Hansard Transcript 1986-Jan-31 | Legislative Assembly of Ontario

Hon. Mr. Wrye: During the past few months the government has embarked on a course of strengthening the occupational health and safety system in this province. In addition to our primary function of protecting workers, we hope through these efforts to raise in the community and in the work place the profile of occupational health and safety, heighten public awareness and thus expand public involvement.

Workers have always been concerned to know of the potential dangers of toxic substances they use or manufacture, but the demand for information, for knowledge, has reached beyond the work place. It is increasingly clear that there is a growing determination in the public to know more about the environmental hazards caused by these toxic substances. In this regard, the grief of Bhopal has been the bitter classroom for our lesson.

As the public gives greater attention to issues of the environment, it will give greater attention to issues of health and safety in the work place. The result will be safer work places, fewer accidents and healthier workers.

In recognition of this fact, I want to announce that later today I will introduce for first reading a bill to amend the Occupational Health and Safety Act to provide workers with the right to know about potential hazards in their work place. Although the act currently contains a number of provisions that attempt to provide workers with appropriate information, these provisions are not enough.

In addition, in response to the growing public demand throughout Ontario for comprehensive information about work-place-originated environmental hazards, the government is enshrining in the legislation a community right to know.

As a result, our legislation will require an employer to provide the prescribed information to the fire department of the municipality in which the work place is located and to the medical officer of health of the appropriate health unit. Any member of the community will be entitled to receive that information upon request. There are four principal elements to the bill I will be tabling.

First, each work place will be required to establish and maintain a central inventory of all the potentially hazardous substances or agents that are now on, or may be generated on, the premises. These inventories will be provided to the Ministry of Labour and, as I have stated, to the appropriate fire departments and medical officers of health. The inventories will be available for the information of the workers. They will also assist the government in its various designation and inspection activities.

Second, the bill requires each container of a potentially hazardous substance in the work place and each source of a potentially hazardous physical agent to be fully and clearly identified with warning labels that are readily understandable to workers.

Third, the bill requires material safety data sheets for each potentially hazardous substance or agent to be in an accessible place in the work place. These data sheets will contain a clear statement of potential hazards, precautions and necessary first aid information, and must be available in English and in the majority language of the work place where English is not the first language understood by the majority of workers.

Fourth, the legislation creates an obligation to provide appropriate training programs for the workers who are exposed or are likely to be exposed to the work place hazards.

The implications of the bill are far-reaching and will affect virtually every worker in the community where hazardous substances are used.

Let me remind honourable members that in 1982 a consultative process was initiated involving industry, labour and the federal and provincial governments to develop the work place hazardous materials information system, or WHMIS as it is referred to. This is a national system of information-delivery to users of hazardous products.

This process resulted in a final report, which was published in the summer of 1985. The report recommended the development of specific federal legislation and provincial adoption of similar provisions by reference by the summer of 1986. However, to date there has been little progress in implementing the report.

The government of Ontario joins both industry and labour in its disappointment at the lack of concrete action in developing a final program. We hope Ontario's initiative today will give renewed impetus to the federal government.

There is no issue for workers that takes precedence over health and safety. This statement requires no elaboration. It stands in self-evident relief against the hundreds of thousands of workers in this province whose ability to earn their livelihood and whose sense of self-worth and self-esteem are tied to their physical well-being.

It is inconceivable that we as a society or we as a government would tolerate or condone unreasonable and avoidable risks to their well-being. As of right, each person in this province should be able to return to his or her home unharmed by the environment in which he or she works. By our actions today, the government of Ontario is taking a further critical step to protect this right.

DISASTER RELIEF

Hon. Ms. Caplan: I wish to bring to the attention of the honourable members and of the people of Ontario the continuing need for funds to assist the unfortunate people of Colombia, who are still suffering from the tragic effects of the volcanic disaster that occurred in November 1985. I am informed that the death toll in Bogota and other areas swept by the eruptions now exceeds 25,000. Thousands more were injured, and countless others lost everything they owned to the molten lava.

The International Red Cross, supported by our Canadian affiliate and provincial divisions, immediately rushed extensive emergency aid, including food and medical treatment, to Colombia. The Red Cross is continuing its relief work in Colombia and is mounting major rehabilitation and construction projects.

Of course, there is an ongoing and pressing need for money to support these programs. The Ontario Red Cross is continuing to receive donations on behalf of the international organization. Later today, I will give a government of Ontario cheque for $250,000 to the Ontario Red Cross for the Colombia relief fund. This fulfils the commitment made by the Premier (Mr. Peterson) on behalf of Ontario in response to the first cries for help last November.

I also wish to report that Ontario is continuing our assistance to the people of Mexico, who were struck by a severe earthquake in September 1985. Members will recall that Ontario committed a total of $500,000 to help in Mexico. We provided $250,000 of this through the Ontario Red Cross for immediate emergency aid, including food and medical care. We also committed an additional $250,000 to assist in reconstruction.

Officials of the Ontario Ministry of Intergovernmental Affairs are working with members of the Canadian embassy and with Mexican officials to identify how best to apply the Ontario funds. When a specific project is determined, we shall be pleased to report to this House.

In conclusion, may I again stress the need for money to assist the unfortunate victims in Colombia and in Mexico. I know the generous people of Ontario have already contributed to these programs, but the suffering and the need go on. Perhaps we can all dig a little deeper to help those who are desperate.

10:10 a.m.

ORAL QUESTIONS

Mr. Grossman: Is the Minister of Health going to be here, as we were informed?

Hon. Mr. Nixon: We expect him.

Mr. Grossman: He may have stopped off at his doctor's office this morning.

Hon. Mr. Nixon: Here he comes.

Mr. Grossman: We have been waiting for the minister. I thank him for joining us. I feared he had stopped at the local pharmacy this morning and would never be seen again.

Hon. Mr. Elston: If that is the question, I was not getting any prescription about my attendance at a local pharmacy. I was not at a local pharmacy. If the honourable is prepared to put a supplementary question, I will be pleased to answer it.

Mr. Speaker: I am sure the Leader of the Opposition will place his question now.

EXTRA BILLING

Mr. Grossman: Bill 94 bans extra billing, not only for doctors but also for dentists performing surgery in hospitals. As the minister is aware, the current plan pays dentists 40 per cent of the Ontario Dental Association fee schedule. When those dentists are totally opted into the plan, is it the intention of the government to pay only 40 per cent of the ODA fee schedule as the full amount or is it the intention to pay 100 per cent?

Hon. Mr. Elston: The honourable member will know we are in the process of speaking to dentists about various agreements with respect to settlement of fees and rates. They are being discussed internally. We have no particular intention and our minds are open. As is the usual custom with the Ministry of Health and various of the associations, we negotiate the rate of reimbursement.

Mr. Grossman: In their case, extra billing is not 10 or 15 per cent; it is the majority of their account. The amount they charge over the schedule of benefits is 60 per cent; so it is an enormous amount. When the minister decides to stop their extra billing, he is going to reduce their payment by 60 per cent of what they currently get or he is going to provide that 60 per cent or a large portion of it, and the dentists ought to know what he is talking about.

If the minister is going to negotiate an amount up from 40 per cent, he will have to acknowledge that some of the net savings of $50 million he claims for ending extra billing, perhaps as much as $12 million of it, will go to compensate dentists. Will the minister indicate whether it is his intention to adjust the current 40 per cent payment upward?

Hon. Mr. Elston: In terms of the negotiations for the reimbursement of activities, it is fair to say there will be an adjustment upward. We are involved in negotiating these claims with the various associations, and we do not have a preconceived position with respect to that.

The member is talking about savings. We are saying that some $4.4 million per month is being withheld from us by the federal people. Those things will be transferred to us to use, and the Treasurer (Mr. Nixon) is very good at allocating resources for best use by the citizens of this province.

Mr. D. S. Cooke: When does the government plan to bring in its election promise of denticare in this province?

Hon. Mr. Elston: Each of us is significantly aware of the benefits of good dental hygiene, and all of us know about the benefits that have been provided to us by good dental care for young people and seniors. The Treasurer and I are busy talking about how these programs can be put together. He and I will be able to make announcements at appropriate times in the future.

Mr. Grossman: In answering the first supplementary, the minister acknowledged that, of the $50 million he is going to get back from the federal government, as much as $12 million, which is the difference between 40 per cent and 100 per cent of the ODA fee schedule, could be spent as the price of opting in dentists -- not yet dealing with experience, expertise or the other prices of opting in doctors. Perhaps the minister might be encouraged to talk about the $38 million, not the $50 million.

Ironically, I want to follow up in my final supplementary on the very question raised by the minister's close friend, the Health critic for the New Democratic Party.

Hon. Mr. Elston: Did the Leader of the Opposition and he have breakfast this morning?

Mr. Grossman: The minister and he were both at breakfast, I understand.

Hon. Mr. Elston: No. The Leader of the Opposition was with him.

Mr. Grossman: No. I am still discriminating.

Mr. Speaker: Question.

Mr. Grossman: I have the minister's campaign promise here, and it explains the reason denticare should be introduced in this province. I quote: "The sole reason for the original exclusion" --

Mr. Breaugh: Wait a minute.

Mr. Grossman: Wait until the members see where we are going. We do not have breakfast with them.

Mr. Foulds: We know where you are going.

Mr. Grossman: We will never get down to where you are. We will be back there a lot more quickly.

Interjections.

Mr. Speaker: Order.

Mr. Grossman: At least we remain an independent party.

It says here: "The sole reason for the original exclusion in the mid-1960s of dental care from our health insurance program was practical: to reduce initial costs and to allow time for a severe shortage of dentists to be overcome."

The minister will agree there is no longer a shortage of dentists. Therefore, can he outline what he expects to be the cost of the program he promised to the people during the provincial election campaign and when, not if, he plans to bring in denticare in this province?

Hon. Mr. Elston: I do not think this is a particularly beneficial forum in which to try to outline the entire program. I am prepared to come back and address to this assembly, by way of a statement, some of the replies to the questions that have been brought forward to me by the Leader of the Opposition.

CONFLICT OF INTEREST

Mr. Gillies: My question is of the Premier. It arises out of yesterday's statement by the Minister of Northern Development and Mines (Mr. Fontaine). That statement speaks to the minister's assets in United Sawmill, but it does not speak for the minister's direct assets in Hearst Forest Management, which would be the beneficiary of the forest management agreement.

Can the Premier confirm that the minister has placed his interest in Hearst Forest Management in a blind trust?

Mr. Davis: And when.

Mr. Gillies: And when.

Hon. Mr. Peterson: The answer to the question, as far as I know, is yes, all his assets have been put in that blind trust.

Mr. Davis: Has the Premier looked at it? Has he checked it?

Hon. Mr. Peterson: I have not checked all of these personally; Mr. Wright has.

Mr. Davis: Why not?

Hon. Mr. Peterson: What does the member mean, "Why not?" If he wants to look at them he can go and look at them. Mr. Wright of the Ministry of the Attorney General has passed judgement on them.

Mr. Gillies: The Premier can sweep this under the rug all he likes. This Legislature has a right to know whether his ministers are in a position to benefit directly from actions of his government.

The minister's statement did not say his interests in Hearst Forest Management had been put in a blind trust. It was not contained in the statement. I ask the Premier again: is he now telling the House unequivocally that they were?

Hon. Mr. Peterson: To the best of my knowledge, as I said, all his assets have been placed in a blind trust. That is exactly what we said he was going to do some months ago.

10:20 a.m.

Mr. Gillies: The Premier has not done what he said he was going to do. He said in his conflict-of-interest guidelines: "By the end of the year all disclosures required of the ministers will be filed with the Clerk of the Legislative Assembly, where they will be available for public examination." When we were in government it was 90 days. The Premier gave them six months and this House has still not had the opportunity to view these conflict-of-interest disclosures.

How much longer do the members of this assembly have to wait before they can see what the interests of the various ministers are? There are a lot of questions that the public wants answered.

Hon Mr. Peterson: I want to satisfy the member's curiosity. He is welcome to look at all of those things. I will repeat the procedure for the member --

Mr. Gillies: We have been waiting more than six months for this and it still has not been filed.

Hon. Mr. Peterson: Does the member want an answer to his question or does he just want to make a little speech? I am delighted he has brought the matter up. I am sorry the member for Leeds (Mr. Runciman) is not here today. The member for Brantford is doing almost as well as that member did on this question yesterday.

The minister said yesterday that he instructed his lawyers to put all of his interests in a blind trust, which I assume was done. It took some time to work out the legal technicalities and it was all fumed over to Mr. Blenus Wright, Assistant Deputy Attorney General, who acts in these matters. He makes the decision when to file, and then they are turned over to the Clerk at some point that is appropriate in his judgement. This was the traditional method employed by the former administration.

It is all going to be available to the public, and the member is welcome to spend as much time as he wants in scurrying through it trying to find some suggestion of conflict of interest. He can put his mind to it because obviously he cannot find anything constructive to do here.

Mr. Timbrell: On a point of order, Mr. Speaker: A researcher for our caucus asked Mr. Wright if we could see the statements and that was denied. We were told we would have to wait until they were filed with the Clerk of the House, and they still have not been filed.

Mr. Speaker: That is not a point of order. It is a point of view.

ST. CLAIR RIVER

Mrs. Grier: I have a question for the Minister of the Environment concerning the report he gave to the House yesterday. I would like to ask about one aspect on which his statement was strangely silent: i.e., the question of hazardous waste disposal.

The report says a more thorough examination of Dow's waste disposal practices is warranted. In fact, it makes it clear that Dow Chemical is to Great Lakes water quality as Inco is to acid rain, and the minister moved very decisively to control Inco. Will he use an order in council to restrict Dow Chemical's waste disposal practices?

Hon. Mr. Bradley: We will ensure that any of the waste disposal practices that are undertaken, not only by Dow Chemical but by any of the industries involved as a result of the stipulations of this report, will be in compliance with the rules and regulations of the province.

Mrs. Grier: That begs the question of how long, but I would rather phrase it in a different way. There are very specific problems identified with respect to Dow's disposal practices in this report. One of the problems is the Scott Road landfill which is shown to contain 2,4-D and 2,4,5-T weedkillers, one of which is so hazardous it is banned in Ontario. Neither of these is made by Dow in Sarnia.

Can the minister tell us where they came from and why he will not move immediately to prevent their disposal in that landfill site?

Hon. Mr. Bradley: If the member read the report carefully, as I know she did, it did not indicate where they came from. It was stated --

Mrs. Grier: That is why I asked the minister.

Hon. Mr. Bradley: Remember, it is a report of officials of the Ministry of the Environment of Ontario and Environment Canada to the ministers, indicating what they have found to this point. It was clearly indicated that they were unable to establish where that material came from. It is stated by companies in the area that they did not dispose of it there. It really gets to the question: if they did not, how did it get there? That is what we are investigating.

Mrs. Grier: That landfill site is operating under a certificate of approval from this ministry which allows the disposal of certain products. Presumably it does not allow the disposal of those not manufactured in this province. There are obvious violations of that certificate of approval. The minister has the power to close the dump. He appears to know very little about where these products are coming from. Will he at least immediately close that landfill site before he proceeds with a further examination and investigation?

Hon. Mr. Bradley: The member is assuming the product that was found is going in there on a continuing basis. Through our investigations and enforcement branch, through the technical people in our ministry and with the assistance of Environment Canada, which has been most co-operative in this regard, we are continuing to investigate that. In any of the cases, as the member is aware, if we find evidence that would call for a prosecution, then we are prepared to prosecute. I think what she is referring to is a product that has been brought there in years gone by. It is not a product that is being brought into the site at present.

EXTRA BILLING

Mr. D. S. Cooke: I have a question for the Minister of Health. The Ontario Medical Association has sent out to doctors this survey of uninsured services for which extra charges may be imposed by doctors now under the present Ontario health insurance plan charges, or in the future under Bill 94.

In the matter of such things as certificates for disability pensions or camps for summer students, insurance certificates, prescription renewals and a whole list of other services that are not now covered, is the minister prepared to amend Bill 94 to make sure that doctors do not institute more of these charges and that the current ones are eliminated?

Hon. Mr. Elston: I have not considered the addition of that amendment to the bill. I do not know if this is a complete list. I will consider the matter in discussion with my cabinet colleagues and my friends here gathered as a Legislative Assembly.

Mr. D. S. Cooke: Does the minister not realize that if Bill 94 and the OHIP fee schedule do not recognize these services and charges, the whole purpose of Bill 94 could be scuttled by the OMA or by doctors who do not believe in equal accessibility to our health care system?

Does the minister further recognize that, under the agreement negotiated by the former government with the doctors, they will be getting a six per cent increase in their OHIP fee schedule this year? Does he not feel that is fair, and that the principle of Bill 94 should be maintained and these charges should not be allowed?

Hon. Mr. Elston: I think it has been the practice in a number of offices that there have been charges for doing reports and other items. I am not prepared to eliminate those on a spur-of-the-moment suggestion here in the Legislative Assembly. As with all matters which have to be considered in legislation, there must be serious discussion about the effect any amendment would have on the impact of the bill.

One thing has to be made very clear to the people of Ontario. Although there has been a good deal of rhetoric surrounding the bill and otherwise, my confidence remains that the profession will not endanger patient safety. I am banking on that. People have every reason to expect that a profession with a very high degree of integrity will not frustrate patient care in this province by moving to any form of action against the bill.

Mr. Pope: To follow up on my friend's question and the minister's response, the minister indicated he would not countenance any amendments to the legislation without full discussion. The OMA says there has been no discussion with respect to this legislation at all and the Premier (Mr. Peterson) confirmed it in a letter of January 21. The minister was not willing to discuss the legislation.

Will the minister now adjourn the debate and start discussions with the OMA on a package of universal accessibility to protect our senior citizens and the financially disadvantaged?

10:30 a.m.

Hon. Mr. Elston: I have been enjoying for some days now the reading of letters and correspondence by the gentleman and his colleagues opposite. I have found, however, that on occasion during the debates there have been some genuine, finely expressed points of view. The process is proceeding through the Legislative Assembly, as it ought to, which is one of the most open forums in the public process.

Everybody here knows there will be opportunities in committee as well. That is the appropriate forum in which we will be able to examine suggestions such as this. I am prepared to examine any suggestions put by any member. In second reading debate, the Legislative Assembly should be allowed to proceed with the examination of the legislation in detail and in principle.

Mr. D. S. Cooke: If some members of the OMA are determined to get around Bill 94 or take any other kind of action to scuttle the real purposes of this bill, such as opting out of OHIP and forcing everyone to pay on the day one receives the service, does the minister not understand it is absolutely essential that he take the appropriate action to protect the patients of this province? One way of protecting the patients would be to amend the Health Disciplines Act --

Mr. Speaker: The question has been asked.

Mr. D. S. Cooke: No, it has not -- to amend the Health Disciplines Act so doctors cannot force patients to pay up front.

Mr. Speaker: Order. The question has been asked.

Hon. Mr. Elston: We must wait and see what will take place. I have confidence that the patients in this province are not going to be disadvantaged by the activities of their physicians. I have said on more than one occasion that the physicians -- even those who do not like the principles of this bill -- have told me face to face that patients can sit down with them and talk about their financial problems.

In this situation, if a person is requested to make a payment, he or she should sit down with the physician and say: "I cannot do it. Wait until I get reimbursed by OHIP and then I will make the payment." That is the type of arrangement that a lot of the physicians who say they are opted out tell me they are prepared to countenance.

CONFLICT OF INTEREST

Mr. McCague: I have a question for the Premier. On Tuesday, the Minister of Natural Resources (Mr. Kerrio) said he would provide all information about his or his ministry's involvement with the Hearst Forest Management matter. Could we now have his assurance that the forest management agreement prepared for signature between the ministry and Hearst Forest Management will be tabled, as will the details of all discussions and written communications with regard to the FMA among the Minister of Natural Resources, his ministry staff, the Minister of Northern Development and Mines (Mr. Fontaine), his staff and the Office of the Premier?

Hon. Mr. Peterson: Surely, no problem.

Mr. McCague: The Premier is in a very good mood this morning. Would he also undertake to prepare a report for the Legislature outlining for us and for the public the economic benefits to a company such as Hearst Forest Management of receiving an FMA?

Hon. Mr. Peterson: I will respond to that question now. It will take a little time, if I may have the indulgence of the House. The honourable member asked me a question, and it is interesting that a statement came from the minister and the deputy minister.

Early this week, the House heard several statements about forest management agreements, therefore, this is an appropriate time to expand on the purpose of forest management agreements. Members may recall that in December I tabled the results of the first five years of these FMAs. Forest management agreements are contractual agreements between the crown and certain forest companies whereby a company undertakes forest management practices -- roads, harvesting, regeneration and forest tending -- on behalf of the Ministry of Natural Resources. Under a forest management agreement, the company carries out silvicultural work formerly done by the ministry. The ministry pays for this work to be done, and any costs exceeding those agreed to in the FMAs by the ministry and the company are borne by the company. The agreements are essentially the same for all companies. They differ only in the particulars relating to specific forest conditions and practices in an area.

The purpose of the forest management agreement is to provide for a continuous supply of forest products to the agreement holder and to ensure that the forests are harvested and regenerated on a sustained-yield basis. The agreement is for 20 years, but at five-year intervals performance and obligations are reviewed and revised. If judged satisfactory, the agreement is extended for a further five years. This is termed an evergreen agreement. The company must prepare forest management plans, annual work schedules and annual reports.

The forest management agreements are a major breakthrough between the industry and the crown in forest management. The agreements will benefit the province in the long run. They provide the basis for an integration of harvesting and silviculture and for an increase in the effectiveness and efficiency of forest operation.

Mr. Timbrell: Mr. Speaker, on a point of order: The member asked for an economic analysis and all we got is a description of the FMA program. That is in the annual report.

Mr. Speaker: Order.

EMPLOYEE HEALTH AND SAFETY

Mr. Reville: My question is for the Minister of Labour with regard to this morning's statement about the right to know. The minister may recall writing to me on August 29, 1985, in response to my letter of July 25: "I note your concern that right-to-know legislation should provide for both community and worker right to know. The Ministry of Labour is not empowered under the Occupational Health and Safety Act to enact a regulation that would provide for community right to know. Our mandate does not extend beyond the work place."

Will the minister explain to the House today his dramatic and welcome change of mind? Could it have been eagerness to live up to the accord or was it perhaps Bill 99, introduced on January 14 by the member for Sudbury East (Mr. Martel)?

Hon. Mr. Wrye: I want to say to my friend the member for Riverdale I was going to give him the credit for the persuasiveness of the letter he wrote to me. As a result of his letter and representations from other honourable members, we thoroughly reviewed this matter in the early part of the fall. By the end of September, when we began to develop the final package of legislation, we had decided that a community right-to-know option could be contained within the amendments to the Occupational Health and Safety Act.

I welcome the support I am sure we will have from the New Democratic Party because of the community right-to-know aspect that is in the bill introduced by the member for Sudbury East. Indeed, there are a number of similarities in both bills.

From the very beginning of the first submission through the cabinet process, we went forward with the community right-to-know aspect.

Mr. Reville: I must applaud the minister for twinning triumph and graciousness.

Will the minister assure this House that his government will move with dispatch to enact this long-awaited legislation and avoid the temptation to set up a task force headed up by, shall we say, the president of Dow Chemical Canada Ltd.?

Hon. Mr Wrye: I say quite sincerely to my friend from Riverdale I cannot give the assurance that we will move ahead in the next short period of time. I want to share the reason with the member and with the House. On a number of occasions, one as recently as November, the Canadian Manufacturers' Association, the Canadian Chemical Producers' Association and the Canadian Labour Congress jointly visited me in my office requesting that we not proceed unilaterally.

10:40 a.m.

The member will note from the statement I made this morning that we are attempting at this point to develop a national initiative. We hope the legislation that will be brought forward this morning will be a prototype for the provincial spinoff. It is amazing that we have done it in seven months while the federal government has just appointed a co-ordinator to begin to look at its responsibilities.

We are going to wait and see if the federal government can move this matter forward, because we would prefer to proceed with the national government and all 10 provinces joining in the initiative. Quite frankly, however, we are not going to wait for ever.

Mr. Gillies: I do not want to get in the middle of this; it is truly beautiful. I want to ask the minister about a continuing problem in the area of occupational health and safety which he undertook to move on some weeks ago in the House. It is the question of the Workers' Compensation Board benefits for victims of asbestosis. Is the minister any closer to a resolution of that situation?

Mrs. Grier: How is that supplementary?

Mr. Mackenzie: Where is the relationship?

Hon. Mr. Wrye: Is that a supplementary?

Mr. Speaker: I was very hesitant and looked quizzical. I believe it is not really a supplementary.

Mr. Timbrell: On a point of order, Mr. Speaker: It deals with the matter of occupational health and safety and is clearly supplementary.

Mr. Speaker: Order. I understood from the member for Brantford that he wanted to participate.

CONFLICT OF INTEREST

Mr. Pope: I am forced to ask the Premier again, will he table today the documents the Minister of Natural Resources (Mr. Bradley) promised on Tuesday, and will he table today the economic benefit analysis?

Hon. Mr. Peterson: I am surprised the honourable member would ask me to table documents, because he might conclude that I had some political motive for trying to ruin his political career if I let all these documents out. This is interesting. On the one hand, we have that member asking us not to table documents and share all the information with the people of this province, and now he is asking me to do it.

The answer to the question is yes, we will share all the information pertaining to that forest management agreement or any other --

Mr. Grossman: Today?

Hon. Mr. Peterson: I do not know whether I can prepare it today; I have no idea of the state it is in, but I will ask the minister to get it ready and it will be forthcoming. The former Minister of Natural Resources, who understands these things and who understood when the original discussions were going on, will understand what has transpired. I am happy to share it; I have no problem with that.

Mr. Pope: I understand what has transpired; that is why we would like the documents. I understand the advertising of the open houses in northern Ontario with respect to this matter in November. I understand all of that. I also understand the economic benefits that accrue from a forest management agreement. I am asking the Premier to table today the benefits of that particular agreement.

Hon. Mr. Peterson: I am not sure I can do it today, but we will address our minds to that forthwith. Believe me, I have no intention of embarrassing the former minister in this regard. Everything will be laid out and we are not trying --

Interjections.

Hon. Mr. Peterson: Look, we were trying to help the member's leadership bid. We did everything we could to do it; trust me. I am sorry about that, but believe me, I tell the member we will help in any way we can.

Mr. Laughren: When the Premier is tabling those kinds of documents, will he at the same time table all correspondence from within the Ministry of Natural Resources concerning the allocation of grants for private greenhouses when the member for Cochrane South (Mr. Pope) was the minister?

Hon. Mr. Peterson: That is a fair question the honourable member has asked me. I have had some people ask me to table the last --

Mr. Gillies: That is not a supplementary question.

Mr. Timbrell: On a point of order, Mr. Speaker: I think we all understand what is going on, but how can you on the one hand not allow a supplementary that is clearly in the same subject area, occupational health and safety, and then on the other hand allow a supplementary that is on a completely different subject, albeit related to the same ministry? If we cannot have consistency, what can we expect from the chair?

Mr. Grossman: A little bit of fairness.

Mr. Speaker: I am somewhat hesitant to reply after the last comment.

Hon. Ms. Caplan: They do not like the answer.

Miss Stephenson: There is never an answer.

Mr. Speaker: Order.

MEDICAL LABOUR DISPUTES

Mr. Mackenzie: I have a question for the Minister of Labour.

I think the minister is aware of the long delays that were experienced under the Hospital Labour Disputes Arbitration Act. I have a list of arbitration delays that is truly disturbing. I will mention only four: the Greater Niagara General Hospital, eight and a half months; the Collingwood General and Marine Hospital, now 10 months; the York-Finch General Hospital, eight and a half months, and the St. Elizabeth Visiting Nurses, eight and a half months.

Can the minister tell us what we can tell the workers in these institutions, who are paying the price of these delays in the arbitration cases?

Hon. Mr. Wrye: I think the honourable member will want to be fair in understanding that the delays often are caused by the unavailability of parties. The volume of arbitrations is disturbing in and of itself, and may be contributing to the lack of availability of parties in that they are involved in so many arbitrations. if my friend wishes, I will look into each of them and let him know what he can tell those involved.

I am disturbed by the increasing pattern of arbitrations in hospital disputes; it appears to be almost automatic. I share my friend's view that the arbitrations are unnecessarily lengthy.

Mr. Mackenzie: Will the minister tell us when we can expect the amendments to the Hospital Labour Disputes Arbitration Act, which I understand he is considering, and what will be in them? Can he give us a time frame for them? We obviously have a very serious problem with respect to delays.

Hon. Mr. Wrye: I cannot give the member a timetable for the introduction of any amendments, if we decide amendments are necessary. The member has referred to the act being under review, and we are reviewing it. As I am sure my friend knows, my assistant deputy minister has some excellent ideas in a number of areas, including this one, and we are taking an active look at the whole issue.

WATER QUALITY

Ms. Fish: I have a question for the Minister of the Environment. I would like to return to the matter of dioxin being found in treated drinking water in several municipalities in southwestern Ontario. Prior to the minister's announcement on Tuesday that dioxin had been found in the treated drinking water and that he was prepared to accept a certain level of dioxin in the water as acceptable, there had never before been any level of dioxin in drinking water set as acceptable. What changed his mind suddenly to accept some levels of dioxin as suitable?

Hon. Mr. Bradley: I cannot recall, and perhaps the honourable member cannot recall from her days as a member of the government, as extensive a testing program in any specific area as we have had in the St. Clair River area. We were testing on a weekly basis and using the very best methods. We were not only using our own equipment, which goes down to parts per quadrillion, but as well the Department of National Health and Welfare assisted us latterly with probably the most sophisticated equipment and methods. This was the first time we actually found it. That is not to suggest it might not have been there in the past when the methods were not as effective.

I have always indicated, and I continue to indicate, a high level of concern about this or any other substance found in the water. I attempted to differentiate between various kinds of dioxin, with tetras being the most deadly -- particularly 2,3,7,8-TCDD, being the deadliest of all. I also attempted to differentiate between the amounts one might find and how minute they might or might not be before triggering a different response.

It is a matter of concern on a continuing basis and we are attempting to address the problem by getting at the sources of dioxin.

Ms. Fish: I do not think the question has been answered. The point is that at no time prior to his statement on Tuesday was any level of dioxin or any type of dioxin considered safe or acceptable in treated drinking water. The minister finds it in the treated drinking water, and the next thing we know he considers that some dioxin is acceptable in drinking water.

Since the minister has refused under previous questioning to take any steps whatsoever, either to improve water treatment facilities in communities where dioxin has been found in the treated drinking water or to provide safe alternative water supplies, what steps will the minister now indicate he has taken to ensure that no further traces of any dioxin, all of which are lethal, will be found in treated drinking water in those communities?

10:50 a.m.

Hon. Mr. Bradley: I consider it interesting that the member who is asking this question was part of a government that sat on its fanny for six years and refused to implement the spills bill, a very progressive piece of legislation that would have dealt with these matters at their source. They sat on their fannies and did nothing about it for six years, yet those members are still fighting the spills bill.

Interjections.

Mr. Speaker: Order.

Mrs. Grier: Yesterday, when I asked the Minister of the Environment whether any other jurisdiction had accepted dioxin in its drinking water, he did not give me an answer. He merely showed his own report and explained how he had arrived at the acceptability of this level of dioxin. Has he discovered, in the meantime, whether any other jurisdiction in the world accepts dioxin in its drinking water?

Hon. Mr. Bradley: I cannot speak for very many other jurisdictions to say whether anybody considers any of these substances acceptable in drinking water.

I can tell the honourable member there are probably very few jurisdictions in the world that test to the level of parts per quadrillion and have the equipment that is available both to the Ministry of the Environment of Ontario through our laboratories and to the Department of National Health and Welfare and its laboratories. There are probably very few others that would be able even to discover the quantity of dioxin -- in this case, octachlorodioxin -- that we have been able to discover in Ontario.

DENTURISTS

Mr. Swart: I have a question for the Minister of Health. He will know there will be savings of millions of dollars annually to the people of this province if denturists are permitted to make, repair and sell partial dentures directly to the public. He also knows how satisfactory this practice has been in Manitoba, Saskatchewan and Quebec, where it has been permitted.

Why has the minister not already taken the simple steps to amend the legislation here so that denturists and the public will have the rights they deserve, and how soon can we expect that legislation?

Hon. Mr. Elston: With respect to the review of the health professions legislation, as members know we are reaching the final stages of recommendations about those groups to be regulated in this province. We have made an announcement already with respect to midwives.

The group of people whom the honourable member has just singled out are involved in the rest of the deliberations with respect to the health professions. I cannot tell him when the legislation will be available. It will require a long series of meetings and discussions with those groups to be regulated. I cannot tell him how long that process will take, but we are getting close to making final decisions with respect to those groups that will be included in the group of regulated professions.

Mr. Swart: The minister knows this is exactly the same answer the Leader of the Opposition (Mr. Grossman) gave three years ago when he held that position.

Does the minister not know that this issue has been studied to death? It is an issue that stands on its own, apart from the Schwartz committee. Does he not realize the member for Brant-Oxford-Norfolk (Mr. Nixon) first tabled a bill on this 13 years ago? Why will the minister not quit the stalling, remove the issue from the Schwartz committee and get the legislation before this House?

Hon. Mr. Elston: In this province we have a review that is looking at how health care is delivered. We cannot deal with one group in isolation. I have found, and other members of this assembly will find, that professionals are dependent on each other because they deliver parts of services in the health care field. In this case, I am not prepared to take one group away from that review. We have a very good analysis of our health professions, and I want to continue speaking and working with those professions to set up a good and workable piece of legislation.

CONFLICT OF INTEREST

Mr. Gillies: I have a new question for the Premier. On Tuesday, he told this House that he understood the financial disclosure documents of his ministers were filed with the Clerk. I went down to the Clerk's office a few minutes ago and they are still not filed. Will the Premier undertake to stop hiding behind layers of bureaucracy and make those documents available to the members of this House today?

Hon. Mr. Peterson: I do not think I said the Clerk, but if I did I was wrong on Tuesday. The situation is that it is filed with the Assistant Deputy Attorney General, Blenus Wright. I think that is what I said. At the appropriate time, in his judgement, he files it with the Clerk.

I know the Clerk cannot answer questions here, even though he knows everything that is going on in this House, but I am sure the Clerk could stand in his place and confirm that procedure. That is what has gone on. It is Mr. Wright who decides when to file those, in his judgement.

Mr. Gillies: The Premier did not say in the House they were filed with the Assistant Deputy Attorney General. He said very clearly on Tuesday they were filed with the Clerk. They are not. The Premier is using any number of delaying tactics to avoid the scrutiny of the members of the opposition.

Mr. Speaker: Supplementary.

Mr. Gillies: Officials of the Ministry of the Attorney General have told us we cannot scrutinize them at their offices. Will the Premier issue a directive today that the members of this House be allowed scrutiny of the documents pertaining to his ministers' disclosures?

Hon. Mr. Peterson: I have said to the honourable member before, and I will say again, we will follow the normal procedures, which were established prior to our coming along.

Mr. Grossman: That is not so. That is inaccurate and untrue.

Interjections.

Hon. Mr. Peterson: Of course we will. Mr. Wright, as I understand it, gathers up the information and satisfies himself that everything is in order. I am told he files one copy with the secretary of the cabinet and another with the Clerk of this House. He is going to be doing that forthwith, so I am told. It is quite clear. There is no big surprise; there is nothing new.

Mr. Grossman: The Premier should order him to table it today.

Mr. Timbrell: Why is the Premier covering up?

Mr. Grossman: It is an absolute coverup. It is unreal. The Premier should order him to do it.

Mr. Speaker: Order.

Mr. Grossman: So much for open government. Everything else is open except their financial information.

Mr. Speaker: Order.

Mr. Grossman: It is unbelievable. He will not order the disclosure.

Hon. Mr. Peterson: Let us hear the financial information of the member for St. Andrew-St. Patrick (Mr. Grossman).

Mr. Davis: Let us see the Premier's; his is ready.

Mr. Gillies: The only thing that is open is the FMA account.

Mr. Grossman: How much longer is the Premier going to wait?

Mr. Speaker: Order. All you are doing is taking away from other members' time to ask questions --

Mr. Grossman: We want information --

Mr. Speaker: Order.

Mr. Sargent: Mr. Speaker, on a point of privilege: In view of the ongoing happenings with Mickey Rooney and his gang in Ottawa on the bugging of the Liberal caucus, I would like to suggest --

Mr. Speaker: Order. Any points of privilege and that sort of thing are usually left until after the question period.

[Later]

Hon. Mr. Peterson: Blenus Wright now is ready to file with the Clerk. I will instruct him to file all the things immediately.

Mr. Timbrell: On a point of order, Mr. Speaker: Now that the Premier has seen fit to file the statements of the ministerial disclosures, will he also file today all the information from the Ministry of Natural Resources?

WATER QUALITY

Mrs. Grier: I would like to bring the Minister of the Environment back to the drinking water issue. The minister appears to be indicating it is simply our ability to discover dioxin that has led to its being announced. Will he assure the House that he will be using the same sophisticated techniques and frequent testing to test drinking water in communities other than those in the St. Clair River area, and specifically in those areas that take their drinking water from Lake Ontario?

11 a.m.

Hon. Mr. Bradley: As the honourable member is aware, the Ministry of the Environment has been testing for dioxin on an ongoing basis since at least 1983, when it acquired the capability to do so. Before that the ministry had the capability of testing for other substances, and it continues to have that ability.

We are attempting to identify on an ongoing basis those areas which would be most sensitive to any toxic materials entering the waterways. One of those areas has been Lake Ontario, which is why the ministry carried out a program of a series of tests around Lake Ontario. We will continue to do that, and in any area where there is reason to believe there could be a greater problem than in other areas we are prepared to increase the frequency of the testing. We will use the same method of testing to ensure that we are aware of any problems that might exist.

Mrs. Grier: In his statement yesterday, the minister indicated he was now prepared to look at activated carbon filter beds for water taken from Lake Ontario. Does that mean he will accede to the request he received from the mayor of the city of Toronto to participate in a project here in Metropolitan Toronto?

Hon. Mr. Bradley: Coincidentally, I am meeting with the mayor of the city of Toronto this afternoon to discuss a number of matters of mutual concern. No doubt that will be one of the matters discussed. I am prepared to listen to what the mayor has to say and make a judgement on that basis.

Ms. Fish: Will the minister now accede to the request of the member for Sarnia (Mr. Brandt) that activated carbon filter beds be installed in the water treatment facilities in the city of Sarnia?

Hon. Mr. Bradley: This is the first time I have heard of the member for Sarnia having asked for that information. Ordinarily, I have been under considerable criticism for indicating there is a problem in the Sarnia area. Most of the time the problem that has arisen has been downstream from Sarnia. On this one occasion there has been a find in the Sarnia water.

We are looking right across Ontario for placement of a demonstration project. That is a full plant project as opposed to the experiment that is taking place at Niagara Falls. We are looking at a number of potential sites to see which would be best to determine the effectiveness of this kind of filtration.

LICENSING OF TRUCKERS

Mr. Gregory: I have a question of the Minister of Transportation and Communications. The minister is aware of his decision of December 19, 1985, at which time he approved the transfer of operating licences of Harkema Express Lines Ltd. in Brampton to an American company, Roadway Express Inc., knowing Harkema's licences had been dormant since 1981.

How can he justify his decision to transfer dormant licences to an American company given the impact on jobs, the impact on our local carriers from increased competition and, further, the timing of his decision given that negotiations surrounding free trade with the United States are at a very crucial stage?

Can the minister provide this House with an explanation as to why he failed to notify the interested parties of his decision, a simple common courtesy practised by the former administration?

Hon. Mr. Fulton: Given the nature and the technicality of the question, I will take it under advisement and advise the honourable member properly.

Mr. Gregory: I am amazed that the minister does not recall making a decision of this magnitude on December 19. I am amazed that he does not recall having signed the letter, which I have with me. Given that the two largest American trucking companies, namely Yellow Freight and Consolidated Freightways, already have access to the Ontario market, does the minister not agree that any move now on international trucking policies is crucial, considering the implications for the trucking industry of further free trade negotiations with the US?

Hon. Mr. Fulton: I am well aware of the member's concern in those matters that have been before the Ontario Highway Transport Board, the body he and his colleagues appointed. I refer him to my first answer and give him the same answer on his supplementary question.

FOREST MANAGEMENT AGREEMENTS

Mr. Laughren: I have a question of the Premier, if I can get his attention away from the Minister of Education (Mr. Conway).

On the eve of the Progressive Conservative leadership convention several months ago, the Provincial Auditor tabled a report which was very critical of the way in which the forest management agreements were tabled, particularly vis-à-vis the awarding of greenhouse contracts. Would the Premier assure us that the timing of the release of that document did not compromise the independence of the auditor in view of the fact that it did embarrass a member of the PC leadership race?

Hon. Mr. Peterson: I am aware of the allegations, since I read in today's paper of something that transpired yesterday. I had not personally been aware of the situation before that.

I understand that the deputy minister made an independent judgement in that regard, and I want to assure the honourable member and other members of this House that it is not our intention to embarrass anyone in these kinds of situations. We are not spending our time searching for things to embarrass anyone, be it the former government or anyone else, because we have such a heavy agenda of things we want to do constructively.

It is our view that information should be shared generally and we have seen that kind of approach from this government. I can assure the member I was not aware of it, whenever it was done. I am told the minister was not aware and I am told it was the deputy minister's decision. Believe me, I like the members across the chamber and I would like to help them all in whatever their career goals are.

Mr. Laughren: In view of the fact that veiled allegations were made that perhaps the timing was politically motivated, will the Premier, in order to clear the air completely, table any kind of correspondence surrounding the awarding of those contracts and the release of the Provincial Auditor's document?

Hon. Mr. Peterson: I am prepared to think about that. Believe me, I do not want to embarrass anyone. I do not know which parts of that information are subject to the accord. We have an accord with the members opposite, too, with respect to the confidentiality of certain documents.

My general inclination is to let everything go to the public, particularly in the awarding of contracts. I agree with the member that everything must be done scrupulously. The awarding of FMAs or any contract of this government is the people's business and they should have the opportunity to scrutinize it. That is generally my view. I will look at the situation.

UNEMPLOYMENT

Mr. Brandt: I have a question of the Premier. A couple of days ago I sent him a letter following up on a question I had raised in the House with respect to the chronic levels of unemployment we are currently experiencing in my riding. To refresh his memory, the unemployment rate is about 15 per cent, and in the construction trades it is now more than 50 per cent.

The Premier asked me to provide him with some suggestions on how the unemployment rate might be reduced. In the letter I sent him, I have suggested a number of projects, such as the expansions that are necessary -- which the Minister of Health (Mr. Elston) knows about -- at St. Joseph's Hospital and at Sarnia General Hospital, road construction and the completion of the East Lambton water line.

Will the Premier give an undertaking today to see that those projects are accelerated in order to bring on some jobs in my community and to alleviate the present unacceptably high levels of unemployment?

Hon. Mr. Peterson: I received the honourable member's letter yesterday or the day before and I appreciate his constructive ideas in that regard.

I cannot give him those assurances in the House today. The reality, as he will know as a former minister of the crown, is that we have unacceptably high levels of unemployment in a number of communities across this province, not just in Sarnia.

Also, he will be aware of the inordinate pressure for capital expenditures for hospitals and public services of all types -- roads and others -- all of which confer a benefit on the community when those allocations are made. We have to approach those things with a very even hand, as he will be aware.

I can assure the member I will discuss these specific ideas, particularly with the Minister of Health, and see where he is on those projects at the moment. If there is anything that can reasonably be done, depending on where they are in our priority list, I can assure him I am anxious to be co-operative, not just in Sarnia but everywhere across the province.

11:10 a.m.

Mr. Brandt: I am pleased to hear that the Premier will be helpful in this regard. Recognizing the need for the prioritization of the various projects that come before cabinet, and recognizing as well that the Minister of Health has a number of critical proposals before him for the expansion of facilities, can I have an assurance from the Premier that he will take levels of unemployment in some of these communities into account when making those decisions, since there are no other differences between some of these communities? They all need new health facilities and the only difference may be that some communities are in a more critical unemployment situation than others.

Hon. Mr. Peterson: It probably would be a consideration, but in my personal view it would not be the major consideration, which has to be need. I am aware of an enormous community lobby for new facilities. The honourable member will be aware of our need for cancer treatment facilities in Ontario at present. That is an area we want to address.

In my own community of London, there are three hospitals that have big capital projects at the present time. I am sure any member of this House could rise and say the same thing about his hospitals. We are going to have to be as objective as we can possibly can be in the circumstances, and the number one priority will be demonstrated need.

ELECTRONIC EAVESDROPPING

Mr. Sargent: On a point of privilege, Mr. Speaker: It goes without saying that this party has the highest regard for the ethics of the opposition. However, in view of what is happening in Ottawa with the bugging of the Liberal caucus, will the Speaker consider electronic sweeping of all cauci here to establish for history that nothing is present?

Mr. Speaker: That is not really a point of privilege, but it is a good suggestion.

PETITION

ROMAN CATHOLIC SECONDARY SCHOOLS

Mr. Ramsay: I have a petition from the Coalition for Public Education.

"Dear Mr. Premier:

"Ontario is a multiracial, multicultural and multifaith society that is well served by a strong public school system. Your government's proposal to extend public funding to the Roman Catholic separate schools is a backward step since it will grant special status to one specific denominational group.

"We urge you and your government not to proceed with this divisive proposal."

INTRODUCTION OF BILLS

OCCUPATIONAL HEALTH AND SAFETY AMENDMENT ACT

Hon. Mr. Wrye moved, seconded by Mr. Polsinelli, first reading of Bill 101, An Act to amend the Occupational Health and Safety Act.

Motion agreed to.

DENTURE THERAPISTS AMENDMENT ACT

Mr. Swart moved, seconded by Mr. Warner, first reading of Bill 102, An Act to amend the Denture Therapists Act.

Motion agreed to.

Mr. Swart: This bill would amend the act to refer to "denturists" rather than "dental therapists," would permit denturists to make, repair, and market partial dentures without requiring supervision by dentists and would permit them to deal directly with the public.

ANSWERS TO QUESTIONS IN ORDERS AND NOTICES AND RESPONSE TO PETITION

Hon. Mr. Nixon: I have tabled the answers to questions 163, 172, 177, 178, 200, 204 and the interim answers to questions 199, 201, and 202 standing in Orders and Notices, and a petition presented to the Legislature, sessional paper 317 [see appendix, page 3705].

ORDERS OF THE DAY

HEALTH CARE ACCESSIBILITY ACT (CONTINUED)

Resuming the adjourned debate on the motion for second reading of Bill 94, An Act regulating the Amounts that Persons may charge for rendering Services that are Insured Services under the Health Insurance Act.

Mr. Andrewes: I have a few brief comments. When we adjourned the debate last evening, we were talking about accessibility. In an effort not to be repetitive, I will go back for a moment to the opening statement made by the Minister of Health (Mr. Elston) on December 19, 1985, when the legislation was introduced. He said, "The principle of accessibility to needed health care without any regard for an individual's financial circumstances or ability to pay is in jeopardy in this province."

We had an interesting interchange last evening with respect to the term "accessibility" and my request that the minister demonstrate in a substantive way, which he did not do in his opening statement, his statement that the principle of accessibility is in jeopardy in this province.

The minister rose on a point of order and asked for permission to ask me a question, to which I acceded. The question was would I conclude my comments so the minister could put some information on the record to substantiate that statement. After I make these rather brief comments -- no doubt my colleagues will have some to add -- we will be delighted to hear from the minister. It is unfortunate that although this debate has been very thorough, succinct and direct, we have not heard anything from the minister that substantiates the statement he made when he introduced the legislation.

The members of the New Democratic Party have been singing songs of support for the government on this legislation. There is no doubt they may have time to reflect on their self-congratulation. Some of them may have more time to reflect than others. To some degree, their songs of support have been repetitive. I would not want to suggest they are calling the tune of the government, but it would appear so. The melody seems harmonious, although the lines are a bit repetitive, but they have still to find the rhythm.

11:20 a.m.

In their presentations to the House, members of the New Democratic Party, as well as the very few members of the Liberal Party who have spoken in this debate, have offered examples of situations in their constituency offices and communities of individuals or families coming to them claiming that they have not been able to obtain the health care they require, that accessibility to the system has been limited because they could not afford this health care and that members of the communities they represent are waiting to see the appropriate medical practitioner and receive the appropriate health care. I have been a member of this House for nearly five years. My constituency office is open every day with the exception of Sundays and statutory holidays, as are those of the members of the New Democratic Party and of the Liberal Party. My number is published openly in the telephone directories of all the communities I represent. I do not feel accessibility to me and my office is restricted in any way. Yet to this date I have not had one individual approach me about accessibility to the health care system.

Many have come to me and said: "I cannot find a nursing home for my mother, my father or my relative, who needs to move out of a hospital situation. I cannot find the proper community day program for a member of my family. I cannot find a treatment centre for my alcoholic relative." However, I have yet to be approached by individuals or families to say they have difficulty in obtaining appropriate health care through a medical practitioner, opted in, opted out or otherwise, if there is an otherwise. I have yet to have that situation put to me.

The minister points out in his statement, and these are his words, that accessibility is in jeopardy in this province. I have issued a challenge to him to prove that. I want to go on at some length to prove to the members of the government and of the New Democratic Party -- I do not have to prove it to my colleagues -- that health care accessibility is in jeopardy in this province, but not because members of the medical profession have either opted in or opted out of a medical plan and are adjusting their fees accordingly.

Perhaps there are situations in parts of this province where it is difficult for an individual or a family to find the right specialist. Perhaps in cases of opted-out anaesthetists, individuals find themselves faced with making sudden decisions. The minister alludes to this situation in his statement and calls it clustering. Even an organization such as the Ontario Medical Association, which is stridently opposed to this legislation, would not argue it is not a problem.

There are situations that need to be confronted and adjusted, but when we look at these situations it is appropriate to read into the record some of the comments made by the president of the Ontario Medical Association, Dr. Myers, in a letter to the Premier (Mr. Peterson) on January 21, when he said:

"Representatives of the Ontario Medical Association, including myself, met with you on several occasions this past fall to discuss problems in the health care system. We agreed with you that the dilemma presented by increasing needs and scarce resources required urgent attention."

That is a significant statement. It is "a dilemma presented by increasing needs and scarce resources" requiring urgent attention.

"We were pleased to hear that you recognized the public purse cannot support the full cost of health care for much longer if we are to maintain our current high standards of care.

"We expressed great eagerness to participate in a fundamental reconsideration of how health care is delivered to the people of Ontario and how it is funded. We further agreed that in the context of such a study, physicians' billing practices should be a part of the exercise."

That is a significant statement, which bears repeating: "We further agreed that, in the context of such a study, physicians' billing practices should be a part of the exercise." I believe the subject of this debate, Bill 94, deals with the question of physicians' billing practices, the amounts that persons may charge for rendering services that are insured services under the Health Insurance Act.

"We suggested further that while a study was under way we would assist you in ensuring that the financially disadvantaged were exempt from any direct charges by physicians."

Does that sound self-serving? Does it sound acrimonious? No, I do not believe so. It sounds to me like an act of co-operation, a willingness to work together in a health care system, an offer on the part of health care professionals to be an integral part of the solution to the problem, a recognition by that group that there is a problem and certainly a willingness to work towards the solution.

Like every member of the government and every member of these two opposition parties, physicians, optometrists, dentists and other types of medical practitioners in this province, whatever they may be, have one basic commitment, and that is to serve mankind. You, Mr. Speaker, would understand that better than anyone else.

What happened after these consultations between the Ontario Medical Association and the government? What happened after this organization showed a willingness to work together to find solutions to a very basic problem? Boom -- a piece of legislation, Bill 94, was introduced on December 19.

11:30 a.m.

Dr. Myers goes on to say: "In the final analysis you refused to hold back legislation on the opt-out question pending such a study. In short, it was you, not we, who refused to negotiate."

Does that sound like an open and consultative government? Does that sound like a government willing to work with professional practitioners to find some answers to the problem? Does that sound like the words that were uttered, we hope sincerely, by the Premier back in July when he was sworn into office? Boom -- legislation, not consultation; gun-to-the-head negotiation, not consultation.

The letter goes on to say: "The OMA now publicly presents you with the offer we made in private. The people of Ontario cannot afford a war between physicians and government. The stakes are too high. The current excellence we enjoy in health care is the fruit of a long-standing collaborative relationship. We plead with you to put away your legislative hammer and join with us in finding a better way. The people expect no less of us."

In the minister's statement on December 19, 1985, he goes on to talk about the question of universality and mentions the range of services:

"We claim that our health care system is a universal one...that the same range of services is available to everyone. We also claim that the system is accessible and that everyone has equal opportunity to receive the services being provided."

When the number of doctors who have opted out of the medical care system is declining, when even the Minister of Health and the Minister of National Health and Welfare cannot accurately define the cost of extra billing or the numbers of doctors who are opted out and extra billing, I find it difficult to accept this next sentence, in which the minister goes on to say:

"In particular, we claim that we have a system where no economic, social, ethnic or age group will be deterred from receiving needed health care or from visiting a physician of choice."

I find it difficult to accept that the minister could make that kind of bald-faced statement at the same time as he was introducing this piece of legislation. I am sure Mr. Speaker has some difficulty with that as well. I hope he does.

I might offer some further evidence for my difficulty in hearing the minister make that statement synonymously with his introduction of this bill. I refer to the Ministry of Health's annual report. If I can find the appropriate section, I want to make one additional comment.

On page 46 of this report is a summary of the activities of the Ontario health insurance plan. At the bottom of this chart is a section called "Mode of Payment," and in brackets it says, "Based on claims payments." It lists a great many disciplines: medical, dental, optometric, chiropractic, osteopathy, chiropody, physiotherapy and "overall." There are two subcolumns headed "Physician" with a percentage sign and "Subscriber" with a percentage sign.

I am going into this in some detail because I think some detailed explanation is required for the sake of the written word.

We see under this extensive list of disciplines, in the "Mode of Payment" column, that 92.5 per cent of the payments made under OHIP activities were made directly to the physicians and 7.5 per cent were made directly to the subscribers.

If I am wrong, perhaps someone will correct me, but I have to conclude that approximately seven and a half per cent of the billings through OHIP either were extra billed or the doctor in question billed the patient -- he may or may not have extra billed, but he billed the patient -- and the patient submitted the bill to OHIP for reimbursement.

We are not talking about 12 per cent; we are talking about what appears to be a maximum of seven and a half per cent, and possibly considerably less, and yet we have this legislation dealing with the question in the government's mind of accessibility.

We are in a situation where a professional body such as the Ontario Medical Association has offered to use what I would loosely describe as its willpower over its membership to ensure that the range of services the minister talks about in his statement are accessible and available. I find it incredible that the minister could make the statements he did in his statement.

He goes on to say:

"I therefore find it intolerable that today, in some major urban centres of this province, women still have difficulty finding an obstetrician who does not extra bill. I believe it is inexcusable that today, almost 20 years after insured health services became law in this province, patients scheduled for surgery must discuss with their anaesthetist the fee for services to be rendered.

"I am also aware that among physicians, extra billing can and does distort normal patient-referral patterns. Doctors in general practice do not always know which specialists extra bill and patients frequently do not find out until they arrive at the specialist's office."

I suggest that sentence requires some clarification because the Ministry of Health obviously does not know which specialists extra bill; otherwise, it would be listed. Like many other members, I am sure, I have a compendium in my constituency office that lists the doctors who are opted in. Therefore, the ministry obviously does not know those who are not opted in.

When figures are bounced around about $55 million a year, about 12 per cent versus eight per cent or three per cent, ambiguity is still there. We still are not assured that the anticipated revenues flowing from the government of Canada as a result of this legislation that supposedly satisfies the Canada Health Act will be as substantive as some might conclude.

11:40 a.m.

The minister in his statement uses terms like "intolerable," "inexcusable," "distort normal patient-referral patterns." Naturally, in a health care system where universality is a very basic principle, accessibility to a range of services must be a very basic principle. However, I have not seen evidence that it is impaired by opting out or by extra billing. If there are instances of that, we have a professional organization that has offered to find solutions by participation and negotiation.

I suggest that the government, for whatever reason -- I am certainly not going to stand here and impugn motives, because the member for Brampton (Mr. Callahan) was impugning motives to the members of the Conservative Party the other evening and I asked you, Mr. Speaker, to call him to order -- has chosen to deal with this particular problem in a very draconian fashion.

What this bill does is give us bottom-line medical care. The minister has chosen to deal with a problem that we, certainly I and the Ontario Medical Association, admit needs to be dealt with in the medical care system. He has chosen to deal with it in a bottom-line fashion. It is a manner that perhaps expresses some expedience, but it is a manner that fails to recognize the excellence of a practitioner. It fails to recognize that this practitioner should have discretion or judgement in the exercise of his or her profession on a day-to-day basis dealing with a variety of illnesses, a variety of treatments. It fails to recognize a more basic right; it denies a basic right. If one is going to practise medicine in Ontario, this bill says that one must do so within the confines of what the government determines will be one's bottom line.

Let me deal for a moment with the whole question of the distribution of the expertise; "expertise" meaning, in this case, the expertise that is carried out by medical, dental and ophthalmology practitioners.

The ministry does have a number of programs to deal with this problem of distribution. The Ontario Medical Association has offered, in the letter I read into the record earlier on, to be a part of the solution of that problem. Ministry programs, of course, are designed to encourage practitioners to move to the less populated areas of the province, to move to those areas where climatic conditions may be such that the lifestyle a particular practitioner and his family are used to may not be accessible or available. These programs assist these practitioners with their moving costs, with their relocation, in establishing clinics -- very worthy programs in the Ministry of Health that have been in place for some time.

As I mentioned, these programs attempt to encourage movement to the less populated areas to solve some of these problems of accessibility resulting not from cost to the individual but from distances travelled or distances one might need to travel to obtain the appropriate treatment.

The important ingredient in finding the answer to these problems is not Bill 94. Even the minister and his parliamentary assistant will agree that the important ingredient is cooperation.

One will not coerce a specialist who has practised in the Toronto area for 15 years to go to Powassan, North Bay, Moosonee or to points in the northwest of the province; one will not coerce that individual to practise psychiatry in Timmins simply by saying: "We will pay your moving costs. We will help you set up a clinic." One will have to get a committed practitioner to say: "Yes; there is a need there and I am prepared to go there and address it."

If one does not have that co-operation and continues to tamper with a system that has been built on co-operation, one will find there will be an even greater problem of accessibility. The concentration, the clustering in this province that the minister refers to in his opening statement will become an even greater problem. Without co-operation, the expertise we need to make this system work will, in itself, become depleted.

My colleague the member for Durham-York (Mr. Stevenson), in his remarks, talked about a small hospital in his riding where a doctor practises gynaecology one day each week. He is a living example of where co-operation has led that community, which is not served by a huge teaching hospital as the Toronto area is served.

A rural community with a small rural hospital now finds itself with regular service by a specialist, a gynaecologist. He has openly said that because this piece of legislation takes away that spirit of co-operation it will lessen his desire to practise in that rural community. Those people who are becoming dependent on his services may soon be without them.

I want to refer very briefly to an editorial that appeared in the St. Catharines Standard on December 2. The editorial is headed: "Discrimination and a Threat to Health Care."

11:50 a.m.

You, Mr. Speaker, and all members of this House, understand that one of the arts of attracting readership in the print media is writing catchy headlines; headlines that will attract attention and that, in some cases, are inflammatory or inciteful. If one puts up an editorial headline that says "Discrimination" in a newspaper in a small- to medium-size city like St. Catharines, the community this paper serves, it stands out. If it were printed with red ink it would not stand out any better than by using the term "discrimination." If the word "threat" is added to it and the two are tied together, suddenly people who seldom read editorials turn the page and begin to read it.

As a Tory in the Niagara Peninsula, perhaps I might suggest with respect that the St. Catharines Standard has never been kind to the Tory party. Some have suggested it is nothing more than a forum for the member for St. Catharines (Mr. Bradley). I could refer to a recent edition where the member for St. Catharines found himself on at least five pages. In fact, there was a full-page story about his antics as Minister of the Environment, and his plans for that ministry and for himself, outlined in red ink.

Mr. Philip: That is not true. the member for Welland-Thorold (Mr. Swart) gets all kinds of coverage in that paper.

Mr. Andrewes: The member for Welland-Thorold occasionally finds himself on page 8. I do not speak disparagingly about the member for St. Catharines, the member for Welland-Thorold, the member for Lincoln, the member for Niagara Falls (Mr. Kerrio) or the member for Erie (Mr. Haggerty), who occasionally find themselves referred to in the St. Catharines Standard. I raise this because I want to show there is some objectivity to this article.

Although as Tories we might cynically suggest this newspaper has never been terribly favourable to our party or our point of view, I have chosen and selected, some might say purposely, this editorial because of where it comes from, and it does bear some objectivity.

The article starts with "Discrimination and a Threat to Health Care." It is about the anticipated introduction of Bill 94, An Act regulating the Amounts that Persons may charge for rendering Services that are Insured Services under the Health Insurance Act. It begins, "In its short life, the provincial Liberal government has rushed into action with some much overdue and welcome legislation...." We see how objective this article is. That is a very objective observation, perhaps prompted by the desire to outdistance itself from its Conservative predecessors of the past 42 years.

It goes on to say, "But there is danger in haste, and the government appears to have stepped too quickly with its plan to ban extra billing by doctors." That is a further objective comment by the St. Catharines Standard. "The result could be a serious threat to the health of the health care system in Ontario." It then talks about a bit of the rhetoric that surrounds this discussion, which has come from all sides and all points of view, and particularly mentions the statement by the Ontario Medical Association that the proposed legislation would be a blatant act of terrorism, an oft-quoted phrase sometimes credited to my colleague the member for York Mills (Miss Stephenson).

It goes on to say, "A total ban on extra billing -- with threats of fines for those who don't conform -- is unfair." Can you believe that, Mr. Speaker? The St. Catharines Standard, an objective publication, said that. "While Health minister Murray Elston may claim `the people' support him (has there ever been a poll conducted which did not find that people want reduced costs of goods and services?), the government must consider the effects such a ban can have on the health care system."

I have marked the next two paragraphs so that I might read them in detail. They are very short: "As it stands now, a ban on billing above the OHIP fee schedule -- and that is something that could stand review -- means a doctor fresh out of medical school would be paid the same as a doctor with years of experience and expertise.

"Forgotten also is the fact that many specialists did not take the easy route by entering practice as soon as they graduated. Instead, they decided to advance themselves and, in doing so, enhance the skills available to their patients by staying in `school' and working towards much-needed specialities. They gave up the luxury of settling down in their mid-20s, raising families and buying a house in favour of added study and experience, sacrificing a great deal of income to climb to the top of their profession."

That is a point worth noting. All of us have on many occasions watched television comedies, movies that have been made, like Doctor in the House, through a whole series of movies made about young people attending medical school and all the problems and all the fun that went along with it. There have been lots of TV doctor shows that demonstrate quite vividly the pressures medical practitioners are under, maybe a little melodramatically on occasion. However, for many of us who have not experienced those kinds of situations, there is some validity to the drama of St. Elsewhere and other types of programs.

Here we have this issue of a number of doctors who have spent an extensive part of their career re-educating themselves, equipping themselves for some greater task than that for which their formal education and their formal training in medical school prepared them. The editorial goes on to say:

"Under the proposed legislation, this would all go for nought. Surely the provincial government -- while maintaining an affordable and efficient health care system -- must take this into account. If not, these doctors may decide to take their skills elsewhere or, even worse, decide to enter the marketplace with the minimum qualifications required. In either case, the people of Ontario will be deprived of their talents."

12 noon

That would be a shame. It would be as hurtful to the health care system as it would be to any other profession. If individuals decided that they did not want to go to grad school; if individuals decided that in spite of their skills at playing hockey, say, they did not want to go on to demonstrate those skills in a greater way or did not want to fine-tune those skills; or if they had the ability to become skilled gymnasts and they abandoned that training for the sake of an easier life, setting aside the discipline that is necessary, I think it would be a shame; and so does the St. Catharines Standard.

The next paragraph is in brackets because I assume it is an afterthought the editor had when he wrote this editorial:

"(It should also not be forgotten that even under the current system where extra billing is allowed, many surgeons and specialists are not unaware of the problems of their patients and the extra costs are waived. This is not as uncommon as many may think.)"

He is saying that not all the medical practitioners who have opted out of the Ontario health insurance plan extra bill. That is an observation of some note. When the editor wrote this editorial, he may have put this in brackets because he felt many people lacked the afterthought he had. Many people fail to make that observation. He was putting himself in the position of many of his readers when he put those comments in brackets.

"The furore over the extra billing ban cannot be regarded as just another labour dispute between employee and management. The government is not the doctors' employer, and the doctors have the right to practise what and where they will. Would lawyers accept a ceiling on their fees? Would plumbers? Would auto workers? Doctors who operate outside the OHIP umbrella should have the same rights as anyone else. With this measure, the provincial government is surely guilty of discrimination." That is an inflammatory comment; nevertheless, it bears some consideration in this debate.

I want to deal with the issue of quality of care. I will come back to the question of accessibility later and offer some examples. In my riding in the Niagara region, accessibility is in jeopardy, not as a result of doctors who have opted out of the plan or of patients having difficulty in securing services from doctors but as a result of many other situations that might arise. I want to deal briefly with this question of quality of care.

In my earlier statements on accessibility, I trust I have challenged, if not refuted, many of the arguments put by the minister in his opening statement and in his response to questions, by the few government members who have taken the time to speak on this bill and by the members of the New Democratic Party who have supported the legislation. I hope I have challenged, if I have not refuted, the question of accessibility.

Those members from outside of the urban centres have a better feeling and sense about this issue. Life is different for those from Etobicoke, Hamilton West and Parkdale. Life is different in Lincoln, Manitoulin, Burlington South, Huron-Bruce and Wentworth North.

Mrs. Marland: And in Mississauga South?

Mr. Andrewes: No, life is not different in Mississauga South. I have to put the member for Mississauga South (Mrs. Marland) in the same category geographically as Parkdale and Mississauga North, but only geographically. However, life is different outside these urban centres.

As my colleague the member for Nipissing (Mr. Harris), the member for Durham-York (Mr. Stevenson) and others have said --

Mr. Haggerty: Where are they?

Mr. Andrewes: The member for Erie has returned. I was just speaking about him earlier. I was speaking about the fact that he and I seldom find ourselves headlined in the St. Catharines Standard as the member for St. Catharines often does. I was doing that simply to put on the record an argument to support the fact this editorial, which I quoted verbatim and read into the record, would have to be an objective one because it was in the St. Catharines Standard. One would have to find a very skilled private detective, and I could not even begin to recommend one, to find a Tory toady on the staff of that paper. One would have to search very diligently.

I want to return to the whole question of quality of care. It is an issue that is much more in the public interest and the public forum. It is one that requires much more of our input in this chamber.

We have heard from the minister, the government, the New Democrats and the Conservatives that we have in this province the finest health care system in the world. Is anybody in the Liberal benches going to deny that? Is anybody in the New Democratic Party going to deny that? I know where my own colleagues stand on that issue. The member for York Mills would vouch for that.

Ms. E. J. Smith: We have an excellent system.

Mr. Andrewes: I do not think any member, including the member for London South (Ms. E. J. Smith), would deny that we have the finest health care system in the world.

Ms. E. J. Smith: That is right. I want everyone to be able to take advantage of that.

Mr. Andrewes: She has acknowledged that we have the finest health care system in the world. I am sure the members of the Liberal Party, the New Democratic Party and the Conservative Party, certainly the member for London South, will agree our objective is to preserve that world-recognized standard.

It is not simply our objective, it is our obligation to preserve it. We can go beyond that for a moment and say our obligation is not simply to preserve but improve it. That is why we are here. That is the purpose of being elected. That is the purpose of government in a government-sponsored program: to make sure it gets better and does not decline or fall back.

12:10 p.m.

We have another obligation, as I am sure the Treasurer, Minister of Revenue and government House leader, the member for Brant-Oxford-Norfolk (Mr. Nixon), would want me to mention to all of us in my capacity as his critic. That other obligation is to improve this system, but to make sure we do so in a manner we can afford.

There are some who will say health care has no price. Yet I am sure the Treasurer would once again say, "Yes, everything has a price; governments cannot go off and simply spend themselves into oblivion." Some governments did. For many years, the Liberal government in Ottawa decided the people of this nation could be bought off by new projects and by pouring money into social programs and into all kinds of situations, and it obliged us as Canadian citizens to pick up those costs. That government did it quite freely. We see signs that this government --

Mr. Haggerty: Even the member's own administration went that route in Ontario. Tell us about that.

Mr. Andrewes: I will tell the member for Erie, because it is a matter of some significance, that the Conservative government, through one of the most difficult periods of recession in 40 years, maintained the social programs and the infrastructure in this province without obligating us to an eternal debt.

Mr. Haggerty: It is costing us about $8 million a day in interest to pay off that debt.

Mr. Andrewes: I remind the member for Erie that in one budget his government has asked the people of this province to ante up an additional $750 million. It has extended the deficit to $2.3 billion at a time when the economy is moving and its tax revenues are growing. It is getting more tax revenues and letting the deficit grow. Is that good budgeting?

Mr. Haggerty: We are just picking up where the Tories left off.

Mr. Andrewes: The folks back in Fort Erie cannot run their businesses that way; the member for Erie never ran his business that way. When business was booming he paid off the banker. He did not go and say, "I need a bigger loan."

The Deputy Speaker: This does have a direct relationship to Bill 94?

Mr. Andrewes: Oh yes, sir.

The Deputy Speaker: I am finding it a little hard to get the thread.

Mr. Andrewes: Maybe I should come back to the topic at hand. I was somewhat diverted by the member for Erie's comments.

Mr. Haggerty: It has been so exciting in here this morning that the building was shaking about 10 minutes ago.

The Deputy Speaker: Perhaps this is an opportune time to advise members that at about 11:30 there was a small earth tremor in Metro Toronto. I am not sure what the member for Lincoln was saying at that point.

Mr. Ward: Maybe somebody was telling him something.

Miss Stephenson: No; somebody was telling the government members something.

Mr. Andrewes: I will take full credit for that. Thank you for that bit of information. I must have been in full flight, because I never sensed any movement. This staid old chamber remained staid and old. Somebody opened the blinds and let the light in, but here we are, talking about quality health care in Ontario.

Mr. Speaker, if I may move away for just a second you will give me some leeway, I am sure, to tell you that I am fortunate today that I brought my notes with me. I must apologize that last evening when I started this debate I was not properly equipped. Some of the to and fro between myself and the minister actually was very helpful; it took us to 10:30 p.m. and I was able to adjourn the debate, even though the relevancy of our conversation perhaps escaped many members.

Mr. Haggerty: The member is just back on the farm with all this.

Mr. Andrewes: We did have questions. The minister asked me questions, and he did not like my responses. I suggested to the Speaker that we have a late show, but he declined to give me permission.

Let us return to quality health care in Ontario, because I want to --

Mr. Haggerty: The member should move over a little.

Mr. Andrewes: I am not sure what the member for Erie is referring to.

I want to come back to the point that we have the best health care system in Ontario. Our obligation is to improve it but in a manner we can afford, and what the affordable level might be is arbitrary and debatable.

A quality health care system has many ingredients. One is the societal attitude expressed from time to time in the comments by members in the debates. It is expressed in the philosophy that the members and their parties bring to this chamber. It is expressed by individuals who from time to time come to see members by visiting them in their constituency offices and on various other occasions. They carry with them a societal attitude that may be a little narrower than all of us can accept.

Quality health care is a very important ingredient in research and in treatment methods. Then we get to the hard core of quality health care: buildings and equipment. We get into the people factor of a quality health care system: the professionals, the practitioners and who they are. They are like my colleague the member for York Mills; they are family doctors, specialists, urologists and psychiatrists. I would not want to try to pronounce all the various disciplines, because I am sure I would not be accurate. Who are the rest of the practitioners? They are the nurses and those who administer and deliver public health programs: hospital staff, those who staff clinics and those who perform services in hospitals.

Another very important human ingredient in our health care system is the group known as volunteers. Through day-to-day participation in its activities, through membership on a health council or hospital board or in some advisory capacity, they bring to the system professional views and skills that may not necessarily be medical skills but are disciplines that are very important components of a quality health care system. They bring those views as part of a planning process and as part of the sustaining and ongoing administrative process.

12:20 p.m.

These are all important direct activities in the day-to-day operation of a system that provides health care to the people of this province. However, it is the professionals on whom we have become most dependent to run the system. That is what makes the system work best and it is what makes our system the best in the world. All the buildings, all the research, all the hospital equipment and all the other advice one can seek is of no use without the professionals to deliver the care.

These people are trained and their skills are well honed. In some cases, they have sworn an oath to a profession. They have committed their lives, their training and their skills towards people and the system. They have opted for that training and that dedication to that skill. There has been a long history of high esteem and respect for this profession.

I have another little anecdote that is relevant here. In our local hospital there are 27 doctors. They invited me to meet with them in the boardroom of the hospital last Thursday morning, which I was delighted to do. Of those 27 doctors, 19 came to that meeting. It was at eight o'clock in the morning and 19 of the 27 medical staff who serve a wide rural community and who work out of that hospital, arrived at that meeting.

That is significant. Those people are very busy people. Some had been up all night and some may be up all night for the next two or three nights. However, 19 of them took the time to come to talk to me, not simply about this piece of legislation but about the health care system generally.

These are people who have dedicated themselves to keeping others alive and healthy. They are people of emotion, understanding and skill. They have entered a profession after very extensive training based on an understanding that their training and skill would allow them to practise their profession. Some of them have invested their life's savings in that training.

Having completed that training and entered the profession, they are asked to invest their skills in making life-saving judgements on the part of their patients. They are being asked to do this in a professional way. Our society has always admired and respected the profession.

When I had this meeting last Thursday with these 19 doctors, it was interesting that they all agreed that if one were to do a survey in the community, most of the people would say: "Yes, doctors are kind of an antagonistic bunch. They make too much money. They do this and that. However, not my doctor. He is a good guy; a fine individual. He is not involved in all these militant actions. He will not get mixed up in this debate. No, he is a great guy."

What was reflected in that observation -- it was not made by me; it was made by the professionals in that room -- was that collectively they know they do not have a lot of public sympathy. Individually, they have a lot of public sympathy from the people they deal with. Collectively, however, they know that by taking militant actions which other groups in society might take to make their point with governments, with people or with legislators, they will not elicit a lot of public sympathy.

I come back to the point that medical practitioners are asked to invest their skills to save lives and the fact that our society has always admired and respected the professions. I do not care what professions they are -- doctors, nurses, pharmacists, engineers, architects, farmers or teachers -- in our society, in spite of its cynicism, in spite of its sarcasm about these professionals, there is a very deep-seated respect for an individual who takes the necessary time to train in a discipline to acquire a talent.

We believe these are people of integrity and wisdom. We trust in their judgement. What has happened now is that professionals all over this province feel threatened by this government because it has set aside consultation and respect for professions in favour of political expediency.

To come back to my story about the professions not being able to elicit a lot of support, this is a government that says, "Here is a category of professionals called lawyers who have QCs, including people such as J. J. Robinette" --

Mr. McFadden: The Premier.

Mr. Andrewes: Give me some other esteemed members of this profession: the member for Brock (Mr. Partington), the member for Eglinton (Mr. McFadden) and the member for Cochrane South (Mr. Pope).

Here is a group of people who have worked diligently at their profession over the years, and suddenly a government says, "Let us beat up on those people, because if we beat up on them the 8.5 million people who are watching us will say, `Here is a government of action that can get things out of the way and cut through all this stuff.'" It forgets they are professionals.

What it has done now is to threaten these professional groups. It has proceeded with legislation against the professional judgement of these people. It is populist legislation. It is politically popular. There is no doubt about that because, as we live in our role as everyday people in society, we like to see government standing up for the little guys such as ourselves. We like to see people prepared to knock down those whom we might view as having a certain advantage over us.

It is only appropriate to warn the Minister of Health and the government that, in spite of the apparent short-term political popularity and benefits of these kinds of moves, what this kind of legislation does is create reaction, as demonstrated by some of the responses my colleagues have received. What it does is alienate the very people upon whom we are depending for this system to work.

Mr. Speaker, you know that on occasion the business of the House gets disrupted by various means. The operation of this House moves along quite nicely when the government and the opposition parties sit down and decide on a reasonable agenda. That is co-operation.

12:30 p.m.

We have a group of professionals who feel threatened because that co-operation has now been set aside for some politically popular, populist legislation. That is very short term. It will alienate a very important component of our social network, the very people who make it work.

There are still a number of people in Ontario who retain that very deep-seated respect for professionals. I warn the government members that if they keep bashing those people around, they are going to get a reaction from them. They are going to see them in their constituency offices on Saturday and they are going to hear from them when they speak in public, because they will not like it. It is populist, it is popular politically and it is short term. Eventually it will come back to haunt the government.

To get back to the question of quality health care, our health care system is a quality system because of the professionals, the ethics and the abilities of the practitioners, just as is the education system, the justice system and agriculture.

I often refer to an old adage that someone laid on me once. A young fellow came to me and said, "I would like to be a farmer but I cannot justify the long-term investment of this kind of money in a farm." I looked at him and said, "But if you want to be a farmer, you have to have a farm."

Mr. McFadden: I did not realize one needed a farm to be a farmer.

Mr. Andrewes: No? How else can you do it? The integrity of professionalism has to spread through many disciplines. The only way the system retains its integrity is by retaining the co-operation and the support of the practitioners involved.

I want to refer briefly to another letter. This was written to the Lincoln Post Express, a paper of some renown. It does not have a wide circulation, but again it is a very fair-minded publication. It is interesting that the publishers of the Lincoln Post Express also happen to be the publishers of the St. Catharines Standard. I note that again so that the members feel there is some objectivity.

This letter was written by Dr. Bill Peters, a young medical practitioner in the town of Lincoln who has two young children. He is fairly new to the community. He entered a family practice with three or four other, more experienced, practitioners who had been in the community for 30 or 40 years or more.

He also undertook to provide care to the seniors who are resident at the Albright Manor. That demonstrates his interest in his community. It also demonstrates his willingness to hone his talents, to direct his talents to a specific area, a specific group of people when the need arises. It is a very sensible letter to the editor of the Lincoln Post Express, but it expresses what I think is the very deep feeling of a young medical practitioner who is getting his practice started, the very deep feeling he has for his community and for the patients to whom he is providing care.

What provokes a young medical practitioner in a community of 4,000 to speak out on an issue that even the Minister of Health would say is probably focused more on the larger urban centres? He has not opted out. Bill 94 is not going to affect him or his income. He is not an activist, not the sort of person one would find demonstrating for political or personal causes. He is too busy dispensing medical care to the people who depend on him for it. He is not a revolutionary.

I make these comments because I think it is necessary to put this in some perspective. He sent me a copy of his letter with a note saying, "Mr. Andrewes, this is a copy of a letter submitted to the editor of the Post Express for publication January 15, 1986.

"As a practising physician in Beamsville I feel it is important that the consumer of health care, the general public, is aware of the impact of the Health Care Accessibility Act.

"I, like all other physicians in Beamsville and Grimsby, am opted in by choice and stand to make no monetary gain in challenging the aforementioned act. However, I do stand to lose freedom both as a physician and as an individual if the present act is passed.

"However, the infringement on freedom does not stop here and you, as consumers of health care, become involved."

I think that has some significance. He speaks from the heart. It is not a casual observation by Dr. Peters; he is a caring professional speaking from his heart when he says the infringement on freedom does not stop here and we, as consumers, become involved.

"This act is only the beginning of an infringement on our freedom and you do not have to look far to understand the effects of socialist medicine. In making civil servants of its physicians, Britain has created a two-tier system of health care and we are about to take the first step towards this under the guise of the present act." He refers to Bill 94. "Very soon to follow are restrictions on which physician practices where and who may see that physician."

He goes on to talk about the needs of the local community. I would like to expand on that to some degree after I finish reading Dr. Peters's letter. "Granted, the present system has its drawbacks but it is working reasonably well, especially when we consider the above alternative," the British system. "The government should focus on the real issues at hand, which include overcrowding of wards and hospital emergencies as well as a lack of long-term care for the elderly, instead of the 12 per cent of physicians who are currently opted out of OHIP.

"If you are concerned about these issues and value your freedom of choice, you should make your feelings known to the local provincial government representative or openly discuss them with your physician."

I have not had a deluge of mail as a result of Dr. Peters' letter. I have not had a lot of public input on this debate because --

Mr. Haggerty: If we can only get that $50 million from Ottawa, it could provide additional health care.

12:40 p.m.

Mr. Andrewes: I know, and other members have expressed the same feelings. In the quietness of carrying on the business of government, I am sure the government has sensed that there is broad public support for Bill 94. Perhaps the government is sitting there saying: "Those dumb Tories. What are they taking up the defence of the OMA for? Why are they so persistent in this debate?"

It is because of people such as Dr. Peters, whose opinion and views about the medical care system I value and trust, as a layman and as one of his patients. I am not a practitioner. I am not directly involved. It is for people such as Dr. Peters, the patients and the constituency he serves that I am taking up this debate and that my colleagues are persistent in putting on the record, for this House to see in the future, that there was a political party with a different point of view about Bill 94, a party that felt very deeply about a health care system that worked.

I do not want to get totally distracted by political expediency, and I hope the members of this House will not get totally distracted. Let us not get distracted by the term "accessibility."

For six weeks this spring, I had the privilege of being the Minister of Health. It was not a long time to form any strong opinions or views about how the health care system should or should not work, and it was not enough time to make substantive changes in that system. I do not believe anybody in the capacity of an elected individual, who brings to that office not the views of a specific discipline but the views of a generalist, should after six weeks have strident views on how the system should or should not work.

One thing I did learn during those six weeks --

Mr. Haggerty: The member should tell us about his negotiations with the medical profession. He was the Minister of Health.

The Deputy Speaker: Order. The member for Erie, the member for Mississauga East (Mr. Gregory) and the member for York West (Mr. Leluk) will please stop interrupting the member.

Mr. Gregory: How about the member for Erie?

The Deputy Speaker: I mentioned him first.

Mr. Andrewes: Thank you, Mr. Speaker. Where was I? I was somewhat distracted by the member for Erie.

Mr. Lane: Start over.

Mr. Andrewes: I should, but I will not. During those six weeks when I was the Minister of Health, I could not help but be impressed by the fact that unlike situations that confronted me in other ministries in which it was my privilege to serve, through the doors of the Ministry of Health came proposals from public groups, professional groups, hospitals, doctors and health care delivery organizations right across Ontario. Without exception, every one of those proposals has merit.

Without exception, one would love to be in a position to say: "Go ahead, let us try it. It is innovative. It is creative. It has potential. It is going to deal with a problem in a particular area in a way government cannot deal with it. Yes, try it on."

One can be enthusiastic. One can combine that enthusiasm with compassion and an understanding of the needs. All it takes is money. That is in contrast to situations in other ministries. The member for Quinte (Mr. O'Neil), as the Minister of Industry, Trade and Technology, and other members understand that in those resource-type ministries, people come through the door with hundreds of proposals. There are two groups, the crocks and the good ones, and it is fairly easy to distinguish between them.

In health care it is not easy. When they come through the door with proposals, there are no crocks, because people's lives are at stake. That is something we should consider as we look at the question of health care and health care accessibility. Let us not get distracted by the word "accessibility." Our health care system has built-in inaccessibility because of the lack of resources I referred to.

Perhaps I should share some of the situations that confront me in my riding in the Niagara region. They are not unlike the situations that confront every member. Two weeks ago, the member for Erie and I were able to attend a meeting with the local association for the mentally retarded. It has some serious problems with housing and the programs it is able to offer to severely handicapped individuals. It has problems in the training and retraining of the trainable retarded adult. It has ongoing difficulty in fulfilling its mandate to the younger mentally retarded who require constant care.

This is built-in inaccessibility. It is nothing money cannot solve. There are willing people who are prepared to give their talent, time and ability to raise funds to administer and provide the care but who are without the other financial resources.

About two months ago, the member for Erie and I attended a meeting with a number of administrators and board members from homes for the aged in the Niagara region. All faced the same problem of rising costs in their operations and were having to ask the residents of the homes to sustain those rising costs. They were not able to expand their operations. All of them are facing similar problems. I am only thankful that in the Niagara Peninsula, in spite of our partisan political views, collectively the six members representing the six ridings can sit down and talk co-operatively about these problems.

Nursing homes are another problem. I do not think there is a member here who has not been confronted by a situation where a relative, friend or constituent cannot find proper care in a nursing home or cannot find an available bed. A person may have to wait in a chronic care or acute care facility, taking up a bed until he can be accommodated in a nursing home. There is not a member here who has not been approached by a nonprofit group operating a home for the aged or even by a nursing home operator for assistance in finding the resources or getting the permission to build additional nursing home beds.

12:50 p.m.

Extended care is another problem -- care for the chronically ill aged population who require a place to live and someone to prepare meals in the comfort of knowing they are not going to feel alone. I remember having it brought to my attention during my six weeks as Minister of Health that in the Niagara region there were some very serious problems with chronic care. There were situations in which acute care beds in hospitals were being taken by chronic patients, and elective surgery was delayed or postponed because acute care beds were taken by chronic patients.

This was not simply a problem in the Niagara region, it was a problem across the province, and I had an opportunity to remedy that situation.

Hon. Mr. Nixon: Would the member mind starting over? I missed some of it.

Mr. Andrewes: Actually, I missed the Treasurer's presence. He brings out the best in everybody.

The Deputy Speaker: Order.

Mr. Callahan: The Treasurer did not miss a thing.

Mr. Andrewes: I am getting to the member for Brampton. Come back tomorrow; there is more to come.

This problem of chronic care was well demonstrated in the St. Catharines General Hospital. We were able to make some moves to accommodate a well-thought-out program to revitalize that hospital, to provide the necessary chronic care beds and to alleviate a very serious problem in that area. Perhaps it was not enough; it is never enough.

That became the subject of some further review by the new government, because it felt that perhaps in our dying days as a government we were being totally partisan in what it would view as a less objective view of the health care system. Even in St. Catharines, which was not a Tory riding, as the member for Erie (Mr. Haggerty) would remind me, and even in London and in many other communities such as Stratford, we were able to do some things about chronic care that needed to be done. However, it is never enough.

Perhaps I can further enumerate the problems in acute care. On the day I met with those 19 doctors at West Lincoln Memorial Hospital -- a hospital, by the way, that currently has an acute care capacity of 81 beds and a chronic care capacity of 16 beds -- two patients who were scheduled for elective surgery had to have their surgery cancelled or deferred because of a lack of beds. Those are two situations in a very small community, situations that no doubt could be multiplied across this province.

That hospital is now in the midst of a very ambitious building program. It is adding additional chronic care beds and it has a very innovative program to incorporate day care, chronic care and extended care all in one hospital community. It is a very innovative program, but it has taken far too long to happen, in my view, as many of these programs do.

In making this observation about the building program at West Lincoln hospital, I would say only that it is an ambitious building program, but it has a $2-million public participation component; $2 million is to be raised by the community. There are 27 doctors practising out of this hospital. Do members know what each of those doctors has pledged towards that project? They have each pledged $5,000. It was voluntary. It is pledged. It is not taxed. These doctors are not the scavengers the government is talking about. These are not the doctors who are extra billing. These are family practitioners, with the exception of about three specialists. They have pledged $5,000 each towards that project.

Emergency wards: We know that the emergency wards of many of the major hospitals are flooded with what medical practitioners tell me are frivolous cases. Perhaps it is easier to allay the fears of a child in pain by taking him down to the emergency ward instead of practising what many of our parents did and sticking a thermometer in his mouth and putting him on a liquid diet.

Mr. Foulds: That is really helpful for a potential broken arm.

Mr. Andrewes: I am not talking about broken arms and broken bones or the seriously ill.

Mr. Foulds: Can the member make that judgement?

Mr. Andrewes: I would not, nor would the member for Port Arthur. In the judgement of the medical practitioners -- not in the member's judgement or mine -- many frivolous cases are brought to an emergency ward because it is there, it is available and perhaps it does not put the onus on a parent or an individual to make that kind of judgement. I am not in a position to say which is frivolous and which is not. I am saying it is a problem that needs to be dealt with.

Mr. Foulds: How does the member suggest we deal with it?

Mr. Andrewes: I thank the member for that comment. He probably has some innovative ways of dealing with it. I am not averse to his idea of clinics, but at the same time I would want to know a little more about them. When he joins in this debate, I hope he will expand considerably on his interjections.

Mr. Foulds: Just briefly; no need to go on at length, the point is so obvious.

Mr. Andrewes: Maybe briefly, but no doubt he will expand.

There is another area one could allude to as an indication of inaccessibility, and that is the whole question of day care for seniors as part of the programs now in many hospitals. Facilities with day care for seniors are associated with hospitals, local health units and homes for the aged. They can receive care and comfort in an appropriate environment for a time and then can go back to their homes for the balance of the day when their relatives or friends come home from work.

This situation is becoming reasonably commonplace in Niagara and the response has been excellent. It is an opportunity for expanded health care and to deal with the very serious problems of overcrowding in nursing homes and homes for the aged. It is an opportunity for senior citizens to maintain reasonable control of their own lives and yet know they have the protection of a system that provides them with that kind of comfort.

You are reminding me of the hour, Mr. Speaker.

The Deputy Speaker: Yes.

On motion by Mr. Andrewes, the debate was adjourned.

The House adjourned at 1:01 p.m.

January 31, 1986

STATEMENTS BY THE MINISTRY

EMPLOYEE HEALTH AND SAFETY

DISASTER RELIEF

ORAL QUESTIONS

EXTRA BILLING

CONFLICT OF INTEREST

ST. CLAIR RIVER

EXTRA BILLING

CONFLICT OF INTEREST

EMPLOYEE HEALTH AND SAFETY

CONFLICT OF INTEREST

MEDICAL LABOUR DISPUTES

WATER QUALITY

DENTURISTS

CONFLICT OF INTEREST

WATER QUALITY

LICENSING OF TRUCKERS

FOREST MANAGEMENT AGREEMENTS

UNEMPLOYMENT

ELECTRONIC EAVESDROPPING

PETITION

ROMAN CATHOLIC SECONDARY SCHOOLS

INTRODUCTION OF BILLS

OCCUPATIONAL HEALTH AND SAFETY AMENDMENT ACT

DENTURE THERAPISTS AMENDMENT ACT

ANSWERS TO QUESTIONS IN ORDERS AND NOTICES AND RESPONSE TO PETITION

ORDERS OF THE DAY

HEALTH CARE ACCESSIBILITY ACT (CONTINUED)