Hansard Transcript 1986-Jan-13 | Legislative Assembly of Ontario

L086 - Mon 13 Jan 1986 / Lun 13 jan 1986

The House resumed at 8 p.m.

ONTARIO DRUG BENEFIT ACT (CONTINUED)

Resuming the debate on the motion for second reading of Bill 54, An Act to Authorize and Regulate the Payment by the Minister to Specified Persons on Behalf of Specified Classes of Persons for the Dispensing of Specified Drugs.

Mr. McLean: I am not sure I see a quorum. I would like to speak at length on this bill and I am just curious whether there is a quorum here.

The Deputy Speaker: There is a quorum present.

Mr. McLean: Thank you very much, Mr. Speaker.

We of the Progressive Conservative Party have been deluged with mail from pharmacists all over this province. All are protesting the Liberal proposal to change the role of the pharmacist in this province. We are also hearing from those on fixed incomes who fear that changes proposed by this Liberal government will increase their costs on this very crucial matter, and that is prescription supply. I make particular reference to those on fixed incomes just to let members know we are not leading a crusade for an élite group of professionals. We believe the pharmacist is providing a vital service and should not be discouraged from this pursuit through oppressive legislation.

To give members some background, the Ontario drug benefit plan in this province was established in 1974. Under this plan, pharmaceutical manufacturers submit prices for their products to the Ministry of Health. These prices are supposed to represent the wholesale cost of 100 units of the product. The prices are then published in the Ontario Drug Benefit Formulary. Pharmacists dispensing drugs to ODB client groups are reimbursed by the ministry at the price listed in the formulary. The pharmacist is reimbursed with a fee for dispensing to a maximum of $5.

As time went on, problems developed. The most serious problem was a price war among generic manufacturers in 1982 and 1983. The price war gave birth to the widespread practice of price spreading. The pharmacists have claimed that price spreading has allowed them to maintain a decent profit margin, and any attempt to lower the spread has resulted in cries for increased dispensing fees to cover lost profits. In 1984, the listed prices for 30 of the most commonly used drugs were lowered and the dispensing fees were increased by 35 cents.

While the cost of the program has increased dramatically since its inception, price spreading and increases in dispensing fees are not the sole culprits. The number of drug benefits covered by the ODB plan has doubled from 1974 to 1983. As well, with the increase in the number of products and people covered came increased administrative costs.

That is a bit of an overview on the history of the early stages of the Ontario drug benefit plan. Now we come today to the situation where our Liberal government in Ontario has entered the confrontation stage. In March 1984, the then Conservative government of Ontario commissioned a study to analyse and make recommendations on the problems in the operation of the ODB .

The Gordon Commission on the Pricing of Multiple-Source Drug Products in Ontario reported in August 1984, and we used its recommendations as a framework for our negotiations with the pharmacists. The Liberal Minister of Health (Mr. Elston) should note the operative word here is "negotiations."

These negotiations were under way in June 1985. The pharmacists say they favour the recommendations of the Gordon report. However, Mr. Gordon has been quoted recently in the press as saying he doubts the pharmacists like his recommendations now because they represent the lesser of two evils.

Here are the primary recommendations from the Gordon report:

"1. The Ministry of Health should continue to publish the Parcost CDI/Drug Benefit Formulary in its present form, listing all products eligible for reimbursement...and the maximum allowable cost for each, and all products certified as interchangeable by the drug quality and therapeutics committee....

"2. Prices should continue to be listed for all drug products in an interchangeable group, and, for each manufacturer's product, should be no more than 20 per cent higher than the best volume price available from the manufacturer" for that product. "This method of determining the price for listing could also be applied to single-source products. ...

"3. The Ministry of Health make it a condition of listing for any particular drug product that the manufacturer of that product sign an agreement with the Ministry of Health stating that the prices submitted are accurate and will be adhered to." The penalties for nonadherence could range from the termination of reimbursement to the restriction of reimbursement price increases.

That gives the members some idea of how drug prices are arrived at. This brings us to the very controversial matter of dispensing fees.

The Gordon commission recommends that the Ministry of Health and the Ontario Pharmacists' Association should continue to negotiate a single dispensing fee. It says, "The negotiated dispensing fee should continue to be applicable to all drug benefit prescriptions with the exception of over-the-counter products, and to all Parcost pharmacies."

For the sake of brevity, I will leave out the recommendations on dispensing fees in this report. Number 3, though, is quite interesting. It says the dispensing fee should not be adjusted just because the basis for determining prices has changed; these kinds of fee adjustments "only serve to erode the usefulness of the cost-plus-fee concept."

8:10 p.m.

The Gordon report also recommends that section 155 of the Health Disciplines Act be amended "to allow pharmacies to charge a usual and customary fee when product substituting or product selecting." It further recommends that section 155 be amended "to delete the phrase `at a price in excess of the cost of the lowest-priced interchangeable pharmaceutical product in his inventory' as it applies to product substitution. Pharmacies should continue to be restricted to the lowest price in inventory on product selected prescriptions."

The report also recommends that the Ministry of Health and pharmacy organizations should set a target level of substitution.

It is the refusal of the Minister of Health to sit down and negotiate with the pharmacists that appears to be the crux of the whole controversy. I cannot understand how the minister can come in and arbitrarily tell these pharmacists how they should run their businesses without at least talking it over in some detail.

We have had considerable response from senior citizens who are concerned that their neighbourhood pharmacies will be forced to close. To those in large centres such as Toronto, the closure of a pharmacy would have an impact, but can one imagine the impact if it is in, say, Coldwater, which coincidentally is in my riding of Simcoe East? Coldwater is a village of 900 people; they are left with two choices: they can go without a prescription or they can travel up to 75 kilometres to pick it up. Of course, they could wait and have it mailed out to them, but it is a matter of health and wellbeing and, today, who wants to wait on the mail?

My colleagues have spoken previously on the undesirable effects of running Bills 54 and 55 together. Bill 55 deals with cash customers and Bill 54 deals exclusively with the Ontario drug benefit plan. Everyone seems to agree there is a need for realignment of the ODB, but there is widespread agreement that the Liberal method of operation is not the way to overcome these problems.

Again, going with consensus, the bills as proposed are not expected to produce the desired result. Indeed, they would produce negative results, which no one really wants to see.

I feel the present government is taking a cavalier attitude when it calls for the bills to be sent to the standing committee for review. A responsible standing committee would call for further input from all parties affected by this proposed legislation.

We can hope, giving the present government the benefit of some considerable doubt, its basic aim was to get lower drug and prescription prices. Now we can look forward to increased prices for drugs in Ontario. Pharmacists resent the attitude taken by the present government, when it will very likely reflect badly on the pharmacy industry.

The pharmacists ask: "How can this government take it upon itself to be such an expert in the field of pharmacy? What is the rush? Why not take the time and talk it over with those who earn their living in the business?" These are the questions we are asking on behalf of the pharmacists in this province.

The Premier (Mr. Peterson) was quick to condemn the Prime Minister for cutting federal transfer payments without consultation. Surely he does not feel consultation is a one-way street travelled only by those who would cut the process off from him while he goes along in his arbitrary way.

The pharmacists went out of their way to let the Premier and his Minister of Health know they wanted consultation rather than confrontation. Had this consultation with the pharmacists resulted in a deadlock, the fairest approach would have been to submit the fee schedule to binding arbitration.

Under the legislation proposed by this Liberal government, we have a formula for a cost increase. Here is how it works out, again according to the people in the business, the pharmacists. The system of acquisition costs, as proposed by the Liberals, is likely to increase costs to the consumer. This proposal removes the incentive for the manufacturer to offer, and the pharmacist to seek, the most competitive prices. This proposed legislation will discourage pharmacists from negotiating purchasing advantages, and as a result, the manufacturer will find less competition in the marketplace. With these results, in the circumstances the net result can only be higher prices.

Getting back to Professor Gordon's report, the pharmacists would be encouraged under his recommendations to seek the lowest possible cost, and that is for the drug component of the prescription. This system, based on the lowest possible costs, would provide across-the-board lower prices to consumers by creating competition among the manufacturers.

We all know the drug component is only one element in the cost of a prescription. The second element is the dispensing fee. Under the bill proposed by this Liberal government, the government would have the authority to determine this fee arbitrarily. The pharmacists feel this authority is excessive and unreasonable. It represents a permanent imposition of government power on a self-regulating profession.

There is a misleading aspect to this legislation as proposed, and that is the posting of the dispensing fee. The pharmacy posting the lower fee may not be selling the lowest-cost prescription, because the cost of the drug component may well be higher.

In the bill as proposed there is no provision for the fact that the government proposes differences in dispensing fees according to the drug prescribed. There will be further confusion because the fee may not necessarily be the same between interchangeable or generic drugs. Some pharmacies may not charge dispensing fees at all on over-the-counter prescriptions. A lower fee may be charged on birth control prescriptions and a higher fee charged for noninterchangeable drugs not covered by legislation.

Can the minister tell this House the value of posting a single fee with these examples? He is not here tonight; he should be here listening to some of these comments. If he could answer that question, I would have to agree with him that there is further need to discuss the matter with the pharmacists. I suggest, though, that when pharmacists can outline such quandaries as this, there is room, and indeed a need, for further consultation. The posting of that single fee will not help the consumer make an informed decision on whether he or she is getting the lowest possible cost on a particular prescription.

This Liberal prescription for harmony in the drug and pharmacy profession is a bitter pill to swallow. What is the rush to ramrod this legislation through? Does this government not realize the threat to a small community to have its pharmacy disappear? Even in some larger centres, when one or more pharmacies shut down, the stress caused to some of our senior citizens whose lives literally depend on their prescriptions is enormous. In the interests of all in Ontario, we should be able to convince the Minister of Health to give the pharmacists in this province a full hearing, and I am sure he will.

8:20 p.m.

During the past several months I have had letters from many pharmacists in my riding. I have met with groups of pharmacists and have listened to their concerns. I have approximately four pharmacies in what we call the small communities and villages in my riding that depend solely on the area for their support.

I have a letter from a young pharmacist who is just starting and I would like to comment on what he has to say. He is just out of pharmacy school. He is Larry Wilson of Washago Pharmacy Ltd., which opened a few months ago in a medical building built by the Washago legion and the community with many dollars collected from the area. They are trying to acquire a doctor, a medical professional, and a pharmacist to serve the people in that small community.

He says the main concern is the handling of the pharmacy fee negotiations by this government. He says: "They are also worrisome. First, the Liberals were reneging on their party's promise of $5.23 as the base fee for prescriptions. They have rolled it back to $5. The new price book for ODB has not come out as it should in July 1985. As a result, we are paying higher prices for drugs, but are being reimbursed at January 1985 prices.

"Most worrisome is the prospect that the government now plans to legislate a new fee without negotiations. Now I understand there is going to be a chance for input from the pharmacists."

He wants to be able to come before the committee to tell his side of the story about the hardship on the small communities, how it will affect him and how the drug delivery system in Ontario has worked so well for years.

In June 1985, I received some letters from pharmacists in my riding. The member for Lincoln (Mr. Andrewes) was Minister of Health. I sent him a letter asking him to negotiate with the pharmacists in Ontario. The letter I got back thanked me for the concerns I brought to his attention and said: "Please be assured that we are aware of these matters and we share your concern that the continued negotiations will produce a satisfactory result. To this end we will strive in good faith for a resolution which is equitable."

At that time, the Minister of Health was negotiating with the pharmacists across the province. It appeared the negotiations would end in good faith and it would be resolved so that all parties agreed. However, that is not what happened when this government took over. It decided to tell the pharmacists how to run their businesses and that is not really what it is all about.

A lot of these people have salaries of between $30,000 and $35,000 per year. They work Saturdays, Sundays, weekends and nights. What other profession puts in those hours for the same amount of money? The government is telling them: "We will not negotiate with you. We are going to tell you what you should be making.

That is not what I am hearing from the public. I am getting letters from senior citizens and from all kinds of people across Ontario. I had a letter today from a doctor. It was surprising because he said, "I do not care whether you make us stay in the Ontario health insurance plan, but I can tell you I do not agree with what the government is doing to the pharmacists in this province." That is from a doctor and it shows there is real concern.

The new government assumes it understands this complex situation. After being out of power for decades, they feel they can dictate to the people of this province what things and how things should be done, but I do not think they can dictate to the professional people of this province.

I have several other letters which indicate to me that there is a great concern among many people about the druggists in this province. There are not many people going to their doctor who at some time or other do not have to get a prescription for whatever reason. Pharmacists give advice to people who need prescriptions which are so vital to the health of families. People depend on their pharmacist for advice. The issue the government does not understand is the importance of pharmacists in communities.

The Minister of Health in his wisdom is right to have a very open and fair hearing at which anybody who would like to appear before the committee has the chance to do so. I believe Bill 54 affects every resident of this province. This is an important piece of legislation and I do not think it should be handled lightly.

I know the minister in his wisdom will find time to make sure that the hearing is fair, that the pharmacists, the senior citizens and the concerned people of this province will be able to appear before the committee and explain their views and considerations of what they feel should take place. Some of the amendments may be small but they could be very important.

What concerns me the most are the small pharmacies in the villages, the hamlets and the rural areas of this province where people do not have to drive a great distance in order to fill the prescriptions the doctors in the small communities they live in have recommended for them.

I hope and feel sure the minister will see fit to make the hearings very thorough so we end up with a good piece of legislation with which the pharmacists and the government will be satisfied, a bill that will be of benefit to all the people of Ontario.

8:30 p.m.

Mr. Partington: I am pleased to express my concerns about Bill 54 and, in particular, to urge the government to refer this legislation dealing with the sale and distribution of prescription drugs in Ontario to a committee for full public discussions before amendment, which appears necessary, and passage.

The government of this province, drug manufacturers, doctors and pharmacists can take pride in having a drug distribution system second to none in the world. The people of Ontario have enjoyed the benefits of this drug distribution system and with it the finest health care system in the world. Although this drug distribution system has been the best, we must continually strive to ensure it remains efficient, effective and sensitive to the needs of the citizens of this great province.

We must do nothing that will damage the system, impair its effectiveness or make it less sensitive to the needs of our citizens. This government, however, in its desire to show speed, decisiveness and power, and perhaps thinking -- although I doubt it -- it will bring quick, needed relief to the people of Ontario, may be damaging the very system it purports to improve. It may be bringing to the people of Ontario long-term pain for its own short-term political gain.

The need for full discussion of Bill 54 and its related bill, Bill 55, has been brought to the attention of all members of this House. One theme that has come to me regularly and loudly is the need for the government to listen to the pharmacists, to be open and permit full input and not to introduce these bills by edict. Time and time again, that theme has been related to me.

I have a copy of a letter to the Minister of Health dated December 10, 1985, signed by Ms. Linda Gaudet on behalf of the St. Catharines and Area Pharmacists' Association. Ms. Gaudet is a charge pharmacist with the Shaver Hospital for Chest Diseases in St. Catharines. She emphasizes the approach the government has taken. I would like to quote a couple of small paragraphs:

"It would appear the minister would like to dictate to the OPA a plan supported by scattered advice from individual pharmacists and unmentioned others. This impression is illustrated by the minister's question to a pharmacist from Geraldton, `Would acquisition costs be better for you?' How can the minister be in a position to arbitrarily legislate pricing practice when he is still asking questions of this nature at this time?"

Later, on page 3 of the letter, Ms. Gaudet states: "When analysing the situation, we as pharmacists play a small role in the entire picture of costs of the plan. In fact, our contribution has been unrealistically held for the past two years. However, we stand to be hurt most by the legislation.

"Further, in response to a letter from a Niagara area pharmacist, the minister states he cannot understand how it is the Ministry of Health is expected to pay large amounts of money to pay for drugs in Ontario which are purchased in other provinces for considerably less. We also wonder why this occurred. It would seem logical that if the minister is currently unable to understand the development of the problem in this province over the last two years, he should be equally leery of legislating radical changes for overnight results. No one can solve a problem they do not understand or have not properly defined."

Following that theme, in a letter to the Minister of Health from Howard Stephen Lackie, 17 Briarfield Crescent, a druggist in St. Catharines in the riding of Brock, he states, "The issue of drug pricing in this province has come under scrutiny and serious attack by your government in order to control the cost of financing the rising cost of the Ontario drug benefit plan, as well as pricing for non-ODB prescriptions."

He goes on: "Your intent to better manage these cost issues is well intended and I support every reasonable effort to provide prescriptions and all health care, as well as all other necessary government-supported social programs at realistic costs to all people of this province. The Ontario Pharmacists' Association has always been prepared and willing to discuss and negotiate a fair and equitable drug benefit program for all interested parties. Yet this legislation is being enacted unilaterally with regard only to the perceived positive benefits of cost savings without regard to the multitude of negative consequences."

One can see from those statements that Mr. Lackie is setting forth the desire of the pharmacists of this province to come up with a reasonable solution to provide drugs to the people of Ontario at fair costs. What he stresses is that there be some negotiation with the pharmacists and the pharmacists' association, that they have input. The pharmacists are the people to whom this government should be listening very substantially.

Druggists such as Howard Stephen Lackie, Ms. Gaudet and others in the riding of Brock to whom I have talked recently, Bob Allen my neighbour, Mr. Yielding of the Potter and Shaw pharmacy in St. Catharines and so many others, are very sincere, bright, long-term members of the community and people whom I am sure have at heart the best interests of those they serve.

Mr. Villeneuve: Confrontation, no consultation.

Mr. Partington: The same theme was expressed in the position paper of the Ontario Pharmacists' Association on Bill 54 and Bill 55. I will quote a statement by them.

"Legislative measures without the fullest consultation with and input from representatives of the key players to be affected by that legislation is destined for unnecessary difficulties and, ultimately, we believe to failure. All of this is completely unnecessary when the interested parties have pleaded for it and remain committed to giving their fullest and best-faith input if only given the chance to do so."

I urge the government to make sure that statement comes true, that it gives the OPA, the individual members and members of the public, anyone who wants to come forward, a chance to express their position and show the good faith I am sure they have. It is exceedingly important to ensure there is input from professionals, experts, pharmacists, doctors and others because it appears there are substantial issues in these bills that are not right and that will hurt society rather than help it.

I will go through three or four of these matters. Section 4 of Bill 54 prohibits pharmacists from charging or accepting payment from ODB customers. Welfare recipients cannot afford to pay the extra for their drugs but many senior citizens can. Even if these senior citizens prefer a more expensive drug than the one covered by ODB and can afford to pay the price differential, this section prohibits that from happening. The pharmacist must either refuse to grant the request or lose money in providing the customer with the more expensive preference.

8:40 p.m.

If the drug is not listed in the ODB formulary and if a physician wants to prescribe it to a patient, he must get the minister's approval. Since section 6 is written in terms of individual patients, each case would require approval. It is obvious it would create a very difficult procedure, especially if a patient were seriously ill.

I find it hard to believe that doctors would equip themselves with all these agreements that would have to be prepared and filed in order to get the proper medicine into the hands of the patient, especially as we know that most of the time the treatment of sick and injured people is not planned. It occurs as an emergency.

Subsection 11(2) of the bill, sections 5 and 6 of the draft regulations and the schedule, establish reimbursement by the ODB plan to pharmacists at the actual acquisition cost of the drug and a dispensing fee. No mention is made of any method for negotiating this fee. According to this schedule, only the cheapest multiple source drug price will be listed, and the pharmacist will be reimbursed for only this amount unless the drug is not available to the pharmacy at that price, unless the doctor writes "no substitution" on the prescription or unless the minister has approved a more expensive brand for use by the patient under section 6.

When we combine that with section 4 of the bill, we take away from a senior citizen or a welfare recipient the right to receive whichever brand of medication his doctor and pharmacist deem best. As a result, the government is in effect prescribing by regulation the best medicine for a patient, a totally insensitive regulation, over and above the prescriptions of the doctor or the dentist at the time the drug is required.

I might mention that Howard Lackie, to whom I referred earlier, listed in his letter to the Minister of Health a great many possible negative consequences of introducing the bill as it stands. As he points out, the issues are very complex, and he lists some of them. Some of his reasons concern the operation of a pharmacy, some concern the profitability of a pharmacy and some point to the disservice to the consuming public. I might mention just a few of the potential negative consequences noted in Mr. Lackie's letter. He states:

"This present proposed legislation will cause closing of pharmacies, a decrease in the work hours available to employees, actual loss of jobs, an increase in unemployment, a severe loss of service to the public in all areas of the province with more drastic occurrences in the rural and remote areas."

The fact that he states them does not necessarily mean they are absolutely true; however, he points them out as problems, and problems such as these must be addressed. The only way problems like these can be addressed is by permitting people like Mr. Lackie to have full input at a public hearing. These consequences would be just terrible if they happened, and it is up to the government to make sure that before these bills are brought to final form, all of these potential problems are properly addressed and assurance is there that they will not occur. Mr. Lackie goes on and says:

"Further negative consequences are higher government administration costs, higher individual pharmacy administration costs, different fees to cash customers and to private insurers, inequitably lower profit margins and return on investment for pharmacies and drug manufacturers."

That is important, too. In the society we live in, it is very important to make sure we keep the free enterprise spirit alive. Every time we add further bureaucracy, further controls and more paperwork, we frustrate the businessman. We make it harder for him to earn a living. As Mr. Lackie has suggested, at some point one might just close the doors and go and work elsewhere.

Mr. McFadden: The government should listen to Mr. Lackie.

Mr. Partington: It certainly should.

Mr. Lackie goes on to talk about a decrease in pharmacist manpower through a disincentive to enter the profession, sufficient disenchantment with it to leave and the inability to improve the consultative process between pharmacists and their customers. That seems very appropriate when we see that one of the spinoff effects of Bill 54 is that the prescription drug will be dictated by regulation, possibly over and above the wishes of the doctor and pharmacist.

He says it would increase utilization of drugs by Ontario drug benefit plan recipients because of the elimination of the restriction to a one-month supply. I guess that refers to Bill 55, but even though it does, the potential concern of especially elderly people stockpiling drugs and then taking so many they get confused, become seriously ill and, as I am sure happens from time to time, are hospitalized because of this is an important point to raise. Although it is in Bill 55, these bills are interconnected and I am sure Mr. Lackie had that in mind when he was writing this letter.

Of course, he talks about a decreased incentive for drug manufacturers to bring new drugs to market. We see Mr. Lackie has raised a number of issues that deserve careful scrutiny by the committee, and there are other matters. I think Mr. Lackie has alluded to them. Ms. Gaudet certainly did in her letter.

I guess we get back down to the overregulation by this government of the manner in which pharmacies will conduct their business. I might refer to the dispensing fee for drugs. Certainly the Ontario Pharmacists' Association in its brief basically stated the effect of Bills 54 and Bill 55 would be to give the cabinet the power to establish not only the cost of the drug or drugs being dispensed, but also the fee to be charged in respect of any prescription, not only in the ODB market but also in all non-ODB market situations where interchangeable products are or may be involved. Such regulation could occur without any input on behalf of the pharmacy or the drug manufacturers, and no provision is made for any kind of recourse, through binding arbitration or other methods, by agreed parties.

The government has indicated it has no intention of being unfair to pharmacists. The fact remains that the legislation gives the right to impose conditions unilaterally on pharmacists in respect to their operations, not only in relation to the ODB plan but also for all other dispensing operations. If this power is used unfairly, even with the best of intentions, the result is a threat not only to the quality of the present drug distribution system in Ontario, but also to its very existence.

8:50 p.m.

It has been conservatively estimated that many pharmacies throughout Ontario will be put out of business if the present plans of the government, as they are understood by the OPA, are implemented. The OPA set that out as one of its concerns. It seems to me that concern is backed by the trend this government has been pursuing for some time; it has been reluctant to negotiate with the OPA.

It has certainly been reluctant to put these bills to committee and have full, open-ended input. That is the very process that has to take place so the pharmacists of this province can have faith in a government which can dictate at any time, without negotiation, according to Bill 54, what fees they are going to charge and how they are going to charge them.

It seems to me that Bill 54 is deficient in that regard. Surely some mechanism must be set out in the regulations that would give pharmacists some influence and input into the fees they are ultimately going to charge, perhaps by some form of conciliation or arbitration process. To leave it solely in the hands of the bureaucracy without any input from the private sector threatens the private sector. It certainly threatens the business of pharmacy.

Under section 9 of Bill 54, ministry inspectors or agents will have broad general powers to search and seize pharmacists' and doctors' records. These records contain confidential information, but the bill contains no guarantee of the maintenance of confidentiality.

Up until this date, the business and profession of pharmacy has been regulated through the Ontario College of Pharmacists and the Health Disciplines Act. It seems to me this government should be moving away from eroding the confidence in the profession of pharmacy, which has served this province well for many years, certainly from my point of view for as long as I have been visiting drug stores. This independence should be continued through the Ontario College of Pharmacists.

Again, the government is perhaps showing a lack of faith in the pharmacists of this province, people like Mr. Lackie, Ms. Gaudet, Bob Allen, John Yeilding, Chuck Luders and many other druggists not only in St. Catharines and in the riding of Brock but also throughout this province. These are druggists who are fine, reputable citizens of the communities in which they live and who contribute a great deal through charitable works and through the operation of very high quality pharmacies.

The government must give these people an opportunity for full discussion. Not only that, but it must also amend Bill 54 so as to continue to allow pharmacists to have control over their affairs, to use their expertise and to use their good faith for the benefit of the people of Ontario.

As I indicated before, many issues in Bill 54 need addressing, and for that reason there must be full public discussion. The thought of passing these bills without full input or discussion from everyone is amazing, it is unbelievable when one considers the many amendments that not only pharmacists but also others say must occur.

It is not only the pharmacists but also the drug manufacturers and the doctors who suggest that sections 4 and 6 of the bill should be amended to allow the doctor and the pharmacist to provide whichever brand of medication they believe is best for the patient and to ensure that the dispenser is fully reimbursed for that brand. They agree that the bill should be more specific, with fewer powers left to regulation. They want the bill to include a method of negotiating dispensing fees, and understandably so.

All three groups want tighter controls on the search and seizure of records and they want guarantees of confidentiality. We have been talking about pharmacists here the last while. It is not just pharmacists; it is pharmacists along with the doctors and the drug manufacturers. Many of them are in agreement on many points that are in the best interests of the public. It is the pharmacists who want the college to have a greater enforcement role, and that is understandable. I certainly support their contention.

With respect to pricing, there certainly is a difference between the drug manufacturers and the pharmacists, at least in the formula for determining pricing. The pharmacists want the best available price listed for each brand of the approved drug product, while the drug manufacturers favour the use of actual product cost plus an inventory carrying allowance. All three groups would prefer to have the Health Disciplines Act amended rather than have this legislation introduced.

It seems clear that what is required is substantially greater input into the background of these bills than has been offered to date to the parties that can best provide that input.

I will quote again from the letter of Mr. Lackie to the Minister of Health. His closing paragraph says, "I urge you to immediately open wide your lines of communication with the Ontario Pharmacists' Association to listen to their position, and to discuss openly and realistically the ways and means to achieve prescription services at reasonable cost."

Concurring with that last paragraph, I urge the government to ensure there is full and open debate, there is full participation in the committee hearings and that after the input has been made, the necessary amendments are made to these bills so that we will continue to have in Ontario a strong drug delivery system, with a vibrant free enterprise pharmacy business and profession throughout the province.

The business of pharmacy, if I may call it that, adds greatly to the sense of free enterprise that we enjoy in this province. I think it is to be encouraged. Of course, by making these necessary amendments, not only will we guarantee a thriving pharmacy sector but we will also guarantee the continuance of the finest health care system in the world for our citizens.

Mr. Barlow: I had not planned on saying much on this bill. However, I feel I should join in this debate and make a few remarks on Bill 54. I wish the minister were here to answer my one question, which is: will this bill and its partner, Bill 55, be referred to committee for full and complete hearings for all concerned citizens of Ontario who wish to participate in the debate? Unfortunately, the minister is not here so I may have to elaborate on my remarks a little more than I had intended to.

Like all of us on all sides of the House, I have received a number of telegrams, letters and phone calls from pharmacists and others in the province who are concerned about how this bill might affect each and every one of us as we buy prescription drugs at our local pharmacies.

I have received telegrams from my riding of Cambridge and from outside Cambridge. There is not an overwhelming number of telegrams, but I have three here. I have one from Richard Bodner, who is the pharmacist at Grandview Pharmacy, a local pharmacy in Cambridge. I think he is a constituent of the member for Wentworth North (Mr. Ward). I guess he could not get far there, so he felt obligated to contact me as a member of --

Mr. Villeneuve: The real opposition.

9 p.m.

Mr. Barlow: -- the real opposition in this province. That is correct. I thank the member. I have other letters here from pharmacists in Kitchener. Of course, they are not represented by an opposition member either; they are represented by a government member. That is unfortunate on their part. I have one from Guelph. I see my colleague the member for Wellington South (Mr. Ferraro) is not here this evening to help me to help this particular pharmacist with his concerns. I have signed petitions. Most of us in this Legislature have received petitions from students. Unfortunately, I have not heard all the debate as it has gone on for the past few days, so I am not sure whether this petition has been read into the record. In case it has not, I will read it into the record at this time.

It is headed "Caution" in big, bold letters, then it says: "This could be hazardous to your health. Two bills have been proposed by the Ministry of Health which will drastically change your method of receiving prescriptions. Do you know how these bills will affect you and me?" It goes on, "To you the customer" -- that is, to all of us in this House:

"1. A longer waiting period for prescriptions.

"2. More questions for you to answer before each prescription is filled.

"3. Shortages of dispensary supplies.

"4. Less protection from drug interactions and drug potency.

"5. Less time to consult with the pharmacist about your medications or other concerns.

"6. Cash prescriptions will increase in price."

Then it continues: "To us your pharmacists:

"1. More time spent on record keeping for the government, therefore less time to devote to your prescription.

"2. Less revenue, resulting in a decrease in staff in the pharmacy."

We are all concerned, of course, about the employment situation in the province as it is today. Each of the students who has signed this sort of petition has expressed the same concern.

"3. Less time for continuing education.

"4. Fewer pharmacies in Ontario -- many will be forced out of business because of financial pressure leaving some towns and villages without pharmacies."

It wraps up by saying:

"Do you feel that this would be satisfactory to you? If not, please feel free to question our pharmacist about this legislation, and please sign and return this letter to your pharmacist, who will forward it to your MPP."

These petitions arrived on my desk, and I am sure all my colleagues in this House have received similar ones. The student pharmacists are particularly concerned about their future when they graduate from the college of pharmacy they are attending at present.

I have also received a bunch of letters, some from Cambridge but many of them from outside of Cambridge, reflecting the concern of pharmacists who live outside my riding but who feel they are not being listened to by their representatives, who happen to sit on the government side of the House.

One pharmacist is the operator of a Shoppers Drug Mart at 1539 King Street East in Cambridge. This letter has one page and one paragraph on the second page. Mr. Speaker, you would probably like me to read the whole letter into the record, but I will not do that at this time.

The Deputy Speaker: If you summarize it, that will be fine.

Mr. Barlow: The Speaker would like me to summarize this letter from Thomas Chow Pharmacy Ltd., 1539 King Street East, Cambridge, which I will do. He starts off by expressing his concern about the two bills that have been introduced in the Legislature. I would like to read just the first sentence of the second paragraph. It says, "Pharmacists, as an association, have worked closely with the former government to develop the present Ontario benefit program." I shall repeat that in case some members did not hear it: "Pharmacists... have worked closely with the former government to develop the present Ontario benefit program."

Mr. Breaugh: Put a little more stress on the "former."

Mr. Barlow: Yes, that is right. For those who do not know, the former government was Progressive Conservative for several years, some suggest for as many as 42 years.

However, I shall go on. This pharmacist goes on to say it was "deemed to be fair and equitable to all parties involved." He is particularly concerned about what is being introduced and what it is going to do. He is telling us the former government was more than pleased to work with the Ontario Pharmacists' Association and it was quite pleased with the results that seemed to be developed.

He says: "Yet in the course of the last three months" -- this letter is dated November 23, by the way -- "Mr. Elston proposes an end to the last 10 years' developments. Not only does Mr. Elston propose to revoke everything, but he wishes to introduce unilateral legislation to regulate my profession" -- his profession -- "something that no democratic government has ever been allowed to do to any profession in our society."

We are seeing more and more of the dictates of the present government to the various professions and businesses. As members know, I am the critic for small business, and I regard pharmacists as small businessmen and businesswomen. I certainly feel this is something that is going to attack their very existence as professionals operating small businesses.

I thought I should read the fourth paragraph. It says:

"Mr. Barlow, I sincerely believe that you are a man who believes in fairness." In all modesty, I have to accept the man at his word on that issue. "All I am asking is that the legislation not be railroaded to meet the January 1 deadline." Obviously it missed that deadline. "Rather, allow the proposals to be studied by committee. Invite input from the public, and I am confident we can reach a mutually agreeable solution to the major issue of price spreading."

That is from one pharmacist in my riding. I have several other letters here. I do not think I shall take time, if members do not mind, to read them all into the record.

Mr. Villeneuve: Go ahead.

Mr. Barlow: I have been encouraged to read them all. No, I think I shall pass one or two of them.

Here is one from G. Buckingham, who resides at 30 Westwood Crescent in Cambridge. He is a pharmacist in that city. In his initial paragraph, he says, "I am writing to you as one of the very many concerned pharmacists in Ontario." Mr. Buckingham says to me in this letter, and I shall share it with members, "All three involved parties, namely, the ministry, the pharmacists and the manufacturers," really have to sit down, and there is a solution to these problems but not unless the ministry is willing to sit down.

9:10 p.m.

He gives a number of statistics as far as his business would be concerned, both in loss of revenue and the cutback in his dispensing fee as well as many other things. I will not bother giving members all those.

He goes on to say, "The Gordon commission found that pharmacy has not been enjoying windfall profits." I think the minister kind of suggested to the people of Ontario that there was a windfall to the pharmacists of the province, and Mr. Buckingham tells me there really has not been.

The word is that $29 million is to be pared from the Ontario drug benefit plan by squeezing the pharmacists. This $29 million translates into about $1 per ODB prescription loss to the pharmacies. In his own store, that is a profit of about $18,000. A loss like that puts the future viability of his operation in considerable doubt. I leave the ramifications of that situation to my imagination and I would like to transfer that to my colleagues in the House; it is a concern to all in Ontario.

I am sorry I am not taking enough time to read the entire letter to members, but another paragraph I highlighted says, "Why does the ministry refuse to meet with the OPA and the manufacturers together to negotiate a Gordon solution?" I understand the minister has not met with the OPA on a regular basis. He has had one or two meetings but certainly not enough to try to come up with a solution.

This handwritten letter to the minister is from a friend of mine, Bob Eberhardt. I am sure the minister recalls reading Mr. Eberhardt's letter. He is expressing the same concern about his own livelihood and those of the people he works with. Another short letter, from Westgate Pharmacy and addressed to myself, sums up a lot of the concerns of the pharmacists:

"I am concerned and disappointed to hear of the proposed legislation that is being put forward by the Minister of Health, Murray Elston. These proposals affect all aspects of pharmacy. I feel that the proposed legislation will have devastating effects not only on the pharmacists in this province, but ultimately it will be the consumer who will suffer. Since serious public study is required on these bills, this should not be pushed through legislation to meet the January 1 deadline."

For a reason we all know, it did not meet the January 1 deadline, but it is something on which the pharmacists want full public discussion. That is exactly what this party has suggested for the past several sessions when we have debated this issue. That letter was from Shirish Shah of Westgate Pharmacy.

Those are some of the letters from pharmacists in Cambridge.

I have other letters from outside of Cambridge, including one from C. J. W. Pharmacy Inc., Shoppers Drug Mart, in Guelph. My colleague the member for Wellington South (Mr. Ferraro) is not here today, but I am sure this pharmacy also wrote to him. It gives a rather lengthy description of its concern, again urging that the situation be given the most serious consideration and to act in a fair and reasonable manner.

I have a copy of a letter from a pharmacist in Brantford who is well represented by my colleague the member for Brantford (Mr. Gillies). We have one from as far away as Cornwall; that riding is also well represented. That pharmacist, Mr. Worrall, indicates many of his concerns.

Here is a letter to me from Family Drug Mart in Kingston. I am sure they have written to other members, if not to every other member of the House. It expresses their concern. That riding is unfortunately no longer represented by a member of the Conservative Party, so they felt it their responsibility to express their concerns to me and to other members of this House.

Bruce Wheeler says in the middle of his letter, "The bills are the result of unilateral action by the Liberal government without any input from the profession of pharmacy." It is very unfortunate that this government, which stands for full and open government, does not wish to consult the pharmacists or the people of Ontario by holding the full, open meetings we have been requesting for several sessions.

I have a letter from the Ontario branch of the Canadian Society of Hospital Pharmacists. I am not going to read that letter.

Mr. Laughren: Why not?

Mr. Barlow: I have been asked to read this letter into the record, but I am going to pass on this one. I just want to say that it is from the Canadian Society of Hospital Pharmacists. A very good friend of mine happens to be the past president of the Ontario Pharmacists' Association, and he is a member of the hospital pharmacists' society.

Mr. Laughren: I still want to hear it. What does it say?

Mr. Breaugh: We are curious.

Mr. Speaker: The member may ignore the interjections.

Mr. Barlow: When I get to a shorter letter, I will read it. This one from the Ontario branch of the Canadian Society of Hospital Pharmacists is in rather small type and it would take a little bit of time to read it. I do not want to take too much time in this House, because I do feel that other members wish to address this very important matter.

Mr. Laughren: The member is embarrassed about something in the letter, is he not?

Mr. Barlow: The member for Nickel Belt is challenging me to read this letter. I am not going to read it.

An hon. member: Read the date.

Mr. Barlow: The date? It is dated November 28 and is signed by Albert E. Chaiet.

I have another letter here, from the great riding of Kitchener. My colleague from just north of my riding is unavoidably detained from attending the House this evening, I am sure. This is also from the operator of a Shoppers Drug Mart there.

Mr. Breaugh: Oh, a small pharmacy.

Mr. Barlow: This is not very long; I might read it.

Mr. Speaker: If it is not repetitious of what you have said before.

Mr. Barlow: No, I do not think so. These are not form letters; they are all individual letters. This is from Charles A. Newman Drugs Ltd.; it is a Shoppers Drug Mart, as I say. This is not addressed to me; it is to the Minister of Health. Just in case he has not read it, let me repeat a few comments. It is dated November 15:

"I have studied the documents recently received from you under covering letter dated November 7, 1985.

"I do not find the legislation an equitable solution to the problems that you state now exist.

"You state your bills will re-establish public confidence in the retail drug industry. I assert any lack of public confidence in the retail drug industry has been generated by yourself through the derogatory statements that you have been making since assuming the post of Minister of Health. The people of Ontario have well-deserved confidence in the retail drug industry.

"Your legislation is not professionally researched and the implications are horrendous for the delivery of health care services to the people of Ontario.

9:20 p.m.

"Unless a just and equitable fee is negotiated, lack of funds will force Ontario pharmacists to curtail services, i.e. free delivery -- which is extremely important to our senior citizens -- and patient counselling. Inventory reductions will cause delays in patients receiving required medication. Staffing curtailments and layoffs will swell unemployment in Ontario.

"Sir, what you gain in lower drug payments, you will more than lose in increased cost for inspections as outlined in your bills, in increased unemployment services, probably even increased welfare services, as well as causing suffering to a large number of the people of Ontario.

"You state you are confident a mutually acceptable agreement on a fair and equitable dispensing fee will soon be reached. I do not share your confidence. You have demonstrated to the OPA since June of 1985 a strong reluctance for the negotiators to meet. You have waffled on having meetings and not having meetings. Sir, I have a lack of confidence in your intentions." That is a very strong statement.

"Sir, I request that you reconsider, gather all the facts from all interested parties and then, and only then, act so that you serve the best interests of all of the people of Ontario."

The list goes on. That one was from Kitchener. There is one from The Village Pharmacy in Petawawa. It was written to all members of the Legislature. There is another from Forhan's Pharmacy Ltd. in Ottawa.

Mr. Sterling: I got one.

Mr. Barlow: This one is addressed to me. Does the member have a copy of it? The list goes on. As well as letters, I have had a number of phone calls from pharmacists not only from Cambridge but also from outside it.

In Cambridge, we have a pharmaceutical manufacturer, Norwich Eaton Pharmaceuticals. I received a letter not only from its general manager but also from 44 of its 58 employees. They all sent a letter expressing their concerns.

Somebody, quite unprompted and anonymously, sent me a letter that happens to be from the member for Kitchener (Mr. D. R. Cooke). Perhaps this has been read into the record before. I am not going to read the total letter. It was sent to a person in Kitchener. The name has been blotted out, so I cannot tell who it is. We are not going to know who it is.

I assume the member for Kitchener has probably taken the party line on this. He explains to this individual who wrote to him, "I feel it is very unfortunate that the Region of Waterloo Pharmacists' Association has been conducting a highly irresponsible campaign...." I find it very difficult that one professional, a professional legislator, and prior to that a lawyer --

Mr. Sterling: I bet he does not have his QC any more.

Mr. Barlow: That is right. He is still a lawyer but he does not have his QC any more.

Mr. Villeneuve: What happened?

Mr. Barlow: When the Grit government came in, away went the QC.

He sent this to an individual in Kitchener. It looks like a form letter that has gone out from every member on the government side who has had anybody raise any questions about these two bills.

He calls the actions of the Region of Waterloo Pharmacists' Association irresponsible. I find it extremely difficult to believe or to understand why a member of the Legislature would say that about a group of professionals. "It is activity which is not befitting a very noble profession." I cannot understand him making such a statement. There are a number of statements in here I really cannot understand him making.

At the bottom of the first page he says, "The fact of the matter is that the new arrangements will result in reduced profits for druggists." Naturally, the druggists are also concerned about that. He goes on to say, "However, it will not create a reduced service." The druggists do not believe that. That is the point they have been making all along and the point we are trying to make to the minister.

Let me read the beginning of the member for Kitchener's final paragraph, "Once again, I regret the undue alarm caused by the false claims of the Region of Waterloo Pharmacists' Association and the Ontario Pharmacists' Association."

I think it behooves the member for Kitchener to stand up in this House and prove which particular points are false. He is telling the professionals in my riding of Cambridge and in the ridings of three other members who happen to sit on the government side of the House that they are making false claims. That is a statement I would not want to be associated with. One of the three members from the Kitchener-Waterloo area might wish to challenge it.

I would like to go on and give a few more incidents, but I know time is marching on. Unless you insist, Mr. Speaker, I will not read any more of this information into the record.

Mr. Runciman: I understand the debate is going to be brought to a conclusion in the very near future, so I will make my comments rather brief. I want to bring to the attention of the House some of the concerns of pharmacists in my riding.

The minister brought in this legislation and made his statement in the House some time ago. It has been said that he tried to find something in the ministry he could hang his hat on and make his mark with and he decided this was the area he wanted to do it in. It perhaps arose out of his experiences in his brief tenure as chairman of the standing committee on public accounts when the Provincial Auditor dealt with the drug benefit plan and had some strong criticisms to make about it.

I do not think any of us disagree that changes are warranted, but we have to disagree with the way this government and this minister have gone about them. This present government is operating under undue influence from the third party in this Legislature. Obviously, that is affecting the Health portfolio more than any other area of this government.

The minister has systematically gone about terrifying virtually everyone involved in the medical field. I was talking to some people in the nursing home field a short time ago about a speech the minister delivered. They all suspected the speech had been written by the member for York South (Mr. Rae) and not by the minister or his staff.

I found quite an interesting article in the Globe and Mail this morning, headed "Liberals, NDP Find Sharing Bed Cosy in Minority House." I am sure that Ian Orenstein and others in that party will find that headline and the story accompanying it very interesting. For those members who are not aware of it, Mr. Orenstein is challenging the leader of the third party for leadership at the convention in June and we wish him well.

9:30 p.m.

One of the other elements of that story indicated that the Attorney General (Mr. Scott) was really a New Democrat who joined the Liberal Party in a fit of opportunism because he had a greater chance of being in government. This government is not only being influenced in the health care field and other areas because of the accord, but also through certain individual members sitting on the executive council who are something less than Liberals.

This is quite openly an antibusiness and antiprofessional government. It is a socialist government in everything but name and this legislation, along with other legislation such as the retroactive rent control and extra-billing ban, are clearly indicative of that. The government has adopted methods of confrontation and it is dealing with virtually every professional group in our society in that manner. Again, this is indicative of its very close relationship with the NDP. We have Bob Rae playing all the old socialist hymns on his organ and David Peterson holding his nose and bowing on cue.

The Deputy Speaker: You are talking about the member for York South and the Premier, I presume.

Mr. Runciman: Yes, I am. I apologize for not identifying the ridings.

I want to talk about a couple of areas of this bill before I get into specific concerns of pharmacists in my riding. One I especially want to make reference to is the section of the bill dealing with inspection.

"9(1) The minister may appoint inspectors for the purpose of this section.

"(2) An inspector or any person acting under the inspector's instructions may examine any records, in whatever form," etc.

"(4) An inspector or a person acting under the inspector's instructions may at any reasonable time," whatever that means, "on producing proper identification, enter business premises where the inspector or person believes a record referred to...may be located...."

Can we blame the profession for being horrified about this kind of legislation being introduced? Shock troops; inspectors. Who will these people be? How qualified will they be? It has to strike terror into the hearts of these small business people -- many of them are small business people -- faced with the possibility of overzealous political appointees making unreasonable demands.

There are shades of Orwell. Mr. Orwell foresaw this socialist alliance in Ontario. It is nothing short of regimentation of the profession and Big Brother overseeing every move.

I mentioned some of the individuals in my riding expressing concern. I will deal with a few of those briefly, especially since many other members have mentioned the concern related to those pharmacists in small communities such as Westport with a little more than 700 people, Elgin and Gananoque with approximately 5,000 in population.

They are essentially concerned that this legislation is going to see the end of many small pharmacies throughout this province. Perhaps the most pertinent one of all these is Watson's Village Pharmacy in Westport, which indicates:

"1. Mr. Elston, the Minister of Health, does not talk or listen to the pharmacists' association. He acts unilaterally and calls the media in when he has something to say.

"2. The wholesale cost of drugs as quoted to ODB should be realistic, but so should the fee. Remember, the fee is in lieu of any other profit or markup and has been stuck at $5 since 1983.

" 3. The thing that can kill a lot of pharmacies is the lifting of the fee per month on maintenance drugs. Mr. Elston's bill would require a pharmacist to dispense the whole prescribed quantity of the medication on one fee.

"A quick look at the cost of many drugs will show you that a pharmacist could be required to dispense drugs costing him $100 to $200 or more with a markup or fee of only $5. One does not have to be an accountant to see that a retail pharmacy cannot stay in business with that situation. Many of us won't."

Briefly, this is from Ben Thompson of Family Prescription Service in Brockville, again to the minister:

"Your actions will cause 20 per cent to 25 per cent of the pharmacies in the province to close or go bankrupt. This will temporarily solve some of the 700 to 800 vacancies in the province. Meanwhile, I am forced to continue working 50 to 60 hours per week managing my store, which grosses $1 million. I am wondering if the bank will renew my credit after my next statement."

This is another letter from Mr. Thompson, again to the Minister of Health: "Tut, tut! Your creeping socialistic hemline is revealing a set of NDP underwear." We could have told him that. He mentions some specific criticisms in respect to the legislation and concludes:

"The arbitrary actions of your ministry have already cost me a five per cent reduction in respect to the gross margin of my dispensary operation. If your ministry persists in these...tactics, you will eventually have few pharmacists to deal with."

I have a letter from Bruce Leslie of Curry Drugs Ltd. in Brockville mentioning the comparison that the minister has made in some public statements between Ontario and Saskatchewan. He says:

"In attempting to make that comparison, Mr. Minister, you failed to let the public know that only one company's product is listed in the Saskatchewan formulary and that the only way they are listed is by having the lowest cost. Is it much wonder, then, that companies are forced to recover losses by making up for losses on such bids?

"It is also interesting to note that in your comparison of Ontario and Saskatchewan you failed to mention the difference in dispensing fees between the two. Pharmacy carrying charges are also extremely high. We estimate that at any given time the government owes us $25,000 to $30,000. This is like an interest-free loan from us to the government. We must pay for most drugs within 30 days, and quite often within one week. For special claim items it is not unusual to wait two to three months for payment. With this sort of money outlay, is it any wonder we are upset about losing the little advantage we have with marginal price spreads?"

Another letter from Mr. Leslie states, "Since July 1, 1985, I have been unable to obtain several drugs at prices which I can use on the drug benefit plan." He goes into a list and indicates further, "With the government dictating so much now, I would find it extremely difficult to promote the profession to anyone considering pharmacy as a career."

Finally, I have a letter from Grenville Pharmacy in Prescott, which falls outside my riding; it is in the riding of Carleton-Grenville. It is from Hugh Gallaugher and indicates that the effects on the pharmacy profession will be in the neighbourhood of a $30-million loss, and for him personally approximately $25,000. He urges that in order to offset this we have to look at an equitable fee increase.

The minister indicated in his statement of November 7 that he was very optimistic a settlement would be arrived at. He said, "I am confident that a mutually acceptable agreement will soon be reached."

He said that in November, and I do not know what progress, if any, has occurred in the interim. I have to wonder why this kind of change in the drug benefit plan, the act that has been brought in and changes in this respect could not have been done in concert with fee increases instead of moving ahead in the arbitrary fashion that the government chose.

9:40 p.m.

That is all I wanted to put on the record this evening. This government has acted in a fashion that has offended the pharmacists of this province and many others in our society. By its actions in dealing through the media for the most part and in suggesting that the bulk of the people in this profession are unfeeling ripoff artists, the government has tarred all with its tactics and unsavoury methods. I would predict that the way the government is handling this group and many others in our society, those actions will come back to haunt it in the very near future.

The Deputy Speaker: The member for Eglinton.

Mr. Laughren: Can you not see me over the head of the Treasurer?

The Deputy Speaker: I am sorry, the member for Nickel Belt.

Perhaps the Treasurer (Mr. Nixon) and the member for Sudbury East (Mr. Martel) would carry on their conversation somewhere else.

Mr. Laughren: I think you are going to have to be more specific.

The Deputy Speaker: Order. The Treasurer and the member for Sudbury East, could you carry on your conversation somewhere else?

Mr. Laughren: Thank you for that much appreciated intervention on your part, Mr. Speaker.

While I support the present bill and the one to follow, I must give a nod to the Tories for their courage in taking on whom they have decided to take on in opposing these bills.

They are taking on the consumers of Ontario. They are taking on the druggists of Ontario, who want a new formulary. They are taking on the Ontario Pharmacists' Association, which wants a new formulary. The courage they have shown in whom they have decided to stake out as their enemy is truly remarkable. It will be interesting to see how they vote. We will see whether their words match that.

I am surprised at the way the Conservatives have been fighting this bill, given the fact that everyone I talk to wants this bill to get out to committee as soon as possible. They are angry at the Conservatives for playing this game of filibustering the bill. The Ontario Pharmacists' Association does not want it left in here any longer. It is most anxious to get it out where it can make its presentation to the all-party committee.

The druggists themselves are quite anxious to get it out. They know what has needed to be said has been said in this chamber. We know and they know there has been no adjustment for a year in the formulary to reflect increased prices, so the Conservatives are playing a very strange game and I guess that is why they have decided it is time they wound it up.

I would remind them, as well, it is not just the Ontario pharmacists and druggists themselves who are anxious. The taxpayers are very anxious too, because they know what $1 million a week means and that is the extra cost to them every week that goes by without this bill becoming the law of Ontario. The Conservatives seem to be able to say in a very cavalier fashion, "What is $1 million a week?" It is something of which they need to be reminded before the taxpayers descend upon them with some anger.

I have not been happy with some of the tactics of the pharmacists and the Ontario Pharmacists' Association. I have seen the ad. The one that is before me now is entitled, "The Biggest Pill You Will Ever Have to Swallow is Being Prepared at Queen's Park." It goes on to point out several things. These are the five headlines in the ad.

First it says, "another dose of government intervention." It is true. It is government intervention. On the other hand, the pharmacists have been beneficiaries of government intervention as well, through the Ontario drug benefit program.

Second, "As of January 1, your personal pharmaceutical records are no longer a secret." What does that mean? Were they ever a secret from the system, with respect to making sure what is being prescribed and the records of druggists are proper?

Third, "The proposed legislation is no cure." Was the status quo a cure? If we are going to save the Ontario taxpayers $1 million a week, then there needs to be some kind of prescription that applies to the industry.

"Fourth, the government creates a future where pharmacists can no longer give you advice and personal service."

That is really putting it on a bit. How can one make a blanket statement that "the government creates a future where pharmacists can no longer give you advice and personal service." That is a blanket statement that means nothing. Of course, the pharmacist is going to be able to continue to give advice and personal service.

The day this bill becomes the law of the land, is the government saying that pharmacists can no longer give advice, that they no longer can give personal service because this bill becomes law? I warrant that the day after this becomes law not a pharmacist in Ontario would agree with that statement. They know that they fully intend to continue to give advice and personal service to their customers, and so they should. They will continue to do so gladly, and they will continue to do so in a very professional way, as they always have. The ads the Ontario Pharmacists' Association is putting out do not do it a service and do not do the pharmacists of this province a service either.

The final point in the ad is, "Do you want your health care delivery system to deliver less?" Who wants the health care delivery system to deliver less? This is not going to deliver less to the customers as they go into drug stores across the land.

Mr. McGuigan: Maybe less to the pharmacists.

Mr. Laughren: Perhaps a little less, but the pharmacists will not suffer as a result of these two bills.

I saw a petition in a drug store in my constituency that implied --

Mrs. Marland: I am worried about the patients.

Mr. Laughren: The patients'?

Mrs. Marland: Yes.

Mr. Laughren: My patience is running thin, too. The petition I saw indicated that people who had a third party program -- for example, the workers at Inco and Falconbridge in the Sudbury area have a drug plan through an insuring company. They were being told that if these bills became law they would no longer be able to have their pharmacy bills paid for by the insuring company. I do not think there is anything in these bills to prevent that. I do not understand the kinds of statements that are being made. It is not doing the pharmacists themselves a favour when that is put in their ads.

By the way, I gather that those ads are costing the pharmacists $350,000. I am not sure why they are spending the hard-earned money of the pharmacists to fight a cause for which they have so little support, except apparently among the Conservatives. I am not even sure about that. We will see how the member for Mississauga South (Mrs. Marland) votes when the time comes.

Finally, I gather that the member for York West (Mr. Leluk) indicated he thought the pharmacists should be able to opt out of the Ontario drug benefit program. If he feels that strongly about the pharmacists opting out, I can hardly wait for his speech on the bill that will prevent opting out by physicians in the province.

Mr. McFadden: I welcome the opportunity to say a few words on this bill to the House tonight. I wish to focus my remarks in relation to several key matters with regard to the impact this legislation will have.

I recognize that, over time, problems have developed with the Ontario drug benefit plan. Members of previous governments have recognized this as well. In fact, under our administration, a major attempt was made to deal with this problem by commissioning the Gordon report. The recommendations of the Gordon report provided the framework for negotiations between the Ontario Pharmacists' Association and the previous government regarding the Ontario drug benefit plan. These negotiations were well under way when the present government came to power.

9:50 p.m.

The manner in which the Liberal government has chosen to deal with the issue will result in many problems if the legislation is passed as it now stands. The Minister of Health has chosen to focus solely upon the cost of providing medication to the public. By doing so, he has ignored the fact that the role of the pharmacist as an adviser on medication will be diminished.

Furthermore, the minister appears to have ignored the effect this legislation will have on the small, independent pharmacies. Many such pharmacies will experience cutbacks in staff and several will be forced out of business.

In proposing this legislation, the Minister of Health has refused to negotiate with the pharmacists, pharmaceutical manufacturers or other concerned groups. This hardly speaks well for open government, about which we have heard so much in this House. The lack of openness displayed by this government in creating this legislation is reflected in the legislation by the very lack of accountability envisaged by the provisions in the bill.

For example, the Ontario Drug Benefit Act states that neither the doctor nor the pharmacist will be held liable by the consumer for any problems arising out of the dispensing of generic drugs that must be listed. Studies have indicated that most adverse drug reactions occur with generic products, which begs the question of who is going to answer to the people who experience adverse reactions? In essence, the proposed legislation forces consumers to use a particular product, but if a person has an adverse reaction to that product, who is going to redress that person's grievance?

Hon. Mr. Scott: The member organized two conventions that had adverse reactions.

Mr. McFadden: The last one is going to be just great. The Attorney General will see the reaction it is going to get right in the province. This bill is the beginning of it. It was a gift to our new leader.

Another problem with Bill 54, as I see it, is that it reduces the dispensing of prescribed medications to the issue of cost and cost alone. Therapeutic value is allowed no place in the decision to prescribe a drug, and the professional knowledge of doctors and pharmacists is ignored.

This fact could have very serious ramifications. Take the case of a senior citizen. For drugs which have generic equivalents only the lowest-price drug will be covered by the legislation. A senior citizen on long-term medication will have to take the drug the government tells him or her to take. It does not matter if that person wants to take a drug manufactured by another company or if the doctor or the pharmacist thinks the person should take another drug.

Furthermore, the drug listings will be revised on a regular basis and the lowest-price drug within a drug classification will undoubtedly change. Over the course of a year or several years, therefore, a senior citizen could have his medication exchanged several times, not by his doctor but by a civil servant.

In my opening remarks, I referred to the harmful effects this legislation will have on small pharmacies. I would like to elaborate on that point. I believe the corner pharmacy will be most seriously disadvantaged by this legislation as it now stands. It is the local pharmacist who may be forced to stand by and watch a long-standing community business collapse as a result of the actions of this open, consultative government. It is the local pharmacist who must be allowed to make his or her views known to the Minister of Health before this legislation is enacted, but who to this point has been denied that opportunity.

There are over 1,000 independent pharmacies in Ontario. The average pharmacist is a small businessman who provides jobs in the community. Most people, including perhaps the Minister of Health, although I hope not, do not fully appreciate the training and work that goes into becoming a pharmacist. Most people see only a man or a woman in a white coat pouring pills from a large bottle into a smaller one.

However, to become a pharmacist a person requires some four years in pharmacy college, and once that person has graduated, his or her principal role is that of a provider of information to the consumer. That pharmacist must keep a record of every prescription issued and make sure the customer is not getting drugs that will react negatively with each other or with other substances.

In respect to day-to-day operation, the average pharmacy dispenses between 75 and 100 prescriptions. In an average day, a pharmacy has to call from 30 to 40 doctors, and many of these require second calls before a new prescription may be filled or a previous one repeated. As well, an average day for a pharmacist includes 25 calls from customers seeking advice about medication. As members can see, much of a pharmacist's day is devoted to doctors' and patients' concerns. The new legislation, as proposed, will require the pharmacist to spend more time on paperwork. The result will be that the time available for necessary consultation and discussion will be diminished.

The Minister of Health boasts that the new legislation could save about $17.9 million. That remains to be seen. Whatever the savings might be, they will come from the operating costs of small pharmacies. Large pharmacies and chains are likely to be able to adjust to the reduced operating costs, but it is clear most small pharmacies will suffer. These corner pharmacies will experience severe cutbacks, employees will be laid off, and some pharmacies in neighbourhoods and small towns will go out of business.

The plight the corner pharmacist will face as a result of this legislation has been brought home to me by one of my constituents, Mr. Emmanuel Atlas. Mr. Atlas employs nine people full-time and one person part-time in his pharmacy. However, if the current legislation comes into force, he states he will be forced to lay off three full-time staff members and totally discontinue home delivery.

In a letter to me, Mr. Atlas summed up the situation in which he finds himself if the proposed legislation is passed. He writes: "After 21 years of owning my own pharmacy, I am being forced to consider closing, since I can no longer meet the needs of my clientele. They are accustomed to high-quality service and attention. I can no longer afford to give this kind of service with your proposed legislation. Canada, I believed, was a democratic country, but this legislation leads me to believe otherwise." It is signed by Emmanuel Atlas of Hashmall's Pharmacy on Eglinton Avenue West.

This case is typical of the effects the proposed legislation will have on small pharmacies. This is why small pharmacists deserve to be heard by the Minister of Health.

After reviewing all these factors, what is the net result of Bill 54 going to be? We can expect to see major injury to independent pharmacies and the closing of many neighbourhood drug stores. These and other potential effects of the bill now before this House lead me to conclude its provisions are ill-conceived.

I recognize the Minister of Health has attempted to deal with the problems highlighted in the Gordon report. The fact remains, however, that for a government which pledges openness and consultation, the process of correcting the problems of the system has been marked by a distinct lack of consultation with the interested and affected parties. The minister has apparently failed to recognize many of the ramifications of his proposals.

I urge him to reconsider a number of the provisions of the proposed legislation and to ensure Bill 54 is referred to a full committee hearing where the general public will have the opportunity to appear and make its views known.

10 p.m.

Hon. Mr. Elston: I will be brief in my comments because we have to get this bill out to committee and go through the various deputations that many of the people who are involved in this desire to make. That includes on my own part, as I indicated in the introduction of second reading, the amendments I have been able to see that are needed in this piece of legislation from input of groups such as the Ontario Pharmacists' Association, the Ontario College of Pharmacists and drug manufacturers, both generic and originators.

A number of groups have been talking to me, and we have been talking and listening to them. We have been doing all the things those people who have been going on at some length have said we were not doing. It is essential that we get this piece of legislation to the committee. I ask some of my friends on the other side of the House who indicated I had no intention of sending it there, how was it I had hoped to have the amendments introduced in committee if it was not going there? It does not make sense.

In addition, I would like to make it very clear, as I stated emphatically on the introduction of second reading of this legislation, that the college has a role to play in the review and operation of this legislation. That takes care of a number of the concerns about the confidentiality, the question of cost of inspectors and other items that have been raised by some of the members who were not listening at the beginning of second reading, probably were not present in the House and probably did not have a grasp of what was taking place in the process.

I have been disappointed in some of the items that have been cited by members opposite with respect to this legislation, bearing in mind that there have been initiatives taken by other Ministers of Health before me, issues have been reviewed and steps decided to be taken that ultimately were cut off by certain processes about which I will not speak.

Those people who have interest in providing comments -- the groups listed in my letter that was requested by members of the opposition and then used as an indicator of my intransigence -- are going to be free to speak in committee. I am not placing any artificial cap on the time with respect to the hearings in committee. I have seen the need for advertising, and the committee will listen to the people who want to be heard.

I again emphasize that I spent a great deal of my time listening to people, reviewing what they said and developing amendments to the piece of legislation where I found the input to be convincing. I will be introducing some of those amendments for the review of those people in those committees. I am looking forward to hearing discussions in committee from those very people who want to take the time to provide us with other input, and to listening, along with committee members, to their efforts to improve the legislation.

I look forward to moving this piece of legislation to committee with its companion Bill 55, which I hope will follow this evening in very short order.

Motion agreed to.

Bill ordered for standing committee on social development.

PRESCRIPTION DRUG COST REGULATION ACT

Hon. Mr. Elston moved second reading of Bill 55, An Act to provide for the Protection of the Public in respect of the Cost of Certain Prescription Drugs.

Hon. Mr. Elston: I will be brief with respect to this legislation inasmuch as many of the members of this House not only have spoken at great length on Bill 54 but also have included in their remarks Bill 55. I hope we can proceed to dispatch this particular legislation to committee as well.

This bill provides a good number of consumer items that I think will be of genuine benefit to the people of the province inasmuch as consumers will know specific information about drugs, the cost of drugs, dispensing fees and others.

I have been very much taken with the support that has been shown to me through many organizations, including the seniors' groups in this province and the consumers' association of the province, and I have received many helpful suggestions from groups with whom I have met and corresponded to try to improve the bill as it goes into committee.

This piece of legislation is a companion to Bill 54, which we just saw passed in principle in this House on second reading. Let me say as well that we have every intention of moving forward with this piece of legislation quickly in the committee, as the members here already know.

With those few remarks, I will be pleased to hear some of the responses from the members opposite.

Mr. Andrewes: As the minister has pointed out, this piece of legislation is a companion to Bill 54. I assume my colleagues will enrich this debate to the same degree they did that on Bill 54. The same issues are pertinent in this debate, and I am confident my colleagues will have as many concerns with Bill 55 as they did with Bill 54.

The bill speaks to the protection of the public in respect of the cost of certain prescription drugs. It also speaks to the issue of interchangeability in prescriptions of what are known as generic drugs for prescribed drugs. Those interchangeable products, of course, will be listed in what has become popularly known as the formulary, and pharmacists in Ontario will be required by legislation to tell the consumer the generic equivalent of the drug he is requesting or that is prescribed.

What happens in this situation in effect is that the client or the patron of the pharmacy makes a decision about whether he will allow that substitution. The criterion, instead of being the type of medication, its benefits or its adverse effects, will simply be the cost that the consumer will pay for the particular prescription. We will not have the pharmacist deciding on the quality of the substitution; we will not have the physician deciding on the quality of the substitution; we will have the patron or the client of the pharmacy making that decision.

We have some serious concerns about this piece of legislation, as we did about Bill 54. We see that the bill in some respects is flawed. One of our principal concerns is that in some instances where an individual is unable to go to the pharmacy to procure a prescription, he may send an intermediary: a friend, a relative, a husband, a wife, a son or a daughter. That family member or that friend -- or, in some cases, that taxi driver -- will make the decision whether the substitution should take place.

10:10 p.m.

The bill speaks about consumer protection. Our concern is that the consumer is not protected. The client of the pharmacy is not protected. For the individual who has procured the prescription, there is no recourse for any ill effect he might have as a result of using the substituted drug. The pharmacist and the physician are protected by the legislation, but the consumer is not.

We believe the legislation is flawed. It is designed to protect the consumer, but the consumer is not protected from the therapeutic ill effects he might have as a result of the substitution. The client or the patient of the pharmacy is not necessarily able to secure the lowest price. The bill specifies that the drug should be sold at its actual acquisition cost; that is, what it costs the pharmacist to put it in his stock. Professor Gordon recommended that the term "best available price" be used, rather than the question of actual acquisition cost. Other groups have talked about the best available price being the lowest possible cost.

We have a piece of legislation that may result in a higher price to the consumer, as smaller pharmacies must pay more. They do not have the same buying power as the larger chains. Small pharmacies, which are small businesses, as my colleagues have pointed out in this House on many occasions, are already in a tough position in competing with the larger chains. They do not have the same buying power the larger chains have had and will continue to have. Therefore, the fear that has been expressed on many occasions by letter, word of mouth and telegram in this House about store closings and lack of service in the smaller communities in this province is a very real concern, and it is set out quite clearly as a result of this legislation.

The legislation talks about a single maximum dispensing fee posted in the pharmacy. That is designed to benefit the consumer. To some degree, it is misleading. The pharmacy posting the lowest fee may not necessarily have the lowest drug costs. Therefore, the prescription cost may not necessarily be the lowest cost.

Finally, our most serious concern about this legislation is the issue of the 30-day supply versus the term used in the legislation, "dispense as written." We have a situation where large quantities of drugs now may be dispensed, not at the discretion of the pharmacist; he or she is "required to dispense" according to the prescription. We have senior citizens and other clients of pharmacies who now can acquire huge supplies --

Interjections.

Mr. Speaker: Order.

Mr. Andrewes: I get the impression that some of my colleagues are perhaps not as enchanted with this debate as I am. However, I will soldier on.

An hon. member: We are paying attention.

Mr. Andrewes: Should I start over again? All of us can recite horror stories about the numbers of pills in the medicine cabinet. All of us have had occasion to visit senior citizens who have lost certain faculties. We have found the situation hundreds of times where prescriptions filled at a pharmacy and not fully utilized remain in the medicine chest in someone's home. This is wasteful. Medication may change in the course of the period of time for which it was dispensed. If it is not thrown out, it is stockpiled or accumulated. It is risky when medications are left lying around and it is confusing in situations where individuals may describe their symptoms to someone else. The other person may say: "Yes, that is what I had. Here is some medication I happen to have left over."

That is entirely unprofessional in a health care system which depends on the integrity of professionals. It depends on the integrity and the professional judgement of the pharmacist. In most cases, a pharmacist keeps a drug profile on individual clients in his community and can consult that profile on a regular basis. He knows the health care program an individual is on and cares about the client or patient he is trying to serve.

There are a number of other issues. The minister alluded to the appointment of inspectors and to our concerns about the role of the Ontario College of Pharmacists. We have some concerns about the excessiveness of the penalties the legislation speaks to. I have raised these concerns because our party feels they are serious concerns. They are issues that will be dealt with in committee and we are anxious at this time to see them dealt with.

I want to say one final word about professionalism. Our role here is to serve the constituents within our ridings, to serve the 8.5 million to nine million people of this province, to do the right thing. Our approaches may differ but our goals are identical. They are common goals. If there is one thing the minister and I share as a common view, it is that something had to be changed with respect to the Ontario drug benefit plan. Improvements had to be made.

That is why my former colleague from Kingston and the Islands commissioned Dean Gordon to undertake a very extensive study to report on the Ontario drug benefit plan. That is why Dean Gordon, in a very conscientious way, brought forward the framework for continued consultation and for revision to that program. That is why, in my short term as Minister of Health, I gave the staff of that ministry instructions to continue that consultation and discussion with the Ontario Pharmacists' Association, using the wisdom of the Dean Gordon report as the guideline for that discussion.

Although the minister and I share that common goal, I do not think we share any measure of agreement on the method he has chosen to achieve it. Rather than continuing to negotiate with the Ontario Pharmacists' Association, the minister chose to air the problem in the media. He chose to create a public perception of the problem by using Ms. Silversides of the Globe and Mail to take the issue to the public, to use a public medium as his vehicle.

Then he dealt with the issue by slamming the lid down on the very practitioners he relies on to deliver the service and introducing a piece of draconian legislation. He is saying to the public that the issue is beyond negotiation, that there is no room left for discussion or for input. He is destroying the goodwill that might exist between the profession and his ministry and the government, and he is seriously affecting the relationships between pharmacists and their clients.

10:20 p.m.

I warn the minister he is dealing with people who are up to the challenge. In spite of his attempts to insult their professional ethics, they are professionals first and will not let a government unilaterally take action against them in any way that affects their professional ethics. They are concerned that the level of service to their clients, the advice they offer, be given on a continuing basis. By way of a piece of legislation, that function might be restricted. Having created a public expectation of a better system, the minister now, through legislation, has beaten a group of professionals around the ears -- the very same professionals he expects to deliver a better system.

The bill is now going to committee, I trust, for revisions and public input. We are grateful for that.

Mr. Speaker: Before I recognize the member for Windsor-Riverside (Mr. D. S. Cooke), I have been listening and looking around the House. I note there have been three private conversations very close to the minister. Thank you very much.

Mr. D. S. Cooke: I will be brief. I find it difficult to believe that, after December and January, with the Tories ranting and raving against Bill 54, tonight we had a voice vote and I did not hear one of them say no. After costing the taxpayers about $6 million and holding up Bill 54, I did not hear the Tories say no. I do not know what the last month and a half has been all about, other than to say --

Interjections.

Mr. Speaker: Order.

Mr. D. S. Cooke: The Tories must be feeling very guilty tonight. They are verbalizing that, and rightfully so. They should feel guilty. The taxpayers have spent $6 million at the behest of the party that always claims to be the one that is economically responsible.

Mrs. Marland: If the member cannot hear, he should get his opted-out doctor to get him a hearing aid.

Mr. D. S. Cooke: The member for Mississauga South (Mrs. Marland) does not know anything about these bills. I have heard their interjections and 90 per cent of that party's members do not know anything about these bills.

Interjections.

Mr. D. S. Cooke: I listened to the member for Durham-York (Mr. Stevenson) this afternoon. I went to sleep.

Mr. Speaker: I am glad to see all these members here, but the member for Windsor-Riverside, I am sure, wants to speak on Bill 55.

Mr. D. S. Cooke: I want to finish my train of thought by saying how irresponsible the Tories have been in the last six or seven weeks. I am glad they finally got the message from groups such as the small pharmacists in our province who desperately wanted these bills to be passed so that we could have public hearings and deal with them in committee.

They have finally come to their senses and even listened to the Ontario Pharmacists' Association, which has said very clearly a new formulary needs to be published and that the irresponsible behaviour of the Tories has not assisted that organization or its membership. I look forward to the next few weeks of dealing with these bills in a responsible way and looking at the amendments that are necessary, both in Bill 54 and in some areas of Bill 55.

I want to mention a couple of areas in Bill 55 that I think the committee should examine. First, I want to be convinced by the Ministry of Health that if we are to pass Bill 55 as it appears in the Orders and Notices now, sections of the bill that are there to protect consumers and that allow for the interchange of generic drugs will not put any individual's health at risk. I have had some evidence and have heard some people express concerns that not everyone can allow his drugs to be interchanged with generic drugs and that some of the fillers that are used in some drugs may harm some consumers. I want to be convinced by the ministry that this is not going to put the health of any of our people at risk.

I suggest it is worth debating in committee, where we deal with these bills in clause-by-clause, not here, where we hear the garbage we have heard from that caucus for the last six weeks.

I commend the minister for his intention in this bill to try to protect consumers. I do feel there are some areas, such as those I have mentioned with respect to the interchange of generic drugs, in which there may not have been a lot of thought put into the possible health implications.

I suggest also that if the pharmacists who are charging cash-paying customers are going to be allowed to set their dispensing fees at whatever the level may be, whatever the traffic will bear, we might examine an amendment to say that if the dispensing fees are going to be lower than those set under the Ontario drug benefit plan, no one will pay higher, even under the Ontario drug benefit plan, than what is being charged by the pharmacists who are charging cash-paying customers. That will guarantee that the Ontario drug benefit plan is not subsidizing the cash-paying customers through higher drug dispensing fees.

Mr. Turner: Is the member going to adjourn the debate?

Mr. D. S. Cooke: I know. I have three minutes and I will not take the entire three minutes.

During the next reasonable period of time -- and the committee will determine how long the hearings will go on -- I expect we will have many amendments to both Bill 54 and Bill 55. When we finish with these two bills, I am convinced we will come out with bills that will protect the consumers and that we will also have in place a better Ontario drug benefit plan than we have had before.

Hon. Mr. Elston: For one more time I will make the point in answer to the former Minister of Health, the member for Lincoln (Mr. Andrewes). We have had public input in the sense that the minister and his staff and the members of the ministry have talked at length -- not just starting in September, when there was a series of articles, but much before then; in July, soon after I came into this portfolio -- about the issues and the problems and found that we had to generate a response.

This response is not the first time a response has been generated. Another Health minister might very well tell us the specifics of his interests and his attempts to do some of the things that are contemplated in this legislation. He might also advise us of the manner in which he was unable to perform and undertake the initiatives he decided he should take. Perhaps he did not negotiate as successfully as he ought to have done. In fact, he did not come up with a product that would have cleared up this problem several years ago. He knows that; I know that. Perhaps a good number of people will come to committee who might like to share with us something of the nature of those negotiations.

I want to repeat again that we have had input, we have talked and we have listened. We have made decisions and we have brought a piece of legislation to this House that I am prepared to amend and on which I will share amendments that have already been brought to my attention that I think will be helpful.

I want to go to committee now and fulfil my commitment to provide the public of this province with better drug legislation and more reasonable opportunities to manage effectively, and to provide the consumers of this province with information they need to be effective consumers, wise consumers and healthier consumers.

Motion agreed to.

Bill ordered for standing committee on social development.

The House adjourned at 10:30 p.m.

January 13, 1986

ONTARIO DRUG BENEFIT ACT (CONTINUED)

PRESCRIPTION DRUG COST REGULATION ACT