CONTENTS
Wednesday 2 October 1991
Appointments review
Mitchell Levine
Mary Sharon Broderick
Herbert Nabigon
STANDING COMMITTEE ON GOVERNMENT AGENCIES
Chair: Runciman, Robert W. (Leeds-Grenville PC)
Vice-Chair: McLean, Allan K. (Simcoe East PC)
Bradley, James J. (St. Catharines L)
Carter, Jenny (Peterborough NDP)
Frankford, Robert (Scarborough East NDP)
Grandmaître, Bernard (Ottawa East L)
Hayes, Pat (Essex-Kent NDP)
McGuinty, Dalton (Ottawa South L)
Stockwell, Chris (Etobicoke West PC)
Waters, Daniel (Muskoka-Georgian Bay NDP)
Wiseman, Jim (Durham West NDP)
Clerk: Arnott, Douglas
Staff: Pond, David, Research Officer, Legislative Research Service
The committee met at 1007 in room 228.
APPOINTMENTS REVIEW
Resuming consideration of intended appointments.
MITCHELL A. H. LEVINE
The Chair: The first item on our agenda this morning is the half-hour review of an intended appointee selected by the official opposition, Dr Mitchell Levine. He is the intended appointee as chair of the Drug Quality and Therapeutics Committee. Welcome to the committee. This is a half-hour review, with 10 minutes allocated to each party for questions and responses. Do you have any brief comments you would like to make at the outset?
Dr Levine: No, I am prepared to discuss whatever the members would like about the committee and myself.
Mr Grandmaître: Doctor, can you tell us about your new responsibilities with the Drug Quality and Therapeutics Committee? Can you tell us what you know about the job or what your responsibilities will be as chair?
Dr Levine: Specifically as chair, because I have been on the committee now for two years, the new responsibilities associated with the chair involve ensuring that the functioning of the committee runs smoothly, that the discussions that take place around drugs that are to be decided upon, in terms of their entry under coverage for the drug benefit plan, are balanced, and that all the kinds of viewpoints that would be important to bring out are in fact expressed in discussion during the meeting. That is probably one of the key things in terms of the actual operations at the time the committee meets.
In addition, there is the need for the chair to help advise the ministry in terms of the future appointments of other members to the chair, appointments to the subcommittees of the committee. These are in addition to the functioning, actually, of the committee. There are some kinds of administrative roles advising the minister on how the committee should be put together, but at the actual committee level, it is to ensure that there is a good, free exchange of information so that the best possible decisions can be made by the committee, and that advice is then forwarded to the minister for disposal or a decision to act on.
Mr Grandmaître: In the last three, four, maybe five years, the Ontario Drug Benefit Formulary has been a topic of great discussions. What is the role of your people, your committee, and the pharmacists? Do you meet with these people?
Dr Levine: Which people? "These people" being pharmacists?
Mr Grandmaître: Pharmacists.
Dr Levine: We have representation of pharmacists on the committee. In addition, there is a subcommittee that has been part of a communications or liaison group, which can meet with other parties that would be interested in having input into this committee. But by and large, the committee's role is to receive information about requests for addition to the Ontario Drug Benefit Formulary. Then the committee looks over these requests and tries to decide, in the best interests of the public, whether drugs should be added or limited, in terms of their addition or accessibility, through the benefits program, so that in a time of scarce resources there is the most rational use of drugs, and they are made available to the people who are the beneficiaries of the program.
We simply advise the minister what we think is the most rational and best way to use drugs and to have a benefits program, and the ministry makes the decisions as to what they do with our advice.
Mr Grandmaître: Also, more and more new drugs are appearing on the market, and I am sure it does not make your job any easier. What is the approach of the committee when you are faced with these kinds of problems with interchangeable drugs?
Dr Levine: Typically, with a new drug that comes to the attention of the committee, the things we look at are: Has there been demonstrated efficacy, does this drug do what it says it is supposed to do, and is it safe?
The next step is to look at whether it is really effective, in terms of the goals or objectives it should have, on the population that is using the drug. Then we take that and put it into the perspective of what other drugs are available: Is this something that is adding something new or is it simply repeating what other available drugs do. Particularly when it is the latter group, when there really is not that much difference from what is already available through the program, we very carefully look at cost, because all things being equal, we would have to ensure that the money is spent wisely. We look at both cost and effectiveness in the sense of trying to decide the cost-effectiveness of scarce resources to ensure that drugs are available but used wisely and rationally.
For the drugs that are interchangeable, what we try to do is look at the issue of whether they are clearly interchangeable in terms of when a patient uses them; are they going to get the same effect as the drugs they are being interchanged for? If we are satisfied on that point, then we usually recommend that they be added to the formulary. The second benefit that would come out of that is that this will usually bring costs down because of the competition that is occurring as a result.
Mr Grandmaître: One last question on the cost of these drugs: Your responsibility I suppose is to provide drugs to needy people, needy families, so they can have access to free drugs. With all the budget cuts that we are talking about, how will this affect your judgement?
Dr Levine: In a sense, I do not think our judgement is going to be changed at all. Over the last number of years in which I have been a member and in the years that preceded me, there has been a strong focus that the committee tries to advise the minister on how to rationally use drugs, and "rationally use drugs" does not necessarily mean adding more drugs. It may mean decreasing the number of drugs to ensure that you are getting the biggest bang for your buck in terms of the way drugs are used. So that focus has been there all along, and I think in the times of cuts, some of this advice may turn into action. So I am not really concerned that cuts are necessarily going to jeopardize the quality of the drugs that are available to the public who need them.
I think we can take the impetus to employ more rational drug therapy as a result of the pressures of scarce resources and economics.
Mr Grandmaître: If you do have the cut on your budget or cost, do you not think that you will be using more interchangeable drugs than the more popular?
Dr Levine: The issue of interchangeable drugs really is not affected as much by that issue because once a drug is interchangeable under the rules that stand, if we can deem that the drug is in fact interchangeable, there is no reason to prevent it from being added to the formulary. If we think it is safe and the public interest is being served by it being added, we add it.
The issue will come about when new drugs, which are usually considerably more expensive than established drugs, come before the committee. If we can justify that there is an added benefit for added cost, we will add it, but if there is not added benefit for added cost, we are likely to give the advice that we have in the past, that maybe this drug should not be added, that it is just not worth the extra cost. I think in these times of restraint, that recommendation is more likely to be heeded, so I think that is where the focus is going to change. The philosophy is not really going to change that much. I think some of the advice or recommendations may turn into actions.
Mr Grandmaître: Thank you.
Mr McLean: I really have not got any questions for you. I have observed that you have been on the board for some time, and you are now being appointed chairman, which is proper and satisfactory to me. I just have to observe that we are wasting time dealing with these appointees who are already, so to speak, appointed, when we could be dealing with things like the Dome --
Mr Wiseman: Mr Chairman, I think this is out of order.
Mr McLean: -- and other things that are important to this committee. This committee should be dealing with something that is fundamentally important to the province such as an investigation into SkyDome and other things in this province.
Ms Carter: This is important.
Mr McLean: They are already appointed. I see it as wasting time interviewing people who are well qualified. I see nothing wrong with the appointment, but to be here to rubber-stamp an appointment is a waste of time to me. This will be the last day that I will be sitting on this committee.
The Chair: A member of the government party, Mr Frankford.
Mr Frankford: I start off by responding to Mr McLean, because I think this is an excellent opportunity of not just interviewing you as an individual, but informing my colleagues on all sides about what your agency is doing. I think it is an extremely important agency because significant costs are associated with it, and people are using drugs every day and will continue to do so in the long term. I totally disagree with Mr McLean's feeling that we are here just to review you as an individual.
Having said that, perhaps I could get into some questions relating to you and the agency. Perhaps I should identify myself as a physician, so I have also used the products of your labours. I guess I am correct that it is the formulary that really is the primary thing that the committee is producing?
Dr Levine: That is correct. It decides which drug products would be available on the formulary, which implies that the ministry would then pay for benefits of those products through the Ontario drug benefits program.
Mr Frankford: Perhaps you could make some comments, express your thoughts about the use that physicians in general are making of the formulary.
Dr Levine: I think the physicians' at-large knowledge of the formulary is rather limited. I think physicians find out about it by prescribing a drug to somebody who is eligible for the program, then finding out it is not on the formulary, so the patient will come back and say, "This drug cost me out of pocket so many dollars when I anticipated I would get it...." So it is on a kind of ad hoc basis that physicians find out.
I think if physicians had more advanced knowledge about why we put drugs on the formulary and why we exclude some drugs, that would help keep in front of the physicians' minds the rationale behind cost-effective utilization of drugs. I think this in some ways has been disappointing, that physicians do not have sufficient knowledge about the formulary. But the ministry, through its regulations and administering of the formulary, enforces the product of the formulary.
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Mr Frankford: Would you feel that it is your job and the committee's job to make it more presentable to physicians and something that is used more in practice?
Dr Levine: Yes. Physician awareness of the formulary and putting extra information into the formulary has been one of the topics of discussion at the committee level. We have talked about not only listing the drugs but putting in that these drugs are listed and therefore available to anybody who prescribes them to somebody who is on the benefit program. What we have said is that giving carte blanche is not necessarily the best thing.
What we would like to do is remind physicians about the appropriate use of the drug. It is going to be covered under the plan regardless of who they give it to, as long as that person is covered. We could say that there are certain indications where this is appropriate, other indications where an alternative is better. It would be a much more educational tool than it has been in the past. We have come to that process.
The other thing that is being changed right now with the formulary is, we are considering going to a more continuous cycle. Right now it is published twice a year. But to have it more dynamic and have it change continuously would lead to problems in terms of publishing the document itself. There are other options available, computer discs and computer software, to inform physicians.
Mr Frankford: Perhaps I could elaborate on the two things you mentioned about more text. I am sorry I did not bring one, because I do not think my colleagues here really know what it looks like, but it really is just a listing, is it not?
Dr Levine: It is a book which lists all the drugs that are available through the Ontario drug benefit plan, categorized by the types of drugs. Beside it is the best-available price for that product. If it is a single product and there is no substitution, it is the price of that product. If there are three drugs that are similar and are equal and can be substituted, all that is listed is the best-available price.
If the physicians knew more about that, they could use it to find that there are certain drugs they might prescribe, which are considered equivalent by our committee, and are less costly to their patients. They can actually use this information in practice beyond patients eligible for the plan. They would appreciate that for their patients who are not under the plan.
Mr Frankford: There are other formularies in other parts of the world which have a great deal of text.
Dr Levine: Yes.
Mr Frankford: I am thinking in particular of the British National Formulary, and there may well be others like that.
Dr Levine: The Australian as well has a large component of educational and directive information on how to best use drugs.
Mr Frankford: Do you feel it is practical that you should be producing the same, or would you like to take advantage of some co-operative arrangement and borrow the text from other places?
Dr Levine: We talked about trying to, as I say, put in more information that would be of educational value to physicians, but we have not taken that step. I think there is some merit to that. As a matter of trying to get it to work, to be feasible, to have it dynamic, so that it changes, so that physicians are not left with stale information that is outdated, that would be one component. We also realize that there are other ways to alter physician-prescribing behaviour to make it more rational beyond simply putting things in print, because physicians do not always read what they are supposed to read.
Mr Frankford: So the ministry has given you a mandate to encourage rational drug use.
Dr Levine: I have noticed over the last two years that I have been a member of that committee there has been a change in tone in that the advice the committee has been giving for the last number of years has been pretty consistent. Rational therapy, the most cost-effective use of drugs, has been a priority, but the ministry seems to be getting more sensitive over the last two years in trying to implement some of the advice that we are giving.
Mr Frankford: You mentioned computer discs or, let's say, electronic methods. Would you like to elaborate on that?
Dr Levine: There are certainly a number of options of how information can be given to physicians, and that is increasing with the greater access to computers in most physicians' offices. One could put the formulary on disc. There are a number of pilot projects being undertaken throughout the province where physicians order their prescriptions through computer. They put the prescription into the computer and then there are a number of checks and balances against diagnoses, age and other issues that might direct the physician as to how he might more rationally use drug therapy.
Mr Frankford: I am not particularly familiar with that, but how does Ontario rate? Is this something where we are ahead of the field or behind?
Dr Levine: No. Probably the British system is ahead of the field in terms of the use of computers in physicians' offices to try to improve physicians' practices. In this sense I think North America is behind Britain, and Canada may be the same as or slightly behind parts of the United States.
Mr Frankford: I have discussed the formulary with pharmacists. The question they have raised is the timeliness, and that drugs which are being prescribed may not be in this. I think another one is that prices change and they may get hit or they may make an unexpected profit by prices changing from what is listed in the formulary.
Dr Levine: There is a clear initiative to try to implement a dynamic formulary which would be amenable to changes continuously throughout the year as opposed to this biannual process at the moment.
Mr Frankford: That sounds as though an electronic method would be by far the easiest --
Dr Levine: I think it would adapt to that change much better than obviously a published hard-copy document.
Mr Frankford: I suspect it might be easier to communicate with pharmacists than doctors, because they have a real financial interest in it.
Dr Levine: What one would ultimately really like -- and many of you may have heard about the smart card process whereby a patient would have on his or her card the drugs he or she is receiving through the benefit program. It would have other important and relevant medical information, but the pharmacist would be allowed to access what is relevant for his duties in terms of health care. Physicians would access other components of the card. You would have a constant flow of relevant and important information. That is really, I think, the way of the future. That has been adopted in a number of countries and parts of the United States where this little credit card, which is actually a computer chip, carries a tremendous amount of information. I think that would make the functioning of the Ontario drug benefit plan sufficiently more rational and useful. That would be a major step in terms of using computers to improve the quality of health care delivered here.
Mr Frankford: Are these your general thoughts or is this something which the committee has actually implemented?
Dr Levine: The committee has had discussions about smart cards, but we are basically waiting for the lead to be taken by other, more appropriate departments or groups within the Ministry of Health.
Mr Frankford: Have I no more time?
The Chair: You are over your 10, actually. I was going to steal a couple of minutes of Mr McLean's time because I recall being a member of Management Board in 1985 and the drug benefit plan was costing taxpayers over some $300 million then. Bette Stephenson was the Chairman of Management Board, trying to do things. I am looking at the costs our researchers provided us with. The costs are going up over $100 million a year. It is staggering. Are you familiar with comparable plans in other jurisdictions in Canada? Is this the most generous?
Dr Levine: It probably would be one of the most generous. There are two issues. One is, what we are willing to pay for people who are in the plan. I think in that sense we are very generous. There are very few exclusions over the course of time. The other issue is, who is covered by the plan. That has some impact, of course. In difficult economic times there are more people on social assistance, and as one becomes eligible for social assistance one becomes eligible for the plan. That may have driven up the cost, let's say, in the last year.
But that aside, I think costs are going up because of the plan's generosity in terms of including all drugs, regardless of whether there is really a better effect for the increase in dollars being spent on newer, more expensive drugs.
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The Chair: You may not want to comment on this recommendation of the Lowy inquiry with respect to ensuring that people in real need are the recipients of this assistance rather than the people who may be worth millions of dollars but who are benefiting from this generosity as well. He was talking about free drugs to those over 65 being provided only to those with an income of less than $10,000 approximately or $16,000-some for couples, which would save the taxpayers, at the time he did the inquiry, about $111 million. Do you have any views on that?
Dr Levine: I guess if I was asked how I would do it and say that perhaps there is a population that is less able to pay for than another, I would say, rather, that we should ensure that even people who have actually good incomes should not be penalized if in fact all of a sudden their costs are going up. There might be a deductible, which has been implemented in the province of Saskatchewan, as an example. Rather than cut out a certain segment of the population from the benefits, say there was a deductible for that group. They could afford the deductible, but when the costs became very high, even people who are more financially solvent should not be excessively penalized. If you are unlucky enough to be on $400 a month of drugs, that is a lot of money regardless of how well you have been pensioned.
I would be concerned about simply cutting off a group cold. I think the bottom line is that you want to make sure nobody is going to go without drugs because he cannot afford it. That is the bottom line. How you work that out, I guess there are a lot of different ways, but I think the bottom line is if you cannot afford the drugs, and you need them, and they are rationally to be used, then the province should assist those people regardless of what other factors are coming into play.
The Chair: The other side of the coin, of course, is that if you can afford it you should be paying the bill, not the taxpayer, generally. Many people paying the bills have significantly lower incomes than the people who are benefiting from that subsidization. That is another element that has to be considered. In any event, what is your experience in dealing with the government, past and present, with respect to recommendations you make?
Dr Levine: I think there has been a change in tone to increasingly adopt the recommendations or the advice of the committee, in terms of trying to make the program more rational. It is a lot of money spent, and I think that over the years there has been money that probably could be better spent elsewhere without jeopardizing the quality of health. I think that should be our focus. If there is wastage in terms of the drugs -- and the Lowy report certainly outlines some of the areas of concern -- I think there is a genuine interest by the government to change that.
The Chair: Thank you very much, Doctor. We appreciate your appearance here this morning and we wish you well.
Dr Levine: Thank you.
MARY SHARON BRODERICK
The Chair: The next witness is Mary Sharon Broderick who is an intended appointee as a member of the Liquor Control Board of Ontario. Ms Broderick, welcome to the committee. You were selected for review by the government party, and I think you probably understand the process. It is a half-hour review with 10 minutes allocated to each party.
Ms Broderick: Yes, I understand that.
The Chair: Do you have any comments you would like to make before we begin?
Ms Broderick: Yes, I do. I thought I might just introduce myself to the members briefly. For the past 10 years I have been a member of the faculty of business at Brock University where I have lectured in marketing management and consumer behaviour. I was born and raised in the Niagara Peninsula and am now living there again. I have obviously had a concern for and an interest in the wine industry in Ontario. I have watched closely as its recognition has grown worldwide.
I have had occasion to consider the Liquor Control Board of Ontario in several of the courses that I teach, and I see it as an organization that has responded to an ever-changing environment, and has had to adapt its policies and procedures because it has faced an increasingly competitive environment and one which has changed radically over the course of the last 10 years.
I have read its strategic report for 1991-92, and I feel I could contribute to the board as it meets its future challenges. I am most enthusiastic regarding this nomination.
Mr Waters: You raised an interesting topic, seeing as how last night we had an opportunity to do some wine tasting here to select a wine for the House. As I look through the backgrounder on the LCBO, I see that Canadian wines' share of the market is only 33%. Part of the principles and objectives for the LCBO is to support the Ontario wine industry. I wondered if you could give us your feelings on how you might be able to change it. European wine is 60% of the local consumption, so I was wondering if you had any ideas on how you could change that around.
Ms Broderick: I think there is a perceptual problem in Canada, that it takes international recognition of our wines before they are believed to be of superior quality here in Canada, such as the award that was won recently by Inniskillin Wines. I think they won a gold medal or a silver medal for their ice wine. That kind of international recognition is critical.
I also believe the support of the government will be something that changes those numbers around. I have some familiarity with this promotion they are currently mounting. I think the timing is good, because this past summer has been the best summer for the wine growers in the peninsula, so they will be producing what I perceive to be -- and I am not an expert on wine growing -- a superior product. I think a superior product, coupled with a good promotion strategy, should generate additional awareness in the marketplace and should increase that number.
Mr Waters: In essence, at the board you would be promoting that we come up with a strategy to --
Ms Broderick: No, I understand they already do have a strategy. I am not altogether familiar with what my role would be at the board. At this point, I am simply a nominee and a lay appointment. I am not altogether familiar with what my position would entail.
Mr Wiseman: I have read the LCBO brochure. You said that the LCBO is in a competitive market. Who are they competing against?
Ms Broderick: I believe they are competing against international producers of spirits and wines. I assume their greatest concern is cross-border shopping.
Mr Wiseman: Just going back to the first point, since all the liquor that is sold in Ontario has to go through the LCBO, and the mandate of the LCBO is to control the sale, I still do not know who you are competing against, other than the cross-border shopping. I understand that issue, but other than that I do not understand who you are competing against.
Ms Broderick: I think my comments were more in keeping with the changing environment in which a business such as the LCBO operates. It is an environment where there are changes in people's behaviour. It is internal, I think, to a certain extent. I read with interest that sales of certain kinds of spirits increased where sales of other kinds of spirits decreased. Now, I am not advocating that this is the kind of business where you promote consumption, but at the same time I believe they are dealing in a dynamic environment, and competition is primarily from the US.
Mr Wiseman: If the challenge of the LCBO is to control consumption, then the fact that liquor consumption is declining would be seen as a good thing. Why would you spend a lot of money and make a lot of effort at sprucing up stores if your goal is to continue to decrease consumption?
Ms Broderick: I think their goal is to offer a responsible drinker the opportunity to purchase. I believe the decrease in the consumption of liquor is a good thing. It represents an increasing awareness of health and fitness. People are more concerned about lifestyle. I believe the Liquor Control Board of Ontario should be a consumer-oriented organization. It should offer service to people who want to buy liquor. I do not think that by sprucing up stores you are necessarily encouraging people to drink more. I think you are just making it a more pleasant environment in which to shop.
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Mr Wiseman: The difficulty I am having here is that the LCBO has controlled the sale of liquor in this province for a long time. They found that some changes were necessary, I do not disagree with that. But if one of the other goals of the liquor control board is profitability and turning that money over to the province, why are we spending all this money on sprucing up stores, and why are we spending money in the liquor control board to increase the number of ad people available, from a few to over 40, when the goal is to decrease consumption?
You are talking about marketing, and everything that you are saying would make a whole lot of sense if you wanted to increase the sale of the product, but if your goal is to decrease the sale of the product and make sure that people are drinking less and abusing it less, then why all this?
Ms Broderick: I think their decision to become more interested in offering an environment which is pleasant, which is convenient, is something that is not designed to encourage more drinking but is simply designed to make it a more pleasant environment for you to purchase in. I am not familiar with all of these areas. As I said, I am a lay appointment. I have read the strategic report, but I have certainly not gone into the detail that answering that question would require.
Mr Wiseman: How much time is left, Mr Chair?
The Chair: You have used up close to seven minutes. You have three --
Mr Wiseman: Mr Frankford has a question, then if I have time, I will come back.
Mr Frankford: The LCBO really has a number of goals which do not necessarily go together, like increasing sales and supporting the local industry and raising taxes and responsible drinking. Another area where I think it has an impact is as a major retailer. I think it is called an anchor tenant in shopping areas. Do you have any views on the impact and any policies which should change around the placing of stores? I am thinking of big shopping mall stores versus smaller downtown stores. I can think of some small Ontario towns where the main streets really could do with more business brought into them. Do you agree, and is this something you would like to work on?
Ms Broderick: Location research as it applies to retail suggests that most growth is occurring in strip malls, although obviously this would be the kind of retail outlet that would generate traffic and so could likely be positioned in a downtown location. It is difficult, because this kind of a product is one where you want people to behave in a responsible fashion and it is, I think, important to make it available, but not to make it so available that perhaps problems develop. I do believe that location is a critical fact or I think it should not be positioned in remote locations, difficult to get at. At the same time, I believe that it should not be someplace that could create problems.
Mr Frankford: Just one last comment. I guess when you say responsible behaviour, since people are not actually drinking at the time, I would suggest that possibly responsible behaviour would be that you do not go in a car. Maybe it would be more responsible to have it in a place where you primarily walk.
Ms Broderick: That is possible.
Mr Wiseman: My last questions is, since today is Zero Garbage Day and the liquor control board has done virtually nothing in terms of recycling, what kind of ideas and what kind of effort would you bring to promote that?
Ms Broderick: I would suggest they are doing something. I think they are making an effort to encourage returning the bottles to the LCBO outlet --
Mr Wiseman: I understand they are thrown in the garbage when they get there.
Ms Broderick: There is sorting. I understand that was taken out of context at least, as much as I know about it, people were returning the bottles, LCBO employees were advised to be pleasant and they were supposed to have been sorted. But at the same time, you are right; I think there is a lot of concern overall for excess packaging, for refilling, for returning, for recycling. I think all of those are challenges that face LCBO in the future.
Mr Grandmaître: I was interested in your opening remarks. Your strengths are in marketing and promoting. I want to follow up on Mr Wiseman's type of question. What we are seeing in Ontario, not only in Ontario but right across Canada, is that consumption is going down. I know one of the objectives of LCBO is profits; you have to make a profit. If consumption is going down, what will be your advice, as a marketing expert, to LCBO to keep its profits up?
Ms Broderick: I believe taxes obviously are the primary concern here. You cannot encourage people to drink more, but I think if you offer a quality product, if part of that quality image is as a result of the price, I suppose, as with anything else, the price increases as the demand goes down. If there is to be a way to maintain revenue, and I think the province enjoys a substantial amount of revenue from the sale of liquor, then you want to maintain that. I think you also would like to see that programs that are supported by or have some support from the sale of liquor in this province are maintained as well. I expect it is a pricing situation.
Mr Grandmaître: So as a marketing expert, interested in the declining consumption in Ontario, you would not hesitate to recommended higher prices? Again, as a marketing expert.
Ms Broderick: I do not advance myself as an expert, thank you very much.
Mr Grandmaître: Nobody is an expert in this room, believe us.
Mr Broderick: I believe it very much depends upon the sensitivity of the market price. Obviously there are thresholds beyond which people will not pay, but I believe that in this instance you do not have a lot of variables to work with. Promoting consumption is unacceptable. Distribution is controlled. The product and the price are really the only two variables you can work with, so if you are offering a superior product at a convenient location, the price should reflect that.
Mr Grandmaître: I agree with you that you are aiming for quality products. I have noticed in the last maybe three, four, five years that the LCBO is in the real estate business. They are picking the best possible spots in town -- strip malls, main drags. In real estate there are only three things that are important -- location, location, location. How come you people are picking the best possible spots in town to make it more accessible for people, with parking and so on and so forth, and yet we are promoting a lot of things in this province to encourage responsible drinkers. How come you are picking these spots?
Ms Broderick: I think that is all part of the --
Mr Grandmaître: Marketing business?
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Ms Broderick: No, I think it is part of the mission. I think the LCBO has become a consumer-oriented organization, and if you are a consumer-oriented organization you are concerned with offering your customer convenience. These locations are convenient locations. It is part of a market-driven approach to business.
Mr Grandmaître: One last question. The LCBO is a crown corporation. Do you think one day in the near future it will be privatized? Should it be privatized?
Ms Broderick: It is my belief that the Liquor Control Board is the best possible way of distributing spirits and wine in this province.
The Chair: Mr McLean, do you have any questions?
Mr McLean: No questions. I wish you well.
Ms Broderick: Thank you.
The Chair: I would like to take advantage of the opportunity to pursue that last question just a bit.
You talked about distribution and you recommended the LCBO as the best source of distribution. But LCBO has another arm, the retail arm, not simply the distribution side of the equation. I guess, as someone who has an MBA, I am curious about your views in respect to a monopoly. I think historically monopolies do not have the same kinds of efficiencies as those who have to compete. I would like to hear your views on that. I know -- I believe, anyway, without having an in-depth look at the operations of the LCBO -- that is one of the things, with your background, that you could take a look at, the efficiencies of the operation versus comparable sorts of operations within the North American jurisdiction, if you will. I wonder if you have any views on that.
There has been a lot of talk over the years about privatization of the LCBO. I can see the retail side of it being privatized and perhaps the distribution side remaining within government control, but I always have had difficulty with government Big Brother being the folks who dispense alcoholic beverages over the counter to us folks who cannot think for ourselves.
Ms Broderick: That is an issue that I would have to consider for more than just the couple of seconds I have here, but I do believe it is an efficient way of distributing alcohol at this point. I think their mandate is control, and I think that should be maintained at this point.
The Chair: Why not just lock the doors?
Ms Broderick: Yes, well, I think it should also be available, but it is not necessarily true that things that are taken over by the private sector are run more efficiently.
The Chair: Not necessarily. Thank you very much. We appreciate your appearance here today. We wish you well.
Ms Broderick: Thank you.
HERBERT NABIGON
The Chair: The next witness is Herbert Nabigon. Mr Nabigon is an intended appointee as a member of the Northern Region Board of Parole. Again, this is a maximum half-hour review. Mr Nabigon was selected for review by the government party. I will give you an opportunity to say something briefly if you wish, or we can get right into questions. How would you like to handle it?
Mr Nabigon: I would prefer you to get right into the questions.
Mr Wiseman: I am pleased you are here. I would like you to describe a little bit your views of how the parole program in the north should work and what the problems are that you think should be addressed.
Mr Nabigon: I am not an expert on the parole board per se, but I know in the north it is common knowledge that there is regional disparity in terms of economic wellbeing in that part of the province. Because of that, there tends to be an increase in incarceration, especially among the native people. There are a lot of reasons for that, multicausal factors, not one single factor that relates to why a lot of native people end up in our institutions.
I think the parole board should be more sensitive to those kinds of issues when it deals with policies and how they should be implemented.
Mr Wiseman: You do an awful lot of work with the Frontiers Foundation?
Mr Nabigon: Yes, I do.
Mr Wiseman: Perhaps you could describe to the committee what that work is and what that group does.
Mr Nabigon: I have been involved with them now since 1969. I have been doing volunteer work with them since then. I now work in the capacity of president of their board. Basically my function is to oversee the overall management of the organization. It is an international development agency which does a lot of recruitment for volunteers all over the world, and fund-raising activities. I work along with my executive director, Rev Charles Catto, in that capacity.
Mr Wiseman: Could you describe some of the rules? Perhaps you should also describe exactly what you do, for example, Operation Beaver and how that contributes to the wellbeing of the native community.
Mr Nabigon: Basically we have a self-help housing program and we establish partnerships in tenant communities, mostly native and some non-native, in the rural part of Ontario or Canada. That partnership exists in the sharing of the labour, and we provide all the technical expertise plus some equipment. Our volunteers come from native and non-native communities to help in the construction of these homes we work on in the north.
Mr Wiseman: Can you describe what positive effects come out of the partnerships that are created?
Mr Nabigon: As you know, the northern communities are all isolated. As I see it, the effect is a cross-cultural exchange between the volunteers and the community. It deals with the isolation a lot of people feel in the north. They have a good exchange and learn from each other, aside from the construction of the homes.
Mr Wiseman: Is there anything you see in that program that would be beneficial in terms of what you would be doing on the parole board?
Mr Nabigon: There are some possibilities in terms of recruiting volunteers from the institutions, although we have never had a recruitment drive in the institutions. One of the issues we have to be concerned about is the safety of our volunteers. We would not want to put our volunteers in an untenable situation.
Mr Wiseman: The cost of an inmate in our system is approximately $110 a day for guards and workers, and approximately another $5 for food and $3 for accessories. Would you see it as more beneficial to try to keep people out of the institutions? Would that be a goal?
Mr Nabigon: I guess there are many ways to incorporate prevention programs. I see it as part of the overall responsibility of the native community not only to conceptualize, but to operationalize prevention programs so they can take care of their young more effectively. As an organization we would be prepared to work in concert with any community that wished to go in that direction.
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Mr Wiseman: How important would it be for the parole board to understand the cultural differences between European society as it exists now and the native society? Is this an important factor in understanding who should be paroled and who should not be?
Mr Nabigon: I have done work in the federal systems around Kingston and there is a move now by the federal government, especially in the area of corrections, to incorporate some of the healing practices of the native community. The healing practices address the issue of reinforcing the positive identity, increasing self-esteem through tradition, and I imagine it is the same in Ontario. I have not been that involved with the Ontario correctional system, but I do know there is a serious problem, almost like a Durkheim study. I do not know if you are familiar with Durkheim. He talked about a state of anomy; that is, the absence of positive values. In a lot of our communities we have an absence of positive values. The native traditions deal with reinforcing positive values and reinforcing a positive self-image. Basically that is the kind of cross-cultural work I would like to do for the Ontario parole board.
I also have a contract with Cecil Facer Youth Centre in Sudbury, doing work with young offenders in their institutions, doing some healing circles with native young offenders from the northern district. So far, although it is a biased opinion, I think it works nicely.
Mr Grandmaître: I was watching a very interesting program two weeks ago, on US TV, but it was good. They were talking about self-government administered by native people. One of the interesting subjects was responsibility for their own justice or judiciary system. It was very interesting to note that these people do not believe in incarcerating people for a long term of 10, 15 or 20 years. They have their own way of, if I can use the word, punishing these people. But for everyday infractions, these people are sentenced, if I can use the word "sentence", to do community work. Do you think our parole system should emulate such a process? Do you think we should have these people do community work instead of incarcerating them at a cost of $110 a day? Do you think this is the right way to do it?
Mr Nabigon: It is a very complex question. I would have to, as in the current system, deal with it case by case, depending on the nature and the severity of the crime. Our elders are what we call spiritual leaders and they have a fairly extensive knowledge on the native justice system and how it should work. They always say one of the things that is missing in our communities is that too much is done for us. We do not have the ability to be responsible for our own decisions and our own actions. They say the whole welfare system has destroyed a lot of the native initiative. They are saying that if we want to take a meaningful role in this system, we have to first of all find ways to increase our responsibility, that with responsibility comes more freedom.
It would be the same, I guess, if the United States started to feed the Ontario people on welfare; what would happen to all the Ontario citizens? They would become dependent on that system. This is the same effect that is happening with us in the native community. We see the need for a major restructuring and a reorganizing of our communities to increase our responsibility and take care of ourselves the way we did prior to the infusion of welfare in our communities. I do not know if that answers your question. It is kind of long-winded.
Mr Grandmaître: Do you think native people are treated fairly by our system, the parole board system?
Mr Nabigon: It is getting better. It was very ethnocentric 10, 15 years ago. The current dialogue is getting better. I see a lot of the people who are responsible for the administration of the justice system in Ontario more receptive to new ways or innovative ways to at least provide some meaningful counselling or treatment for our young offenders and native offenders in general. I would say it is getting better. It is far from perfect, but it is getting better.
Mr Grandmaître: Now that you are appointed to the parole board, will your friends see you as a protector?
Mr Nabigon: It depends. Like any other community, there is a wide range of opinions in the community. I think the more militant native people will probably see me as a protector of the status quo. The other opinion that comes from the elders, which I take a lot of my guidance from, says there are two sides to every story and you have to look at both sides; it cannot be all one-sided.
In my younger days, when I was in my 20s, I was very much in the radical movement of the native bid for more power and responsibility. When I was telling my grandmother about my activities and about all the injustices committed by the non-native society, the white people, she told me: "You've got to remember one thing, that the sun shines for everybody, it doesn't only shine for Indians. Our day will come when the sun shines for us also." I understand the wisdom of her words today. She was very wise and knew the dynamics of behaviour.
Mr Grandmaître: I hope the sun shines for you for many years to come.
Mr Nabigon: Thank you.
Mr McLean: You are accepting a very responsible job and I wish you well. A lot of people will be looking up to you.
Mr Nabigon: Thank you.
The Chair: This is difficult to do this back and forth, but we do have a little bit of time left, so, Mr Waters, I will give you a chance.
Mr Waters: I just wanted to ask a question. When I was reading the background once again, I read that, "The Ontario Board of Parole operates within the legislative criteria defined by the Parole Act, which specify that the board may grant parole if it considers that: the inmate has derived maximum benefit from imprisonment." Others include, "the reform and rehabilitation of the inmate will be aided by parole...the release of the inmate on parole would not constitute an undue risk to society." It is more the first point that I wanted to ask a question on. How do you feel about that, "the inmate has derived maximum benefit from imprisonment"? When I read that, I found it sort of difficult to comprehend.
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Mr Nagibon: I laughed when I read that myself. To be facetious about it, if they are going to feed you for a couple of months, why not? That is the maximum benefit.
Mr Waters: I was trying to figure out how there was a benefit to the inmate being in prison but wondered if maybe I was missing something.
Mr Nabigon: To give a serious slant to that question, I have an opportunity, because of my work in the prisons doing healing circles, to meet people who say they would rather be in jail than at home, which is a sad commentary. A lot of these young people do not have any warm places to sleep, it is like a little retreat, a holiday for them. I see where our Frontiers Foundation can provide a service to those kinds of communities, and their maximum benefit, to put it in those terms, would be very realistic for somebody who does not have a warm place to sleep.
Mr Waters: You will be in my region, because you will have the Parry Sound Jail as part of what the board covers. I can recall that when I grew up, now and then there were people who a week before Christmas used to try to get in for the winter. That is a sad commentary. Maybe that is the maximum benefit, but I do not see it as much of a benefit.
The Chair: Mr Nabigon, I have a quick question, too. There was a situation that developed in my riding, in talking to some professionals in the justice system, about an individual who is in provincial jail, sentenced for two years less a day for sexual assault on a 12-year-old girl and within three weeks he was out into the community. Obviously when this became known someone recognized him on the street or what have you. There was quite an uproar. I raised it in the Legislature and he was pulled back into the institution.
In talking to justice officials, they said there is pressure from the Ministry of the Attorney General to put these people in jail -- wrongdoers, if you will -- and then on the other side of the coin of course is that corrections, because of overcrowding primarily, is always under pressure to move these people out. It is a two-pronged question. I am not sure about the situation in your area, your area's responsibility, but you may be faced with those kinds of pressures perhaps, to move people out or look upon making favourable decisions, just because of jail overcrowding situations, which are not necessarily in the best interests of the community.
The other element of this is, this victim and the victim's family were not made aware of this individual's re-entry into the community. I am wondering about two things here. How are you going to deal with those kinds of pressures, how do you feel you can deal with those kinds of pressures in respect to overcrowding and moving people out who perhaps should not be moved out as quickly as is being suggested? The other side of it is, do you have any views on victims' rights? Perhaps victims should at least be made aware of the movements of a perpetrator.
Mr Nabigon: There are several aspects to deal with. One is a policy-related question that has to deal with a very explosive situation like sexual abuse. Everybody is repulsed by those type of crimes, and the community, I think, has to take priority in these types of crimes. The safety of the community should come first.
The Chair: I am glad to hear you say that.
Mr Nabigon: With regard to the overcrowding situation, I think the parole board has to be more innovative. I am sure if you take 100 prisoners and review each one's file and why he is there, most of them are there for crimes against property but not crimes against the person, so I would look at crimes against property with a lenient point of view and look for treatment maybe, if they are alcohol-related. Most of them are there for alcohol-related crimes. But for sexual crimes, and especially abusing kids, I think society has to take a really dim view of that and implement the legislation that is there and use the frameworks to get the maximum punishment.
The overcrowding situation requires politicians to come up with some policies that will address those kinds of issues. It is a very complex question, I think, especially the overcrowding.
The Chair: Thanks very much, Mr Nabigon. We appreciate your appearing here today and wish you the best of luck.
Mr Nabigon: Thank you very much.
The Chair: Members, that completes our reviews for this morning, and again, I would like to request concurrence to deal with all of the appointees.
Mr Wiseman: Mr Chair, I would like to put a motion on the floor to defer confirmation until next week.
The Chair: You want to defer until next week?
Mr Wiseman: Yes, please.
The Chair: All right. If one member so requests, that is the way it will be handled. That concludes the business of the committee. One thing I want to request is that members of the steering committee remain here. We will have a brief meeting and hopefully be out of here in 20 minutes.
Mr McLean: On a point of order, Mr Chairman: Just for clarification purposes, is the mandate of the committee with regard to dealing with the appointees still in place in the Legislature? It was supposed to be on a trial basis.
The Chair: It is a permanent standing order.
Mr McLean: So it is continued. I guess the other question that I have is and you can clarify it for me, are we going to be dealing with any agencies, boards or commissions during this next period of time, or are we going to continually deal with appointments until the session is done in December?
The Chair: I will respond to that and then Mr Waters can say something. We had an agreement that for at least one sitting per month we would deal with an agency of government. In fact, that is one of the things the steering committee is going to be talking about: the agencies we want to schedule in over the next couple of months. There is that minimum, if you will, and if we have additional time, we can look at other agencies.
Mr Waters: That was what I was getting at. I had actually been talking to our legislative research person, as well as some of our staff people, trying to get a handle on it, because I wanted to know -- like, today we are free at 11:30. Let's say we had an hour one day. Could we not schedule that hour? Even though we had, let's say, reviewed a couple of intended appointees, if we had an hour, an hour and a half or two hours left, could we not even use that to also schedule in an ABC for part of the hearings?
The Chair: We can devise the schedule as we see fit, the steering committee in agreement with the committee as a whole, but we cannot do this on a moment's notice. We have to notify witnesses. We have to give them a fair amount of notification in respect to the kinds of things we want to deal with. But, sure, we can do that.
Mr Wiseman: Perhaps the subcommittee when it meets at 11:30 could devise a timetable for the next month and take into consideration the concerns that are being voiced here, and then maybe the subcommittee could send it on to the House leaders for approval and perhaps we can set out some kind of an agenda over the next little while. Is that a possibility?
The Chair: I do not see why we have to go to the House leaders.
Mr Wiseman: We could just do it here?
The Chair: We can set our own agenda. That is all there is to it. Anything else on this? Perhaps we could adjourn now and the subcommittee members can stick around and we will try to get this resolved as quickly as possible.
The committee adjourned at 1120.