hydro One and ensure that people get a break?

Hon. Kathleen O. Wynne: Minister of Energy.

Hon. Glenn Thibeault: I’m very pleased to rise and answer the leader of the third party’s question. When it comes to the great riding of Sudbury, we have talked to the families there, and all the families in the great riding of Sudbury will be receiving that 8% reduction if this legislation passes today.

Part of the issue is that the NDP doesn’t have a plan when it comes to energy, so they don’t understand the whole process. When we’re talking about northeastern Ontario, my part of the province, there are over 69,000 families that will be receiving that benefit, and we’re very proud of that.

When it comes to Hydro One, we’re on track to ensure that we’re going to realize the target of $9 billion generated through the IPO. Let’s talk about Greater Sudbury again. We can talk about investment after investment after investment: $173 million for the four-laning of Highway 69; $26 million for Maley Drive; $20 million through OCIF. This is fantastic for the north, and I’m very proud of these—

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

Interjections.

The Speaker (Hon. Dave Levac): Stop the clock. We are at warnings. Cupping your hands to make sure a megaphone makes it louder is not conducive to applying what the Speaker is looking for. It also is not helpful, when somebody is giving an answer, that the chipping comes on from the same side that provokes. So it stops on both sides.

Final supplementary.

Ms. Andrea Horwath: It’s not just people, Speaker. This is Ontario Small Business Week. Small businesses across the province cannot afford their hydro bills. Wherever I go, whether it’s Sudbury, Kingston, Hamilton, right here in Toronto, Niagara—you name it, Speaker. I talk to small businesses everywhere, and they’re all telling me that the cost of hydro is the difference between growing or going out of business.

According to the Ontario Chamber of Commerce, one in three—one in three—small businesses say that the cost of hydro has a negative impact on their ability to invest in the future of this province by investing in their businesses. They simply can’t do it.

Will this Premier give some hope and confidence to small-business people and start getting hydro costs under control by stopping the sell-off of our hydro system, by stopping the sell-off of Hydro One?

Hon. Glenn Thibeault: I’d like to thank the member for highlighting small businesses and the importance of small businesses, because we recognize that on this side of the House. Let’s take a look at a couple of examples about the programs that we are offering and how they support small businesses.

Donaleigh’s Irish pub in Barrie took advantage of the Business Refrigeration Initiative offered through PowerStream. They received more than $2,500 in one-time incentives and will save $2,400 annually on energy.

Arbor Memorial, a funeral company, has its head office in Toronto. They used incentives from the Save on Energy program to green their office, upgrading their intensive HVAC system—$100,000 per year in savings.

Canada Malting Company up in Thunder Bay was one of the very first announcements that I was able to attend. Through the Save on Energy program, they got $2.5 million back. They’re saving $1 million a year in their energy programs.

We get small business on this side, Mr. Speaker, and we help small businesses.

Health care funding

Ms. Lisa M. Thompson: My question is for the Premier. A constituent of Huron–Bruce recently called me about his 73-year-old wife, who needs to have orthopedic surgery. She has been waiting since July 2015 for surgery on her knee. That’s 15 months and, frankly, that’s unacceptable.

My office called the surgeon, and we talked to their staff. We were told that they actually have 300 people on a wait-list, some for as long as two years. Speaker, the surgeon’s office explained that the wait times are due to government regulations which dictate that although a surgeon is available, they’re only to perform surgeries as funding permits.

Speaker, why should people’s quality of life have to be put on hold because of this Premier’s wasteful spending and mismanagement? What I would like to know is, what does the Premier have to say to these people?

Hon. Kathleen O. Wynne: Minister of Health and Long-Term Care.

Hon. Eric Hoskins: Well, Mr. Speaker, I’m the first to admit that there’s more work to be done, but we need to recognize exactly where we’re situated here in Ontario. We have among the best wait times—we’re the first to have measured them, by the way—among the best surgical wait times in the entire country.

In fact, in the last decade we have decreased the wait-time for hip replacement by 42%. We’ve decreased the wait time for knee replacements by 51%. We’ve decreased the wait time for cataract surgery by 37%. So there are dramatic improvements. In fact, for hip and knee, more than 80% of individuals achieve those replacements within our targeted amount of time that we aim for—what’s called a level-4 target.

But there is more work to be done. I would also expect to be able to work with our hospitals and our clinicians so that those patients who do require those procedures more urgently are able to get access to those surgeries urgently.

The Speaker (Hon. Dave Levac): Supplementary? The member from York–Simcoe.

Mrs. Julia Munro: Back to the Premier. Premier, my constituent Duncan Drummond has been on the emergency wait-list for shoulder surgery for over seven months—an emergency list which, upon investigation, we find is 100 people long. A hundred people are waiting on an emergency list. At this rate, it will be another two years. He is number 101.

His granddaughter describes his condition as a “pseudo-paralysis” on an arm that leaves him in agonizing pain. Mr. Duncan’s wife and daughter are here today in the hope that you will understand how important it is for him to be moved along at a faster rate than at this time.

To the Premier: When will you exercise your constitutional obligation to provide health care for my constituents and the rest of the province?

Hon. Eric Hoskins: I want to acknowledge the Duncan family being here today. This is an important issue and I’m pleased that they are able to see the discussion.

We need to continue to improve, there’s no question. But for those individuals that do urgently require procedures, we expect clinicians and hospitals to be able to put them to the top of the list, Mr. Speaker, and we have made significant improvements. We continue to do that.

We continue to invest millions of dollars in bringing down wait times. When you look at knee replacements alone, our average wait time is half of what it is in the OECD. For hip replacements, the OECD—the Organization for Economic Co-operation and Development—their average wait time for hip replacements is 121 days. Canada’s is 85 days for a hip replacement. Here in Ontario, it is 70 days.

We are at the front of the line, but there, of course, is always more work to be done, in concert with our front-line clinicians and surgeons themselves.

Automobile insurance

Mr. Jagmeet Singh: My question is to the Premier. Mr. Speaker, in 2013 this government promised to reduce auto insurance rates by 15%. The rates didn’t come down. They campaigned on this promise in 2014, and again—no surprise—the rates didn’t come down. In fact, what’s going on is, for the second quarter in a row in 2016, rates are actually going up. What makes this even more offensive, Mr. Speaker, is that our benefits have been slashed. This government has allowed the insurance industry to slash benefits.

My question is: Has the government just given up on this promise to reduce auto insurance?

Hon. Kathleen O. Wynne: Minister of Finance.

Hon. Charles Sousa: I appreciate the question and the concerns that we all have about reducing auto insurance rates, about ensuring there’s fairness in the system and about ensuring that consumers are well protected. Ontario continues to be the most generous in terms of benefits still.

We have reduced rates. They have been going down on average almost 10%, Mr. Speaker, and that’s important. It’s not at a point in time that matters; it’s on an ongoing basis to provide sustainable reductions in costs, in fraud, and in the engagement of certain activities within the sector that have to be improved, and that is being done. It’s being done in consultation with the sector. It’s being done in consultation with the public. All in all, consumers are demanding greater affordability and they want choice, and Ontario is providing both, Mr. Speaker.

The Speaker (Hon. Dave Levac): Supplementary?

Mr. Jagmeet Singh: The reality is, over the past two quarters this government has approved rate increases—they’ve approved them. Another reality is that the government controls rates. They have the ability to control auto insurance rates in this province, and they’re simply not doing it. What they are doing, though, is allowing the insurance industry to exploit the people of this province. They have allowed them to slash benefits tremendously. What’s so offensive is, it’s not just all the people of Ontario; it’s even the most seriously injured people who are seeing their protection slashed.

The government claimed that this was a stretch goal; they never really intended to achieve this goal anyway. But that’s not what the people voted for. The people want to ensure that the next generation has an affordable life, that they can afford to live in this province. It’s not helping when rates continue to increase.

When will the government stop prioritizing insurance company profits over protecting the people of Ontario and finally commit to affordable auto insurance rates in this province?

Hon. Charles Sousa: The fact of the matter is, auto insurance rates on average are going down. That’s just simply not true, what the member said. On occasions there are points where rates vary depending upon specific companies. There are over 110 companies that participate in this industry.

All in all, Mr. Speaker, our reforms have been put in place. Programs have enabled us to further reduce rates overall. We are improving the degree of victims who get responses in a timely manner. That was also a problem, Mr. Speaker. That is being done.

We have been doing a lot of work to try and reform the system to provide better service to consumers and victims, while at the same time provide for greater affordability, and it’s being done on a number of reforms that have been enacted and that are continuing to be so. Some of them were delayed, Mr. Speaker, because the members of the opposition—and that party specifically—voted against measures that would have enabled us to act more quickly.

We are doing what’s necessary, Mr. Speaker. Auto rates are going down overall.

Health care funding

Ms. Ann Hoggarth: My question is to the Minister of Health and Long-Term Care. This week, provincial and territorial health ministers from across Canada met with federal Health Minister Jane Philpott and indigenous leadership in Toronto to discuss several key aspects of health care. From what I have seen in media reports, much of the discussions were on the future of the federal health transfer. I know that the federal government has a role to play in the sustainable funding of our health care system, not only in Ontario but across Canada.

Would the minister be able to provide us with an update of those very important discussions?

Hon. Eric Hoskins: We had an excellent two days of meetings here in Toronto with my provincial, territorial and then, yesterday, federal health minister colleagues. Although we didn’t agree on everything, we did agree that a stable financial base is essential for all of the provinces and territories to be able to continue to provide the high-quality services that we do. I know that Minister Philpott agrees with that as well.

We had an excellent two-hour session with national indigenous leaders and their organizations yesterday morning. It was powerful to hear from them, and the specific recommendations and proposals that they’ve put forward.

It’s important to note—because I think most Ontarians don’t understand this—that roughly 80% of the dollars that go towards health care across this country is provided by the provinces and territories, and only about 20% by the federal government. We’re hoping to maintain that federal share. We think that’s the fair approach to take.

The Speaker (Hon. Dave Levac): Supplementary?

Ms. Ann Hoggarth: Thanks to the minister for that response. I also believe it is important that we have a strong federal partner, finally, in order to sustainably fund health care in Ontario. I look forward to further updates.

Minister, would you be able to inform the House how incoming funds are directed entirely towards improving health care for Ontarians?

Hon. Eric Hoskins: Historically, 50 years ago this year, medicare was created in this great country. There was a commitment to share 50%-50% between the federal government and the provincial and territorial governments. That has declined down, as I mentioned, to about 20% being the federal contribution. We want not to maintain that but to bring it back to where it used to be in terms of the historical partnership that did agree.

But I want to reassure Ontarians that every single dollar we get through Canada Health Transfer for health care from the federal government goes to health care. In Ontario, that contribution now from the federal government amounts to about 1.5% of our annual health budget that we get from the federal government. Of course, as many of you know, in many years our budget for health has gone up by 5% or 6%, sometimes even 7%. It certainly has consistently been above 1.5%.

We’re looking for a fair relationship. We’re looking for an increase to the federal contribution so it respects history.

Health care

Ms. Lisa MacLeod: My question as well is to the Minister of Health.

In Ottawa, we have the second-longest wait times in Ontario for MRIs. The government says that 90% of those needing a “non-urgent” MRI should get it within 28 days, but the Champlain LHIN said it could take up to 132 days, not 28. Ottawa Hospital’s CEO, Jack Kitts, also told the Ottawa Sun that without more resources, “I don’t want to leave you with any misconception that going from 132 (days) to 28 is realistic.”

According to the Ottawa Citizen, the government also won’t pay the operating costs for the Ottawa Heart Institute’s new MRI.

The government is failing my constituents, and the people in Ottawa–Vanier who will be going to the polls on November 17, with unachievable targets because of unavailable cash. Why is this government setting targets it can’t meet because of payments that they won’t make to operate these MRIs in Ottawa?

Interjections.

Hon. Eric Hoskins: Thank you, Mr. Speaker. I just wanted to consult with my colleagues, because I understand that the member opposite was at the Queensway Carleton announcement last Friday with the Premier, where we announced a fantastic new senior-specific clinic, called an ACE clinic, which will make a dramatic impact. I know you were very happy with that investment.

Mr. Speaker, when it comes to MRIs—I will definitely address the issue substantially now and in the supplementary—we are making considerable progress. Again, on MRIs and CAT scans and ultrasounds, we’re either at the top, in terms of the shortest wait times in Canada, or very near the shortest wait times. We’re measuring them and we’re making significant progress.

We realize that we need to continue to invest, particularly in these important diagnostic procedures, and we need to make sure that those who need the procedure most urgently get it most urgently.

The Speaker (Hon. Dave Levac): Supplementary? The member from Thornhill.

Mrs. Gila Martow: My question is to the Premier.

Isaac Kraus of Thornhill has worked in Canada most of his life and he paid his taxes, but now he’s 62 years old and diabetic. He had a family doctor for 30 years who suddenly retired, and Isaac said he panicked. He knew what was ahead. He tried to find a new family doctor and he was called in for interviews, as though he was applying for a job, and rejected. He believes that doctors did not want to take him into their practice due to his diabetes.

Does the Premier understand the challenges faced by patients with diabetes and other illnesses in this province?

Hon. Eric Hoskins: We expect all our primary care providers to welcome individuals into their practice, regardless of what their medical history might be. I