Legislative Assembly of Ontario

MINISTRY OF THE SOLICITOR GENERAL AND CORRECTIONAL SERVICES

MINISTRY OF HEALTH

CONTENTS

Tuesday 7 June 1994

Ministry of the Solicitor General and Correctional Services

Hon David Christopherson, minister

Michele Noble, deputy minister

Don Wadel, chair, Ontario Board of Parole

Dr Paul Humphries, senior medical consultant and manager, clinical services, correctional services division

Ministry of Health

Hon Ruth Grier, minister

STANDING COMMITTEE ON ESTIMATES

*Chair / Président: Jackson, Cameron (Burlington South/-Sud PC)

*Acting Chair / Président suppléant: Lessard, Wayne (Windsor-Walkerville ND)

*Vice-Chair / Vice-Président: Arnott, Ted (Wellington PC)

Abel, Donald (Wentworth North/-Nord ND)

Carr, Gary (Oakville South/-Sud PC)

*Duignan, Noel (Halton North/-Nord ND)

Elston, Murray J. (Bruce L)

*Fletcher, Derek (Guelph ND)

Hayes, Pat (Essex-Kent ND)

Mahoney, Steven W. (Mississauga West/-Ouest L)

Ramsay, David (Timiskaming L)

Wiseman, Jim (Durham West/-Ouest ND)

*In attendance / présents

Substitutions present/ Membres remplaçants présents:

Mills, Gordon (Durham East/-Est ND) for Mr Wiseman

Murphy, Tim (St George-St David L) for Mr Ramsay

O'Connor, Larry (Durham-York ND) for Mr Wiseman

Runciman, Robert W. (Leeds-Grenville PC) for Mr Carr

Sullivan, Barbara (Halton Centre L) for Mr Ramsay

Wilson, Gary, (Kingston and The Islands/Kingston et Les Iles ND) for Mr Hayes

Wilson, Jim (Simcoe West/-Ouest PC) for Mr Carr

Clerk / Greffière: Grannum, Tonia

Staff / Personnel: McLellan, Ray, research officer, Legislative Research Service

The committee met at 1545 in committee room 2.

MINISTRY OF THE SOLICITOR GENERAL AND CORRECTIONAL SERVICES

The Chair (Mr Cameron Jackson): We have approximately an hour and 30 minutes remaining for the estimates of the Ministry of the Solicitor General and Correctional Services.

In rotation, I believe we're ready to proceed with Mr Runciman's questions for 25 minutes. The minister has advised me that the staff and the chair from the Ontario Board of Parole are here as per your request and that the package of the minister's staff responses are on their way in sufficient copies for the committee.

Hon David Christopherson (Solicitor General and Minister of Correctional Services): The only thing to add is, there are one or two pieces that are still required, but the overwhelming majority of them are in a full, comprehensive package that's on its way.

The Chair: Good. We'll proceed with Mr Runciman.

Mr Robert W. Runciman (Leeds-Grenville): In respect of the package and the parole board officials, what was the response in respect of my request to have a copy of the Attorney General's letter of advice to you related to the release of Clinton Suzack?

Hon Mr Christopherson: Yes, I said I would undertake to determine whether we could release that. I've done so. We're advised that we can. I have copies here. I don't know if they're in the package or separate.

Ms Michele Noble: They're separate.

Hon Mr Christopherson: Separate. I have the letter here. We can circulate it now, if you want, Chair.

The Chair: Please.

Ms Noble: Just a further point of explanation -- well, you can read the letter when you get it. It's a letter to myself from the Deputy Attorney General.

Mr Runciman: I wonder if we could have the officials from the parole board come forward.

Hon Mr Christopherson: Yes. We have Don Wadel, who is the chair of the Ontario Board of Parole, and also Ken Sandhu, who is the executive vice-chair. Both are here to answer questions the committee may have.

Mr Runciman: Mr Wadel, could you advise us what's happened with respect to the parole board? I gather you've been advised not to talk about the circumstances surrounding the release of Clinton Suzack, which are certainly of interest to me and a lot of other Ontarians, especially people in the Sudbury area.

I'm just wondering if you can advise us as to what kinds of changes have occurred within the parole board in the last eight to 10 months, if any, from an administrative perspective, from a personnel perspective and anything you might be able to comment on.

Mr Don Wadel: The parole board is constantly undergoing change to try and help us to better fulfil our mandate, which is to contribute to the protection of the community, and there are ongoing activities that help us to work in that direction.

In terms of specific things that have been done, I could relate things in three areas: in terms of information required for the board, in terms of accountability of members and processes for conducting hearings and in terms of our ability to report on the relative success of parole. All of these areas are long-term developments that the board's been working on for a number of years, but some of those elements have come to fruition more recently.

Mr Runciman: How long have you been the chairman?

Mr Wadel: About a year and a half.

Mr Runciman: So, since you've moved into this office, you're saying nothing new in terms of personnel changes, administrative changes, has occurred and in fact most of these initiatives were undertaken and committed to some years ago.

Mr Wadel: Yes. It's been an evolution, and I think there will always be an evolution of steps to try and ensure that we improve our ability to assess and predict risk in particular, to make sure that the content and quality of information that's available to board members are continually improving. As the knowledge improves in terms of what's available through research findings and so on, we're learning more all the time about ability to identify risk factors and apply them to some predictive ability.

Also, I think most recently what has improved in our ability to report on the relative success of parole is that we have operationalized a management information system that was recommended by the standing committee on government agencies. That's fully functioning now, and it will help us to highlight not only the characteristics of people we're seeing and whether victims or observers are involved, but also what the outcomes are.

We're able to track now very specifically, for instance, how many cases result in revocation and, of those cases, where there is reoffending present and what the nature of that reoffending was. That allows us then to continue to develop other processes to examine cases that are unsuccessful and see if there are ways that we can, again, continue to improve our practices to better be able to predict risk and to make sure that we're easing people into the community at a minimal risk to that community.

Mr Runciman: I know you've been advised not to talk about a specific case, for reasons which I don't agree with, without seeing the letter but just from the minister's stand on this issue. But in a general way, one area you didn't mention was, when you have an application before you for parole and you have access to CPIC, the Canadian Police Information Centre, is there not some sort of process whereby you would review an individual's record to ensure that there were no outstanding warrants against any individual applying for parole within Ontario, outstanding warrants either within this jurisdiction or outside of Ontario? Is that not a normal course of the review process?

Mr Wadel: Yes, it is. In fact, that constitutes some of the core information that's required for us to proceed with any case. Whether or not there are outstanding warrants, we're required to provide hearings for people who are eligible, and that's people between six months and up to two years less a day. The fact that a warrant may be present doesn't mean that they're no longer eligible.

Certainly that information is presented to us. We make every effort to encourage the offender to address outstanding matters, and that's really in his own self-interest, because if in fact parole were granted and an outstanding warrant was executed, it could result in a disruption of the parole period or the termination of the parole period. So we make every effort to encourage them to deal with that, and there are mechanisms in the ministry to pursue that warrant by notifying the jurisdiction where the warrant is held and trying to get them to act on it.

What we find, though, is that in some cases the warrant is a radius warrant and it can only be acted upon if the person is physically present in that region. In other cases, the jurisdiction chooses not to pursue or execute the warrant.

So what the board does is, if there is an outstanding warrant, we proceed with a full hearing and make a decision based on the merits of the case, but the fact that there is an outstanding warrant would be registered as a significant factor in determining whether that person is prepared to become a law-abiding member of the community.

Mr Runciman: I find this extremely difficult, trying to talk around an issue, but your background, as someone advised me, was part of your appointment. You were with the John Howard Society?

Mr Wadel: Yes. My full background is, I was eight years as an assistant superintendent of a correctional centre in Alberta and then eight years as executive director of a branch of the John Howard Society. In both cases, the objectives were very similar: to protect the community from the social and financial costs of crime. So my background includes both institutional and community experience.

Mr Runciman: I guess that most people, perhaps incorrectly, look at John Howard as sort of an advocate, a voice for ex-cons, people who have served time or have been incarcerated. So your immediate role prior to coming to the parole board was as an advocate for people who had served time in provincial or federal institutions.

Mr Wadel: It's not an advocate. The John Howard Society's mission is, again, to provide services, to reduce the social and financial costs of crime, to try and provide very specific treatment services, basically the same type of services that are in existing institutions, to reduce risk of repeat criminal behaviour. It's not advocating on behalf of people.

The society's programs are there to try and reduce reoffending by reducing the risks and needs that any individual offender might present. So it's certainly not, as you're describing it, an advocacy group.

Mr Runciman: This is a little awkward, I'm sure, for you, as it is for me, but recently the chair of the federal parole board resigned because there had been some criticism about release of some individuals who then reoffended in a very serious way, committing several murders. Because of the widespread criticism of the board, I gather the chair felt it was appropriate to leave the position.

As you know, certainly there was a great deal of concern about the release of Mr Suzack and subsequent events. I guess if you draw an analogy between what's happened federally and this incident at the provincial level, why do you feel that you should be treated in a different way? You talked about accountability. Where does the buck stop in terms of these kinds of end results if the public is left in the dark in respect to what may have occurred within the ministry or within the parole board? We've been told absolutely nothing, and what you're telling us today is, in effect, absolutely nothing in terms of specifics that may have resulted from the internal review and the charges that were laid against Mr Suzack.

I guess I'm asking you to justify why you believe that you should be acting differently or treated differently than the chair of the federal parole board.

Mr Wadel: I think two things: One is, I believe that the board and I, as chair, should be evaluated on our success in meeting the mandate of the board, which is contributing to the protection of the community. I know we have taken steps now, through this management information system, to report very specifically on the incidents where people can complete their periods of parole, as well as where they're revoked; in what cases they're revoked for a technical reason, which is managing the case well in the community, versus reasons that are unsuccessful, where they're reoffending.

I think if you look at any particular decision, there are so many factors and influences involved in that decision. It could include the quality and content of information that's available to the members, the rigour of the process that occurred, but also, in the community, the type and degree of supervision, the services that were available to that person. So any particular decision and, even more so, any particular outcome are the result of really wide-ranging factors. I think it would be too simplistic to look at the accountability that you're talking about.

I think what we have to do is, every quorum now of the board is subject to, and has been for years, random reviews where we examine on a regular basis the ability of the quorum to work within the procedures that govern any hearing. We look at the content, the quality of information available to those members, and we look at how well they incorporate that information to make the difficult decision of what's an acceptable risk. There are so many factors.

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We are taking steps, in terms of accountability, to review those cases, to ensure that training is improved on an ongoing basis, to ensure that the quality of information is improved on an ongoing basis and to ensure that we incorporate any developing knowledge about ability to predict risk into our practices. I think the way we should be judged on is, overall, what basically the success level is in parole decision-making.

Mr Runciman: I suppose in a general way that's fair, but I think when you have situations like this particular one that just scream out for answers -- you talked about your system having been in place for years. That's not providing any solace to the people in Sudbury. You say, "What's unacceptable risk?" Again, I'm only looking at this from a perspective of having very limited information available to me as a member of the Legislature, let alone as a member of the public, but I've been advised after the shooting -- for example, I've been contacted by the police in Sault Ste Marie indicating that they'd written to you saying that Suzack posed a menace to society, along with an outstanding warrant, along with a number of other issues. It just leaves one shaking their head in respect to how in the world this kind of guy could be released out onto the street.

You talk about an unacceptable risk. If you have a police force telling you that this guy is a menace to society, how the hell do you define an unacceptable risk to society? Those are the kinds of answers we'd like to have. You can talk in generalities, and I gather you've been restricted, for who knows what reasons, in terms of addressing the specifics of this case, but I think when we talk about you having that kind of a message before your adjudicators, God, I don't know how many of us could accept you saying: "We decided in wise counsel amongst this quorum that this guy posed an acceptable risk to society. There was an outstanding warrant which dealt with a violent crime in Alberta, plus the police saying he posed a menace to society, but we think this is an acceptable risk."

I don't think too many people would agree with you. We'd be interested in knowing how you can reach those kinds of conclusions, given the information in front of you. I think in an instance like that -- and maybe this is being unfair, looking at one case in isolation, but it's a case that may have, and I emphasize "may have," resulted in a death. That has to come back and fall upon your shoulders. Somebody has to be accountable for that kind of a decision.

I guess there's not an awful lot more you can say. Thanks.

The Vice-Chair (Mr Ted Arnott): You're completing your --

Mr Runciman: No, I'm not. I'd like to talk to Dr Humphries as well, if I still have some time.

The Vice-Chair: You have about 20 minutes.

Mr Runciman: Dr Humphries, welcome back. I don't know if you're really the person to answer the question or questions I have for you or not, but there may be advice coming from other quarters.

I'm interested in pursuing the Camp Dufferin situation and the fact that there are young offenders who may have been infected with the AIDS virus. What's happening in respect to that? I've been advised that there's some concern that there is not the effort being made to locate something like 84 former inmates about whom there's some concern about them being infected, that there's really not the concerted effort to locate these individuals, as might be expected. I know that falls into Dr Schabas's area, but I'm just wondering what you can tell us about that situation.

Dr Paul Humphries: I'd be happy to, Mr Runciman. The information was brought to our attention from the London Police Force on a Friday that an individual who was part of a pornographic ring there had indicated that he was HIV-positive, that he'd been at Camp Dufferin and that he'd been involved in tattooing with some of the other residents there. On that Friday we went into motion and started to identify everyone who would have been at the camp at the same time as that young offender was. That was leading into a weekend, and by the following Wednesday we could identify 84 possible people who had been in contact. By Thursday, that had been moved over to the Ministry of Health, as is proper custom on our part.

We then, in addition to that, identified all the other institutions that resident had been in as part of his "criminal behaviour." I talked with my colleagues in Health, and we felt that we should interview that young man relating to the other institutions as well. We felt it would be better if they did the follow-up than if we did, because there is more trust with Health than with the correctional side of it.

It's my understanding that they went in and once again talked with him. They are doing the follow-up. When I checked with Health about a week ago and I talked with Dr Evelyn Wallace, they were still in the process of following the contacts.

Mr Runciman: Do you know how many of the 84 they've been able to locate and contact in this period of time?

Dr Humphries: I would be breaking a very real confidentiality to answer that, if that's okay.

Mr Runciman: Why would that be? I'm sorry.

Dr Humphries: Let me explain that. If one removes this from the Camp Dufferin situation, let's talk about the earlier days when the Ministry of Health was actively involved in following up on syphilis, gonorrhoea and things like that. What would happen is a person would be reported to them. They would start a very confidential process of following up on the contact, and then those people would identify other contacts until eventually there would be a fair number of people you would be following up from the communicable disease point of view. Obviously, clients would not be prepared to share information if they knew that information was going to be shared. That process is very confidential.

Mr Runciman: I'm not asking you for names. I am asking you, out of 84 possible contacts, how many have been located and apprised to be tested. I've heard it is very few. It seems to me there should be significant concern about these people making additional contacts if indeed they are carriers. This is a problem that could mushroom, and there's been a rather noticeable lack -- maybe this is unfair -- of effort in terms of trying to locate these individuals and ensure that they are tested and that they're not passing on the virus if indeed they are infected. So it seems to me it should be a very significant priority.

I have difficulty with your indicating that you can't advise me how many people have been contacted. I don't see any question of confidentiality arising, other than the fact that if my source is correct that very few of these people have been contacted and there's really a minimal effort under way to locate them, I think people have a right to be concerned and have a right to know about it.

Dr Humphries: In following up on these contact persons, it would be turned over to the local public health unit. I can assure you that they have talked with the young individual. They have obtained one or more contact names and one or more public health units have been involved. I should not go beyond that.

Mr Runciman: That's essentially the information I heard, Mr Minister, and I think you should be concerned about this as well, that very few health units have been contacted in respect to this and very few individuals have been located. I don't know when this arose. How long is it now: four weeks, five weeks?

Dr Humphries: Approximately.

Mr Runciman: I don't think, in that period of time, the effort that's called for here has occurred. It's a good issue to raise in question period, I guess.

Hon Mr Christopherson: I have no doubt, Bob.

Mr Runciman: On the HIV, we talked about the mandatory testing issue the other day and you said you were not a supporter of mandatory testing because of the period of time that the virus takes to show up in the system. Aren't there jurisdictions now that are using new techniques whereby they can detect the virus within something like 48 hours? If you're in the institution, they don't have this time lag that you expressed concern about the other day.

Dr Humphries: Yes, I keep hearing about this as well and I hear it's coming from Japan and Southeast Asia countries etc, but I have not personally been able to get a real reading on it from a North American point of view. I've talked with Dr Calzavara, who did our big study. We've talked with Dr Carol Major, who's head of the epidemiological part of the provincial lab in Etobicoke, and I'm not aware of some kind of technology we could use at this time that would change the windows from the six weeks to six months. I'm not suggesting it's not available, but I can't get a reading on it; I hear about it.

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Mr Runciman: Yes. If it is available, would that change your attitude in respect to mandatory testing?

Dr Humphries: It would sure alter how we would look at HIV and its presence and what's possible and what is not possible.

Mr Runciman: Is it possible to reserve my remaining time for the next rotation?

The Vice-Chair: Yes, I believe that's possible, Mr Runciman. So you would yield the floor. I turn now to the New Democratic caucus and Mr Duignan.

Mr Noel Duignan (Halton North): You know that when a crime is committed the fact that a process goes into place: The police hunt for the criminal, the criminal is caught and they work their way through the justice system. It's something like bolting the door after the horse has left the stable. What I would like to know is what your ministry is doing in terms of crime prevention.

Hon Mr Christopherson: We've been doing a lot since the beginning of the term, actually, but particularly in the areas of crime prevention. In fact, a lot of that now is reflected in the initiative we're seeing with the federal government, which very much was pressure from local communities, local provincial governments, to initiate a federal crime prevention council to put together a crime prevention strategy, again because a piecemeal effort by any one ministry, any one part of society is not going to do the job. At numerous federal-provincial conferences, Ontario has committed itself to both those endeavours and worked with the federal ministers to make sure that comes about.

Locally, one of the key things that we've done recently, just a few weeks ago, was the announcement of a provincial weapons enforcement unit. That goes hand in hand with the gun amnesty that I also announced on behalf of the government, all in an effort to try to take guns out of society, knowing how much they play a role, particularly in violent crime.

We have Crime Prevention Ontario, which is an umbrella group within the province that endeavours to bring all of the players together. One of, if not the key, financial backers of Crime Prevention Ontario is the Ontario government.

The Attorney General has initiated actions with regard to designating dangerous offenders in an attempt to ensure that for those who, quite frankly, even if their sentences are completed, should not be on our streets, there's an opportunity legally to do something about that. In fact, it's interesting to note that the federal Justice minister has said at federal-provincial-territorial justice ministers' conferences that if every other province used dangerous offender applications to the same degree that Ontario did, they wouldn't need to look at some of the changes they have to federally. That's as a result of a proactive measure on the part of our Attorney General.

That same Attorney General has also sent out directives to crown attorneys to seek stiffer sentences where weapons are used in the commission of an offence, again to recognize that there's a greater threat to society when we're dealing with any kind of crime that involves a weapon, particularly a handgun.

My own ministry since last fall has been actively working on a public safety-violent crime project which is developing a series of standards for police services across Ontario to assist them in crime prevention and, in terms of carrying out their duties, in seeking out those who have committed offences so that we're doing that using the best practices possible and also that again we have a consistent approach right across the entire province. We've seen our Education minister put forward a very comprehensive package of zero tolerance of violence within our schools. Our government, as you know, has taken a strong line on fighting racism in society, to reduce the tensions that exist, again in an attempt to provide the kind of communities we want.

We've dramatically increased our funding to rape crisis centres and sexual assault centres, some of that coming after the fact, but in many ways preventing further assaults on individuals and on families. We've put out standards on domestic assault and sexual assault and hate bias crimes. All of these things are geared to try to deal with the specifics and within the criminal justice system as it exists, but also to try and get at the root causes of crime, so that indeed, as you put it, we aren't just chasing the horse after we've closed the barn door.

Mr Duignan: Also in the area of crime prevention, cooperation between the various jurisdictions could be with other provincial governments and with the federal government, and indeed between other police forces. There was an incident recently where something happened to me on the 401. I got off the 401. I was lucky enough to see a police cruiser. I flagged it down. "It's got nothing to do with me. You have to go and find the nearest OPP station and report it there." I still see that lack of coordination. That's still not quite 100% there. What are you doing to address that particular issue?

Hon Mr Christopherson: If I can pick up on that, one of the key things that I've learned in my time in this ministry is on the whole issue of jurisdiction. We're seeing it again with the concern around children involved in pornography, where we're going beyond the boundaries of one particular jurisdiction but there is case after case to show where the technologies that are involved, the amount of sophisticated expertise that needs to be brought to a lot of cases, may be beyond one particular police service but a neighbouring one has that expertise. More and more, we're working towards trying to see that kind of a cooperative effort.

Police services have very much been standalone. They've seen their turf and not beyond it and have been very protective of that. Police chiefs have talked to me about the need to have protocols and arrangements that allow us to have the kind of cooperation that needs to exist in modern-day policing.

Mr Duignan: Finally, before I go on to my colleague, on the whole question of the new weapons units, I'm not quite sure how that will work and how it will address the problem of violent crime in Ontario. Maybe you could expand on that a little.

Hon Mr Christopherson: I was very pleased that we were able to provide the kind of leadership that I think this government is committed to in fighting crime. We worked with the police chiefs, particularly the intelligence branches, to determine some of the key areas we can focus on. Based on a previous project codenamed Gunrunner, there was a recommendation that indeed such a unit be created in the province. That's where we took our lead.

What we will do is strike a standalone, independent unit that is dedicated to gathering intelligence and determining where the networks are that are smuggling guns into Ontario as well as existing networks. One of the things about smuggling guns that we need to be aware of is that if you smuggle cigarettes or booze or drugs or other commodities, they're used once and they're gone. Guns, once smuggled into our province, can circulate for decades, wreaking all kinds of havoc. There's a real need to deal with the guns that are coming across the border as well as the networks within our province that see the guns being moved around and being purchased, unfortunately much more easily than the police and this government would like to see.

The whole purpose of this is to provide a standalone, dedicated unit that would gather all of the intelligence that's necessary to determine where these linkages are and then to be able to disrupt those linkages, arrest the individuals and, at the same time, strangle the flow of illegal weapons into Ontario, begin to do what we can to remove the guns, particularly handguns, which are the ones that cause some of the greatest damage.

I was very pleased that at the news conference the commissioner of the OPP -- and it will be guided by the OPP -- was present for the launching of that new unit. So was Chief McCormack of Metro Toronto as well as Chief Bob Middaugh, who is the president of the Ontario Association of Chiefs of Police.

There's been solid buy-in from across the province, from every police service I've talked to, to be a part of this, to be supportive of it and to make sure that it's a success and do everything we can to take these illegal weapons that are doing so much damage off our streets.

Mr Derek Fletcher (Guelph): My questions perhaps should go to the chair of the board of parole. Is that person here?

The Vice-Chair: Mr Fletcher, you have about two minutes to ask your question.

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Mr Fletcher: Okay, maybe I'll put them all into one, then. I have about three questions.

The minister was talking about safe streets. Recently -- well, more than just recently -- there has been a lot of talk about people being released. I'm just wondering: When a person is on the parole board or is on the board, do they get trained as far as anything -- they don't just come off the street and all of a sudden start making decisions, do they, about who can get out and who can't?

Mr Wadel: No. There's extensive training before any board member becomes actively involved in any release decision. That training includes orientation at the regional office in terms of role and responsibilities, and then it includes, at the centralized Bell Cairn Staff Training and Development College, at least eight days of intensive training, which includes case preparation, decision-making, and interviewing skills. It also includes a hearing workshop for hearing chairs, and again there's a concentration on their specific roles and responsibilities, how one formulates and assesses risk.

Mr Fletcher: Okay. Someone's before the board. What kind of information does the board consider when it's making a decision whether or not to grant parole? Is it just good behaviour?

Mr Wadel: No. The key decision that has to be made at any hearing is to assess risk of reoffending. There's core information that's required before we'll proceed with any hearing, and we get that core information from three main sources.

One is the police. We're very interested in criminal history and any specific information about the offence that the person's been convicted of, as well as any outstanding criminal matters. So that's one core package of information.

From the institutional side, we want to know about the risk-need assessment that's been made by institutional staff. We want to know what the institutional behaviour has been like. We want to know what steps they've taken to address the identified risks and needs through community programs. So that constitutes another core of information.

Then, very importantly, we have a community report. The community report includes any information in terms of previous supervision in the community. It includes an assessment of the types of supports available in the community, such as employment opportunities and so on. It also includes recommendations in terms of what specific types of treatment would be required to appropriately supervise and manage that case in the community.

Mr Fletcher: Success rate: How many are going back in and how many are being offenders once they get out?

Mr Wadel: In our current annual report, 84% of offenders to whom we've granted release complete the parole period. Of the 16% who haven't completed it, half are returned because they violated a condition of release. So they're being managed and supervised in the community, and if they fail to abide by a curfew or they drink when they have an abstention to drink or they don't attend treatment, they're brought back in. That's about half of that 16% -- more than half, in fact. In less than half it's new criminal behaviour.

The Vice-Chair: Thank you, Mr Wadel. In the absence of the Liberal caucus, Mr Runciman has 13 minutes remaining, if he would care to continue.

Mr Runciman: Minister, I just wanted to ask you a bit about Project P. What kind of budget does Project P have on an annual basis? Does Project P fall under your ministry through the OPP?

Hon Mr Christopherson: Yes, Project P is a permanent unit to fight illegal pornography. It's a standalone unit that's been around since 1970-something --

Mr Runciman: It's been a while.

Hon Mr Christopherson: I'm also waiting to get some information up here in terms of details of budgets and things, as much as I can give you.

Mr Runciman: In terms of manpower and dollars that are budgeted annually?

Hon Mr Christopherson: I'm just waiting for those figures.

Mr Runciman: Okay. Maybe while we're waiting we could talk a little bit about your meeting in London this morning. I'm just wondering if you're looking at what's happened in London and drawing an analogy with the Prescott situation and Project Jericho, which laid out a plan in terms of how to deal with child sexual abuse. Are you going to use the Prescott situation as a model in terms of what's happened in London?

Hon Mr Christopherson: As you know, the meeting was to sit down and take a look at what is the scope of the problem. There were OPP officials, ministry officials, the London police. The questions you're asking are quite valid, and I can understand you asking them; unfortunately, they come before the recommendations come to me. That was the purpose of the meeting, and then ministry officials will put the proposal in front of me. I've had a very quick briefing, kind of while I'm walking, hearing what's come out of the meeting. I need to get a fuller briefing.

I would think, and I'm speculating now, that obviously there would be a tie-in with our Project P as well as the London police. The media continues, as you know, to use the term "task force." In policing circles it's known as a joint forces operation. Some of these, as I've said before, are well known to the public; others are not, others are undercover operations.

The purpose of joint forces operation is numerous, the obvious one of course being to ensure that the kind of assistance Chief Fantino was seeking, where he needs resources over and above what he can provide, as well as linkages with other jurisdictions -- this provides the vehicle to do that, rather than everybody re-creating on an ad hoc basis: How does London contact Metro? How does Metro link in and loop up Hamilton-Wentworth and others? There are established procedures for putting in place a joint forces operation which spell all these things out, and then we make sure, as a government, that the resources that are needed are there for the operation.

Mr Runciman: Are you looking at this purely from a policing perspective? Was there any involvement of Comsoc, children's aid? Was there any concern in terms of these discussions about how we deal with the victims, or was this simply policing: How do we lay charges and get these people off the street?

Hon Mr Christopherson: As you know, my primary responsibility in the government is the policing end of it, and then at the other end too after the courts have done their business, but in an issue like this, where there may be minors involved, the need to bring in other ministries will be a part of our considerations.

It's still very early days. There is not a province-wide game plan in place. The detailed recommendations aren't in front of me; they're still being developed. At the point the police have their recommendations for me, I will be looking at that with my colleagues in the cabinet to make determinations on where and to what degree we should bring in other ministries, and that may happen at different points along the way.

The answer to your question is that yes, if it's necessary, that's what we'll do, and to make a determination on the definition of "necessary," I will be apprising my colleagues in areas that I think they need to be aware of and where there may be a role for their ministry to assist in the police activities.

Mr Runciman: What about Project P? Do you have that information now?

Ms Noble: We don't have the specific budgetary detail broken down in terms of the individual units of the OPP. Staff have just left the room to see whether that's available, and we'll bring it back here if we have it before the end of the meeting.

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Mr Runciman: If you don't have it -- I have to go up and participate in the debate -- you can provide me with that information. I'd like to know the numbers and the annual budget. I'm just wondering, Minister, whether you have a feel for whether the numbers are adequate. I'm not basing this just on the London story, but I remember that a few months ago there was a significant series of stories in the Toronto Star, I think it was, with people identifying Toronto as the North American centre for the production of child porn. Clearly, if that was accurate, it's a significant problem in Ontario. Some of the comments I've seen, by at least one officer in Project P, is that they just don't have what's required to do an adequate job. I'd be interested in whether you have any feeling about that subject.

Hon Mr Christopherson: I would answer it this way: The fact that there's a standalone unit with dedicated officers committed to this issue only, given the myriad issues out there, is an indication of the support we've shown to this. I don't think I'm able to take credit for creating it. I think it was done by one of the previous governments.

Ms Noble: It was created in the 1970s.

Hon Mr Christopherson: There you go, Bob. Your government can take credit for creating it, and we've continued to provide the support to it. I have not had representation made to me by officers from the intelligence community that they're not able to do the job at hand. You can pick any area of government these days and there's always a need and they could use more money, but I do think they've been given adequate resources.

The key now is that there's a clear path. There is evidence coming out of London that we need to have a concerted effort, and that's what we're acting on now. If it's a question of resources, then I'll be answering to you and everyone else as to whether or not we've provided those resources.

Mr Runciman: I'd just like to compare the resources, as we don't know what that is right at the moment, in Project P versus what hopefully you'll have a handle on: the program where you've involved Metro and others in the gunrunning problem. What has the province budgeted for that? Do you have a figure on that?

Hon Mr Christopherson: We're not releasing the dollar figures, as you know. It's not done when these kinds of activities are undertaken. There will be a core complement of 24 officers. I expect that will fluctuate to even higher numbers at some time during the course of events, given the involvement of other police services. Chiefs have committed to provide whatever resources are needed if the unit finds itself working within their jurisdiction, but there will be a core of 24.

Mr Runciman: Have they committed enthusiastically?

Hon Mr Christopherson: As far as I can tell. Yes, I would say they are very enthusiastic. They see this as a serious issue --

Mr Runciman: Certainly it's a serious issue.

Hon Mr Christopherson: -- because, as you know, it's not just public safety; we're also talking about officer safety. Many times it's police officers who are the ones who are face to face with individuals using illegal weapons, particularly handguns. My sense, in moving around the province, is that this is being welcomed not just by the senior officers of police services but by the cops on the street, who see this as a response to an issue they're very concerned about as they go about their job.

Mr Runciman: In this squad, or whatever you call it, group, have you drawn officers from the Metro intelligence squad? Have they been seconded for this?

Hon Mr Christopherson: There will be officers seconded from most of the major police services.

Mr Runciman: These are people from specific ethnic backgrounds?

Hon Mr Christopherson: Who is selected is the choice of the operation officers, not for me to make, but Metro has committed, as have the other major police services, to assign people on a seconded basis to the full-time unit. I'll leave it up to the police officers responsible to make the decisions on who best should be assigned.

Mr Runciman: Just one quick question about photo-radar. I forget the figure off the top of my head, but it was something like $75 million that the Treasurer projected in terms of revenue in the remainder of the fiscal year; something like that, $70 million, $75 million. Did you make any representations in terms of the revenues that were going to be derived from photo-radar? As the top cop and the guy around the cabinet table who is representing the interests of police officers and policing, did you make any effort to see that those revenues would be dedicated revenues?

Hon Mr Christopherson: I don't think there's a minister around that table who hasn't taken a run at the consolidated revenue fund at one time or another. The fact is that the money is clearly dedicated to the consolidated revenue fund, and there is no way of changing that, barring changes to legislation.

Mr Runciman: You're avoiding my question. I think this is an argument you could have made, and should have made if you didn't, because these are normally offences that would have been captured by a police officer or officers. You, as well as anyone, have to be very much aware of the growing public concern with respect to law-and-order issues and very much aware of the tough time getting adequate resources to provide the needs that people are calling out for in this province.

It seems to me that if there is one where you should've been banging your fist around the cabinet table in terms to dedicated revenues, this is it. Did you make that case? I don't want these general statements that everybody goes after the consolidated revenue fund. I asked you a specific question. Did you make the case to have these revenues dedicated to police resources in the province?

Hon Mr Christopherson: I wasn't trivializing your question. I was saying that the answer to the question, very directly, is that the money from traffic offences, fines, goes to the consolidated revenue fund. Short of saying that we should change the entire structure, there's nothing that can be done about that. Did I recommend we change the entire structure? No, I didn't.

But let me say this about police officers, and this is something that we did talk about and that I did advocate. The new computer equipment that's coming into the patrol cars is being very much welcomed by the officers. The fact that officers won't, in the middle of the night, any longer have to go up to cars pulled off to the side of the road and stick their hands inside a car window is very much appreciated by officers. The fact that we're able to redeploy officers from highway patrol in terms of speeding and redeploy them to other activities, including crime prevention, is very much welcomed by police officers. This whole issue is one the police community is very much eager to see launched.

Mr Tim Murphy (St George-St David): I wanted to ask the minister about the ammunition bill. We are discussing it upstairs indirectly, and occasionally directly, in fact. You've now had some time to sit back and consider it. I have talked with a number of chiefs of police who've indicated support for the concept, from Brant to Sturgeon Falls to Toronto. What I'm wondering is whether you would or would not commit to bringing forward this bill or a similar bill before we have an election.

Hon Mr Christopherson: Two answers to that. One is that I've already stated on behalf of the government that the issue of more responsible control over the sale and accessibility of ammunition is something we support. There's no question of that. The issue now is, how best should that happen and who will do it? My understanding is that the intent of the legislative committee is to make some of those determinations, and that's why they have a list of experts who are coming.

I don't want to pre-empt the legitimate discussions they're having, and I mean this very sincerely. I don't want to pre-empt that, because if I sit here and say to you, "We're going to bring in legislation and that's that," then why are you bothering to go upstairs and talk about it? Why are you bothering to listen to lawyers give you advice on who has the constitutional responsibility? The fact is that we're prepared to do it if need be.

There is a legitimate question about whether the federal government really has sole ability to do it or whether we can. The other thing is, if we get a signal from the federal government that it's going to do this and going to do it quickly, it doesn't make a lot of sense for provinces on their own to start putting in a patchwork type of series of regulations and laws that may be changed by federal action.

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Mr Murphy: We can argue back and forth, but the provinces can show leadership occasionally by doing things independently of the federal government. There is a history in a series of fields, from drugs to tobacco, of joint administration within a field. We have already had two constitutional experts, including one as renowned as Professor Peter Hogg, say that yes, the province can do it, and in terms of what we are doing upstairs, a commitment to doing it does not preclude the appropriate examination in committee of how best, where best etc. So I'm not sure I accept your arguments for not giving a straightforward yes or no.

Hon Mr Christopherson: Let me respond to what you just said. I was not attempting to dodge this at all. I've stated very clearly that the government is in support of the initiative. As to the question of showing some leadership, I don't think it's great leadership for us to put the very, very limited and scarce resources of this government, through our staff people, working on an issue on which the federal government's going to step in a month or two later and impose its will on how this ought to be done. That's not good government in tight times, in my mind.

Really, what we have a question of is: Are the feds prepared to move, and if they aren't, what are our options? If they are going to, when are they going to do it? If that's acceptable in terms of a time line, we ought to support them in their efforts and urge them to do it as quickly as possible. If they're not going to do it, then what will be coming in front of the Legislature are the means that we see available to us.

Mr Murphy: We had in -- I forget the name of the office, but in essence the firearms office, the CPFO.

Hon Mr Christopherson: Henry Vanwyk, the chief provincial firearms officer.

Mr Murphy: One of the concerns I had was that in 1994 they are not going to be able to visit and inspect all the places that sell ammunition and firearms in the province. There are two reasons for that: One is an increase in duties, but also the social contract being passed. What are your plans for making sure that all those 1,020 or 1,200 institutions that sell firearms and ammunition under the provisions that allow them to do so in the Criminal Code are going to be visited and inspected this year?

Hon Mr Christopherson: I can't give you a commitment that every one will be inspected this year. I am in regular contact, as you can appreciate, with the chief provincial firearms officer all throughout our discussions about weapons and ammunition, as well as in the conversion from the .38 calibre revolvers to the 9mm and .40 calibre pistols. I know his office has had a great deal of increase in its workload, not just because of the social contract, although that's an implication in many places, but simply because of the demands coming from my office alone in terms of the resources I've demanded of him as I'm dealing with this serious issue of public safety.

I look forward to the results of the committee recommendations. I don't think -- well, you tell me, more accurately, but I don't think you and the Tories are going into this with the intent to be unreasonable and pie-in-the-sky about the way the world ought to be, particularly at a time when you're also advocating that there be constraints in public spending and that we need to keep an eye on our budget lines. So I'm very much looking forward to receiving the recommendations that say where we ought to be increasing any inspections, if that's relevant to the issue of ammunition.

Mr Murphy: If we want to be political about it, we can be. But the bottom line, it strikes me, is that if you are going to be serious about the words you're using, it's going to require, at the minimum, even if we aren't going to do any further regulation, inspection once a year of those places that sell firearms and ammunition. They told me clearly that is not going to happen this year. I'm asking, in the context of an environment where I think all of us recognize a public desire for action on these issues, how you're going to make sure that's going to happen.

Hon Mr Christopherson: I'll be frank with you. I'm not sure whether it's mandatory or whether it's best practice that they be inspected. If it's best practice, obviously we'll do the very best we can with whatever is available. If it's mandatory, we're going to have to visit that to ensure that we're meeting our obligations under the law. If you know, or anybody else, that's fine.

Mr Murphy: I can tell you that there's a significant drop in the number of inspections expected from last year to this year, at a time when there is at least a perception, and I think a reality, of increased crime involving weapons.

Hon Mr Christopherson: Again, I would say to you that would be part of a --

Mr Murphy: Regardless of whether it's mandatory or not.

Hon Mr Christopherson: I hear you, but what I see is that we need to be looking at ammunition, and not just the ammunition alone. If we're going to ask the feds to revisit the issue of control under the explosive weapons act -- I believe it's the proper legislation -- then maybe there's a whole host of other measures we ought to be looking at.

When you say to me, am I going to do what's necessary to make sure that we're doing the job we should? the answer is yes. If you're asking me exactly what those details are today, no, I don't have them. I see that as part and parcel of our collective effort to try to come to grips with the availability and the accessibility of ammunition, as well as weapons in general. I think quite frankly everything, provincially and federally, is on the table for review.

Let me also say that I have a great deal of confidence in the expertise of the chief firearms officer for Ontario. I have no doubt that the measures that need to be taken will be taken.

Mr Murphy: It's not a question of questioning the chief firearms officer's expertise at all; it's a question of having the resources to do the job no matter how expert you are.

I want to move on. You have kindly provided me with a written response to a question regarding the social contract impact on policing, and I want to follow up. I'm going to do so by way of an example that's in my community: 51 Division, which is a very busy division in Metropolitan Toronto, encompasses a fair part of my riding. They have a normal complement of a foot patrol allocation of 24 officers and are down to 16, for which I am told quite clearly that the responsibility lies in the social contract. They have also been squeezed in a variety of areas. In the allocation of the Metropolitan Toronto Police Force in general, they are down from their unit strength by more than 500 police officers, when the largest division I think in Metropolitan Toronto has fewer than 500 police officers. So it's a significant amount.

While you say there have been no massive layoffs, my real question is related to the impact of the social contract on safety in communities, not how you got to achieve savings to the extent that savings were achieved, but the police are telling me quite clearly that they aren't able to do as good a job in communities because of the impact of the social contract. What I want to know specifically is what you are doing as minister and what the ministry is doing to monitor that impact.

Hon Mr Christopherson: We have a policing services division whose responsibility within the ministry is to provide me with information on what is happening in the various police services across the province as it relates to this issue and all the other issues that we're responsible for, as well as reversing the information flow so that the services are also receiving things they need to know from us.

I would point out to you, though, to put things in context, that you can't have it both ways, Tim. When we're talking about controlling the deficit and we're talking about controlling expenditures, one can't get up one day, on Monday, Wednesday and Friday, and preach about constraint and responsible spending, and then get up on alternate days of the week and talk about needing more money here, here and here. We have approached the social contract, budgetary constraints, taxes in general in a way we think is balanced and measured. You want to nod your head up and down. You don't want to acknowledge all that. I know it's nice and easy not to.

Mr Murphy: That's irrelevant to the debate.

Hon Mr Christopherson: It is entirely relevant.

The Chair: This sounds even better as a debate in the House, but in the interests of time, I'd like to finish on this wonderfully high note.

Mr Gordon Mills (Durham East): How can you say it's irrelevant?

Mr Murphy: It's just rhetoric. I want an answer to the question.

The Chair: It is estimates and the time is used accordingly in the way members see fit.

Mr Murphy: The people in my riding don't want to hear this kind of stuff. They want to hear an answer to how they are going to live on a daily basis, when 460 weapons offences in six months in one division --

The Chair: I'd like to bring everybody back to our agenda. Because we're a time-sensitive committee, I'm afraid we must call the vote momentarily. I apologize for the interjection, but I wanted to bring some order to that and got myself engaged in a debate. I'm sorry.

Mr Mills: I live in his riding and I'm quite happy with the police protection.

Mr Murphy: And the representation too, I hear.

Mr Mills: It keeps me awake with the all the sirens.

Mr Murphy: He's always whining to me for more service too.

The Chair: If we could proceed at this time, I have several votes to conduct. If I have agreement from the committee, I'd like to proceed with those votes.

We have almost completed the time allocation, but since we are going to be starting the Ministry of Health estimates in a few minutes, I thought it best that we call the vote at this time.

Shall vote 2801 be approved? All those in favour? Opposed, if any? Carried.

Shall vote 2802 be approved? All those in favour? Opposed? Carried.

Shall vote 2803 be approved? All those in favour? Opposed? Carried.

Shall vote 2804 be approved? All in favour? Opposed, if any? Carried.

Shall vote 2805 be approved? All those in favour? Opposed, if any? Carried.

Shall the 1994-95 estimates of the Ministry of the Solicitor General and Correctional Services be approved? All those in favour? Opposed, if any? Carried.

Shall the estimates of this ministry be reported to the House? All those in favour? Opposed, if any? Carried.

I would like to thank the ministry staff who have been in attendance and the committee members for this round of estimates.

This committee will take a four-minute recess. I would ask the members to return so we can commence the estimates of the Ministry of Health.

The committee recessed from 1652 to 1708.

MINISTRY OF HEALTH

The Chair: I'd like to reconvene the standing committee on estimates. We're here to do nine hours of the Ministry of Health. We're pleased to welcome the Honourable Ruth Grier, minister.

Minister, according to our standing orders you have up to 30 minutes for your opening statement and then the Chair will recognize Mrs Sullivan, the Health critic for the Liberal Party. Please proceed, Minister.

Hon Ruth Grier (Minister of Health): Thank you, Mr Chair. I'm pleased to be back again. I think this is my second time as Minister of Health to defend my estimates. Whatever ministry I'm in seems to be the one that is chosen for estimates, and I really enjoy the opportunity of discussing and questioning. I look forward to our time here.

As I appear for the second time, to present the 1994-95 estimates of Health, I look forward to discussing both the dramatic and the substantive changes that have been taking place as we improve our health care system. It's now been two and a half years since my ministry announced a health restructuring agenda designed to ensure more efficient use of scarce resources and to shift the emphasis from treatment to health promotion and disease prevention. Much hard work has been done since then.

Since I first appeared before this committee in July 1993, we have had a new cancer strategy in Ontario. We are working to meet the special needs of people with kidney disease, diabetes and acquired brain injury. We have a more efficient hospital sector. We have a health system that is less open to fraudulent abuse. We have a plan for long-term care that responds to the needs of seniors and those with physical disabilities, and a plan for mental health services that puts people first.

We have innovative approaches to meeting the health needs of individuals in their communities, approaches that include the use of nurse practitioners, midwives and birthing centres. We have programs that stress good health and disease prevention, such as our tobacco strategy and our program for vaccinating pre-teens against hepatitis B.

I am very proud of these accomplishments and I am proud that Ontario has been a trailblazer in the area of health care restructuring. We've only to look beyond our own situation and our borders to see that others are far behind us in grappling with the many problems inherent to modern health systems.

Over the past couple of years, we've written much of the book on paring back an overgrown health care system with a minimal amount of pain. A possible title of such a book could be How to Improve Health Care Without Spending More Money. But it's a book that has had several authors. It's the result of a collaborative effort, a partnership led by district and local health planners, including health care providers, hospital administrators, the public, unions and planners from the ministry.

I've been particularly pleased by the way that people from all sectors of health care have embraced the idea that change is necessary, indeed inevitable, and have risen to the challenge of coming up with new and better approaches for getting things done.

A vivid example of this comes from our hospital sector, which has been going through a period of intense restructuring. The results are now coming in, results that could not have come about without consultation and cooperation among all the concerned players.

There is a Collingwood newspaper that I know my critic from the third party will be familiar with that said on page 1 a couple of weeks ago, quoting Ontario Hospital Association President Dennis Timbrell, who is of course one of the key players in restructuring: "On the national scene, only Ontario and Manitoba still put faith in local governments' operation of health care. Other provinces have taken central control and abolished local boards. They have absolute central control, but there is no evidence that this improves the quality of health care or cost-effectiveness."

It's good to hear such comments because it reinforces the fact that we're on the right track. Indeed, I believe that our emphasis on involving the health community at all levels throughout the restructuring process has been key to our success. In particular, district health councils throughout Ontario have been playing a key role in making hospitals more efficient and more cost-effective.

Windsor-Essex is a prime example of where the district health council took the role of lead planner. It recently completed two years of work in designing a new hospital system, one that improves efficiency while maintaining jobs and services. Not only did they redesign the hospital system; they recognized that they couldn't do that without redesigning and reconfiguring their entire health services system. With less duplication, there are economies of scale that free up literally millions of dollars to spend on prevention, detection and other needed local health care services.

Look at Doctors Hospital here in Metropolitan Toronto, another success story in the making. It was the first community hospital in Metro Toronto to undergo a major project review as part of our province-wide review of capital projects. That was two years ago. Doctors Hospital is now being redeveloped as a state-of-the-art, comprehensive ambulatory care facility, one of the first of its kind in North America.

Perhaps most exciting about this is the fact that the voices of 1,300 people, representing a wide variety of community interests, were listened to before the Doctors Hospital redevelopment plan was drafted. I'm sure that all those who participated in the consultations will be very proud when the new facility is completed in a few years' time.

We have been working with hospitals to come up with other innovative approaches for cutting operating costs, and one of these has to do with the way that hospital supplies are purchased, distributed and stored. Through a ministry-funded study, we found that hospitals could save $250 million, more than 20% of the $1.1 billion spent on supplies each year, by improving their materials management systems. Much of this saving could be achieved simply through group buying, because Ontario hospitals represent one of the largest purchasing organizations in the world.

In another bid to have hospitals become more efficient, we recently announced $7.8 million in funding for pilot projects that help minimize hospital stays and act as a bridge between hospital and community-based care. Included here are 20 quick-response teams covering more than 70 hospitals across the province which will receive $5.4 million. These teams will help people entering an emergency department find the most appropriate care, which will often mean home care rather than being admitted to hospital.

The remaining $2.4 million will go to four existing hospital-in-the-home projects. These projects provide acute and palliative care at home, and mean the patients may be discharged earlier than in the past or may avoid hospital altogether. According to a recent evaluation of the hospital-in-the-home program, the costs are about 25% lower than in-hospital care, but even more importantly, patients and families say that they are very satisfied with the quality of care provided.

So, as can be seen, all this planning, coordination and cooperation is resulting in a new system of hospital care, one that keeps costs in check without compromising quality and one that is spreading across the province.

It remains a system where miracles can and do happen, such as the 20-hour operation that separated Siamese twins Margaret and Susana this past weekend at the Hospital for Sick Children. It was wonderful to know that our system is capable of conducting such state-of-the-art procedures, and it's heartwarming to know that compassion remains a cornerstone of our system. I can tell you that it made me feel very good when I read that the twins' father had thanked not only the doctors and the nurses who performed the amazing surgery on his daughters, but he also thanked the government and the taxpayers for paying for the operation.

Since the restructuring of our hospitals is well underway and well in hand, we were able this year to turn our attention to another part of the health care system, one that constitutes almost one third of the entire health budget. I'm talking, of course, about OHIP, where we reshaped the eligibility rules to save $48 million and where we introduced a three-month waiting period for OHIP, a move designed to prevent people from returning to Ontario just to receive medical care.

Stamping out health fraud was something that we discussed at length when I appeared before this committee last year, and which is a priority for our ministry. I believe it's important for us to be equipped to investigate any misuse of the system, to crack down on medical fraud by providers and patients. An ex-RCMP officer who had been part of the Ministry of the Environment's enforcement and investigations branch was put in charge of our province's investigative unit, and we are adding to his capacity eight investigators.

These tough new measures are working. We discovered, for example, that over the past year 21 doctors had overbilled OHIP by $1.4 million. All of them have been ordered to repay what they owe. We simply cannot afford to tolerate any abuse of the system if the system is to continue providing quality health care for Ontarians.

A new health card is another example of how we are tackling abuse head on. Security features on the new cards such as the cardholder's photograph, a magnetic strip containing cardholder eligibility information and a holographic overlay to prevent counterfeiting should prove to be strong deterrents against fraud.

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We are at the point now in the evolution of our Ontario health care where we can redirect and reinvest our health care dollars in new areas of care. While maintaining our institutional health framework is important, just as important is establishing a community-based approach to health care, and while treating illness is important, just as important is health promotion.

I believe that we are on the right track in these areas and I believe that our system is improving without more money being spent on it.

As far as community-based care goes, we have made considerable progress this past year. While overall ministry spending has declined slightly, both this and last fiscal year, spending for community and public health continues to increase.

This meant that last year, for example, we were able to approve three new community health centres, and just last Friday I announced that four more would be approved in this fiscal year, which will bring the total number of community health centres in the province to 56. For 1994-95, spending on community and public health will increase by 5.3%, a reflection of our commitment to moving towards a more community-based approach to health care.

Our long-term care strategy is an excellent example of this. Ontario's social demographics are going through major changes. Seniors currently account for only 12% of the population. By the year 2010, however, census projections tell us that it will be a very different story. In less than 20 years, the number of seniors in Ontario will increase by 45% and the number of people over 85 will increase by almost 125%. At the same time, the long-term trend towards greater life expectancy for the general population and for people living with disease and disabilities will also continue to rise.

Ontario currently spends over $2.1 billion for long-term care services. This includes institutional care, home care, the integrated homemaker program and other community support programs. But we are committed to moving away from institutional care and increasing the number of community-based services. In fact, over the next two years, we will be investing an additional $199 million to expand community and in-home long-term care services.

The keystone of our new long-term care delivery system will be the multiservice agency or MSA. These will be local, volunteer-led, community-based agencies that offer people easy access to a variety of home care and support services close to their homes.

The local MSA will coordinate referral, assessment, evaluation and service delivery. And while the ministry has guidelines, we are leaving the exact design of each MSA up to district health councils. This way, they will be developed locally based on local needs and resources. As Dennis Timbrell in the quote that I had earlier mentioned said, developing locally based services based on local planning is unique in Ontario.

The MSA principle is to put people first, to ensure that they can make informed choices and that adequate and consistent services are available in all parts of the province.

Putting people first also lies at the heart of our strategy for helping people with mental illness. Here again we are working with district health councils to transform the current system of fragmented community-based services into one that is strong and coordinated.

In many areas, the transformation has already started. The Hamilton Psychiatric Hospital, for example, now runs the Annex, a supportive housing program for people with schizophrenia. In other areas like Simcoe and Thunder Bay, mental health organizations have set up employment programs to help people live in the community and maintain their jobs.

Last January, we announced that more than $1.2 million a year would go to 10 new supportive housing programs for people with serious mental illnesses, programs that enable people to live independently.

As we address the current and future needs of individuals and their communities, we find ourselves moving more towards a holistic form of medicine, one that relies on the skills of a wide variety of health care providers. While physicians will of course remain an integral part of the system, other health professionals will take on greater responsibility for patient care.

Midwives are among this new breed of care givers. I'm pleased to say that Ontario midwives have a rather special status that no other midwives in the country yet have. Our midwives are officially recognized, and they are being integrated into our regulated health system.

Midwifery services are now available in many communities and the demand for those services has been overwhelming. Midwives are obtaining hospital privileges and some will eventually find their way to one of the three freestanding birthing centres which we are spending $2 million to set up -- one in Toronto, one in St Jacobs and one in Sudbury. A fourth is being planned for the Nee-Gan O'Chee community in Fort Albany.

As I've said, physicians will remain an integral part of the health care system. So it's crucial that appropriate numbers of specialty physicians are available to communities throughout the province. In moving towards this goal, we will be looking to the work now being carried out by the Provincial Coordinating Committee on Community and Academic Health Science Relations, PCCCAR. I don't pretend to be able to rhyme off that acronym without having a note on what that lengthy title is. PCCCAR has three main objectives: to develop a comprehensive policy and planning framework for health human resources, one that is based on community needs; to examine the function and financing of academic health science centres; and to restructure Ontario's post-graduate medical education system.

On this last point, PCCCAR recently recommended that the ministry adopt a new management framework for post-graduate medical education. This framework, which they called the pool system, will enable the ministry, in concert with medical schools and teaching hospitals, to better manage the number and mix of new physicians eligible to practise in Ontario. This will mean that we will be in a better position to respond to population health needs.

This is the first time that the province has systematically approached the issue of health-human resource planning, and I think that it is a fundamental requirement of the kind of planning and the kind of decisions that we will have to make in the future. Indeed, meeting the unique needs of communities across Ontario is itself a critical component of our health planning. Again, I would like to use the north as an example, as its needs are quite different from those of the rest of the province.

To meet those needs, we have set up a northern health programs and planning branch, with offices in Thunder Bay and in Sudbury. The mandate of this branch is to work with local health councils to help improve the delivery and the coordination of ministry programs and services in the north.

For some years now, one concern has been the northern health travel grant, the government program that helps northern residents who must travel for specialized care. Early this year, we made the program fairer and more efficient.

The ministry now pays travel costs based only on the distance between a person's home and the nearest appropriate specialist or designated health facility. People can still choose any specialist, but if there's a specialist closer to home who offers the same service, the grant will help cover only the distance to that specialist.

I believe that this reform will encourage people to use the excellent specialists already available in northern communities. It will also save money and encourage more specialists to practise and remain in the north. And, of course, it will mean more accessible health care for northern residents.

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The north is also where we established what I consider to be one of the most significant initiatives of this government: the Northern Diabetes Health Care Network.

Diabetes is the third leading cause of death by disease in Ontario. People with diabetes have twice the chance of having a heart attack or a stroke. Diabetes is the leading cause of adult blindness. It is an unfortunate reality that the incidence of diabetes is higher in the north than in the rest of the province. That is why the network is so very important, because for people with diabetes, it represents a precious chance to prevent the very serious potential complications of the disease.

As with all such initiatives, we listened to the people who will be using the service. The network was established through consultations with francophone, aboriginal and other community representatives. The result is that each of the 34 centres that are part of the $5-million network is a home-town idea. Each centre offers programs that are planned in the community and for the community.

Diabetes is also a leading cause of kidney failure. So we have been planning and investing in services geared to the needs of people with kidney disease. Demand for end-stage renal disease services has been increasing by about 10% per year right across the province. To keep up with this, we just completed a three-phase, $22-million expansion program for dialysis service. The aim was to bring service as close to home for as many kidney patients as possible.

In addition to the expansion program's basic funding of $22 million, we added another $27 million of life support funding to hospital operating budgets for end-stage kidney disease services, and $10.6 million has been spent on new equipment and renovation projects.

At the end of 1988, before the expansion started, there were 2,073 dialysis patients in Ontario. In December of last year, the number had risen to about 3,339 patients. That is an increase of 1,266 people now being served.

Because of all this additional spending on dialysis services, we can now treat 1,400 more patients than we could five years ago. And we have begun the work to enable us to plan to meet future needs, especially in central Ontario. Because the fact remains that never before have dialysis services been as available and as accessible, but we, at the same time, have to plan to meet the growing need in the future.

Our efforts to foster healthy communities are far-reaching and not limited to certain areas of the province. I want to talk a bit about what has been an innovative and multi-award-winning campaign to prevent young people from taking up the smoking habit. It is a province-wide campaign and it is part of our overall cancer strategy which includes the tough provisions of Bill 119, now before the committee of the whole House, as well as funding for education and enforcement officers to make sure that retailers are adhering to Bill 119's rules and not selling tobacco to young people under the age of 19.

Another health promotion initiative is our recently announced $6-million program to vaccinate grade 7 students against hepatitis B, the sometimes fatal liver disease that affects more than 300 mostly young adults annually.

Our new health network, which will provide pharmacists with information about Ontario drug benefit program clients, will help prevent duplications or possible interactions with other medications. This is extremely important, because every year more than 17,000 Ontarians need medical treatment for prescription drug reactions, and about one out of five seniors in hospital is there because of a drug reaction.

The health network has already played a significant role in helping seniors. Let me tell you how it worked in one specific example, to save a 70-year-old Markham man from serious illness. He was taking a blood thinner for a heart valve problem. While visiting his daughter in Niagara Falls last month, his arthritis flared up and he went to a local clinic. He forgot to tell the doctor, whom he'd never met before, about his heart medication. The doctor, who didn't know his medical history, gave him a prescription for an ASA drug. But when he went to the drug store and the pharmacist entered the new prescription on the health network, the computer flashed a warning that the new drug would react with his heart medication. The pharmacist talked to the man and to the local doctor and arranged for an alternative medication.

That's precisely how the network is meant to work and how it is working. What would have happened without that warning? Possibly, for the patient, severe internal bleeding, leading to hospitalization; maybe worse. But because the health network was in place, the outcome was a happy one, just one of what I am sure will be many such outcomes in the years ahead.

We have also, of course, made changes this past year to the Ontario drug benefit program that will save money without compromising drug therapy for those covered by the plan. Among the cost-saving measures that we introduced are prescribing guidelines for anti-infective drugs, the addition of 46 new generic products to the Ontario Drug Benefit Formulary, the addition of 24 new brand-name drugs at no additional cost to the system and no price increases in 1994 for drugs listed on the formulary.

We have also reviewed and subsequently delisted extended-release dosage products. These long-acting medications can be 10 times more expensive than their regular-dosage counterparts. As well, 134 over-the-counter drug products were removed from the formulary, but all are available at reasonable cost without a prescription and their removal will not have a negative effect on health outcomes.

We are all aware that there will always be certain diseases and medical conditions that require specialized treatment and care. Diseases such as cancer and conditions such as acquired brain injury cannot always be prevented. Consequently, it is important that our health care system is equipped to meet the current and future needs of people facing such health crises.

In April, I had the privilege of announcing Ontario's first comprehensive cancer strategy, born out of our discussions with 600 people who told us that while it is important to treat the disease, it is just as important to care for the person. Highlights of our cancer strategy include:

-- The setting up of a provincial cancer network to help coordinate services into a seamless cancer care system, a system that includes everything from health promotion, prevention, early detection and treatment to support services and palliative care.

-- Establishing a task force on primary prevention in cancer to look into the best ways of treating the disease.

-- Providing services that meet each person's physical, emotional and spiritual needs.

In Ontario, we now spend more than $1 billion a year on cancer care, and expanding cancer services is a priority for our government. So in spite of pressures to cut back on spending, we have put $269 million towards expanding, building and renovating cancer centres. This includes $185 million for the nearly completed Princess Margaret Hospital.

Let me say that I very much welcome the recent announcement by Princess Margaret Hospital and the Toronto Hospital which will see the two facilities working together to coordinate their cancer services. This fits perfectly into our strategy of creating a cancer network for Ontario.

This year, we will increase funding for cancer services by $15 million to help plan regional services, expand the Toronto Bayview, Kingston and Ottawa regional cancer centres, and fund bone marrow transplants, breast-feeding programs and community support groups.

As members know, there have always been services for people with cancer in Ontario, but the same cannot be said for those with acquired brain injury. Consequently, for many years people had to seek treatment in the United States, a situation which, I am pleased to say, is changing.

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Each year, as many as 15,000 Ontarians receive brain injuries that require hospital care. It only makes sense that the road to recovery for these people might be improved if treatment facilities were available close to home where they have the support of families and friends. That's why we are investing heavily in hospital and community service programs to help Ontarians with ABI.

For example, last summer we announced $4.26 million to strengthen community-based behavioural programs in Hamilton, London, Kingston and Toronto; $3.9 million has gone to the ABI program at Chedoke-McMaster Hospital, and a further $2.85 million is being spent on community outreach and repatriation. In 1991, we spent $4 million for 12 hospital and community projects across the province. In 1993, we awarded almost $1 million to Thunder Bay and Sudbury for hospital ABI service improvements, and in March, Premier Rae announced $2.1 million for a major expansion of rehabilitation services in Toronto for people with acquired brain injuries.

The progress that we're making in helping people with acquired brain injury is consistent with our overall strategy for health care in Ontario. That strategy is based on the notion that if we are to ensure the effectiveness of the system, we must plan and deliver services based on the needs of local people and the communities in which they live. Whether we succeed or fail will depend on the extent to which those needs are met, and while history will be the final judge of this, I believe we are succeeding.

As I said at the outset, it has been two and a half years since we introduced our health restructuring agenda. That agenda has been to ensure more efficient use of scarce resources and to shift the emphasis of our health care system from treating disease to preventing it.

What we are really talking about is an evolution of health care in this province. Evolution is a gradual process, one that takes time. While I think that we can acknowledge that part of this evolution was started by previous governments, and I do acknowledge that, it is clear that no previous government demonstrated the courage, the conviction and the resolution to make the substantial changes that we have, especially in the areas of cost containment and the introduction of major reforms.

Such changes have dramatically sped up Ontario's health care evolution. They have led to a system that is already better in tune with the needs of people in communities as diverse as Toronto and Dryden. They have produced a system that is well prepared to meet the needs of future Ontarians and the communities of tomorrow.

Our government has great faith in this new health system. Not only is it good for the health of Ontarians, but we believe it can also contribute to Ontario's good economic health. Health industries are responding to the changes in the health care system, to the shift of patients from institutions to home and community settings, to the need for innovative health promotion programs and to the demand for cost-effective technologies. At the same time, international demand for a wide variety of health services is growing rapidly.

We want to help our health care industries bring their products and expertise to this burgeoning market. We are doing this by listening to the recommendations of such groups as the health industries advisory committee, which came up with a strategy for improving the competitiveness and accelerating the growth of our health industries. We are providing $7.65 million to bring that strategy to light and to help give Ontario's health industry a boost. Industry leaders say that this investment could lead to 40,000 new jobs in the province by the year 2004, and I think the bottom line here is that if industry succeeds, we all succeed.

As a government, we're committed to getting Ontario back to work. We believe that making sure people have jobs and job security is a key factor in their personal health, the health of their families and the overall health of the communities in which they live. But such a state of health does not stop at employment. Ensuring people have access to decent housing and education and to a clean, safe environment are also important factors, and we have been working to include them in our formula for the health and wellness of Ontarians.

I'm very proud that what we are doing fits with the World Health Organization's definition of "health," that it is a state of complete physical, mental and social wellbeing and not merely the absence of disease and disability. Indeed, this definition, this philosophy, if you will, forms the foundation of our approach to ensuring the healthiest possible Ontario.

I'm sure that members of the committee will have comments and questions both on what I've said and on the issues that are of concern to them. I look forward to addressing them. There will be representatives of the ministry here to help me do this, as they have all of the information that I think anybody could think of asking for. We will certainly attempt to provide whatever is needed so the committee can have a constructive discussion of our estimates. I look forward to the response from my critics in the opposition parties and to the questions that will follow.

Mr Duignan: I know it's not a point of order to applaud the minister for such a fine speech, but that's not my point of order. Seeing that there's less than 15 minutes left on the clock and there's an expected vote, I was wondering maybe if we could hold over the two opposition replies.

The Vice-Chair: Is there a consensus on the committee that we do that?

Mrs Barbara Sullivan (Halton Centre): I'm quite willing to do that, as long as we're assured that we don't lose any time in the estimates process.

The other issue I wanted to raise as a point of order is that the estimates books were here very late this year. We got them late yesterday in my office.

Hon Mrs Grier: I'm sorry. They were delivered to the House leaders and the opposition parties were informed they could be picked up early last week. We found a typo on a couple of pages and I asked to take them back and change that and we discovered that as of -- when was it? -- we went over to see if we could change the typo and none of them had been picked up, so we took them back, changed the typo and returned them to the House leader's office.

Mrs Sullivan: As soon as we heard that the Health estimates were going to be presented, we were in contact with our House leader's office and I finally got my copy of the book yesterday. I was speaking with Mr Wilson and the same thing occurred with him; he did not have a copy of the documentation until yesterday.

Hon Mrs Grier: I'm sorry. They sat there for a week waiting to be picked up.

Mr Jim Wilson (Simcoe West): I think I should just elaborate. I forgot to enlighten the Liberal critic that indeed the minister may be correct, because they were sitting in our House leader's office, which I didn't know about. I've just read the whole thing during the minister's speech, so I'm rip-roaring to go.

The Vice-Chair: I'm afraid it's not a point of order, but your complaint has been registered, Mrs Sullivan.

Having said that, I will adjourn the committee until tomorrow after routine proceedings, when we will hear from the opposition critics.

The committee adjourned at 1748.