The House resumed at 8 p.m.

SUPPLEMENTARY ESTIMATES, MINISTRY OF HEALTH (CONTINUED)

On vote 3002, institutional health services programme; item 2, ministry direct services:

Mr. Chairman: The hon. member for Brantford was about to say something.

Mr. Makarchuk: I would like to touch on the matter of the ambulance service in the city of Brantford and Brant county. Before the minister embarked on his austerity programme or whatever it is, we had an excellent ambulance service that was fulfilling its functions. The people in the community had confidence in the service and they were quite happy with what was going on. Then you decided to start cutting back and cutting out. Consequently, there is a great deal of concern in the community about what is happening when you talk to some of the people who have had dealings with the service.

The other day a gentleman approached me and pointed out that he had to wait two hours for an ambulance to appear at his doorstep. He said it was lucky it was not an emergency situation for he had to wait two hours.

I have received letters from other people where the ambulance attendants who arrived on the scene were not properly trained. In this case, it was a heart attack case that eventually was fatal. They did not have oxygen. They did not provide the proper care for the patient en route to the hospital. In fact, they weren’t even able to get to the hospital in time. The gentleman who told me about it did all sorts of things around the apartment. Eventually he got in his car to follow the ambulance and found out that they were sitting in the middle of the street doing nothing.

There was another letter that was sent -- and I am going to read this letter into the record -- to Mr. Brubacher from the Brantford General Hospital. The letter is dated November 23, 1976.

“Dear Mr. Brubacher:

“The executive committee of the board of governors of this hospital has unanimously directed this appeal to you for the establishment of a more permanent ambulance service for the city of Brantford at the earliest possible time. Allowing for past promises of such an arrangement at a much earlier date, the latest being September of this year, you can gather some appreciation of the frustration that has developed. As further delays can only add to this frustration, the committee further specifically directs that such assistance as necessary be sought, including that of the Brant County District Health Council and Mac Makarchuk, MLA for the riding of Brantford.

“While we have reason to believe that not all of the many complaints aired on an open line radio programme are entirely valid, we are aware of many instances creating a general atmosphere of dissatisfaction. Extended use of an interim service is considered to be largely responsible for this deteriorating situation, mainly because it has proven a barrier to good communication and understanding.

“The medical staff of this hospital is both disappointed that no one fulfilled an understanding to attend a full staff meeting and frustrated that continued efforts to effect such a meeting are not materializing. Also, nurses and other staff would like opportunities to exchange information which can only be beneficial to the patient. There are also those problems inherent with changing personnel who obviously are not familiar with the city and district, thus delaying calls. We need not remind you of the changes which accompanied this transfer of the service from the Brantford fire department but we emphasize the ramifications of such changes to those long associated with the excellent service rendered by a competent, co-operative and disciplined staff carrying out their duties in a consistent manner.

“Administratively, we have no complaints with the service being based at this hospital, other than to support the contention that it is difficult, if not impossible, to find a contact with authority to speak for the service. No one seems to know why the telephone service, which creates annoyance and potential hazard in the emergency department, wasn’t modified long ago. Perhaps this would partially explain the frustration of one of your attendants who stated he could solve the matter by taking the patient to other hospitals.

“We trust that you will take this request and these supporting remarks in the spirit in which they are given and that you will not hesitate to seek our assistance if we can be of any help.”

The letter is signed by K. J. Muir, administrator of the Brantford General Hospital.

I think you are aware that there has been a change. As I understand it at this time, you are looking for somebody to take over the service in Brantford on a permanent basis and you have been looking for quite some time. Could you at this time give us some indication when you are going to make up your mind? When are you going to have a permanent ambulance service, who is going to administer or run that ambulance service, where is it going to be operated out of, and when can the people in that area count on you to provide the kind of ambulance service or something similar to what they had before you got your hands on it?

Hon. F. S. Miller: They will have a much better one than they had before we got our hands on it. I lived in Brantford at one time, too. You know full well that the service in Brantford was run by the fire department. You know full well that they didn’t have any people trained through the Borden course in that department. That was probably the major reason we had to reconsider the change and why we’ve had to have it operated for a short term until such time as we’ve got trained operators.

Proposals were called for; we’ve accepted them. We have now got a name up and I’m told that within next week or so the new people will be named and will be operating by the first of the year.

I get tired of the complaints about the ambulance service in this province. Go somewhere else, to some other province, and you’ll discover how lucky we are in this province to have a very fine, well-operated, well-trained system, one which most people consider to be the best in North America.

Mr. Makarchuk: Mr. Chairman, I’d like to correct the minister --

Mr. Nixon: The ambulance service?

Hon. F. S. Miller: In Ontario.

Mr. Makarchuk: -- about there not being trained people available. The people who ran the ambulance service were fire department people and I think most of them, if not all of them, had taken a St. John Ambulance course. They were well-trained and knew what they were doing in comparison to what you’ve got now.

The reason, of course, is that you feel that some of the people you are going to get on staff eventually will go for some community college training and then operate the ambulance service. At this time, as I understand it, I don’t think there are very many of them available -- or that the courses are available at present for these people to take.

I’m glad to hear that you are going to name the person in one week and by the beginning of the year we will have the ambulance service and you feel that we should consider ourselves lucky. I have to point out to you that we had a good ambulance service there because the local community got together and got that ambulance service there. Admittedly, the ministry paid money into it; there’s no question about that. Surely, you don’t expect us to be grateful because we have got some of our money back?

The other point is if you wish to compare us to somebody else, I’d like you to sort of discuss these things with some of the people who didn’t quite make it to the hospital -- persuade them or convince them of how great things are.

Hon. F. S. Miller: You alluded to a two-hour call. First, I challenge you to tell me there was any ambulance in Ontario without oxygen and if you have the details, I’d like to have the details on it. Oxygen is a standard part of every ambulance’s equipment in this province. If some ambulance did not have it, I want the details.

The question of a two-hour call must have been a request for the transfer of a patient for routine diagnostic services not for any emergency. We simply code calls from, I think, one to four, on the basis of the information we’re given. If it’s a code four call I believe it’s an emergency; if it’s a code one, it may be a transfer. If somebody says to us, “I have to go to the hospital” -- you know full well that a lot of people do use the ambulance, in effect, as a taxi service -- they may have to wait until there aren’t emergency calls or until there are enough spare standby vehicles and that’s only proper. We’re providing a service which didn’t used to be provided by any stretch of the imagination and wouldn’t be provided in ambulance services.

Our ambulance service is growing at the rate of some 10 per cent, I think, in volume of calls per year and we can attribute the great bulk of the increase to simply taxi service not to emergency service.

Mr. Nixon: I don’t know if the hon. member wants to pursue his present line of discussion or not but I suppose the one I want to raise with the minister is somewhat similar. It has to do with the Willett Hospital in Paris, Ontario. The minister is aware that he has been to the Willett Hospital to announce to the local board that it would be closed. There was fortunately a strong response from the community and from the courts which has delayed this but the matter pertains to the ambulance service associated with the Willett Hospital. Whether or not Willett closes, and we trust that it will not, there should be a 24-hour service available in the community of Paris.

The hon. member for Brantford (Mr. Makarchuk) has been talking about the shortcomings as he sees them in the service in Brantford but the minister is probably aware, certainly his officials would be, of a reduction in the budget for the ambulance service associated with the Willett in Paris. It’s difficult for me to discuss this because the last thing I want to suggest to the minister is that any action should be taken which would facilitate any reduction in service in Paris. If, in any way, he has this in mind surely there has to be an efficient 24-hour service in Paris associated with the Willett Hospital and for those serious cases which can’t be treated in one of the smaller community hospitals such as Willett which would facilitate transfer to Brantford or Hamilton or even London.

I understand that the budget in the Willett situation has been substantially reduced. I want to suggest to the minister that we have to beware, certainly from his point of view, of an inconsistency in policy, and that one of the things that must be maintained at a very high rate of efficiency is the ambulance service associated with that hospital. I trust he will be able to assure us that with this additional amount of $1,567,500 sufficient support will be maintained.

Hon. F. S. Miller: We certainly are going to maintain the ambulance service at Willett Hospital, whether it continues to function as an active hospital or not. On the question of the budget at Willett Hospital, I am sure you would share the feeling with me that it is serious. I am told that they had an overspending problem relative to their 1975-76 budget, let alone their 1976-77 budget. That is the area we are attacking -- not the quality of the service but the cost relative to other services.

Mr. Hodgson: I sit here in the Legislature and listen to all the complaints against ambulance services rendered throughout the province of Ontario. I represent a riding that has two hospitals -- York Central Hospital and York County Hospital -- one is at Richmond Hill and the other at Newmarket -- and I hear nothing but praise for the ambulance service that is rendered out of both those hospitals to the community. I haven’t had one complaint --

Mr. Conway: How about courthouses?

Mr. Nixon: Just don’t get sick, Bill.

Mr. Hodgson: -- not one complaint against the ambulance service. I have heard a lot of praise for the ambulance service, and I want to pass this on to the minister so that he will have --

Mr. Ferrier: What about courthouses?

Mr. Hodgson: -- a little bit of confidence in the services that this government is rendering to the people of the province of Ontario.

Mr. Nixon: You should be moved up into the front row, Bill.

Mr. Renwick: We have confidence in you, Bill, but not in the government.

Mr. Hodgson: This thing of always complaining gets you nowhere.

Mr. Conway: Back to basics.

Mr. Mancini: I am most pleased to rise in these supplementary estimates to speak on the ambulance services that are rendered throughout the province of Ontario and particularly in the great riding of Essex South. I am sure the minister is already aware that we do have a great many concerns in my constituency about the type of finances and the types of intervention that we receive from the director of the ambulance services branch in his ministry.

First of all I would like to speak to the minister about the Harrow ambulance service branch which services the communities of Colchester North, Colchester South and the town of Harrow. It serves approximately 10,000 and some odd people. We have been told that we would have a budget for the year 1976 of around $60,000 and we expected something in that vicinity for the year 1977. However, we have now come under the heavy hand of the restraint in a programme that has been initiated by this minister in his health budget. We find that we are going to be cut by over one-third -- not five per cent or 10 per cent or a few thousand dollars that a small service can cope with, but over 30 per cent of this ambulance service budget is being cut by your director, and we just cannot accept this.

We have met with your director and we have heard all the praise that he has given Mr. Smith and how very capable he is in operating his ambulance service and how we know that he can operate with 30 per cent less. But I would just like to inform the members of this House, he is being paid to operate a 16-hour-a-day service and he operates it 24 hours a day.

Just tell me how he can tell his friends in the community who are involved in a car accident, or are ill with some sickness, “No, we stopped at 4 o’clock,” or, “Call Leamington,” or, “Call Amherstburg.” He’s not that type of guy and he wants to give the people in the area a good ambulance service.

[8:15]

He’s got students from St. Clair College who are taking these courses but there aren’t going to be any jobs for them. He’s paying them very low wages and consequently he’s getting a high turnover of employees. It’s not doing his service any good and it’s not doing the people of that area any good at all, either.

We’re concerned about how the director of your ambulance services branch can go into an area and say, “Your budget is cut by 30 per cent. We think you’re a great guy and we think you know how to operate this ambulance service with a 30 per cent cut -- just go out and do it.” Like rah, rah, rah! I don’t think we can tolerate that type of cutback.

We received resolutions from all three councils and they have been down here to meet with your director. He tells them to speak with the regional man and to visit the other places in the province of Ontario which are in their group. I don’t know how he ever came to put the Harrow ambulance services within this particular group because this ambulance service does not do any taxi calls; it’s all emergency calls. I’d like your response on that before I carry on.

Hon. F. S. Miller: First of all if you formed a government, perish the thought --

Mr. Moffatt: Don’t let it cross your mind.

Mr. Nixon: This time next year you will be back running a train in Santa’s Village.

Hon. F. S. Miller: -- you would still be faced with getting value for the taxpayer’s money. You just don’t want value for the taxpayers’ money.

Mr. Nixon: You’ll be back on the beat. You’ll be back on unemployment insurance.

Hon. F. S. Miller: Your ambulance system is making 332 calls a year for a cost of $62,000.

Interjection.

Hon. F. S. Miller: That’s about $200 per trip.

Mr. Nixon: It’s $200?

Mr. Hodgson: How does that grab you?

Hon. F. S. Miller: When you look at that, I think one should stop and realize that I have the job --

Mr. Mancini: Three to four calls.

Hon. F. S. Miller: -- and you would have the job of getting value for the money spent. I would hazard a guess that if the councils had to fork that money out for the service in your area, they would be watching the budget of that operator in a way we are never going to watch it. You know full well they would. Therefore, I am still spending taxpayers’ money and I intend to get value for it. If that means we have to curtail the service and have standby at night -- I think we could show you how many standby night calls ever occur -- then we will have to ask them to do that.

Mr. Conway: What about Uncle Lorne?

Mr. Eakins: Are you trying to make up what you lost in Ontario Place on the ambulances?

Hon. F. S. Miller: Take a look at the budget changes -- there was a 21 per cent increase between 1974 and 1975; 39 per cent the next year. The ambulance service hasn’t exactly been a slow growth business. All I’m saying to you is at this point we have to start getting value for money and that, sadly enough, means looking for --

Mr. Nixon: You’re the one who provincialized it.

Hon. F. S. Miller: -- some co-operation between the independents who have tended to run things their own way. Let me tell you, when these guys were running it with their own cash and collecting the money from the patients, they didn’t spend $62,000 a year running the service.

Mr. Mancini: I would like to bring to the attention of the minister -- I’m sure he’s already heard about this if he’s so concerned about the costs -- why did you meddle around with the Amherstburg-Anderdon-Malden ambulance service? Why did you fool around with a totally voluntary service which was hardly costing your provincial programme a penny? You wanted to go in there and make those people provincial.

Mr. Nixon: You took it over.

Mr. Mancini: You wanted to take over their dispatch service and they told you they couldn’t operate like that and still save the taxpayers a lot of money. But you and your director didn’t care at all. You had this big, grand programme in your mind that the whole ambulance service across the province was going to work for the Ministry of Health and here we go.

Mr. Hodgson: You are getting carried away.

Mr. Nixon: You took it over and now you are complaining.

Mr. Roy: You should get up and apologize.

Mr. Nixon: You want to call the tune and now you are complaining about paying the piper.

Mr. Mancini: Now that I’m on the point of the Amherstburg ambulance service --

Interjections.

Mr. Chairman: Would the hon. member for Brant-Oxford-Norfolk (Mr. Nixon) stop interjecting?

Mr. Nixon: Just assisting.

Interjections.

Mr. Hodgson: How many copies of Hansard do you want?

Mr. Roy: It’s okay; he’s going to be around here longer than you.

Mr. Nixon: Goodbye, Bill.

Mr. Mancini: Now that we’re talking about the Amherstburg ambulance service, I believe, if I’m not wrong, that they’re spending $40,000 to $50,000 per year from the Ministry of Health, and that the vehicles this service uses were purchased by the donations of the people in that tri-community. It wasn’t because of the Ministry of Health. There were $10 and $15 and $20 donations from ordinary citizens and you wanted to put those people out. That’s how much you care about restraints.

Hon. F. S. Miller: Mr. Chairman, I’m just tempted a bit. You know, those $10 and $15 collections, which are true, were used to buy a Cadillac because they weren’t satisfied with the ambulances other people had in the province, and we still happen to be paying for that unit.

Mr. Mancini: Mr. Chairman, whether they were Cadillacs or not --

Mr. Nixon: Didn’t the minister once run a used car lot?

Mr. Mancini: They were bought by the people of that tri-community with their own money and in the way they saw fit. They have over 30 people, and they have a large waiting list of people who want to get on the volunteer ambulance squad. You tried to squash that, so don’t tell me in this House about restraint.

Hon. F. S. Miller: Mr. Chairman, at no time have we tried to squash the Amherstburg service. For a volunteer service, $45,000 a year isn’t too bad.

Mr. Mancini: They’ll be glad to hear that.

Hon. F. S. Miller: Secondly, they do get the money back for their vehicles. While they insisted upon buying them, they still get depreciation allowance in their budget, so they get back the value of a normal vehicle from us. The differential between a Cadillac and a Dodge, which we would have provided, is charged to the local citizens. I have to tell you that in my own honest opinion, you don’t get to hospital any safer in a Cadillac than you do in a Dodge.

Mr. Mancini: I feel the minister is making a great to-do about the Cadillac that has been bought by the people of the Amherstburg area. But I’d just like to tell the members of this House that I have a great deal of respect for the people who run the Leamington ambulance service. It’s run by the Jacobs brothers. They do get quite a bit of money from this ministry. They spend over $100,000 per vehicle. The Amherstburg people run three vehicles for $45,000 and they have great service and there’s a lot of pride in the community.

It was a little less than a year ago that your director was down in the Windsor area and I believe it was the deputy reeve of Colchester South who heard him mention how he was turned off by the volunteer ambulance service people. It was the deputy reeve of Colchester South who brought this to my attention, and he also brought it to the attention of your director. So don’t tell us about your restraint programme because you tried to squash it -- a true volunteer service.

Now you try to make fun of it because of the vehicle which the residents in the area bought. You’re trying to tell the members of this House that they’re going out and they’re wasting money. They’ll be glad to hear that, because it wasn’t too long ago --

Hon. F. S. Miller: You are getting carried away.

Mr. Mancini: -- that the Premier (Mr. Davis) was down in our riding and he happened to visit the lovely town of Amherstburg. He took this very nice tour of the tri-community -- Amherstburg-Anderdon-Malden Station -- and he commented, “My God, you know, this must be one of the best branches in the whole province.”

Mr. Nixon: And they’re not getting paid?

Mr. Mancini: That’s right, we’re not getting paid. I wish your director would just come to grips with that. We’re tired of the cutbacks in Essex South in this ambulance area. If you think the people in Harrow could work with a 30 per cent cut, you’re wrong. You’re just not going to give the people the service and it’s going to be on your shoulders.

Mr. McClellan: Does the member for Renfrew North want a Cadillac too?

Mr. Conway: I must say, Mr. Chairman, I want not a Cadillac for Renfrew North, but a courthouse for York North.

Mr. Hodgson: Do you have any Cadillacs up there, Sean?

Mr. Conway: I thought it was Erasmus who authored In Praise of Folly but that speech from York North makes me think the farmer from up York North way --

Mr. Hodgson: We are not all farmers.

Hon. Mr. Rhodes: Knocking the farmers.

Mr. Conway: I just wanted to raise a very brief point again. It has to do with something the minister raised in one of his remarks not very long ago. That is having regard to what we all recognize is the serious escalation of the use of ambulances as taxis, which I think were your words. On a policy level, are you contemplating to perhaps discourage, if such is possible, that abuse of a very costly service? Having listened to your eloquent articulation of the concern and since it’s obviously part of the reason for the escalating costs in the ambulance services branch, I’m wondering if you or members of your officialdom are giving any serious contemplation to deterrents in that particular regard?

Hon. F. S. Miller: Yes. We’ve been very concerned about the use of vehicles for non- emergency purposes. So far we’ve been trying some jaw-boning in certain areas. I know I visited one ambulance dispatch in a major city where, when they got an obvious transfer call, they would point out to the person that they had to pay for part of the call. I’m giving serious consideration to ways and means of raising the deductible or perhaps even passing the whole cost on, if a person other than an officer or a doctor orders an ambulance for somebody for a non-medically necessary trip. We may have to go that route because ambulances are just far too costly for people to use as convenience vehicles.

Mr. Moffatt: I’d just like to ask the minister one brief question. If an official person, such as the principal of a school or the attendant at a hockey arena, summons an ambulance and it is deemed by your ministry not to be necessary in retrospect, then some other person will have to pick up that fee. That’s what you said.

Hon. F. S. Miller: I didn’t say that and you know it. I’m talking about transfer calls, and let’s listen to that. People call up in the middle of the day and say, “I have to be at such and such a hospital because I’m having my haemoglobin read.” They get taken down there and they get taken back. Theoretically, they spend $5 to do it. In many instances the hospital can’t collect it and writes it off because it isn’t worth pursuing.

All I’m saying is we can’t afford that. Obviously in the case of any call made in all seriousness because they think somebody was hurt or in need of a call, no one is going to argue with that kind of thing, now or in the future.

Mr. Moffatt: How many do you get?

Hon. F. S. Miller: Lots of them. I can give you the percentages.

Mr. Chairman: Shall item 2 carry?

Mr. B. Newman: I wanted to ask of the minister, now that the district health council has been formed in my own community, has he set a deadline as to when they have to report concerning the rationalization of the ambulance services in the area?

Hon. F. S. Miller: I can’t answer the question until I get the information. If you’ll just hold on a second, I’ll get it.

Mr. Conway: Did item 2 carry?

Hon. F. S. Miller: Just a second now.

Mr. Conway: Mr. Chairman, I directed my question of course to the Chair and not to the minister. I wondered if the vote had carried.

Hon. F. S. Miller: Only one of us can be on our feet at a time.

Mr. Moffatt: Well, sit down.

Mr. Conway: I wasn’t aware that the member for Muskoka was the chairman. I asked on a point of order.

Hon. F. S. Miller: I was just going to refer the question to the gentleman who just asked me. But I will gladly obey the Chair.

Mr. B. Newman: Mr. Minister, are you going to provide me with the answer?

Hon. F. S. Miller: Mr. Chairman, I was trying very hard to. The member for Windsor-Walkerville’s rather ebullient companion from Renfrew North was bouncing up and down like Alka-Seltzer in a glass.

Mr. Singer: What’s your next joke?

Mr. Breithaupt: Moving right along.

Hon. F. S. Miller: I am told the committee is expected to report in April or May on the rationalization in the Windsor area.

Mr. B. Newman: You are leaving the decision as to the type of service for the areas completely the responsibility of the district health council. Is that it?

Hon. F. S. Miller: I never leave the decisions entirely to them. I’m asking for their advice. The decision will be mine.

Mr. Conway: My apologies, Mr. Chairman, for my unusual intemperance in interrupting the Minister of Health. I just wondered, Mr. Minister, in following the comments that you offered in response to my good friend from Durham East, would you perhaps table the material which you said you had available on the calls and the abuse of calls? I’d be interested to see that.

[8:30]

Mr. Singer: Of course. With pleasure.

Hon. F. S. Miller: I don’t know if I can do it at this moment. I was told that code one calls are 25 per cent of the total; I can give you that information.

Mr. Conway: Are you aware of any pattern in those calls, as to where they originate or what kind they might be?

Hon. F. S. Miller: The one thing I can do with the ambulance service with great confidence is give you the statistics on the source of calls, the frequency, the type of call, all those things because OASIS, as we call it -- the Ontario Ambulance Information System -- really has --

Mr. Breithaupt: OASIS?

Hon. F. S. Miller: -- almost complete capability to draw a map of a given area showing where the calls originate and what type of calls they were.

Mr. Conway: I’m wondering, is there any evidence to indicate a pattern or a concern for the origin of calls which you might deem to be abusive?

Hon. F. S. Miller: I think it depends upon the community. We have some communities where there is a very high percentage of transfer calls from, say, the home for the aged to the local hospital and back, that kind of thing.

Mr. Nixon: And the doctor’s office?

Hon. F. S. Miller: I don’t know if they are to the doctor’s office so much.

Mr. Nixon: There are some.

Hon. F. S. Miller: In any case, we can get that information and I think it would be complex enough to be fairly voluminous. I think, for those one or two or three of you who’d be interested, I would suggest you spend an afternoon seeing the data and the sources of it and become familiar with the way the system operates. I think then you’d probably want to move over to this side and support me next time.

Mr. Breithaupt: I don’t think that will be quite enough.

Mr. Nixon: Not bloody likely.

Mr. Conway: On that point, I would be more than delighted, on the basis of an afternoon’s survey of that material -- certainly not to join that side of the House, God forbid -- to discuss with you some of your considerations for cutting back. One of the concerns I would have is that those cutbacks would not, as we’ve seen in so many other of the cutbacks administered by this government, lack sensitivity, particularly for those people in that area who might not be able to protect themselves.

Mr. Norton: Come on. Stop using that language.

Mr. Conway: I’d be quite happy to spend an afternoon looking at that data.

Mr. Norton: You can do better than that.

Mr. Angus: You had your chance this afternoon.

Vote 3002, item 2 agreed to.

On item 3, institutional care services:

Mr. Ferrier: I’d like to deal with --

Mr. Conway: Gold mines?

Mr. Ferrier: We’d like to deal with those, too.

Mr. Wildman: Are you against gold mines?

Mr. Conway: Not at all.

Hon. F. S. Miller: Gold mines and ambulances have a lot in common.

Mr. Wildman: What disease did you have?

Mr. Chairman: Could we have some order, please?

Mr. Ferrier: About a year ago the minister announced that he was closing the northeastern regional mental health centre and he was going to transfer the services provided by that centre to North Bay. After quite a campaign, he said he was going to set in place some community mental health care teams and a 20-bed psychiatric unit at St. Mary’s Hospital in Timmins.

Mr. Conway: That will defeat the government the next time.

Mr. Ferrier: They gave us the story at that time there weren’t going to be too many people from our part of the country who would need to be in a mental hospital for a very long period of time and most of them would be treated in our area anyway.

Mr. Wildman: We’re the only sane people in the province.

Mr. Ferrier: I have a letter from the minister dated October 5 and I had asked earlier how many patients were in North Bay from our area. Curiously enough, there were 79 patients in North Bay and a number of them were from my riding; quite a number of them were from the riding of Cochrane North and others were from the riding of Timiskaming. While the 20-bed unit at St. Mary’s served a purpose and has been looking after a number of people on a short-term basis, it still means that a lot of people from my area and these other areas have to drive all those miles down to North Bay for any long-term treatment; and in this case there are 79 people. In certain instances you’re sending them down by ambulance if they’re so disturbed. It means those people have to be a long way from home; and the families, if they are going to see them, are the ones who are having to pay the extra expenses in terms of travelling arrangements and perhaps overnight accommodation in North Bay on a weekend so they can visit a little longer.

I don’t accept the solution you provided in that part of the province, because there is no other part of the province that has to go so far for psychiatric care. We are lucky, I suppose. Every week or two the psychiatrist from North Bay comes up and does a quick assessment of those who may be in Timmins. To my way of thinking, you haven’t really provided the kind of service we had before.

Mr. Chairman: Will the member for Ottawa East (Mr. Roy) and the member for Sault Ste. Marie (Mr. Rhodes) stop mumbling above their breath?

Hon. Mr. Rhodes: He is bothering me.

An hon. member: Don’t tell the House.

Mr. Chairman: Ignore him.

Hon. Mr. Rhodes: He is speaking French and I can’t understand him.

Mr. Nixon: Chauvinistic minister.

Mr. Chairman: Just ignore him. The hon. member for Cochrane South may continue.

Mr. Ferrier: Yes, I think it would be a good idea if they talked outside if they’ve got something to say.

Interjection.

Mr. Bain: They don’t. That’s why --

Interjection.

Mr. Ferrier: But the people in my area, at St. Mary’s Hospital in particular, have decided that to serve the community they would take on the extra programmes that were needed in terms of the 20-bed psychiatric unit and the outpatient care that’s provided for our part of the province. There’s another outpatient care programme operating in Kapuskasing, I believe, and one in the southern part of our area; I don’t know whether it’s in Tritown or in Kirkland Lake. Since then you’ve also put in place a children’s programme, for which I think you’ve allotted $188,180; but I don’t know how well that’s working out.

When you take a look at all the programmes there -- the people you’re treating in North Bay and the extra cost for those; the psychiatric unit at St. Mary’s; the three community programmes; the children’s programme; and then the cost of the retarded centre -- I really wonder what saving you’ve effected by that at the cost of a good deal of disruption as far as the community is concerned.

You’ve made a significant improvement as far as the mentally retarded are concerned, but you certainly have seriously disrupted the mental health programme. If this programme we have is so good, why don’t you move in a big way to implement it throughout the rest of the province and save some money there too? I think you’ve just used us as sort of whipping boys. That’s the kind of treatment the north gets all the time.

An hon. member: In the ear.

Mr. Ferrier: The resentment we’ve built up against the south and this government has got lots of justification and lots of basis. This is just the kind of thing that happens.

St. Mary’s Hospital did agree to take that programme. First of all, they were in quite a period of consultation with officials of your ministry as to what kind of a budget they should set up and what kind of a programme they should implement. They did almost everything in conjunction with officials of your ministry. Your ministry said to do this and to do that, and in many cases that is what they did. The budgets were not approved this last year until way on in August and, lo and behold, you had cut the programme in the psychiatric services at St. Mary’s way back. You’ve got the letter I had so I can’t quote the figures but it was quite dramatic.

Hon. F. S. Miller: It is part of the year.

Mr. Ferrier: I don’t know whether it was part year or not, but it was a major cutback to what they had requested.

So they came down and they talked to John Maynard, I think it was, one of your officials and they talked to you at the Ontario hospital convention and you restored some of that budget, so it wasn’t such a dramatic cutback as appeared when you gave the first letter of approval. But even with the part you restored, there are still some major things left out of that budget.

They were led to believe by officials of your ministry that the renovations for the outpatient programme in the old nurses wing and the putting in of some new windows -- because they say there are spaces beside the window frames so you can see right outside and it’s pretty cold -- that those kind of things would be considered as operating expenses. After they submitted them your people said, “No, that’s not operating expenses, that’s capital expenditure and you’ve got to treat it as that. You pay a third and we’ll pay two-thirds.”

They felt that because they had taken the programme to help the ministry out and to help the community out that they wouldn’t have used that part of the nurses residence or they wouldn’t have had to knock out partitions and do all that kind of work. They felt it wasn’t justified that you asked them to accept that as a capital cost.

Another thing that was very bothersome to them was the fact that there is no security officer, I believe, in either the inpatient wing or the outpatient wing and you expect nurses to deal with a person who is very disturbed. They have had people who jumped out the window. I think that kind of thing needs serious consideration.

As far as the rehab programme and the aftercare programme was concerned you arbitrarily cut it in half. It just looks as though somebody said, “Well, that’s too much so we’ll just halve that,” as though they are a computer or something that doesn’t try to understand what is involved.

If you’ve made the major saving that you say you are going to be making at our expense, then I don’t think those kinds of parings and seemingly arbitrary cutbacks are really justified. The people have tried to work with you on this programme and they feel kind of upset about this. I know you can come back at me and say that as far as the capital construction programme is concerned it was tendered a good deal more than you had allotted for it. We appreciate your concern and your funding of that, but if they hadn’t accepted the tenders the work wouldn’t have gone on anyway, so it wasn’t really their fault that it was over and above.

I know that you are having this looked at and I hope that you are prepared to make further adjustments, because those people have got so disturbed that they say they can hardly talk civilly to the people from your ministry when they go up there.

[8:45]

The other thing I want to bring up in connection with this is the whole question of the district hospital that you’ve been talking about. Apparently, a reporter from the Porcupine News phoned down and you told him that because the hospitals weren’t prepared at this juncture to accept the health council’s recommendation of getting the two hospital boards together you had shelved the project and you weren’t considering it. That’s the way it came out in the Porcupine News. The thing that bothers me is if you go into an area and make a commitment that you are going to do something, surely you must have some studies and some reports that would lead you to believe that this is the course of action to take. You surely are not guided solely by political expediency.

Interjections.

Mr. Ferrier: I’ve gathered that the minister has tried to operate the ministry apart from crass politics, that he’s tried to do things on a rational basis --

Mr. Bain: He is crass politics with a smile.

Mr. Ferrier: -- with facts and figures and valid reasons for the policies that he puts forward and the decisions that he reaches. I would expect there are lots of this kind of study and thought and reason that would lead him to make the statement that he thinks there’s a district hospital needed for that area. I think there is at some juncture. Certainly there needs to be some way of attracting specialists into that area and there’s got to be some way of providing greater bilingual service in the whole of the northeast.

There are also political considerations in the consolidation of the city of Timmins. The community of South Porcupine is very jealous of its community. They still are not thinking completely of Timmins as one city and it’s going to take some time to work that out. I don’t think leaving the two boards as they are and encouraging greater co-operation is any reason for scuttling a regional hospital which you originally had proposed. It’s going to require some statesmanship and some tact, but we are growing together slowly and in time we will come together as far as hospital care is concerned much more quickly than you really think.

There’s already a piece of property bought which all have agreed is a valid location. It’s on the outskirts of what used to be the town of Timmins. I think your health council has got to be a little better in selling some of the proposals they formulate. I don’t think they’re very much in contact with the communities they are supposed to represent. I don’t know that you’ve got any elected persons on there. They are all appointed. I don’t think there’s the councillor of one municipality on it.

Hon. F. S. Miller: Yes.

Mr. Ferrier: I’d like to know who they are. Maybe you can tell me when you reply. I’m not so sure that the health council is really selling any of these programmes. They are putting forward ideas and then they are letting the people run off in two different directions. As I say, I think it’s going to take time, but all the area will accept a district hospital in time.

That report in the Timmins-Porcupine News that the whole thing is now off because you’re having problems was a little bit premature, I think. I hope you’ve thought a little bit more about it or else maybe you’ve been misquoted. I hope you’re keeping your options open and will look at the kind of service that you hope to provide at some point when the funds are available in that region.

You have talked to me about a rehabilitation area for chronic care people -- and that you think there are a number of chronics who can be rehabilitated. You want that kind of a facility some place in the northeast and maybe that’s in your thinking about the regional hospital, I don’t know. But I don’t think you should scuttle those kinds of thoughts and plans that you have had all of a sudden. I think that they are reasonable -- they are feasible. But it is going to take a little bit of a selling job by some of the people up there -- you want to pour a little bit of oil on troubled waters and get the trust of the whole community and then you can go ahead.

I have spoken quite lengthily and maybe the minister will have some response.

Hon. F. S. Miller: Mr. Chairman, I seldom congratulate members, but I realize when we moved into your town and closed the psychiatric hospital we were causing major problems for the district. I have to say that while you pleaded for -- I think the wrong mike is on again, by the way. Is that one not working?

Mr. Angus: Eenie, meenie, minie, moe.

An hon. member: Move over one notch.

Hon. F. S. Miller: I can move over one notch as long as it gets it on the record, because otherwise it doesn’t show up.

Interjection.

Hon. F. S. Miller: I am not worried about you hearing. I want Hansard to get my words of wisdom.

Mr. Moffatt: Recorded for posterity.

Hon. F. S. Miller: I have to say to the member that considering the difficulty of the case he acted in a very reasonable co-operative way while putting forward the legitimate complaints of the people in the area. I have to also say that the hospital did. In the beginning one of our compromises was to leave the 20 beds at the psychiatric hospital base, even though in our own opinion they were probably better in town. The hospital then suggested that it would take these beds.

We have had problems, and all I ask is some understanding at the local level that the programme is not working as well as it should mainly because we still don’t have a psychiatrist. It is interesting that the other town in which this same change was made, Goderich, has found that the 20 beds are adequate. Outside of some professional disagreements that are going on, we believe the programme is coming along reasonably well -- and I heard that from their own lips last week. So I have every reason to believe that as we get a psychiatrist to go north, and as you know that has always been a problem even when we had the psychiatric hospital there, then the programme itself should meet our expectations.

Let’s both keep an open mind on the question of money. Hospitals quite understandably have a tendency, whenever something new happens, to do their best to get the maximum number of dollars added to the base for that programme -- because we don’t restrict the spending of those dollars to the particular programme. I suppose it’s like bartering cars. They are just trying to make the best possible deal for their hospital. They are doing, I am sure, an honest job. But at the same time I have to look at it with a bit of a jaundiced eye to see that they aren’t getting a few things in that perhaps they might have wanted for other things that they couldn’t get in the normal course of events. Let’s both keep our options and our minds open on that, and I hope we will find a resolution that’s fair.

As you mentioned, I have seen the board chairman at least twice on this issue -- three times that I know of, as a matter of fact. The first time it was related to the health council’s desire for them not to build their addition. I then got the two of them together in the middle of the summer and got agreement to go ahead, even though had the new hospital been in the immediate future it would have been wise not to spend that money. That very agreement tacitly accepted the fact that the new hospital was still some years off.

There are people who say we don’t need a new hospital in Timmins -- that in fact the two hospitals are adequate. I think though when I visited you first in May, 1974, I was impressed with one thing. The communities of South Porcupine and Timmins had already agreed that they wanted one hospital. They knew where they wanted it and they weren’t arguing about it. That impressed me. I was very fresh from the Haileybury-New Liskeard-Cobalt problem. It hadn’t quite reached its climax at that point, but certainly I was aware of the potential down in that area. If you look back at the clippings from your newspapers in May 1974 and again later, they mention me commenting that where hospitals were obviously working together, as Timmins and South Porcupine were, the chances of getting money, in a very competitive age and time, were better. I still say that.

The health council did make a recommendation that seemed logical, that if the new hospital was to be built and the site was already agreed upon, they should start amalgamating their operating facilities between now and then so there would be an orderly changeover. They even recommended a time to do it. What surprised me was the violence of the reaction against it. If it was political, then I don’t understand it, because the chairman of the board of the hospital that is objecting is a good member of my party, I understand. I can’t really be accused of arguing with a man who isn’t on my side to begin with; he is -- or was.

Mr. Conway: Send him to Lorne.

Hon. F. S. Miller: I think my comments there were that I was concerned at what the evidence meant -- not the evidence, but the implications of the reluctance to join boards. It made me wonder if the agreement to have one hospital was as real as the advocates had made me think it was on my two trips to Timmins to look at the site. To me, that’s the major problem, because I don’t really want to have another Tritown problem. I think the indication of good faith has to be evidenced by the combination of boards some time before the hospital construction begins. If we need to wait a while, fine, I am not shelving the project, but I point out that the risk of them not being able to co-operate does have the resulting action of delaying or possibly delaying the final building of the hospital.

We said two years ago it would probably be 1980 at the earliest before that hospital would be built -- or in the 1980s. I think somebody misread it in the paper, when I said it could delay it two or three years, to mean that it wouldn’t be built until 1980 with the delay. I say to you it could be later than that because of the lack of apparent co-operation on the local scene.

If it is illustrating a reluctance of the two towns to come together, yes, I agree we’re wise to wait a while. I don’t think it jeopardizes the eventual outcome, but that outcome has to have local acceptance. I’m just not going to ram that one hospital down the throats of the two communities until I’m sure both boards want it to occur. That’s really all I was saying.

Mr. Roy: Mr. Chairman, I have been wanting for some time to discuss with the minister the hospital facilities in Ottawa. I suppose the last time we had a discussion about them was back in the election of 1975, a year ago, because I have not had occasion to discuss these matters at any length of time in the estimates.

I recall the government got all hot and bothered during the election of 1975 when the doctors at the Ottawa General Hospital put out a report. That report stated, I suppose in very concrete and very vivid terms, the human suffering that was involved in the delay in admitting patients at the Ottawa General Hospital. We’ve known and talked for years about the fact that, in terms of roads, justice facilities, hospital facilities and other facilities, eastern Ontario, and Ottawa in particular, was not getting its fair share.

Mr. Conway: Here, here -- inequality.

Mr. Roy: Over and above this, we now find that not only don’t we get our fair share of facilities or provincial government services, but we pay higher taxes. And we pay higher taxes because the minister’s colleague, the Treasurer (Mr. McKeough) has imposed regional government on us.

Some hon. members: Oh, oh.

Mr. Conway: They put up with the fellow from Renfrew South (Mr. Yakabuski).

Mr. Roy: The Treasurer is the fellow who masquerades as the champion of local autonomy and says he doesn’t want to interfere, but he imposed regional government.

Mr. Nixon: He did that. We voted against it.

Mr. Roy: In any event, it was fully documented in the election of 1975 what the lack of health care facilities meant in human terms in Ottawa and at the Ottawa General Hospital in particular.

[9:00]

I think the minister is obviously aware of these statistics, but just to give you an idea, if one looks at the funds expended in health facilities since 1966 in various areas of the province, the figures are there. But we’re only talking about millions of dollars, we’re not talking about human suffering; we’re not talking about delays; we’re not talking about doctors who can’t have their patients enter hospitals, or patients who are waiting for serious operations and who have to go through undue delays in length of time; we’re not talking about chronic-care patients who are taking up active-care beds and so on.

So I say, when you look at these statistics of the millions of dollars which are expended in various areas, it’s there in terms of money. If you look, for instance, at what has been spent in the London area since 1966, we come to a figure of something of $192 million in London.

Mr. Nixon: One hundred and ninety-two million in London. There is no regional government there.

Mr. Roy: In Hamilton, something like about $217 million dollars has been spent from 1966 to 1975. If you look in Toronto, it’s $478 million. Of course, if you look in Ottawa, you’re at the rate of about $165 million.

Mr. Nixon: That’s the nation’s capital.

Mr. Roy: How is it that in an area where the population is superior or at least equivalent to Hamilton, and certainly greater than London, we’re getting fewer health facilities, that we’re given less funds than those areas? The figures are there.

What happens Mr. Chairman, is that -- I was going to call you Mr. Speaker, but that word I say with caution these days -- Mr. Chairman, I want to say to you that we’ve known this for years and the people of Ottawa have complained for years. The reason is certainly not obvious because if there is an area in the province that has sent a lot of Tories down here it’s eastern Ontario.

Mr. Conway: That’s what got them the new hospital in Muskoka.

Mr. Roy: I look across at my colleague from Ottawa West who joined with me last year in complaining about this situation. Maybe he will join me again this evening.

Mr. Nixon: He is the francophone member.

Mr. Roy: Yes. But I say to the minister, and I say it especially to my colleague from Ottawa West, what has happened is that the Tories from London, from Hamilton and from Toronto have out-Toried him. They’ve had a position closer to the ministry, to the strings of power, to the funds, to the pocketbook. That’s where the funds have gone.

Mr. Conway: That’s the trouble.

Mr. Roy: I want to say to my colleagues that we could talk about millions if they like, but what it boils down to is a question of human suffering. At that point in 1975 during the election a report was brought out by doctors and it said, for instance, on the question of emergency cases, that emergency patients had to wait sometimes 15 hours for treatment. We’re talking about people who are waiting in the emergency department of the Ottawa General Hospital; we’re talking about urgent cases; we’re talking about cancer operations where people had to wait two or three months for an operation.

Things like that don’t happen around Toronto, London or Hamilton. The doctors in Ottawa discuss this with their colleagues in Toronto and it’s a farce. They say, “How come you’re waiting two or three months to get patients admitted in your hospital when down here --” in fact, you went out and polled sections of hospitals in other areas.

Of course, elective surgery around the Ottawa General Hospital is for all purposes non-existent. But this is not limited to the Ottawa General. I was talking again recently with the doctors at the Civic and they’re starting to experience problems as well. What happens is that there’s a vicious circle going on. The ministry says, “One of your problems in Ottawa is that you have too many active-care beds taken up by chronic-care patients.” The doctors say, “That’s right, we do, we have that. But where do we put the chronic-care patients? We don’t have any beds for them.” It’s sort of a vicious circle. You say, “You’re spending too much money because your chronic-care patients are taking up active-care beds and could be taken care of more cheaply in other institutions.”

Having heard this argument long enough, the people at the Ottawa General have tabulated a whole list of hospital days lost as a result of lack of chronic-care facilities, for instance. I’ve got all of these here, dating back to November 1975. Just as an example, I look at November 1975 and I see here that there were 548 hospital days lost, active days lost. When you consider that the average stay of a patient at the Ottawa General is 9.78 days, it means that 56 patients could not be admitted because chronic-care patients were taking up these beds.

So there were 548 days in November of 1975. If we go into January, 1976, during that period of time there were 1,313 days lost. Again, if you look at the 9.78 days of the average stay, 134 patients were not admitted because of the chronic-care patients taking up these beds.

I can go on, Mr. Chairman, and I think I will. In February 658 days were lost; 67 patients could not be admitted. In March, 1976, there were 555 days; 56 patients could not be admitted at the Ottawa General Hospital. In April, 1976, 919 days; 94 patients could not be admitted. In May, 1976, we lost 1,066 days; 109 patients could not be admitted because of the lack of chronic-care facilities in Ottawa. In June, 1976, 315 days; 32 patients could not be admitted. In July, 1976, we’ve got 511 days; 52 patients could not be admitted. I go right down to October, 1976, where we have 429 days lost; 44 patients could not be admitted.

So it’s obvious from these statistics, Mr. Chairman, that the situation is really not improving in Ottawa. We’re scurrying around from one institution to the next, trying to find chronic-care beds. We don’t seem to be moving at all on the question of the new hospital related to the University of Ottawa. There seems to be an approach taken by this government to delay things. We’re facing an austerity programme; the minister is going around the province closing up hospitals, whether he’s got jurisdiction to do it or not. The delay and the fact that you’ve not spent adequate funds in those areas is being felt in human terms.

These hospitals get ministerial orders saying, “Tighten up your budget, you should be operating more efficiently.” I guess they’d be operating more efficiently if they could get their chronic-care patients out of that hospital.

Mr. Chairman, I know this minister is not running the whole show -- he’s got to speak to Darcy once in a while -- but the fact does remain that it’s reduced in human terms. The doctors, I suppose by nature, are reluctant to get involved publicly in this. When you brought out this report last year -- oh yes, they were rebuked -- and one of your colleagues, the member for Ottawa South (Mr. Bennett) said, “Oh yes, there’s a problem in Ottawa -- it’s those Quebeckers who are coming across the river.” Just as though Quebec has moved there over the last while, at which time provisions are supposed to be made about Quebec. That is a red herring. You know it’s a red herring, and you know it’s a fact.

Mr. Moffatt: Did he say that?

Mr. Roy: Yes, he did.

Mr. Conway: I thought it was Paul Yakabuski’s redneck contribution.

Mr. Roy: The member for Renfrew South did say that as well.

It is a fact, that the health facilities in western Quebec are not adequate, but then it’s a fact of life that Ottawa just happens to be across the river from Quebec and that there are patients who go both ways. There are Ontario patients who go to Montreal and there are patients who go from Fort Francis or the Lakehead to Winnipeg. I think one of your colleagues suggested there should be some sort of penalty for patients who come in from outside the province and use these facilities. I say it’s a two-way street. Ontario is using other areas, and their minister was sensible enough to see that could not be corrected that way.

But what I want to hear from the minister, Mr. Chairman, is when he is going to honour his promises about chronic-care facilities in Ottawa. He has not lived up to them. There was a promise of 300 or 400 chronic-care beds. We’ve seen at best -- what 200? -- not even 200. The last figures I saw indicated we did not have 200 chronic-care beds in Ottawa.

But the question remains, when is construction going to start on the new Ottawa General or the new hospital which is supposed to be attached to the University of Ottawa? The Ottawa General Hospital, which is still operating now, was condemned by about four of the minister’s predecessors, back in 1960.

Mr. Nixon: Going back to Matt Dymond.

Mr. Roy: Yet that’s still the facility we’re using. I think it’s high time that the good life enjoyed by citizens in Hamilton or Toronto, and the facilities enjoyed by people in London and so on may be enjoyed by people in the Ottawa area. I think it’s time the minister really made a commitment to that area. It’s all very well to talk millions, because most people feel it doesn’t affect them personally, but it affects them in human terms when you see the documentation that was prepared by the doctors at the Ottawa General Hospital.

I would like some response from the minister on this issue, because I want to speak a little longer on the other question of French-language facilities. I can hardly lift this report, but I want to talk to the minister about it a little later.

Hon. F. S. Miller: I’m sure the hon. member’s comments will read very well in the local press when he sends them home, but I think he should look at the shopping list for the city of Ottawa and he’ll realize it hasn’t done too badly. In fact, I’m sure some of his colleagues beside him would like to see their own communities do so well.

Two new hospitals were completed within the last few years; the Children’s Hospital of Eastern Ontario and the Queensway-Carleton, which is just coming on now. One new hospital is already planned -- Ottawa General -- at $61 million.

Mr. Roy: When?

Hon. F. S. Miller: My friend, they are seeing me tomorrow about the money. We’ve put up our share; now we have to get their share.

Interjection.

Hon. F. S. Miller: There’s a poison control centre, one or two in Ontario, in Ottawa. A brand-new cardiac unit at the Civic Hospital, costing over $2 million a year to operate, started this year. More than 190 chronic-care beds were added this year. That’s pretty good for one city in one year. There are 322 of your beds being used almost steadily by people from Quebec. That may be a two-way street, but certainly it seems to have more traffic one way than the other.

Mr. Morrow: Just one way mostly.

Hon. F. S. Miller: When we look at those factors, I think we have to realize we have a problem. There were something like 300 people sitting in the Ottawa hospitals who were chronic people. We now have an assessment and placement service functioning in Ottawa as a result of my visit there in September 1975.

You have about 3.8 beds per 1,000 people in Ottawa, I think. That’s twice as many as some jurisdictions in the United States --

Mr. Roy: How does that compare with London and Hamilton?

Hon. F. S. Miller: In London I will be closing 1,000 beds one of these days.

Mr. Ferris: What?

Hon. F. S. Miller: My deputy says 400 initially.

Mr. Ferris: A thousand?

Mr. Bain: That will make a nice headline in the London paper.

Hon. F. S. Miller: We’re hoping to get the Westminster Hospital in our control; that’s where the closures will come. That’s been on the books for a long time.

Mr. Ferris: Every election it’s been on the books.

Hon. F. S. Miller: The fact is it’s being held up by the federal government -- not by the province of Ontario.

Mr. Ferris: You said it was finalized weeks ago.

Hon. F. S. Miller: No, I didn’t. I said we’ve crossed the last hurdle; that’s what I said.

Mr. Ferris: What are you going to do --

Mr. Nixon: Frank, you should be the last minister to fall into that excuse. The Minister of Housing (Mr. Rhodes) blames the federal government, but not you.

Mr. Acting Chairman: Order, please. The minister has the floor.

Hon. F. S. Miller: Not only that, I went to the province of Quebec --

Mr. Nixon: You get half your budget from Ottawa.

Hon. F. S. Miller: I went to the province of Quebec on November 11, 1975. I negotiated with the Quebec minister to get 200 more beds opened in Hull. I’ve been given the assurance that would be done. So those things I think I did in the interests of Ottawa, and reasonably effectively.

Mr. Roy: Just to clear up the record about these hospitals that you’re talking about. First of all, the citizens of Ottawa and area got together and there was a fund drive for the Children’s Hospital. However, the Children’s Hospital was a necessary institution and, therefore, it did not alleviate the lack of active care beds for adults in the Ottawa area. Let’s be fair about that.

The second thing is that the Queensway-Carleton Hospital was built in an area because a number of citizens from Ottawa -- I’ll say it, and I don’t want to offend anyone, but a good bunch of Conservatives got together and said we need a hospital in west Ottawa.

Mr. Moffatt: Those are mutually exclusive terms.

Mr. Roy: They got funds to build this hospital but, as you know, this hospital is being used basically for chronic care. They don’t have many active care beds.

In relation to Ottawa General, where the minister says he’s going to spend $61 million, that hospital has been needed since before 1960. I’d like to know from the minister whether he’s prepared to put on the record a commitment that there will not be any delay in this. If the minister is trying to say that Ottawa has been spoiled the last while, that is not the case. Some of these are specialized, needed facilities which are taken for granted in other areas of the province. But the Ottawa General is something that has been planned and worked on for many years and it is something we need.

I want the minister to make that commitment, that there will not be any delay in the construction of that hospital.

[9:15]

Hon. F. S. Miller: Mr. Chairman, it’s very easy to make promises if you don’t have to do the -- if you’re not responsible; that’s one of the luxuries of the opposition.

Mr. Conway: The Premier (Mr. Davis) does it all the time, he ran a whole campaign on it.

Hon. F. S. Miller: The fact remains we had set a price on that hospital. If tomorrow, in my discussions with the various people -- and I am seeing them tomorrow --

Mr. Eakins: The minister will be doing it in a few months, why not start now?

Hon. F. S. Miller: That’s fair enough. The electorate will have their chance.

If the total cost is properly within those limits which we have prescribed, then you get your hospital almost immediately.

Mr. Roy: Yes, but as the delay goes on and it’s stopped and it’s on the books again, you’re really saying to the people with your budget, “We’re going to give you less beds.” And that’s not what is required there.

Hon. F. S. Miller: If you think that increasing our share from $30 million to $42 million, or whatever it is, after allowing for inflation, is not accurate, then I haven’t read it. We have used the indicators the federal government gave us for inflation since the hospital was originally costed. We have allowed for all those in increasing our share. That is done.

Mr. Roy: Okay. I think it’s obvious, Mr. Chairman, that my point has been made. The concern of the minister in addressing himself to that problem is the best evidence there was a real shortage in Ottawa. I give this minister some of the credit for it. But I think that one of the reasons for it is because there was such a stink raised about it during the last election. We were concerned about this problem, and the way to get response and to get public support was to put it in human terms.

Mr. Conway: It doesn’t help eastern Ontario.

Mr. Roy: The other thing I want to talk to you about is this report here that I can hardly lift. In fact you probably do exercises on this every morning, lifting it up and down. It’s called “Report on the French Language Health Services, Task Force ‘76.”

Mr. Maeck: Don’t go through it page by page.

Mr. Roy: I suppose I should give you some credit for having established it and for taking a look at the problem of the lack of French in health services across the province. I think the title speaks admirably for what their conclusions were: Pas Problème, No Problem? -- which is basically the approach that’s been taken by the government.

Hon. F. S. Miller: Mr. Chairman, there is a question mark at the end of it, you know that.

Mr. Roy: Yes. There is a question mark, and it’s well placed.

Hon. F. S. Miller: Yes.

Mr. Roy: If you look at the report they mention without any hesitation that this government does not proceed very swiftly in the implementations of bilingualism. They’re being kind when they say that. From the basis of policy to the implementation of the actual facilities or services, sometimes there is quite a delay.

Mr. Conway: But you will get a new driver’s licence.

Mr. Roy: I think what they’re saying basically is that this government, in spite of the policy, has not really made the sort of commitment you would think a province like Ontario would make. For instance, it should not be prepared to accept that in areas of eastern Ontario there would be psychiatric care facilities treating people, when they can’t even communicate with them. It seems to be a lack of humanity to be attempting to treat patients who have this sort of problem when you have difficulty communicating with them.

The children’s hospital in Ottawa, for instance, was meant to be a centre for all of eastern Ontario. Some centres in eastern Ontario -- for instance Prescott-Russell -- are 80 to 85 per cent French. You’re bringing children in there, and yet the doctor or some of these specialists -- 12 out of 12 of these specialists can’t speak French. Eight out of eight of the heads of the nursing sections can’t speak French. Of the 12 interns and residents, only three can understand French. When you get with children it becomes a problem to communicate. How can you treat them if there is some difficulty in communicating with them? It goes on.

The minister has told me personally before that the way to solve the problem is to proceed with caution, not to raise the flag, as you say, because there is a backlash. I’m not without knowing that it exists and not without knowing that we are politicians and that you don’t want to push too hard because you get a backlash the other way. But it reaches a point where caution really becomes an excuse for not doing anything. If there is a commitment and there is a policy, then you should proceed with it. I think there is that responsibility on this province.

I don’t want to start sabre-rattling and say if the people in Quebec feel the way they do and if they vote the way they do, it is because they feel that they can only keep their culture and exist as French-Canadians in the province of Quebec. I don’t like to use that sort of thing. It is just like saying to Quebec, that if you people decide to go and separate economically things are going to be tough for you. Surely that is the type of blackmail we shouldn’t use.

But if we are going to show good faith as Canadians, if we are going to say to the French-speaking Canadians in Quebec, look at how we treat our minority groups in Ontario and we want you to treat the English-speaking minority in Quebec the same way, do you think the English-speaking residents have that problem in Quebec when they go out for hospital facilities or hospital services or health services in that province? The same thing could be said about the courts and so on.

I think we have to make that sort of commitment, especially from this province, because if we don’t succeed in this province, that’s the ball game if this province can’t make that sort of commitment.

The best evidence that the system works is to show that the minorities in this province can exist as Canadians and can keep their culture and their language. That’s the way we operate. That’s the evidence right here and a special relationship that Ontario has.

But if we are not prepared to make that commitment here, as Levesque takes over in Quebec, you can just feel it in this province now. I saw it the other day in the House when people felt we’ve got to start doing more. The Toronto Star is starting to write front-page editorials and all that stuff.

Surely we shouldn’t have to wait for that. The commitment must be made and we must proceed with it. I say to you, Mr. Chairman, and to my colleague, that that is the best evidence of the commitment towards this country and towards the protection of the two groups and of their culture and their language. When we get into a situation where we have reports like this that say there is no problem, then that’s what they are going to say in Quebec as well, that there is no problem either.

Hon. F. S. Miller: I think the last sentence needs to be rephrased a bit. You know full well that report is not saying there is no problem. The very reason for choosing that title was to emphasize the fact that there is a problem. It wasn’t trying to downgrade it. If anything, it highlights it with almost 300 recommendations of one kind or another. There are an awful lot of specific ones in that report. I have read the thing in both languages, as a matter of fact, in an attempt to learn a few more words in the French language because I don’t pretend to be bilingual --

Mr. Roy: You are not bad.

Hon. F. S. Miller: -- even though that report kindly says I am. I see there’s a footnote on page 8, or something to that effect.

Mr. Cassidy: They were casting around for straws at that point.

Hon. F. S. Miller: They were casting around for straws, but I had met with the committee a couple of times. We commissioned that report. We asked people we know would look at the situation and tell us if it wasn’t good enough. We didn’t ask them to write a report saying we are great guys.

Mr. Roy: I hope not.

Hon. F. S. Miller: We asked them to tell us where on earth we could find a better way of serving the legitimate needs of a minority in this province, something our government is prepared to do. It’s much more popular in terms of vote-getting in most of our ridings to stand up and be anti-French culture. The fact is that consistently the Premier and a number of us have stood up and been the opposite. I have been and I will continue to be.

Mr. Conway: Not all of you.

Hon. Mr. Rhodes: Not all of you either, pal.

Hon. F. S. Miller: Not all of you. I think individuals often react in their own areas to these problems. The fact remains that I recognize the legitimate needs. I do recognize that not every Ontario citizen who speaks English finds it easy to get service in Quebec in his own language. I have had to go through that myself a few times with little kids who were hurt in an accident on the highway or something. I lived there for six years of my life, but I will say it is easier in Quebec than it is in Ontario. The basic thing that report points out is that it is not a policy problem but a fundamental shortage of trained people in the health care field who can speak two languages.

Mr. Roy: That’s right.

Hon. F. S. Miller: I can wave all the wands I want in terms of policy but we have to have people there who can speak both languages. Frankly, Ontario has been far more liberal.

Mr. Cassidy: It reflects your lack of priority, though.

Hon. F. S. Miller: Sure, it’s a priority. The fact remains --

Mr. Cassidy: It reflects your lack of priority.

Hon. F. S. Miller: Please let me talk, Mr. Cassidy. The rest of the evening has been quite tranquil.

Mr. Moffatt: Only because you were making progress.

Mr. Eakins: You were moving right ahead too, Frank.

Hon. F. S. Miller: The fact remains that the University of Ottawa, if you look at the number of French-speaking students in the medical field --

Mr. Roy: It’s criticized as well.

Hon. F. S. Miller: -- quite a few of them are from the province of Quebec, right? Sadly enough, they will go back and practise there I assume. At the same time, we have great difficulty -- not impossible odds, but great difficulty -- getting French-speaking Ontario citizens into Quebec universities, do you agree with that?

Mr. Roy: I wouldn’t be surprised.

Hon. F. S. Miller: So I think almost half the students in medicine at the University of Ottawa are from the province of Quebec. I’d be delighted to have them stay if they were going to help us out in our problems.

We are determined to act upon as many of those recommendations as we can, as quickly as we can. I’ve said, I think to the member for Cornwall (Mr. Samis) the other day, that I hope to be able to reply within two months to all of them, or to most of them anyway, and at the same time recognize that that report is written with the ideal in mind and that probably we both agree that not everything recommended in there is entirely practicable. We’ll take that which is possible and we will do it at a speed that’s acceptable to the majority of the people in this province. I think in the final analysis we will have served both parties well.

Mr. Roy: I just want to mention this thing: I don’t want to say that you haven’t done things, but all I want to emphasize is that the title really reflects to some degree the state of mind of this government.

Hon. F. S. Miller: Sure it does.

Mr. Roy: You really were overly cautious. The time to be overly cautious about Confederation or the unity of this country and so on is pretty well over. For those of us who believe in the same things that you and I believe in, it’s time to stand up and be counted and be prepared to lead. I think it’s high time that we showed some form of leadership in this.

The report, if nothing else, will make you realize there are many areas which must improve, that there are going to be some problems in accepting or in implementing some of these recommendations. But the fact remains that the commitment, if you had a commitment in the past, has not been all that obvious, and it has to be obvious now because, as this report says, some people are not receiving or possibly not receiving the attention they deserve because they cannot communicate.

What it boils down to really is that it’s obvious from reading this report that not only the government but the institutions as well really haven’t turned their attention to this. It is something that they sort of proceed with and always felt that it was not a necessity. So this is why it’s important to highlight this. This is one of the areas and these are the types of steps, the types of commitments that we must make. Let’s not proceed as we have done in many areas, because I say to you that, sure, politically sometimes it’s not that appetizing, but I think you’ve got to convince your leader to be prepared to make that commitment.

Even though it may well be there is a backlash, I tell you that over the long term surely those of us who believe in this sort of thing, those of us who believe in this country are prepared to make this commitment -- and I think that’s most citizens in this province. Sure, they’ve got some hang-ups about certain aspects of bilingualism, but by and large I think their commitment is to Canada. I think they are prepared to see this type of commitment made in a way to enhance not only the rights and privileges of the minority but in fact to keep our neighbours in Quebec with this country.

[9:30]

I say this is the type of commitment that you’ve got to make. I just wanted to say that the title seems to reflect really a lack of attention, a lack of awareness that there was even a problem there. Even the University of Ottawa is criticized in this report for not having taken proper steps; you would think that the University of Ottawa, which is supposed to be a bilingual institution, would have taken more steps.

I say to the minister, I don’t think this is the only area we are going to have to talk about. We are going to have to talk about justice, about French-language education for English-speaking students, and so on, but I am convinced that the citizens of this province are prepared to make that sort of commitment. I think what we need from you and from that government is a bit of leadership.

Mr. Acting Chairman: The member for Peterborough.

Mr. Cassidy: Bravo.

Mr. Conway: A fine member.

Ms. Sandeman: Mr. Chairman, perhaps I could begin by asking the minister if a dreadful itching goes along with the swine flu vaccination. Is that okay? I mean, am I going to drop dead?

Hon. F. S. Miller: It is the first sign of a fatal illness.

Ms. Sandeman: Oh, dear.

Mr. Cassidy: Eat your heart out.

Ms. Sandeman: I did notice that you had a stretcher coyly hidden up there behind the screens.

Hon. F. S. Miller: That was for our party.

Ms. Sandeman: Oh, I see. Okay. I would like to speak on this vote on the institutional care services, as they relate to both the operation of hospitals and the extended health care nursing home part of the field.

I noticed the minister prefaced his remarks by commenting that one of the reasons he needed to introduce supplementary estimates was because his money-saving programmes didn’t take hold as quickly as he had hoped, that some of the savings anticipated for this year hadn’t happened and he had to meet the shortfalls. I would like to suggest that perhaps part of the problem that led to that kind of situation in the ministry, and the necessity for supplementary estimates, was that it really is impossible to do overnight the kind of planning that the minister was trying to do for health -- to introduce massive cuts in the health care field and to shift his interest to other alternative facilities in the kind of panic way that we saw earlier this year and on the ad hoc basis on which it was done.

I would like to suggest to the minister that he take time to look at what’s happening in the health care field in Manitoba, where a five-year programme is in operation, rather than an attempt to cut back the budget in six months and then, six months later, bring in supplementary estimates because you find you can’t do it. Back in May of this year, Mr. Desjardins, the Minister of Health and Social Development in Manitoba, announced a five- year programme for health facility construction in the province of Manitoba.

The interesting thing I find about that programme is that it is carefully based on an analysis of the health care needs of the whole province -- the acute care bed needs, the extended care needs and the personal care needs, both in Winnipeg and in the rural areas of the province. No decisions were made overnight to close hospitals. In fact, in Manitoba they have set out their objectives in the hospital and bed provision programmes. Their objectives are much the same as we would hope to see in Ontario; to relieve pressure on the waiting list for personal care accommodation and hence on the improper use of hospital facilities; and to enable Manitoba to move towards lower-cost alternative programmes in line with current discussions with the federal government relating to proposed changes in cost-sharing agreements.

The improper use of hospital facilities is something that concerns all health care personnel across the country, and it’s interesting to see that Manitoba has taken a grip on that and realized that you can’t put a stop to it overnight and save millions of dollars overnight; you have got, first of all, to look at what you have got and then supplement existing beds and explore alternative ways and means of improving services to end up with a rational provision of beds over a longer-term period.

In fact, what they have done in Manitoba is to add 973 personal care beds and to construct more than 1,500 personal care beds, but I believe 607 of those were replacing substandard facilities. Thus, as you increase the number of personal care beds, at the same time you may cut down on unnecessary acute care beds in hospitals. But you have to do both at the same time. You have to do it on a long-range plan and you have to do it after considering what you already have in your province and what you need.

What we saw in Ontario last winter and in the spring of this year was a panic-stricken reaction to some severe cash flow problems in the province, to a very large deficit, a very large burden of debt interest on our finances, and we say ad hoc-ery of the worst kind. We saw, for instance Doctors’ Hospital closed and after that the announcement of a bed study; the uses of beds in downtown Toronto. Any sane planning would have studied the bed needs first and closed the hospital second, if indeed it was necessary to close the hospital. It’s extraordinary that that kind of thing should have happened in that Alice in Wonderland fashion.

Then we get the extraordinary sequence of events around the Hillcroft private hospital, which the minister announced would be closed. And then the Premier turned up at a testimonial dinner for Glen Hodgson -- I didn’t have the pleasure of knowing Glen Hodgson but I believe he used to be a member of this House. The Premier turned up at a testimonial dinner in the riding in which Hillcroft private hospital is situated and announced at the dinner, to the surprise of the owner of the private hospital, “I am turning this hospital into a nursing home,” which was --

Hon. F. S. Miller: Oh, oh, oh. That’s not true.

An hon. member: Can you correct that?

Mr. Chairman: Can you rephrase that?

Hon. F. S. Miller: Pardon me. I think the member has erred in her conclusion.

Mr. Moffatt: Either that or the newspaper was wrong.

Hon. F. S. Miller: I personally told that lady, before my heart attack, that we were doing that.

Ms. Sandeman: Oh, I’m sorry. I thought you meant it wasn’t going to be turned into a nursing home -- Oh, I’m correct that it was to be turned into a nursing home.

Mr. Breithaupt: It was the doer, not the deed, he was referring to.

Ms. Sandeman: Okay. We needn’t argue about when she was told --

Hon. F. S. Miller: It certainly wasn’t to her surprise.

Ms. Sandeman: Okay: We needn’t argue about when she was told and when she was not told. The point at issue is that the nursing homes in this province have been asked to go through a perfectly sensible series of stages if they wish to extend their beds. The ministry tells us that studies are done of nursing home bed needs in particular areas.

Nursing homes in the Lindsay-Peterborough area have for years been applying for extra beds and have been turned down, apparently because there was no need in the area for extra nursing home beds, so the nursing home operators were told. Bobcaygeon, interestingly enough, already has two nursing homes, one of which was, I believe, the only nursing home in that area to have been granted new beds within the last year and suddenly we see that a private hospital which wasn’t needed can, overnight -- before your heart attack -- turn itself into a nursing home.

Not unnaturally, the nursing home operators in the area were saying: “What about the previous bed freeze we were told about? What about the tendering procedures we all have to go through? Does this hospital meet the standards laid down by the ministry for nursing homes? Pretty rigid standards, and quite rightly so. What is the expense of turning the private hospital into a nursing home going to be?”

It seems to me that that is another example of ad hoc-ery. I hesitate to call it political opportunism if, indeed, it was you who made the announcement and not the Premier at that testimonial dinner. At the time that we’re looking at the range of alternative care to replace your hospital beds, your misused hospital beds, we have to consider what is happening to home care in this province.

I find it very difficult to consider home care in a vacuum. Home-care patients, as the minister suggested, can relieve the pressure on hospital beds and in fact many of the patients who are being cared for in nursing homes or at home are patients who, if those beds are not available, are taking expensive hospital beds. But, once again, when we look at what’s happening to the home-care programme we find reaction to crises -- apparently long-term planning has gone out of the window. Local areas in home care are finding it almost impossible to make rational sense of the budgeting procedures. I am sure the minister is familiar with what happened in Peterborough this year. The VON in Peterborough maintain home-care services that are typical of similar organizations across the province. They submitted their budget last March, a rock-bottom budget, very carefully thought out; but they didn’t receive a firm budget from the ministry until early in September when they were told that they were 20 per cent over their allowed budget and that they would have to cut out $55,000. That means that for the last six months of the financial year they’re going to have to cut by 40 per cent. They were told when they spoke to Dr. King that apparently a $2 million cut in global budget for 38 home-care programmes had been imposed by the ministry, which would be a 15.5 per cent cut over all, and the cut would have to be absorbed by all the programmes across the province.

It’s already evident, in many home-care programmes across the province, that the reductions are being made, or were being made even before the September announcement, in the care given.

Mr. Chairman: That is in vote 3003; that is another vote.

Ms. Sandeman: I am trying to tie it in, Mr. Chairman, with the relationship to the acute-care beds in hospital which are improperly used. The pressure on them could be relieved if home-care facilities were available. My remarks are tending toward some proof of that.

Mr. Chairman: There is $1.2 million in vote 3003, item 2, for that.

Ms. Sandeman: Yes, but we are talking about institutional care.

Mr. McClellan: There is a connection.

Ms. Sandeman: It is very difficult. The whole problem with the ministry is that we have to speak of it as a whole. You can’t plan rationally by thinking of home care as a distinct item separate from the others.

Mr. Chairman: If we were dealing with the estimates of all of the activities of the Ministry of Health, you could get it in under policy. But since we’re dealing with specific items for additional funding for supplementary estimates, in order to keep things on an even keel I would appreciate it if you would stick to item 3 in vote 3002, institutional care services.

Ms. Sandeman: Yes.

Mr. Bain: That is what you were doing, keep going.

Ms. Sandeman: That is what I was doing but he has interrupted my train of thought. What is happening because of the cutback in home care is that hospital patients are not being allowed home. That is another reason we need supplementary estimates for hospital care. What has happened in Peterborough is that the hospital programme that is tied in with home care -- if you’ll excuse me mentioning the connection, Mr. Chairman -- is having an extra strain on it.

We have, as the ministry is well aware, a very good record in the Civic Hospital in Peterborough of one-day surgical admittances. I think 50 per cent of all the surgery done in the Peterborough Civic Hospital is on a one-day bed occupancy basis and the patients are then discharged with home care follow-up where necessary.

However -- and I don’t know how I’m going to slip this past you, Mr. Chairman -- because of the cutback in home-care funding it looks as if it will not be possible any longer to discharge these patients on a same-day basis, and therefore we’re keeping them in expensive hospital beds which is costing more in the long run, unnecessarily.

The same kind of thing applies to cataract programmes. Cataract patients shouldn’t have to stay in hospital for more than four days. With a decent home-care programme, the institutional cost could be cut down by discharging the patient to home care. However, when you cut back on a home-care programme by 40 per cent in the last six months of a programme, it means you have to keep cataract patients in hospital, adding to the cost of institutional care.

[9:45]

The minister mentioned in his discussion on this vote, or perhaps it was in his introductory remarks, some pilot projects in programmes which were to be alternatives to institutional care; quite expensive pilot projects. I think there were three -- one in Thunder Bay and I’ve forgotten where the other two were. Interestingly enough, in Peterborough the home-care people haven’t waited for ministry guidance to go into an expensive pilot project. They have taken it for granted that part of the reason for their existence is to provide alternatives to institutional care. They have set up with the physicians of the community, after long, hard work, a service which they call a substitute for hospital care programme and they use it as an alternative to that expensive institutional care which we’ve been discussing.

However, with the continued cut in their budget for the end of this year it looks as if they may have to abandon that programme and those patients are going to be causing you maybe the reason for your supplementary estimates.

I think I would be dishonest if I continued my remarks on home care. I think I’ve made the tie-in and perhaps you’d allow me to come back on the next vote on home care.

Hon. F. S. Miller: I only point out that last year the Peterborough home-care budget was $213,000. This year it’s $270,000 and I find it difficult to understand that being interpreted as a 40 per cent cut.

Ms. Sandeman: Am I allowed to answer that?

Mr. Chairman: Yes.

Ms. Sandeman: Thank you. The 20 per cent cut is on the budget that was sent in by the VON in March. The reason for the increase, of course, is that the criteria have changed quite considerably since last year. As the minister himself mentioned, home-care programmes have expanded and there are changes in programme eligibility, so you would expect an increase. For instance, home care now covers physiotherapy for nursing-home patients. Homemaker services under public-health-nurse supervision have been increased and you have to allow realistically for that increase when you’re setting up a budget. Which doesn’t mean to say you do not set up a careful, pared-to-the-bone budget if you are as careful as the VON people are in Peterborough.

The 40 per cent cut comes about because they were cut 20 per cent from their expected budget, but six months before the end of the year, so that they had to achieve all the savings during the last six months of the year. Of course, you’re aware of what happened in October when some zealous bureaucrat told them he would like to make all the cut at once and told them they would have no cash flow for the month of October. I’m happy to say that that problem was solved.

I understand also, if the Chairman will allow me to complete my train of thought, that they were told, “You are panicking too soon. We don’t really mean it that we’re going to cut $55,000 from your budget. We’ll set a final figure in November.” If I may say so, it really isn’t good enough to set a final budget for the 1976-77 budget year three-quarters of the way through the budget. There is no way in which local programmes, either at the institutional or home-care level, can make rational decisions if they don’t know until late in November what they’re going to have to spend. I hope you can give us some assurance that that won’t be repeated next year.

Hon. F. S. Miller: Mr. Chairman, if I sat here listening to the various comments of all the members who make it look like we’re a bunch of ghouls who cut everybody mercilessly, how then am I spending half a billion dollars more this year than last year on health care?

Mr. Germa: You’re wasting it.

Hon. F. S. Miller: I’m wasting it. I’ve tried to point out that some of the things I’m doing in terms of reducing certain services is because I genuinely believe we’re wasting it in certain places and that I need the backing of you gentlemen and ladies in this Legislature. We sent guideline letters out to Peterborough way back at the beginning of the year. They sent in a budget 33.6 per cent over last year’s budget in spite of the guidelines. If anybody gets a guideline letter and totally ignores it when he spends his “money”, surely he will run out of money before the year-end. You can’t really get information from us in March saying you’re allowed to increase last year’s budget by this and spend at whatever rate you wish and then complain at the end of the year because somebody says you’ve overspent the amount.

Even then we came along and bailed them out with $30,000 to $40,000 extra to keep their programme going, and frankly, if every home-care service in this province chose to set its own eligibility criteria without any respect to those set by us, we would have no control, no matter how worthwhile the programme is. Therefore, one must live within the parameters set by the policy. That’s why we have three experimental project areas in Hamilton, Thunder Bay and Kingston, to determine if we can spend the money more effectively.

I think my opening comments said I would be delighted to spend more money in this area providing that in fact the alternative savings are effected in the rest of the system. I’m just hoping we might be through by 10:30, Mr. Chairman, so I’ll say no more.

Mr. B. Newman: I wanted to raise two issues with the minister concerning item 3, the institutional health services programme.

The first issue is a long-standing one that is concerning the phasing out of the Riverview Hospital. Is the minister’s decision firm on that? Do you intend to close the facilities as of March 30 of this coming year, or are you still negotiating --

An hon. member: Terrible.

Mr. B. Newman: -- with the IODE people and particularly with the chairman of the board of Windsor Western Hospital, a Mr. Mason, who has been attempting to get from your officials a statement as to the expenses involved with the hospital?

Mr. Bounsall: Say you’re flexible. Say you’re flexible. Change your mind.

Hon. F. S. Miller: You know how flexible I am.

Mr. Bounsall: You can be on this one. There is simply no economic argument for closing!

Hon. F. S. Miller: I’m waiting for some information from the health council and until I get it I’ll make no more comment.

Mr. B. Newman: Then, in other words, we can assume that your decision is not firm, that the hospital may remain after March 31 of the coming year.

An hon. member: Until after the election.

Mr. B. Newman: I hope that the minister will provide statistical information to the individuals who have asked for it in the same form that he has normally provided information. The latest figures that your officials have given to them are sort of jumbled up and there is no way of making a comparison between the way they have submitted their figures normally and the way the minister has submitted them normally in the past.

The other issue that I wish to raise with the minister is concerning the curtailment of certain elective out-patient services. I know the minister is aware that the Metropolitan Hospital has been forced by him to curtail certain services. As a result of the curtailment, Mr. Minister, you may be restricting the budget of Metropolitan Hospital, but what you are actually doing is adding to the overall total cost for the health services in the community. Because now Metropolitan Hospital can no longer carry out certain outpatient services especially when it comes to certain tests. It sends the patient to private labs when the facilities at Metropolitan Hospital and maybe other hospitals could be used. In sending them to the private labs you have only substantially increased the health services costs in the municipality.

Could I have a reply from the minister to that comment?

Hon. F. S. Miller: I’ve been aware, Mr. Chairman, that many hospitals tried to off-load lab work because a global budget allowed them to do just that -- to send it to private labs when, in fact, they had the capacity within the institution to do the work.

They are not paid on a fee for service basis. We’ve spent a good deal of time looking at the problems that give a hospital an incentive to send work out. I can’t say that I have any solution yet but I think we’re approaching some. I can also say that the budget letters that are going out today and tomorrow -- a month before the end of this year, for the next 15 months -- give them total dollar budgets for the hospital, with no restrictions on how they use those funds.

Mr. B. Newman: Then may I bring to the attention of the minister the letter that Metropolitan General Hospital had to mail out and to give to patients at the hospital? It’s dated August 30, when this issue broke in the community.

“Dear Patient:

“We sincerely regret that we have had to reduce certain elective outpatient services, and we hope this measure will be a temporary one.

“The amount of outpatient services which the hospital is permitted to provide is limited by, and is in direct proportion to, the funds allotted by the Ministry of Health. During the past 20 months the demand for these services at Metropolitan General Hospital has been in excess of the amount approved. The phenomenal increase can be attributed to two major factors: (1) The general trend of population growth on the east side of the city and the easy accessibility to the Metropolitan General Hospital; (2) the consolidation of neoplastic services at this hospital. These require more diagnostic tests than most of the other types of services.

“For the year 1975 the hospital may not recover the costs for the excess outpatient work performed. It now appears that for 1976 the hospital will not be reimbursed for an even larger amount. In this event, the hospital would be in a most difficult financial situation.

“The specific outpatient problems have been discussed with the Ministry of Health during the past year. They will now be presented to the new Essex County District Health Council. Failure to obtain a revision in the distribution of health funds will extend the outpatient service constraint period indefinitely. The present severe restrictions will continue until the excess service already performed falls within the approved amount. We hope that this will occur before the year end.

“The decision to reduce services was reluctantly taken, and the hospital regrets any inconvenience it may cause you. Your family doctor has been advised of the constraint, and you should contact him with a view to making other arrangements to have your tests carried out.

“We hope that we will be able to serve you again in the near future, and we ask for your understanding and co-operation during this difficult period. Sincerely -- ” and it is signed by Mr. J. A. Ritchie, executive director.

You will note in that letter that he specifically mentions that the family doctor has been advised and other arrangements will have to be made to have these tests done. All the minister is doing is adding extra costs by referring this work to the private labs.

Hon. F. S. Miller: Mr. Chairman, I sometimes get a little angry at hospitals who play a double game. That hospital got $2.5 million more this year than last year. That’s a heck of a lot of money. If you listen to that letter -- and that was a power play, as far as I’m concerned -- it was a game they were playing; they figured if they got enough people upset in the community they’d get the extra money they thought they were entitled to. The fact is that $2.5 million more than the previous year for a single hospital is an awful lot of money.

Mr. B. Newman: The minister is also aware that he transferred patients from the Riverview Hospital to that hospital; so even though he may have provided additional funds, he also had additional patients in the hospital. That will easily account for the additional funds.

Mr. Mancini: Why don’t you tell us that?

Mr. B. Newman: The minister should want to tell both sides of the story too.

Mr. Chairman: Is the hon. member for Windsor-Walkerville finished?

Mr. B. Newman: I thought I would get a reply from the minister on my last comment. The minister has no comment?

Hon. F. S. Miller: No reply.

Mr. B. Newman: Then he prefers to have the total health costs in the community escalate to a lesser degree by having the services performed in the hospital as opposed to a private lab?

[10:00]

Hon. F. S. Miller: Mr. Chairman, at the end of the month the hospital withdrew that letter.

Mr. Burr: Mr. Chairman, may I ask the minister whether he thinks that the total bill to the government through OHIP will not be greater for these lab tests than it would have been through the hospital itself?

Hon. F. S. Miller: Mr. Chairman, the slowest growth section of my budget this year -- the one that is underspent -- is OHIP.

Mr. Burr: Nevertheless, that’s not answering my question.

Mr. Moffatt: You spend money just because you haven’t spent it?

Hon. F. S. Miller: No, no. I am just saying that during the year the actions we have taken to control the demand on lab tests have been fairly effective. I am not condoning what happened in Windsor or anywhere else, and Windsor wasn’t unique. Hospitals around this province in a number of instances did much the same thing one way or another. I really didn’t think it was particularly fair of them to do it because they knew they could get an immediate local reaction. Other hospitals went along and did their darnedest to work within the amounts of extra money we gave them.

I got one of the highest increases in government this year. It wasn’t like some of the other ministries that got fewer real dollars this year than last year. I got more real dollars for health care. There were more jobs in the hospitals in Ontario than there were last year. I find it a bit difficult to accept when hospitals, which could have done the work within their global budgets for less money, make the decision themselves to send the work out into a high cost area. I agree it was more costly to let it go out. I didn’t like them doing it. I found many hospitals, on the other hand, that did their level best to help us in a tough year.

Mr. Haggerty: I would like to discuss a problem with the minister; not to spend money but to suggest to him a way to save money. I have mentioned to the minister on previous occasions -- I think for the last five or six years to the different government ministers -- the matter of nurses’ residences. Throughout Ontario many municipalities have constructed these residences close to the hospitals. One in the city of Port Colborne -- I think it was constructed in 1968 -- has been vacant for almost that length of time. It hasn’t been used to the fullest extent.

I suggest to the Minister of Health -- and to the Minister of Housing, I’m glad he is here tonight -- that they could make good use of this vacant building in the city of Port Colborne. There are about 50 self-contained units in this building. It could be used for a senior citizens’ residence, and there is a great need for further senior citizens’ residences in the city of Port Colborne.

I think this is one way the Minister of Health can dispose of the building. He can either sell it to the Minister of Housing for a senior citizens’ residence, or rent it to the minister and generate some revenue.

There is also a nurses’ residence in the city of Welland -- I understand it was just constructed a few years ago -- that is vacant too. I understand that the former nursing school in St. Catharines has a large nursing residence there. I don’t know how many floors it has but I understand it contains a number of units and it is sitting there almost vacant. I’m not quite sure about this particular one but I understand there is a possibility it is vacant also.

The minister should be making use of these vacant nurses’ residences throughout Ontario. I am sure that there could be a vast savings in money. It costs money to heat those buildings all year round and to maintain them. If they are sitting there vacant you are missing the boat, Mr. Minister, by not making some general use of these buildings.

Hon. F. S. Miller: First they don’t belong to me, they belong to the hospitals. Secondly, I totally agree with you. Thirdly, I will be glad to recommend it to my colleague, the Minister of Housing.

Mr. Haggerty: The Minister of Health has contributed a large amount of funds --

Hon. F. S. Miller: Yes, but I don’t own them.

Mr. Haggerty: This is right, but I think you should have some input --

Mr. Deans: The Minister of Housing --

Hon. F. S. Miller: I can only say in the city of Hamilton that’s been done. I believe the nurses’ residence in Hamilton is currently being used as a residence for people who just come in and rent a room. In fact, if I am not wrong, there was comment from some people in the business that it was unfair competition, wasn’t there?

Mr. Deans: Don’t involve me in your problems.

Hon. F. S. Miller: I’m just looking at you for confirmation.

Mr. Deans: Don’t look at me. I am not the minister.

Mr. Haggerty: I am delighted to hear the minister say that they are making some use of them.

Mr. Deans: What’s the matter? Can’t you fight your own battles?

Mr. Haggerty: But why in this particular instance can’t you use some of your persuasive voice in the matter of bringing a finalization to this agreement between the Minister of Housing and the Port Colborne General Hospital Board?

Hon. F. S. Miller: Mr. Chairman, I don’t know that it is proper for me to tell them what to do with it. I want them properly used.

Mr. Deans: Tell him to direct his question to me, I will answer it. Remember the last time you told somebody to do something with the hospitals.

Mr. Moffatt: Subtle, subtle.

Hon. F. S. Miller: However, I’d be glad to whisper in their ear.

Mr. Deans: I think I was about to raise a question on behalf of the hon. member for Lake Nipigon (Mr. Stokes) who does such a magnificent job as the chairman.

An hon. member: Oh, we’ll agree with that.

Mr. Deans: He has a problem that he wants to bring to the attention of the minister, and he asked me if I would raise it for him, since he can’t from the seat that he’s currently in.

I wonder if the minister has given any further consideration to the difficulties that confront the people who reside in the immediate area of the Terrace Bay hospital, knowing full well that the Terrace Bay hospital has been condemned, that it is a fire trap, that it doesn’t have adequate outpatient facilities, that it provides little if any heart treatment facilities, and that there is currently a major industrial undertaking by Kimberly-Clark which will bring in at least 260 new families into the immediate area, which in itself is justification for at least an adequate health-care facility?

Does the minister think that some time in the fairly near future we might be able to get the approval of the finalized plans, the more detailed plans, rather than the approval in principle that has been given but which in itself is rather meaningless, since it doesn’t provide one single brick, or doesn’t make any clear indication to the people of the area that their immediate needs are about to be met?

Hon. F. S. Miller: Just about a week ago I met with the general medical supervisor of Kimberly-Clark, I believe a Dr. Dedmon -- does that ring a bell with you as the right name? I discussed the Terrace Bay problem with him. I can assure you it is on my list. I told Dr. Dedmon that within two or three weeks I’d be getting a complete list of all the potential capital projects in the province. I would then try to tailor them to the tiny amount of money left to me for capital projects for next year. Believe it or not, it is only in the range of $20 million that I have to play with -- $20 to $30 million.

Mr. Moffatt: What’s $20 or $30 million?

Hon. F. S. Miller: In terms of hospitals, when you heard somebody a minute ago talking about one hospital at $60 million --

Mr. Grande: What I am concerned about is the term that you have it “to play with.”

Hon. F. S. Miller: I am trying to tailor as many starts as possible into the number of dollars that I have that are discretionary. It happens that that hospital is still doing pretty well on my priority list. I won’t know for perhaps a week whether it makes next year’s or not, because I have to see just which hospitals are the most critical in my total list. It certainly has to be one of the more important ones involved in terms of where we have to go. I think it’s 23 beds, if I recall.

Mr. Deans: It is not any great facility.

Hon. F. S. Miller: I suggested to Dr. Dedmon, and I’d recommend to the community too, that they start looking at Red Lake and Atikokan hospitals where basically stock plans were used. If you recall, between the time I approved Atikokan hospital about May 30, 1974, and the time it was built was about 15 months. This would be one of the ways, if we are able to say yes, that both time and money would be saved in that area.

Mr. Deans: I want to say on behalf of my colleague, who knows as much about this as I do, maybe even more --

Hon. F. S. Miller: I think so.

Mr. Deans: -- that they could easily provide the facility that he requires with a very small number of dollars out of $20 million.

Hon. F. S. Miller: Two million dollars.

Mr. Deans: Two or three million dollars would adequately provide for the needs of the area, considering the fact that Kimberly-Clark is spending some $200 million or $300 million.

Anyhow, I want to turn to another matter because it’s closer to my home though not closer to his heart. I was wondering whether in that $20 million, I understand from a letter that I received yesterday or the day before, or Friday last, that Mr. Orris was meeting again with the Hamilton-Wentworth health council to discuss their progress in determining the possibility of providing some kind of health-care facility for the east end of the Hamilton area. My colleague the member for Hamilton East (Mr. Mackenzie) and I, together with his predecessor, have probably spent more time on this one problem than we have on any single problem that I can recall. I wouldn’t be exaggerating if I were to say that we haven’t been entirely happy with the progress.

I can’t think it would be unkind to say that we weren’t satisfied in the fullest that the previous health council had even begun to address itself to the needs of that area. The current health council has now been in existence for about a year -- maybe not quite a year, maybe eight to nine months.

Hon. F. S. Miller: Since January 28.

Mr. Deans: Is that right? They have been in existence for some time and I haven’t seen any evidence of their eagerness to provide even a plan that would begin to meet the need. I don’t know whether it’s because they have been too busy. Mind you, I have to confess the difficulties we had over Chedoke tended to keep some of us busy for a while, but that seems to have been resolved.

There is a rather large expansion of homes and families taking place in the east end of the city of Hamilton and in the Stoney Creek area, which my colleague from Hamilton East and I jointly represent. I think that anyone looking at Hamilton would appreciate that the facilities currently available are not geared to meet the needs of that expansion and that expansion is likely to continue for some considerable period of time. The emphasis that has been placed on the rebuilding of the Hamilton General Hospital, necessary though it may well be in the eyes of some, I think is undue, over and against the needs that are evident in the east end of the city and the west end of the town of Stoney Creek.

I would like to ask the minister, given that it is now just slightly over two years since I got what I considered to be a commitment from the minister, whether he thinks that maybe we could expect to see something more concrete before the next election. I am not sure when that might occur. Maybe you have more insight into that than I have. I wouldn’t like to go back to the people of the area and say that I have another commitment but I still don’t have a building or even the indications of what, where, when and how; but whatever it is that’s going to be built is going to be built. Perhaps you would like to address yourself to that for a couple of minutes.

Hon. F. S. Miller: I sent the hon. member a copy of a letter from Mr. Orris to the Chairman of Management Board (Mr. Auld) the other day, saying they were discussing it at the very time you were asking me the question. I would suggest that we are putting pressure on them for the resolution of that problem. In fact we wrote into our request for a rationalization of the beds in the city of Hamilton an insistence that part of the city get the proper level of health care -- health services I think is the way we defined it -- and we are pushing them. I believe we are meeting with them again on Monday next.

Mr. Deans: I don’t want to be privy to private conversation, but by the same token I think that in all fairness this is not a political matter. This has nothing to do with partisan politics at least. I would very much appreciate if the health council could see fit to allow my colleague and I to hear what it is that they are considering in order that we might properly represent the people who elected us. I think it is fair to say that neither he nor I, nor anyone else, has made it a major issue as far as the elections or otherwise are concerned. I think the need is there, and if the minister could we would appreciate very much the opportunity to sit in.

Hon. F. S. Miller: I would suggest two things. First, both of you are very welcome to discuss with Milton Orris, the area planning co-ordinator, your concerns, and I would be glad to instruct him to contact you to do so. Secondly, it might be very wise if you both had some discussions with the health council itself, because we are leaving this, as we properly should, to its resolution. I recognize their problems in their first year of operation. Even though they are very senior in other ways, they have reorganized and I believe they are going through some problems of alignment with the various providers in the community. Your direct intervention in this matter, I think, would probably be very useful.

[10:15]

Mr. Deans: Just one final point on it and then I’ll let it go.

I don’t have the letter in front of me, but my recollection of the letter that was sent to me, I believe it was in October of 1974 -- I think that was the first time that I ever received anything concrete with regard to this proposal -- my recollection of that was that as a condition of the extending of the funds for the rebuilding of the Hamilton General -- Now the rebuilding of the Hamilton General is going along apace; they are already in the process. And I understood that the funds were forwarded on the basis of them having shown a plan for the provision of care for that east end.

I think that it would be all too easy -- and I’m not suggesting that they don’t care, because I’m sure they do, and I know many of the people on the health council are just as concerned as I am -- I think it would be all too easy to delay it until another time. I think that’s really what’s happened over the last 24 or 25 months and I think that before we go any further with the rebuilding we should simply say that there has to be a clear indication, because the people in the east end deserve that kind of an indication.

I want to turn to another point with you, if I may. I confess that this was perhaps an isolated incident, but it’s only isolated because I haven’t had a chance to check it out and I raise it with you very briefly. I was concerned to have it reported to me by a very agitated lady the fact that she could not have a relative admitted to a hospital because there wasn’t a bed in Hamilton area. The lady was suffering from something which, if I were to describe it to you, I’m sure you would agree was of a crucial nature. I’m not going to get into the details of it here.

I was surprised to find that the hospital and the doctor involved simply stated that there wasn’t a bed, emergency or otherwise, in the Hamilton area that he could find for her. Have you recently reviewed the numbers of beds in use since the more recent cutbacks to determine whether the per capita use and the daily use of the beds is reaching a point that might be crucial?

Hon. F. S. Miller: I think it’s always dangerous to make an assumption on the basis of one refusal, but it would seem that you’re still over-bedded in the area, and that the real question would be how well are the beds being used. There is an assessment and placement service, I believe, functioning in Hamilton and that assessment and placement service should be looking at the utilization of beds.

Mr. B. Newman: In discussion with the minister concerning the phasing out of Riverview Hospital, I made mention about the financial statistics and analysis that the ministry provided to those who are attempting to point out to you that the phasing out and the closing up of Riverview Hospital is really not a savings in dollars, but simply a transferral of costs from Riverview to the other hospitals in the community.

Earlier in my comments I made mention of a David Watson. It should have been David Wilson rather than Watson. Professor David Wilson, chairman of the board of IODE, said the Ministry of Health had outlined Riverview’s financial status, but it wasn’t done in the format the board could understand and in the format which was agreed upon. Will you not provide to them the statistics that they require in the format that was originally requested and which was agreed upon by you people?

Hon. F. S. Miller: I am told that the latest figures for Riverview were provided in the format they requested.

Mr. B. Newman: As of when?

Hon. F. S. Miller: November 19.

Mr. B. Newman: November 19? Thank you.

The other issue I mentioned to the minister concerned the curtailment of services at Metropolitan Hospital. Now, I want to read this letter to you because it shows you how one class of patients that use Riverview Hospital are really being penalized. This was addressed to me back in April of this year; it came from a constituent. This concerns cutbacks at Metropolitan General Hospital on blood samples for outpatients which means, in her instance and in many other instances, victims of cancer.

“When on chemotherapy, you must have a blood sample every week before treatment. The treatment itself is inhuman -- the aftereffects and so forth -- and you’re very ill. I know from personal experience. But you could get it over with in one day -- three hours’ waiting time on a good day. Hundreds of victims for Essex and Kent counties -- children, teenagers, middle-aged and elderly.

“To take a blood sample from a cancer patient on chemotherapy requires skill that is not going to be found in any clinic. Your veins collapse, are hard to find. It takes patience and knowledge and you will not find it in any other place but in Metropolitan Hospital, because no one else deals with cancer patients. Most patients are too ill to question anything, but I’m not. Getting a blood test now will require an extra day; and since most people are driven by volunteer workers, I wonder how they’re going to make it.”

The balance of the letter is really not important, but I would like the minister to reply to that when he talks about the curtailment of services at a hospital, especially the curtailment of services in relation to cancer patients at Metropolitan General Hospital, which is the chief hospital for that type of service.

Hon. F. S. Miller: I don’t have the knowledge to reply to that. I’ll just have to look into it.

Mr. Chairman: The hon. member for Timiskaming.

Mr. Conway: Great fellow.

Mr. Ferrier: Outstanding.

Mr. Bain: That means a lot, Mr. Chairman, coming from an almost northerner.

Mr. Conway: Do you own a bakery?

Mr. Bain: Mr. Chairman, I trust you’ll be able to keep the unruly member for Renfrew North under control.

The matter that I’d like to raise with the minister tonight is one that he is familiar with; that is, the future use of the old Kirkland Lake hospital. I’m sure the minister will remember in the House when a petition was presented on two separate occasions. The petition finally had over 8,300 signatures of people in Kirkland Lake and area. This petition called for the conversion of the old Kirkland Lake hospital into a chronic care and extended care facility.

The petition was supported by all segments of the community -- the Kirkland Lake council, the medical association, the hospital board, the United Steel Workers and the Chamber of Commerce. The petition was a genuine feeling of support for the idea of converting the old Kirkland and District Hospital into a chronic care and extended care facility.

I realize that the average person doesn’t have the expertise that officials from your ministry have; therefore, they look at things in a quite straightforward fashion. In Kirkland Lake we have a building that is a good building, a building that is still worth a considerable amount, and we also have a need in the area for facilities in extended care and chronic care.

It would seem to the average person that that makes a good match. We have a need and we have a vacant building, an excellent vacant building. The ministry, upon receiving this petition, upon questions asked by myself and upon resolutions passed by the local council, was agreeable to conducting a hospital accommodation survey. The survey was conducted in May and it was apparently mailed out in August by the Ministry of Health.

The only problem with the survey is that it’s typical of most government surveys. It’s nebulous at best and confusing at worst. I think that one could use the survey to support almost any position that one wanted to hold. I would hope the minister wouldn’t use the survey to justify not converting the old Kirkland and District Hospital into a chronic care facility, because I feel that that would be the best use that could possibly be made of the old hospital building.

There could also be use made in a rehabilitation-nursing care sense as well. We estimate that if you consider the need for chronic extended care and rehabilitation nursing care you need approximately 60 beds in the Kirkland Lake area. The old hospital could be converted at minimal cost. You wouldn’t have to undertake extensive remodelling.

The main section of the hospital is less than 20 years old -- approximately 15 years old -- and the hospital itself is in very good shape. Presently it’s being maintained by the Ministry of Government Services. There are security guards on duty and it’s now been heated through one winter and we’re starting our second winter. So the government is laying out a considerable amount of money already to maintain the building, yet there seems to be no disposition in sight for the building.

As I said, the need is very great. The patients who could use this kind of a facility are there already and would like to be able to move into it. There are people who are in the senior citizens’ residence, Teck Pioneer Residence, who would better use a facility such as a chronic and extended care hospital.

There is also a tremendous lack of senior citizens’ units in our area. I think this is true of the north in general. I think this might be an area where the ministry could start something that would be innovative. We know that your ministry and the Ministry of Community and Social Services tends to compartmentalize people, and you say, “Well, senior citizens’ units -- that’s taken care of by the Ministry of Housing. They’ll have to build some senior citizens’ accommodation.” Sure, that’s nice to say, but the Ministry of Housing has consistently had a limited budget and the units are not being built nearly in the quantity that they’re needed.

Here we have a hospital building, a good building, that has rooms in it that could be easily used for senior citizens who would like to live in a senior citizens’ apartment atmosphere. Not only could you have extended care and chronic care, you could also have a good mix; you could have some sort of senior citizens’ units as well.

The need, I think, is very difficult for the minister to appreciate because he may not be totally familiar with the number of elderly people in northern Ontario who just do not have adequate facilities. One group of people that have a tremendous need are single senior citizens. I know a number of elderly miners who have long since retired and are living on inadequate pensions, who live in rooming house facilities.

Would the chairman like me to move adjournment and we can --

Mr. Chairman: We could pass the vote.

Mr. Germa: Seventeen people are waiting.

Mr. McClellan: Mr. Chairman, I don’t think we are under any constraint to finish this evening, if I understand correctly from the House leader. Perhaps we could continue the debate on Thursday.

Mr. Chairman: Can you break your remarks here then?

Mr. Bain: I will continue with the need for this facility for retired miners and such or I could continue that next time we sit, Mr. Chairman, so I will move adjournment then.

Mr. Conway: Broken again.

On a motion by Hon. Mr. Auld, the committee of supply reported progress and asked for leave to sit again.

On motion by Hon. Mr. Auld, the House adjourned at 10:30 p.m.