Hansard Transcript 1986-Feb-04 | Legislative Assembly of Ontario

Hon. Mr. Riddell: As the honourable members know, our prime farm land is one of our most precious natural resources and must be protected for this generation and future generations. We all know about the development pressures that threaten our vital land base: urban expansion, transportation or utility corridors, landfill sites, resource or recreational uses.

During the past eight years the land use planning principles of the food land guidelines have been incorporated into official plans by most Ontario municipalities that have agricultural land. Today I am announcing a revision and strengthening of these food land guidelines because, quite frankly, we do not feel they are tough enough to do the job. In addition, the legal framework has changed in the intervening time.

The new Planning Act calls for Ontario to spell out areas of provincial interest in provincial policy statements. Municipalities and others involved in the planning process must take these into account.

Today my colleague the Minister of Municipal Affairs (Mr. Grandmaître) and I are releasing Ontario's proposed food land preservation policy statement. We are releasing this proposal for comments by government agencies, municipalities, food producers, agricultural organizations, members of the public and other interested parties.

We do not want to put this in place until the people who will be affected by it have had a chance to respond. We are setting a deadline of April 30, 1986, for their comments.

I wish to highlight for the honourable members a few of the important proposed changes in this policy. The first concerns urban expansion.

Under the current guidelines there are no time limits for justifying the amount of prime agricultural land required for future urban expansion. We want to change this. Our proposed policy establishes a maximum planning period of 10 years for determining how much land should be set aside for perceived future development.

There are far too many examples across this province where prime farm land has been designated prematurely. Because of unforeseen circumstances, some of this land is now not required for development for another 30 years, if ever. Under this policy, municipalities would no longer be able to take land out of agricultural production based on 25- to 30-year planning guesstimates.

Second, the policy has been broadened so it applies to all types of development on prime agricultural land, including Hydro corridors, pipelines and highways. The need to use prime farm land for this type of development must be justified and, where justified, siting and construction must be carried out in a manner that will minimize the impact on the land and farming practices.

The third proposed change concerns severances. Experience has proved that severances, originally granted to retiring farmers, or for housing for farm help, or to deal with surplus dwellings from farm consolidations, frequently change ownership and become nonfarm residential lots. Often people from the city buy these country lots and move in unprepared for the sounds and smells of farming operations next door. Complaints arise about the smell of manure or the noise from farm machinery early in the morning or late at night. Farmers, on the other hand, complain about trespass on their property, damage to machinery and crops and pilfering.

For these reasons, under the proposed policy, there no longer would be any severances granted for retirement or for housing for farm help. Accommodation for retiring farmers and needed farm help can be handled in better ways than by the fragmentation of our land resource. In circulating this proposal for comment we are also including a draft of a new set of separation distances to be used in planning nonfarm land uses near livestock operations.

In effect, this is an update of the 10-year-old agricultural code of practice. Where nonfarm uses have been permitted in the rural area, using the code has minimized conflicts. Unfortunately, however, past planning mistakes have created many real and potential land use conflicts. They can interfere with farmers going about their normal business.

We need a thorough examination of the whole matter. For this reason, I also am announcing today a six-member minister's advisory committee to make recommendations on the right-to-farm issue. The legal term "the right to farm" usually means laws or policies to allow farmers to carry on normal farming practices without harassment from neighbouring land uses.

The chairman of the committee is Donald Dunn, director of my ministry's food land preservation branch. The other members are Dorothy Middleton, a dairy farmer from Crysler and president of Women for the Survival of Agriculture; Earle Muir, a fruit grower from Niagara-on-the-Lake; Barnie Evans, a cattle breeder and consultant from Embro; Otto Crone of Hagersville, a pork and cash crop farmer and chairman of the Ontario Farm Pollution Advisory Committee, and Ralph Ferguson, of Watford, a cash crop and beef farmer and former federal Minister of Agriculture.

There are a number of questions I want them to answer. What is the type, extent and seriousness of problems interfering with normal farm practices? Will our proposed new policy statement give farmers adequate protection in land use planning matters? How effective are other existing policies and should they be changed?

We also want this group to evaluate the effectiveness of farm operation protection programs in other jurisdictions and to examine the type of right-to-farm protection required by farmers in Ontario. The Ontario government is committed to keeping a land area available for agriculture on a long-term basis. We also want to ensure that agricultural activity can take place within that area with a minimum of disruption from competing or incompatible land uses. We feel the proposed policy statement on food land preservation and the right-to-farm study are positive steps towards achieving these goals.

2:10 p.m.

Mr. Timbrell: On a point of privilege, Mr. Speaker: I do not want to detract in any way from the announcement of yet another task force, but I want to draw your attention to standing order 18(a) which reads: "Privileges are the rights enjoyed by the House collectively and by the members of the House individually conferred by the Legislative Assembly Act and other statutes, or by practice, precedent, usage and custom."

It is the practice, the custom and the style of this Legislature, sir, that when a statement is to be made to the House, the media do not see it or hear of it before the members of the House. However, I am told that today on Radio Noon, on the Canadian Broadcasting Corp., this very statement was the topic of extensive discussion and that the Minister of Agriculture and Food participated in that discussion. I submit that the privileges of this House have been abridged.

Mr. McClellan: I would like to support the argument made by the government House leader.

Mr. R. F. Johnston: What is the matter? Is the member sick?

Interjections.

Mr. McClellan: I meant the opposition House leader. I know he will agree with me that this kind of violation of the standing orders has never, ever taken place in this assembly before.

Hon. Mr. Riddell: Speaking on the point of privilege, as usual the honourable member is inaccurate in his comments. There were no elaborate discussions of this statement this morning. I happened to be asked to speak to the Ontario Vegetable Growers' Marketing Board convention, which is taking place at the present time. I referred to it in my speech. There was absolutely no discussion of any kind following the speech. One sometimes feels one has to go outside this House to get the kind of people who expect to listen to policies rather than come in here and --

Mr. Speaker: Order. The member brought up a point of privilege and I have let other members comment on it. As I recall, over the past number of years, other Speakers have received the same request from honourable members. I do not believe there is anything in the standing orders that says any individual must first come to the Legislature. However, I also add that it would be common courtesy to do so. I believe that is the ruling that has been given by many Speakers in the past.

ORAL QUESTIONS

PSYCHIATRISTS' SALARIES

Mr. Pope: My question is for the Minister of Health. It has to do with his ability to communicate and negotiate with the various client groups he is obliged to serve as Minister of Health. We have already seen the response of the Ontario Pharmacists' Association and the Ontario College of Pharmacists with respect to the ability of this minister to communicate and negotiate openly prior to introducing legislation. We have already heard the member for Humber (Mr. Henderson) comment on the ability of this minister and of the Premier (Mr. Peterson) to negotiate with the Ontario Medical Association prior to legislating.

Medical staff at Ontario psychiatric hospitals are shortly going to begin job action that will remove their services from their patients for varying periods of time. This, along with other issues that have surfaced during the past couple of months --

Mr. Speaker: Question please.

Mr. Pope: -- will affect the quality of health care in this province and will also obviously affect the quality of health care being delivered in these specific facilities. Will the minister meet immediately with the doctors and avoid this unnecessary confrontation?

Hon. Mr. Elston: I imagine the honourable gentleman knows that I have already extended the opportunity, through one of the ministry officials, for those physicians to meet with me concerning the question of working conditions. That took place at a meeting that was held almost a week ago. I think the member will acknowledge that offer was made on behalf of myself to those physicians.

Mr. Pope: I know what offer was made to the physicians. It was an offer by the chief negotiator representing this minister, who told the negotiating team representing the psychiatrists that he had no mandate to negotiate; that it was a new government, a new mandate and he had nothing to negotiate. This is exactly why during the past week the doctors have accused the minister of negotiating in bad faith.

This is what they told us directly. Is he telling me they are wrong? Will he instruct his negotiator to negotiate an end to this impasse?

Hon. Mr. Elston: The honourable gentleman is absolutely wrong. I have never refused to meet those people and talk about working conditions. I sat down and met with a group of four of those physicians earlier when a fact-finder had been appointed to make a report to me. That fact-finder has reported just in recent weeks. In fact, a report was to be made public on January 24. It was made public on January 22 as a result of some interviews and communications.

A meeting has been set up for Thursday this week between my parliamentary assistant and the physicians to discuss at a preliminary level some of the concerns they have with respect to setting up a framework for discussing working conditions.

Quite honestly, the reason I am not meeting with them on Thursday is that I am not going to be in Toronto to meet with them. I have requested that they meet with my parliamentary assistant so we can set up a framework in which we can enter into dialogue with respect to these working conditions at the earliest possible opportunity, and I will continue to talk to those people about those working conditions.

Mr. D. S. Cooke: This matter has been raised twice before in the Legislature with the minister's colleague the Chairman of the Management Board of Cabinet (Ms. Caplan). Why will his government not put in place the recommendations of the fact-finder? Why set up the fact-finder and then not accept the recommendations, the main recommendation being that there should be a process of negotiations whereby the doctors are allowed to bargain as a bargaining unit?

Hon. Mr. Elston: I am not sure the Chairman of Management Board alone can establish one guideline for negotiations with a professional group without looking at the entire question. I believe she has taken it under her auspices to review the style of operation of the negotiations for the professional groups who are hired by the people of Ontario.

I have provided an opportunity for the physicians in this case, as they requested. That I have also extended to them the opportunity to talk about working conditions is a positive step, one that has taken place at my initiative, to ensure they do not feel they are unable to have input into the style of practice in the psychiatric institutions in this province.

Mr. Pope: To quote the member for Renfrew North (Mr. Conway), this is the same bafflegab that we heard with respect to the pharmacy negotiations and the doctor negotiations. The pharmacists know what the minister means by negotiation. He finally said it on November 27, an hour before legislation was introduced. The member for Humber knows what he means by negotiation. The minister is pulling the same stunt with the same rhetoric on this group of professionals. It is his obligation to get involved in this issue and settle it. When is he going to undertake those obligations?

Hon. Mr. Elston: The member knows full well that I have extended my offices to speak to these people about their working conditions, as they have requested. I met with a group of physicians when I was at the Queen Street Mental Health Centre. In my office, I met a group that was led by a former member of this august chamber. I have met those people and I have undertaken to look at their concerns about the manner in which working conditions have been and are being determined in their facilities. This gentleman is laughable in his criticism of how open this minister and my ministry have been with respect to this issue.

2:20 p.m.

CANADIAN DOLLAR

Mr. Timbrell: I have a question for the Treasurer. I am sure that since the Treasurer assumed office last June 26, one of the things he has monitored daily is the value of the Canadian dollar and its impact on the province and its economy. Since he became Treasurer, through his actions, in particular in the budget of last October, we have seen the debts of the province move from the target of the previous administration of $1.2 billion to $2.2 billion. We have seen tax revenues increase by $750 million because of measures he took, plus growth in taxation from sources already in place. We have seen a windfall transfer from Ottawa of $250 million.

Can the Treasurer tell us today what he plans to do now -- not in April or May, when he is planning his next budget, but today -- to stem the growth in government spending and to take decisive measures to reduce the government deficit and contribute to bolstering support for the Canadian dollar?

Hon. Mr. Nixon: The honourable member might have included in his litany the fact the credit agency, Moody's, reaffirmed our triple-A credit rating after taking three months to review the fiscal position of the province. I hesitate to mention that because we know Standard and Poor's, reacting immediately after the budget, reduced our credit rating from triple-A to double-A-plus. What we lost on the lemons, we got on the oranges.

As far as we are concerned, the commitment to fiscal responsibility continues. It was part of our election program, part of the commitment made by the Premier (Mr. Peterson) on his elevation to this office and part of my statement both in the budget of October 24, and the statement in July.

Our commitment is to fiscal responsibility. We believe we must accept the programs that have been lacking in this province for so long to provide job opportunities and housing and to take some stand to improve the environment and northern opportunities. We intend to pay for those in a clearly understood and responsible way, which is part of the budgetary program I announced to the House on October 24.

Mr. Timbrell: It is amazing how Standard and Poor's and Moody's have a place in the Treasurer's order of importance today that they did not have about six months ago. What a difference.

The Treasurer will recall we have pointed out repeatedly that there was nothing in his statement of July 11, and nothing in his budget of October 24, with respect to the creation and maintenance of full-time employment in Ontario. He will also understand that because of what is happening to the Canadian dollar and interest rates, there is understandably a lot of nervousness in the business community about necessary investment decisions that must be made now for the balance of the calendar year.

What is the Treasurer going to do now in specific terms -- not in April or May -- to bolster their confidence and to sustain growth in Ontario, which in the main has been generated by policies of the previous government?

Hon. Mr. Nixon: I hope the Minister of Finance for Canada brings the deficit of his government under some control. It has grown tremendously since the Progressive Conservative Party took over responsibility for our fiscal affairs. There is no doubt the falling dollar is associated with the concern felt internationally at the very high levels of deficit maintained at the federal level.

I understand the Minister of Finance for Canada is contemplating a budget in the next three weeks. I hope very strongly that this will restore in some measure the failing confidence of the investors because of the size of this deficit and the inadequacies of the government of Canada in bringing its spending programs under control.

Mr. Rae: The Treasurer referred very acutely to the fact the dollar is falling, something all of us have observed. We have also observed that interest rates have been rising. Given the historic reality that higher interest rates slow down growth, destroy jobs and make it far more difficult for our economy to prosper and thrive, has the Treasurer made any particular representations on behalf of the people of this province to the federal government that going back to that tired technique of permitting higher interest rates in an effort to prop up the dollar only destroys real growth in the economy?

Mr. Speaker: The question has been asked.

Mr. Rae: Has he made representations to the Minister of Finance about the folly of that approach by the government of Canada?

Hon. Mr. Nixon: I am sure the Minister of Finance has read my widely reported comments that indicate, as far as I am concerned, the dollar at the level of 70 cents has been remarkably valuable for the competitive position of Ontario.

I am very much concerned that interest rates, which have gone up a full one per cent in the last three or four weeks, actually from 10 per cent to 11.5 per cent, are throwing a wet blanket on the investment in housing which has fueled our economy so efficiently and effectively over the last six weeks. I feel very strongly that there is a larger threat to our economy in this province from high interest rates than the sagging dollar.

I do not have any better crystal ball than anyone else here, although I have access to the opinions of the officials in the Treasury who are usually infallible in these matters. Their indication and our hope is that the Canadian dollar will maintain a value very close to, if not at, 70 cents or slightly above during the coming year.

For that reason, we sincerely hope interest rates will not be allowed to move above what they are now. The concept of their soaring into the teens is something that fills me with apprehension.

Mr. Timbrell: That sounds amazingly like government by hope, prayer and maybe.

Since the Treasurer has difficulty dealing with the general question of economic policy and what can be done to sustain Ontario, let me ask about a specific sector. As the member for Brant-Oxford-Norfolk, he will be well aware of the effect of fluctuating interest rates and the value of the Canadian dollar on the agricultural sector in the last five to six years. He will also be aware of the extensive efforts of both our government and his to deal with that problem. Surely he is also aware that the Minister of Agriculture and Food (Mr. Riddell) is reported recently to have said that in the April budget there will be even more assistance for the farm community to deal with the problems of interest rates and long-term financing.

Mr. Speaker: Question.

Mr. Timbrell: Rather than waiting for April, today or at least before the House rises in the next two to three weeks, can he disclose to us his exact plans for the farm sector so that, in the face of yet another round of difficulties with the value of the dollar and interest rates, they can plan with certainty for their crop seasons?

Hon. Mr. Nixon: I will not list for the honourable member the accomplishments of the Minister of Agriculture and Food. He is very effective at bringing those to the attention of the House himself. In the budget we intend to have programs that will assist the farm sector and, as a matter of fact, the manufacturing and resource sectors on a wide basis. I am not prepared to enunciate our budgetary plans now because they are still being formulated.

The member must realize, because of his previous responsibilities and his good judgement which continues, all these matters are in the hands of the government of Canada. We certainly hope those people are going to bring down a budget that is going to moderate these changing and fluctuating values for the benefit of the whole of the country.

2:30 p.m.

ST. CLAIR RIVER

Mr. Rae: My question is to the Minister of the Environment, who described himself the other day as not a fish-eater. There are a lot of other things I would call him as well. He is certainly not a pollution-eater either.

Given that his report stated on page 12 that Dow Chemical is the only known producer of chlorinated solvents in the area and is now dumping nearly two tons a week of this stuff into the river, what further evidence does the minister need before he launches prosecutions under the Ontario Water Resources Act and the Fish Inspection Act, since the evidence is overwhelming that Dow Chemical is today poisoning the water and fish in Ontario?

Hon. Mr. Bradley: As I indicated to the critic for the New Democratic Party yesterday in answer to this question, we are prepared to press charges against any of the polluters who can be identified as violating any of the environmental laws of Ontario. I am happy to do that if the evidence is there to justify that. The member points out there is in existence around there considerable evidence that perhaps would point to prosecutions in a number of areas. In terms of the spills we are prosecuting, in terms of the caverns about which we are prosecuting, and in terms of the specific instance he has again raised in the House, the member will be aware that we are prepared to prosecute if there is evidence. At the present time, the investigations and enforcement branch is working on that very item.

Mr. Rae: One does not have to be Perry Mason or Sherlock Holmes to go through the report and realize that a process of chemical pollution is going on and that the only producer of some of these chemicals is Dow Chemical. Dow is to the Great Lakes what Inco is to acid rain.

What is the minister's hangup? Why is there a delay in pressing effective charges rather than this $5,000 penny-ante business? Why does the minister not get down to it, stop the discharges and start fining the companies, particularly Dow Chemical, that are poisoning the water and the fish? What is the delay?

Hon. Mr. Bradley: Unlike the member for York South, I am not a lawyer and I am unable to bring to these matters the kind of legal expertise he brings to this House. I guess he has never appeared as a prosecutor. As the member will be aware, we have people in the Ministry of the Environment who are considered to be some of the toughest prosecutors to be found in Ontario. I know the member opposite would regret very much having to go into court against some of the people we have who have fought cases in the courts on behalf of the Ministry of the Environment.

We want to make sure we have an ironclad case. I know that the member, as a person who is familiar with the legal system, would want to ensure that the case we present is the best possible case. In that regard, we are gathering evidence to ensure that will be the case. When the member sees the ultimate results, I am sure he will rise in the House to applaud the efforts of the Ministry of the Environment.

Ms. Fish: The other day, when the minister made his comments in the House about the finding of dioxin in treated drinking water, he indicated his concern that there was inadequate identification of specific sources of the highly deadly pollutants in the water. Is the minister saying now that the sources are specific to industries located in Chemical Valley or is he maintaining his earlier position that the sources are ambient?

Hon. Mr. Bradley: The member is not really directing what I consider to be a supplementary question, but I am not the Speaker so I will answer the new question she asks.

Mr. Hennessy: The minister would like to be the Speaker and the minister. What a job! He can tell me to shut up and can answer his own question.

Hon. Mr. Bradley: That is not my goal, I assure the member. I am pleased to see him and the member for St. George (Ms. Fish) here now that the vote on first-contract legislation is over.

In regard to the question asked by the leader of the New Democratic Party, to which the member for St. George is asking a supplementary, if one looks at some of the specific materials and exactly where they are found, in cases where they are immediately adjacent to the outfalls of various companies, it is easier to tell precisely where they are coming from. When we are talking about situations that exist downstream, it is more difficult to pinpoint the sources. As I indicated, and I know the member will want to admit to the House this was the case, there are a number of possible sources and I rule out none of these sources.

Mrs. Grier: I would like to try a supplementary that might be supplementary to the answer given to my leader's supplementary.

Today the minister is reluctant to press charges until he has more evidence. In response to a question from me a couple of days ago, he was reluctant to issue a control order because he felt it might be appealed. I want to remind the minister that commercial fishing in Lake St. Clair was destroyed in 1969 as a result of mercury emissions from Dow Chemical. At that point, in March 1970, the then Minister of the Environment, the Honourable George Kerr, did issue a control order and that control order was complied with and the mercury emissions ceased. Why is the minister so reluctant to take immediate decisive action?

Hon. Mr. Bradley: The member will be aware that instead of --

Mr. McClellan: Let us have some more bafflegab.

Mr. Rae: Where is George Kerr when we need him?

Hon. Mr. Bradley: It is not bafflegab at all. It may not be the answer the honourable member wants to hear, but members of the House would agree it is not bafflegab. It is a real answer.

I am explaining to the member, and her leader recognizes this as well, that we want to proceed in the most effective manner. The most effective manner is a regulation that cannot be appealed. We will have the most effective and far-reaching regulation in this process, covering any jurisdiction in Canada and -- who knows? -- perhaps in North America.

When that is in place, the member will be in the House to applaud that initiative.

PENSION FUNDS

Mr. Rae: I have a question for the Treasurer. I have just learned that on September 18, 1985, the Pension Commission of Ontario approved the withdrawal of $75 million that was designated as surplus by Noranda Mines Ltd. Can the Treasurer confirm whether that withdrawal has taken place, and what does he intend to do to stop this incredible takeaway by companies of money that really belongs to the working people of this province?

Hon. Mr. Nixon: The withdrawal took place with the approval of the pension commission, as the answer tabled in the House a couple of days ago would confirm. This left about $54 million in the fund for the company to fulfil its responsibilities under its pension agreement. I am informed that the amount is 125 per cent of the requirement to meet the payout from the pension agreement.

The present law of Ontario allows these withdrawals of surplus funds. We are currently reviewing changes that may accompany changes to general legislation dealing with private pensions to deal with the matter.

Mr. Rae: The Treasurer is admitting that a company was permitted to withdraw 60 per cent of the money that had accumulated in that fund due not to the genius of the company but simply to higher interest rates. We now have information -- and this is with respect to only two companies -- that in 1985 and 1986, Dominion Stores and Noranda have withdrawn $137 million between them.

What does the Treasurer intend to do to stop the run which has clearly been taking place for two years, and which may now be intensified as a result of various statements he has made in the Legislature? What does he intend to do to ensure that those funds stay intact as of now? What does the Treasurer intend to do to protect the value of the investment of the workers of this province?

Hon. Mr. Nixon: A few days ago, the honourable member made reference to the possibility of a run on the pension funds. I have inquired about the level of withdrawals and those that are pending. I am assured they are not out of perspective with projections, and that the pension commissioners do not identify this as a run on the fund. The matter has to be reviewed before appropriate action is taken, and my colleagues in the cabinet are undertaking such a review.

Mr. Andrewes: It is the view of the pension commission that 125 per cent is adequate to protect the pension rights of employees. Is that view sustained by the Treasurer?

Hon. Mr. Nixon: There is no doubt that 125 per cent of the requirement will enable the pension fund to pay those requirements. The argument is put, however, that the surpluses might very well be attributed to improving the payout, particularly those surpluses that are accruing from the escalation in the economy and perhaps from no other source. We are concerned about those moneys and their allocation.

2:40 p.m.

Mr. Rae: We are entitled to know this very clearly today: is it the view of the Treasurer that the money, which is contributed to a company pension plan on behalf of the working people of this province, is being held in trust? Does that money belong to the workers or does it belong to the company? Should it belong to the workers or should it belong to the company? Will the minister impose a freeze on all withdrawals until such time as he has indicated clearly to the House precisely what he is going to do to protect the money that is there, in our view -- and let me make it very clear -- on behalf of the working people, held in trust and not simply being held by the companies for the --

Mr. Speaker: Order.

Hon. Mr. Nixon: Those important matters are under consideration by me and my colleagues.

LIQUOR LICENCE BOARD OF ONTARIO

Mr. Timbrell: I wish to ask the Minister of Consumer and Commercial Relations when, how and why he arrived at, and communicated to Willis Blair, his intention to sever Mr. Blair's relationship with the government of Ontario and the chairmanship of the Liquor Licence Board of Ontario.

Hon. Mr. Kwinter: I have not communicated anything to Willis Blair.

Mr. Timbrell: Is the minister therefore indicating that the report in last Saturday's London Free Press of Mr. Blair's imminent replacement by Mr. Drinkwalter, of the Ontario Police College at Aylmer, is unfounded? Or is he saying -- and I hope he is -- that he has every confidence in Mr. Blair and that he will continue to carry out his responsibilities'?

Hon. Mr. Kwinter: I am saying that the reports in any of the media are speculation, and just that. If there is going to be a change, it will be announced by this government in due course.

INSURANCE RATES

Mr. Swart: My question is also to the Minister of Consumer and Commercial Relations. I am sure the minister must be aware of the long effort by the Canadian Institute of Chartered Accountants to get insurance companies to use generally accepted accounting practices in reporting their financial results. In spite of the fact that they do not, the minister has defended the high escalation of rates by saying they have severe financial losses.

Since he is the minister responsible for regulating the insurance industry in Ontario, I want to ask him whether he supports the accountants in calling for this change so that he and the public will really know the profits of the insurance companies?

Hon. Mr. Kwinter: I can say to the honourable member that I do support it. It is one of the charges that have been given to the task force, namely, to see whether we can get some standardized reporting. As the member will know, it is very difficult to compare insurance companies because of that problem. Everyone has a different formula for determining profits. It is one of the things the task force is looking at.

Mr. Swart: In view of the minister's answer, may I remind him that two weeks ago my leader told him that profits for property and casualty insurance were up sharply in the third quarter of 1985? I quote the minister's response, "He should take a look at the 20 companies that are dealing only with liability insurance."

Is the minister aware that it was not until yesterday that his staff responded to repeated requests from our staff for the names of those 20 companies, and then they said, "Get it from the Insurance Bureau of Canada." Where is the minister's freedom of information, and is he not seen to be mouthing a defence --

Mr. Speaker: Order.

Hon. Mr. Kwinter: I am very well aware of those inquiries. It is not our position in government to provide a research service for the member's caucus. He has his people and he has access to that information.

EXECUTIVE ASSISTANTS' SALARIES

Miss Stephenson: I am somewhat intrigued at the schizophrenia of the government in relation to fiscal responsibility. As the Speaker will know, the salaries paid to cabinet ministers' assistants have skyrocketed rather dramatically within the last seven months. In the previous government, the maximum salary for executive assistants was $48,000. In truth, fewer than a dozen very long-term employees, including one of mine who had been employed in that capacity for 10 years, had barely reached the $40,000 level. Most of them did not make more than $40,000.

The present government has a minimum salary level of $45,000 for executive assistants and the upward limit is more than $56,000. That is almost equal, in some instances, to an assistant deputy minister's salary.

Will the Chairman of Management Board please explain this huge increase in salary which, I remind her, comes directly from the taxpayers' pockets?

Mr. Speaker: Order. That is a very good question.

Interjections.

Mr. Speaker: Order. It was quite a lengthy question. Please do not take any extra time. Let the minister answer.

Hon. Ms. Caplan: I am pleased to respond and also to remind all members of this House that the Board of Internal Economy recently dealt with requests specifically from the outgoing government as to what its needs in opposition would be. The services and staff provided to this party when in opposition were significantly leaner. It seems the member's party could not hire anyone for less than $32,000 now it is in opposition. This is an issue the Board of Internal Economy addressed in dealing with this House, and those funds also come from taxpayers' dollars.

The point I would like to make is that this matter was reviewed by the transition committee. Recommendations were made to this government so we could hire the brightest and the best to ensure the efficient and effective running of this government.

Interjections.

Mr. Speaker: Order. We will wait until everybody is ready. I do not mind.

Miss Stephenson: I am sure the Chairman of Management Board realizes that the salaries paid to executive assistants and special assistants have nothing to do with the Board of Internal Economy. These huge increases are not limited to executive assistants. The salary range for special assistants under the Liberal administration goes from $38,000 to $47,000. In the former government, the maximum level of salary for special assistants was $34,000.

As I said, this government has preached fiscal economy. Can the minister tell me when her government is going to start to practise it?

Interjections.

Mr. Speaker: Order. I will wait until the members quieten down.

Mr. Martel: We want to hear the question.

Mr. Speaker: I really did not even hear a question, but does the minister want to respond?

Miss Stephenson: Yes, there was a question.

Mr. Speaker: Was there'?

Miss Stephenson: I will remind the Speaker that there was a question. I want to know when the government is going to start to practise fiscal responsibility and stop this orgy of spending.

Mr. Speaker: All right. Fine.

Hon. Ms. Caplan: The point I was making in regard to the Board of Internal Economy was the issue that we dealt with quite recently for all members of this House, particularly the requirements of opposition members for their staff, which has increased significantly, and the representations that were made regarding the salary levels.

The issue of payment of staff is something we should all be interested in. There is not anyone in this Legislature working for a minister who is paid the salary levels of the federal members, who are paying in excess of $80,000 for a chief of staff executive assistant.

Interjections.

Mr. Speaker: Order.

Hon. Mr. Riddell: If the member for Don Mills (Mr. Timbrell) would put his television set back where it belongs, we would be able to watch this.

Mr. Speaker: Order. Would the Minister of Agriculture and Food (Mr. Riddell) like to take the gavel? Time is going on and you are wasting question-period time.

2:50 p.m.

EQUAL PAY FOR WORK OF EQUAL VALUE

Ms. Gigantes: My question is for the Minister of Labour. Now that the government has informed the whole world of the details of the public service pay equity bill, will the minister explain why he is not tabling the bill in the Legislature today?

Hon. Mr. Wrye: The legislation is nearly ready. As the honourable member knows, all pieces of legislation go through a number of cabinet committees and the wording of the legislation is now being reviewed.

Ms. Gigantes: According to the estimates that have been broadcast wide and far, the accompanying documents to the tabling of the legislation will indicate that women working in the public service of Ontario are owed up to and beyond $80 million. I wonder whether the minister will give us assurance today that women working in the public service in Ontario will start to see some of that money by the end of this year.

Hon. Mr. Wrye: First, the member will know we have to wait for the tabling of the legislation.

Second, the honourable member will understand, as she has been around here a long time, that once the legislation is introduced, the timetable and the progression of the legislation are as much a responsibility and privilege of the opposition as they are of the government.

AFFORDABLE HOUSING

Mr. Gordon: I have a question for the Minister of Housing. On January 14 in this House, I quoted the Assistant Deputy Minister of Housing as having stated that any new building by the private sector would be at the high end of the market and that only in 20 years would that housing become affordable housing.

The minister responded that this was the opinion of Gardner Church and that I should go back to the assured housing for Ontario policy as the policy that will provide affordable housing. In estimates Mr. Church has repeated his assertion and said it is a fact, that it is not an expression of opinion from the government and that these units will be luxury units.

Again, I ask where are the units that will address the affordability crisis in this province?

Hon. Mr. Curling: The honourable member knows that any housing start cannot begin today. We have to wait until the plan is constructed. It takes time to put up all this construction. He is asking where it is, and I am telling him the private sector has indicated very strongly and confidently that it will build. The member will see we are on target. The response has been tremendous.

Mr. Gordon: It is quite obvious the minister and the assistant deputy minister do not agree. The assistant deputy minister does know what is going on, nor does the minister. Nevertheless, the minister is relying on the Rent Review Advisory Committee to come up with a formula to get the private sector back into the housing market. The fact is his assured housing for Ontario policy is nowhere near assured. It is dependent on some magic formula.

What is assured about a program that is based on a magic formula that has not yet been arrived at?

Hon. Mr. Curling: The honourable member knows that Bill 77 was introduced and accepted and is now law. Bill 78, which completes the overall rent review process, is coming through very soon for second reading.

There is no magic formula. The Rent Review Advisory Committee is working out the details about how it will be implemented.

DOMINION STORES

Mr. Morin-Strom: I have a question for the Minister of Consumer and Commercial Relations regarding the recent withdrawal of $62 million from the Dominion Stores pension plan. I am sure the minister has had the chance to review the data and the analysis of the Pension Commission of Ontario, which agreed to this withdrawal.

Can the minister confirm that the pension surplus was created in large part by Dominion's action in divesting itself of two thirds of its stores, along with those employees still working there, and the ongoing shutdown of many of the remaining Dominion Stores? Has Dominion not completely taken advantage of its employees, not only by reducing the work force but by thereby directly creating in large part the pension surplus?

Hon. Mr. Kwinter: Under the existing legislation a company negotiates its pension arrangement with its employees and they enter into a contract. Dominion Stores entered into a contract. It has funded in excess of the legal limits -- actually in excess of 125 per cent. It applied to have its $62 million withdrawn. It was according to the terms of the arrangement. The pension commission agreed with it and allowed it to remove the funds, satisfying itself that all the obligations to the workers under that contract were satisfied.

Mr. Morin-Strom: Is the minister not concerned that the obligations have been severely reduced by the actions of divesting itself of the stores and laying off employees in the shutdown of further stores and that the pension surplus may have been created not by excess gains in the investment but by actions directed --

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

Hon. Mr. Kwinter: I have no indication that what the honourable member says is correct. We are dealing with two separate issues. One is the pension issue and the other is a problem of store closings, severance and a labour problem. They are separate issues. Under the pension plan the pension commission is satisfied that nothing illegal, immoral or untoward has happened.

EXECUTIVE ASSISTANTS' SALARIES

Miss Stephenson: I have a question of the Chairman of Management Board. Would the chairman provide for us specifically a list of all those assistants in ministers' offices who are paid at or above the maximum level set by the previous administration?

Hon. Ms. Caplan: Let me say I am amazed that this is the level of questioning that would be coming from a previous minister.

Interjections.

Hon. Ms. Caplan: Further, I find very surprising the plethora of questions in Orders and Notices dealing with this matter. The payment of ministry staff is a personnel matter, and I do not see what the honourable member's problem is.

Interjections.

Mr. Speaker: Order.

Miss Stephenson: The minister spoke earlier about the current government as an example of lean government. I hope her answer is not an indication that she is using either me or herself as an example of lean government.

Hon. Ms. Caplan: The lists of all the members of the staff in the ministers' offices, their salary ranges and all the appropriate information have been tabled here in the House. I frankly cannot see what the member is in such a flap about.

3 p.m.

FACULTY OF ARCHITECTURE AND LANDSCAPE ARCHITECTURE

Ms. Bryden: I have a question for the Premier. In the University of Toronto's statement of general objectives, approved by the governing council in 1973, it undertook "to maintain a breadth of endeavour in each broad field of knowledge." It included the professions in the list of fields.

Does the Premier agree the university may not be fulfilling this objective if it proceeds with the closure of the oldest faculty of architecture in Canada and the only one in Metro Toronto, and that this is a matter of public interest to the province, which provides substantial funding?

Mr. Speaker: Order. That was a very good question. The Premier.

Hon. Mr. Peterson: I am sure it was a good question, but what was it? I am sorry; I missed something the member was quoting.

Mr. Hennessy: That is arrogant. Is he deaf?

Mr. Davis: It is in front of the Premier. It is on his paper.

Hon. Mr. Peterson: Mr. Speaker, if you could control the members opposite, I would hear the member. She was quoting from something. I am sorry. I could not hear it and missed it.

Mr. Speaker: Perhaps the member could summarize the question.

Ms. Bryden: I asked the Premier if he agreed this was a departure from the stated objectives of the University of Toronto. Because it is a matter of public interest, what does he plan to do about it?

Hon. Mr. Peterson: I am not familiar with the stated objectives. I gather the member read them and I am sorry I did not hear them. I will review the matter.

We take the view the University of Toronto is an autonomous institution. I take the member to this hypothetical possibility: If they want to add or subtract a department to that university or any other, should it be the minister's responsibility to say yes or no? Does the member want the minister to dictate which courses or faculties are part of these autonomous institutions? If she takes that view, she is pushing a far more intrusive attitude in education than has been historically practised in this jurisdiction.

As the minister has said, he is not happy to see this decision. The member and I know -- at least, so I read in the newspapers -- there have been problems at the faculty of architecture for almost a decade. Someone has been unable to solve them. I have no idea whose fault or responsibility that is. Presumably, the president came to the conclusion and is going to recommend that institution should be done away with. I have absolutely no idea whether the governing council or board of governors is going to subscribe to that view.

However, these are autonomous institutions. The member has to respect that, unless she is telling us the minister alone should be the czar of education and decide on faculties, colleges, schools, how many teachers and those kinds of things. That is the problem.

Ms. Bryden: The minister is retiring behind the smokescreen of autonomy. He is not discussing the public interest of the profession, the students seeking entry into it, and the needs of Metro Toronto for a school of architecture. He also is not considering the kind of public hearings that will be planned by the university. Will he sit down with the president and the governing council and discuss the kind of public hearings that will allow the reason for this decision to be discussed and the resources that may be available to maintain the faculty of architecture?

Hon. Mr. Peterson: To the best of my knowledge, the minister already has chatted with the president of the university and others involved, and he has expressed his personal view. I want the member to be very careful. If it is her party's policy that the minister should unilaterally set what courses are taught by which faculties and universities, or if that is her position, she should stand up and say it. If it is not, she has to understand one cannot just arbitrarily stick one's nose in occasionally when it suits one's purpose. One has to respect the process.

Obviously, there will be hearings. A matter like this should have a full public airing by the architectural community about the needs over a long time, and we would support that. Ultimately, someone has to make a decision. We respect the right of the board of governors to make that decision.

Mr. McFadden: If the University of Toronto goes ahead with its current plan, it has been suggested there be a four-year closure period, during which the students who are there now will slowly come to the end of their program, with one class after another, like ten little Indians; first there were four years, then there were three, then there were two and then one year. I feel sorry for the kids who might be in that last year.

With the amount of taxpayer support that goes into the school and the commitment we have made to the education of these students, surely there is a responsibility on the part of the government to see that the academic position of these students is looked after and that they be offered positions elsewhere, if it becomes clear their education cannot be continued at the University of Toronto. Would the Premier be prepared to protect the position of the students and guarantee that their education will be secured?

Hon. Mr. Peterson: The honourable member puts forward a most reasonable point. I assume that is part of the president's proposal and will be discussed in the future. I cannot imagine him being so callous as to jeopardize the educational future of those young people who have committed themselves to that faculty in good faith. I would be most surprised if I heard anything to the contrary. I can ask the minister to discuss the plans of the president with him. The point is a sensitive one and we have no problem with it.

RETAIL SALES TAX

Mr. Barlow: My question is to the Treasurer. I am sure he is very much aware of the widespread concern and confusion in the food service industry today because of the recent changes to the Retail Sales Tax Act. The act exempts prepared food in various eating establishments where the total charge is less than $1, while taxing some foods which are considered to be snack foods at the normal seven per cent rate. The Treasurer indicated in this House that this is only the first stage in his government's attempt to keep its election promise of a $4 exemption for restaurant meals.

If the Treasurer's next budget is going to include yet another change in the Retail Sales Tax Act as it pertains to restaurant meals, will he let the retailers and food service people of this province know this now -- not in April or May when the budget comes out -- so they will have time to be prepared for this expensive changeover?

Hon. Mr. Nixon: I cannot do that. The honourable member will recall that the $1 exemption for prepared food from the retail sales tax was announced on October 24, and did not come into effect until January 1, so there were many months for preparation. The member is correct when he says that a number of retailers have experienced some confusion and difficulty with this, but I can assure him the officials in the Ministry of Revenue and the Treasury are offering every assistance.

The difficulty is mitigated to some extent by the thought that there may be an additional change in the next budget, but I am not prepared to predict that or announce it at this time. If there is a change, however, it will be implemented in the same way as the last one, going into effect only after debate and approval in this House.

Mr. Barlow: I realize this was announced in October and was not implemented until January 7. By that time, people were totally confused. They had to change over their cash registers.

Will the Treasurer consider some form of compensation to the retailers of this province for serving as his provincial tax collectors? Since they have to train and retrain their staff and change over their equipment, will the Treasurer offer some compensation to his tax collectors?

Hon. Mr. Nixon: We already have a program of compensation for licensed vendors who collect the retail sales tax. While it is not enough, it is still at the highest rate of any jurisdiction in Canada.

VISITOR

Mr. Stevenson: On a point of order, Mr. Speaker: I would like to take a second to introduce Sharon Wilson, the Ontario County Dairy Princess, who is sitting in the gallery.

3:10 p.m.

EMPLOYEE HEALTH AND SAFETY

Mr. Martel: I have a question for the Minister of Labour. During the fall, I asked the minister for inspections in places such as Duracell, Allied Heat Treat, Mobile Material Handling Equipment, General Motors, Inco, Falconbridge and the ambulance services. Is the minister prepared to provide the inspection reports requested and the inspection reports prior to the ones requested?

Can the minister explain why there is always such a large number of orders issued when we ask for an inspection, and the previous inspections show virtually no orders at all?

Hon. Mr. Wrye: I do not believe there is any statutory problem in sharing those reports with my friend. I know he would like to have a look at some of the reports and I will take a look at that.

With respect to the differences between the orders in the most recent visit, and then in the one that is taken after questions have been raised, I suggest to my honourable friend that one example or answer might be that these are simply snapshots taken at the time of the visit and matters can change. I have seen individual instances where matters obviously have changed. At the same time, I would be less than candid if I did not indicate to the House, as I have indicated to my own officials, my concern about the fact that revisits a short time after an inspection has been done, and after questions have been raised, appear to turn up an unusually large number of questions.

Mr. Martel: With all the violations the minister has found, such as the ones at Allied Heat Treat, how many does he intend to prosecute?

Hon. Mr. Wrye: I do not have a list. I expect that in the short term the number of prosecutions will rise. In the longer term, l hope it will begin to decline as the orders with fixed dates -- my friend knows we now have fixed dates -- are complied with by the dates announced. I expect the prosecutions will begin to decline over time. I do not know whether prosecutions have begun in any of the cases raised by the member today. I am still waiting for final reports on some of them, if I remember the instances the member raised with me.

CHEMICAL LEAK

Mr. Haggerty: I would like to direct a question to the Minister of the Environment concerning the Niagara region. His ministry has released a report on the Ontario Hydro property in Niagara Falls showing evidence of cyanide contamination in the area. What action is his ministry taking as a result of the report?

Hon. Mr. Bradley: This is the Cyanamid property, or at least the Ontario Hydro property where we have found cyanide in the soil. The member will recall that upon becoming Minister of the Environment, I instructed our ministry to address all the concerns found in the Niagara River Toxics Committee report. When one goes looking for problems, of course one finds problems.

We have scheduled meetings, I think for February 11, with Ontario Hydro and Cyanamid to bring to their attention our abatement program for this property. It concerns me greatly that we found this. I made a promise we would address all the concerns on our side of the river and that is what we are going to do.

PETITION

ONTARIO INSTITUTE FOR STUDIES IN EDUCATION

Mr. Shymko: This petition is addressed to the Lieutenant Governor and the Legislative Assembly of Ontario and reads:

"Whereas the government has decided to merge the Ontario Institute for Studies in Education and the University of Toronto, we, the undersigned, protest this move by the Treasurer of Ontario and petition the Lieutenant Governor and the Ontario Legislature that the Treasurer rescind this ill-advised budget item and that he reaffirm OISE's mandate to serve public education in Ontario."

There are approximately 1,400 signatures on this petition.

ANSWERS TO QUESTIONS IN ORDERS AND NOTICES

Hon. Mr. Nixon: I wish to inform the House that I have tabled the answers to questions 164 and 193 in Orders and Notices [See Hansard for Friday, February 7].

ORDERS OF THE DAY

HEALTH CARE ACCESSIBILITY ACT

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: On a point of order, Mr. Speaker: Yesterday during the debate on Bill 94, I used as an example of my concerns about accessibility, a situation that existed in the city of Thorold respecting a young child whose parents were not able to obtain proper nursing care.

I want to correct the record. I have learned subsequently that as a result of some changes and different interpretations of the guidelines, the ministry now is prepared to supply the services, and the situation has had a somewhat happier resolution.

Mr. J. M. Johnson: I am pleased to have the opportunity to present my views on Bill 94, the so-called Health Care Accessibility Act. I will start off by expressing my concern that Bill 94 will not improve access to health care but, indeed, may have the opposite effect. This bill has the potential to rip apart our excellent health care system by deliberately antagonizing and penalizing the heart of our system, the medical profession.

Without consultation, but with the support of its socialist friends, the Liberal government has declared war on the entire medical profession. If you think, Mr. Speaker, that the reference to a war is too strong, let me read into the record excerpts from a column by Greg Parent in the Toronto Sun of January 28, 1986. It is headed "Extra Billing War: Top Doc Refuses Offer of Peace."

"Despite a government plea for a truce, Ontario's ugly little war over extra billing by doctors won't end soon. Dr. Earl Myers, head of the Ontario Medical Association, said yesterday the battle-weary association won't stop fighting until legislation banning extra billing is put on hold."

Dr. Myers went on to say that if the bill was withdrawn, the OMA would be prepared to negotiate the health care scheme. That is all I want, for the Minister of Health (Mr. Elston), on behalf of the government, to negotiate in good faith with the medical profession to bring an end to this ugly little war before it affects the delivery of good-quality health care to the people of this great province.

There are stories in the press constantly that are not beneficial to the people in need of doctors' services. They are not beneficial to the doctors and are not beneficial to the public. I want to read a few examples. They include: "Doctors the Scapegoats"; "Extra Billing Ban Contravenes Charter MDs' Lawyer Says"; "New Law Won't Drive MDs Out: Peterson"; "Family Physicians Join the Fight Against Plan to Ban Extra Billing"; "Force Your Leaders to Let Us Ban Extra Billing, Elston Tells MDs"; "Elston Urges MDs to Defy Leaders on Billing Ban."

These are all part of a so-called war that is not beneficial to anyone in this province, and certainly not to the people who are in need of surgery. It cannot be too reassuring to them to be concerned that there may be problems relating to their doctors or to the health care system.

It is appropriate at this time to place my own position on this issue on the record. I truly believe we have one of the finest health care systems in the world. Several years ago, I had the opportunity to serve on a select committee of this Legislature that reviewed our health services. The Ontario health care system came out as one of the best in this country and, indeed, was considered one of the best anywhere.

3:20 p.m.

Having said that, I also accept the fact that every health care system needs improvement. Ontario is no exception. Our system needs more co-operation and co-ordination, more funding, more beds, more specialists in some areas of the province, better mental health programs, more care for seniors, homemaker services and better cancer treatment facilities. It does not need confrontation or angry and disillusioned doctors who feel they are being conscripted into a state-controlled medical system with no personal freedom for either the doctors or their patients.

I also recognize the fact that there are problems and abuses in the matter of extra billing that need to be addressed. I hope the Ontario Medical Association and its membership will also accept the fact that there are problems relating to the extra billing principle and will negotiate in good faith with the government to resolve these problems.

It is my personal opinion, shared by many in my party, that all senior citizens should be exempt from extra billing. As well, all citizens who are on welfare, handicapped or in financial need should not be penalized by having to pay extra. I suggest that we could use the Ontario drug benefit plan as an example of the many people who should be exempt from extra billing for medical care.

It is my understanding that many anaesthetists extra bill. Perhaps it is time to consider that anaesthesia is part of the basic service provided by a hospital and that fees for such services could be adjusted in such a way as not to require any extra billing. I have been advised by many doctors that the liability insurance for anaesthetists is extremely costly. Since these doctors nearly always use hospital equipment and since the hospitals require insurance, surely the two could be combined at some saving to both.

Since I have been presenting my own personal views as a member of this Legislature on some of the matters that are confronting us as a result of Bill 94, I would like at this time to bring forward the concerns of many of the medical doctors in my riding. The best way to do that is simply to read into the record a couple of newspaper articles appearing in the Mount Forest Confederate on January 29, 1986.

The first is a news story entitled "Doctors Back Action Plan Against Banning Extra Billing":

"Doctors in Wellington and Dufferin counties are overwhelmingly supporting their provincial organization's call for mass resignations from medicare and a promise to defy any law banning extra billing.

"Dr. Robin Fishburn, president of the Wellington Medical Society, said the majority of doctors in the two counties are going along with the Ontario Medical Association's action plan.

"Most of the 100 doctors at a meeting last week -- about half of those who practise in Wellington and Dufferin -- signed pledge sheets and opting-out forms showing the OMA their support.

"Mount Forest doctors wrote a letter to the Confederate, which appears on the editorial page this week, outlining the issues as they see them. The doctors say they stand `firmly united against proposed government legislation that would end extra billing.' None of the family doctors in Mount Forest practise extra billing.

"The legislation, introduced by Health minister Murray Elston in December, prohibits doctors from charging more than the rates set out under the Ontario health insurance plan. Anyone who charges more, or extra bills, would be liable to a fine of up to $10,000.

"The OMA decided last weekend to ask its 17,000 members to sign letters of resignation from the plan (although these would probably not become effective for three months) and to sign pledges that they will charge a nominal amount (ranging from a penny to a few dollars) above the OHIP rates if the legislation is passed.

"Those attending last week's meeting showed `very, very strong support of the OMA stand against this act,' Dr. Fishburn said. `We feel it is unwarranted, oppressive and the guys are overwhelmingly in favour of taking action.'"

The second is a letter to the editor that appeared in the same issue of the paper. It is from the family doctors in Mount Forest and it reads:

"No family doctor in Mount Forest practises `extra billing.'

"Why, then, do these doctors stand firmly united against proposed government legislation that would end extra billing?

"Let us examine the issues as we see them. The Health Care Accessibility Act provides that `The Minister of Health may enter into agreement with...the Ontario Medical Association.' To put this in context, the minister may, but is no longer obliged, to discuss or negotiate the OHIP fee structure with the doctors. He may, under this legislation, also decide on doctors' fees on his own, without representation from the physicians.

"Would any other citizen care to casually hand over the decision of how much his or her service is worth to a government agency whose avowed aim is to cut the cost of the service he or she provides? And perhaps you do not know that this same government recently breached a contract with us, refusing to pay fees it had negotiated with the Ontario Medical Association two years previously. Can we put our trust in such a government in the future?" That is the question they ask, and it is a good question.

"Furthermore, `a physician...shall not charge more or accept payment for more than the amount payable under... OHIP.'

"Although only six per cent of all doctor-patient encounters in Ontario currently involve extra billing -- and this figure is decreasing yearly -- we would like to retain the freedom to enter into a doctor-patient relationship if we wish. This principle becomes especially important if the government continues its irrational course of underfunding not just physicians' services, but necessary health care services of all kinds.

"We believe that the logical extension of the government's present course is that we will become severely regulated employees of a cheap and low-quality health care system, (the best the government can afford if nobody pays for it).

"And do not forget to look at the other side of this coin. Not only are we not allowed to charge more if we think the service warrants it, you as a patient cannot pay more. You too are denied the freedom to make a contract by this legislation with a physician of more skill or experience if you so wish. Let us take it one short and frightening step further. What happens when this shortsighted political plan takes us down the road of `The National Health' system as it has in Britain and elsewhere. Then, when you tire of the frustrating wait of a year or more for specialist care (the situation in all of these free health care systems) will you have the choice of purchasing private insurance or paying an independent physician? No! You have lost your rights to negotiate for better health care too.

"These are the very real dangers we see lurking behind the smoke screen of `extra billing' in this proposed act.

"Yet there is more! What of the crime of seeking your own fee commensurate with your skills and experience? How many of you are paid based on merit, skill or experience? Common sense tells us that in an economically free society a doctor who charges an exorbitant fee would soon be forced to lower the fee or be short on patients. Yet this piece of legislation provides a maximum fine of $10,000 per `offence'. It is disgraceful that our maximum fine for impaired driving is $2,000; does the government honestly feel that an opted-out doctor is a greater menace than a drunk driver?

"Enough of doctors and principles. What about the hard cash? What about extra billing?

"We recognize that a few physicians have been insensitive about billing over and above OHIP rates to patients who cannot really afford to pay. The majority of doctors who charge extras have discussed this matter frankly with their patients and offered other alternatives if the ability to pay is lacking. That is to say either the service was provided at a lower or no fee or a referral was made to an opted-in physician. If you were not treated `fairly' by an opted-out of OHIP physician or surgeon, you should break off your contract with them and report the problem to the College of Physicians and Surgeons as well as your family physician so that the problem can be rectified.

3:30 p.m.

"We, as physicians, have grave concerns about the quality of future care in Ontario if the Health Care Accessibility Act is passed.

"We know we have your trust and we solicit your support as, through our professional association, we work to let the government know that its Bill 94 is a dishonest and unjust piece of legislation. Be assured that during this difficult confrontation you, our patients, will continue to receive uninterrupted care of the quality you have come to expect."

This letter was sent to the people of Mount Forest and area through the local newspaper. It is signed by S. J. Wetmore, MD; T. N. Wilson, MD; R. D. Fletcher, MD; H. M. Perrin, MD; L. Pede, MD; S. Goodall, MD; K. S. Babey, MD.

These seven doctors have not opted out and are not charging extra. They are enrolled in the present system and are extremely happy with the system as it is today but they will not be if Bill 94 is passed.

Last week, I met with these seven doctors who practise medicine in my home town of Mount Forest, and I was very disturbed at their very deep concern about the ramifications flowing from Bill 94.

Please note, as I mentioned, that not one of these seven doctors is opted out, and none had any intention of extra billing any patient at any time. I, personally, have never had a single complaint about any of these doctors.

They were totally satisfied with the status quo and will not be financially affected by any changes in the legislation, but they are deeply concerned that they, as professionals, are losing their freedom of choice and will be treated as criminals by the proposed Bill 94.

They are incensed by the $10,000 fine for charging $10 over the fee schedule as set out by the Minister of Health. Drunk drivers receive only a $2,000 fine, and doctors ask the question: "Are opted out physicians five times as detrimental to society as drunk drivers?" I think not.

They fear the concept of every doctor and everything in the health field being under direct control and scrutiny of a politician, even if he is Minister of Health. They are angry that the health care system in Ontario will fall into the same mess that now exists in Britain.

Two of the doctors came from England, and they had first-hand reports to relate about the horror stories in that socialistic medical system.

The doctors expressed dismay that Bill 94 provides that the Minister of Health may enter into an agreement with associations representing physicians, dentists and optometrists to provide methods of negotiating and determining the amounts payable under the Ontario health insurance plan. Does that mean the minister may not as well. Should "may" not be "must"?

I received a phone call at noon today from a doctor in Orangeville who expressed his deep concern about subsection 3(3), which says pretty well the same thing:

"The Lieutenant Governor in Council may make a regulation providing that the minister may enter into an agreement under subsection (1) with a specified person or organization other than an association mentioned in subsection (2)."

He was quite disturbed by that clause. He was also incensed with the $10,000 fine. He said he was opted out for four or five years but is back in the system now and had no intention of leaving it. He also said that he serves on many committees as a volunteer but that if this bill goes through, he will no longer provide his services to those committees.

Mr. McKessock: How much money did he lose?

Mr. J. M. Johnson: I am not sure, but I think he was from Melancthon.

I will emphasize, as I mentioned, that these doctors have not opted out and they do not extra bill, but they are very discouraged by this proposed piece of legislation. Their concern, and that of many doctors in this province, can be best summed up by a letter to the editor in many papers by Dr. Calvin Gutkin. I quote:

"Concern is for Patients and Future of the Health Care System:

"Dear Editor:

"The concern expressed by most of Ontario's 7,500 family doctors who oppose the Peterson government's proposed Health Care Accessibility Act deserves special attention. Unlike many of our physician colleagues, most family doctors (greater than 95 per cent) are not opted out and do not extra bill. Our concern is for our patients and the future of our health care system, and our fight is for the freedom of those of us living and practising medicine in a country which once took pride in protecting the rights and respecting the integrity of individuals such as ourselves.

"Over the past decade, the costs involved in maintaining a quality health care system have escalated and the public purse has been stretched beyond its capacity to afford the resources required. Rather than admitting their failure to come to grips with this scenario, governments have found it politically expedient to create the myth that paying doctors is the problem.

"As family doctors whose role each day is to act as advocates on behalf of those for whom we care, we are asking our elected officials to review the facts and address the real issues of concern to our patients. We applaud any discussion which honestly addresses the issue of accessibility, but surely when we speak of better access, we must be speaking about issues such as improving the facilities and resources available to care for the elderly, the disabled, the abused and the underprivileged; surely we must be referring to the need for increased community services, improved home care programs and more appropriate utilization of our hospitals for both inpatient and outpatient care. Surely we must recognize that it is in areas such as these that the real problems with accessibility to health exist.

"For most family physicians, passage of the Peterson government's health bill will have little or no impact upon our income, but will have major impact upon our freedom and our rights. For most of our patients, passage of this act will make little or no difference with respect to their access to doctors, but it will also do nothing with respect to improving their access to other vital health care needs.

"The real problem, facing not only doctors but all Canadians, is not extra billing. It is the ongoing trend towards underfunding and the resultant deterioration of our health care system. The real dilemma facing the population of Ontario today is not related simply to accessibility to health care -- it is rather more significantly the question of accessibility to political wisdom.

"Calvin Gutkin, President, Ontario Chapter, College of Family Physicians of Canada."

I hasten to point out that while I have emphasized the concerns of many in the medical profession, I have no intention of fighting the battles of the Ontario Medical Association. They are quite capable of fighting their own.

"Tonight, however, I am defending the people of Ontario from the threat of a weakening of the health care system. I am arguing a people point of view because I believe in their good health and their right to pursue a creative lifestyle of their own choice with vigour and energy. I believe in their health and wellbeing.

"I am also arguing for democracy and freedom. I am arguing that it is not advisable for the state in peacetime to conscript physicians or any other group in society and compromise their democratic freedoms and circumstances, other than in a temporary state emergency.

"The apparent permanent civil conscription of virtually an entire profession in peacetime is a serious and disturbing matter. I feel conscience-bound to oppose it. I believe such a step to be unwise and I would argue that point just as vigorously for any other group as I would argue it for physicians. This bill proposes to compromise the right of two citizens to negotiate a simple contract with each other. I cannot favour that."

3:40 p.m.

The last three paragraphs are direct quotes from Hansard, January 28, from the comments made by the Liberal member for Humber. I happen to agree totally with these remarks and endorse them as my own. The Liberal member has the right to defend the people of Ontario from an excessive and ill-advised piece of legislation. I know all members of this assembly will agree that the Conservative members have that same right.

Speaking of rightness, Thomas Henry Huxley said, "It is not who is right, but what is right that is of importance."

On this issue most people, when asked whether extra billing should be outlawed, respond in the affirmative. That is true even in my riding of Wellington-Dufferin-Peel.

I would like to refer to two questionnaires, one from the member for Cambridge (Mr. Barlow), who represents a small-city urban riding, and one from my own riding, which is mainly a rural riding with several small towns. Both questionnaires had very similar responses.

The questionnaire from the member for Cambridge asked the question, "Should the province's doctors be allowed to bill beyond the OHIP fee schedule?" In reply, 27.9 per cent said yes; 64.8 per cent said no; and 7.2 per cent were undecided. It went on to ask, "Is Ontario's existing health care system meeting your needs?" In reply, 85.8 per cent said yes; 10.8 per cent said no; and 3.4 per cent were undecided.

My results were very similar. To the question, "Is Ontario's existing health care system meeting your needs?" I had a return of 1,525, which is excellent. The reply came back with 1,313, or 86 per cent, saying the system was satisfactory. The member for Cambridge had 85.8 per cent; so it was practically identical. I had 138, or 10 per cent, say no, it was not and 74, or four per cent, were undecided. The two responses were nearly exactly the same.

To the question, "Should the province's doctors be allowed to bill beyond the OHIP schedule?" 313, or 20 per cent, said yes; 1,106, or 72 per cent, said no; and 112, or eight per cent, were undecided. Again, it was very similar. They are a small urban riding and a rural riding and the responses were practically identical.

We should take that a step further. Of the respondents, 85 per cent are satisfied with the health care system as it is now. Since the health care system is based on the service of our physicians, what will happen to the system if this government does not treat our physicians with the respect and understanding they deserve? I do not want to imply that the Ontario Medical Association is totally right and the government totally wrong, but surely there must be room for reasonable compromise.

To carry the polling process or questionnaire forward, I would like to refer to a recent poll by the government asking whether there were any aspects of the health care system in Ontario that needed to be changed or given special attention.

Of the replies, 41 per cent said no changes were needed and seven per cent said they would ban extra billing; 52 per cent named such things such as the need for more hospital beds, better preventive medicine and more extensive pollution controls. Only seven per cent felt that extra billing was the most urgent problem facing our health care system.

If one asks people, as I did, "Should the province's doctors be allowed to bill beyond the OHIP schedule?" three out of four will say they should not be allowed to extra bill. Would that same 75 per cent favour banning extra billing if it meant a decline in the quality of our health care system? The answer to that is given by the 85 per cent who say they feel the system is excellent or quite satisfactory.

I cannot emphasize strongly enough my position and that of my party to defend the excellent health care system of this province. We must continue to do what is right, not what is popular. The Liberals and New Democratic Party always accused the Tories of governing by poll; yet we never bowed to the polls on this issue, while the new alliance has done that very thing.

Mr. Shymko: Catholic school funding is one example.

Mr. Martel: Put it in your ear, Yuri. You know who announced it.

The Deputy Speaker: Order. Would the member for High Park-Swansea and the member for Sudbury East please let the member speak?

Mr. J. M. Johnson: Ontarians hate controversy. Unfortunately, that is what the Liberal government and its NDP cohorts have given us with their high-handed, ill-thought-out, controversial legislation.

The Liberals tell us this move will improve access to the health care system, but they do not tell us that when a similar system was imposed in Quebec, more than 200 of the top specialists left the province within a few short months. Many of them came to Ontario. Where will they go now? Do the Premier or the Liberals give a damn?

I would like to quote from the Toronto Star of January 30, 1986: "Premier Says Extra Bill Ban Will Drive Out `Odd Few' MDs." The article by Alan Christie goes on to say:

"Premier David Peterson has admitted he expects `an odd few' doctors to leave Ontario when his government bans extra billing...`I hope they (doctors) don't leave,' Peterson told reporters yesterday before a cabinet meeting. But he added `I don't think it is a major problem' because Ontario already has more than enough doctors."

Surely our Premier is not suggesting we have a surplus of doctors and it might not be too bad if some of them go elsewhere? Is that what he is suggesting? Surely not. If it is the Premier's feeling that Ontario has too many doctors, then why is he so concerned about the small percentage of doctors who have opted out of OHIP? Or is the government using Bill 94 as a means of getting rid of some of the perceived surplus of doctors? Surely not.

In conclusion, I want to reiterate my deep concern that Bill 94 will endanger the excellent health care system we have developed over the decades in Ontario. I strongly urge the government to delay action on this bill until it has the opportunity to meet with the medical profession, without stated preconditions, to develop and implement a program to deal with all the health care issues, including extra billing, and to work together in a spirit of co-operation and goodwill that will benefit all the citizens of this great province.

The Deputy Speaker: The member for Sudbury East.

Mr. Martel: I have not heard so much claptrap since the 1969 debate when we brought the --

Mr. Sheppard: We are going to hear a lot more now.

Mr. Martel: I was here when medicare was introduced and Robarts called it a machiavellian scheme. The Tories have never been very sympathetic about OHIP.

Mr. Shymko: The NDP supported it then.

Mr. Martel: No, we voted against the bill. My friend is wrong. He should once and a while check Hansard so he knows what he is talking about when he comes here. We voted against the bill.

One of the reasons we voted against it then was that it did not eliminate premiums. We tried to get the government not to allow premiums. As members know, premiums are collected in only three provinces now, Ontario being one of them. Is that not strange?

Mr. Sheppard: Is the member willing to pay a 10 per cent sales tax?

Mr. Martel: They do not have a 10 per cent sales tax in Saskatchewan, Manitoba or British Columbia.

Mr. Sheppard: We are going to have it here in Ontario because of the Liberal government.

3:50 p.m.

Mr. Martel: The member can say that, but it is not the case. We opposed the bill then. It is strange that doctors are the only free enterprisers I know who define what their rate is going to be and are then paid out of the public purse. That is not a bad way of running a shop, really, if one can set one's fee schedule and then say to the province, "Pay whatever we want to bill even though we have an agreement."

When we debated the bill the first time around, the doctors told us -- and members might want to check this out -- they were losing between 20 and 30 per cent of their income because people were not paying their bills. Medicare was a bonanza for them because they collected on every person they billed. Take that into consideration. Unlike any other profession --

Mr. Shymko: A big bonanza now.

Mr. Martel: The member for High Park-Swansea should check it out to see whether at that time the doctors did not argue that they were losing 20 to 30 per cent of their income because people failed to pay their bills. They now collect everything.

I used to be in a profession. When I taught school, I signed an agreement. Humble as I am, I was a crackerjack teacher. Humble as I am, I was an A-rated principal. I could not say to the board, "Look, my friends, you have to pay me $10,000 more than the rest of the principals." My association had negotiated a salary, and I did not have the privilege of saying, "Pay me more."

I cannot understand why doctors think they can belong to a profession and have the privilege of saying, "Here is our agreed fee schedule, but if I so desire, I can charge more." What kind of nonsense are the Tories talking about?

Mr. Shymko: Freedom of choice for every patient in this province.

Mr. Martel: What does the member mean by freedom of choice? They have choice under this bill.

Mr. Shymko: The freedom of self-governing professions.

Mr. Martel: But they are paid out of the public purse. The member forgot that.

The Deputy Speaker: Order.

Mr. Martel: In fact, I am glad my friend put his foot in his mouth. I could not charge any extra. I could not say to the board, "You have to pay me more," nor could the member for Kitchener-Wilmot (Mr. Sweeney) nor could any member who is a teacher in his profession say: "I am so good. Pay me over and above what the agreement we have arrived at says."

Mr. Shymko: When the member for Sudbury East (Mr. Martel) sends his kids for some private tutoring, does he regulate the fees?

Mr. Martel: Oh, wait a moment. My friends want it both ways.

The Deputy Speaker: Order. The member for High Park-Swansea is interrupting the speaker. Would the member for Sudbury East please continue to address the chair and there will be no interruptions.

Mr. Martel: Thank you for your help, Mr. Speaker.

If I may just pick up where I left off before I was so rudely interrupted, I was not allowed to charge extra. I find it strange that five per cent of the doctors have determined they can bill over and above what has been agreed to as the OMA fee schedule. By what divine right are they allowed to do this?

Mr. Pierce: One has the right not to accept their services if one does not want to pay.

Mr. Martel: But what is a contract'? What is it really worth?

The Deputy Speaker: Order.

Mr. Martel: Who else can set his fee schedule and then say, "Pay for it now out of the public purse, and we will go over and above what has been agreed"? That is what the member is saying to me.

The bill is rather simple. Humble me, I am really amazed. An anaesthetist in Sudbury said to me, "After I reach a certain point, I make 25 cents on the dollar." He says he has now cut back his practice and does not work as hard because he makes so little after he reaches a certain income. In a moment, I am going to come to what all this leads to. He makes 25 cents on the dollar. The government can pay him more if it wants, but he is going to get less and less clear pay. The point is, how can anyone be part of an agreement, reach an agreement and then say, "I want to bill extra"?

The bill is simple. It says that one can either be in or out of medicare, but one can charge only one price. I have heard all the nonsense about interference from government. I taught in a good school system; our educational system is pretty good. Where is the interference with me as a teacher because my salary is a salary that is agreed to? Where am I not at liberty to do my job as a teacher? I have said to the doctors in my area: "Tell me where you see the interference in doctor-patient relationships. All we are saying is you can be in OHIP or you can be out, but you can charge only one fee."

What interference are they talking about? How are we infringing on the doctor-patient relationship by this move? I think 95 per cent of the profession supports the other five per cent in this, and I sometimes wonder what they are thinking about because it is silly. I do not think there is a politician in this Legislature who would tolerate interference in the doctor-patient relationship. No one in this House is going to tolerate any interference whatsoever. That is the biggest red herring that has ever been dragged across the stage that I know of.

Perhaps someone from the Tories can elucidate this for me. When one is either in or out of OHIP -- it does not matter -- and one can charge only one fee, how does that interfere with the doctor-patient relationship? Somebody should tell me how that interferes with what goes on between the doctor and his patient. It is absolute insanity. I have never heard such nonsense in my entire career.

The stuff I have heard from the Tories is not even rational. Some of the things I listened to last week boggle the imagination. I do not know who their scriptwriters or ghost writers are, but they do not have much credibility when they run some of these things across the platform.

Mr. Sheppard: Come on. The member should not judge everybody over here by the way he does it himself.

Mr. Martel: Perhaps the member for Northumberland can tell me how there is interference. The big cry is, "We will not be able to practise medicine the way we want." That is baloney. I am sure all of us have said to doctors: "If there is any interference from the politicians or anybody trying to tell you how to operate your practice, get in touch with us. Let us know because we will not tolerate it." What is really at stake is the money.

Mr. Sheppard: Money has nothing to do with it.

4 p.m.

Mr. Martel: Baloney. What is it then? They cannot charge more. What and where is the interference? Perhaps some will demonstrate that for me.

Having spent some time in hospital, I think doctors work bloody hard. Our whole system is backwards. We will pay $600,000 or $700,000 a year to an athlete to skate up and down the ice and shoot a puck. We will pay professional baseball players $1 million a year to entertain people for 80 or 100 games. We will do the same for actors and rock stars, paying tremendous amounts of money. We have some problem with the doctors, but society can find all kinds of money to pay an athlete $1 million for a year's service. There is something wrong in our system.

My party has fought this battle for as many years as I have been here. We are not interested in the final amount the doctor makes, but that he charges the same as everybody else. If he wants to wear himself to death with a turnstile operation, that is his problem. I wish doctors would not do it. I have suggested to doctors in my area, and I hope somebody is saying --

Mr. Pierce: Is the member suggesting that they go home at four o'clock at night?

Mr. Martel: No, they do not. I am saying maybe they should. There should be options for doctors in this province to take a different pay system if they want to. I know doctors who have quit their practice and gone to work for companies because they want some kind of a home life. They work for a salary --

Mr. Pierce: It is not because of a lack of patients.

Mr. Martel: That is right. It is because they have chosen to have a different quality of life where they use the skills they have, serve their patients well and have time for their families. There should be options in this province which would allow the doctor, if he wants to, to become part of a scheme which would provide him with a pension plan. One of the reasons they work hard and have a turnstile operation is that they have to put every cent away themselves for when they retire.

I said to the doctors: "Why do you not look at your fee schedule? Instead of asking for an increase in pay, why do you not try to negotiate a package of benefits to include drug coverage, a vacation and a pension scheme so you can get off the treadmill?" Do you know what they said, Mr. Speaker? I spoke to a number of doctors in my area and a number of specialists in Toronto who said, "That is what we need."

We have people such as Dr. Moran who represented the doctors a few years ago. He came to the New Democratic Party and his first statement was: "I do not believe in medicare and I do not support it. I am opted out." To make that kind of an introduction is similar to waving a red flag in front of a bull. The Ministry of Health should consider, in conjunction with the doctors, assisting them to formulate a package including a pension, drug benefits, a vacation and perhaps some sensible hours. That should be an option.

I suspect a lot more doctors would find that very attractive, specialists included. They would have to have a good salary. I know railroaders in my home town who make $55,000 a year running a locomotive. I know miners who make $45,000 a year. We are talking about highly skilled people who spend long hours and who are in this system of almost a turnstile operation because they have to put money away for all the years they will be retired.

They do not have a drug benefit plan. They can be subject to illness and they should have a plan to protect them, just as we do here. That is worth far more money to us than some of the income we make.

Somebody might tell them that, because I have spoken to a dozen doctors in the past two weeks and they think that is a great idea. They would like that. I suspect a lot of doctors would opt for it and that would break down this turnstile operation. At least it should be available for those who want it. The rest who want to run around like mad all night and eventually end up earning 25 cents on the dollar as take-home pay would --

Mr. Pierce: A miner does the same thing. If he works on a bonus and works long and hard hours, he gets extra money and makes 25 cents on the dollar. What is the difference?

Mr. Martel: The point I am making is he at least has a pension scheme and vacation time.

Mr. Pierce: The more he puts out, the more money he makes.

Mr. Martel: Yes, most people do. We are not objecting to that. We are saying we do not object if he wants to work that way, but he cannot charge extra as opposed to his --

Mr. Pierce: The doctor is not like a miner who can charge time and a half or double time or bonus time.

Mr. Martel: No, they all get the same. When they work overtime, one does not make any more per hour than another.

Mr. Pierce: It is based on their production. They make more money.

Mr. Martel: I am not stopping them from producing. I am not stopping them from the number of hours they work.

Mr. Pierce: They get a premium for the same production only after hours.

Mr. Martel: That is right, but they all get the same rate, do they not?

Mr. Pierce: But a premium rate.

Mr. Martel: The number of patients a doctor sees increases the value of the take-home pay.

Interjection.

Mr. Martel: The member cannot tell me that if he and another guy are working underground, he will get $1 more per hour than his co-worker who is doing exactly the same work, putting in the same number of hours. Now, if he wanted to stay extra hours --

Mr. Pierce: The bonus is on production, not on hours.

Mr. Martel: I understand it is on production, but if one puts out the same amount of production, one still takes home the same amount of pay, whereas a small group of doctors have decided they not only want the same amount as the guys who work the same number of hours as them, but they also want to charge extra for their services. That is all we are arguing about.

The rest is gobbledegook that has come out of the member's party. All we are talking about is people charging the same rate. The member can make all the arguments he wants, but it comes down to one point and one point only. Five per cent of the doctors who bill extra have decided that over and above the fee schedule that has been arrived at they want to charge more. Interestingly enough, most of them are specialists who take the highest share of OHIP now in terms of dollars.

I am saying, "Wait a minute, you cannot do that." Despite all the gobbledegook -- a doctor is either in or out, that is fine -- in the final analysis, all we are interested in is that they all charge the same rate, whatever the fee schedule is for the specialist, anaesthetist, etc. All the rest of the stuff is nonsense.

If the government wants to be positive, it might look at the possibility of saying to the doctors: "We are going to give you a couple of options. You can continue this turnstile operation if you want, you can put yourself into an early grave if you want; or you might take a look at a scheme that includes a different form of pay. It might be fee-for-service but no extra billing. We will help you to establish, for those who want it, a pension scheme so you do not have to run like mad to accumulate enough money to be put away for when you retire, or if you should take sick at 45, you have something to cover you," -- as we would want, and as we have.

I have spoken to a dozen doctors in the last two weeks. They like that idea, because they reach a point with respect to income where they take so little home of what they are getting paid that it is down to 25 cents on the dollar. I throw this out as a suggestion, a possibility of us doing something like that. None of us in this party is going to back down against extra billing. We brought the first petition in here in 1978 or 1979 with about 350,000 names opposing extra billing.

4:10 p.m.

Last week, a couple who are pensioners came in to see me. The wife has to get a treatment every four months. In the OHIP fee schedule, it costs $180. The specialist in Sudbury is charging $245 every four months. He charges 25 per cent more than the fee schedule. There is something wrong with that. We all work here and we work out there. We do not set our own fee schedules and then, once we reach an agreement, say, "I want to be paid over and above that."

I do not know whether the farmers do that. I do not think so. They get a flat rate for their beef, whatever that rate is.

Mr. McLean: It changes every day.

Mr. Lane: It is too bad it is not a flat rate.

Mr. Martel: Yes. They get the same and they cannot say: "I want $200 more for my cattle. This bull is such a good bull, I am going to charge an extra $200 for this one."

Mr. Pierce: That is the bull we are getting now.

Mr. Breaugh: Do not look at me and talk about the price of bull.

Mr. Martel: I told the member that for a reason.

Mr. Pierce: We do not have to buy the cow if the bull is free, and that is no bull.

Mr. Martel: As I say, I have heard a great deal of nonsense about what this bill does, and I defy a Tory to tell me how we are going to interfere with the doctor-patient relationship. I have suggested to the doctors in my area that when they come across somebody playing games and interfering with the way they run their practices, they should let me know because there is not a member of this House who would tolerate that sort of interference.

This bill really is a very simple one in that, if one is in or out, one charges the same fee. I suggest to the Tories their arguments have been nonsense. They are standing in front of a moving train. They will have their opportunity to vote on this in a standing fashion. It will not be like the drug bill. They will have the opportunity to stand, and when they know the majority of the public is against them, they might see the error of their way.

I simply remind my Tory friends, though, they did not want medicare in the first place. Robarts called it a machiavellian scheme. There was a great fight, and he could not have obtained his funding back from Ottawa if he had not gone in, so he accepted this machiavellian scheme. The Tories never tried to perfect it. They left in premiums and extra billing. We are slowly eradicating a couple of the flaws, but my friends want to stand in front of the train and make all kinds of silly allegations that do not hold water. We do it for five per cent of the doctors and, at the same time, we are losing about $50 million from Ottawa. As I said, I do not know any other profession in which one sets one's own fee and then collects from the public purse, as one does with this one. With this free-enterprise system one sets one's fee schedule and says, "Pay," and gets it out of the public purse. In closing, I simply remind the Tories that when we brought in medicare, doctors told us they had been losing 20 per cent to 30 per cent of their income because patients failed to pay up. I was here when the legislation came through, and that was one of the great benefits for doctors -- they collected all their money. They have done not too bad.

I think we can improve it by giving them a couple of options. I suspect if one were to put out a questionnaire to the doctors saying, "Would you like to have the government help you develop a vacation schedule, a pension scheme in particular" -- which most of them desperately want -- "and some sensible hours?" they would come clamouring to get that done. I offer that as a suggestion to the government. As I take my seat, I tell the Tories they are standing in front of a moving train. They should get off the track or they will be run over because they are going to lose on this one.

Mr. Sheppard: I am pleased to participate in this debate on the Health Care Accessibility Act as I feel this is a very important issue to all the people in our province. I do not necessarily agree with the last speaker who said that only the Tories are going to suffer. I just want to put on the record that yesterday I went to Dr. Percy Vivian's funeral. He was the Minister of Health in George Drew's cabinet back in the early 1940s and was the only professional in the House at that time. He was responsible for bringing county health units to Ontario and the pioneer who brought medical care to Ontario. I wanted to get that on the record because I was at his funeral yesterday in Port Hope. He was the last living member of the Drew cabinet from the early 1940s.

The Minister of Health (Mr. Elston) introduced this bill in the Legislature on December 19, 1985, providing for a complete ban on extra billing for all insured physicians' services, insured dentistry services performed in hospitals and all insured optometry services, under the pretext of preserving the principles of universality and accessibility in the Ontario health care system.

I use the phrase "under the pretext" because accessibility is not the real issue. Everyone has seen the present figures which indicate approximately five per cent of physicians opt out of OHIP. It is a declining percentage from the 1979 figure of 18 per cent.

Out of this present figure of five per cent, approximately 77 per cent of these opted-out doctors practice in Ontario's seven major centres, while the other 23 per cent are located in smaller, rural communities.

In my riding of Northumberland, very few doctors chose to opt out. Until the bill was introduced, I do not think any of the doctors in Northumberland opted out.

A highly respected physician from Campbellford wrote: "I have always been opted-in, not because I believe OHIP fees were fair, but rather because the population I served was such that a billing practice other than this would be too stressful for my patients. Your proposed Health Care Accessibility Act does nothing to ensure accessibility. I have never had a problem of getting an opted-out specialist to see one of my patients on an OHIP fee basis. However, I have had continuing problems getting patients to have investigative procedures done within a reasonable length of time, getting operating room time for my patients, and so on."

The Ontario Medical Association strongly agrees that to opt-in the profession will not make the services of physicians more accessible.

Quite honestly, I cannot see how medical attention could be more accessible. When people are sick, they can call their doctor's office to arrange an appointment, usually within a few days if not for the same day. Should the illness require immediate attention on a weekend or evening, the person just has to go to any emergency department at the nearest hospital and be assured of seeing a doctor without having to wait until the next business day.

On January 14, the Minister of Health stated in the Legislature: "We heard from a variety of people, from local physicians' associations, nurses, hospitals, senior citizens' groups, health care organizations and private citizens. The intention to ban extra billing had the solid support of the great majority of the participants."

I do not know where the ministry fished out these apparent supporters because every doctor I have spoken to disagrees with the minister.

By introducing this bill, the Minister of Health is obviously not aware of the depth of anger he has stirred amongst the physicians in my riding, not to mention numerous doctors across Ontario.

4:20 p.m.

Our present health care system is one of the best in North America. Although it would be unwise to assume that all 88 per cent of doctors now in OHIP are happy with the system, it seems true the majority of doctors are quite comfortable operating within the current fee schedule.

This system was built carefully over decades of listening and careful negotiation in cooperation with individual professionals. The medical profession as it stands, is self-governing, works well and efficiently. I could not agree more with my colleague, the member for Cochrane South (Mr. Pope) that nothing will be accomplished unless members of the medical profession are treated with the respect and dignity they deserve.

Surely no one can dismiss the fact that doctors provide a basic human need requiring tremendous skill, not to mention sacrifice, devotion and extreme concentration at all times.

As I mentioned earlier, the issue in question is not really accessibility. The real issue is a matter of government control versus professional freedom and freedom of choice. We all have to recognize that this province has a health care system envied by many jurisdictions. We must also remember that the professionals in the health care system are the primary deliverers of quality, professional care.

In order to improve the quality of health care in Ontario, we need the co-operation of these professionals. We must listen to their ideas, work with them and work with the private doctors. To shut off negotiations with the Ontario Medical Association is certainly inviting chaos. Angry, frustrated and alienated doctors cannot perform in their usual caring manner.

If a ceiling has to be placed on a doctor's right to charge what he feels is appropriate for his services, why should he work evenings to be on call in case of emergencies? Why should a doctor volunteer his time for committee work in board hearings if we are going to cut him off? Why should a doctor not merit a higher fee than what OHIP will reimburse for his specialty, be he a brain surgeon, cancer specialist or a dermatologist? Services that are performed free of charge will stop.

I had a phone call this morning from a patient who happened to phone her doctor. She wanted to know if her boy could go back to school after having measles. He said: "I am going to charge you for this call, because I am going to charge you for every call that is made to this office. Before I did not, but now I will."

They talk about $50 million. It could cost us more than $50 million if every doctor in Ontario charges for every phone call patients make to their doctor. Services performed free of charge will stop. As a result, doctors will be charging OHIP for every single service provided. This problem will cost the government more money than the proposed $50 million a year saving.

It is inevitable that our present health care system will deteriorate in quality, as it did in British Columbia and in Great Britain, if self-governing professions are taken over. As members of the Legislature are aware, when Britain made doctors state workers, their system crumbled and eventually illegal bribes were used for faster medical attention. It is also not uncommon in Britain to wait three to four years for a single operation, due to the underfunded system.

When our doctors become state employees, all we have to look forward to is assembly line medical care.

Dr. Michael Morris who now practises in Warkworth, came to Canada from England in order to escape the health care system there. Canada was known, even overseas, to have an excellent health care system. Dr. Morris now feels extremely angry and threatened by this proposed legislation. He predicts the outcome will be disastrous, as he witnessed in England, if extra billing is banned in Ontario.

With the passage of this bill we are inviting inaccessibility because patients will be unable to obtain appropriate care. Some of our specialists will decide to move out of Ontario, leaving us without accessibility. Many others will choose not to practise, thus stoking the fire of inaccessibility once more, especially in our rural northern communities such as Uxbridge, as outlined by my party's Health critic. Opting out will ensure that our first-rate specialists stay in Ontario.

There has to be a common goal among this government, the members of the Legislature and Ontario professionals. That goal should be to create the best possible health care system with universally accessible, affordable care that would be available to all residents. In order to achieve that goal, we must co-operate and negotiate as a single entity.

In general, the move to ban extra billing is very short-sighted. It is just a political move to gain brownie points with the public. I must agree with the member for Wellington-Dufferin-Peel (Mr. J. M. Johnson) that the public perception out there is in favour of the patient. However, the doctors are talking to their patients every day, telling them how they feel, and a lot of our senior citizens are agreeing with the doctors, as they did in 1982 when this came up before.

I am pointing out the way doctors in the great riding of Northumberland are feeling without taking into consideration what the long-term implications may mean or what this could do to our present health care system.

Is this the beginning of a Liberal government trend, with the prompting of the New Democratic Party, to strip all our professionals of their democratic right to choose their own method of billing? No other professional group has its wages set by one employer, the Liberal government of Ontario. What is truly needed to improve our health care system is beds, equipment and adequate hospital funding, certainly not the stripping of professional freedoms.

The member for Humber (Mr. Henderson) certainly does not agree with the bill that the Minister of Health (Mr. Elston) introduced in December.

Mr. Haggerty: How is the member voting on this bill?

Mr. Sheppard: The member should wait and see. How can I vote against my doctors when they are coming out with the truth? How is that member going to vote? The member for Humber is going to vote against the bill. Did the member opposite not hear him in the House the other night?

I have a letter from a doctor in Havelock, and I want to read a couple of extracts:

"Dear Sir:

"I have just received a copy of Health Care Accessibility Act, 1985, and I feel that I must write to express my outrage at this assault on my professional freedom. This is not a Health Care Accessibility Act but a blatant attempt to gain control of the medical profession. If you really wished to improve accessibility, you would stop rationing diagnostic technology, increase the number of chronic and nursing home beds, increase funding for the home care program and supply adequate operating room facilities to handle the backlog of cases.

"This could be accomplished by reallocating the large sum of funds spent on the health care bureaucracy in Queen's Park and reducing the huge sum Ontario hospitals spend on administration.

4:30 p.m.

"Contrary to your statement that this will save $50 million a year, I can assure you that it will probably cost an additional $50 million a year. This is due to the fact that I will expect to be paid for all my previous unpaid-for committee work (i.e. hospital, community, district and provincial) that I am required to perform. Also, I expect to be paid for my unpaid on-call time. I wish to draw to your attention that I am an opted-in physician and always have been. I will fight this legislation to the very end, especially during the upcoming election campaign this spring."

That was from Dr. Mendum in Havelock.

I also have a letter from Dr. Stephens and I want to quote some comments from it:

"As a member of the medical staff of Campbellford Memorial Hospital and as a family physician practising in this community, I feel it important that your readers be made aware of another side of the controversy surrounding the provincial government's announced intention to ban extra billing by doctors.

"It is ironic that the provincial Liberals are caught in a trap set for them by their federal counterparts. In a futile attempt to salvage their rapidly declining popularity, the federal Liberals pushed through the Canada Health Act just prior to the last election. Under that act, provinces which allowed physicians to bill patients at rates above the provincially approved rate (in Ontario, OHIP's fee schedule), would have an amount equal to the total billings above the provincial schedule deducted from federal transfer payments to the province. The act was heralded as a defence of the medicare system.

"Both the federal Liberals and now their provincial counterparts have based their arguments on two semantically contrived nonissues. The first of these is accessibility. The Liberals would have us believe that in some ways patients are denied access to the health care system by the fact that 12 per cent of the province's doctors are opted out. This is just plain silly. I have been practising medicine in this province for more than 10 years and I have never once had a patient denied access to good health care on this basis. They have been denied proper care when beds were not available in hospitals due to overcrowding or when hospitalization was prolonged due to lack of sufficient nursing home beds. I can't imagine any branch of medicare in which all practitioners are opted out and so greedy and cruel that they would deny access to a needy patient on the basis of ability to pay. Accessibility is a nonissue.

. "The second nonissue is the term `extra billing' itself. For reasons which are not immediately obvious to me, the media has chosen to accept the OHIP fee schedule as the standard. No other profession in this province which has resisted the urge to unionize has its fees unilaterally set by government. The medical profession, like other professions, establishes fee guidelines for its members. These guidelines are not binding but are considered fair value for services rendered. OHIP currently pays about 70 per cent of the Ontario Medical Association fee schedule. Opted-out physicians who charge the OMA rate are not extra billing -- opted-in physicians (those of us in the 82 per cent majority) are underbilling when they accept OHIP rates as full payment. Extra billing as a term should be discarded and the concept recognized for what it is -- an invention of the politicians used by them to divert our attention from the real problems in the health care system which are much more difficult to solve and for which there is no ready scapegoat.

"The vast majority of doctors in this province are very upset by the government's proposal. Let's consider why. The Liberals and their NDP partners -- a case, I think, of the myopic being prodded by the blind -- would have the public believe it is because we are all greedy and self-serving. Strangely the public seems ready to accept this even though they would all undoubtedly say their own particular physicians were the exception to the rule.

"The issues for me, and I suspect for the large majority of my colleagues, are not money remember, we already accept underpayment for our services -- but freedom and the future of the profession. The government is stating that when the legislation passes, it will unilaterally dictate what physicians will be paid.

"They cloak this in such terms as `after suitable discussion' but we all know that a government under financial pressure will define `discussion' as that period of time allotted to try to convince the medical profession that the government's position is the correct one. If, after the day or two allotted to this process, the profession does not agree, too bad. There's nothing we can do anyway.

"I don't expect much sympathy from the taxpayers of Ontario if doctors are paid less. I admit we do pretty well, but I honestly believe the taxpayers are getting good value for their money.

"The real issue is not what's happening now, but what comes next. When the government has beaten us on the issue of the freedom to bill what we feel we are worth, what comes next? Will they be telling me where I can work, what tests I can order on my patients, whom I can admit to hospital and for how long? Will they tell me how many patients I must see each day and how many hours I work per week? The average small-town physician now works 65 hours per week -- if we cut back to the standard 40, who will fill the gap?

"Essentially what is happening is that the government is conscripting me and my colleagues into the civil service on the cheap. They get all the benefits of control of the profession and we get none of the benefit of being civil servants, indexed pension, limited hours, paid vacations, etc."

I want to put this in Hansard. The next paragraphs are very important. I made a comment in the paper a couple of weeks ago stating that I did not have that much to worry about in Northumberland because none of the doctors there extra billed. This is a letter from Dr. Stephens. He sent me a copy. I want to quote this because I want it to go into Hansard.

"Allow me to correct Mr. Howard Sheppard's perception that `the proposed legislation will have little effect here.' Because this legislation will in a very basic way change the rules under which we work, it will in the long run change the practice of medicare in Ontario. The flip side of that, by the way, is that it will also change the practice of being a patient in Ontario. Doctors will be less available. Office hours may change. Already in this community one specialist who is opted out has elected to change his practice pattern and this will have very direct repercussions for the services available at Campbellford Memorial Hospital.

"Allow me in closing to quote Michael Davis, publisher of the Kingston Whig-Standard from an editorial he published in the paper this past week: `The real crisis in health care costs is not doctors' incomes, but the success of our medical treatment. The population is living longer and the older we become the more medical treatment we consume. An ageing population will continue to push up medical costs. We are going to have enough problems coming to grips with these increased costs without grinding down our physicians in the process.'

4:40 p.m.

"The proposed legislation should not be passed in its present form. If it is, there is no doubt in my mind that we will rue the day that we deliberately tell our most important group of medical personnel they can no longer function except as employees of the state."

That was signed by Dr. Henderson, MD, a medical doctor in Campbellford.

Here is a comment I want to read. It is headed, "Cheap-Shot Politics.

"In this week's Journal we have something that we do not have enough of usually. I am referring to the letters to the editor. One letter in particular is the result of the modern, cheap-shot politics being practised by our new provincial government. This letter was written by Dr. R. W. Henderson and should be a warning to us all.

"Let us get one thing straight. Premier David Peterson is not stupid. On the contrary, he is brilliant. That is why he is so dangerous. He has taken a page out of Pierre Trudeau's book -- if you want to be a socialist and gain power, become a Liberal. Who cares if it flies in the face of what Liberals used to stand for? The bulk of the media is with you; these days, that is all that matters. People and their freedom do not."

"The cheap shot I referred to is of course the extra or, as Dr. Henderson puts it, the under billing of OHIP. What Peterson has done is to take an affluent, high-profile group and legislate what they earn. Dr. Henderson is right when he says doctors will get little sympathy. But who is next? Is David Peterson suddenly going to get the guts to legislate what lawyers will make? Do not bet on it. Is David Peterson going to legislate what teachers and GM, Ford and Chrysler workers will make? Like hell.

"No, he is going after individuals, free from union control. Who is next? Mr. Peterson shows his contempt of the public's intelligence when he tries to blame the OHIP mess on the doctors. It is just not true and everyone knows it.

"Very few people would put in the years of training to become a doctor, let alone work the hours that they do. To attack them because they make more than the average citizen is cheap-shot politics at its most contemptible. But that does not seem to bother David Peterson either.

"Just ask yourself this question: `How would you like your wages legislated by politicians?' Remember, a freedom lost is seldom regained. Who is next?"

We have three different organizations in Northumberland. We have the Colborne, Cobourg and Port Hope doctors. Dr. Trevor Hearnden is head of the doctors in Cobourg, Port Hope and Colborne. I want to read into Hansard a couple of proposals he sent to me a while ago.

Mr. Haggerty: What is the date of that letter?

Mr. Sheppard: January 21, 1986. What is wrong with that? It is entitled, "Proposed amendments to the Health Care Accessibility Act.

"1. An amendment to require the provincial government to negotiate in good faith with the OMA and to seek binding arbitration if no agreement can be reached. This modifies section 3 of that act, which at present does not require the government to negotiate. It should be acceptable to the NDP and would probably be hard for them to oppose."

Did the members of the NDP hear that?

"2. An amendment to allow doctors to freely negotiate and charge fees for services provided in a private office. When such fees are above the OHIP rate, no part of them would be covered by OHIP. This would leave the profession with a small degree of independence while eliminating the large additional fee charges by some surgeons and anaesthetists.

"3. An amendment to exclude small gifts, such as a bag of apples at Christmas, from the act and thus to avoid the risk that a doctor accepting a small, unsolicited gift will be fined $10,000."

Mr. Haggerty: I do not think the letter has convinced the member.

The Deputy Speaker: Order.

Mr. Sheppard: I would also like to say that I talked to a couple of doctors in the town of Brighton, Dr. Laughlin and Dr. Twiddy, who are concerned about the health bill. I also had a phone call from Dr. MacLeod, who is head of the doctors in Campbellford. He is outraged with this new bill. He phoned to tell me almost all the doctors were going to opt out in the Campbellford area. He also informed me that Dr. Lewis, who is a specialist in the city of Peterborough and used to come down once a week, will not come to Campbellford unless it is an emergency.

I think the Minister of Health should have a very serious look at this bill and go back and start to negotiate. Had he negotiated first with the Ontario Medical Association, we would not be debating this bill in the House today.

Mr. R. F. Johnston: Hansard will note the applause was thundering, especially at my desk.

It is a privilege to rise and speak in this debate. I have always wanted to participate in an Alice-in-Wonderland kind of fantasy world. Following Tory speakers and having now tried to read a fair amount of the Hansard records of this debate, it is with great incredulity and surprise that I rise to try to understand what the Conservative caucus is about in this debate and what position it wants to take to the people of Ontario.

This party to my right, which used to be such a slave of polls and used to do nothing that would offend 51 per cent or 50.5 per cent of the electorate, who might have been in favour or opposed to something, now defies all the public opinion polls, which indicate that 70 per cent and maybe even 80 per cent of the people of Ontario are opposed to extra billing. It now decides it will stand up and fight for the pre-eminent rights of doctors over patients, over the rest of consumers, to opt out of a government-paid plan to provide accessible health care to all people in Ontario.

What a bizarre turn of events, especially when one considers what the -- what was that, Mr. Speaker?

Mr. McClellan: One member said it was a crock.

Mr. R. F. Johnston: It is a crock. My goodness, was it not the federal government -- Mr. Speaker, you know these things so much better than I -- was it not Mr. Mulroney who raised the matter, who said extra billing was a bad thing and decided he was going to punish provinces that did not stop this heinous process?

Mr. Taylor: That was Bégin.

4:50 p.m.

Mr. R. F. Johnston: Oh. I thought it was a recent Prime Minister who did not turn this around. Mr. Speaker can correct me on this. De Havilland and the energy plan and all that kind of thing were federal Liberal programs, as I understand it, which had been changed by a Conservative government in Ottawa recently. They did not like the national energy program. They did not like owning de Havilland. They tried to get rid of Canadair, as I recall.

However, when it came to this business of punishing the provinces because they did not like extra billing, did Mr. Mulroney rescind that? Did he say, "It is outrageous that the rights of doctors to charge more than they had bargained for is a right that must be kept sacrosanct?" No. He said: "This is maintained. This is a sacred trust." He said this, lowering his voice several octaves. He did not change this policy.

What about the communications that we thought were so close between the member for St. Andrew-St. Patrick (Mr. Grossman), the leader of the Conservative Party in Ontario, and his federal leader? Somehow the word did not get transmitted down through Sinclair Stevens or whoever it is who carries the word to the Ontario caucus about what the federal Conservatives are thinking. Instead, we have this strange rising in their seats of some 50 members, who take on this very notion, reading letters into the record, some of them from this century and others from people who are not even doctors talking about their problems with this particular principle.

Mr. Pierce: Some were just patients.

Mr. R. F. Johnston: Most of us have had our patience totally taxed through this business and do not want our patients taxed any further. The patients of this province are taxed through OHIP premiums and then are doubly taxed by members of the medical profession who decide that the salaries they get through OHIP rates are not sufficient for them and that they should charge over and above that.

Not one member of this House has not had many more letters in the past, if he is willing to admit to it, from people who feel threatened by extra billing, who think there is a more important principle involved than the privilege of a doctor to practise medicine -- and it is a privilege, not a right -- and that there is a principle of right of access by all, no matter what their economic status, to good quality health care.

That is what OHIP is supposed to be all about. Unfortunately, when it was brought in, a concession was given to doctors to avoid the confrontations that had taken place in Saskatchewan, and the concession was that they should have the right, if they chose, to charge rates over and above those that were legislated by the government of the day.

It is a very strange labour practice concept, that of bargaining for one set of fees and then actually being able to charge more. Because that practice has been in this province for so long, for some people in this province there has been a double standard, and access to medical care has been impinged on, to lesser degrees than perhaps one would think might have happened. It was not unbridled greed. The whole medical community did not respond and try to take extra money out of the pockets of patients. It is only a small group of practitioners who have done so.

As members of this Legislature, we have heard from many people who have had operations and have had bills sent to their homes afterwards for up to several hundreds of dollars. The member for Windsor-Riverside (Mr. D. S. Cooke) and other members of this caucus have risen in their seats time and again when past Tory Ministers of Health have raised this with us.

"Give me examples," they used to cry plaintively, and we would rise in our seats and give them examples of how people had been charged large amounts of money, often in cases where they could not afford it, and nothing was ever done about it, as if the principle of equal access for all were not being infringed and impinged on by that action.

For those of us who stand a lot in this House on labour issues, trying to get more equality for workers, whether it is equal pay, first-contract legislation or whatever it may be that is maintaining the vestiges of a class structure in this province, it is incredible to think that these people way off to my right, to the far reaches of Genghis Khan, would actually come to the defence, and make a priority of their defence of a profession which is the strongest union in this country, a monopoly union, which has, in my view, blackmailed previous governments into allowing the excesses of extra billing, rather than defend the rights of first-contract workers.

That they would get up and vote against first-contract legislation -- and those who did not have the guts to get up and vote according to their consciences walked -- as we saw with only 24 of them in the House the other day -- basic legislation to make sure that people at the low end of the income scale, workers in this province

Mr. Taylor: Mr. Speaker, on a point of order: Referring to the member's comments about Conservatives who did not have the guts to vote on first-contract legislation yesterday, I unavoidably missed that vote. I want to say I would have voted against that legislation had I been here.

Mr. R. F. Johnston: I would never want it to be thought I would ever suggest that the member for Price Edward-Lennox would ever have voted for that legislation. I would never suggest such a thing and I am sorry if the honourable member felt I would suggest he would ever vote for progressive labour legislation. However, there were others who were on record as wanting first-contract legislation, who supported it being in the speech from the throne --

Mr. Speaker: I am sure we will get back to the subject at hand.

Mr. R. F. Johnston: -- and they vacated the premises, shall we say, before the important moment came.

Just yesterday they voted against that kind of legislation and today in this House they can get up and support people who are earning $130,000 a year, because most of the people who opted out are specialists who make an awful lot of money, and say that those workers of that monopoly union should have the right to charge more than levels of payment which already put them amongst the most well-off individuals in our province.

I was thinking it is the most incredible performance. I do not know what constituency they think they are playing to. Maybe it is just a matter of putting the coffers ahead of politics and hoping to get donations or something from those people who have money. However, I tell the Tories they are going to be punished for this electorally. When they rise and vote against this legislation on second reading, as I sure hope they do, they will all be recorded -- those who are in their seats, all 20 of them. Those people in their ridings, who make up that 70 per cent of the people of this province who understand that it is fundamentally wrong to impinge upon the access to equal rights to health care by extra billing, are going to punish them in the next election.

The Tories may get the vote of a few specialists, but in my view, they will not even get the vote of most of the doctors. The vast majority of the doctors have understood from the beginning that extra billing is not necessary to get by in this province, that they do very well on their own. They will not be supporting the Tories. The Tories are going to be a much smaller group come election day.

Mr. Lane: Do not feel sorry for us. We always do fairly well.

Mr. R. F. Johnston: I take it back. Since I have been asked not to feel sorry for them, I will not feel sorry for them. I will only say that in some cases I may even miss them. In other cases, I definitely will not.

5 p.m.

It is important that we pass this legislation early. I look forward to this going out to the standing committee on social development for hearings, so that the people of Ontario can express their opinions about this legislation; ending this strange, bizarre behariour to my right, this prolonged debate, getting the legislation out to a committee and then back in here and passed, ending extra billing once and for all in Ontario.

Mr. Pierce: I am pleased to have this opportunity to speak on Bill 94, the Health Care Accessibility Act. It is an important piece of legislation. In effect, it proposes to change the nature of medical care in Ontario, to end the independence of the medical community; it turns its back on the record of more than a decade and proposes to recast our health care system.

I cannot respect the manner in which this bill has been introduced. I must question the priorities of this government in managing our successful health care system.

If Bill 94 is made law it will be a black mark in the story of health care in Ontario and will attempt to turn back the clock. It will try to impose a rigid framework on a free-flowing system that has served the people of this province well. It will expose the bad results that come when the complex problems of today are approached with a closed mind or a simplistic outlook.

This bill has nothing to do with accessibility to health care, despite its title. Indeed, if truth-in-advertising laws could be applied to government, this administration would be suspected of misleading the public by calling the legislation the Health Care Accessibility Act. This bill will not improve accessibility to health care. I believe it will not improve the quality of health care to which Ontarians currently have access.

Let us call a spade a spade. This legislation should be called the unchanged access to more expensive and less effective health care act. That is what this bill will really achieve, and that is why I cannot support it.

Let us look at the record. On a yearly basis, about four per cent of Ontarians seeking medical care are extra billed. That means about 96 per cent of Ontarians seeking medical care are billed according to the OHIP schedule.

In my riding of Rainy River, I do not know of any extra billing by local doctors. The current billing system was set up in Ontario for two reasons: first, to respect the position of doctors as responsible, independent professionals; and second, to provide choice to the public. The public could receive sound, quality care under the OHIP system. If it wanted a few frills it could pay more and have them.

This flexible system provided a good working atmosphere for the setting of the OHIP fee schedule. It allowed our medical schools and hospitals to attract some of the finest medical minds in the world and to pay salaries befitting their world-class status.

It was a system built on trust and mutual respect. It is a system that has survived and worked well. Our health care system has a high reputation. Why? Because it achieved the kind of balance that gave the people the best that private and state medical programs had to offer.

Ontario's medical care system is the envy of a lot of people throughout the world. The system works. It gives this province the best of both worlds. It is pragmatic and effective.

The government will say Ontario is out of step with the rest of Canada, that we are being punished to the tune of $50 million a year for retaining a system we developed to meet our own needs. I would argue that what might work for Saskatchewan or British Columbia would not necessarily work for Ontario. In addition, just because the other provinces ban extra billing does that mean such a move is really effective?

When one looks at the geographical size and the population density of Ontario and compares them with British Columbia and Saskatchewan, one is looking at apples and oranges.

When Quebec banned extra billing, Ontario welcomed more than 280 specialists from that province. To me, that statistic alone is a sign of success.

However, the government will say we must keep in step, we must obey the Canada Health Act. If not, Ontario will be out $50 million. That is a significant amount of money, but how effective will $50 million be in the $2.2-billion budget of the Ontario health insurance plan? How much more service will that $50 million provide? How many more doctors will be encouraged to relocate in remote communities? How many more world-class specialists will be encouraged to settle in our province?

Can anyone on the government side answer those questions? I do not think they can. I do not think there are any statistics, any figures, any evidence to show the $50 million a year, which is to be transferred to Queen's Park from Ottawa, will in any way improve accessibility or the quality of health care we enjoy in this province today. The evidence is just not there.

When the Progressive Conservatives moved to set up our health care system, we did not do it overnight. We understood we were dealing with a very complex system. We understood that what we were doing would have a tremendous impact on the people of Ontario. We moved slowly, not out of reluctance but because we cared. We cared to build a climate of understanding, to build carefully and well. We took the entire health care community into our confidence. We sat down and had meeting after meeting so that everyone was aware of what was happening, so that a climate of trust and confidence could be built, a climate essential to the effective operation of any state medical plan.

What has this government done? It has moved swiftly, but without consultation. It will listen to the doctors, but only after introducing the legislation. The government will listen only if it can get its way.

Even my friends to the left recognize that in order to enter into negotiations both sides have to be at the table, and both sides have to be willing to give and take in order to reach a fair settlement.

This is not the way to negotiate or to build a health care system. It is not the way to establish a climate of trust and understanding. This government has a closed mind and is moving in lock-step, like a wind-up toy, to the dictates of the accord signed last May; many of my Liberal friends act as though they would prefer to ignore or pretend this document does not exist.

I am not defending the salaries earned by doctors. Anyone who knows a doctor or has watched a youngster make his or her way through medical school will have a better concept than I of that. What I am defending is the system of medical care that has served Ontario well and has the potential of serving Ontario well for many years to come.

The Liberals, however, have another objective in mind. That objective is not improved access; the figures just do not support that argument. The objective is dogmatic and partisan. It has no connection with the reality of health care in Ontario today. If access was the government's goal, it would have taken a different approach. It would have looked at the situation with the anaesthetists and the obstetricians. They are not in the Ontario health insurance plan. Everyone who has had an operation would probably agree that an anaesthetist is essential to the successful completion of the process, but the government has ignored that situation. I suppose it hopes the province will sleep through the problem. If access was this government's concern, it would have tackled this challenge.

If access was the government's concern, it would have looked at hospital beds. Mr. Speaker, I listened to the third party, and I know you do from time to time. If members had listened to them recently during question period, before they became entranced with the mysteries of insurance, they would have heard that many hospitals are faced with overcrowding.

5:10 p.m.

My colleague the member for Simcoe East (Mr. McLean) brought up the problems the Royal Victoria Hospital in Barrie is facing. If access was this government's concern, it would have tackled this challenge.

What about the cancer clinics? The media in Toronto has brought to our attention the challenges facing staff at Princess Margaret Hospital.

My colleague the member for Sudbury (Mr. Gordon) brought up the challenge of building a cancer clinic in his community. The Minister for Northern Development and Mines (Mr. Fontaine) has given this problem his usual attention, which means he has ignored it.

If this government was serious about access, it would have tackled this question. What about the north? Any of the government members could ask the northern members on this side of the House about access to medical facilities. Flights to the south, even though they are partially subsidized, are not enough. We need expert medical care in all areas north of the French River. Each community across the north needs access to specialized care in its area.

Previous governments were serious about this problem. They did positive things for health care in the north. They offered incentives for doctors and dentists to locate in northern communities. They helped doctors and dentists get established in the northern areas. They worked with communities to build the institutions, set up the health councils and put the basic framework in place. Even members of the third party cannot deny that was an ongoing program.

That framework can be built upon. It should be built upon to ensure that the people of the north have access to the same specialists found in the south and to ensure that those specialists are available and living in the north. If this government was serious about access it would have tackled these challenges first.

What about care for the elderly? The government should ask the members on this side of the House who represent communities with an ageing population. They would tell the government that there is always something extra that can be done for the elderly.

The government is proud of its recent announcement of programs for the elderly. I will not comment until we see these programs put into effect. I will not hold my breath until that moment. If this government moves as quickly to put these programs into effect as it has to bring down its housing policy, I may very well be dead if I hold my breath until that moment.

Home care programs always need more support; more chronic-care beds and more beds for nursing homes are needed. These are the never-ending concerns and are what is meant by accessibility to health care. If this government was serious about access, it would have tackled these challenges.

What about the air ambulance service? Since its inception in 1981, this first-class service has flown more than 24,000 patients to various medical facilities throughout northern Ontario. If this government was serious about access, it would have looked to further improvements in the air ambulance system.

Mr. Ward: We have.

Mr. Pierce: That is right. The government has moved the co-ordinating services to eastern Ontario, and the people operating those services do not even recognize that there are airports in northern Ontario that require people to light the flare-paths before an airplane can land.

What about hospital care in the north? Since 1970, new or replacement hospitals have been built in the north. In Kirkland Lake, Englehart, Red Lake, and in my own riding in Atikokan, Marathon, Wawa, Hearst, Chapleau, Sturgeon Falls, Kenora, Sudbury and Terrace Bay.

It is interesting to note that a number of these hospitals were not built in Conservative ridings but in opposition ridings. That is where the health care services were needed and where the attention was put. More than this, the previous Progressive Conservative government had a strategy to develop a network for self-sufficient health care in the north.

Special emphasis was put on the development of health care services by means of regional referral centres in five major centres: North Bay, Sudbury, Sault Ste. Marie, Timmins and Thunder Bay. Together, these five cities make up 63 per cent of the population of the north. As a result of this program, the north has access to cardiovascular surgery, neurosurgery, nuclear cardiology, burn treatment, life support, cancer treatment, orthopaedics, obstetrics, perinatal services, psychiatry, chronic care, ambulatory medicine, children's treatment, pacemaker treatment and dialysis. All of this is available in the north today, thanks to the efforts of the previous government. It is a firm foundation for future growth.

If this government was serious about access and quality health care, it would be building on this network in a constructive manner. It would be building up health care in co-operation with a system rather than chasing ideological moonbeams. If it was serious about access, it would be looking at programs such as native healers.

That may seem a little foreign to some members, but native healers provide a necessary service throughout northern Ontario. If it was concerned about access, it would be looking at the northeastern Tel-help network and the northern Ontario ambulance radio system. That is what accessibility to health care should be, but the government's legislation does not deal with these programs. It does not tackle the concrete challenges that face our health care system.

Health care is much too important a concern to be treated in so frivolous a manner. Few things are more important to a community than the health of its people. For a government to be providing improved access and a better health care system through legislation such as this is nothing but a cruel joke on the people of this province.

People in Ontario look to Queen's Park to provide responsible leadership on health care concerns. They expect responsible action and respect for their needs. They do not expect word games or game playing. That is all we are seeing here today. As a union man, I know what it means to bargain in good faith. It means that both sides sit down without any hidden agendas, put their cards on the table and work out their concerns until a practical compromise is reached. There are no threats, just honest discussion. That is what the OMA is asking from this government, honest discussion. The government is saying, "We are going to pass this bill whether we talk or not."

The fair thing would be to set aside this legislation, to sit down and work out the differences; to show the people the government is really concerned and has some feeling for the accessibility of health care and that it is not just out to attack professional groups in this province. But this government will not put down its big stick. The government will shake it in the faces of the province's doctors and say that now it is willing to talk. That is not open discussion. It is certainly not bargaining in good faith.

If this were any other group of workers, my friends to the left -- I use that phrase loosely -- would be on their feet demanding that this government change its ways. Let me warn them that if this government is so cavalier with the rights of one group of workers -- in this case, our doctors -- what is there to stop it from rolling over the rights of others? Remember the respect this government has shown for the opinions of others when another labour situation arises.

5:20 p.m.

I do not believe this government has much to be proud of in the way it has handled Bill 94. It has tried to manufacture an issue. It has tried to create a situation whereby it will look tough and decisive, but the real business of government is not smoke and mirrors; it is in achievement and in showing that quality services exist for the people and that the people have effective access to those services. The real business of government lies not in newspaper headlines but in real achievements for the betterment of the community.

From the way this government has handled Bill 94, I am not convinced it is really interested in effective governing. Members of the government party know that. We should ask the member for Humber (Mr. Henderson) or participants at the recent policy convention in Windsor. This government knows that informed opinion finds a great deal that is questionable in Bill 94. The government should know the approach it is taking to health care will benefit very few people in the long run.

I cannot support this legislation because of the way it has been introduced and handled by the government. It has shaken the atmosphere of trust and mutual respect which has provided Ontario with some of the best health care found anywhere. Despite its title, Bill 94 will do nothing to improve access to health care in Ontario. Despite the government's rhetoric, Bill 94 will do nothing for health care in the north. It will do nothing to help the people of the district of Rainy River which I represent. Indeed, it has only annoyed the local medical community.

Through its handling of this legislation, its method of dealing with the OMA and its approach to health care concerns as a whole, this government is continuing to prove itself unfit for the responsibilities it eagerly seized last June. The people of Ontario are judging the government. It will be judged in the end not by the number of headlines it receives in the papers but by its achievements. Ontario does not need Bill 94. Stop fooling around, get down to the real business of government and give us the legislation our province needs. Give us the leadership our people deserve.

Mr. Pollock: I am pleased to be able to enter this debate. I would like to put on the record --

Hon. Mr. Sweeney: We are voting at 5:45 p.m.

Mr. Pollock: Good for the minister.

I do not believe there is a single doctor in my riding who has opted out of OHIP. They are all general practitioners. As far as I am concerned, they do a first-class job of serving the medical needs of the riding of Hastings-Peterborough.

I have always had a lot of sympathy for those specialists who do very special operations. I had a young gentleman working for me at one time whose mother had been diagnosed as having a brain tumor. The operation was scheduled for a particular day. The family was called in, and just before the operation started the doctor came over to talk to them. This fellow told me the doctor was alert, young looking, energetic and very concerned about this operation. He went into the operating room and was there for 12 hours. It was a far more serious operation than they had originally thought. My employee told me when the doctor came out of the operating room he was just about beat. He looked older and one could tell he had been under a tremendous strain. I have a lot of sympathy for those doctors who do these very special operations.

I would like to talk for a few minutes about some of my concerns and things that have happened in my riding.

Thank goodness we now have far better ambulance service than we used to have in the rural areas. I can recall a situation in a rural area not far from where I live. A chap was in a car accident and the steering wheel had crushed his chest. This man knew a little bit about medicine and wanted oxygen, but there was no oxygen around. They had called the ambulance, but the ambulance driver was not familiar with the rural area and got lost. As a result, this chap hung in there for two hours, but eventually he died. That was because of lack of good ambulance service at that time in that area. Now the local fire department has a resuscitator and it can administer oxygen. If it had had that at that time, it might have been able to save that gentleman's life.

There are also other health care needs we have in the riding of Hastings-Peterborough. For the last two years or so there has been a plan for the nursing home to close down in Norwood. The lady who was running the nursing home wanted out of the nursing home business. She only had 33 beds, and she had to do a lot of renovating to stay in the business. She wrote the minister and stated she wanted out of the nursing home business.

Finally, the government did move all of the people in these beds over to Marmora, but these elderly people had lived in the Norwood area and they felt their privileges were being ignored by someone taking them 20 miles away and placing them in a nursing home a long way away from their families and relatives. I know they are getting excellent care in Marmora. Nevertheless, we need a new nursing home in the Norwood area. We have been lobbying to try to get extra beds for that area. So far, we really do not have a commitment for those extra beds. It is certainly a concern of mine and --

Mr. Haggerty: How long has the member been lobbying?

Mr. Pollock: For about two or three years anyway.

Mr. Haggerty: That does not say much for the past government, does it?

Mr. Gillies: It does not say much for the present government.

Mr. Pollock: We were promised 60 beds a while ago. Apparently they have just been reannounced, but we still do not have a commitment. It is certainly a concern of mine to have a nursing home in the Norwood area.

Let me take a minute just to say we have one of the best health care systems in the world and tampering with our health care program is a real concern of mine. I would just like to take a few minutes to discuss the different health care programs around the world.

Let me first take a look at the British system. This program has been in existence for 33 years. This program pays all the medical expenses and is totally free to the British public. Since the British system was implemented, health care in Britain has declined steadily. There is currently a list of 641,000 people waiting for hospital beds. There are only 364,000 beds available in the British hospitals. This means there are two people waiting for one bed. Those who pay out of their own pocket for beds go to the top of the list. Britain allows private insurance and permits doctors to practise outside of the national health system. These doctors are paid directly by their patients. Even some trade unions, traditionally opposed to private medicine, now enroll their members in private health plans.

5:30 p.m.

The Swedish system is somewhat different from the British system. The Swedish system covers everything from free dental care for children to free home visits and cab fares for the elderly. Medical care is provided almost entirely through the hospitals -- for even minor illnesses -- or by the company health centres. Many large Swedish firms operate their own health care centres. More than 90 per cent of the doctors in Sweden are employed by the state.

Getting a doctor to treat one privately is an almost impossible process. An American journalist working in Sweden had to return home to America to receive treatment for a minor ailment that had been plaguing him for a year. He said that Sweden has well-trained doctors, beautifully equipped hospitals and all the modern medical conveniences; the only problem is one can never get access to them.

Mr. Philip: That is why they live so long.

Mr. Pollock: The member said that the other night.

Mr. Philip: Why do they live so long if the system is so bad?

Mr. Pollock: The Swedes pay user fees and that is a real surprise to me. They pay five dollars for each visit to a doctor and six dollars for each visit to a hospital. They pay a maximum of $10 for each prescription drug. As of July 1, there will be a ceiling on the direct cost to the consumer. All the health care costs are paid by taxes collected by the government. They do not even have volunteers in their system.

Swedes have a population approximately the same size as that of Ontario, eight million. The Swedish health bill is about $10 billion to $12 billion, double ours. Swedes spend nine per cent of their gross national product on health care. Ontario spends about five per cent. Swedes pay directly for three per cent of their total health costs. Here in Ontario, we pay approximately 20 per cent through our OHIP premiums.

Where most people in Sweden receive their health care, doctors work from nine in the morning to five o'clock in the afternoon, and they are on call at overtime rates in the evening and on weekends. This is a clincher. Because of the high income tax, doctors tend to take their overtime as time off rather than in cash. The result is that most of the doctors take holidays of between three and five months.

Mr. McClellan: We all know this is the very essence of truth.

Mr. Pollock: I doubt if they all have yachts anyway.

Interjections.

The Deputy Speaker: Order.

Mr. Pollock: It has been a real pleasure participating in this debate.

The Deputy Speaker: I did not want to discourage the member for Hastings-Peterborough. Is there any other honorable member who wishes to participate in the debate? The member for Dufferin-Simcoe (Mr. McCague).

Mr. McClellan: He has already spoken three times in this debate.

Mr. McCague: Is that correct?

The Deputy Speaker: You can only speak once on each bill in the House.

Mr. McCague: I shall continue.

I am pleased to speak on Bill 94 and to bring to the attention of the House some of the feelings of people in my riding about this legislation. I am disappointed that until I offered to meet with certain groups within my riding, I had only two letters from constituents who were opposed to extra billing, and one from a doctor who thought it was a good idea. That does not seem to indicate the level of concern that we in this House would like to think there is out there about the bill, regardless of what side of the issue one happens to be on. Of course, it is understandable from the doctors' point of view, because they have never been known to be very political people.

They go about their work and basically mind their own business. They do not like being interfered with by politicians. The present move by the Liberal government does have them upset, and for valid reasons.

The doctors raise the issue of the long-term viability of the health care system in the province. A lot of things are raised by groups in society when some legislation or some action is proposed, and they often do that on the basis of a certain fear they see in the future.

In this case, the doctors have a point of which this Legislature should take cognizance. The fear they are raising is borne out by the chaos or disarray of the Quebec system at present, and further underlined by the actions taken in Britain which have now resulted in a system with which no member of this Legislature would be satisfied. We cannot deny the doctors the point that we may be leading into that type of less viable system.

I want to make a comment or two about the contribution made in this debate by the member for Humber. He has a sister in my riding who does not agree with him, but I happen to agree more with the member for Humber than with his sister who shares the opposite opinion.

Mr. McClellan: She must be a New Democrat.

Mr. McCague: That is a choice, but a poor one.

The member for Humber gave a very reasoned speech on the subject and one that, in my riding, is as popular as any article that I have recently been able to circulate.

He stated at the time that he had campaigned on a promise that they -- they being the Liberals -- would negotiate with the Ontario Medical Association. He believed the operative word in the Liberal promise was "negotiate."

After hearing his remarks, it is my view that the government did not seriously try to negotiate the extra billing question. The issue, in his opinion, is the health care of Ontarians and the democratic right of two people to negotiate a simple contractual agreement with each other, perhaps with certain safeguards provided by the state.

He stated he was defending against the threat of a weakening of the health care system. He also argued that he believes in democracy and freedom, as I do, and that it is not advisable for the state, in peacetime, to conscript physicians or any other group in society and compromise their democratic freedoms and circumstances other than in a temporary state emergency.

The bill compromises the right of two citizens to negotiate a simple contract with each other. We are both opposed to this. He talked about personal liberty. That is important to him, and it is impossible for him to support legislative measures that compromise personal liberty. Freedom is not negotiable. He states he is a Liberal because he believes in individuals, but also a professional who believes in professionalism.

5:40 p.m.

We all agree that we cannot improve the health care system by seeming to alienate and demean the professionals on whom we rely to provide the excellent services and competent leadership that makes the system work. He asks whether we want the practice of medicine to become a state monopoly. Look at state monopolies around the world. What kind of doctors, surgeons and anaesthetists do we want? He defends the right of any citizen or group to freedom from conscriptive control, as do we in this party.

He does not believe in one side dictating to the other by saying: "We are going to negotiate you a three per cent raise this year. As soon as you agree, we will start negotiating the means by which we will bring it about. If the union says, "No way," the company could hardly say, "See, they would not negotiate." Does that not sound like some of the newspaper articles you have read in the past?

This is not his idea of negotiating in the context of freedom and democracy. The present Liberal government, namely the Minister of Health, suggests an absolute ban on extra billing is a matter of principle and the principle is nonnegotiable. The member for Humber states, "In truth, however, the non-negotiable ban on extra billing is not a principle at all, but a chosen tactic or strategy for solving a particular problem as perceived by particular people." Did he get this impression during caucus discussions?

I have received representations from the fine doctors in my riding. I have also received letters from several people outside it. I know various members will have brought those letters to the attention of this House and I will be dealing only with those from my riding.

We have in Ontario major teaching hospitals and research facilities employing many doctors, many of them internationally recognized specialists. Who will pay for university teaching of undergraduate and post-graduate medical students? At present, teaching-hospital specialists see this as an honorary part of their work. Who will pay for clinical research? Could we expect any doctor to provide these services on a goodwill basis after the passage of a bill such as Bill 94?

How does the government plan to compensate doctors after taking away their right to set fees? Is it possible to control the extra billing by adding an innocuous code to the OHIP cards of the financially disadvantaged? Why does the government not withdraw the bill, start from square one, and discuss this and possibly other options to solve the problem?

People on social assistance, by having a designated number on their OHIP cards, would not be hurt by extra billing. Anyone in need because of unfortunate circumstances could apply to OHIP to get the designated number. Senior citizens below a specific income level could be issued a designated number, thus eliminating them from the hardships of extra billing. This may be too simplistic.

We have the best health care system in the world, as has been said many times by all, and the finest doctors and specialists. Some of them went to school for 14 years to become the brightest and best in their field. Are we to discourage excellence when we do not have to do that? The present maximum of 15 per cent of the doctors in the province who extra bill has not hurt the population. We can help those caught at the lower-income end. The government should enter into negotiations with the doctors to solve the problems of extra billing and not ban it.

I have a thoughtful letter from the head of the medical staff of the Dufferin Area Hospital in Orangeville. David J. Scott writes to the Premier: "I feel compelled to write in regard to the recent legislation entitled" -- and we know what that is.

"All physicians in the area of Dufferin county are opted-in physicians so the legislation will not change our billing practices, and this is the situation for most of the province. However, it appears to me to be a drastic measure designed to improve the so-called accessibility for five to six per cent of the services rendered to Ontario patients by opted-out physicians.

"To all intents and purposes, the Ontario physicians have been conscripted by your government without some of the other benefits which civil servants enjoy nor any of the protections they also have.

"The withdrawal of services is repugnant to most of us and we really have limited means to express our opposition to your government's action in spite of a long and faithful service to the people of the province. Certainly our experience with previous governments, as well as the present government, has not been one of trust and good faith, and I can only suggest the people of this province will ultimately be the losers because of the actions of your government. Even in Great Britain and the province of Quebec where other systems are in force, patients do have alternative forms of service, which will presently be denied in Ontario.

"I find the latest action of government just another episode in which the self-governing professions are being systematically controlled and manipulated simply for political expediency. It is indeed a sad commentary on the evolution of public policy that in these times of supposed emphasis on individual rights governments feel compelled to draft legislation which effectively limits our freedoms. It is government action which has made the Charter of Rights so necessary.

"In the final analysis, physicians will gradually become less personally committed, less prepared to spend hours of nonremunerative time being on call and working on various hospital committees. This is a particularly onerous responsibility in a small community.

"I send this letter more in sorrow than in anger because it is becoming increasingly clear that long and faithful service is being sacrificed on the altar of political expediency."

I am sure you would agree, Mr. Speaker, that is an excellent letter.

There have been a lot of very thoughtful articles on the subject in the newspapers in my area. I have one that I am sure our New Democratic Party colleagues will love. It is written by a lady in Collingwood who has never been backward about expressing her opinion in whatever way she thought in any of the local newspapers. Her name is Mrs. Nora McLaughlin of Maple Street.

She writes to the editor: "The dictatorial attitude of the Liberal-NDP government awakened many of us to the realization that we have all but lost our individual freedom.

"Some journalists believe that we will never regain it. `Free individuals are doomed,' writes Derek Nelson from Queen's Park. `Doctors should accept reality,' writes Lorrie Goldstein, Queen's Park reporter, in the Toronto Sun.

"Some people do not agree and are fighting back. One is Merv Lavigne whose battle is described in Derek Nelson's article. Lavigne is a Haileybury community college teacher who is involved in a Charter of Rights case before the Ontario Supreme Court." I think this has been read into the record previously.

She goes on to say, "No doubt many of their total of 152,000 members" -- that is the Ontario Public Service Employees Union; no, it is not OPSEU. That is not part of the article.

Mr. McClellan: The member is afraid to read what it says about --

Mr. McCague: I will send Hansard to her.

Mr. McClellan: He should send it to all of them.

Mr. McCague: Would the member for Bellwoods (Mr. McClellan) like to include any others in my riding whose vote he is trying to encourage?

It says: "David Peterson stripped many Ontarian citizens of their right to fair and democratic representation by signing the two-year pact with Rae."

Did the member say "Right on?" Did someone say that?

5:50 p.m.

"The pro-life movement in Ontario was the first victim. The doctors are the second. The ban on extra billing is clearly Rae's baby. It is noticeable that Rae is as visible doing all the talking while Peterson stays out of the newscasts. Why? Is it Rae's turn to play Premier? Or did Peterson sell a piece of his soul to gain power, although he had no stomach for his legislation?

"There is more on the agenda with which many citizens would disagree if they understood it. Equal pay for work of equal value is one; it is not the same as equal pay for equal work.

"The dictatorial handling of the doctors by the Liberal-NDP government contrasts sharply with its differential treatment of Dr. Morgentaler. Mr. Elston, Minister of Health, even gave him an Ontario health insurance plan number. If Ontario citizens value good quality medical care and individual freedom, they will support the doctors. If the doctors lose their battle through the lack of our support, we will get the quality of medical care and government we deserve."

Freedom of the press is observed. We were very fortunate last Friday night to have the Minister of Health in our riding to address the Collingwood hospital foundation and we much appreciated the effort he made to be in attendance. While he was there, the doctors were carrying on some kind of demonstration outside, and the minister did speak to them. One of the strong Liberals in my riding introduced the minister. When he went to go home he had a flat tire. I guess members know who got blamed for that. However, one of the doctors did give him a ride.

This editorial appeared on December 23 in the Barrie Examiner:

"Ontario physicians are fighting mad over the provincial government's soon-to-be-legislated ban of extra billing, the practice followed by some doctors, mainly specialists, of charging over and above the negotiated OHIP fee schedule.

"They charge the ban infringes on their rights, that it will encourage assembly-line medicine, that it is really a smokescreen for the shortage of health care dollars for medical care facilities, such as new expanded hospitals, and that extra billing does not really deny access to the doctor of individual choice. They are right on all counts.

"If they mount a full-fledged campaign to fight the extra-billing ban, it may be one of the last battles in a two-decade-long process that has reshaped the health care system in Canada that began with the introduction of universal government-supplied medical and hospital insurance.

"Realistically, the Ontario government had little choice but to ban extra billing. To do otherwise would not only have broken the pact the governing Liberals have with the provincial NDP, but also shortchanged the provincial taxpayers by some $75 million in federal health care moneys." I think that figure is a little high.

"Nearly two years ago, the Trudeau government, determined to stamp out extra billing and hospital user fees in some provinces, made portions of such transfer payments conditional on banning those practices. Decisions to ban extra billing or hospital user fees had previously been taken by a number of provincial governments as a result of the federal government pressure through its transfer payments. Unless the Ontario doctors can successfully fight the extra-billing ban in the courts, full-blown socialized medical care is here to stay in the province and across the country."

I do not think one can say that too often, "Unless the Ontario doctors can successfully fight the extra-billing ban in the courts, full-blown socialized medicine care is here to stay in the province and across the country." That is exactly what our friends to the left would wish.

There is another letter to the paper by a doctor, N.D. Gripper, who has been in my home town for many years. The headline reads, "Bottom Line of Liberal Bill 94 Right to Deal with Patients." It says:

"Recently, there has been a lot of publicity over the Liberal government's Bill 94, of which, as Barbara Amiel wrote in the Sunday Sun on December 29, `In one fell swoop the Liberal government of Ontario has nationalized an entire profession, turning doctors overnight into civil servants.'

"At issue is the toss by the medical profession of Ontario of its right, since the days of Hippocrates, to deal directly with patients for payment of services. There are 15,000 doctors in Ontario. About 12 per cent of them exercised this about seven per cent of the time by billing beyond the payments from the government's insurance plan (OHIP). Nevertheless, the remaining 88 per cent knew they had this right and could use it if they wished as an escape from direct government control or as a bargaining tool in this proudly free country.

"Premier Peterson has removed that right, thereby conscripting the profession inescapably into the government arena for his own political benefit. Unfortunately, as we have so often seen, politicians come and go and we are left with the gravestones of their political ventures for the rest of our lives.

"To be specific, the federal government, as a result of Monique Bégin when minister of health, withholds $50 million a year from the health care transfer payments to Ontario until the physicians' freedom to charge above OHIP payments is removed by the provincial government. This represents half of one per cent of an Ontario provincial health budget of $9 billion -- hardly a major factor, bearing in mind $800 million is spent on the tobacco industry while many major health service problems go unattended.

"Physicians have little taste for political confrontation, have very little bargaining power that can be directed at the government and need the support of their patients if they are to retain their ever-diminishing independence."

Here is another article from a Collingwood paper. I will just tell members the headline: "Professionals or Civil Servants? Doctors Say This Is the Debate."

The doctors in Collingwood, when the minister was there on Friday night, chose to boycott the fund-raising dinner. They did buy tickets, however, which were for the benefit of the hospital foundation, because they were able to sell those 27 seats the second time around and, as a result, were able to make about $20,000 towards future expansion plans at the hospital. The headline was, "No Doctors in the House When Elston Arrives."

This might be an appropriate time to break off and I shall continue this evening.

The House recessed at 5:58 p.m.

February 4, 1986

STATEMENTS BY THE MINISTRY

FOOD LAND GUIDELINES

ORAL QUESTIONS

PSYCHIATRISTS' SALARIES

CANADIAN DOLLAR

ST. CLAIR RIVER

PENSION FUNDS

LIQUOR LICENCE BOARD OF ONTARIO

INSURANCE RATES

EXECUTIVE ASSISTANTS' SALARIES

EQUAL PAY FOR WORK OF EQUAL VALUE

AFFORDABLE HOUSING

DOMINION STORES

EXECUTIVE ASSISTANTS' SALARIES

FACULTY OF ARCHITECTURE AND LANDSCAPE ARCHITECTURE

RETAIL SALES TAX

VISITOR

EMPLOYEE HEALTH AND SAFETY

CHEMICAL LEAK

PETITION

ONTARIO INSTITUTE FOR STUDIES IN EDUCATION

ANSWERS TO QUESTIONS IN ORDERS AND NOTICES

ORDERS OF THE DAY

HEALTH CARE ACCESSIBILITY ACT