Hansard Transcript 1986-Feb-11 | Legislative Assembly of Ontario

Mr. Cousens: As co-chairman of the Ontario Legislature Committee for Soviet Jewry with the member for Beaches-Woodbine (Ms. Bryden) and the member for Mississauga North (Mr. Offer), it gives me great pleasure in announcing the release today of the human rights advocate, Anatoly Shcharansky, perhaps the best known of the Soviet refuseniks, a man who has sacrificed the last nine years of his life in prison charged with treason, anti-Soviet agitation and propaganda.

We know his real crime was his pursuit of freedom of thought, freedom of religion and freedom to join his wife Avital in Israel. We are all aware, as Canadians, that a crime of this nature would place each and every one of us in permanent detention in countries such as the Soviet Union.

Today is a day of celebration and one of deliberation. Anatoly Shcharansky has become one less statistic in the ranks of the oppressed, but he is just one of thousands of individuals faced with the denial of basic human freedoms, the denial of rights and decencies that we in this country so often take for granted.

Along with my colleagues in the Soviet Jewry committee, I ask the members today to applaud the recent release of Mr. Shcharansky. We also ask them to join with us in our continuing pursuit of justice for all the Anatoly Shcharanskys of this world. Today they remain nameless and faceless, but through our efforts and support, tomorrow they will not be speechless.

Hon. Mr. Peterson: I join with my colleague and my other colleagues in this House, many of whom have spoken eloquently on the subject in the past, and say that the prayers of millions were answered today. I am sure all members of this House and all citizens of the province share our overwhelming sense of joy at Anatoly Shcharansky's release from bondage.

This renowned human rights activist has inspired the commitment of many here in Ontario; many members of this assembly of all parties have been involved actively, speaking out forcefully and eloquently for his freedom and the cause of his fellow Soviet Jews.

His effectiveness in fighting for freedom, even while behind bars, has provided a beacon for all who are free in this world and all who wish to be free. In the words of Gérard Filion, "Freedom is not a gift but something that must be won." Anatoly Shcharansky deserves our congratulations for having won his and having done so much to help others win theirs.

Mr. Rae: This is indeed a gloriously happy day and one that unites all of us in the House. I have been fortunate enough to speak from many platforms, as has my wife, on behalf of the cause of Soviet Jewry. It is not only a symbolic day for those of us who have worked so hard. I am looking across at the government House leader, the Treasurer (Mr. Nixon), and I know his feelings on this subject and the experience he had while travelling to the Soviet Union together with others.

I simply want to say on behalf of my party how delighted we are for the cause and how specially pleased we are for Mr. Shcharansky and his very brave and courageous wife and family, who have taken up not only the cause of Anatoly Shcharansky but also the plight of literally thousands of others who live in the Soviet Union, who are not able to practise their religion freely, who are not able to express themselves and who are not able to leave the country and immigrate to Canada, the United States or Israel. We simply have to admire the courage of people who have given up so much and fought so hard for this day.

We join with all members of the Legislature in expressing our solidarity with the Shcharansky family and our solidarity with all those who live not in freedom but in oppression. It is so important that we remember them this day and celebrate with the Shcharanskys but continue to fight, and fight as hard as we can, for all those who know not yet the dream of freedom.

Mr. Speaker: The Leader of the Opposition. On a point of order?

Mr. Grossman: On the same matter, Mr. Speaker.

Mr. Speaker: With respect, I believe if I allow you, then I will have to allow all members to --

Hon. Mr. Nixon: Let us go around again.

Mr. Speaker: Go around again? All right.

Mr. Grossman: I might point out that the member for York Centre (Mr. Cousens) was speaking as chairman of the parliamentary committee on Soviet Jewry. I would have thought it appropriate for each of the party leaders to respond and then to proceed with normal business. My colleague was speaking not as a member of our party but as chairman of an all-party committee.

I will take just a moment of the House's time to reflect upon these happy events. As one who has shared a platform with many members on all sides of the House in supporting the cause that Anatoly Shcharansky has represented for many years, I feel a special bond because I have been in the Soviet Union. In 1972, I was searched, followed and threatened by the KGB for having attempted to take religious articles to the Soviet dissidents. That is food for thought, in that the very taking over the border of prayer books and prayer shawls is an offence in the Soviet Union. I did that, as did many other Canadians with, I might say, less attachment to the cause than I had.

As a result, through 10 days of intimidation, searching and being followed by the KGB, I had the crushing and shattering experience of seeing Soviet Jewish dissidents arrested as they walked in the front door of the hotel we were staying in on their way simply to meet with me and others to get a prayer book. They were arrested in front of our eyes by the KGB, who knew it would cause a great deal of unrest and knew it would make the government of the Soviet Union look as foolish and as oppressive as it did, but that mattered not to them. Suppressing any attempt to contact the brave people behind the Iron Curtain who carried the cause of human rights only was to them an offence so serious that they felt it warranted arresting people in front of the eyes of free western observers.

2:10 p.m.

I watched fellow Jews being arrested in the lobby in front of us, being taken away screaming, asking that we carry a message to people in the west that they shouted out as they were carried away. I can remember as we left leaving my topcoat and all the articles of personal clothing we did not need, including some articles of my then pregnant wife, for the brave people left behind, whom we met in a park at 3 a.m. They knew even then they were being watched and their lives would be in peril after we left.

On this day when citizens throughout the world gather to celebrate the release of just one of thousands of imprisoned and enslaved people who only want to speak for human rights and dignity in the Soviet Union, I want to remind everyone that this brave martyr who has been freed represents thousands more who are suffering equally and tens of thousands more who will never even have the minimum human rights accorded a so-called citizen of the Soviet Union.

Words cannot be enough upon his release today. We must not use words to celebrate the release of one or two or three brave dissidents. We must use actions to back up the demand, the request, for freedom, human rights and dignity by thousands of others who are left behind only because they do not have the courage to be imprisoned or the notoriety to be freed.

Hon. Mr. Nixon: I want to speak briefly and express my relief and optimism upon the news of the release of Mr. Shcharansky, who now will be joining his family in Tel Aviv, I understand. It was regrettable that he left the eastern bloc countries with a group of spies, and the implication was that he was one of them, without implying anything other than to say he obviously was not. He had simply expressed publicly his intention to assert his individual liberties. The upside of this whole thing is that he is now permitted to leave the Soviet Union and rejoin his family.

We should see this might indicate a small or slight change of opinion on behalf of the relatively new leadership in the Soviet Union. I earnestly join with the views and hope expressed by other members that perhaps the thousands of people who feel they should and want to leave the Soviet Union to join their families elsewhere, mostly in Israel, in the reasonably immediate future will have the freedom to do so.

I was very interested in the comments of the Leader of the Opposition (Mr. Grossman). Along with the chairman of the Ontario Human Rights Commission, Rev. Stan Lucyk of Timothy Eaton Memorial Church and Miss Charlotte Gray of Ottawa, I travelled under the auspices of the Committee on Soviet Jewry. It may have been our or at least my bucolic innocence that about two years ago led us to feel we could travel by public transportation about Moscow, Leningrad and Riga, telephone and meet the people who had been refused exit visas, who -- at least the ones we met -- were very brave and realized the ramifications of meeting us.

I sometimes thought we were not doing them the greatest service by singling them out, but they seemed to be very glad to see us. I cannot point to anything positive that we did, although we did carry large amounts of material that was useful to them. We took it through customs and were fully examined but not questioned. The only thing that was taken away from me was some tapes of a Canadian Broadcasting Corp. program by Stephen Lewis on this matter. I assured the customs inspector that Mr. Lewis was a leading spokesman for democratic socialism in the western world, but that did not seem to impress him. They gave me a receipt and indicated I could pick up the tapes on my way out.

It may be that the heavy hand in oppressing is now lightening somewhat and that with hope and prayer the people who have been subjected to this oppression and repression may very well find things are better in the future. I sincerely hope that is so. The coming of Mr. Shcharansky to the west and his travelling to Tel Aviv to join his family are a remarkable indication that this might be happening.

STATEMENTS BY THE MINISTRY

EQUAL PAY FOR WORK OF EQUAL VALUE

Hon. Mr. Wrye: This is a historic day for the women of Ontario. Later this afternoon I will introduce legislation aimed at establishing pay equity in the Ontario public service.

All Ontarians can support the principle that the value of work is not measured by whether it is performed by a man or a woman. In fact, the Employment Standards Act requires that women be paid the same as men for equal work in the same establishment. However, our current laws have left women far short of reaching full economic equality.

Let there be no mistake about the reason for this legislation. This bill is about equality. We cannot speak of a just, decent, humane society if we do not mean a society with a basis of equal treatment and equal opportunity for all. From government, whose primary obligation is to ensure equality, we expect nothing less. To women, whose burden has been the injury of inequality, we owe nothing less. For future generations, whose ideas about equality we help to shape, we must establish nothing less.

The Public Service Pay Equity Act is the first legislative initiative in a program of initiatives by this government in fulfilment of this obligation. It is a clear statement by the government declaring that the economic disadvantage endured by women because they are women is now to be ameliorated.

Pay equity is not intended to penalize anyone. It is intended to redress past injustice.

Despite the dramatic increase in female participation in the work force during the past 20 years, women have been channelled into predominantly female occupations with earnings significantly lower than those of men. While there are many reasons that account for the difference in earnings, one factor that contributes to this differential has historically been the lower value placed on jobs performed by women. Our bill is intended to reduce significantly that gap in the public service.

L'équité salariale est un objectif réalisable. Elle a pour but de remédier à une injustice historique en valorisant le travail des femmes. Aujourd'hui, j'ai l'honneur de déposer une loi qui nous aidera à atteindre ce but. Notre gouvernement veut que les femmes soient rémunérées équitablement à la valeur de leur apport.

From the very outset, this government has acknowledged the inherent complexities in developing a workable pay equity policy. Ontario is fortunate to be able to benefit from the experience of other jurisdictions that already have pay equity legislation. At the same time, we have developed an approach tailored to Ontario's needs.

The bill is complex and comprehensive. It defines a sophisticated process for phasing in implementation. It achieves the twofold purpose of dealing with the technical problems of implementation and demonstrating fiscal responsibility, while building on the strengths of the collective bargaining system.

2:20 p.m.

The Public Service Pay Equity Act redresses systemic gender discrimination in compensation for work performed by employees in predominantly female groups of jobs in the public service of Ontario. It shares with the green paper the six principles that form the basis of pay equity policy in Ontario.

1. The purpose of pay equity is to address gender-based pay discrimination only and not general issues of wage levels.

2. Only employees in predominantly female occupations will be eligible for pay equity adjustments.

3. Pay equity will not require jobs to be of identical value for comparisons to be made. It contemplates comparisons between jobs of equal or comparable value.

4. Equal value comparisons will be limited to a given employer's establishment.

5. The legislation will not be retroactive prior to proclamation.

6. Wage reductions will not be permitted.

Let me outline the highlights of our legislation.

1. The act will cover about 76,000 employees, 29,000 of whom are in predominantly female groups of jobs.

2. Both a proactive and a complaints-based approach are adopted by the legislation. The first phase of the program obliges the public service employers and the appropriate bargaining units to identify inequities and to provide redress. In the second phase of the program, after completion of the proactive phase, individuals or groups of employees may register complaints about gender-based compensation practices.

3. For the purposes of determining gender predominance, a predominantly female group of jobs will mean a group with 60 per cent or more of the positions occupied by women. In the context of a proactive program, this is the most inclusive definition of any jurisdiction. A predominantly male group of jobs means a group of jobs with 70 per cent or more of the positions occupied by men.

4. A pay equity commission will be established to enforce compliance with the legislation.

5. The value of jobs will be assessed according to a composite of the skill, effort and responsibility normally required in the performance of the work and the conditions under which the work is performed.

6. Pay equity will be achieved when the pay for the representative job level in a predominantly female group of jobs is at least equal to the pay for the job level in a predominantly male group of jobs where the work performed in the two job levels is of equal or comparable value.

7. Pay equity plans are to be developed in stages. Each plan will provide for the development or selection of a gender-neutral job evaluation or comparison system; identify all predominantly female and all predominantly male groups of jobs; provide for the application of the system to positions in these groups of jobs; and provide for the necessary adjustments in the rates of compensation.

8. The legislation will specify time periods for the negotiation and development of pay equity plans and pay adjustments.

9. The first adjustments in pay are expected to be made approximately two years after proclamation. They will represent not less than one per cent of total payroll for the employees covered by each respective plan from the date of proclamation. The last pay adjustments could be made by the end of the fourth year. It is expected that total adjustments required will represent an increase of approximately four per cent of total payroll. This will amount to an ongoing increase in total payroll of approximately $88 million.

10. No employer will be required to increase the compensation payable pursuant to all pay equity plans combined, in any 12-month period, of more than one per cent of total payroll for the preceding 12 months.

11. A pay equity plan will prevail over the provisions of a collective agreement.

I commend all those persons within government, especially my colleagues the Chairman of Management Board (Ms. Caplan) and the Attorney General (Mr. Scott), and officials of our ministries who have worked on this bill so painstakingly and tirelessly.

I also commend the many persons outside government with whom we have consulted, especially the representatives of the public service unions, the Ontario Federation of Labour, various women's groups and others who have helped to shape public policy. All those persons have helped bring us to this day. I commend and thank them.

The bill I will table today is fair, balanced and workable. It is a reflection of our determination to make changes and our commitment to lead the way towards those changes.

There is never an end-point to justice; there is only a beginning. For the women of Ontario, today is their beginning.

SPRAY PROGRAM

Hon. Mr. Kerrio: All members are aware that parts of eastern Ontario, primarily in nine counties in the area of Tweed, Napanee and Carleton Place, are in the midst of a serious gypsy moth infestation. That infestation has multiplied 246 times in the past four years. By the end of 1986, we expect that 750,000 hectares will be under attack in eastern Ontario.

Gypsy moths are more than just a nuisance. In the larva stage, these insects can defoliate, weaken and eventually kill entire forests. They have the potential to damage or destroy wildlife habitat, timber and recreational opportunities. There is no doubt that if the infestations are left unchecked, the areas affected will suffer a loss of jobs in the forest, tourism and recreation industries.

Over the past month, we have conducted five open houses in eastern Ontario to outline the province's proposal for dealing with the problem as it exists on crown land. Today I would like to deal with the issue of private land.

As members know, aerial spraying is the only practical way to cover large areas of infested forest during the time the moth is in the larva stage. We believe an aerial spray program for private land is best designed and implemented at the local level.

I will be seeking authority to provide both financial and technical support for county spraying programs. This support will be formalized through agreements between the province and individual counties.

I will be recommending that, under the provincial Forestry Act, funding will be made available in 1986 to enable the nine eastern Ontario counties to reimburse private land owners who participate in an aerial spray program. An amendment to the Municipal Act is required to provide the counties with the authority to plan and implement spraying programs on private land.

To ensure all-party support for the program, a stated condition will be that funding may be applied only where the private land in question has been sprayed with bacillus thuringiensis, a biological insecticide spray.

Mr. Harris: On a point of order, Mr. Speaker: I would like to point out quickly a very serious discrepancy in the minister's statement which he may want to address even now. We congratulate him on the Bt spraying, but I cannot understand why Bt --

Mr. Speaker: Order. Would the honourable member take his seat? He may ask that during question period.

Any other ministerial statements? Oral questions; the Leader of the Opposition.

[Applause]

Mr. Grossman: Actually, that applause was for the member for St. George (Ms. Fish), who really led the fight on Bt.

ORAL QUESTIONS

EXTRA BILLING

Mr. Grossman: I have a question for the Minister of Health (Mr. Elston). He will be aware that, as well as banning extra billing by medical doctors, he is also banning extra billing by oral surgeons. There are approximately 150 of them in this province who extra bill, but in their case, only 30 per cent of their total accounts are covered by the Ontario health insurance plan. That means oral surgeons are faced with the prospect of losing up to 70 per cent of their income earned through hospital-based services, or the government will have to close that gap in one way or another.

Would the minister update us today specifically on the discussions he is having with the Ontario Dental Association and the amount or range within which he is thinking of raising the OHIP schedule benefits for opted-in oral surgeons?

Hon. Mr. Elston: We are having discussions with the ODA, but at this point I am not able to provide a range of fee schedule adjustments for the members of the House.

2:30 p.m.

Mr. Grossman: I say to the Minister of Health that he and his leader, as we will get into later this afternoon, are quite mistakenly leaving the impression that suddenly, without offsets, $54 million is going to be available to solve all sorts of health care problems throughout this province. The minister will also have to acknowledge that he is going to have to use a portion of that, perhaps as much as $13 million, to increase the OHIP schedule for the then opted-in dentists.

I suggest it is therefore very important that the minister outline today the range in which he is thinking of compensating the dentists for bringing them in, before he and his colleagues go around the province suggesting there is going to be $50 million in net funds available from the federal government. How much is it?

Hon. Mr. Elston: The gentleman will want to know there are some suggestions that the amounts of insured services within the hospital sector may be reduced for the operation of dental surgeons. That is one proposal that has been put forward to me. I am considering that. In fact, if I follow the suggestion of the ODA, there may be a decrease in the number of insured services within the hospital sector. Those things are all before us. We are taking a look at all of those options that are available to us when we consider a suggestion for the fee schedule.

Mr. Grossman: With respect, if we heard the minister accurately, he is saying the number of OHIP insured services that oral surgeons currently provide in hospitals may be reduced.

Mr. Speaker: Is that the question?

Mr. Grossman: If the minister is saying there are fewer services going to be insured by OHIP for oral surgeons, then I invite him to explain how that provides more accessibility, not less.

Hon. Mr. Elston: What I advised the honourable member in answer to his question was that a suggestion was put to me in a conversation with the ODA which would accomplish a reduction in the number of services. I have not decided to do that. The suggestion is there with respect to what that association has been putting before me.

All I can tell the member is that we are having discussions. We are actively talking to these people with respect to a range of services. I have not come to any decision at this point with respect to a range of compensable items. In fact, in all honesty, I cannot tell him today how much money is being considered there.

Mr. Grossman: One would have thought that when the minister was running around the province offering allegedly more accessibility he would have said to the ODA: "The government rejects that suggestion outright." The minister talks about inconsistency.

HOSPITAL BEDS

Mr. Grossman: I have another question of the Minister of Health. As he will acknowledge, there is a critical crisis, not a little crisis but a critical crisis, in our hospitals across this province because of an acute shortage of beds for the chronically ill.

The minister knows patients are being treated in emergency wards, in corridors, in solariums. Before the minister reminds everyone of his only answer to these kinds of things, which is that we over here have had 42 years to solve the problem --

[Applause]

Mr. Grossman: The members over there applaud that because that is the only answer they recognize.

Mr. Speaker: Question.

Hon. Mr. Bradley: I thank the member for the confession.

Mr. Speaker: Order.

Mr. Grossman: I want to give the minister the opportunity to tell us specifically what his government is doing to deal with the existing problems now. What is he doing to solve the problem, regardless of how it got there?

Hon. Mr. Elston: I have taken several initiatives with respect to meeting needs for funding of areas where there are growth difficulties and growth problems. We are looking at a number of projects in the province and are trying to come to grips with emergency room needs.

We are working with our institutional branch in a very meaningful way to address some of the problems which this gentleman has brought to our attention, rightly, as historical problems. We are working on those, and we have made some announcements with respect to programs.

Mr. Grossman: I remind the minister that there is an outstanding announcement of 4,500 nursing home beds. He recently made an announcement of allocations of 10s and 20s, and those were the allocations announced by Keith Norton in the fall of 1984.

Does the minister agree with Dr. John Mulloy of the Sudbury and District Medical Society, who says the number of active care beds at Laurentian Hospital is "unsafe" because of the overflow of chronic care patients? What specifically is the minister doing to solve that problem, or does he disagree with Dr. Mulloy?

Hon. Mr. Elston: We have responded with an initial announcement of some nursing home beds, as was indicated by the honourable gentleman, but I can tell him that we have also announced EldCap beds in northern Ontario to take some of the pressure off the requirements up there. We are working actively to address the particular problem that has been addressed by Dr. Mulloy. I do not know directly of Dr. Mulloy's situation.

I can tell the member that the Minister without Portfolio responsible for senior citizens' affairs, the member for London North (Mr. Van Horne), has done a great deal to co-ordinate the efforts to respond to the chronic care needs of this province. We are dealing with it in an overall fashion, not with the ad hockery that has been the past problem. We are dealing with it in a co-ordinated fashion, and we are working hard to come up with programs that will assist services to the elderly of this province.

In addition, the Minister of Community and Social Services (Mr. Sweeney) provided us with assistance through the co-ordinated home care program. We have also put together a chiropody program, which will help patients to remain much more independent. We have done a number of things that will help our seniors remain more active and more independent in their communities.

Mr. Rae: I know the minister will have to realize that what we are facing in this province with respect to older people who are in beds at a cost of between $400 and $500 a day and who have been in long-term care situations in hospitals for more than six months or a year, and in some cases more than two years, while we have a cancer epidemic which is becoming more serious and we have a great many physicians making severe criticisms of the nature and the ability of the health care system to respond. Those are legitimate concerns and legitimate grievances.

Mr. Speaker: Supplementary.

Mr. Rae: Why have we had no specific announcement with respect to the severity of the chronic care problem and no specific response with respect to the cancer problem, which is epidemic in the province?

Hon. Mr. Elston: In fairness, it is quite clear that we are coming to grips with the chronic care problem. As I said earlier, the Minister without Portfolio for senior citizens' affairs has been working very hard at that.

With respect to cancer treatment, we have provided equipment in Windsor. We opened a linear accelerator at Thunder Bay, and the member for Fort William (Mr. Hennessy) and the member for Port Arthur (Mr. Foulds) were there to assist me with the opening of that facility.

Many programs have been introduced in this province to deal with cancer treatment, and many ways have been introduced to keep the people who are in most need of service -- the seniors -- in their communities longer. I applaud the member for Kitchener-Wilmot (Mr. Sweeney) as Minister of Community and Social Services for the recent introduction of the homemaker's program.

Hon. Mr. Bradley: A good answer.

Mr. Grossman: About three is all it deserves. May I ask the Minister of Health this question? Given the extraordinary crisis that is out there and the fact that the Treasurer (Mr. Nixon) found in his budget, just to name four items, $60 million for roads, an alleged -- I use that word carefully -- $100 million for northern development, $6 million for tobacco farmers and is about to spend who knows how much to bring doctors back into the plan, juxtaposed against all those priorities and apart from the study by the Minister without Portfolio for senior citizens' affairs and all the generalities, can the minister tell us exactly how much money he has committed already to solve the chronic care bed problem? A one-word answer; just give us the figure.

Hon. Mr. Bradley: Is it yes or no, or what is it today?

Mr. Speaker: Order.

Hon. Mr. Bradley: Let him tell us what he wants.

Interjections.

Mr. Speaker: Order.

2:40 p.m.

Hon. Mr. Elston: I want to advise the honourable gentleman that I do not have the particular number at my disposal at the moment. I will inform the members of the House when I have had an opportunity to check that over, but I can tell them that this government has done more in the past several months than was done by the members opposite by making sure that we do not necessarily put people in institutions; we use homemaker programs and other programs to keep those people in their communities where they are able to be independent and productive and valuable members of --

Mr. Speaker: Order.

Interjections.

Mr. Speaker: Order. Will the minister take his seat, please.

Interjections.

Mr. Speaker: I do not mind waiting. I just feel sorry for the members who want to ask questions. A new question, the member for York South.

Mr. Rae: Saying they have done more than the Tories is hardly cause for a provincial demonstration.

EQUAL PAY FOR WORK OF EQUAL VALUE

Mr. Rae: I have a question for the Minister of Labour. In the Inflation Restraint Act, which his party supported in 1982, the law covered the councils of every municipality, every local board as defined in the Municipal Act, every board as defined in the Education Act, the corporation of every municipality, every hospital listed, every crown corporation, every local board of health, all the commissions and boards of government -- literally hundreds of thousands of workers, 500,000 workers in the province. When it came time to freeze the wages, they chose to define the public sector in a very general, broad and generous way, and he supported that.

I wonder why, when he chose to freeze people's wages, he managed to define the public sector in a very generous and broad way, but when it comes time to deal with the problem of equal pay he chooses the most narrow possible definition of the Ontario public service.

Hon. Mr. Wrye: I want to thank the honourable member for his question because it shows there is obviously little to criticize in this legislation. We did not bring in that legislation in 1982.

Mr. Rae: The minister supported it, voted for it and his leader was front and centre pushing for it, so he should not give me that nonsense that it was not his legislation.

If the minister chooses not to answer that question, perhaps he will answer the next one. That legislation was effective the date it was read in this Legislature on September 21, 1982, supported by him at that time. He accepted that. With respect to this legislation, he has a phase-in program that in the case of some workers will take as long as two, three or even four years. Can he explain the discrepancy in that regard?

Hon. Mr Wrye: Once again, we did not bring in the legislation in 1982. That is ancient history. We have brought in this legislation today. We believe that it is reasonable, that it is workable and that four years down the road, when the women in the Ontario public service and in the agencies, boards and commissions affected by it have $88 million more in their pockets, they will be congratulating this government.

Ms. Fish: On the question of the base to which the legislation applies, why has the minister confined the applicable base to job categories where 60 per cent of employees are women rather than to all women in the public service?

Hon. Mr. Wrye: If we had pay equity for all women in the public service, I am not sure it would be pay equity. I am not sure what it would be, but it sure would not be pay equity. In choosing the 60 per cent figure, this government has chosen a figure that is 10 per cent lower than that in Manitoba, and it is lower than that in any other jurisdiction anywhere in North America. I think that is pretty commendable.

Ms. Gigantes: The minister knows very well that the Manitoba legislation applies to the broad public sector and covers a much wider range of employees in the province than this bill will.

How are we to have confidence in the so-called commitments of this government to bring in private sector equal pay when he will not extend the coverage of his public sector bill to the public sector as broadly determined?

Hon. Mr. Wrye: I know my friend the member for Ottawa Centre is a very difficult individual to convince. She did not think we were going to bring in this bill and we have. All I can say is that the matter of the broader public sector, and indeed the private sector, is moving forward, as the member knows, and in time we will see the wider public sector and private sector initiatives.

I want to remind my friend she would not want to leave the impression that the narrow public sector and the broader public sector legislation in Manitoba are phased equally. They are not. I think she would not want to leave that impression. As well, she would not want to leave the impression that Manitoba has any private sector legislation, because it does not.

Ms. Gigantes: I would like to know what gives the minister the right to say that I believed or I did not believe legislation was coming. He has no right to say that.

Mr. Speaker: Order. New question.

EX-PSYCHIATRIC PATIENTS

Mr. McClellan: The Minister of Health will be aware of two events in the city of Toronto this week: today at city hall a memorial service for homeless people who died on the street in this city and tomorrow the beginning of another inquest into the death of Drina Joubert, another ex-psychiatric patient who froze to death while living in a truck just prior to Christmas. Many of these people who have died on the streets were constituents of mine when they were residents of the Queen Street Mental Health Centre.

I have a question for the minister arising out of coroners' inquest verdicts into the deaths of Mr. Abdel Nasser of Portugal in July 1984 and Mr. Amiti Mizrahi in December 1985. What action has been taken with respect to the verdict of the Mizrahi inquest, that medical staff at psychiatric facilities be provided under law with the means of ensuring that discharged patients are released into an environment where they will receive proper care and attention? What is he going to do to get the Gerstein report out of the limbo in which it currently languishes?

Hon. Mr. Elston: I cannot comment to the member in a specific way, but I will try to get the information together and reply tomorrow. In a more general manner, however, I can reply that every effort is made to place patients discharged from that particular institution. I have been told they place them, as much as they can, in areas where they find there are acceptable residences.

Although I guess the member has some degree of difficulty understanding, I can tell him there are shortages of approved facilities. Just recently, under the auspices of our community mental health program, we have approved three supportive housing projects. We are working very hard at a problem which has existed for a little while and we will continue to work very hard at providing suitable supportive housing in the city of Toronto.

Mr. Reville: The minister should know that those efforts are shockingly inadequate. It would have been instructive for him to have joined my leader and myself for lunch today at All Saints Church, where there is a hostel and where many ex-psychiatric patients live.

Will the minister undertake to call on the undoubted talents of his cabinet colleagues the Minister of Community and Social Services (Mr. Sweeney), the Minister of Housing (Mr. Curling), the Minister of Revenue (Mr. Nixon) and the Attorney General (Mr. Scott) and table, on the return of the House in the spring, a comprehensive plan of action to deal with the income, health and housing needs of Ontarians who, failing such a plan, will continue to die on the streets in this and in future winters?

2:50 p.m.

Hon. Mr. Elston: We have taken steps to improve the services we have provided to those people who have found themselves on the streets. The Minister of Community and Social Services has developed some programs. We have developed some responses in trying to help fund programs for supportive housing and we are working to co-ordinate our efforts with the Minister of Housing to do other things to help ex-psychiatric patients. We are working on that and I have the co-operation of the members of the cabinet in coming to grips with a very real and difficult question.

I have spent some time touring houses in Parkdale, in the area which has generally been the focus of the difficulties which ex-psychiatric patients have had over the years. I was not pleased with some of the facilities I saw. We are working hard at coming to grips with that and with providing better housing and better support for those people in the city of Toronto.

Mr. Grossman: While I do not agree with the member for Bellwoods (Mr. McClellan) on very many issues, it is the height of gall for the Minister of Health (Mr. Elston) to suggest that the member for Bellwoods has difficulty understanding the issues. With respect, we suggest the minister does not understand the urgency of this issue.

I suspect the minister has not read the Gerstein report in detail and is not in a position to comment on it in detail. It is important to note that he ignored the Gerstein report in his answer and said he would comment tomorrow.

Hon. Mr. Elston: The honourable member should get things straight for a change.

Mr. Grossman: The minister is having a bad day; it is going to get worse.

Mr. Speaker: Order. Place your question please.

Mr. Grossman: Is the minister prepared unequivocally to commit to spend as much on solving the ex-psychiatric patient problem as he is prepared to spend to pay dentists for being opted into the Ontario health insurance plan?

Hon. Mr. Elston: First, if there was some misunderstanding as to what I said to the member for Bellwoods, it was that I would reply on the inquest information because I did not have information on that item, as was suggested. If there is a misunderstanding, I apologize to the member for Bellwoods and I apologize to the member for St. Andrew-St. Patrick (Mr. Grossman), who has a way of misunderstanding a great deal.

We are making efforts to provide money to come to grips with a problem which has been there for some time. We have provided supportive housing for three new projects in Toronto and we are not unaware of the Gerstein report as the member indicated. We have followed it quite thoroughly.

Mr. Reville: It will be shocking for the House to know that those three projects account for about 30 beds and we have a couple of thousand people needing this kind of service.

For the minister's information --

Mr. Speaker: By way of question.

Mr. Reville: By way of question, has the minister not read the verdict in the Nasser inquest and the verdict in the Mizrahi inquest which say he should implement Riva Gerstein's report?

Hon. Mr. Elston: I have seen those. I am not familiar with all the details on the spur of the moment. I will make myself more familiar with those items so I can come back and tell the member for Bellwoods, the member for Riverdale (Mr. Reville) and all members what those things said and what action we have taken.

The Gerstein report is very important to us and we in the Ministry of Health are doing a great deal to bring ourselves into line with implementing a number of those recommendations.

SUGAR INDUSTRY

Mr. Stevenson: I have a question for the Minister of Agriculture and Food. Would the minister clearly state his position on the issue of a floor price for imported sugar?

Hon. Mr. Riddell: There are a lot of ramifications to the sweet sugar policy. We have written to Mr. Mayer. We have said that whatever he is prepared to do for the sugar beet growers in western Canada, he has to give the same consideration to the high-fructose producers in this province.

However, if we were to support a floor price of 25 cents or even 20 cents, the member has to understand what that would do to the processors and end users of the product in this province and in this country. It has a lot more ramifications than he would care to believe.

Mr. Stevenson: I bring to the attention of the minister that we have plants in London, Port Colborne and Cardinal. We have a 16-million-bushel market that amounts to about $60 million a year to the corn farmers in Ontario. We are very much aware of the energy that the minister put into other programs of essentially the same value. Why is he not putting the same energy into maintaining this portion of the domestic market as he is putting into other issues of similar value?

Hon. Mr. Riddell: I do not know what more I can do. As the member well knows, the sugar policy is a federal matter. Many months ago I contacted my counterparts in Ottawa and stressed that they had to give consideration to the high-fructose producers in this province if they are going to give consideration to establishing a floor price for the sugar beet producers in western Canada. I have written to the federal minister; I have sent him a telegram. I have been endeavouring to protect the high-fructose sugar industry in this province, but it is a federal matter.

SAFETY ON TRANSIT VEHICLES

Mr. Hayes: My question is to the Minister of Transportation and Communications. On July 12 my colleague the member for Hamilton East (Mr. Mackenzie) and I wrote to the minister asking him to respond to a serious safety problem resulting from overcrowding at the front of city transit vehicles. Although we have not received a response to our letter, I am sure he has had plenty of time to study this situation.

Is the minister prepared to amend the Public Vehicles Act to require a white line at the front of city transit vehicles behind which passengers have to stay?

Hon. Mr. Fulton: I thank the honourable member for his question. I am well aware of his position regarding the white line issue. We do not have time in this session, as the member knows, to introduce anything new in legislation. This issue has been under review for some time. At the request of the member and his colleague, I agreed to meet Mr. Johnson from the Amalgamated Transit Union on this issue. We did so and it is interesting to note that he did not raise this issue.

Mr. Hayes: Neither did the minister, I gather. Now that the minister has met with the transit union workers and is aware of the problem, will he assure us that he will finally take some action to remedy this very serious situation?

Hon. Mr. Fulton: I am sure the member is aware that there is a net dollar cost relative to this issue. While it is not the deciding factor --

Mr. R. F. Johnston: What about the accidents?

Hon. Mr. Fulton: The only accident that was reported to me dates back to 1946.

I assume the members opposite will ensure their support of funding for added buses that may be needed to address the issue.

PLANT SHUTDOWN

Mr. Hennessy: I direct my question to the Minister of Natural Resources. Great Lakes Forest Products in Thunder Bay announced today it is closing its waferboard plant in that city with a loss of 150 jobs. As well, in a news conference today the company said that the Ministry of Natural Resources did not fully co-operate with Great Lakes. How can the minister ignore the loss of 150 jobs?

Mr. Mancini: I cannot believe that.

Mr. Hennessy: The member does not believe anything.

3 p.m.

Hon. Mr. Kerrio: I do not think it is as easy as that. I have a note before me that deals with this issue, and there is something more than the involvement of the Ministry of Natural Resources to resolve this problem. There is a difficulty there with management and union on where to get their raw materials for the waferboard plant. We are doing everything we can to co-operate to help resolve the problem. I am sure the union and management are attempting in every way to resolve their differences. I will be helpful to the member in any way I can to resolve the issue.

Mr. Hennessy: With all due respect, that is not good enough. It is easy to blame somebody else. That is what the minister has been doing since he took office.

In all fairness, will the minister get in touch with Great Lakes Forest Products and try to save these 150 jobs? At the top of the announcement, Natural Resources was stated to be the culprit. It was to blame for the 150 jobs being lost in the city of Thunder Bay. The minister should not blame somebody else.

Hon. Mr. Kerrio: I am sure the honourable member is not suggesting I am blaming someone else. What I have said is that we have talked to the people in the mill. They have described the problem as being a difficulty in getting the raw materials.

Mr. Gordon: What is the minister going to do about it?

Hon. Mr. Kerrio: I have just explained what we are doing about it. We are doing everything we can to resolve the problem. We are going to resolve the problem by helping to make sure material flows to the mill. Right now the resolution has to come between the union and management. We are doing everything we can to co-operate.

Mr. Gordon: The minister is going to do nothing. He does not care about jobs in the north.

Hon. Mr. Kerrio: The member can say what he will, but those are the facts.

Mr. Foulds: Can the minister tell us specifically what steps he and his colleagues are going to take to ensure that the plant stays open?

Hon. Mr. Kerrio: That is a good question, an excellent question, a very sensible question. I plan to have people from my ministry meet with the management and the union to see how we can be helpful.

URBAN TRANSPORTATION DEVELOPMENT CORP.

Mr. Foulds: I have a question for the Premier. With the closing of the bids for the Urban Transportation Development Corp. today at five o'clock, will the Premier give the Legislature the assurance that no bids will be accepted or finalized by his government until a committee of this Legislature has had a chance to review them?

Hon. Mr. Peterson: I cannot give the honourable member that assurance. However, let me tell him what assurances I will give. It is my intention to consult widely on this matter, as I have said before, and to have every single thing that is done by this government reviewed. I am mindful of the fact it will have to be subjected to a very high degree of scrutiny. There will be people who disagree with what we do, no matter what we do.

As the member said, we are anticipating the close of those bids today at five o'clock. They will be analyzed very carefully. We are most concerned about maintaining those jobs. However, I cannot give the member the exact assurance he would like to have because of the time frames involved.

Mr. Foulds: Does the Premier not understand he is in danger of doing the same thing the federal government did with de Havilland, that is, signing a deal secretly without a public review of the benefits of the deal? Will he give us an assurance that he will not okay any deal that leaves the taxpayers holding the bag for the liabilities of UTDC and the private sector gaining the profits and assets of UTDC?

Hon. Mr. Peterson: I read that editorial in the Toronto Star as well. The taxpayers of the province are carrying that liability at this point, even when they hold the company. The member assumes there is some great asset against which they can prepare for those liabilities. The member's response to this matter is not one that understands the reality of how that company has functioned in the past or will function in the future, whether the taxpayers own it or whether it is owned by private enterprise.

Obviously, we are concerned about the ongoing liabilities. They exist. The member will recall that the former government signed a $300-million bond in order to sell that system to Vancouver. The member is liable for that and so am I, whether we have the company or not. If the company went bankrupt tomorrow, we would still carry that liability. In that sense, it is not one from which we can unburden ourselves.

The only real guarantee is the viability of the technology. I am concerned about the jobs and the ongoing viability of that company. This transaction is in extremely competent hands.

Mr. Grossman: The Premier alleges his government has no walls or barriers, but refuses to guarantee that this Legislature will have an opportunity to peruse that deal before the government agrees to sell UTDC. When he says he will "consult widely," and those were his words, can he specifically tell us with whom he is going to consult? Will that include the unions and, if so, which ones? Will it include people in the private sector and, if so, whom? Will it include the political parties in this assembly? For example, will it include the New Democratic Party, which is part of the accord, or will it not? Whom is the Premier going to consult?

Interjections.

Mr. Speaker: Order.

Hon. Mr. Peterson: The point is that I will consult widely. I am very mindful that governments that do not consult widely and take people into their confidence can make horrible mistakes. I look back to a government that spent $650 million on an oil company. If it had asked anybody in the private sector or anybody with any brains, it never would have done it. It is a move the member supports to this day.

We have very competent people who advise on these matters. We are mindful of the fact that jobs are one of the most important issues at stake, as well as many other commercial considerations. When we make up our minds, we will be satisfied we have the best advice possible. Unfortunately, I hate to say it, but that does not include the member because he has not demonstrated judgement that was that good in the past.

Mr. Timbrell: On a point of order, Mr. Speaker: We were informed around 1:30 p.m. that there would be no ministers absent. I see four ministerial seats physically vacant. Since my next question was to be to the Minister of Housing (Mr. Curling) --

Mr. Speaker: Order. I would love to help the member. However, I have nothing to do with that whatsoever. It really is not a point of order.

LICENSING OF TRUCKERS

Mr. Gregory: I have had a great deal of difficulty making myself heard. I have also been having a great deal of difficulty getting an answer to a question I asked the Minister of Transportation and Communications. I can understand this because apparently he has been wrestling with white lines on transit buses, which has been taking most of his time.

I am referring to my question on January 31 and a further point of privilege I raised last Thursday. In both cases, I have received no reaction. Will the minister explain his recent decision to allow the dormant licence of a Canadian trucking company, Harkema Express Lines, to be purchased by an American firm at a time when employment levels are unacceptable in Ontario?

Hon. Mr. Fulton: As I mentioned to the honourable member, the question was being fully answered for him. I inquired of my staff before question period and the answer should be ready tomorrow. The member should be aware the company in question was virtually dormant and very small in nature. The company acquiring it is taking it on to operate what exists now as a very small operation. As I said earlier, I will provide him with more complete information later.

Mr. Gregory: I am quite aware of the situation or I would not have asked the question. The fact is the licences were dormant and not being used. By making this decision, which he made on December 19 and did not remember it, these licences are being sold to an American company to operate American trucks in Ontario with American drivers, who are replacing Canadian workers who are here. I ask the minister to supply this information.

3:10 p.m.

Hon. Mr. Fulton: With respect, in answer to the member's original question, I did not say I did not remember it. Out of respect for the question and since he wanted a proper and complete answer, I said we were attempting to provide him with that.

The member is well aware they are Ontario-Canadian drivers, not American.

Mr. Hayes: Regarding the licences that the member mentioned that have lain dormant that are the property of the government, if this was not a viable operation to begin with, why would the minister put a price list on these and sell them to another corporation?

Hon. Mr. Fulton: If I understood the member, I do not think we were putting a price tag on them. We were attempting to get a dormant operation viable again in the interest of the workers of Ontario.

WETLANDS POLICY

Mr. Laughren: I have a question of the Minister of Natural Resources. It is not about spraying today but about his lack of a wetlands policy for Ontario.

He will know there has been 10 years of study, input and consultation on the part of the previous government and we still do not have a policy. Is it now true that he intends to spend up to two years reviewing feedback from 800 municipalities in the province on the possible wetlands policy? If that is true, does he not think the time for delay is passed and he should bring forth a draft wetlands policy now?

Hon. Mr. Kerrio: Yes, I do believe we should be bringing forward, as quickly as I can arrange it, a wetlands policy. I am very concerned that we are losing the wetlands and about the impact they have on the high waters. We have lost that retention. We have lost the ability of game and wildlife to have the advantages of wetlands. I shall accelerate the study of the wetlands and be very willing to share it with the members opposite.

Mr. Laughren: I hope the minister is serious in his remarks. I am concerned, however, that at a time when the policy is being drafted, there is an interministerial committee set up to review a possible policy and review the recommendations for the municipalities, but that task force does not include anyone on it from the Treasury or the Ministry of the Environment. They are certainly two key ministries that we need if we are going to have a sensible wetlands policy.

Will the minister give this House his assurance that those two ministries will be invited to have someone on that interministerial committee?

Hon. Mr. Kerrio: Yes, I think we will have to have those ministers involved, because if we are going to preserve the wetlands, I am sure there is going to have to be some concessions made for those people who are holding the wetlands. I will take that into account.

Ms. Fish: Will the minister also be bringing forward changes in the taxing laws to enable those who hold wetlands to have preferential property tax payment?

Hon. Mr. Kerrio: I do not think it is within my purview, but I will talk to the appropriate minister.

DEMOLITION CONTROL

Mr. McFadden: I have a question of the Minister of Municipal Affairs. On December 18, the minister assured this House that he would introduce legislation to control the demolition of affordable housing by the end of January. Why has he failed to honour this commitment?

Hon. Mr. Grandmaître: The honourable member will realize that our legislative agenda has been a very lengthy one. It is my intention to bring in legislation respecting demolition, I hope late in April or early in May. We will be introducing such legislation.

Mr. McFadden: When increasing numbers of units of affordable housing are being threatened by demolition, what does the minister have to say to senior citizens and other people on fixed incomes when they are in danger of losing the housing they can afford as a consequence of the minister's failure to act at this time? His failure to introduce the legislation simply delays the eventual enactment of that legislation. What does the minister have to say to these senior citizens and others who could be deprived of their housing in the next few months as a result of his failure to act?

Hon. Mr. Grandmaître: At present, Metro Toronto has the authority to stall the demolition. That is where the authority lies. It is not for me to impose on municipalities, as the former government imposed, instead of consulting and passing on the authority.

Mr. Reville: I can understand the minister's irritation at getting the question from that side of the House, but will he not agree to bring in quickly, in the new session, a comprehensive demolition control policy so that cities and municipalities across Ontario, and not just Metro, can protect their housing stock?

Hon. Mr. Grandmaître: I guarantee to the honourable member that legislation will be brought in shortly. I have draft legislation on my desk at the present time.

CANADIAN TEXTBOOKS

Mr. Grande: My question is for the Minister of Education in regard to the textbook procurement policy known as Circular 14. In view of what appeared in press reports about a public repudiation of the Minister of Citizenship and Culture (Ms. Munro) by the Minster of Education, and in view of the rejection of the recommendation of the Macaulay Special Committee on the Arts, which recommended the government "amend Circular 14 so the criteria for textbooks selected include the words `published by Canadian-owned companies,'" and since the minister appears to side with foreign-owned branch plants that control 65 per cent of the textbook market in Ontario, will the minister commit himself to strengthening our homegrown, Canadian-owned book publishing houses and thereby our culture by immediately establishing a review of Circular 14 --

Mr. Speaker: The minister.

Mr. Grande: -- with a view that over a 10-year period books will be bought from Canadian publishing houses?

Hon. Mr. Conway: As I indicated to Mr. Sheppard of the Globe and Mail, I feel confident that Circular 14 and the policy that underlines it, contain at present a strong pro-Canadian policy that has produced an approved list of publications. The vast majority -- I think it is 95 or 96 per cent -- is authored and manufactured in Canada. I have indicated to that gentleman and to others that I am quite prepared to work with my colleagues in this government, in this Legislature and elsewhere to increase the participation of Canadian authors and Canadian-owned companies.

The textbook policy of this ministry has a very strong pro-Canadian bias and is the most effective and stringent anywhere in the country.

Mr. Grande: What the Minister of Education just said suggests that a review is not going to take place. Has the minister so soon forgotten the words of the Premier (Mr. Peterson), who said, "We would not trade away Canada's heart and soul"? Why will the minister not move to strengthen this province's cultural industry in the book publishing and textbook sectors, so that the children in our schools can study Canadian books published in Canada and written by Canadians?

3:20 p.m.

Hon. Mr. Conway: I have not forgotten the Premier's very wise counsel, but I also note, if my memory serves me correctly, that something in the order of 95 per cent of all the material in Ontario's elementary and secondary schools, the overwhelming majority of textbook materials in Ontario schools, not only is authored by Ontarians or Canadians but is also manufactured in this province or country.

Obviously, I feel strongly that we must have the strongest possible pro-Canadian posture. I think what we have is very good. As I indicated to the journalist and as I am indicating to the House, I am quite prepared to work with the community to see how we can improve on that.

Mr. Davis: Understanding the discrepancy that exists within local boards as to the buying of textbooks and library books, will the Minister of Education give an undertaking to this House that he will review Circular 14 as well as encourage boards to spend more money in providing textbooks and reading materials for the young people in the educational system?

Hon. Mr. Conway: As the member for Scarborough Centre (Mr. Davis) will remember, we have discussed this matter privately. There is under way a review of the current ministry regulations as they relate to the amount of dollars dedicated to textbooks in the Ontario school system. That has been the subject of some controversy, as his friend the member for York Mills (Miss Stephenson) knows. I expect that review to be completed shortly, and I give the honourable member the assurance that it will be shared with the assembly at a early time upon its release.

CONSTRUCTION WORKERS

Mr. Pierce: My question is for the Minister of Industry, Trade and Technology. I am sure the minister will recall that in December 1985, the member for Ottawa South (Mr. Bennett) asked him whether he had made the Premier (Mr. Peterson) aware of the problems that Ontario construction workers were having in securing employment in Quebec, while Ontario's doors were open to Quebec workers to work in Ontario.

I am sure the minister is also aware that the policy of the New Democratic Party government in Manitoba is to hire only Manitobans on construction projects. It appears the Ontario construction worker now has no place to go. What does the minister propose to do about this inequity?

Hon. Mr. O'Neil: As I mentioned to the member for Ottawa South at that time, this will form part of the discussions we will have concerning free trade and interprovincial trade, and it will be raised between the Premiers.

Mr. Pierce: It will be all well and good to bring that up in the summer as a matter for discussion, but I am sure the minister recognizes that the union halls in this province are full of workers looking for work today. Workers are coming in from both sides of the province. What is the minister prepared to do today to ensure Ontario construction workers can get jobs in Ontario?

Hon. Mr. O'Neil: I guess this has been mentioned by a few people on this side of the House. The members opposite had more than 42 years to do something about it. However, the honourable member raises a matter that is very important, and I can assure him we will be discussing it both on a first ministers' level and on a ministers' level in the upcoming talks.

MINISTRY'S TIMETABLE

Mrs. Grier: I have a question for the Minister of the Environment. I have asked the minister a number of questions over the past few months, and in reading and reviewing his answers I have to say they are long on promises and rather short on action.

I will not bore the House by repeating my questions, but I want to remind the minister of a few of the items on which he promised almost immediate action: intervener funding in July 1985; the Salford dump; safe drinking water, and he assured me in November he had been working on a strategy for some time; Ethyl Canada and the St. Clair River in December with a strong regulation and an assurance of immediate action; and on polychlorinated biphenyls in foods, last December he said he would draw all the information together and provide it to members.

Can we expect a whole list of ministerial statements tomorrow, or if not, when we will get some action?

Hon. Mr. Bradley: I hate to give this answer because I know the members of the third party will agree with it, but their leader will say it is nothing to cheer about. More has been done in the past seven months than in the previous 42 years. The honourable member's leader will say that is not an accomplishment.

As the member well knows, we have moved in a number of fields to make Ontario a sounder place environmentally. She will recall that six years of procrastination on the part of the previous government was brought to an end as we proclaimed the spills bill to come into effect, dragging the party over there kicking and screaming into acquiescence, it appears at least.

She wanted action on acid rain emissions, and we developed a very strong acid rain program. She wanted us to move in a number of fields that the Speaker will not let me extol at this time.

Mr. Speaker: Not too much more.

Hon. Mr. Bradley: We have been making genuine and reasonable progress in all those fields. I would have thought the member, near the end of this session, would be standing to applaud all those efforts and the many new initiatives that will be ongoing.

Mrs. Grier: With the legacy of inaction the minister inherited, there is an awful lot more to be done. While he can take some satisfaction in what has been accomplished, what I am trying to get from the minister is some timetable for specific action that would diminish the amount of pollution that is going into our water and air and that, the minister will acknowledge, has not been diminished by his actions to date.

Hon. Mr. Bradley: The member mentioned intervener funding and I say to her, because she raised that issue, two issues of interest have come up.

Mr. Stevenson: There is an interesting tangent.

Hon. Mr. Bradley: The member for Durham-York (Mr. Stevenson) is on the edge of his seat waiting for this answer.

The member will recall that when a request was made for intervener funding in the Tricil situation, the then Minister of the Environment said, "What a reasonable opportunity to provide that kind of intervener funding to provide the balance and fairness." When the people from 3M in London came to us, we said, "Yes, we will be happy to provide intervener funding because it is very reasonable."

In many of those cases, significant progress has been made; that will be continued and accelerated as we get further on --

Mr. Martel: Is the minister getting paid by the word?

Mr. Speaker: Order.

SERVICES EN FRANÇAIS

M. Guindon: J'ai une question pour le ministre délégué aux Affaires francophones. En effet, les libéraux ont promis lors de la campagne électorale du printemps dernier de mettre sur pied une commission sur les services en français. De plus, le 4 septembre 1985, le premier ministre (M. Peterson) a déclaré que cette commission serait créée dans un mois. Finalement, le ministre délégué aux Affaires francophones est même allé plus loin à ce moment-là en déclarant que la commission en question serait mise sur pied deux semaines plus tard.

Ma question est la suivante: Je demande que le ministre nous dise exactement quand lui et son Conseil des ministres se décideront enfin à déposer la loi cadre qui avait été promise depuis si longtemps à la population franco-ontarienne.

3:30 p.m.

L'hon. M. Grandmaître: Je dois rappeler au député de Cornwall, comme je l'ai mentionné tantôt, que l'ordre du jour législatif du nouveau gouvernement libéral est très chargé et que présentement je suis en train de travailler avec mes collègues du Cabinet et du caucus du gouvernement pour présenter un projet de loi qui soit acceptable, non seulement aux trois partis politiques mais à toute la population francophone de l'Ontario. J'ai l'intention de présenter ce projet de loi le plus tôt possible, c'est-à-dire dès notre retour en Chambre.

Mr. Timbrell: That is not what the minister has been telling ACFO.

Interjections.

Mr. Speaker: Order.

Mr. Pope: The minister is talking out of both sides of his mouth.

Hon. Mr. Fontaine: The member should ask his leader --

Mr. Speaker: Order. Would the honourable members show a little respect for the chair?

Mr. Pope: Never mind the lies up north.

Mr. Speaker: Order.

An hon. member: We are on to the minister. It did not work.

Mr. Speaker: Order.

Interjections.

Mr. Speaker: Order. I am going to leave the chair for five minutes.

Mr. Speaker suspended proceedings at 3:30 p.m.

3:35 p.m.

PETITIONS

ZONING BYLAW

Mr. Hennessy: I have two petitions, for the Minister of Municipal Affairs (Mr. Grandmaître) and for the Minister of Natural Resources (Mr. Kerrio), which read as follows:

"Re: Proposed zoning bylaw, section 34 Planning Act, replacing bylaw No. 828:

"Please accept this notice to you that we, Jack Kydd of the township of O'Connor and Rene Beerthuizen of the township of O'Connor, hereby object to the passing of the above zoning bylaw on the following grounds:..."

It is signed by 150 people.

FACULTY OF ARCHITECTURE AND LANDSCAPE ARCHITECTURE

Ms. Bryden: I have a petition.

"To the Lieutenant Governor and the Legislative Assembly of the province of Ontario:

"Under the provisions of standing order 33(b), we, the undersigned, request that the annual financial report of the governing council of the University of Toronto for the year ending April 30, 1985, be referred to the standing committee on social development."

This petition, signed by 20 members of the New Democratic Party, will permit the committee to consider and hold public hearings on the proposed closure of the faculty of architecture and landscape architecture at the University of Toronto.

ROMAN CATHOLIC SECONDARY SCHOOLS

Mr. Sargent: I have 400 petition cards from citizens and students of Grey county in opposition to the funding of the Roman Catholic separate secondary schools on the grounds that it will grant special status to one specific denominational group.

There are 400 names here, and 400 will follow this week.

Mr. Henderson: I have a petition:

"To the Lieutenant Governor and the Legislative Assembly of Ontario:

"We, the undersigned, beg leave to petition the parliament of Ontario as follows:

"Whereas Ontario is a multiracial, multicultural and multifaith society;

"Whereas the people of Ontario have been well served for decades by a strong and effective public school system;

"Whereas many world-class leaders in business, academic and artistic endeavours and community leadership have been educated and trained in Ontario's public school system;

"We therefore believe that your government's proposal to extend public funding to Roman Catholic separate secondary schools is a backward step because it will grant special status to one specific denominational group and thereby weaken the public school system as it currently exists and discriminate against other denominational groups who may accordingly wish to establish similar publicly funded separate school systems;

"We therefore urge you and your government not to proceed with what we view to be a highly divisive proposal, and we urge you to abandon your proposal for extended funding to separate schools forthwith."

That is signed by Jerry Stein and about 1,000 members of District 12, Etobicoke, of the Ontario Secondary School Teachers' Federation.

ABORTION CLINIC

Mr. Pierce: I rise to present a petition on behalf of 35 citizens of the district of Rainy River with respect to the regulations that are allowing the Morgentaler Clinic to stay in operation. I will not read the "therefore," because it is very lengthy.

3:40 p.m.

CONSTITUENCY BOUNDARY

Mr. Pollock: I have a petition that reads as follows:

"To the Lieutenant Governor and the Legislative Assembly of the province of Ontario:

"Whereas both reports of the electoral boundaries commission have recommended that the townships of Thurlow and Tyendinaga, the town of Deseronto and the Tyendinaga Indian reserve be removed from the Hastings-Peterborough constituency;

"Whereas these municipalities are part of Hastings county and work with the provincial and county offices in the city of Belleville, the county seat, rather than offices located in other county seats;

"Whereas these four rural municipalities have a community of interest with other rural municipalities in Hastings-Peterborough;

"Now therefore we, the undersigned, petition the Lieutenant Governor and the Ontario Legislature to leave the townships of Thurlow and Tyendinaga, the town of Deseronto and the Tyendinaga Indian reserve in the Hastings-Peterborough constituency."

It is signed by 15 members of the Melrose Women's Institute.

I have another petition, which reads:

"To the Lieutenant Governor and the Legislative Assembly of the province of Ontario:"

I will skip over the middle section, it is the same as the one I just read, and come to the last paragraph:

It is signed by 62 Tyendinaga senior citizens.

REPORT

STANDING COMMITTEE ON PUBLIC ACCOUNTS

Mr. Harris from the standing committee on public accounts presented its report as follows:

The committee begs to report it has completed its consideration of the report on the audit of forest management activity by the Office of the Provincial Auditor, which was referred to the committee on December 6, 1985.

MOTION

COMMITTEE SITTING

Hon. Mr. Nixon moved that the standing committee on procedural affairs and agencies, boards and commissions be authorized to meet following routine proceedings on Wednesday, February 12, 1986.

Motion agreed to.

INTRODUCTION OF BILLS

PUBLIC SERVICE PAY EQUITY ACT

Hon. Mr. Wrye moved, seconded by Ms. Caplan, first reading of Bill 105, An Act to provide Pay Equity for Employees in Predominantly Female Groups of Jobs in the Public Service.

Motion agreed to.

ONTARIO INSTITUTE FOR STUDIES IN EDUCATION AMENDMENT ACT

Ms. Bryden moved, seconded by Mr. Philip, first reading of Bill 106, An Act to amend the Ontario Institute for Studies in Education Act.

Motion agreed to.

Ms. Bryden: The purpose of the bill is to give the Ontario Institute for Studies in Education the power to grant degrees, including honorary degrees, diplomas and certificates in education.

MUNICIPAL AMENDMENT ACT

Hon. Mr. Grandmaître moved, seconded by Mr. Morin, first reading of Bill 107, An Act to amend the Municipal Act.

Motion agreed to.

Hon. Mr. Grandmaître: This bill will enable counties to participate in a program that is being initiated by my colleague the Minister of Natural Resources (Mr. Kerrio) to combat damage to our forests being caused by gypsy moth infestation in eastern Ontario. I hope all members will support this legislation and thus enable counties to participate in this important Ministry of Natural Resources program in eastern Ontario.

Hon. Mr. Nixon: Mr. Speaker, before I call order 20, I would like to indicate to you and the clerks at the table that an agreement has been reached among the three parties that the debate on this order will be completed at 5:50 p.m. so a vote may be taken. We have requested that the final 30 minutes be reserved for the minister and that the intervening time be shared equally between the two opposition parties.

Mr. Wildman: That is all very reasonable.

Hon. Mr. Nixon: Whatever the time is, it would be approximately 45 minutes. I am sure we have sufficient expertise and electronic technology to work it out for us.

Mr. Speaker: Does the House agree to that allotment of time?

Agreed to.

ORDERS OF THE DAY

HEALTH CARE ACCESSIBILITY ACT (CONTINUED)

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

Mr. Baetz: In the interests of time and to give my esteemed leader ample time for his final words, I will confine my remarks to what I believe are some of the basic underlying issues, principles and philosophies of the extra billing controversy.

I believe the issue is not really an administrative, operational or functional one; rather, it is a philosophical one. It is a matter of basic principles and policies. To the extent that there is a lack of clarity and uncertainty about basic policy, there will be an equal amount of uncertainty and consequent disagreement at the administrative and operational levels.

I believe we would all agree and support the idea that basic services provided by our health care system should be universal, accessible to all on an equal basis, regardless of ability to pay. Moreover, we would all likely agree that this system is based on certain established rights and that these basic services should therefore be provided as a right rather than as some privilege that can be arbitrarily extended or withdrawn.

We should not allow our mental processes to be muddied by thinking that health care in Ontario is an insurance. It has long ago lost all the fundamental vestiges of an insurance program, and indeed the Liberals were about to remove the last one with the removal of premiums.

Much of the confusion arises over the fact that many people assume all rights are exactly the same: a right is a right is a right. In reality, there are essentially two different types or categories of rights. The first are those traditional and clearly defined: legal, civil and political rights that deal with the rights and freedoms of the individual. These rights are refined and protected through our common law. The essence of these rights is that they guarantee the equality of all individuals. Under these rights, we are all treated equally at all times and in all circumstances.

3:50 p.m.

There is a second category of rights, namely, social rights, sometimes called collective rights. Social rights are a relatively new concept in social policy and have been fully developed only since the Second World War. This concept was brought together for the first time in the Universal Declaration of Human Rights in 1948, followed by the covenant of 1966. Articles 22 to 26 deal exclusively with social rights, and article 25 especially is the cornerstone of much social legislation around the world since then. It states in part: "Everyone has the right to a standard of living adequate for the health and wellbeing of himself and of his family, including food, clothing, housing and medical care and necessary social services."

There is a fundamental difference between the traditional legal, civil and political rights on the one hand and the more recent concepts of social rights on the other. The difference is that the former guarantee equality for all under all circumstances, while the latter guarantee equality for all, but only up to an adequate level in the provision of income, housing, education, health care, etc.

For example, the right to an adequate income, while it may apply to every member of the population, extends up to only a certain minimum level, after which people are on their own. Likewise, the social right to adequate housing extends only to a certain adequate level and does not guarantee a home on the Bridle Path. The right to an education extends only to a certain level for all people, beyond which individuals are on their own.

It is also important to note that levels of adequacy are relative. What is regarded as adequate varies from time to time and from country to country. It is determined by prevailing social values of the governing society and, above all, by the economic resources available to any country.

The basic question then is, on what kind of rights is our health care system based? Is it built on legal, civil and political rights or on social rights? I suspect that because this question has rarely been clearly addressed or concisely answered, it is the cause of much debate and controversy, including that over extra billing.

I believe our health care system is based on social rights rather than on legal or civil rights. It is based on social rights that have been implemented and supported by federal and provincial legislation. The level of service guaranteed as a right by legislation is very high because our value system and our widely accepted scale of public priorities places health care at the very top of all our programs that are based on social rights.

The manner in which health care costs have escalated during the past decade, compared to those of other social programs based on social rights, such as education, basic income security and housing, clearly reflects the very high priority we have placed on health care. There is no evidence that this scale of priorities will change, but the development of our basic health care system, based as it is on social rather than on legal rights and limiting its guarantees to adequate levels, will develop in both quantity and quality on the basis of our social priorities and the economic resources available.

If the right to health care were a legal and civil one, there could be no talk whatever of affordability. Our legal and civil rights are inalienable and are not subject to prevailing social priorities and economic restraints.

No doubt there are those who would argue that our health care system is and should be based on legal and civil rights rather than on the more limited social rights. They would probably point to older, more developed social democratic countries as examples of where health care programs are based on and do try to function on the egalitarian principle of civil and legal rights.

I would dispute their observations. In my eight years as elected president of the 84-member-nation International Council on Social Welfare, I had a golden opportunity to meet with social policy leaders in many countries on all continents. I know of no country in the world where the health care system actually operates on the basis of legal and civil rights in a purely egalitarian manner, even if it may have started out to do so.

Quite a few members here like to cite Britain as the shining example. Sir William Beveridge, the master builder of the post-Second-World-War social security system, including health care, probably did not worry very much about whether the system was built on legal or on social rights. He was essentially a systems and organization man and not a social philosopher. He was convinced his proposed system would be so efficient that in a few years' time the backlog of health care needs would be met and costs would sink.

The then Minister of Health, Mr. Bevan, was less sanguine; as a politician he was probably more aware of human nature. However, he was convinced that the monolithic, all-inclusive national health care scheme would work if he spent enough money virtually to bribe everyone to participate. He got the British Meal Association to agree because, in his words, "I stuffed their mouths with gold."

We all know what happened to the National Health Service. It staggered and folded under its own bureaucracy, its own weight of ever-growing universal demand and a stifling bureaucratic delivery system.

Mr. Rae: Rubbish.

Mr. Wildman: What has Thatcher done about it?

Mr. Baetz: I will give the member some facts. While 56 million Britons are entitled by right to full, free health care and equal accessibility, in reality at any given time, some 650,000 patients are waiting for 350,000 places.

Mr. Wildman: Even Margaret Thatcher does not agree with this.

The Deputy Speaker: Order.

Mr. Baetz: To alleviate this unsurmountable pressure for health care through the central health services system, many Britons have been permitted and even encouraged to turn to private care outside the national scheme. The trade unions, the vehement opponents of private medical care, now enrol many of their members in private plans along with some 10 million Britons.

In conclusion, the basic policy issue facing us on the extra billing question is the following:

Is our health care system a purely egalitarian one, based on civil and legal rights that guarantee but also restrict all patients to an equal level of service at equal cost in any and all circumstances, or is the system based on social rights that guarantee an adequate level -- and in our case, that is a very high level of service for all -- at an equal cost but allow the patients and doctors the right to contract for extra service at extra cost to the individual patient?

If the system is the latter, as I believe it should be, it surely allows for some personal choice by patients and doctors, provided the basic guarantees for all have been met as a social right.

By outlawing all extra billing, as it will, even if the doctors have met their basic guarantees, this bill will attempt to force our health care program into the straitjacket of one monolithic, inflexible, bureaucratically run system where accessibility and standard of care will ultimately be reduced to the lowest common denominator. As I said before, this system has not functioned in any part of the world to everyone's satisfaction.

In pursuit of this goal, the bill will seriously infringe upon the civil and legal rights of personal choice, the right to contract for the doctors; and the rights of doctors and the patients will be removed.

Finally, the traditional rights, responsibilities and privileges of the doctors arising out of their free association in the Ontario Medical Association will be seriously eroded. No trade union would tolerate such an intrusion and erosion of its mandate. All these rights -- the right of personal choice, the right to contract, the right to freedom of association -- are essential elements in our free, democratic society.

Mr. Wildman: Why did the member introduce Bill 179?

Mr. Speaker: Order.

Mr. Baetz: Those rights are the distinguishing features that separate us from the planned socialist state.

This is the issue the minister has so far refused to discuss even though he may honestly feel he has done so. The quotation in the Toronto Star on Tuesday, February 4, is the most revealing in this respect. The minister is quoted as saying: "I have always been willing to discuss the issue with doctors. What I am not willing to negotiate is maintaining extra billing...." That is the only issue.

I urge the minister to lay down his pistol and sit down with the doctors to discuss some of these very basic issues, policies and philosophies with them. Once the minister has reached consensus on those basic principles, he will undoubtedly reach agreement on those practical obstacles that are or appear to be standing in the way of guaranteeing the social right of basic health services to all regardless of cost.

I am confident the doctors, through their association, could very quickly meet the practical requirements we are all looking for. However, if the minister insists on stubbornly pressing on with the bill without prior discussion of the basic issues involved, I very much fear our health care system, which must constantly strive to reach the ever-receding horizons, will falter and accessibility for all, and even basic services, will become only a sad memory and an unanswered dream.

Finally, in the negotiations the minister should be carrying on with the doctors, he should learn the mistake of Health Minister Bevan, that he cannot make it work without the doctors' co-operation and that he cannot make the doctors co-operate simply by stuffing gold into their mouths. In this case, it is principles that are more at issue than gold.

4 p.m.

Mr. Rae: I want to start the debate by agreeing with both the member who has just spoken and the Ontario Medical Association in one respect. I agree with Dr. Myers or the member for Ottawa West (Mr. Baetz) or any other spokesman for the OMA when they say the debate and the issue is not a narrow one, but an issue that reflects on some very fundamental questions, not only about our health care system, but about our society. It does involve some very basic questions about our values. I also want to state that my agreement with the member for Ottawa West and with the OMA ends right there.

Our attitude to our health care system reflects two things. It reflects our attitude to health and it reflects our attitude to each other. When I talk about it reflecting our attitude towards health, we have to appreciate that there has been over the years a very real debate among those who have had in their minds, in their policies, in their politics and in their economic structures, the notion of health simply as the absence of disease, the treatment of which should be purchased on an open market. That is a model for those who see the essential problem as a medical business problem.

In the first view, health care is basically the treatment of individual disease, an engineering problem, a medical problem. However, I want to suggest that in the transformation of our society and in the transformation of all societies around the world a different definition of what health is all about has emerged and a different notion of what the health care system should be about.

The member for Ottawa West quoted many learned documents. I would like simply to quote the definition of health as contained in the charter of the World Health Organization, where it says, "Health is the state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity." From that definition of health comes a very different definition of our health care system, because it means that wellbeing is a basic human right and that wellbeing is something that society has an obligation to ensure to the very best of its ability. There is a conflict about dollars and about values.

We have those who see health as a vehicle for private profit, a market of wants to be supplied by shrewd and capable professionals, a medical market with health as a commodity. In this regard, I would like to quote what I have found to be an extremely apt description of what that kind of attitude and system are all about. It is contained in a remarkable book recently published by Paul Starr of Harvard University called The Social Transformation of American Medicine.

So much of what we are discussing in this House takes place under the shadow of the increasing commercialization of medicine in the United States. Mr. Starr has these very acute words to say at the end of his book, in the section entitled "The Struggle for Medical Care":

"Those who talked about health care planning in the 1970s now talk about health care marketing. Everywhere one sees the growth of a kind of marketing mentality in health care and, indeed, business school graduates are displacing graduates of public health schools, hospital administrators and even doctors in the top echelons of medical care organizations.

"The organizational culture of medicine used to be dominated by the ideals of professionalism and voluntarism, which softened the underlying acquisitive activity. The restraint exercised by those ideals now grows weaker. The health centre of one era is the profit centre of the next."

That is precisely the context in which this debate is taking place. I am delighted that both the Minister of Health (Mr. Elston) and the Minister of Community and Social Services (Mr. Sweeney) are here, because they know full well about the case of the London hospital and about the nature of the presence of private profit-oriented groups that are intensely interested in marketing their activities in the nursing home field, a subject I have been talking about ever since I came to this House.

We are in the middle of a broader and deeper debate about the nature of health and how we promote it. It is a debate about whether we see health as a market to be exploited by capable and shrewd professionals, organizations and corporations, whose entire underlying need is to increase their share of the market and their profits or whether we see health as something else.

Health is something else. It is not a commodity. It is not something to be traded on the open market. It is a basic human right that reflects our attitude to each other. That has to be the principle that is in place. That is what this issue is all about. It is not a narrow issue.

Mr. Pope: Straw man.

Mr. Rae: I see the Tories saying it is a straw man. It is not a straw man. That party has presided over the erosion of the health care system and the increasing presence in our society of corporations that are interested, not in health care as a need but rather in health care as a market. We defeated that government after May 2. I am proud we defeated it and it was in large measure because of this that we did it.

There are those who say we are talking about the socialization of medicine. To those who say that, I say amen; we are talking about the socialization of medicine. We are saying that health is an individual and social right that is too fundamental to be left and treated as a commodity.

In the history of this province and in the history of our country, this is not a new debate. Indeed, in the history of western societies, it is not a new debate. It has been going on for a long time and I suspect it will continue to go on for a long time because of the presence in the United States of a very different kind of society, economy and attitude towards health care.

The notion of a decent public health insurance system that established the principle that health care is not something to be treated as a commodity goes back to many organizations in our country. It goes back to the emergence in the late 19th century of a modern labour movement. It goes back to the organizations that took place in the Prairies after the emergence of the great wheat economy, with the emergence of political parties and movements that were concerned about the ability of people to form a different kind of society together.

It was part and parcel of the work of early labour parties and early democratic socialist parties in this country and in this province. It has been adopted as an objective by countless professional groups, by countless groups of individuals who were concerned about the care people were getting in our emergent society in Ontario in the 20th century.

The objective of a national health insurance plan as a basis for public policy was adopted by the Liberal Party of Canada at a convention in 1919, the same convention that elected Mackenzie King as its leader. The Liberals were only in power between 1921 and 1930, and from 1935 to 1957, so one will certainly have to agree that they hardly had the chance to implement the resolution they adopted at their convention in 1919.

4:10 p.m.

It is interesting, and I think little known, that it was a government in British Columbia in 1932 that passed a bill that covered people earning less than $2,400 a year, which was never proclaimed or implemented because of the systematic opposition of the British Columbia Medical Association between 1932 and 1937. It was finally dropped.

We have to turn to Saskatchewan to find the origin of a truly social health insurance plan, beginning with municipal plans, a plan in the Swift Current area which included everybody who lived in the region, a movement designed to eliminate tuberculosis in Saskatchewan, so that in the 1930s and 1940s Saskatchewan had the lowest rate of TB of any province in Canada, and culminating, as we all know, with the election in 1944 of the first Co-operative Commonwealth Federation government, indeed the first democratic socialist government at provincial or state level in North America.

It was Mr. Douglas who introduced, first, hospital insurance. We have to think of the courage it took for a provincial government to initiate on its own a hospital insurance program without any assistance whatsoever from the federal government. That assistance was held up consistently throughout the 1950s by Ontario. It was Ontario that said, "We will not have a national plan, and until we have one, you cannot give any money to anybody else."

One has only to read the recently published memoirs of Paul Martin to understand just how profound was the opposition of Ontario under the Tories to hospital and health insurance during the 1950s, to appreciate the courage that was exemplified by the Douglas government, going ahead on its own with hospital insurance.

It was after 1959 that Mr. Douglas announced that the government was not going to stop at hospital insurance. It was going to introduce a comprehensive health insurance plan which would contain the basic principle that no one would suffer or be forced to pay private insurance. No one would be forced to pay doctors directly. There would be a universally accessible plan that would be fair to the profession and the citizens of the province.

When the minister introduced this legislation in the House, he referred to Mr. Justice Emmett Hall as the father of medicare. I had to laugh at that point. I realize central casting has given all Liberal ministers instructions not to mention any New Democrat, the accord or anything else in any conversation, speech or otherwise. I just want to quote for the record what Emmett Hall said about Tommy Douglas.

He wrote to him in 1971, as Mr. Douglas was retiring from the leadership of the New Democratic Party, and said: "I just cannot let the occasion pass without writing to say that Canada is very much a better country in which to live by reason of your contributions in the political and social action fields.

"I think your greatest and enduring accomplishment was the introduction and putting into effect of medicare in Saskatchewan. Without your program as a successful one in being, I could not have produced the unanimous report for the Canada-wide universal health recommendations in 1964. If the scheme had not been successful in Saskatchewan, it would not have become nationwide. Generations to come will be your debtors."

I do not think any of us could put more eloquently than those words of Mr. Justice Hall the debt the people of Canada owe to Mr. Douglas for the courage he showed in introducing medicare to Saskatchewan in 1962.

It was a tough, tough battle. I do not know what the minister has been reading at night. If he is like me, that is the only time he gets to read anything. I suggest he take some comfort as he meets the challenges he faces. He can take some comfort from the courage that was shown by a government that had no friends anywhere in Canada. It was called every name in the book by those powerful vested interests opposed to any change. It was vilified up and down the country, opposed by the Liberal Party of Saskatchewan -- at that time under Mr. Thatcher -- the Saskatchewan Medical Association, the Canadian Medical Association and the entire insurance industry in this country. That government had the guts to proceed and prevail. I hope this government has the same kind of courage when it is faced with the opposition of vested interests.

I have been reading for some time about what has gone on in the past regarding this issue. I want to quote from a comment, a remembrance by Dr. Orville Hjertaas, who was one of the few doctors who had the courage to practise during the strike in 1962. I am quoting from Weekend Magazine of July 15, 1978.

"Dr. Hjertaas describes a situation where a child with an acute appendicitis attack needed an immediate operation. Dr. Hjertaas browbeat a local anaesthetist into assisting by threatening to announce on radio and television that the anaesthetist was abandoning the child. That worked only once. Two subsequent patients having spontaneous miscarriages had to be turned over to the hospital emergency committee.

"He says: `They lay in bed at the hospital for a week bleeding. No one took them to the operating room to be scraped. That was the kind of pressure tactic they used. I came into one of the women's rooms one night and found her husband sitting beside her in tears, a great big man with tears coursing down his face watching his wife helplessly.'

"At the end of the first week of the strike, a British anaesthetist parachuted in by the government arrived at the clinic. Shortly after dawn on a Sunday, Hjertaas and the anaesthetist slipped the two women into the hospital operating room for a D and C. `That did not endear me to the profession,' said Hjertaas wryly."

Where was Ontario when this great battle was going on? Nowhere to be seen. Ontario was on the side of the insurance industry. Ontario's government was the captive of the Ontario Medical Association and the Canadian Medical Association. We had a half-baked bill brought in by John Robarts in 1966 which would have left 40 per cent of the patients excluded from the system.

It is interesting to look at the reaction of the Tories to those great debates in the 1960s and early 1970s. A comment made in Mr. Robarts's most recent biography is that one of the things John Robarts regretted most about the time he was the Premier was the fact, as he puts it, "Medicare was rammed down the throats of the people of Ontario by the Pearson government in Ottawa." That is where the Tories have stood on this issue. That has been their contribution to this historic debate.

With the work of the minority governments in the mid-1960s, we finally made medicare the law, not only in Saskatchewan but across Canada. We forced the changes in Ontario until we finally moved to the Ontario health insurance plan system, proclaimed in 1971.

The health care system that has been built by the people of this province is one of the achievements of which we as a people can be most proud. To extend, deepen and strengthen that system is one of the greatest political tasks of our time, and it is not one we are going to be turned away from because of the vested interests of the Tory party or the vested interest in the insurance industry or the vested interest in the Ontario Medical Association.

4:20 p.m.

People talk about what the medical association's position has been. I speak as one who is the grandson of a doctor and the nephew of a doctor and I see doctors almost every day in my wife's family. It is not a question of the individual or professional integrity of our doctors in Ontario; it is a question of the opposition of the OMA with its historic, deep-seated failure to understand that the idea of universal accessibility is so dear to the hearts of the people of this province that they simply will not have it denied.

It is regrettable that we are in the middle of a very difficult conflict, but if there has to be a conflict, then all I can say is let us resolve it with courage, but let us always resolve it in favour of the people of the province and not in favour of a vested interest that has always been opposed to the extension of health care. They opposed it in British Columbia in the 1930s, they opposed it in Saskatchewan in the 1960s and they opposed it in Ontario in the 1960s and the 1970s. They have always opposed the notion of universal medical care itself. We have to bear that in mind when we examine the position of the Ontario Medical Association today.

With respect to the problem of extra billing, I want to suggest that our party took up the cudgel once we had moved the country and the province to the point of accepting the need for a universal scheme. We launched a campaign in the late 1970s, a petition that was signed by more individuals in this province than any other petition presented to the Legislature up to that time.

One of the very first experiences I had as an elected federal member was meeting with a woman in my constituency office in the fall of 1978 and being told by her that she was being charged an extra $400 for surgery on her shoulder. I can remember the argument and the discussions we had in our caucus federally. I can particularly remember them because Tommy Douglas was completing his career on the federal scene in the six months prior to the election of May 1979. I can remember the eagerness and determination with which Tommy encouraged our federal leader to take up the case and raise it, as we did raise it consistently throughout that period, to get the federal government to move. We had members here, the former Health critic behind me and sitting with me, who raised the issue consistently.

I want to recite a few of those cases so people will remember how serious this problem is and how much it has contributed to a sense in the province that extra billing does amount to a barrier and does raise a problem. I want to quote a few if I may.

A constituent of my colleague the member for Sudbury East (Mr. Martel) called to complain about extra bills she had received for medical services performed by an ophthalmologist in Toronto. The amount extra billed for the first visit was $15.20. The amount extra billed for the second, an operation, was $687.20; that is 180 per cent above the OHIP rate. On June 22, 1983, the amount extra billed was $218, for a total of $920.88. The family depends upon Mr. Stewart's salary, which is $18,000 annually. That is the reality for the Stewart family of Sudbury East.

A member of another family living in Willowdale, who has asked that the name not be used, had coronary bypass surgery on September 3, 1980. The amount extra billed was $600. This would not be so onerous if it were not for the fact that Mrs. C has had a series of operations on nose, ear and eye related to cancer and the side-effects of the treatment she took in 1981. To correct the problem, Mrs. C was obliged to see four doctors in all, and each and every one of them overbilled.

Another case I raised in the House occurred on April 29, 1983. A woman was advised, while her daughter was sitting undressed in her hospital room ready for a tonsillectomy, that the anaesthetist's charges would exceed the OHIP rate. I am sure the House will recall that case, because it forced the government to make some changes. She then proceeded to receive a letter from the managing partner of a group called Don Valley Anaesthetists, which said: "It is also apparent that you were misinformed as there is only one fee schedule for medical services in Ontario and that is the rate published by the Ontario Medical Association."

What arrogance. Here we have people who have been practising for years under the Ontario health insurance plan and they are pretending it never happened, as if the only rate in effect was the rate established by the OMA.

She then received three invoices from Don Valley Anaesthetists and finally a letter from Dixon Commercial Investigators Ltd., a multinational company retained by Don Valley Anaesthetists to collect the account. The letter she received from that group contained the wording, "Your credit record is an open book." That is just one example.

Let me give another example of a gentleman in London who visited a hospital for eye surgery. He was extra billed for each consultation as well as for the hospital visit and the anaesthetist's services. The services charged to him amounted to more than $300.

I could go on and I will raise a couple of other examples because they describe how serious the problem was, is and remains. There are those who say it is not a problem. All I say is that they are flying in the face of the facts that have been presented and have been expressed by every senior citizens' organization and by people who are faced with a virtual monopoly of anaesthetists, for example, who are opted out, a whole slew of psychiatrists who are opted out, a whole range of obstetricians and gynaecologists who are opted out in given areas and where there is no choice given to the patient.

The member for Ottawa West spoke about the importance of choice. What choice do people have who are going in to have an operation where every doctor in that hospital is opted out and insists on an extra fee? What level of choice is there in countless parts of the province where the only specialists available are those who have opted out?

For example, there is the letter raised by my colleague the member for Timiskaming (Mr. Ramsay), whose election to this House added a breath of fresh air to the entire place. I am sure we all agree. This is a form letter from a doctor to a constituent who was told she would have to pay $3,000 for an operation, of which only $1,700 would be reimbursed. The form letter from the doctor states as follows:

"It is the responsibility of the patient to pay the doctor's invoice in full within 30 days of the date stamped at the top of invoice. After that time, interest is charged on the outstanding balance at a rate of two per cent per month."

Who do these guys think they are? Who is better able to afford to carry the cost of slowness in receiving an OHIP cheque: a doctor making $125,000 a year or somebody who has to get by on $15,000 or $20,000 a year? Where do these doctors get off sending these kinds of letters to people and then coming to us and saying: "It is not a matter of money. It is a matter of principle." Give me a break. Surely to goodness, people can see the situation for what it is.

This is a woman who had to spend more than $3,000 on 14 day trips to prepare for this operation. I add that the letter was written before we managed to change the situation with respect to people having to travel for medically necessary care.

For those who say, "The problem is one of yesteryear," I want to mention a case brought to my attention today by my colleague the member for Scarborough West (Mr. R. F. Johnston). The surgeon gynaecologist's bill is $1,005. OHIP will pay $469. That is an extra billing amount of 114 per cent. In addition, he has been told the anaesthetist will probably bill 40 per cent over the OHIP rate. The family has to agree to pay his bill within two weeks of the surgery. This is for a cancer operation.

Where were the Tories throughout these years? They told us it was not a problem or an issue. The then Minister of Health, now the Leader of the Opposition (Mr. Grossman), had all sorts of excuses. He said, "The only people who get extra billed are rich people." We asked him time and again and he never once produced a single fact to back that up. He just said it as a matter of faith. He knew that. The only people who were extra billed were rich people from Toronto.

He was even in Sarnia the other day saying the same thing. He said: "Extra billing is a Toronto issue. It is one of these other yuppie issues such as clean water. It is another one of those yuppie issues that nobody else has bothered about except for yuppies." I have news for the former minister; we remember what he said.

4:30 p.m.

What else did he say? After receiving a letter from my colleague the member for Windsor-Riverside (Mr. D. S. Cooke), who has done such a marvellous job in recent years on this issue as our health care critic, the Minister of Health at that time stated: "The total surgical fee of $1,200 charged by the ophthalmologist is $200 more than the OMA rates. His other charges have not exceeded the OMA rates," as if that should matter at all.

The OMA rate is negotiated by doctors, with doctors, for doctors. It is not a rate that is set by tough, hard bargaining among the OMA. It is a rate that is settled by the profession itself. It is not negotiated with anybody. It is established out of thin air by the profession itself.

It says, "The anaethetists' fee is the OMA rate, and the reimbursement that they receive is in accordance with the OHIP schedule of benefits." He then goes on to say:

"I would suggest that Mrs. D discuss the matter of the extra billing with her physician. It is our experience that opted-out physicians frequently reduce or waive the extra fees in cases of financial hardship."

Charity medicine should have gone out decades ago. Charity medicine should have been killed off in Saskatchewan in 1962. It was, for them. It should not exist in Canada and Ontario today. We should not have Ministers of Health saying to people, "If you want to settle your disputable fee with your doctor, get down on your knees and tell them how badly off you are," and that will settle the issue.

I want to quote something that Tommy Douglas said in 1959 in the Saskatchewan Legislature when he introduced the principle of medical care to Saskatchewan. He said:

"I want to say that the time is surely past when the people should have to depend on proving need in order to get services that should be the inalienable right of every citizen of a good society. It is all very well for some people to say that there is no stigma or humiliation connected with having to prove need. This is always said by people who know that they are in no danger of ever having to prove need themselves."

When I see the letter of the Minister of Health, I think of what Tommy Douglas said in 1959 in his eloquent reply to that kind of answer from a Minister of Health or from doctors who say that they are the ones who should be assessing need, that they are the ones in a position to assess whether there is a problem.

What has the response of the OMA been to this legislation? The response has been this. I think it has basically been sixfold. I want to deal with those six arguments.

The first thing they have said is: "It is not extra billing; it is balanced billing. It has something to do with the OMA schedule." I have had doctors come into my office, very sincere people, and say: "Mr. Rae, I wish you would not keep using that phrase `extra billing.' It is not extra; it is balanced. All we are doing is charging the balance between the OMA schedule and the schedule that is negotiated with the government and paid for by OHIP."

All I can say to the OMA is: "Please, with respect to that argument, come into the 20th century. Recognize the fact that the rate that matters to the people of this province is the rate that they have to pay. If they have to pay you an amount over and above the rate that is given to them by OHIP, it is extra for the people. Let us stop the notion of balance and all the other fictitious arguments pulled out of the air. It is extra. It comes out of people's pockets. It is money they have to pay. It is money they are spending on that that they cannot spend on other things. It is extra. It is not balanced; it is extra."

The second argument they make is that it is not a barrier. I have heard this argument expressed by the leader of the Tory party: "Let the doctors judge. Let the doctors judge because they know." I have seen it quoted again recently in this debate. The doctors said: "I know whether a patient needs it. I have a sense as to whether they need it. I can tell whether they are on welfare. I know my patients well. I can judge whether they can afford it."

That occupational arrogance is ill suited to a profession working in the field of health. It is not up to doctors to determine what people's incomes are. It is not up to doctors to determine whether they feel somebody else is in need. That is not the job of doctoring. That is not what doctoring is all about, and it is time we put that argument to rest.

I am not interested in discussing my financial affairs with my doctor, and I do not think any other patient is either. I do not think they should have to discuss their financial affairs with their doctors. To quote from Mr. Douglas again: "That argument is always made by people who know they are in no danger of having to prove need." How true that is.

The other argument we hear from the Ontario Medical Association is that the right to extra bill recognizes seniority, to which I will simply say: "Rubbish, it does no such thing." There is no way of telling whether a doctor who has opted out or who extra bills is senior to somebody who stays in the system. There is no evidence anywhere in the province to suggest the basis upon which people extra bill is whether they are senior to someone else. That is factually incorrect.

What we do know is that extra billing and opting out follows a pattern. It is a pattern that has nothing to do with seniority. It has everything to do with peer pressure, with the ways in which certain groups in a monopoly situation can work in certain areas and with the ways in which certain specialties are more determined than others to opt out for a variety of historical and other reasons.

The fourth argument I have heard is that it destroys the doctor-patient relationship and means a return to what they call assembly-line medicine. To this I can only say that every factual study establishes clearly and definitively that there is no basis for the argument that doctors who extra bill spend more time with their patients than doctors who do not extra bill.

I am constantly amazed at those same doctors who say this is not a dispute about money or dollars. Those same doctors who say that say equally quickly: "If I am not allowed to extra bill, the entire attitude I have to the treatment of my patients will be radically transformed."

I say to those doctors as kindly as I can that they cannot have it both ways. Doctors cannot simply say, as one doctor has in a letter to his patients, written in 1986: "Until now, we have been able to afford the extra cost of mailing prescriptions or phoning them in. I will no longer be able to do this. My patients recognize I spend more time and do a very comprehensive examination. I will now be forced to see more patients in the same time with a minimum examination."

How sacred can the doctor-patient relationship be to a professional whose entire attitude to the treatment of his patients is transformed overnight by a change in his economic circumstances? It troubles me deeply, just as the incident I described yesterday troubles me very deeply.

There are two other arguments we hear from the profession I want to touch on because I think they are fundamental. The first argument is that extra billing is the essential element of a free profession. The second argument is that it is not the real problem. I want to touch on these issues.

This bill to end extra billing is only an attack on professionalism if one equates professionalism with a market relationship with an individual patient. If that is the definition of professionalism then, yes, a ban on extra billing represents a problem for that kind of attitude towards professionalism. However, it is not an attack on professionalism. It is a rejection of the view that to be free and autonomous, the medical profession has to have a business or market relationship with the patient.

4:40 p.m.

Professional autonomy is not being attacked in any way whatsoever. What is being attacked is the cash nexus in health care. That is what is being attacked and that is what deserves to be attacked. The trick is to do it in such a way as to preserve professional autonomy.

I say to the OMA with great respect, and I have said this to Dr. Moran, the focus of its concern about the passage of this bill should be the way it relates to the government and the nature of the way it bargains collectively for a fair schedule that will apply across the province. I think the OMA is in danger of missing the entire boat by not focusing on that issue, which is a very legitimate issue for any profession receiving its pay from and dealing with the social insurer of this province, which is the government of Ontario. That is the issue.

We have heard a lot of descriptions of this bill. It is not Russia, it is not conscription, it is not terrorism and it is not rape. It is an insistence that the doctors' economic relationship be with the social insurer and not with the individual patient, and that is all this bill is.

The integrity of the medical profession and the sanctity of the professional health relationship between the doctor and his patient have not been touched or affected in any way whatsoever. That point has to be made again and again. This bill is about the economics of health care. It is about whether patients should be charged or billed directly. It is about whether money should be coming out of patients' pockets for the care they are getting from a doctor. It is not about the autonomy of the medical profession.

I have a higher view of the professionalism of the doctors of this province than to think that can be devastated and taken away simply because the nature of their economic relationship with patients has changed. I am surprised more than I would have thought when I hear doctors saying, as we heard the doctor suggest in the letter to me yesterday, that what this does is throw professionalism out the window. No, it does not. It does so only if one has a very narrow and very economic view, a very acquisitive view, if I may be blunt, of what professionalism is all about.

Professionalism is not about acquisitiveness; it is about service. Professionalism in the field of health care is especially about service. Doctors should be proud of their profession and should have more pride than to suggest it is being taken away because they have to deal with the government collectively rather than with each patient individually.

Finally, there is a suggestion from the medical profession that it is not the real problem. I agree extra billing is not the only problem. I am delighted to hear the doctors coming forward with examples of overcrowding in hospitals. I am delighted to hear the profession is fighting for quality of care. I only wish, if I may suggest so bluntly, they had been as eloquent in the past decade with respect to this problem as they have suddenly become in the past six months, but I am delighted to see them fighting for it.

It is not the only problem. There are deeper problems at stake. There is the future of our health care system, affected, as we all are, by an ageing population, and there is the need to get rid of our hangup about institutionalization and to provide more care at home.

There is the need to get at the environmental and social causes of ill health, to attack the nature of the cancer epidemic that is plaguing us, to deal with the causes of environmental and social stress and to deal with the problems of mental health patients that were touched on so eloquently by my colleagues the member for Bellwoods (Mr. McClellan) and the member for Riverdale (Mr. Reville) today.

There is the need to deal with the crisis in disability and the fact that people are not compensated or cared for properly. There is the need to deal with the fact that our delivery systems are antiquated and outdated. There is the need to deal with the fact that our attitude towards community medicine is antediluvian and needs to be transformed. There is the need to deal with the fact that 35 per cent of doctors today are not on a fee-for-service basis and are employees.

These are the key issues of the 1980s and the 1990s that matter and that together we must work towards solving. We must solve them in partnership with the medical profession, but in partnership also with all the other health care professionals who do not extra bill and who do not believe they have a sacred right to a direct relationship with their patients' wallets. We must solve them in partnership with everyone in our society who believes in the transformation of our health care system and who sees it as a system that not only will treat disease once it has broken out but will also genuinely prevent ill health and promote health and physical, mental and social wellbeing. That is the objective of the system, and it is on that basis we must all join together and see that the system is transformed.

When the OMA says it is not the only problem, I agree. When they say it is not a real problem, the evidence is totally to the contrary; it is a real problem.

It will take courage and vision to build this kind of health care system. It will take the courage for us to move beyond some models that have been given to us from the past. It will take toughness to deal with the complete corporatization and privatization of health care we see in the United States, constantly trying to get into Canadian markets, as they call them. That will require courage.

Perhaps I can close with the words of Woodrow Lloyd, who was the Premier of Saskatchewan during that very difficult time of the strike in 1962 which I mentioned. Speaking to a meeting of the Saskatchewan Medical Association, Woodrow Lloyd said:

"We seek not to change the ends of medicine. We do seek to find ways and means to adapt the financing of medical care to 20th-century society and the legitimate expectations of that society. In this, the ancient mission of medicine need not be lost. Its achievement can be advanced. I invite you to join in a bold attempt to consolidate past gains and to move towards new horizons in the field of medical care."

Those are good words for this debate and for the future of Ontario. We will be supporting the passage of this bill tonight, with pride as its real authors.

Mr. Grossman: I rise to address some comments, particularly to the Minister of Health, on the occasion of second reading of Bill 94.

I do not intend to move the debate this afternoon into a recitation of arguments and facts that have been well put by all sides on many occasions. I need not go into those arguments or add to them the kind of hyperbole we have just heard. I feel the hyperbole of 1986 is no justification for the mediocrity of 1996.

I respect the position of the leader of the New Democratic Party. However, I do not agree with it. I accept his motivation and concern. Where we diverge is in the conclusions we draw as regards how best to achieve accessibility and all the other goals of the health care system. In its firm commitment to accessibility, which goes unchallenged, the New Democratic Party need not go back to T. C. Douglas, Woodrow Lloyd or anyone else to reaffirm its commitment to full accessibility. We accept it.

I believe an understanding of the implications of jumping too fast without having understood the implications and complications in a vast and difficult health care system could, perhaps inadvertently, cause a lot more damage than it could repair some problems.

Neither do I feel obliged this afternoon, in response to the remarks of the New Democratic Party leader, to defend the commitment of this party and of my predecessors as Minister of Health, not only to the health care system but also to full accessibility to that system.

4:50 p.m.

While one can hearken back to insurance companies and arguments put by John Robarts and others in 1962, the fact remains that the proof is on the streets and in the hospitals and communities across Ontario. The proof lies in the reality, as I am sure all members of this House will agree, and I defy them to disagree with the reality, that here in Ontario we have built the finest health care system in the world.

I say that not by way of defending the previous administration or giving all the credit to us for that system. Quite the reverse; I mention it because it is fair to point out that the previous administration had more than a little to do with that success and to re-emphasize the point that health care providers opted in and opted out. The secret behind building the world's finest health care system was various health care professionals all working together. That speaks more eloquently than the attempt of others to suggest our commitment has become eloquent or clear only in the past few months. All of this did not happen by accident.

As members of this House know, during my time in public life I have served the people of Ontario in many capacities: Minister of Health, Minister of Industry and Trade, Minister of Tourism and Recreation, Minister of Education, Minister of Colleges and Universities, Minister of Consumer and Commercial Relations, Minister of Treasury and Economics, Provincial Secretary for Social Development and government House leader.

As I look back over those responsibilities and try to determine in my own heart and mind which of those gave me a sense of self-satisfaction, a sense of self-worth and a sense of accomplishment, I must say to the minister it was my year and a half as Minister of Health. I care deeply about that system. I wanted it then to evolve and progress, and I want today to see it evolve and progress. I want to see it continue to be a system the rest of the world looks upon as one of the most progressive, well managed and caring in the world. It is for that reason I have watched the activities of the current Minister of Health very closely.

I talk regularly with the health care groups, the health promotion advocates, patients' rights groups, people involved in the institutional sector, professional nursing care associations, home care providers, the doctors and a plethora of other health care providers. I know them. We worked well together. We did not always agree, but we had a good, solid relationship.

In short, I watch the Minister of Health with a great deal of interest and concern. I might say that outside of question period, I do so with less than a partisan concern, but more because of my care for a system I came to be very closely attached to and interested in.

While I will be largely critical in my comments today, I do want to say to the minister that I do not question his dedication and sincerity as the minister responsible for the health care system. I think for the most part he has been sincere, and I know he does not have an easy task.

The Minister of Health is surrounded by vested interest groups, each with its own narrow self-interests to defend. When the minister fails to comply with their demands, he will be accused of being either a slave to the more traditional vested interests or a slave to the Treasurer. I understand the pressures he is under. In fact, he is charged with the responsibility of running a $9-billion system, and he is responsible, directly or indirectly, for more than 200,000 people providing a vital service to the people of this province.

When the minister appears at the cabinet table and approaches his colleagues, not all will understand the complexity or impact of what he is talking about. They have their own problems, priorities and objectives.

The Minister of Health knows what I am talking about. He has been around long enough to understand the real challenges he faces during his time as minister. He has begun to grasp the need for and the awesome challenge of reforming the health care system of Ontario. He knows very well we must incrementally begin to shift the system from its existing institutionally based bias, which the New Democratic Party leader has spoken of, to a more community-based, more responsive and cost-effective orientation, which I might pause to say I am proud to have played a part in, at least by beginning and encouraging the expansion of those services started by my predecessor, the member for Don Mills (Mr. Timbrell), and other fine Ministers of Health in this party.

The minister knows we must shift the system from its current curative model to one that promotes illness prevention. He also knows that if he is to achieve those critically important goals, he simply must have the co-operation of all health professionals, including the physicians.

I hope the minister has a vision of the future in health care. I hope that vision is similar to the one I have just expressed. I fear that vision of the future of the health care system -- one which, apart from politics, we all share -- is being disrupted in a major way by the government and its approach to this issue. That vision of the future may have been rendered unachievable by the current crisis caused by this legislation.

Let me be clear for members of all parties, particularly the New Democrats, who I am sure would not want to be unfair or unkind in this important debate. Let me state it again. No one in this assembly or in this party has ever disputed the goal of accessibility. All of us in this House and in this great party believe our health care system must be universally accessible, regardless of one's ability to pay. That is what we as a party and all of us in society in Ontario and Canada believe in; simply put, it is the goal of universal accessibility.

There is a variety of ways to achieve that goal. The act before us today articulates one and only one way to achieve it: an outright ban on extra billing. A ban on extra billing may achieve the goal of accessibility. However, we fear it would be a hollow victory, because it is obvious there will be fewer of the fine doctors who are accessible today residing and working in Ontario. We would certainly have more unhappy doctors fully accessible than we have today. It would be a kind of Pyrrhic victory.

In this party we concede that banning extra billing is one of the options. I concede that to the minister. I believe, though, it is a highly punitive and negative option, one that is rapidly transforming our health care system into a battlefield where some doctors are pitted against their patients, some nurses are pitted against doctors and our physicians have been pitted against government, sometimes the media and certainly current public opinion.

I am one who has stepped on to that battlefield in a small way myself on occasion. During that confrontation, I came to respect the need not to cause permanent scars in the system, the need to handle that circumstance so carefully that after the fee dispute the doctors would continue to have self-respect in this province; and I, as a member of government, would say nothing that would polarize the community or that would make them feel less welcome or more threatened by government.

The Minister of Health does understand the need to handle this situation with a great deal of tact. It is the classic example where the government clearly has the power in this assembly to win the battle but perhaps to lose the war. The Minister of Health understands what I am saying, and he understands the implications and impact of the current methods.

Perhaps he feels the precise option he is stuck with was handed to him as part of the accord and is the price and source of some of the power, some of the conditions for power, that allowed him to get his job. If the minister's hands are currently tied, by the accord or by the office of the Premier (Mr. Peterson), I ask him to contemplate the situation and his primary responsibility as the guardian of a fragile coalition that makes up the health care system of Ontario.

5 p.m.

I understand the Minister of Health will be obliged to take the party position on this one, and he will no doubt do so effectively when he gets his turn in a moment. I ask the Minister of Health to reflect on what he has learned over the past seven or eight months, long after today's debate is over, during the next couple of weeks and months. I ask him to reflect on whether this is the option he would have selected apart from the dictation of the accord and the demands of the Premier's office.

I wonder whether he honestly believes that the act as written will achieve what the government claims and what the cost is of achieving it in that way. I wonder whether the minister might reflect over time on whether there might not be more appropriate, more effective and less punitive mechanisms to achieve the goal of universal accessibility. I think the current minister shares our vision of the future of the health care system. He knows it is possible to improve upon it, shift it from institution-based care, make it more humane and caring, more accessible and provide the means it will need to evolve to meet the changing needs of the 1990s.

I fear the minister's understanding and concern about those issues is not shared throughout the government. I fear the government's primary concern is otherwise. It is unquestionably tied up to a great extent with political concerns, be it to fulfil the accord or to continue to move where the polls are saying it is clearly popular to go.

However, 1996 will arrive. The member's responsibility as Minister of Health is to make sure he leaves to his successors a health care system that will be as strong, vibrant and as happy in 1996 as he found it in 1985. With the experience he now has, I believe the Minister of Health knows he could achieve universal accessibility within the health care system without necessarily resorting to an outright ban on extra billing and, most important, without the current confrontational tactics to which it seems his Premier is so committed and with which he feels so comfortable.

The Premier says, "We have to ban extra billing by this April or we will lose $54 million in federal transfer payments." Is that true? Of course it is not. When the former federal Liberal Minister of National Health and Welfare introduced the Canada Health Act, she recognized that the provinces and their respective medical associations would require time to resolve these issues. Madam Bégin therefore gave all provinces a three-year transition period to comply without penalty. The Premier is wrong. April 1987 is the deadline. It is not April 1986.

The Premier also says, "We will not withdraw the legislation and sit down and negotiate with the OMA." Why not? Other provinces have demonstrated they can arrive at settlements with their doctors. Why can we not negotiate a settlement in Ontario? The government of Nova Scotia was able to reach an agreement with The Medical Society of Nova Scotia prior to introducing its legislation. That agreement provided for final-offer arbitration to resolve fee disputes and a three per cent increase on fees as the price to end extra billing. By the way, that three per cent settlement was equal to the amount withheld by the federal government in Nova Scotia's case.

I am certainly not saying that is the model we should follow here, but the model we should follow is that of negotiating and trying to settle before introducing legislation. In Nova Scotia, they arrived at an agreement.

There have been negotiations and agreements in several provinces. All those negotiations ended with a ban on extra billing. However, those negotiations, first, did not alienate doctors. Second, in each case there may have been no alternative to banning; in Ontario, the alternatives have not been explored.

The government of Nova Scotia did not threaten its physicians with punitive legislative measures. It did not threaten them with $10,000 fines. It did not create a climate of hostility and confrontation. It simply went out and achieved a settlement.

The government of Saskatchewan has been referred to. It reached an agreement with its medical association prior to introducing legislation. In fact, the Saskatchewan Minister of Health and the president of the provincial medical association issued a joint press release hailing "a new era of co-operation and consultation" two weeks prior to the introduction of legislation in that province.

Why is it that we cannot seem to arrive at that agreement in Ontario? Why is this government so committed to a strategy of confrontation? The government of British Columbia also managed for several years to negotiate annual contracts effectively banning extra billing in return for a satisfactory fee schedule. They formalized their agreements through legislation in 1981. Why does this government seem so incapable of entering into a fair, honest and open negotiation with our health care providers? Why are groups of doctors calling meetings all across this province and threatening to defy what they believe to be an unjust law.

Why is that happening in Ontario? Does the government believe our doctors are less honest, fair, reasonable, committed and dedicated than doctors in other provinces? Is that what the government believes? If it does not believe that, why does it not try to negotiate with them as governments in the other provinces did?

The Treasurer (Mr. Nixon) likes to say his government is banning extra billing to save $54 million a year in federal transfer payments. Is that true? Let us look at it. The Treasurer knows the current gap between the OHIP schedule and the OMA fee is 30 per cent. Is he going to close that gap of $600 million? Is he going to close 10 per cent of it, $66 million? If we were to follow the Nova Scotia government's model, upon which this government's legislation is based, we would still lose the $54 million totally as the tradeoff for banning extra billing.

Based on past experience in other parts of Canada, we clearly have to find the government increasing doctors' payments by at least that $54 million. Why then is the government going around the province giving speeches about how it is going to reinvest the $54 million in alleged savings on new health care projects? Come on, do not play that game.

The government has also been strangely silent on subsection 12(2) of the Canada Health Act. That section stipulates that where extra billing is not allowed, reasonable compensation will be provided through an agreement with the doctors and dentists, or through conciliation or binding arbitration. Therefore, full compliance with that legislation will obviously cost far more than the $54 million the government talks about. If we are going to spend more -- and the minister will -- surely there are other priorities. We are going to be paying and paying for this step. It is a big price in human and financial terms. The biggest price will be in the way the medical fraternity responds to the actions and methods of the government.

Very little has been said about dentists. I mentioned it in question period this afternoon. The government does not talk about it. Let us talk about the financial implications of banning extra billing by dentists in hospitals. Currently, OHIP pays $8.5 million annually for hospital-based dental services. That is about 30 per cent of the Ontario Dental Association rate. The additional cost to close that gap is $13 million. That is $13 million which will have to be spent out of the $54 million coming back. The minister should mark the figure down to $41 million before he begins to address doctors and their fee schedules. Let us stop pretending this banning of extra billing is going to save money. The minister knows it is not a cost-saving program.

Let us look at some other facts. The bill tabled on December 19 provides for the right of physicians either to opt in or opt out of the OHIP plan. Let us look at some of the facts and statistics which I am sure even the minister's colleagues, only three of whom unfortunately are here to hear, might be interested in.

5:10 p.m.

Prior to the introduction of this legislation, opting out in this province had dropped from a high of 18 per cent in 1978, when the Liberal Party of Ontario supported extra billing, down to a low in November 1985 of 11.8 per cent. Further, I wonder whether the minister's colleagues, or perhaps the minister, are aware that of all the doctors in this province only 3.1 per cent are neither opted in themselves nor part of an associated medical group that is opted in. Of all the doctors in this province, only 3.1 per cent do not bill the Ontario health insurance plan.

It is not 11.6 per cent or 11.8 per cent, and it certainly is not 18 per cent. It is not even five per cent, which is the number of bills that are extra billed. Only 3.1 per cent of all the doctors in this province never submit bills to the OHIP plan directly. Their colleague the member for Humber (Mr. Henderson) will tell them that. He will tell them how accessible it is.

Under the legislation, a physician can opt out. That physician can bill his patient directly and OHIP will reimburse the patient within six to eight weeks under the current opted-out level. We know that today about five per cent of the claims are pay-patients. I wonder whether the public is aware that as a result of the government's methods and its action against doctors, the rate of five per cent direct billings will skyrocket in a matter of months to 35 or 40 per cent.

Let us look at it in tangible terms. If a single parent were to bring her two children and herself to a bill-direct physician for a simple checkup, the same doctor she has been going to for years, she now would be out of pocket $60 for six to eight weeks, and more likely 16 to 20 weeks because of the volume the computer will face.

What does that do to accessibility in this province? What does that do to improve access to the health care system for the financially disadvantaged? When direct billing was five per cent of total OHIP claims, it was a relatively minor issue. However, as a result of the way in which this government has proceeded, we now will see a 35 to 40 per cent increase in the magnitude of that problem. Will that make it better or worse? Will it improve accessibility or harm it?

I believe the Minister of Health understands these implications. During the adjournment, I ask him to explain it to his leader. The Premier believes he has a great political issue -- the forces of good against evil, politics that put people in white hats and black hats, cowboys shooting at each other, gunfights outside the corral and the hospital.

He even claims publicly that he is prepared to go to the polls on the issue. On what issue? Is it to support a government that refuses to sit down and negotiate in a civilized manner on behalf of the people? Is it to support a bill that does not achieve the goals this government has claimed it would?

Mr. Ferraro: That is baloney.

Mr. Grossman: The member should lean over and ask his colleague. He is just one seat away from him. Ask him what negotiation is all about.

When the people of this province see the trauma in their health care system, they will have some tough questions to ask. They will want to know, reasonably, whether the confrontation could have been avoided, and it could have been. This government will not be judged on how sincere it was when it introduced the legislation. It will be judged on how well the health care system is working. This issue has to be treated a little more delicately than as just another political football.

The concept that every Ontarian is entitled to a comprehensive range of health care services without reference to ability to pay is deeply ingrained in our identity in this party and, without exaggeration, is one of the strong unifying bonds we all share in this Legislature regardless of party affiliation. We are all committed to the principles of universal access, a comprehensive range of services, portability, public administration of the insurance plan and access to services without financial barriers.

That is not what the debate is all about. It is a question of how well we can fulfil these principles. That depends on our complex and interlocking relationship with a great number of health care providers, with a host of the world's leading doctors and health-related professionals, associations and the like.

By definition, a health care system is one that results from an activity of profoundly human dimension, and this quality permeates every aspect of the system. The minister knows that. He knows the importance of partnership and co-operation in the system. He knows confrontation will harm the quality of care for years to come. It will not be just for today.

This Legislature will rise this week. We will have several months off from our daily partisan battles here. I appeal to the minister to use that time wisely and prudently. I urge him to begin a dialogue with the Ontario Medical Association to explore alternative options on the accessibility issue.

Would the OMA consider a limited ban on extra billing? It is not sufficient, I say to the minister, for his leader to say the OMA has not made that proposal to him. The minister is in charge. He speaks to them every day. It is his job to keep peace in the system.

Let us have no ivory tower politics here. It is a simple plea to the minister to pick up the phone and say: "Hey, we read in the paper that maybe some of your people might support this. Shall we talk about it?" Why does the minister not do that? It cannot hurt. They may say no, but why does he not call them? The arrogance of his leader on this issue is unacceptable. We do not expect him to call; we know better than that. We expect the minister to call.

Perhaps the OMA might agree that no hospital-based services be extra billed; that the needy, the seniors and the 25 per cent of the public on OHIP assistance not be extra billed. Would the OMA agree that anaesthetists should not extra bill and should perhaps become salaried at a higher rate of remuneration?

What about increasing our resources in community health clinics, in health service organizations and in those geographic communities and specialties where extra billing may threaten the principle of universal accessibility?

What about the tax system as a potential mechanism to reinforce our desire to have the vast majority of physicians opted in and billing at OHIP rates? Can we not ask the OMA to suggest its own alternative mechanisms for compensating physicians?

I am going to pause for a moment to read an excerpt to the minister. This is from a document put out by the Liberal Party of Ontario a couple of years ago. I will read an excerpt from the health care section, which is a quote from the now Premier: "The deterioration in our health care system must be halted. This can only be achieved through a consultative approach which emphasizes rational planning and adequate funding." A consultative approach. Has power got in the way of consultative approaches? That is all we ask for in this debate.

I urge the minister, not for the politics here but for the sake of the system, to consider the options, to explore them honestly and openly with the OMA and that before he and the Premier say no to the suggestion they simply talk and have a dialogue; think for a moment about what the health care system will be like five or 10 years from today if confrontation is the rule and unhappiness and dissension permeate the system.

We can count the seats in this House. We know the government and its accord partners may very well succeed in bludgeoning the physicians into submission. We know that. We understand the vote that is about to occur. I ask the minister to contemplate at what cost.

I began my remarks by reminding the minister that I do not doubt his commitment to the system or his sincerity. I have never questioned the honest and deep nonpolitical commitment of the New Democratic Party. I question the understanding of both parties of the implications of what they are about to do. I do question a bit the understanding of the system and the commitment to the principle, as exhibited by the leader in a grasp for power politics.

I ask the minister, what is the cost? Will physicians not feel that some of their basic rights have been destroyed because they were forced, rather than negotiated, into the plan? Will they be so fed up that they begin to deliver health care services differently -- not this year, I do not accept that, and not in five years, but in the next generation of physicians? Do we need to create a circumstance where people say: "Gee, do you remember what it was like in the 1970s and 1980s? Do you remember the quality of the system we then had? What has happened? Where did it go wrong?"

Will physicians be so antagonistic that our vision of a strengthened community-based health care delivery system becomes unachievable? Is that a fair price to pay?

5:20 p.m.

We in this party do not want to give up that vision, Ontarians do not want to give up that vision and I do not believe the current Minister of Health wants to give up that vision of a reformed health care system, but that is one of the prices the government is going to pay. It is not only the extraordinary price of spending tens of millions of dollars on compensating physicians for making them do something they do not want to do, when that money could be used for something else in the system.

It is not only the financial price; it is also a question of morale and good feeling in the system, a question of co-operation. As a former minister, I say the government is going to need that co-operation. Lack of co-operation will mean the quality of health care in this province will be compromised, not in 1986 but in 1996. I do not believe this minister wants to leave that as his mark on the health care system. There has to be a better way.

Mr. Speaker: Mr. Grossman moves, seconded by Mr. Timbrell, that Bill 94, An Act regulating the Amounts that Persons may charge for rendering Services that are Insured Services under the Health Insurance Act, be not now read a second time, but be referred back to the Premier and the Minister of Health with instructions to enter into immediate discussions with the affected health care providers, with a view to repairing the damage which has been done to the fabric of the province's health care system; to closing the chasm which the government has fostered between it and the health care providers; and to providing all Ontarians with full accessibility to quality health care.

Mr. Grossman: Our plea to the minister is to wait, talk, negotiate and see if there is a better way. His obligation to the health care system goes far beyond his obligation with respect to the polls, the directives of his Premier and the requirements of the accord. We understand his dedication. If he cares about the health care system, he will accept our reasoned amendment, stand it down and do what every other province has done, and that is to talk with their doctors. The minister should respect them, work with them and build a better health care system. He should not cling to the facile politics of the moment.

Hon. Mr. Elston: I rise at this particular time to speak at a very historic time in the development of Ontario about the commitment of a government of the people of this province to a system wherein we can guarantee there will be access to medical care without having regard to whether a person has $5, $10, $15 or more in his or her bank account before that person receives adequate medical treatment.

This is not just a passing piece of legislation. This is an important piece of legislation, which should have been worked on some time prior to our government coming into place. It is something I know certain members of the party now claiming to be the official opposition had some thoughts about. There are some people over there who had some very interesting thoughts about this legislation, who may not have felt compelled to stand and speak from the heart, as a number of people in this Legislature have spoken.

I can think of no finer time when there should have been well-thought-out, well-delineated, well-placed versions of what people feel should have been philosophically done in this Legislative Assembly. I apologize to those members I did not have an opportunity to hear, but I did spend some time listening attentively to those people who had taken the time to sit down and develop thoughtful responses to the legislation, not only to the physicians' letters but to the problems that have been brought forward to me as minister.

Whether it was the member for Timiskaming, the member for Fort William (Mr. Hennessy), who talked so eloquently in days gone by about northern health care needs, the member for Cochrane South (Mr. Pope) or other members of this Legislature, they all pointed out that as good as our system is, we have many more miles to go before we can claim to have a system without need of reform.

There are some members of this Legislative Assembly who spoke eloquently about the personal involvement of their families. The member for Scarborough-Ellesmere (Mr. Warner) spoke of his grandparents. The member for York South (Mr. Rae) spoke about constituents of his own and of other people.

Some who spoke in this Legislative Assembly refused to speak at all about those situations where we know people have been disadvantaged. They refused to acknowledge that studies throughout this country have verified that the people who have limited resources in this province are the ones who will be deterred from accessing the health care they so rightfully deserve to receive in this country.

It is not a question of whether a physician is able to directly bill his patients. It is, without a doubt, a concern of this minister, of this government's first minister and of the members of the executive council that people should be able to receive medical care, not a financial examination at the hands of their physicians and surgeons before they get what is required to sustain their lives and what is required to keep them independent and vital parts of our society.

I cannot for a moment sustain any thought that anyone in our country can think that he alone, as a physician or any health care provider, should examine a person first and foremost from the question of whether he has more money in his wallet than could be sustained on his insurance plan payout. To me, that does not ring true.

I cannot suggest at this time that I have an ability to speak as eloquently as other members who have spoken before me. The member for York Mills (Miss Stephenson) has sustained in her own way a very real and concerted effort to put a point of view about which she feels very strongly. I have a great deal of admiration for the way in which she developed her argument. Although I was not here to listen, I read her comments attentively and I followed her development of the profession as she ran through the medieval times and compared the development of medicine to that of law and of others.

Although I did not hear all of his speech, I heard part and read part of the speech of the member for Scarborough-Ellesmere. He had a very well put and well-placed argument, a very strongly held position.

I listened to the eloquent and very well developed arguments of the member for York South, the leader of the third party. The emotion with which he developed the argument which spoke so eloquently to the needs of the people of this province and to the people of all of Canada and to the work that has been done to lay a base for where we are today in this Legislative Assembly speaks truly of a long and worthwhile struggle to come to grips with what we all recognize and, the member for St. Andrew-St. Patrick (Mr. Grossman) will agree with us, we all ought to have, namely, access to medical care without reflection on financial ability.

5:30 p.m.

For those members who feel they must vote against this piece of legislation, I ask them to sustain in their own minds why they feel a pocketbook or bank account should be examined before medical treatment is provided.

I do not pretend to be a speaker who can light up the members of this august body. I do not pretend I can speak with the passion I have heard expressed today by my colleague the member for York South. However, I defy anyone to downplay the degree of feeling, the passion I feel about the need for this piece of legislation.

Along with my colleagues I know, and we are sustained by the anecdotes, as they are called by the opponents of this legislation, of the times when there has been disadvantage placed upon the shoulders of the people of this province. We cannot tolerate that. Some members may feel the occasional case makes no problem for us. I disagree, because for every time one of these items comes to light, there are many more we will never find out about.

There are too many people who are sensitive about having inadequate means to provide for their families, inadequate means even to provide for themselves. How can we, as people who should have compassion for them, stand and vote against the right of people to have access to medical treatment?

We have progressed a long way in this province. As the member for York South would indicate and verify through his reading of history made by the Liberals of many years gone by, we have been moved to deal with this issue at other times. It has not been dealt with. History would indicate people have not moved to come to grips with what the member for St. Andrew-St. Patrick tells us now is in the hearts of all of us in this House, the desire to have universal accessibility.

Perhaps there are different meanings, as the member for St. Andrew-St. Patrick tells us, to coming to grips with how that universal accessibility can be delivered. Perhaps that member is right in saying he desired to co-operate with the health professionals to develop a new vision. He may be right in that there are things he did, and for which he tried to take credit this afternoon, to develop a new vision of the health care system. Perhaps during the tempestuous days when he was Minister of Health there was some respect gained and some co-operation, but reading back through the annals of history and the text of debate in this Legislative Assembly, one does not often see that co-operation about which he spoke so eloquently today.

Unless we have some misconception of what has transpired over these past several months, let me remind members we have cast about this province for any number of solutions to a very difficult problem. Perhaps one of the biggest problems for us as a government has been to have members of the medical profession acknowledge that extra billing is a problem.

Let me verify that. When people are refused access to health care because they do not have the money, that is a problem. Let me also verify again, as has been said by the member for St. Andrew-St. Patrick and the member for York South, that this is not the only problem we have with our health care system. As good and as well recognized as our system is, none of us can take pride in the fact there are deficiencies which have gone unaddressed for some time.

None of us can take satisfaction when we hear of difficulties in one institution in providing care when it is needed, or when we find groups of health professionals feeling they are on the outside of the system wanting in to participate.

Without doubt, there are any number of things we can do to improve our system. This is a step we must take if we are to come to grips with the very basic questions of how our health care system is to be developed in Ontario. Are we going to prescribe for the people of this province the necessity of carrying their bank book, their bank balance with them every time they go to see a physician or any other health care professional? Or are we going to say to those people they can visit the physician, dentist or optometrist of their choice without fear of having to be embarrassed by some radical examination of their ability to pay for services which they as a citizens of this province have a right to expect?

I have a number of notes with a lot of interesting statistics about what has happened in the past, such as the Canada Health Act which was passed on April 17, 1984. It was passed with the support of all three federal parties, although I presume some people would like to disagree with that. The Liberals, Progressive Conservatives and New Democrats joined in what I think was a unanimous stroke for a sense of the vision of future health care in Canada.

Not only was the passage unanimous in the House of Commons, it was unanimous in the Senate, that chamber of sober second look. In Ontario we have brought in legislation which will put us in a place to join our colleagues in Quebec, Nova Scotia, Saskatchewan, Manitoba, British Columbia, the Yukon and the Northwest Territories. It is about time Ontario caught up.

So the member for St. Andrew-St. Patrick will be aware of the discussions we attempted, we have taken every opportunity to discuss ways of coming to an agreement. Although he admonished the Premier and me to make further efforts, his admonishments are not required. We are currently making efforts, and we will continue to work hard at coming to grips with any number of options which may be put forward by the Ontario Medical Association. My colleagues here need not be concerned about the earnestness with which this government will pursue available options.

We have been earnestly seeking that dialogue about which the member for St. Andrew-St. Patrick spoke earlier. We have been rebuffed, not only in private but in newspapers, during meetings and in any number of places. The member for St. Andrew-St. Patrick would know exactly why no agreement was arrived at prior to the introduction of this bill. We can read the pronouncements of the general secretary or the president of the OMA.

However, at this particular juncture I can say to the members of the Legislative Assembly that, as a result of our recent work and debate on this legislation, I have received several pieces of correspondence from members of the medical profession. I have received telephone calls, as has the Premier, with suggestions as to how the negotiations could perhaps be commenced again. We are in receipt of any number of expressions of support from professionals for beginning these negotiations. We are working with those people who have any genuine suggestions. We will proceed to cast about for any opportunities that make themselves available to us and we will continue to reach out for any opportunity that will enable us to break what the member for St. Andrew-St. Patrick calls an impasse.

5:40 p.m.

I can acknowledge this has been a very difficult time for discussing issues such as extra billing. It has been a very difficult time to get a forum in which one can even have the words "extra billing" mentioned by people on both sides of the issue. We have semantic arguments. We have "balanced billing" and we have "extra billing." We have any number of ways of expressing it. We have had meetings with the profession in which euphemistic phrases were used to indicate the issue of extra billing, but I can tell members it has not deterred us from trying to discuss this particular matter in its fullest sense at every opportunity with the people who would provide us with information to assist us in coming to grips with this problem.

I think it is fair to say this particular minister has a vision of the health care system. We are viewing a number of reforms in the system to which the former Minister of Health, the member for St. Andrew-St. Patrick alluded earlier. We have taken the opportunity to introduce a series of new initiatives with respect to health care in this province. I mentioned some today in question period in reply to the member's question about what we are doing for certain chronic care bed needs.

We have a vision we will pursue with full knowledge that we have co-operation from health care professionals, from the people who really make this system work. We will continue to come up with ideas developed by the health care professionals in this province so we can make our system one of the best in the world.

I do not take any particular pride in being the Minister of Health who follows in the footsteps of a government that was here for 42 years. I take some pride in the fact that despite some of the things that were done, we have a very good system. I do not take any solace from the fact that because of some of the things that were not done years before, we have a golden opportunity to improve upon the system. I take it upon myself, and this government takes it upon its shoulders, to ensure that we build upon what is already there in a very worthwhile way for the benefit of the people of Ontario and not for the benefit of any particular interest group.

As members of this Legislative Assembly and as former members of the opposition party, we know that sometimes government does not move as quickly as we would like. I am finding that as the Minister of Health. I am finding there are certain degrees of patience necessary to develop policies with which we can proceed to finance and fund appropriately and to implement. As we did in dealing with the arguments that have been put before us in opposition to extra billing and the debate about this particular problem, patience is a commodity with which we will tackle all the problems listed by various members of this august body.

I have considered a number of suggestions of the people. There have been any number of suggestions that were made in passing and one of them has been with respect to the fine. Some feel the $10,000 fine in this bill is too high. Sometimes they pick out a little corner, the wording of a phrase or two in the bill, and say, "Why can you not change it?" We are open to making changes. I am open to considering the possibility of moving that fine to a level that would be commensurate with that under the Health Disciplines Act if people want to see that event occur.

I am in tune with any ideas that will make this a better piece of legislation. I am in tune with any number of suggestions that will help us negotiate with the members of the medical profession, such as the item the member for St. Andrew-St. Patrick spoke about earlier, the question of compensation. None of us wish to disadvantage the members of the medical profession by the use of this legislation. That is why I made sure we would not close off options and opportunities to discuss the manner of deciding financial compensation.

It is obvious that this government is committed to ending extra billing in this province. We have taken a long time to reach out for the suggestions of the members of the medical profession to assist us in developing legislation. We have taken the added course of establishing forums in nine centres in this province. We have done a number of things that were designed to helped to bring that profession in to speak with us and to form a partnership to deliver a system and a legislative package that would be fair. We will continue to reach out to develop that partnership with respect to meeting the needs of the health care system of which so many people have talked.

I look forward to moving ahead into a third stage in this legislative process where we can have open hearings in a committee of this Legislature so we can examine fully what some physicians have described as a matter of principle and a matter of freedom. I look forward to participating in that open forum so we can get at the heart of what these arguments really are all about.

For the part of the Liberal government of this province and that of our colleagues who support us, the principle is one of being able to receive, without question, medical attention from every source in this province. That is not a hard concept to grasp. For our part we are going to support this legislation and move ahead to develop it more fully so it reflects the manner in which the people of Ontario can be assured that they will have universal accessibility to health care in this province. For the people of Ontario, it is about time.

Mr. Speaker: Mr. Elston has moved that Bill 94 be now read a second time. Mr. Grossman has moved a reasoned amendment. I would like to remind all members of standing order 54(a), which says, "If a reasoned amendment...is offered to a motion for second...reading, the first question proposed by the Speaker is whether the bill will now be read a second...time."

The question I am placing to the House is, shall the bill be now read a second time?

5:59 p.m.

The House divided on Hon. Mr. Elston's motion for second reading of Bill 94, which was agreed to on the following vote:

Ayes

Allen, Bradley, Breaugh, Bryden, Callahan, Caplan, Charlton, Conway, Cooke, D. R., Cooke, D. S., Cordiano, Curling, Eakins, Elston, Epp, Ferraro, Fontaine, Foulds, Fulton, Gigantes, Grande, Grandmaître, Grier, Haggerty, Hayes, Johnston, R. F., Kerrio, Knight, Kwinter, Laughren, Lupusella;

Mancini, Martel, McClellan, McGuigan, McKessock, Miller, G. L, Morin, Morin-Strom, Munro, Newman, Nixon, Offer, O'Neil, Peterson, Philip, Poirier, Polsinelli, Pouliot, Rae, Ramsay, Reville, Reycraft, Riddell, Ruprecht, Sargent, Smith, D. W., Smith, E. J., Sorbara, South, Sweeney, Van Horne, Ward, Warner, Wildman, Wrye.

Nays

Andrewes, Baetz, Barlow, Brandt, Cousens, Cureatz, Davis, Dean, Eves, Fish, Gillies, Gordon, Gregory, Grossman, Guindon, Harris, Hennessy, Jackson, Johnson, J. M., Lane, Leluk, Marland, McCaffrey, McCague, McFadden, McLean, McNeil, Partington, Pierce, Pollock, Pope, Rowe, Shymko, Stephenson B. M., Sterling, Stevenson K. R., Taylor, Timbrell, Treleaven, Turner.

Ayes 66; nays 40.

Bill ordered for standing committee on social development.

The House recessed at 6:05 p.m.

February 11, 1986

HUMAN RIGHTS

STATEMENTS BY THE MINISTRY

EQUAL PAY FOR WORK OF EQUAL VALUE

SPRAY PROGRAM

ORAL QUESTIONS

EXTRA BILLING

HOSPITAL BEDS

EQUAL PAY FOR WORK OF EQUAL VALUE

EX-PSYCHIATRIC PATIENTS

SUGAR INDUSTRY

SAFETY ON TRANSIT VEHICLES

PLANT SHUTDOWN

URBAN TRANSPORTATION DEVELOPMENT CORP.

LICENSING OF TRUCKERS

WETLANDS POLICY

DEMOLITION CONTROL

CANADIAN TEXTBOOKS

CONSTRUCTION WORKERS

MINISTRY'S TIMETABLE

SERVICES EN FRANÇAIS

PETITIONS

ZONING BYLAW

FACULTY OF ARCHITECTURE AND LANDSCAPE ARCHITECTURE

ROMAN CATHOLIC SECONDARY SCHOOLS

ABORTION CLINIC

CONSTITUENCY BOUNDARY

REPORT

STANDING COMMITTEE ON PUBLIC ACCOUNTS

MOTION

COMMITTEE SITTING

INTRODUCTION OF BILLS

PUBLIC SERVICE PAY EQUITY ACT

ONTARIO INSTITUTE FOR STUDIES IN EDUCATION AMENDMENT ACT

MUNICIPAL AMENDMENT ACT

ORDERS OF THE DAY

HEALTH CARE ACCESSIBILITY ACT (CONTINUED)