Hansard Transcript 1986-Jun-09 | Legislative Assembly of Ontario

Mr. Speaker: I ask all members to join with me in recognizing in the Speaker's gallery Hayden Shell, member of the Legislative Assembly of the Parliament of Victoria, Australia. Please join me in welcoming Mr. Shell.

TABLING OF INFORMATION

Mr. Speaker: Also, with respect to the matter raised by the member for Carleton-Grenville (Mr. Sterling) on June 4, he made reference to the precedents book prepared in the office of the Clerk. I find these precedents made no effort to record such matters as those referred to.

In the past, if a minister was prepared to answer a question previously asked by a member who was absent, then before proceeding with the answer, he or she obtained the agreement of the leader or House leader of the party to which the questioner belonged to proceed, or received objection to the response from the leader or House leader. If the latter was the case, then the answer was deferred until the questioner returned.

Mr. Sterling: To me, that sounds exactly what happened in the past. In this case, the minister did not defer when asked.

Mr. Speaker: Order. The matter is not debatable. The member has the right to appeal, but it is not debatable.

Mr. Sterling: With your indulgence, Mr. Speaker, would it be possible for you to refer this to the standing committee on the Legislative Assembly so it might deal with future problems associated with this type of circumstance?

Mr. Speaker: I appreciate the member's suggestion; however, we are working under provisional orders. I am quite certain the standing committee on the Legislative Assembly will review all decisions that have been made and discussed over the previous period and over future periods.

SPECIAL WARRANTS

Mr. Harris: On a point of order, Mr. Speaker: Regarding Votes and Proceedings of Thursday, June 5, on page 198, "Sessional Papers: Special warrants for payment of money approved during the interval between sessions dated April 1, 1986, (No. 66) (tabled April 24, 1986)," I would presume that is in error. They were not tabled as of June 4. I believe there was some indication from the Clerk of the House that they were tabled June 5 and I wonder if that is an error in Votes and Proceedings.

Mr. Speaker: I thank the member for drawing that to my attention. I will certainly check it out.

MEMBERS' STATEMENTS

MONTH OF RAMADAN

Mr. Davis: Today is a special holy day of thanksgiving and prayer for more than 150,000 Muslims in Ontario and more than one billion Muslims around the world. Today marks the culmination of the month of Ramadan, a month of fasting for all Muslims.

The month of Ramadan is holy because the Koran, the holy book of Muslim, was revealed to the prophet Muhammad during this month. In today's world when many go hungry, the month of fasting brings to all Muslims a realization of what a large part of the world's population faces on a daily basis. Not only do Muslims fast during the month of Ramadan, they also practise self-restraint over their thoughts and actions and attempt to purify their souls and live a clean life.

I believe I speak for all parties in conveying to all Muslims, but especially to those in Ontario, our sincere good wishes and greetings on this festive day and our congratulations on the successful completion of the month of Ramadan.

CANADIAN AUTO WORKERS

Mr. Hayes: It is with great pleasure that I rise today to congratulate Bob White and his union's membership on the final ratification of an agreement which allowed the formation of the National Automobile, Aerospace and Agricultural Implement Workers Union of Canada, in short, CAW for Canadian Auto Workers.

I am extremely proud to be a member of Local 200 of that great Canadian union. It is a union with a proud tradition of working, not only for the benefit of its membership but also for all working people in Canada. It has fought for progressive changes and fairness and justice for all Canadians. It has proved it can negotiate with our American friends in an amicable way and continue to work together for the betterment of all working people.

Interjection.

Mr. Hayes: Someone mentioned free trade. I would like to make this announcement today. I attended the convention at the Royal York Hotel this morning. Opposing free trade is one of the issues they are going to be fighting very strongly. I hope this government and the federal government will take note of what the Canadian workers have done and let us set our own course and our destiny.

2:10 p.m.

COMMITTEE MEMBER

Mr. Ferraro: As chairman of the committee of parliamentary assistants for small business, I have a very brief and happy statement. I want to welcome to the committee the parliamentary assistant to the Minister of the Environment, the member for Prescott-Russell (Mr. Poirier). I am sure his addition to the committee will prove beneficial, not only for members of the committee but also for all small businessmen in Ontario concerned with environmental aspects. Some of the action and positive work being done by the committee will be made evident to the House in the very near future.

PROVINCIAL PARK

Mr. Bernier: I would like to bring to the government's attention an issue pertaining to Woodland Caribou Provincial Park, situated on the Ontario-Manitoba border west of Red Lake in northwestern Ontario.

Further to the response of the Minister of Natural Resources (Mr. Kerrio) last Wednesday, a meeting was held at the Guild Inn in Toronto in 1983, which was attended by all parties interested in the development and planning of new provincial parks. At that time, a new management policy was established for this park. It included controlled mining exploration, trapping, commercial fishing, limited hunting opportunities, high-quality tourism and harvesting and propagation of wild rice. Following broad and lengthy public hearings and discussions, all parties unanimously agreed on the new criteria. The people of northwestern Ontario were led to believe this new management approach would be implemented and acted upon.

Three years later, we now learn that these criteria are about to be changed. For pure, crass, political reasons, this management approach is being reviewed. People all across northwestern Ontario are fearful, upset, worried and getting angry with this reversal. The Minister of Natural Resources has lost the confidence of northerners. Where is this government's commitment to northern Ontario? Where is its commitment to jobs? Where is its commitment to accept an agreed-upon, sound economic development? I ask this government to put the 1983 operational guidelines in place and to prove to us that it does listen to northerners.

ADULT PROTECTION WORKERS

Mr. R. F. Johnston: Ten years ago, the government of the day established a group of workers known as adult protection workers, who were supposed to be independent advocates and case managers for adult mentally retarded people in our communities. They were to work with institutions, with local associations for the mentally retarded and with various government ministries and agencies to make sure the best possible programming was made available for these people.

This government is starting to undermine the independence of these people. A group of adult protection workers who worked independently at Sheridan College for many years, now is being moved to Oaklands Regional Centre, a centre for the handicapped in the province in a storefront operated by that organization. In Sault Ste. Marie, the ministry is amalgamating the Algoma Mental Health Association and the Sault Ste. Marie Association for the Mentally Retarded and is placing those advocates in the same facility and under the same budget controlled by the agencies with which they are supposed to advocate.

I implore the Minister of Community and Social Services (Mr. Sweeney) to agree with the Ontario Association for the Mentally Retarded and transfer these advocates to the Ministry of the Attorney General so that they can be truly independent and not be bound by the kinds of pressures they will feel in agency settings.

RECOGNITION OF SENIOR CITIZEN

Mr. Callahan: I rise to pay tribute to an outstanding senior citizen, Alicita Marshall, who is 82 years young. She is the founder of the Marina Historical Guild, an idea that came to her in 1954 when her husband, who was then president of National Cash Register, was involved with Crippled Civilians. The idea was to create dolls that were figures of history in Canada. The essential feature was that this program was made available to the handicapped. People in wheelchairs and various other forms of handicapped positions were able to do these things and have some meaningful way of expressing themselves.

I had the great honour of attending a dinner with this very revered senior citizen, along with the Minister without Portfolio (Mr. Ruprecht). It was an experience I treasure. She is a woman who is doing a great deal for the handicapped in Ontario and apparently throughout the United States.

NOISE BARRIERS

Mr. Jackson: I would like to rise today on an issue of great importance to the people of my constituency who live near the expansion of the Queen Elizabeth Way near Lakeshore Boulevard. These people, many of them seniors, living in the Brant Park Apartments and those living on Bellview Street and Bellview Crescent, appreciate progress and understand there are costs associated with it, as do the people of Burlington South generally.

Unlike the Minister of Transportation and Communications (Mr. Fulton), who balks when shown the costs of progress towards extending Go Transit to Burlington, these people did not balk until it became clear it was not only money this expansion was costing but also increased traffic noise and ruined sleep hours together with stress and adverse health effects.

The minister pointed to sound predictions and said the residents were not really being inconvenienced. The residents did their own study of ministry specifications, which showed that the levels are substantially higher than the ministry's predictions. One resident, Bob Pickard of Brant Park Apartments, has gone to the time and expense of a sound study, which shows the area should be in the top priority for sound barriers and not, as has been indicated, be left in the ministry limbo several years down the road.

Perhaps where there are residential complaints, the ministry does not feel action is warranted. The minister should be advised that the city council of Burlington knows this area perhaps better than he does, and its members say, "The city of Burlington remains unconvinced with the response provided by his ministry."

The minister and government officials show no reluctance to rush down and take credit for the opening of the new skyway bridge. I still have a pocketful of pictures from the minister. It is even more important that the minister should show the same quick response to the residents on this matter.

DEVELOPMENTALLY HANDICAPPED

Ms. Bryden: I want to draw attention to the problems of an individual who is developmentally handicapped and who seems to be falling between the cracks in our welfare system. I am referring to Vito Desimini of Mississauga, who is facing charges and a trial for an offence under the Income Tax Act, which it is evident he did not understand. If we are a caring society and if the government claims to be a caring government, it should be looking at the problems of this individual and the failure of our welfare and corrections system to meet his needs.

His case should be of particular interest to the Minister of Community and Social Services (Mr. Sweeney) and the Minister of Correctional Services (Mr. Keyes). Both of them, I am sure, are caring persons, but they do not seem to have persuaded the Treasurer (Mr. Nixon) to put up sufficient funds for the developmentally handicapped or to see that facilities are provided where a person such as Vito Desimini can be looked after.

There is a tremendous waiting list for group homes. He is paying $410 for rent and his allowance is $436 a month.

Mr. Speaker: The member's time has expired. I am sorry.

2:17 p.m.

STATEMENT BY THE MINISTRY AND RESPONSE

RECREATION SERVICES

Hon. Mr. Eakins: As National Fitness Week, just gone by, has demonstrated, more and more Ontarians are taking part in fitness and recreation activities on a regular basis. My ministry plays a major role in ensuring that our citizens are able to participate. I am pleased to announce today that three programs that relate directly to recreation in Ontario will receive substantial funding this year from our government.

The community recreation planning program supports community planners and decision-makers. It provides financial assistance to obtain professional expertise for help in planning the future development of recreation services. Improved community services will no doubt result from the $2 million in funds allocated to this program.

A second program, the Wintario development program, exists to improve Ontario's level of participation in recreation. The Wintario development program is a major backer of our amateur sports system. Under this program, our provincial athletes are assisted with funds needed to attend important provincial, national and international competitions. Wintario development also assists sports groups that are hosting national and international sports events in Ontario.

This program also helps community and provincial recreation organizations meet the special needs of a variety of groups within the community, including our seniors and the disabled. More progress in meeting our recreation, sports and fitness goals will now be possible. I am pleased to announce that $8,190,000 has been allocated to the Wintario development program.

A third program is designed to ensure that our capital investment in recreation facilities is well managed. The facilities management program provides funds to enhance the capabilities of the staff who operate our arenas, pools, community centres, parks and other recreational facilities. A total of $1.4 million has been allocated to the facilities management program.

I urge those communities, community recreation groups and sports groups which are interested in these programs to contact the nearest field operations office of my ministry or the appropriate sports governing body. We have three concise and easy-to-read booklets available on who is eligible and how to apply for assistance under these programs.

Mr. Hayes: I am pleased the ministry has come out with these programs to meet some of the needs of the young, the elderly and the handicapped and is also providing financial assistance for planning future developments for recreational facilities.

The minister will be quite pleased to know that a week ago Saturday I joined in National Fitness Week and participated in the township of Tilbury North walk. I walked 10 miles that day to help raise funds for the recreation committee.

One of the things I would like to point out is that when I was taking that 10-mile walk, some of the people involved in recreation asked me about some of the programs. When they apply for them, they get back letters saying the programs have run out of funds; so I am very pleased the minister is putting some more funds in there. Maybe we can take another look at some of those areas to let us get Essex North back into some of the recreational facilities.

2:22 p.m.

ORAL QUESTIONS

EXTRA BILLING

Mr. Grossman: I have a question for the Premier with regard to the extraordinary disruption in the health care system that is quite possible later this week or next week. It was reported last week in the newspapers that two very experienced mediators have indicated they believe they are capable of resolving the current conflict between the government and the Ontario Medical Association. Since he has had a few days to reflect on that offer, etc., is the Premier today prepared to entertain the possibility of picking up the phone, calling the OMA and suggesting a mediator?

Hon. Mr. Peterson: Since our discussion with the doctors started many months ago, I have had many offers from people who felt they had the solution, offers of mediation in a variety of different forms. I am not talking about these two gentlemen, but when pressed, it did not seem there was anything constructive they could add to the face-to-face discussions we have had with the OMA.

As the honourable member knows, ultimately, decisions have to be made. We do not want to put this thing over for ever. We have attempted to work it out. If we can meet with the doctors face to face to solve the problems, we are happy to do that.

Mr. Grossman: If he is happy to meet with the doctors to try to solve this problem face to face, with impending chaos in the system, why will he not pick up the phone, call the OMA and suggest, first, another face-to-face meeting and, second, that he is willing to discuss its indication that it would be happy to have a mediator if only he would request it? Why will he not do that today?

Hon. Mr. Peterson: The honourable member is quite at liberty to criticize the decisions of this government, but we do not feel at the moment it would be constructive in bringing any kind of solution. I read things that he reads in the newspapers and suggestions that are made. Sometimes they are accurate and sometimes they are not. I have no indication this would solve the problem at this point. If I felt it would, we would be very happy to chat with them.

Mr. Grossman: Let us look at where the situation is now. From the time this discussion started, the OMA has agreed to stop extra billing for three categories of people. In its latest communication with the Attorney General (Mr. Scott), it has indicated a willingness to go further. The OMA has indicated it would like a truce and that it is willing to have a mediator attempt to go further. Given all those indications from the OMA, the Premier surely would have to agree there is the slightest chance that a mediator might prove to be helpful in these circumstances. Why would the Premier not select that reasonable route of having a mediator over and above the kind of option we are now facing, which is a potential, major withdrawal of services?

Hon. Mr. Peterson: The question is to mediate what. Obviously, we took a conciliatory approach. The minister sat down with the doctors over 11 meetings and he put forward a very specific, 10-point proposal. My honourable friend reads the newspapers, so I am sure he will see there was a considerable amount of favourable view of those 10 points. We were prepared to sit down and discuss every one of those with the doctors. At one point, as I reported to this House and was criticized for so doing, there were some grounds for optimism that it could be worked out. Then the doctors changed their minds on the particular point. They were getting advice from a new adviser, Mr. Trevino, someone the member knows quite well because he went to the mat with him, and they changed their minds on the subject. I am sorry we could not work it out along those lines.

The bill is not through the House. We are working on it, with the help of the opposition and of all the members in the House. If there are ways to solve some of these situations, and for the government the bottom line is ending extra payments for patients, then we will be happy to work with them.

Mr. Grossman: There has rarely been a more categorical misrepresentative view of a series of negotiations than the one the Premier has just represented to this House. It is categorically and factually incorrect and inaccurate.

Mr. Breaugh: Wait a minute.

Mr. Foulds: I seem to remember some of the reports in 1983 were not too accurate then.

Mr. Grossman: Our second question

Interjections.

Mr. Speaker: Order. I listened very carefully. The Leader of the Opposition stated that the Premier misrepresented. Would the Leader of the Opposition withdraw that word?

Mr. Grossman: Mr. Speaker, if you feel I used the word "misrepresented" to this House, I would withdraw that.

Mr. Speaker: I listened very carefully. Do you withdraw?

Mr. Grossman: I withdraw that word if it is your belief that I used it, Mr. Speaker.

Mr. Speaker: Thank you.

Mr. Wildman: What does the member think he used? Does the member not know what he used?

Mr. Grossman: Go get your instructions from them and call us later.

Our second question is for the Minister of Health (Mr. Elston), who on this very critical day is not yet in the House. We are informed he might be here in 15 minutes and we ask to stand down our second question until he arrives.

Mr. Speaker: Does the House agree to stand down the second question? Agreed.

PENSION FUNDS

Mr. Rae: I have a question for the Minister of Financial Institutions. Our party has just learned that Consolidated Foods of Chicago, which owns Sara Lee, a company that is operating in Brampton, has just applied to the Pension Commission of Ontario to withdraw approximately $3 million, and that this plan also covers workers at Electrolux, although the workers at Electrolux are not unionized.

As a matter of government policy, will the minister at the very least place a freeze on any further haemorrhaging of pension funds, which on Thursday the Legislature said belonged to workers and not to companies, until such time as we have passed a law in this province which clearly reflects the view of this Legislature?

2:30 p.m.

Hon. Mr. Kwinter: The leader of the third party will know we cannot deal with pension funds retroactively in that way. However, we have implemented a policy that any company requesting a withdrawal must give everybody who is going to be affected by that request 30 days' notice. During that 30-day period, these people can make representations on why the company should not be allowed to make withdrawals. That is the situation now.

Mr. Rae: In effect, the minister is saying he is not prepared to do anything other than buy a little time. Does he not think it only fair, in the light of the decision that was made by this Legislature by way of resolution on Thursday, that he do something to give effect to that resolution?

Hon. Mr. Kwinter: The effect of that resolution was just that; it was a resolution. As the leader of the third party knows, I am bringing forward a new Pension Benefits Act and that can be debated. If it is the will of the House that an amendment be made to it, that will have the force of law.

At present, there is no way we can enter into any type of negotiation that will alter a contractual agreement between management and labour without having legislation, and it will not be retroactive. It is not going to happen.

Mr. Rae: The minister should know that his own pension commission, in its submission to the court last week with respect to Dominion Stores, said the plan was not a negotiated document but was a document administered entirely and exclusively by the company.

In the light of that fact and the reality that the vast majority of pension plans are not genuinely negotiated between the parties but are presented to the workers on a take-it-or-leave-it basis, whether they are organized or not, does the minister not recognize the obligation of the government to step in on behalf of Canadian workers to protect this money and make sure it does not disappear back to the United States but stays in Canada to improve their pension plans and effectively protect them and their dependants?

Hon. Mr. Kwinter: I do not want to get into much detail on the cases before the courts, but the member will know that in the Dominion Stores case the withdrawals were considerably more than that part that is being litigated. There is no question that the pension commission felt there was some area for some kind of dispute about one section and that is why it is before the courts, but there was no dispute on the other parts. It was something the pension commission felt was right and it gave the approval to do it.

Mr. Rae: The minister does not know. The pension commission approved the whole thing. The matter was not taken to court by the pension commission. It was taken to court by the workers because the pension commission did not do its job and did not protect the workers, in the view of the workers. The pension commission never had anything to do with it.

BEACH POLLUTION

Mr. Rae: I have a question for the Minister of the Environment. The minister will be aware with respect to our beaches, not only in Toronto but also all along the Great Lakes system, of the growing evidence of pollution of those waters by means not of high-pollutant chemicals but by the reality of continued pollution of sewage and of raw sewage floating directly into the rivers.

Can the minister confirm that his latest budgetary estimates show very clearly that under item 3, water resources activity, his ministry spent $4 million less than was authorized in 1985-86? Is he aware that the budget for grants to municipalities has been cut by $1.5 million, his budget for the Canada-Ontario agreement for sewage program has been cut by $1.7 million and that when it comes to basic sewage work from one end of the Great Lakes to the other, protecting the environment and dealing with the pollution of our beaches, he is doing less than the former minister Morley Kells did?

Hon. Mr. Bradley: That is a criticism I must take seriously because to be compared in those tones and in that particular case is something to behold.

I can assure the member that our ministry is working hard on a couple of programs which we think will be very helpful in alleviating this problem. As the member would know, part of the problem has been identified as combined sewer systems which in a large storm produce an effluent that cannot go through the plant; if it does, it removes all the chemicals used for treatment. That is one problem.

A second is considered to be some urban runoff. There are those who contend that even if we separate the storm and sanitary sewers, there is still a significant problem of urban runoff bringing some of the same bacteria into the lake system.

In the light of these large problems, particularly those which relate to international waterways -- he member for York South (Mr. Rae) is losing attention over there --

Mr. Speaker: Order. Would the minister please conclude?

Hon. Mr. Bradley: -- it is our view that we should have our national government involved.

Mr. Rae: We need sewage separation in dealing with ministerial statements when it comes to answers. The coliform count is definitely up with respect to the answer. That is the concern I have.

Mr. Speaker: Supplementary.

Mr. Rae: There have been special proposals made to the ministry on the construction of detention tanks which would deal with both the problems the minister is describing, those of sewage separation and runoff. Why has the ministry not responded to the study dealing specifically with detention tanks? It has been completed for some time. I go back to the bottom line. Why is he spending less when it comes to grants to municipalities and the Canada-Ontario agreement for sewage program? Why is he spending less and doing less than the previous government?

Hon. Mr. Bradley: As the member would be aware, the last time I was in this community with the federal Minister of the Environment, the Honourable Tom McMillan, we were dealing with a continuation of a program which deals with sewage treatment plants, for instance. That is the program to which he makes reference.

There was money available for sewage treatment plants for a time under what was called Central Mortgage and Housing Corp. In the agreement we have signed with the federal government, we have agreed to continue our operation in this regard, to provide the necessary funding and to deal with that problem.

In regard to those relationships directly with the municipalities, we have ongoing discussions with both regional municipalities and local municipalities with a view to providing in the near future the type of enhanced program we feel will deal adequately with the problem.

Mrs. Grier: The minister says he is having ongoing discussions with the municipalities. I am sure the minister is aware that the closure of the beaches in Etobicoke and in the western end of Metropolitan Toronto is happening earlier in the season than previously. The minister has not yet informed the Metro municipalities of how much funding will be made available to them this year. Can the minister tell us what he intends to do to clean up the beaches of Metropolitan Toronto this summer?

Hon. Mr. Bradley: If the honourable member anticipates that every beach in Metropolitan Toronto will be open this summer, she should be aware that even under a New Democratic Party government not every beach would be open every hour of every day this summer.

Interjections.

Mr. Speaker: Order.

Hon. Mr. Bradley: To be fair, that would not happen. I can tell the member --

Interjections.

Mr. Speaker: Order.

Hon. Mr. Bradley: I know the member is interested. Some of her colleagues may not be, but the member asks a good question.

We will be working in conjunction with the area municipalities, specifically with Metropolitan Toronto, with a view to providing additional funding this year to deal with the problem of sewer separation and with the type of program the member's leader mentioned, which involves ponding of the storm runoff. We will also be looking at the other potential sources, industrial and farm runoff and things of that nature, to ensure we have a comprehensive program that pinpoints problems and spends the money most effectively. We will be doing that on an increased funding basis this year.

2:40 p.m.

EXTRA BILLING

Mr. Grossman: My question is of the Minister of Health. At Sensenbrenner Hospital, as a result of the current disagreement between the government and the Ontario Medical Association, the chief of staff has resigned, the president, vice-president and secretary-treasurer have all resigned from the medical staff executive, and all medical staff have withdrawn from all administrative positions and functions pertaining to hospital operation. As required by law, the board of governors can no longer fulfil its mandate and uphold the Public Hospitals Act.

Given this situation, of which the minister was notified last week, how is it that his office staff could have said in response to a request for assistance from the hospital, "Nothing is to be done for the time being"?

Hon. Mr. Elston: The honourable gentleman knows that some things have been done there. There have been contacts with respect to the people who are acting as staff at the hospital, who are admitting patients and who obviously have the primary obligation to ensure that the care of their patients is maintained. The honourable gentleman knows that contacts were made.

My reading of the situation when I left here last week -- I do not have an update today; I just came in from the constituency -- was that the matter was in hand.

Mr. Grossman: With respect, this is not meant to be a judgemental situation. The question is whether the resignations due directly to the government's handling of Bill 94 bring that hospital into a situation where it no longer complies with the Public Hospitals Act or regulation 865.

Having read the communication from Sensenbrenner, and knowing the situation as he does, will the minister not agree with me that the hospital is no longer able to meet the provisions of the Public Hospitals Act and regulation 865?

Hon. Mr. Elston: On reading the regulation, one would have to be aware of the fact that there are various ways of establishing the peer review and the quality control that are necessary inside the hospital. We are of the view that if efforts are made by the board to establish, formally or informally, the mechanisms to review the quality of care inside that institution, it is carrying out the mandate of the Public Hospitals Act.

Each of us must be very much aware of the fact that physicians who admit patients to public institutions are also required, along with the board members, to provide the very best assurance that quality medical care is being given inside those institutions. Having some information about the contacts that were made, I am assured -- at this point, anyway, unless the honourable member has a particular case he wants to bring to my attention -- that things are going well at Sensenbrenner Hospital, although, as he has rightly stated, it may be that the chief of staff and others have resigned from the official or more formal mechanisms.

Mr. Grossman: To make matters worse, we are informed that the trustees of the hospital have indicated they may also resign because they do not want to be held personally responsible for problems that may arise.

Is the minister going to approach the next few weeks, and the possible withdrawal of service due to the way the government has handled Bill 94, from the standpoint of making his own judgements from day to day on which hospitals are able to carry on? Or, instead, is he going to enforce the Public Hospitals Act and have a strict interpretation of whether hospitals comply with that act?

I put the proposition to the minister that if he is going to make judgement calls with regard to when hospitals can safely operate and when they cannot, he is playing fast and loose with the health of the people of this province.

Hon. Mr. Elston: I am not playing fast and loose with the health of the people of this province. The member knows that full well and he ought to stand up and admit this is the case.

He went out and addressed a gathering on the front steps of this public institution and told people they ought to do the necessary things. He came very close to suggesting, although he might back away from it now, that there be a withdrawal of services by that august gathering. He will probably say this is not so at this point. He is backing away already, and he is talking about playing fast and loose. This poor guy does not know what in the world is going on.

I can tell this gentleman that I am interested in maintaining the quality of health care for the people of this province. When we found out about Sensenbrenner, we reacted. We took the opportunity to review the situation and we are continuing to review it. I do know contacts were made to ensure there is quality of care. If the member says there is not quality of care provided for the patients of that institution, tell me that specifically. If that is his allegation, put it up front.

Mr. Grossman: The minister's attempt to blame other people for the withdrawal of services, which unilaterally he has caused --

Mr. Speaker: New question.

Mr. Grossman: -- is a shameful display of lack of courage to face up to the circumstance in a strike created by the Premier (Mr. Peterson).

Mr. Speaker: Order. Your question is to which minister?

Mr. Grossman: It is his strike; let it hang around his neck.

Much as the minister wants to throw the onus on other people for assessing when health care is threatened, as his Premier wants to throw the onus on others for showing that mediation would be helpful, I want to repeat the question. Is he going to make a personal judgement with regard to when a hospital can continue to operate or is he going to enforce the Public Hospitals Act to the letter, in order to ensure the health care of the people of this province?

Hon. Mr. Elston: We have mechanisms in this province to operate and manage our public hospitals. They are called boards of trustees. Those boards are functioning. The people are taking the steps that are necessary to function and they are carrying on well. If the member is suggesting that is not taking place, he should make the specific case and I will look into it. He knows I will. He need only give the specifics of it, with none of this casting about for the ifs or the hypotheticals. Please put the specifics and I will examine the case.

Mr. Grossman: I want to give the minister some specifics: the chief of staff has resigned; the president, vice-president and the secretary-treasurer have resigned; the medical staff has withdrawn from administrative positions and functions relating to hospital operations. Those are specifics with regard to what has happened at the Sensenbrenner Hospital.

My question is simple and the minister has ducked answering it. In view of those resignations, is it his view that the Sensenbrenner Hospital totally complies with the Public Hospitals Act and the regulations thereto? Does it or does it not?

Hon. Mr. Elston: It is my understanding that they have made the necessary arrangements to carry out the intent of that act, which is to ensure the quality of care for the patients in that institution. As I understand it, they are providing quality of care for the patients in that institution as is required.

SEWAGE TREATMENT PLANTS

Mr. D. S. Cooke: I have a question for the Minister of the Environment. Is the minister aware that the city of Windsor is dumping one million gallons of untreated waste a day from the east-end sewage treatment plant? What is he prepared to do to make sure the city of Windsor lives up to any regulations he would expect the private sector to meet and the city should also have to meet?

Hon. Mr. Bradley: For a number of years, I believe the city of Windsor has experienced that problem because of lack of capacity at that plant. Our ministry officials have met with the representatives of the engineering department in Windsor on many occasions. In this case, an expansion to that plant has been planned to deal with that problem.

Mr. D. S. Cooke: The reality is that the expansion is not planned until the end of the 1980s and it is already two years behind because the city cannot afford it.

Is the minister also aware that literally thousands of homes in the south end of Windsor are still hooked up to septic tanks and dump raw sewage in the Grand Morais drain that goes into Turkey Creek and into the Detroit River? There are also hundreds of people on sewers that are not separated, so raw sewage is going directly into the Detroit River. The total cost of correcting this problem for the city of Windsor is $145 million. If the minister realizes the city cannot afford it, why does the province not start a program and get it cleaned?

2:50 p.m.

Hon. Mr. Bradley: The member will be aware that over the years the province has contributed a significant amount of money to the cleanup of problem sewage treatment plants, as the former minister also would indicate. It is our view that additional funds are required for this. The member may be aware that I have been in discussion with the federal Minister of the Environment, particularly in the light of two facts: first, that these are related to international waterways, and second, the historical assistance that has been provided by the federal government in years gone by. I can add a third, that there is the need for what we call infrastructure renewal, which was discussed at the annual meeting of resources and environment ministers.

It is my view that the honourable member is quite correct in his assessment that there is a need for more funding for activities of that kind. This province is prepared to play its role. We invite the national government to participate in what we think can be a very comprehensive and extensive program that will solve many of the problems that exist around the province.

HEALTH SERVICES

Mr. Bernier: I have a question for the Minister of Health. In allocating the 176 chronic care beds to northern Ontario, did the minister consult with the four northern Ontario district health councils to obtain a picture of their needs?

Hon. Mr. Elston: With respect to allocations, they are not finalized. I spent some time in northwestern Ontario at the end of last week. I spoke with some of the members of boards of local hospitals, as well as with the district health council and members of the hospital committee to get some first-hand information with respect to the needs in that area. However, the allocation is not yet fixed.

Mr. Bernier: Can the minister assure the people of northern Ontario that we will get our fair share of that 3,000-bed allocation?

Hon. Mr. Elston: I think the honourable gentleman recognizes better than anyone that a series of awards has already been made for extended care beds in his area under the auspices of a ministry for which he was minister. The EldCap program openings are just beginning. We are looking at the influence they will have on the needs for that area during the next several months. However, determination of actual allocations is not yet final.

WORKERS' COMPENSATION BOARD

Mr. Hayes: My question is for the Minister of Labour. He is well aware that the Windsor and Essex region is one of the most industrialized areas in southwestern Ontario. I am sure he is also aware that for the period January through September 1985, the Windsor-Essex region had the highest rate of compensation cases and the highest accident frequency and severity rate in Ontario. Can the minister explain why, as in the tradition of past Tory Ministers of Labour, he has chosen to ignore the needs of the heavily industrialized city of Windsor and area by failing to locate a Workers' Compensation Board regional office in that city?

Hon. Mr. Wrye: I will be happy to explain. I am sure the honourable member will remember that last fall, as part of the reforms under Bill 101, Workers' Compensation Board changes were made in the administrative structure. Since October 1985, there is a new independent board of directors of the WCB. That board has substantial business and trade union representation, as well as representation of injured workers' groups and the public.

In the late fall, reacting to the need for further decentralization, a need I have emphasized to the new chairman of the board, Dr. Elgie, the board of directors of the WCB made a determination for three new regional offices to add to the regional offices already in place in London and Sudbury. Their determination was to put those offices in Hamilton in the first instance, then in Ottawa and then in Thunder Bay. In the first two cases, it was necessary to have large regional offices and large centres to reduce the case load in Toronto. In the third case, important cost factors were involved. I am sure the member's colleague the member for Port Arthur (Mr. Foulds), as well as the member for Fort William (Mr. Hennessy), can confirm that for him.

Mr. Hayes: I find it rather interesting that on several occasions the minister has stated he cannot really influence the WCB, but at the same time, when it made the announcement in Hamilton, he was there to take credit for opening that regional office. Will the minister take action to put a WCB office in Windsor to meet the needs of the people in Windsor and in Essex and Kent counties?

Hon. Mr. Wrye: I am delighted to hear the honourable member put that information on the record. I am sure all his colleagues agree the minister ought to interfere, because -- let us be clear -- he is suggesting the minister ought to interfere and say to the board of directors of the WCB, "Look, fellows, I am the Minister of Labour, I am from Windsor, I want an office in my community and I want one now." If that is what the member is saying, he ought to say that.

I was in Hamilton, along with the chairman of the WCB, as the member may or may not know, to announce three new regional offices and to make it clear, and I made it clear on any number of occasions, that this government believes firmly in the policies of decentralization. Unlike the previous government, we have moved ahead with three new regional offices and we intend to move ahead with more as soon as the appropriate time comes.

Mr. Hayes: On a point of order or privilege, Mr. Speaker: Maybe I should have made a clarification. I should have asked the minister whether he would take credit for it if it got there.

Mr. Speaker: Order.

ASSISTIVE DEVICES PROGRAM

Mr. Andrewes: My question is to the Minister of Health. When does he anticipate meeting the commitment of his leader, made to the Ontario March of Dimes, that "Liberals stand for immediate implementation of the assistive devices program for all ages"?

Hon. Mr. Elston: We have moved in that area in several stages. We have worked on expanding the program, first, to the age of 21. We will be expanding that to 22 on July 1. In addition, prostheses will be covered for all age groups starting July I and respiratory services will be made available September 1, 1986.

Mr. Andrewes: Great progress. This is a very complicated supplementary so the minister will have to listen carefully. For medically prescribed devices under the assistive devices program, the ministry covers 75 per cent of the costs and the patient pays the other 25 per cent. How does the minister rationalize the apparent contradiction between his concern on Bill 94 for health care accessibility, where he is arguing that patients are limited in accessibility in about four per cent of the cases, when in the case of assistive devices every patient who qualifies pays 25 per cent of the cost all the time? How does the minister rationalize that contradiction?

Hon. Mr. Elston: It has taken us about 25 years to implement a fairly wide-ranging insured medical services program in this province. It takes some time to put things into place. I understand that. There are a number of areas in which we have to make sure our ability to service the program is in place and working. We have made sure we have July I in place for those who require prostheses. We will be making the necessary arrangements for September I with respect to respiratory equipment. We are working away at that. The concern all of us have is that people do have accessibility to this.

Right now, for a good number of people there is no assistance whatsoever and we are moving to ensure there will be assistance available -- for prostheses and respiratory equipment -- and I am pledged to moving even further.

Mr. Andrewes: For all ages.

Hon. Mr. Elston: For all ages.

3 p.m.

SPECIAL EDUCATION

Mr. R. F. Johnston: I have a question for the Minister of Education. It concerns special education and a program of Bill 82, which is supposedly now in place throughout the province, guaranteeing all children an education appropriate to them. Why is there no program available in the entire region of Ottawa-Carleton in any of the school boards for French-speaking children who are blind or severely visually impaired? There are two teachers in the English-speaking section but none at all in the French-speaking section in that region.

Hon. Mr. Conway: As the honourable member indicated, in September 1985 all school boards in the province were to be prepared to provide for the requirements of all their exceptional students. That is the law of the province. They either provide directly or through a purchase of service. I am not aware of the situation in the national capital area to which the member makes reference but I will be happy to take today to investigate, hear the board's side of it and report back to him tomorrow.

Mr. R. F. Johnston: One of the things the minister is likely to find is that it is very difficult to provide programming when there is nobody capable of teaching it. Does he realize that in the whole of Ontario I have only been able to find one person who is credited to teach to the visually impaired in French? She works in Sudbury.

Why do we not recognize training from Quebec as acceptable in Ontario? Why is it that we have no program available anywhere in Ontario to train teachers in French to look after the visually impaired?

Hon. Mr. Conway: The member does raise a valid point about a specialized area where our requirements are not fully met. My colleague the Minister of Colleges and Universities (Mr. Sorbara) and I have been reviewing ways and means of dealing with those rare but specialized circumstances. We hope we will be able to address all of those in the not-too-distant future. Again, I would like at least 12 hours to investigate the particular matter that --

Mr. R. F. Johnston: It is not so rare. There are more. I will be back.

Hon. Mr. Conway: I know there are some. My health unit cannot attract an occupational therapist to my county. Some people do not want to locate in Renfrew, if the member can believe that. I do not know why that should be a concern, but it is.

I recognize that there are some difficulties. I do not deny that, but the member's concern about the national capital is something I will investigate and will report back on to him very promptly.

SENIOR CITIZENS' SERVICES

Mr. Cousens: I have a question of the Minister without Portfolio responsible for senior citizens' affairs. Last week, on Monday, June 2, in a statement to the House the minister indicated: "In addition, I will continue my role in policy development in health and social services. I will address three major areas. The first of these areas is a new extended care act."

Can the minister please describe the nature of this extended care act and the services for the elderly that would be impacted by such an act?

Hon. Mr. Van Horne: The member for York Centre picks on what I think is one of the most significant parts of our white paper. What it will do is put under one piece of legislation what has existed under three pieces of legislation, the Charitable Institutions Act, the municipal Homes for the Aged and Rest Homes Act and one other piece of legislation.

Mr. Rae: The Nursing Homes Act.

Hon. Mr. Van Horne: It will provide a single, improved act, which would apply to all providers and establish uniform criteria in such areas as inspection services, programming, staffing, quality of care and physical plant standards. That other piece of legislation is the Nursing Homes Act, which was mentioned by the leader of the third party.

Mr. Cousens: We know the Minister of Health (Mr. Elston) is preparing to introduce amendments to the Nursing Homes Act. Will the Minister without Portfolio's proposed extended care act make the Nursing Homes Act redundant, or is it his intention to further confuse Ontario by bringing in the issue of regulation of extended care beds and by proposing yet another piece of legislation?

Hon. Mr. Van Horne: Certainly not. As the Minister of Health indicated within the last week or so, he is bringing on stream interim measures to address a very deep concern of ours, that is, the whole nursing home process. It will not interfere; as a matter of fact, it will go beyond that. I am surprised that the member, in asking his question, did not also address the issue of heavy care, which is a concern to all of us and which also will be addressed as we rewrite this legislation.

INTERNSHIPS

Mr. Wildman: I have a question of the Minister of Health. In view of the fact that in his ministry's underserviced areas program there are approximately 75 positions vacant in northern Ontario and in view of the fact there is a significant number of refugee doctors in Ontario who are willing to practice in the north, will he ensure that there is a sufficient number of internships available to enable these doctors to qualify under our medical licensing regulations?

Hon. Mr. Elston: Over the past several years and months in this province, we have provided a number of graduates of foreign medical schools with opportunities to intern in Ontario. The honourable member knows one of the problems that has arisen is that there are about 600 positions generated by graduates of Ontario schools and others which are then open in addition to that. As I understand it, all positions are open to anyone who applies. These reviews are made by the people who locally know what the needs of their hospitals are, and from there they go on to qualify under the requirements of the College of Physicians and Surgeons of Ontario.

It seems to me that if we analyse the number of people who are coming into the system in Ontario, we will find a very high percentage of what are called graduates of foreign medical schools now practising in Ontario. We have had a substantial increase in the numbers of people registered to practise in Ontario who are graduates of non-Ontario institutions and are finding work here in Ontario.

Mr. Wildman: The point is, there are not enough internships. Is the minister not aware that we have a number of Vietnamese doctors and 52 Polish doctors, among others, who have indicated they wish to practise in northern Ontario? His own leader, now the Premier, indicated in 1984 this was an idea that should be carried out. Will the minister take action to ensure that there is no longer the current waste of talent? For instance, why should a well-qualified dermatologist be out of work when there is a need for a dermatologist in Sault Ste. Marie? Why should there be one internist serving as an orderly and another serving as a file clerk in Toronto hospitals? Is this not a tremendous waste of talent?

Hon. Mr. Elston: One of the requirements of the Ministry of Health and of the college of physicians and surgeons is to ensure that those people who are trained have qualifications which will meet the public needs and the public protection in Ontario. It seems to me we will have to be sure that, whatever program is devised to assist some of those people, the public interest will be protected. That is what we are doing now. We are taking a look at policies which will protect the public interest and we will continue to do that.

HOSPITAL FUNDING

Mr. Rowe: My question is to the Minister of Health. Operating grants for hospitals this year are being held to a four per cent increase. This fails to cover the increase in operating expenses of hospitals and is putting a tremendous strain on their budgets. Royal Victoria Hospital in Barrie, for example, is budgeting a $2-million deficit, Cornwall General Hospital a $500,000 deficit and North Bay Civic Hospital a $1-million deficit. What action is the minister currently taking to ensure that hospitals do not curtail services to patients because of a lack of funding on his part?

Hon. Mr. Elston: The honourable gentleman will know this government has done a great deal to take the pressure off the funding deficiencies which existed over the past decades. We have done a great deal to alleviate the difficulties from which a number of those people have suffered in the past. It is not uncommon for people to take a look in the early stages and see a deficit being forecast for their institutions. Over the course of the next several months, there will be a very close monitoring of those institutions to see whether the projected settlements do what is expected, or at least what is projected they will be doing at budget time. We work very closely and will continue to work very closely with those institutions which are projecting there will be a deficit at the year's end.

I have found over the past 11 months or so, however, that the deficits which were projected in many cases did not reach the magnitude which was felt would result at the very early stages. I am very confident that the people in the institutional branch of my ministry will be able to monitor and look after the deficiencies in funding which the member has suggested might be projected by those various institutions.

3:10 p.m.

Mr. Rowe: This government has done a lot. Royal Victoria Hospital had a $50,000-surplus a year ago and now it has a $2-million deficit.

Hospitals are being put in a very difficult position because of underfunding. One striking example is in Cornwall, where the Cornwall General Hospital has been forced to divert more than $1 million of its capital reserves to meet its day-to-day operating expenses.

Will the minister consider increasing the amount of operating grants given to hospitals so that they are not forced to use funds already set aside for other projects?

Hon. Mr. Elston: The honourable gentleman will be pleased to know that the diversion of those capital funds over the last little while has taken place under an administration for which he ran and for which he claimed a great deal of support.

I met recently with members of the Ontario Hospital Association and others who are interested in looking at the funding mechanisms and who are working at implementing some new funding mechanisms to deal with the realities of the 1980s.

In addition, we are looking at reporting mechanisms that will let us be more aware of the exact nature of the monetary needs of various institutions. When the honourable gentleman stands here and says this $1 million, for instance, was just in the past few months, or suggests that to be the case, he is obviously mistaken, because that has taken place over a long number of years. If there has been a deficiency, we have moved to help alleviate the difficulties that have been suffered in many of our institutions. In fact, this past year we provided some extra funds to help some of those institutions over the hump.

ONTARIO LOTTERY CORP.

Mr. Swart: My question is to the Minister of Tourism and Recreation. The minister will recall the scam earlier this year surrounding the sale of Ontario Lottery Corp. tickets in the United States, particularly the case of Chubby Gallagher of Maine, who was not able to collect $10 million even though he had sent in money for the tickets in good faith. Can the minister explain why this scam continues after his commitment to this House last January 16 that he would take action against it?

Hon. Mr. Eakins: I assure the honourable member that we are working on something in this regard. This scam will not continue very much longer, and I am sure I will have something to report to the House very soon.

Mr. Swart: Is the minister aware that a new company has apparently been formed, by the name of Horizon International, which is now selling those tickets in the United States. This company is based in Brampton and is charging, in Canadian dollars, about $3 above the face value of the ticket. Is the Charles Wilson who heads this company not the same person under a different name who headed the infamous Financial Freedom Group and the Winshare Club? I ask the minister again, why does he not stop this scam by taking the simple legislative action to prohibit all Ontario Lottery Corp. tickets being resold above their face value?

Hon. Mr. Eakins: As I have told the honourable member, action is being taken, and the member will be hearing something very soon on that.

PHARMACEUTICAL LEGISLATION

Mr. Leluk: My question is to the Minister of Health. Seven months ago, the minister expressed to this House a concern and an urgency to have the pharmacy bills, Bills 54 and 55, passed as soon as possible in order to issue a new Drug Benefit Formulary. The standing committee on social development completed its clause-by-clause second-reading review and approval of these bills some five weeks ago. Does the minister still believe in the urgency of Bills 54 and 55? Does he still intend to bring this proposed legislation forward for final reading and House approval during the current sitting of the Legislature and, if so, when?

Hon. Mr. Elston: I still believe in the urgency of Bills 54 and 55. The honourable gentleman will know from an earlier answer in this House that I am analysing what has come out of the committee stage. He will know that these bills have benefited from his extraordinary wide-ranging interest and from a number of amendments that were proposed by his party and by the other opposition party.

We are in a position now where we are analysing exactly what those bills are providing. It is of interest to know that under the current Bills 54 and 55 it will be the responsibility of either the college or the ministry to find prices for every drug in Ontario, whether it is listed under the Drug Benefit Formulary or not. We are trying to find out exactly what will be required so that we can make this workable.

To answer another part of the member's question as to when it will be done, I am interested in moving with it fairly soon, but I am obligated to go through it clause by clause, which is attracting wide-ranging debate and some degree of waiting when it comes the time to vote. As soon as Bill 94 is over with, we will be able to move on to other legislation.

Mr. Leluk: The minister has had five weeks to analyse what has come out of clause-by-clause debate and second reading. The minister knows full well that his delay in bringing these bills forward for final reading and House approval is costing the Treasury substantially -- in his own words, $4 million monthly. He knows it is costing Ontario consumers, is restricting the advent of new beneficial drugs and is threatening the survival of some small independent community pharmacies. Knowing all this, why does the minister continue to procrastinate?

Hon. Mr. Elston: We are not procrastinating. I should mention to the member, as I did in response to a question he asked last week, that arrangements have been made to request information on prices. He will have to explain to us how we are to save all the money by bringing in a new Drug Benefit Formulary and yet save all the groups of people he has mentioned all the money. I am having a difficult time figuring out what he is saying. Is he saying he wants us to make the prices lower than the 1985 formulary? Is he telling us they ought to be higher?

The honourable gentleman should know I would like to have these pieces of legislation come in as soon as I can. I understand there is some suggestion that the member from the opposition party may want to move some amendments to this legislation. If that is the case, he should advise me soon so that can be taken into account when we move the legislation.

ONTARIO LOTTERY CORP.

Mr. Foulds: I have a question for the Treasurer about lotteries. There is more than one scam going on around the Ontario Lottery Corp. these days. He knows that his colleague the Minister of Tourism and Recreation (Mr. Eakins) has started an audit with regard to the lottery corporation's expenditure of funds. Can he account for the Treasury's expenditure of lottery corporation funds? It received $250 million from the lottery corporation in 1984-85, but paid out only $99 million according to Public Accounts. Can he account for the $150-million skimming off into the general consolidated revenue fund? What steps is he going to take to prevent it in the future?

Hon. Mr. Nixon: One step is the announcement in the budget that we are going to change the emphasis in allocating Ontario Lottery Corp. funds, including recreation. We are going to expand them to hospital services and general expenditures. The utilization of the word "scam" is inappropriate in this and previous cases. In the past, the allocation of the lottery funds has not been totally taken up on the basis of government policy. These funds have been coming in faster than they have been allocated and that is one of the reasons the expanded allocation was noted in this year's budget.

Mr. Foulds: Can the Treasurer then explain why he brought in Bill 38 in the form he did? It does not specifically allocate the funds towards sports, recreation, culture, cancer treatment, hospitals and university research, but leaves it wide open for the funds to be swallowed up by the consolidated revenue fund. What administrative and legislative steps will he take to make sure that the funds from lotteries are spent on the things that he says they will be spent on, instead of skimming them off and using them in a pre-election credit?

3:20 p.m.

Hon. Mr. Nixon: I regret the suspicions expressed by the honourable member. He should know better than to think that would ever cross my mind. The references in the budget to expanding the utilization were by no means inclusive. We consider the expenditure program of the government to be worthy of the support of all members of the House. I am prepared to predict that the honourable member will vote for the budgetary policy as so expressed.

SENIOR CITIZENS' SERVICES

Mr. Andrewes: My question is to the Minister without Portfolio responsible for senior citizens' affairs. This morning there were 24 patients waiting in the halls of Toronto East General and Orthopaedic Hospital for appropriate bed placement. We are told that at any one time 60 patients are inappropriately placed in acute care beds at Toronto East General. What is the minister doing to resolve a serious problem of health care accessibility?

Hon. Mr. Van Horne: That is not unlike the member's question of a week or so back wherein he asked about chronic care beds in the Hamilton area. He knows full well that the assignment of such beds is the responsibility of the Minister of Health.

A week ago, in announcing the white paper and the master plan we were presenting, the teamwork that was evidenced is going to be one of the ongoing signs or symbols of a new approach to providing care for seniors. Specific to that question, as we bring on stream our regional geriatric assessment units to accommodate the various health problems of seniors and the one-stop shopping to accommodate the other support services for home services, we will, by and large, resolve the whole placement and treatment process.

We are all aware of the intricate involvement of a variety of ministries with the provision of assistance and care. If we are honest for a minute, we also know these problems are not resolved overnight. I can assure the member that problems such as the one he brings forward today will be resolved.

PETITIONS

NATUROPATHY

Mr. Warner: I have a petition signed by 90 people, which reads:

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

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

"Whereas it is our constitutional right to have available and to choose the health care system of our preference;

"And whereas naturopathy has had self-governing status in Ontario for more than 42 years;

"We petition the Ontario Legislature to call on the government to introduce legislation that would guarantee naturopaths the right to practise their art and science to the fullest without prejudice or harassment."

GASOLINE PRICES

Mr. Callahan: I have a petition, which reads:

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

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

"That the government of Ontario reduce gasoline tax by 1.1 cents a litre from 8.3 cents a litre to 7.2 cents a litre immediately and phase in further reductions over three years to 5.4 cents a litre by 1989."

Mr. McCague: I have a petition similar to that of the member for Brampton (Mr. Callahan) from residents of Dufferin-Simcoe.

MOTION

ESTIMATES AND SUPPLEMENTARY ESTIMATES

Hon. Mr. Nixon moved that the estimates as they are presented to the House be referred to and considered in the committees as indicated in the allocation statement printed in Orders and Notices today, and that the supplementary estimates as they are tabled in the House be referred to the same committees to which the main estimates have been referred for consideration within the times already allocated to the main estimates, and that any order for concurrence in supplementary supply be included in the order for concurrence in supply for that ministry.

Motion agreed to.

ORDERS OF THE DAY

House in committee of the whole.

HEALTH CARE ACCESSIBILITY ACT (CONTINUED)

Consideration 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. Chairman: When we left off on Thursday, we had carried section 3. I believe the next amendment in order is that of the member for Lincoln (Mr. Andrewes) moving to add section 3a.

Mr. Andrewes moves that the bill be amended by adding the following section:

"3a. Subsection 3(1) shall be deemed to be complied with if the minister has entered into an agreement with the physicians, dentists and optometrists that provides:

"(a) for negotiations relating to compensation for insured health services between the minister and the provincial associations that represent physicians, dentists and optometrists;

"(b) for the settlement of disputes relating to compensation through, at the option of the appropriate association referred to in clause (a), conciliation or binding arbitration by a panel that is equally representative of the association and the minister and that has an independent chairman; and

"(c) that a decision of a panel referred to in clause (b) may not be altered except by an act of the Legislature."

Before we start, may we have a little quiet and attention to the member for Lincoln. There are a lot of private conversations going on in the House, especially close to the member for Lincoln.

Mr. Andrewes: I am delighted that the member for Grey-Bruce (Mr. Sargent) is here.

Mr. Sargent: It is pay day.

3:30 p.m.

Mr. Andrewes: In deference to my friend the member for Grey-Bruce, who I am sure will want to listen very carefully, I want to review our reasons for proposing this amendment.

Last Thursday we debated at some length an amendment put by the member for Windsor-Riverside (Mr. D. S. Cooke). It set out a very lengthy process of negotiation and discussion leading up to an option that either party could enter into for continued arbitration which would subsequently become binding on both parties. In his amendment, the member set out that process in some detail. It was in subsection 3(17) of that amendment that the member took the process off into the jurisdiction of the Arbitrations Act.

That amendment was not supported by ourselves or by the government. We are not proposing to restate our positions with respect to the amendment, other than to say that our reasons for not supporting it are very clear. Our desire, though, if this bill is to pass the Legislature -- and it would appear, to use the expression of the member for Renfrew North (Mr. Conway), that I, unlike Joe Clark, can count; and therefore, it is obvious to me, as it is to the member for Renfrew North, that Bill 94 will carry and will pass the Legislature -- we want to make sure as a party that Bill 94 treats all of those who are -- I was going to say loosely "offended by it" -- but make that affected by it in a fair and reasonable way.

I want to tell the Minister of Health (Mr. Elston) that, had the Speaker allowed question period to continue for a short time further and had the Attorney General (Mr. Scott) been here, we would have sought his opinion about Bill 94 and whether it was the government's intent to make Bill 94 nondiscriminatory. We were quite confident that the Attorney General, in his wisdom, would have told us it was his intent to make Bill 94 nondiscriminatory in the sense that those who were impacted by the bill would all be impacted equally and fairly.

It appears that this bill, which brings into effect in Ontario the Canada Health Act, impacts on doctors, physicians, dentists and optometrists, but, by giving effect to the Canada Health Act, it leaves out one of those groups from one important aspect of the Canada Health Act. I go back to the act itself. It is section 12, as members will recall, that starts off by saying in subsection 1:

"In order to satisfy the criterion respecting accessibility, the health care insurance plan of the province," and that is the Ontario health insurance plan in this case, "must provide for insured health services on uniform terms and conditions and on a basis that does not impede or preclude, either directly or indirectly whether by charges made to insured persons or otherwise, reasonable access to those services by insured persons."

That, of course, is the government's argument for bringing in Bill 94. It is premised on the intent of paragraph 12(1)(a). Bill 94 is predicated on the intent of that clause. Therefore, it seems logical that the government would wish to be consistent in its intent; that is, to implement the effect of the Canada Health Act.

Going on, paragraph 12(1)(b) states the health care insurance plan of a province "must provide for payment for insured health services in accordance with a tariff or system of payment authorized by the law of the province;

"(c) must provide for reasonable compensation for all insured health services rendered by medical practitioners or dentists."

That was the subject of some discussion when we dealt with the amendment put by the member for Windsor-Riverside which set out the negotiation process. The minister will recall that in his comments he suggested there was in place at present a negotiation process which he felt was reasonable. Our arguments were that when one is dealing with an issue of this magnitude and substance, the negotiating process has to be acceptable to both sides. Therefore, we were not adverse to the intent of the amendment, except that it was too explicit and perhaps too binding in its process.

We come to paragraph 12(1)(d) of the Canada Health Act, which states the plan of a province "must provide for the payment of amounts to hospitals, including hospitals owned or operated by Canada, in respect of the cost of insured health services."

It is in subsection 2 where the argument lies in support of our amendment. Subsection 2 says:

"In respect of any province in which extra billing is not permitted, paragraph (1)(c)" -- which is the paragraph on compensation -- "shall be deemed to be complied with if the province has chosen to enter into, and has entered into, an agreement with the medical practitioners and dentists of the province that provides,

"(a) for negotiations relating to compensation for insured health services between the province and provincial organizations that represent practising medical practitioners or dentists in the province."

If I may refer briefly to the bill itself, subsection 3(1) begins, "The Minister of Health may enter into agreements with the associations mentioned in subsection 2, as representatives of physicians, dentists and optometrists, to provide for methods of negotiating and determining the amounts payable under the plan in respect of the rendering of insured services to insured persons." Then it goes on to list the associations.

Subsection 3 reads, "The Lieutenant Governor in Council may make a regulation providing that the minister may enter into an agreement under subsection I with a specified person or organization other than an association mentioned in subsection 2."

With respect to paragraph 12(1)(a) of the Canada Health Act, which requires the government to enter into agreements with medical practitioners and dentists of the province for negotiation relating to compensation for insured services between the province and the provincial organizations that represent practising medical practitioners or dentists in the province, that section is complemented by subsections 3(1), (2) and (3) of Bill 94.

3:40 p.m.

If we go to the second part of subsection 2 of the Canada Health Act, it continues: "If the province has chosen to enter into, and has entered into, an agreement with the medical practitioners and dentists of the province that provides...

"(b) for the settlement of disputes relating to compensation through, at the option of the appropriate provincial organizations referred to in paragraph (a), conciliation or binding arbitration by a panel that is equally representative of the provincial organizations in the province and that has an independent chairman..."

We assume the minister wishes to be consistent in providing, as is provided under the Canada Health Act, "for the settlement of disputes relating to compensation through, at the option of the appropriate provincial organizations referred to in paragraph (a), conciliation or binding arbitration." Conciliation or binding arbitration is provided by the act and it is required that the province provide that option for dentists and medical practitioners.

The Canada Health Act is silent on the profession of optometry. It is our conclusion that in drafting Bill 94, it was the minister's and the government's intention to include the practice of optometry and to give the practice of optometry the same terms and conditions for the negotiation of its remuneration from the health services plan as it gave to the physicians and to the dentists. I am confident the minister would not want to appear to be discriminatory in dealing with this profession when it was quite obvious that it was his intent to bring the effects of the Canada Health Act into play in Ontario.

In making my arguments here, I hope the minister will consider this amendment. I understand he may have some concerns about the wording, and I am prepared to stand down the amendment if, in the wisdom of the minister and his advisers, he wishes to take some time to reword this section. Our intent is abundantly clear, and I am confident the minister will consider accepting our intent.

If he fails to, I caution him that Bill 94 will become a discriminatory piece of legislation. It accords certain procedures to two of the three groups which Bill 94 impacts but does not give the same procedures, privileges or options to the third group, the optometrists. Therefore, I think it wise that the minister spend some time considering the intent of this amendment and considering, if it was his intent in bringing in Bill 94 to give effect to the Canada Health Act, why he chose to include only two of the three groups on the basis of that background.

Hon. Mr. Elston: With respect to this style of amendment, I do not think it is appropriate for the legislation we have. I have worked quite considerably through staff with the Ontario Association of Optometrists. I understand the association has expressed some concern that it is not getting binding arbitration in the legislation at its unilateral decision. I prefer to work with the various associations in implementing suitable proposals for reconciling disputes.

I prefer to leave it at that. The legislation as it stands will allow me, the ministry and the government to make those arrangements with those associations without going through the mechanics of the sections proposed by the member for Lincoln.

I am quite aware of the need to provide a degree of fairness in the mechanism which is ultimately arrived upon. However, I do not see the member's amendment fostering the fairness of the development of those bodies any more than the current bill will allow us to do.

I am quite prepared to live with the negotiation and process which is currently established under Bill 94.

Mr. Sterling: I would like to ask a question of clarification more than anything else, from the minister and from the member for Lincoln. Does the minister understand the amendment to give to the optometrists the same rights which the Canada Health Act supposedly gives to the physicians and the dentists? In other words, does the minister believe this amendment in some way gives to this profession what was given to the other two professions under the Canada Health Act? Am I interpreting that correctly? It is rather a difficult cross-referencing of sections, acts and jurisdictions. Perhaps the minister can clarify that for me.

Mr. Andrewes: I am delighted to reply to my colleague the member for Carleton-Grenville (Mr. Sterling). I was listening to the question very carefully but I was also making some notes on the comments the minister made previously so I could refer to them at some future time.

I think the question was, is it the intent of Bill 94 to give effect to the Canada Health Act? Was that the member's question?

Mr. Sterling: Partly.

Mr. Andrewes: In my view, it is the intent of Bill 94 to give effect to the Canada Health Act or, otherwise, why would we be having this whole kerfuffle? Why would we be talking about the refund of the withheld dollars by the federal government? Why would we be talking about ending the practice of extra billing in Ontario if the whole thing is not predicated on the Canada Health Act, which is the subject of the current debate and controversy in the province?

I am assuming that was the purpose of Bill 94. If it is the purpose of Bill 94, it should treat fairly all parties cited in Bill 94.

3:50 p.m.

Mr. D. S. Cooke: I am a little confused -- and I was when I received this amendment from the member for Lincoln -- in that the amendment simply says that at the choice of the association it will be able to opt for conciliation or arbitration.

The amendment we voted on last Thursday was a detailed negotiation section that adopted the negotiation process that is in place now with the Ontario Medical Association. It has a provision for an independent chairman and a provision for making certain facts public if an impasse in negotiations takes place. It went through a lengthy process that I think imposed good-faith bargaining on both government and the association.

The member for Lincoln said he could not support it, for whatever reasons. In reviewing Instant Hansard, the reasons given were not very substantial. However, they come to us today and we debate an amendment that says all you have to do is walk in the door and say, "Sorry, we have an impasse and we want to go to arbitration," and there would be absolutely no negotiations whatsoever. It provides for a very irresponsible approach to negotiations. It provides for an expectation that negotiations will fail and that we will always end up in arbitration. I do not think it is worthy of support.

I was disappointed last week. I think the reason the member and the Conservative caucus decided to bring forward this amendment is that they felt some heat from some people who were calling them and endorsing our proposal. The Conservatives felt they had to come up with a counterproposal that was filed with the members of the Legislature only late last week, well after we had started clause-by-clause. As a result, we have this before us today. I do not think this is a responsible approach to the negotiations and I do not think it is worthy of the support of the members of the Legislature.

Mrs. Marland: Based on the comments of the minister a few moments ago that he is quite content to go without this amendment because he has full confidence in the negotiations -- is the minister leaving?

An hon. member: I will be within earshot. I am sure I will be able to pay attention.

Mrs. Marland: I have a question of the minister, not purely a statement. Perhaps I will wait until the minister returns to his seat. This is a rather important bill in the eyes of the people of this province. I also suggest this is an equally important amendment. Considering the impact Bill 94 may have, regrettably, on the people of Ontario, I will wait until the Minister of Health returns to his seat.

Mr. Andrewes: I want to respond briefly to the comments of the member for Windsor-Riverside. He suggested that our amendment provides for a sort of open-door policy of binding arbitration. That is not the intent of the amendment. The intent is to give effect to the Canada Health Act, which I believe is the purpose of Bill 94.

I have already indicated that if the wording is inappropriate, it should be altered. I would be delighted to stand down the amendment, tidy it up and alter the wording. However, if he is opposed to giving effect to the Canada Health Act in Bill 94, I want to hear from him. That is what I sense he is saying to me at present, that two groups cited in the Canada Health Act will have certain privileges, while a third will not.

Mr. D. S. Cooke: What are those privileges?

Mr. Andrewes: My colleague has a copy of the act. I think this addresses another point he is concerned about. He said that any one of these three groups could walk through the door and suddenly undertake binding arbitration. That is not what the Canada Health Act says. It clearly has two clauses. One begins "for negotiations relating to compensation..." and says each province has to enter into an agreement with an association representative of the medical practitioners or the dentists for negotiations relating to compensation for insured health services between the province and the provincial organization.

We then go to the other subsection, which is the next stage, where the negotiations have broken down and there is a dispute relating to compensation. At the option of the appropriate provincial organization referred to in paragraph (a), there is conciliation or binding arbitration. It is all very clearly set out. There is no question of what is involved, and we are asking the government to support fairness and reasonableness.

Mrs. Marland: Based on the minister's earlier comments, he is quite confident the reason there is no need for the amendment we have just placed on the floor is because he is quite satisfied with the negotiation process. He is quite confident the route to settlement through negotiation will work.

What would the minister do differently with the negotiations with the Ontario Association of Optometrists than he has done in the past six months with the Ontario Medical Association? If his confidence is so great in the process of negotiation, can he tell us how he can make it work this time, since it obviously has been an abysmal failure in the past?

Hon. Mr. Elston: The honourable member is absolutely and totally wrong. The mechanism worked very well with the OMA. We had one meeting, and we solved the outstanding issue of bargaining with respect to fees. The member does not know what she is talking about. It took half a meeting and we settled that. The mechanism worked well. We sat down, we exchanged information, we came to grips with that, and that fee resolution was done very quickly. In this situation, the member is absolutely and totally wrong about this being an abysmal process. It worked very well.

Mrs. Marland: Which negotiation is the minister referring to as a successful form of negotiation?

Hon. Mr. Elston: The fee resolution and dispute mechanism, about which we heard a little last Thursday. It was the same mechanism that was proposed by the third party, except that it added the arbitration at the end of the route. It is a Joint Committee on Physicians' Compensation for Professional Services, about which the member has probably heard so much, and it worked very well. The part of the amendment I cannot support is the binding arbitration section, although I have some sympathies with respect to a mechanism such as the JCPC, which is working well between us and the OMA.

Mr. Chairman: Before we carry on, would the member for High Park-Swansea (Mr. Shymko) and the Minister of Education please carry on their conversation elsewhere?

Mr. Sterling: I want to ask a point of clarification of the Minister of Health. The Canada Health Act provides that to be opted in, as I understand it, first, it is necessary for the province to agree to enter into agreements for negotiations. Second, it is also necessary for the province to provide an option to the dentists and the physicians to go to arbitration if there is not a settlement of the negotiations. Is that not true, or can the minister interpret what clause 12(2)(b) is aiming at?

4 p.m.

Hon. Mr. Elston: It is our understanding that all we need is an agreement that does not have to require binding arbitration. Before her retirement, the Honourable Monique Bégin made considerable effort to indicate that the Department of National Health and Welfare would look at any consensual arrangement between the parties as fulfilling the mandate of the Canada Health Act.

The Canada Health Act is focusing now with respect to this resolution mechanism on determining whether the compensation level is reasonable. From that standpoint, as I read our communications with the federal authorities, they are not much concerned about how we get there provided there is reasonable compensation.

Mr. Sterling: Having said that, if there is a negotiated settlement or an agreement with, for instance, the Ontario Dental Association or the Ontario Medical Association, is it not true that under the Canada Health Act in order for us to opt into the system, we have to provide them with the option of going to arbitration? Is that for the negotiation agreement or for the negotiated settlement of the finer detail?

Hon. Mr. Elston: This is not my amendment, and it does not do some of the things about which the member is asking questions. As a result of our communications with the federal authority, I can tell the member it is not required to have necessarily binding arbitration. They do not care how we resolve any questions to be decided between the government and the various associations. They are interested in determining that compensation is reasonable.

The member must be aware, because he prefixed a couple of his questions by having us opted in, that there is no opting in or opting out of the Canada Health Act on the basis of our provincial membership in the Dominion of Canada. We are inside this legislation, whether we like it or not. The only thing we can do is comply with the Canada Health Act and receive the refund of some $100 million that is being withheld from the people of Ontario by Canada, and we must move to do that by April of next year.

We do not opt in or out of the Canada Health Act; we are inside the Canada Health Act. All that has to be determined once we remove extra billing is that there is a reasonable level of compensation provided to the people who are inside the ambit of the Canada Health Act.

Mr. Sterling: I am sorry, but I am still puzzled by the answer the Minister of Health has given me. Subsection 3(1) of Bill 94 talks about the minister entering into agreement with three associations, the physicians, dentists and optometrists.

Let us say he cannot enter into an agreement with any of those three groups. Does the Canada Health Act say under that section that if he bans extra billing, he must follow that particular section of the act? Is he saying clause 12(2)(b) of the act has no meaning? He is giving me the impression that in the interpretation of some officials that clause does not have any meaning. When does clause 12(2)(b) ever kick into effect? Under what circumstances could it kick into effect? Why did the Parliament of Canada pass that as a section of the act if it has no meaning?

Hon. Mr. Elston: The honourable gentleman probably knows that the current Minister of National Health and Welfare in Ottawa is being very flexible in his reading of the Canada Health Act. He has told us that several times. All that is required in Ottawa at this time, and even before this time, is that there be a way of providing for reasonable compensation. That does not require necessarily binding arbitration. It does not require in their reading any of the parts the member specifically wants clause 12(2)(b) to be analysed for.

As long as there is reasonable compensation and an agreement to arrive at that, we fulfil the requirements of the legislation under the Canada Health Act. I cannot straighten out the member any more on that; that is as specific as I can be. I can tell him what we have been told by the federal authorities. They will read it on the basis of reasonable compensation, but they have taken great pains to make it clear that does not require binding arbitration to be in place in all situations.

Mr. Sterling: Then the minister's interpretation of Bill 94 is that he is not giving to either the physicians' or the dentists' associations any option towards binding arbitration. In other words, under Bill 94 or the Canada Health Act, they cannot opt for binding arbitration. Is that correct? Is that the minister's interpretation of what these associations have the right to do?

Hon. Mr. Elston: It is not required under the Canada Health Act that binding arbitration be in place. What is required is that reasonable compensation be provided.

Mr. McFadden: I find the recent exchange between the Minister of Health and the member for Carleton-Grenville interesting. It seems to go part and parcel with the way things have gone in terms of the Canada Health Act and the arguments that have been going on here.

The genesis of a lot of our difficulty in Ontario today and the reason we have worked into this stalemate between the government and the Ontario Medical Association has been the way the Canada Health Act was set up and the requirements of that act.

Based on the comments of the honourable member for Lincoln and the background of this amendment, this latest exchange indicates that the Canada Health Act is a bit obscure. As the minister has said, the federal government is now prepared to be quite flexible in its approach. If something basically fits in with the wording, it is quite happy provided everybody toes the line.

Part of the problem is that when the bill was conceived in Ottawa, it was conceived poorly. In the House of Commons hearings that were held about these kinds of rights and negotiations, attempts were made to deprive the OMA and other medical bodies of the right to appear in their own right before the parliamentary committee. If other groups outside of parliaments and legislatures had the chance to make submissions more thoroughly, the federal act would be a lot better than it now is.

With regard to the amendment put forward by the member for Lincoln, he points out and the amendment tries to deal with the fact that optometrists were not included under the Canada Health Act. It is a strange omission. Optometry is important. The minister obviously uses the services of an optometrist from time to time, as do a large majority of this House. I am one of the minority who does not. I assume a lot of members of Parliament did as well when this bill was passed. It is strange these people were left out.

Therefore, it seems only fair that the optometrists be included in Ontario and in the kinds of remedies that have been provided for under the Canada Health Act. At least these benefits and remedies would be available to optometrists in this province, even though they were overlooked in the federal act when it was drafted and passed.

The particular amendments under clauses 3a(a) and 3a(b) seem to be very well placed. I know the member for Windsor-Riverside would like a lot of specifics about how binding arbitration might be put into place. This is an area that should be left to the government to work out with the relevant association. It is an area that could be covered by regulation. Very clearly, it makes sense that binding arbitration in line with the principles set out in the Canada Health Act should be permitted at the option of the association involved.

4:10 p.m.

I know we can say this might presume that the physicians, dentists or optometrists might start negotiating in bad faith in order to work around to binding arbitration. I do not think that would be the result. It could happen from time to time. It seems that binding arbitration is a two-edged sword for both parties. If any of the medical associations opt for binding arbitration, it is putting itself in a major way into the hands of a third party, which will make a final judgement on its full compensation. I doubt whether any of them would want to do that before they were pretty certain they had a good case and had been dealt with unfairly in negotiations.

The member for Windsor-Riverside commented that the doctors, dentists or optometrists might in some way deal with the government in bad faith in negotiations. I do not think that is valid ground for opposing this amendment. The amendment only gives effect to the objective and approach that, as far as we can tell, was indicated by the federal Parliament when the Canada Health Act was passed. The whole process of the presentation and passing of Bill 94 arose as a consequence of the impact of the Canada Health Act, according to the Premier (Mr. Peterson) and the Minister of Health. Therefore, it seems only fair and sensible that we bring this legislation into line with the Canada Health Act itself.

The provision that states the decision of the panel cannot be altered except by an act of the Legislature seems to be a necessary safeguard and safety valve for the people of Ontario. Binding arbitration has led sometimes to gigantic increases that would be totally inconsistent with what the taxpayer can afford to pay through the Treasury of Ontario. Therefore, it would make sense to have the proposed clause 3a(c) included so that if the government felt it was needed, legislation could be introduced to amend the award to within what could be reasonably afforded by the province. That surely would give the safety valve that many people in the general public feel would be necessary to protect taxpayers from arbitration awards by an independent group which has no particular responsibility to the taxpayers in an elective sense.

By way of observation, in general I do not think it is necessarily in the public interest for a government department, agency or crown corporation to be bound by binding arbitration. Public bodies, such as the Legislature and the cabinet, are better able to make a judgement as to what is in the best interests of the public and any single group. The Legislature is in a better position to make a decision as to what the province can afford.

However, where the health and wellbeing of every Ontarian are potentially at stake and if negotiations do not go forward well, this could be an instance where we could justify binding arbitration on the grounds of public policy. The safety valve to the Legislature gives the necessary override that any legislature should have to protect its position in terms of taxing power and constitutional powers.

I cannot help but observe that this section, and the bill itself, will have a very fundamental effect on the basic rights of a very important group in our society. It has been my experience as a lawyer that things very frequently work their way through this House into legislation, come into effect and then the individuals, the groups affected and their counsel are horrified to find what the ultimate result will be.

My concern with Bill 94 is similar to that in the sense that I think the taxpayers, physicians and patients have reason to be worried about the long-term effect of Bill 94. This section is particularly urgent in this regard in that as a Legislature we must find every possible route to bring the physicians, dentists and optometrists of this province back into the fold. We do not want a situation in this province in the long run where the physicians will feel they are in an antagonistic position to government. That is certainly not what we want to see.

I keep hearing on both sides: "Whom do you want to control the health care system? Do you want it controlled by physicians or do you want it controlled by politicians?" In my view, that is to some extent a specious argument, because it would seem to me the argument is, "Do you want the medical system in Ontario to be controlled by physicians or by bureaucrats?" It is very clear to me that the politicians, the members of this House and the Minister of Health are not really running the health care system. It is being run by unseen bureaucrats who are, in effect, not responsible to this House and who are certainly not responsible in any direct way to any committee of this Legislature on an ongoing basis, except once in a while at estimates time.

It seems to me that the primary group from which we want to have input and commitment is the medical profession. As a consequence of that, it is urgent that they feel they are not being put upon. We have to have an environment in which they feel their terms of employment are fair, the process is fair and their rights are being protected. In my view, in the long run if the physicians feel comfortable with the system and feel their rights are protected, they are going to do a far better job for everybody in Ontario than if they do not feel that way. One can say, "The doctors may be unhappy, but so what?" The "so what" means that if they are unhappy, it is the patients who will be hurt. I am sure that is something none of us in this Legislature wants to see happen.

To me, this amendment goes quite a way to at least protect the doctors and give them some necessary rights if this bill is passed, and it would appear at this point that it is going to go through the Legislature this spring. I cannot see any valid reason why the minister and the government are not in agreement with this amendment. It does not stop negotiations from going ahead in good faith with the physicians, the dentists and the optometrists. Surely the first thing we want to see is good-faith negotiations, so that the doctors, the dentists and the optometrists are happy in the system. That clearly is to the benefit of all patients.

4:20 p.m.

However, if the negotiations are not getting along well, we do not want a province-wide walkout; we do not want strikes, slowdowns or resignations; because when these things happen, who is being affected? Sure, the doctors may lose a bit of income, but in the long run it is operations that are postponed, treatments that cannot be provided and hospitals that cannot operate well. In the end, it leads to an undermining of the absolutely essential care that everybody in Ontario has a right to expect.

Labour-management problems, broken-down negotiations, strikes, uproars and resignations, as we have discussed earlier in this House, are hardly to the benefit of the patients or the system of medical care in Ontario. Consequently, the move suggested under clause 3a(b) to conciliation or binding arbitration, at the option of the association affected, seems to me to put good faith back into the system. It creates a model whereby doctors, when they find they cannot work out an amicable settlement, can then have it referred to arbitration.

This will have the effect of moving the whole matter from confrontation over the bargaining table to arbitration. It will have the effect in the long run, I suggest, of preventing strikes, resignations and slowdowns in Ontario. Surely that has to be an ultimate objective of all of us.

I hope the individual or individuals who will be responsible for looking after the arbitrations will be reasonable. In general, on the basis of what I have observed of arbitrations in various other professional matters, I think the arbitrators' awards have not been badly out of line. I hope that, once the arbitration process was finished, the arbitrator's award would be acceptable to the government and to the medical profession and that therefore we would be finished with the kind of bitterness we have seen being generated during the last number of months. We would not have to face this every year or two.

The only time we might face this from time to time would be if the Legislature itself, obviously at the instigation of the government, felt it was necessary to bring the matter back to the House because it was not in a position to support the decision of the panel. I hope the government would not make a common practice of legislating fee schedules in this House. I assume this will not become the practice. It has not become the practice in any other areas where binding arbitration has been brought in.

I would see nothing wrong with the discussion of fee schedules in this House if the binding arbitration award were too excessive because, in supporting this amendment, I am not arguing that doctors are entitled to keys to the public safe. I do not think our party has ever felt that and I do not think doctors are looking for that. In conscience, none of us could offer any group the right to unlimited access to public funds or to any form of award that an arbitrator might come up with. The Legislature gives the public the necessary safety valve, which we can then use if we find that the award coming out of the panel is unreasonable or excessive.

I gather that the minister, at least up to now, is not persuaded by the arguments we have put forward. I do not know whether he is any more persuaded by what I have said. I note by the shake of his head that he is not. The minister heard most of what I said, so I assume he has heard most of the arguments I have put forward.

Mr. D. R. Cooke: Go back to talking about trade issues.

Mr. McFadden: The member for Kitchener intervened and asked me about trade issues. I am glad he mentioned that.

Mr. Chairman: That is not an appropriate subject unless it ties exactly into this amendment.

Mr. McFadden: The member for Kitchener knows, and I think the minister will confirm, that in the area of practitioners we have quite a free trade in people going from Canada to the United States to practise medicine. Family practitioners tend not to go to the United States, but unfortunately Ontario has lost a number of specialists in recent years, and on the basis of the recent discussions I have had with members of the medical profession a number of specialists are prepared to leave Ontario if this bill passes.

We have free trade in the sense that people can come and go to practise medicine where there are jobs and will be admitted to the United States. I can assure the member that doctors such as Dr. Munro, who recently announced he was leaving, and many other specialists have no trouble getting green cards or any other form of status to practise in the United States. In the same way, Canada would never turn away outstanding physicians from other countries. We have not been doing that. Ontario has been a tremendous beneficiary of many excellent practitioners who have come to Ontario from various countries around the world, let alone from other provinces.

I am about to wind up. I do not know whether the member for Kitchener wishes to raise any other points at this time. He indicates he does not.

Mr. D. R. Cooke: I do not know whether there is a market in the US any more.

Mr. McFadden: There is quite a good market, actually. There is a list of specialities available in the US.

Mr. Barlow: Especially for optometrists and those who are not treated fairly in Ontario.

Mr. McFadden: That is right.

Mr. Chairman: Order. You have to stay on the topic, which is the amendment of the member for Lincoln.

Mr. McFadden: This is the kind of amendment that will keep doctors in Ontario, which has to be one of our most important objectives. We want our doctors to be happy while they are practising here, to be happy to practise in this province. We do not want them to start looking to other places to practise their profession. It is clearly to no person's benefit to have outstanding specialists leave this province because they are not happy with the whole environment in which they are operating.

In my view, this amendment would be a positive factor and a positive argument in having physicians stay in this province and continue to practise here. I am worried about the way the bill now is. If Bill 94 carries the way it is, with the amendments that have gone through so far, it will inflame the situation even more in its amended form than would the bill as it was introduced by the minister a few months ago.

This amendment would go at least some way in alleviating the concerns various physicians, dentists and optometrists have raised with me. I am not saying we will not lose some specialists, but this amendment would go at least some way towards alleviating the distress being felt by the world-class physicians we have in this country. The irony is that the government in the speech from the throne talked about "world class."

Mr. Chairman: You are too far off this amendment.

4:30 p.m.

Mr. McFadden: I will end by saying that in my view this amendment is the kind of world-class amendment that would enable us to keep our world-class physicians in Ontario. It provides a framework for negotiations and discussions that maintain the tradition of good faith and good-faith negotiations we have enjoyed in this province for years and years, and which we are in danger of losing if we carry on in the current track we are in.

While I know the minister and his parliamentary assistant, the member for Kitchener and others have been listening with rapt attention to what I have been saying, I hope they will concur with me, on second thought, that this proposed amendment is well thought out. I hope they will concur with me that it meets the current needs of physicians, dentists and optometrists, and it will go a long way towards dealing with the bad faith the physicians feel they have had to face. I hope it will help to make the enactment of Bill 94 less unacceptable to all of the excellent health care professionals we have in this province.

Mr. Cousens: The points raised by the member for Eglinton (Mr. McFadden) and the member for Lincoln underline the significant importance that our Legislature must place on the long-term relationship that we are to have with the whole field of specialists in medical care and services provided to our people in Ontario.

The amendment the member for Lincoln, the critic for Health, has tabled in the House today has to do with the process of long-term relationships that we have with our health care providers. It is a matter of treating them in a way in which they can go away from negotiations and be a part of the process of being totally involved, of having a sense of participation but not a sense of having things thrust at them.

We are talking about the spirit of the whole bill with this amendment, which goes beyond what would seem to be a small amendment. It has to do with the relationship the government will have, and should have, with those service providers.

We are talking about a long-term bill. I suppose one of the first things that will happen when the Conservatives come back into power is that we are going to have to look at this bill again. We are going to have to look at it in such a way as to correct the inconsistencies and problems that are implicit in it, that are inherent in the process that is being developed by the government. What the government has to do now is make sure that the bill reflects an honest balance of what all the people of this province want to have, not to the exclusion of a particular group such as the optometrists.

There is something here that the member for Lincoln has failed to address, and that is that the bill does not go far enough, even with the amendments, to touch upon other medical service providers.

We are now talking about a government coming down upon the medical providers. It is imposing upon them a way of doing things. There is no longer room for the free enterprise system. There is no longer room for trust. What we are seeing instead is a system that has been calculated to put the professional bodies that I am concerned about at a disadvantage. That disadvantage is that one is dealing with one's own financial remuneration, as one deals with the way in which one is paid for services rendered. I do not think there is anyone in this House who does not want to see a fair return to those who are providing a service. We want to make sure the process that is being delineated and defined within this bill is truly fair. That kind of fairness comes through the amendment that has been proposed by the member for Lincoln.

We are talking about that relationship, of an agreement. We have seen a breakdown of agreements within our province with other professional bodies. There would be nothing worse than to have that happen here again within Bill 94. We saw it with the teachers in the 1970s when we had to bring in Bill 101 to provide for an arbitration process, the way of dealing between the teachers and the boards, without every strike having to be brought to the attention of the Legislature.

That kind of negotiation does not just happen. As legislators in this province, we develop the context and lay it out, so that those who are participants in that negotiating process know they have a court of last resort, another step to go, without having an imposition of compulsory binding arbitration.

There is a problem to our whole government approach these days, which is that, number one, one must have government involvement in everything. This Bill 94 begs further government involvement. One of the greatest problems we have with this legislation is that it takes away something of the freedoms and rights of the medical profession, and in that sense it brings in upon all the medical profession a new set of rules that are foreign to our Canadian and Ontario way.

It is quite well known in Britain, where there is socialized medicine and a system which is restrictive and controlling and forces them to be within that kind of environment.

In Ontario, we have been free of that kind of government imposition, for lack of a better word, through a process of fair play and honest negotiations in which we had the checks and balances. I say "had," because very shortly we are about to lose those checks and balances that have been inherent in medical delivery services within this province. This amendment has to do with spirit. It has to do with the intention of the government dealing with those providers and saying to them: "Yes, we know you should sit around this table. We know you have something to contribute to that. We are prepared to listen, but if it does not work out, we are prepared to go to another level of negotiations, which has to do with arbitration."

I know the New Democratic Party will have trouble supporting this amendment. It has traditionally been opposed to any kind of arbitration.

Interjection.

Mr. Cousens: If there is that opportunity. I did not realize they were listening so carefully.

Mr. Andrewes: It is time for a sober second thought.

Mr. Cousens: Indeed, I take that back. If there is a possibility of the third party having the wisdom and insight to support this amendment in that way, it shows that anyone can think more deeply than I was prepared to give credit for. I hope there is that possibility.

Mr. Breaugh: Throw on another shovelful.

Mr. Cousens: I just have to comment that --

Hon. Mr. Wrye: I think the member blew it if there ever was a --

Mr. Cousens: No, we are prepared to listen to what the NDP has to say on a matter of this sort. We are trying to soften the harsh nature of Bill 94 and, through this kind of amendment, to broaden it so that there is an understanding that allows others to participate in the due process.

What is due process? When one is into that negotiation of price schedules and provision of services, it becomes a matter of professional ethics and pride to be able to sit down with others and work it out. To leave out other medical components to those discussions can cause them a sense of frustration if they are not able to raise their problems to the level we are trying to reach through this amendment.

4:40 p.m.

There are many aspects to this amendment that we should be looking at. If we fail to make the changes we are suggesting, we can see reasons for dispute if we do not have a clear method designed for that negotiation process to continue after we have started discussions and to take it through to arbitration. At that time, we could leave ourselves wide open to a breakdown in the delivery of services which would end up affecting the people in our communities who are looking to us to make sure they are provided with medical services of a high quality at all times.

There is a possibility that the Constitution could be invoked in support of this amendment and the rights and freedoms of other professional bodies being able to benefit from this kind of legislated process. Not to do so is the worry I have, because if it is not done, if there is no consideration of the optometrists or the dentists, as two examples of other great providers of medical services, we then could be facing a breakdown. That is the concern we have, and I would like to know whether the minister has any comments about what he will do when that breakdown occurs. If the negotiations break down, has he any suggestion for bringing them together without this legislation? Does he have a method of providing for that kind of arbitration? Is there a technique he can use?

We are not always going to have such a fine talker as the present Minister of Health, who is able to talk himself out of every question. We have asked him questions in the Legislature for the past several months and he has become adept at sidestepping every question. But he cannot sidestep this question, because here he is dealing with those who are saying: "It is our profession. It is our existence."

Hon. Mr. Elston: How much are those guys going to talk? Is the member going to talk out the clock?

Mr. Cousens: I want to get an answer. If the minister will answer the question, I will be glad to sit down.

Hon. Mr. Elston: Let the member wind up. I will answer his questions as soon as he winds up.

Mr. Cousens: If the minister is in a position to do so, I would like him to comment on what he would do if this amendment were not done. I am not satisfied the government really knows. There has to be a position on the negotiation process.

We are opening up new ground. We have never had to start legislating common sense before. Legislation should stay away from certain areas. We have been able to have a middle ground in this province in dealing with the medical profession so that we did not have to legislate every point of view, every discrete point there was. There was a sense of fair play. There was an environment for discussion.

What we are seeing now, through Bill 94, is a closing down of that environment, and that concerns us, especially when it starts involving other professions as well. We are going to see the Minister of Health bring in bills every year now and in the foreseeable future as he or she seeks to modify this flawed legislation.

The minister is going to come in next year, possibly even as early as September or October. We might never get out of this House by the time he has had amendments to change the bill the government already has. Because of new ideas he has had, because of new thinking that has come in, because of new responses from the public, because of the response of the medical profession, the minister will feel compelled to start modifying this legislation even before it has been implemented. That is a sign of legislation that has not been fully thought through. It has not been fully understood by the government.

There is a chance that, because the Minister of Health is looking very interested and very concerned about this amendment, he might well have a change of heart. There have been changes of heart from the government in the past, and we might see one today that could begin to open up a fresh approach to the negotiating process that includes more than just the doctors. It could include the optometrists, the dentists and maybe even other specific fields of interest.

We are talking about all the legal and procedural issues associated with the self-regulation of health professionals. Many health professionals who are serving the people across our province are going to come more and more under government legislation and control. As soon as that happens, the government is going to have to start controlling more of what they do in the process of conversing with government than ever before. We have never had to do it, but the thin edge of the wedge is in this bill, which begins that process now whereby we take away common sense, whereby we legislate everything and whereby we start forcing discipline that was not needed before on each of these different health delivery services.

I therefore challenge the Minister of Health to rethink his position and open that up. The minister has possibly never been involved in the negotiating process. That has to do with his experience in different areas. His experience would probably be in other areas. He comes out of the education profession, and I bet he was a dandy teacher.

Mr. McFadden: He was a lawyer.

Mr. Cousens: Was he a lawyer? I bet he could be a good lawyer, too. I would have thought he was a teacher.

Hon. Mr. Elston: I was a teaching lawyer.

Mr. Cousens: He was a teaching lawyer. I know he is a good man; I like him as a person, which is also a problem, but I do not think he understands the damage he is going to do to the health field in Ontario with this legislation. Neither do I believe the people opposite in the government are aware of the damage they are going to do. This has to do with a genuine concern for the needs of the people of the province. It goes beyond talking about doctors; we are going to have legislation in this House for the foreseeable future as we start dealing with all the different ramifications of every bill.

Welcome to the chair, Mr. Chairman. You have had a very good person to take your place while you were away. He has done an excellent job, and I commend him for it. It is very difficult to sit in that chair and listen as carefully as he was. I respect that, having done that before. We commend you as well, Mr. Chairman, for your service to the House.

I wish the government would listen. When he was sitting in the chair, the member for Kitchener was not of the government. He was sitting there as an honourable member truly trying to do the right thing. He was an outstanding acting chairman, and if he could have the same kind of impact of listening with the government, this kind of bill would go through.

All the people of Ontario want fairness for everybody. That is something one provides in the spirit in which this bill is brought forward.

Mr. Chairman: Remember, you are on section 3a, concerning negotiations, disputes and settlements.

Mr. Cousens: I knew I liked the member for Kitchener better.

I am talking particularly about clause 3a(b), which begins, "for the settlement of disputes relating to compensation through, at the option of the appropriate association referred to in clause (a), conciliation or binding arbitration."

I wish we did not have binding arbitration in there. There should be another method of resolving disputes, rather than binding arbitration. Every time we have compulsory binding arbitration as the end result, people automatically stop negotiating and hope for a good arbitrator. That is probably one of the major flaws in labour relations in Ontario right now. If we could get rid of compulsory binding arbitration and have good --

Mr. Breaugh: On a point of order, Mr. Chairman: The member has spoken for 20 minutes in favour of it; I take it we are about to have another 20 minutes opposed to it. Is that where he is at?

Mr. Chairman: That is not a point of order.

Mr. Breaugh: We are trying to find out which side of the fence he is sitting on.

Mr. Cousens: It has been difficult, and it is all the more difficult when we realize that in the negotiating process, one has to impose compulsory binding arbitration --

Mr. Breaugh: He is speaking against it.

Mr. Cousens: -- but it is, unfortunately, necessary.

Mr. Breaugh: Now he is speaking in favour of it again.

Mr. Cousens: I am talking options. I wish we did not have to have it in here, but unfortunately we do. We have not yet found a good way to handle negotiations of any kind in this province.

Mr. Breaugh: Oh, philosophy.

Mr. Cousens: Philosophy undergirds all we are doing as politicians and as legislators. It affects everything we do in the Ministries of Labour, Education and Health. What we are failing to take into consideration, and what I am concerned with, is philosophy. We want to have the spirit behind the negotiations that allows all parties to --

Mr. Breaugh: Oh, spirit.

Mr. Cousens: I do not mean the liquid spirit that the member for Oshawa (Mr. Breaugh) may know more about than I do.

Mr. Breaugh: I know more about most things than does the member for York Centre.

4:50 p.m.

Mr. Cousens: The member is challenging me that he knows more things about most things. If he is so learned, I would be honoured to hear him talk in an eloquent and intelligent way on compulsory binding arbitration as a solution. It is tragic that it becomes almost built in to legislation in every way. Compulsory binding arbitration was included by the third party as one of the amendments as a way of resolving disputes between the doctors and the government. Am I right or am I wrong? I know I am right.

Mr. McFadden: You are right.

Mr. Cousens: Yes sir.

Mr. Breaugh: You are wrong.

Mr. Cousens: The member's party was wrong to bring it in. If there is anything so inconsistent with the socialist philosophy, it is to have binding arbitration. It was in one of the amendments they were bringing to this House on Bill 94. It is inconsistent with everything Bob Rae has said in the past. None the less, who really cares what Bob Rae says anyway? We are interested to see the change.

Mr. Chairman: Please refer to all members by their seats.

Mr. Cousens: I would be glad to take any part of his anatomy, Mr. Chairman. I would be pleased to take his silk stockings. The member for York South (Mr. Rae) is the one to whom I was referring. Until now and until the annual meeting of the third party, he is its leader. At the end of that time, who knows? It could be the member for Oshawa, who has the capability of being the leader, according to one short sentence in the Globe and Mail last week.

We are dealing with the core of the issue. It has to do with philosophy. I thank the member for Oshawa for bringing that to my attention. I was going beyond the words to the very depths of what this whole bill and this amendment are all about. That is the philosophy of the relationship between the government and the delivery services -- the doctors, dentists and optometrists -- to see that those bodies, as they are represented to the government through their associations, have a relationship that is handled with integrity and honour, that they know their relationship is going to be satisfactory and that there is a process they are going to follow. If that process is laid out and defined in legislation, there will not be the guesswork attached to it.

What we have now is a flawed bill. It is not complete or refined. It does not meet the needs of all those doctors, optometrists and dentists. We are anxious to see if we can do something about that through this amendment. There are other amendments we will have to bring to the House. All are part and parcel of what it is to be a responsible opposition.

The responsibility we have is based on a philosophy. It has to do with respect for those who are providing a service. I will give an example. The Toronto Transit Commission drivers and our teachers are both groups which have had legislation to force them back to work.

It is despicable when government has to do that. It shows a breakdown. It means our system is not working as it should. However, it means this Legislature is prepared to act in a responsible way. As a legislator, I want that right to intervene in those deliberations and discussions if and when it is necessary. In all that is before the House in this bill, there is nothing which will give us that right. We are asking for that right in this legislation. That is the problem with it. There has been no consideration of the rights of legislators in the ongoing service of these medical units, these doctors, dentists and optometrists. In the long term of our province, we will probably have to have amendments that add other professions within the health delivery field before too long.

I have a document here which goes into the Health Disciplines Act and the different colleges and how those who are providing these services to our province are increasingly concerned about what is happening to them. Within legislation by our government and under federal legislation as well, they have a degree of self-regulation established. That means they must provide certain rights to those they serve. The optometrists will have a body that is elected to serve their needs and through their representatives they will become the participants and the negotiators who will be working on behalf of their people. Are we saying they do not exist? We are by this legislation, without this amendment.

We are saying it does not matter that they are there. We are saying everything will go along just fine. I doubt that, not when we have begun a marriage and a relationship as we have through Bill 94. It will take a long time to repair the relationship between the doctors, the dentists, the optometrists and this province. We will not see an easy process of sitting down around a table as friends and being able to work out an agreement unemotionally, in an honest, realistic way.

Let us at least recognize that and open it up so they have other options. Let us say that we as legislators are building that option for an extended discussion into this legislation, one that can take us to conciliation or binding arbitration, as the amendment suggests. I hope that means we stay on the conciliatory route and that we never have to get to binding arbitration. If we are able to have a mediator and allow this to take place through good dialogue and discussion, we know something can be positive and it can be worked out. At least they know it can be positive and it can be worked out.

If it all fails, our amendment includes a court of last resort, which is this House. Every one of us is unhappy when we as legislators must come into this building and end an impasse, as we did two years ago with the Toronto Transit Commission and as we will be prepared to do in the future if necessary. If the public is threatened by a certain lack of service and by what is going on, then we as responsible legislators must be prepared to do that.

The amendment allows that the decision of a panel referred to in clause (b) may not be altered except by an act of the Legislature. If we have to get back into it, if nothing is happening, we could then get into it. It is an open-ended invitation. The Legislature never takes its responsibility for granted, but before this legislation is finally introduced and passed, we are asking for that opportunity.

I appreciate the indulgence of this House and the fact that there is a possibility that the Minister of Health is very seriously considering the option we have just been discussing. I think he knows that now is the time to make the corrections that should be made to the legislation. It will be wrong for us to come back to this House again and again to refresh it, to change it, to adopt new amendments to it, to make it so that it solves all the problems. However, the minister is inviting this unless he considers it seriously. Our job now is to think in advance of those things happening and to try to come up with solutions before they happen. Let us consider those options.

I am very pleased, indeed proud of the fact, that the member for Lincoln has considered this and has brought it to this House. He is saying something that all of us should think of more seriously. We can do it right if we start right now.

I look forward to hearing what the Minister of Health has to say on some of these comments. There are others on which I do not want to hear what he has to say because I do not think he can fully understand the philosophy behind the Progressive Conservative Party. He is a Liberal and he is promoted by the New Democratic Party in what he is trying to do. He does not understand the good faith that can exist in relationships and negotiations. Also, he has to understand the breakdowns that can take place. There are the positives and the negatives. Our amendment today does give cognizance to the sad possibility of breakdowns. It also includes a process by which the negotiations can continue and be proceeded with.

5 p.m.

Mr. Sterling: I was hoping the Minister of Health was going to be here to answer some questions. I thought he had actually indicated to the committee that he was going to respond to my colleague the member for York Centre. I was interested in hearing what he had to say about his particular --

Mr. D. R. Cooke: Why does the member not write him a letter?

Mr. Sterling: I had some specific questions I wanted to direct to him in order to --

Mr. Barlow: The parliamentary assistant is not here either.

Mr. Sterling: There are only four Liberals here.

Mr. Cousens: The Liberals have only four members in the House.

Mr. Sterling: If it was not for the many Conservatives here, we would not have a quorum.

Mr. Ashe: It is up to the government to maintain a quorum.

Mr. Cousens: Some of them are only half here anyway.

Mr. Chairman: Order. I might remind the member for Kitchener that he is not in his seat. Will the member for York Centre please let the member for Carleton-Grenville carry on with his remarks?

Mr. Sterling: Since the Canada Health Act does not direct itself to optometrists, why does the Minister of Health feel it necessary to include optometrists in Bill 94? I am very sorry the minister is not here because it makes some difference to my remarks. If there is no requirement under the Canada Health Act to have the optometrists in Bill 94, why are they included while other health care professionals are excluded? It does not seem to make much sense to include some groups or to be selective about the groups put in.

Some time ago in this debate, about an hour ago, I asked some questions about the meaning of paragraph 12(2)(b) of the Canada Health Act. I was quite amazed at the response from the Minister of Health, who I know is a solicitor and I presume can read the law. I wanted to argue with him or to put forward the point that the amendment put forward by the member for Lincoln assists in crossing the t's and dotting the i's within this legislation.

It is important to point out that part of the reason the Liberal Party put forward for bringing forward the ban on extra billing, as it has said, was the great $50 million it was going to get from our federal government. They will get that $50 million only if they meet certain criteria. As the member for Lincoln has pointed out, section 12 of the Canada Health Act puts forward those criteria.

I will shorten it, but the section says one cannot extra bill. Paragraph 12(1)(b) says a provincial health plan "must provide for payment for insured health services in accordance with a tariff or system of payment authorized by the law of the province." That is what Bill 94 does. Paragraph (d) says the plan "must provide for the payment of amounts to hospitals, including hospitals owned or operated by Canada, in respect of the cost of insured health services."

The most important criterion this amendment deals with is paragraph 12(1)(c), which says one gets the $50 million, but the plan "must provide for reasonable compensation for all insured health services rendered by" -- and it singles out two of the health professions -- "medical practitioners and dentists." It must provide for reasonable compensation.

Subsection 12(2) deals with how to provide that reasonable compensation. It says the government must enter into an agreement with the medical practitioners and dentists of the province. That is what subsection 3(1) of Bill 94 attempts to do. It says, "The Minister of Health may enter into agreements with the associations mentioned in subsection 2." It includes not only the dentists and medical practitioners but also optometrists.

First, I hold that it was not necessary to include the optometrists in Bill 94. The bill could have dealt with only the dentists and the physicians. I wanted to ask the Minister of Health about this, and I wish he had paid me the courtesy of being here to answer the question before I launched into these remarks so I would have had it clear.

The act is very clear on what it says must be included in the agreement between the province and the dentists or the Ontario Medical Association. In clear language, the Canada Health Act says that, to get the $50 million, there has to be an agreement that provides: "(a) for negotiations relating to compensation for insured health services between the province and provincial organizations that represent practising medical practitioners or dentists in the province."

Therefore, in the agreement, there has to be a provision, first, for negotiations, and "(b) for the settlement of disputes relating to compensation through, at the option of the appropriate provincial organizations referred to in paragraph (a)" -- that is, the dentists and the physicians -- "conciliation or binding arbitration by a panel that is equally representative," etc., and "(c) that a decision of a panel referred to in paragraph (b) may not be altered except by an act of the legislature of the province."

It is all very nice for the Minister of Health to say to me that Monique Bégin said all they were concerned about was that there be some method of negotiation for compensation to the physicians or dentists. However, Monique Bégin, our Minister of Health or Jake Epp, the present Minister of National Health and Welfare, are not above the law or the Canada Health Act.

If this legislation goes through and this Minister of Health, as he has indicated to us today, enters into an agreement with the physicians which does not provide them with the option of arbitration, he leaves himself open to litigation. A citizen, probably not of this province but of another part of Canada, might say: "Why should we give $50 million to Ontario? Ontario entered into an agreement with the physicians which says they do not have an option to go to binding arbitration."

That is what the Canada Health Act says. It is right there in paragraph 12(2)(b). It is an option.

An hon. member: Why would the member not vote for our amendment last week? That is what the amendment said.

Mr. Sterling: No, the New Democratic Party amendment said --

An hon. member: You are wrong; read it.

An hon. member: Is the member for Windsor-Riverside in his seat, Mr. Chairman?

Mr. Chairman: Order. Carry on, the member for Carleton-Grenville.

5:10 p.m.

Mr. Sterling: That is what this says. It is right here. Paragraph 12(2)(b) says there has to be the option in the agreement. What we are putting forward is trying to perfect the legislation.

Hon. Mr. Elston: Is the member supporting the legislation now?

Mr. Chairman: Order. The member for Carleton-Grenville is being interrupted. Please do not do so. Carry on.

Mr. Sterling: The Minister of Health asks if I am supporting the bill. I am not supporting this legislation. I do not mind admitting it. The biggest lie the government ever perpetrated on the Ontario public was that there was a problem to begin with.

Mr. Chairman: Order. Please retract that word. It is not appropriate for the chamber.

Mr. Sterling: Would "misrepresentation" be appropriate?

Mr. Chairman: No, retract the word "lie."

Mr. Sterling: I retract the word "lie."

In meeting the demands of section 12 in order for this province to gain the $50 million the minister has talked about so often, would it not make more sense to include in this legislation the amendment dealing with the option put forward by the member for Lincoln? If he does not put that forward, what is to prevent a member of the public from coming out and saying, "You have not put in the agreement with the doctors" -- or with the dentists, if the minister enters into an agreement with them -- "that they have the option to move to arbitration."

That does not fit in with the letter of the law as contained in paragraph 12(2)(b). I want to perfect it. We are going through all this hassle and tremendous upheaval in our health care system because of this phoney issue which has been raised of there being a great problem out there with extra billing. I have been a member of this Legislature for nine years and I have not had more than two calls about extra billing in all that time. I listen to my people when I go back to my riding, and I do listen to them. I do not listen to a bunch of malarkey that people put forward as a phoney issue to try to gain political points.

Hon. Mr. Elston: That is not a phoney issue. The Parliament of Canada wanted to take action on this. Does the member think they are phoney as well? Tell Jake Epp he was phoney.

Mr. Chairman: Order. The minister will have lots of opportunity to present his position.

Mr. Sterling: I do not care what the Parliament of Canada does. I care what the assembly of Ontario does. That is what I am elected to; I am not elected to the Parliament of Canada. If the minister wants to run for the Parliament of Canada, he should go run for it. The minister is here, and so am I. We are dealing with Bill 94 and a phoney issue that the Liberals dreamed up during an election campaign.

Hon. Mr. Elston: Brian Mulroney does not think this is a phoney issue. He voted for the Canada Health Act.

Mr. Sterling: I voted for the Canada Health Act?

Hon. Mr. Elston: No, the member's friend Brian Mulroney.

Mr. Sterling: I do not care what Brian Mulroney did.

Hon. Mr. Elston: The member supported him in September 1984. Does he not like him any more?

Mr. Chairman: Order.

Mr. Sterling: I campaigned for Dr. Bill Tupper, the member in my riding, and Jennifer Cossitt. They are tremendous people. I do not make my decision at the ballot box on only one issue. There are lots of issues that are much more important than this phoney issue.

Interjections.

Mr. Chairman: Order. There are too many interjections. Will you carry on?

Mr. Sterling: Perhaps the member for Oshawa would like to sit down and compare election results some time.

If this legislation goes through the way it is, if the minister does follow that way, I would appreciate hearing his comments. I respect him as a politician and I respect him as a lawyer. I do not know whether the advice he is getting is all that great but I think, to protect the people of Ontario, he would want to put in the legislation that an option for arbitration should be included in those agreements, because when one gets into negotiations with the Ontario Medical Association it may not want it. It may not want that option. If it does not want it, for the government to sign a paper it may succumb to its wants in this matter and, therefore, the government will not have the option. I do not think the law could be any more clear. This is black and white under paragraph 12(2)(b) of the act.

When the minister was out I did ask why the optometrists were included --

Hon. Mr. Elston: I know. I have that all noted down here. I will answer as soon as you finish.

Mr. Sterling: -- and why other health care professions were not included in this piece of legislation. I will reserve my further comments until I receive the answer to those remarks.

Hon. Mr. Elston: I was wondering if the member had his half hour in yet. It seems pretty clear. Is he sitting down so he can take a breath of fresh air to get his sails filled again? I would hate to see a guy run out of wind when he has himself programmed for half an hour. The members are doing this tag team thing.

Mr. Chairman, I know you will be interested in the word "filibuster" because the members on the opposite side would not really want to do that, but it seems they are extending, at least, this sort of discussion.

Mr. Sterling: On a point of order, Mr. Chairman: Why does the minister not answer some of the questions? Who is filibustering here? Is it the Conservatives or is it the minister?

Mr. Chairman: That is not a point of order.

Hon. Mr. Elston: I am happy to see the member recovers quickly. He got his wind back just in time to raise a point of order. I can say to the member that with respect to physicians and dentists they are included under the Canada Health Act. The optometrists are not, as the member knows.

He will also be interested to know that insured services provided by optometrists are fully insured in the province. From that standpoint, that makes them different from groups such as chiropractors. That is why they are included in this legislation and people such as chiropractors are not.

The member will know there is a limit to the insured service level which the province pays to chiropractors. It is somewhere around $200, in round figures. That makes a difference between the chiropractors and the other three groups I mentioned.

Mr. Sterling: What about the physiotherapists? Are their services not fully insured?

Hon. Mr. Elston: It has nothing to do with the amendment.

Mr. Chairman: That is a fair comment. That is not in the amendment of the member for Lincoln.

Mr. Sterling: Do these three groups, the optometrists --

Hon. Mr. Elston: Search for another question.

Mr. Chairman: Order. Carry on, member.

Mr. Sterling: Are these the only three groups with fully insured services?

Hon. Mr. Elston: Is the member finished? Does he want me to answer his question? The honourable gentleman is talking about groups of people he may want to add, by way of amendment I presume, to that of the member for Lincoln. What he should have done was talked about this last Tuesday in caucus when they went over these amendments. At least that is what I understand happened. If the honourable gentleman wishes to get some detailed explanation as to why that amendment is in the form that it is, he should talk to his Health critic. He should have examined the Health critic during his presentation in caucus last week to get an understanding of why the amendment goes as far as it does or does not go far enough, in his opinion.

If it does not go far enough in the member's opinion, he should be chastising the member for Lincoln, not me. He should go after him. I think he would have done well if he had brought this to his attention before he brought it in here.

Mr. Sterling: The Minister of Health is awfully touchy today. How many assistants does the minister have?

Mr. Chairman: Please speak to the amendment.

5:20 p.m.

Mr. Sterling: I asked a question. The three groups the minister is dealing with in Bill 94 are the three groups the member for Lincoln is dealing with. I am asking the minister a question. Are there other groups that are fully insured in Ontario? Can he answer that for me?

Hon. Mr. Elston: Mr. Chairman, I do not think it would be of benefit to the discussion of the amendment.

Mr. Chairman: That is not appropriate to the amendment in front of us.

Mr. Sterling: It is obvious the minister has been very selective in singling out the optometrists. They are not in the Canada Health Act, but they are in Bill 94, and the minister is now avoiding answering me. He is a minister of this open government. I am asking him a simple question across the House and he refuses to answer and tell me whether there are other groups that are fully insured. What more easy question could he answer?

Mr. McClellan: Why do you not put it in the Orders and Notices?

Mr. Sterling: I want to know the answer now because it is relevant to the debate. The debate has to do with how the minister is dealing with one group. He singled out the optometrists to put them in Bill 94, but they do not have the same protections under the Canada Health Act as the dentists and the physicians. That is patently unfair.

As a person who is not familiar with all the ins and outs of the Canada Health Act because my area as critic has more to do with the justice area, I became more convinced as I read the legislation that the amendment of the member for Lincoln is reasonable. I do not see how it causes the government a problem in the long run. I do not understand why the government will not accede to accepting in good faith the amendment to Bill 94.

From the minister's reactions to my questions, I get the feeling this is more of a political matter. He does not want to give the Tories a win, no matter what happens. I had thought there was some degree of openness and understanding on the part of the new government. I thought it had learned. In all its remarks on just about every issue, we have heard so much about how it is open to suggestion. It wanted to have discussion in the Legislature and wanted to talk about reasonable ideas.

This is a reasonable idea. It goes beyond being reasonable. Down the road, it could keep the government out of some trouble. The answers the minister has given me are not satisfactory. I do not think they address the issue. Unfortunately, it is a legal issue. I am not arguing whether there should or should not be arbitration; I am looking to the formal requirements of the Canada Health Act. Whether at the federal level or at the provincial level, the minister should deal with the legal questions and cover his situation as well as he can.

If this province loses $50 million because the minister does not want to accept the amendment of the member for Lincoln, I hope the government will get tagged with it. I am drawing this to the minister's attention so that we can tag him if that comes to pass. I hope the minister will see fit to accept the amendment of the member for Lincoln, because the member said he is quite willing to alter the wording as long as the thrust that he has put forward is carried to fruition.

Mr. Andrewes: I want to seek clarification from the minister on a couple of issues in response to the member for Carleton-Grenville. Basically, he asked about the intent of the government of Canada under the Canada Health Act, that is the substance of all this debate.

Is Bill 94 to give effect to the Canada Health Act in Ontario? The minister is nodding his head. Does that mean no?

Hon. Mr. Elston: There is no point in replying, because these are the same questions we have been asked before and I imagine will continue to be asked. All the honourable gentleman is trying to do is fill time. That is all his colleagues are trying to do: waste the time of the House. They are trying to filibuster. That is what is happening.

Mr. Andrewes: With respect, I have attempted to keep my comments relevant and to the point of the amendments that have been presented. The minister can cast stones in other directions if he wishes, but I hope he will not cast them in my direction.

To be satisfied with the answers the minister has given to previous questions, I have to determine this. Let us say the Ontario Medical Association comes to the ministry, sits down at the table, as it is entitled to do under the Canada Health Act and Bill 94, and says: "This is the process by which we want to arrive at appropriate remuneration. We want to start by appointing a committee. The ministry will appoint its members to the committee. We will have a chairman, to whom we will both agree, and we will negotiate." That is the first phase. We can call that committee the Joint Committee on Physicians' Compensation if we want. We are entitled to do that. It seems Bill 94 and the Canada Health Act allows the government to do it, and it can be called the JCPC.

At some point, the government can provide for mediation, a fact-finder or other flexible forms of negotiation and consultation. I choose that word rather than calling it arbitration. It is some sort of consultation, mediation, or a fact-finder's report. However, let us say the OMA and the Ontario Dental Association say to the minister, "We have not been able to arrive at a satisfactory agreement, and we want what we are entitled to under the Canada Health Act: binding arbitration." Can the minister say no and still present the government of Canada with an agreement that says we have satisfied the requirement of the Canada Health Act?

Hon. Mr. Elston: I said before and I will say again that the route the people in Ottawa had in mind was not the mechanism by which one gets there, but establishing reasonable compensation. As long as reasonable compensation is established, it is my understanding that from their point of view they do not care what mechanism is used to get there.

Mr. Andrewes: Let me be clear. if the mechanism is binding arbitration, they are happy.

Hon. Mr. Elston: And if it is not, they are happy.

Mr. Andrewes: That is fine. I understand that. One can stop anywhere along that process, as long as both sides are happy to stop there. If one side is not happy to stop until it gets to binding arbitration, there is no agreement.

Hon. Mr. Elston: There is a test for this, as I have said several times. I said it to the member's colleague who is now getting his breath back to start again some time. The real test is not the mechanism by which one gets to reasonable compensation. The test which is going to be used is reasonable compensation. That is the only test I am aware of upon which the federal government is going to pass judgement, not by where one was on any continuum or whatever, which is what the member is trying to establish. It is not that way. It is the result. It is the reasonable compensation.

Mr. Andrewes: I do not mean to be stubborn on this issue. I still do not understand.

Hon. Mr. Elston: The member does not want to.

5:30 p.m.

Mr. Andrewes: I do want to. The minister is saying the test will be whether there is reasonable compensation for the services rendered. That is the test, not the method by which one gets there. In order to get there, if one side insists on binding arbitration in order to get there

Hon. Mr. Elston: It is a waste of time.

Mr. Andrewes: He keeps saying it is a waste of time but I do not understand his answer. I think it is very ambiguous and it is leaving us with the impression that the Canada Health Act which provides for binding arbitration will accept Bill 94 without the OMA or the ODA or the Ontario Association of Optometrists having the rights of binding arbitration. That is what he is telling me.

Mr. D. S. Cooke: Maybe I am right and maybe I am wrong. I think the member for Lincoln is on the wrong track in that if he reads subsection 3(1) of the act he will see that is the first step. Because they defeated our amendment last week, the first step is to sit down and negotiate a negotiating process. Once that negotiating process has been agreed to, that is how fair compensation is set under the bill. It may or may not provide for arbitration. It depends on what is negotiated between the government and the association.

Mr. Andrewes: That is right, but they are not accorded the privilege of binding arbitration.

Mr. Chairman: Rather than trying to speak from their seats, the members should stand if they are speaking on the amendment. The member for Cambridge (Mr. Barlow) has indicated that he wishes to speak. Is the member through with the point that has been going back and forth recently? Thank you very much.

Mr. Barlow: I was trying to follow the dialogue on that point. I think I am beginning to understand it. I am not too sure.

Perhaps it will get further clarification before too long so we can get on with this important piece of legislation I have been following this afternoon, as I have followed the total bill ever since we have been debating it in the House. Giving this amendment careful thought, and I had an opportunity to discuss it with the member for Lincoln, I certainly feel I want to support this as part of this bill if the bill is going to go through. I still have strong hopes, but probably false hopes that there will be some waking up on behalf of both the government and the third party to realize that this is not the way to access the health of this province and to assist the providers of health and the residents of the province by bringing this bill in.

Mr. Breaugh: That is unfortunate. We are talking about an amendment.

Mr. Barlow: No, I am getting back to the amendment.

Mr. Breaugh: Which amendment is it?

Mr. Barlow: I totally agree with the amendment the member for Lincoln put forward as it relates to the optometrists of the province.

Mr. Breaugh: Are you for it or against it?

Mr. Barlow: That is what I say. I have been giving it very careful consideration. I have decided that I am going to support the amendment. I have a copy of the amendment. I have been questioned on this, Mr. Chairman. The amendment says: "Mr. Andrewes moves that section 3 of the bill be amended by adding the following." It is to give proper dialogue to the optometrists so they will agree with the Canada Health Act.

Mr. Breaugh: I misunderstood then. I thought it was binding arbitration.

Mr. Barlow: I am sure the member has been listening to the same arguments as I have, those that have been put forward by several members who have spoken on it. There are a few things that concern me on the amendment and that is why I was very interested in listening to the dialogue that flowed back and forth between the minister and the member for Lincoln. I feel now I am beginning to understand it. Perhaps in the wrapup, unless the minister has completed his wrapup, we can get a final determination of how this will relate to the Canada Health Act. This is the concern we have had in this party and why the amendment was brought forward in the first place.

I am prepared to support the amendment to add section 3a, but I still cannot support the bill when it finally comes forward. That is the main concern we in this party and the people in my riding have. All the people who have written to me have indicated their opposition to this bill. If it is going to go through, many of the amendments that are put forward must be incorporated in it to make the best of a bad bill.

6:23 p.m.

The committee divided on Mr. Andrewes's motion to add section 3a to the bill, which was negatived on the following vote:

Ayes 27; nays 60.

Mr. Chairman: Hon. Mr. Elston moves that the bill be amended by adding thereto the following sections:

"3a(1) Where the minister is satisfied that a person has paid an unauthorized payment to a practitioner, the minister may direct the general manager to pay to the person the amount of the unauthorized payment.

"(2) Where a person has paid an unauthorized payment to a practitioner and the general manager has paid the person under subsection 1, the practitioner is indebted to the plan for an amount equal to the sum of the amount of the unauthorized payment and the administrative charge prescribed by the regulations.

"(3) The general manager may recover from a practitioner part or all of any money the practitioner owes the plan under subsection 2 by setoff against any money payable to the practitioner by the plan.

"(4) If the general manager recovers money from a practitioner under subsection 3, the general manager shall forthwith serve on the practitioner notice of the amount recovered, the account in respect of which it was recovered and the practitioner's right under section 3b to request a review of the issue of whether the practitioner has received the unauthorized payment.

"(5) The notice under subsection 4 shall be served by registered mail addressed to the person to whom the notice is being given at the person's latest known address and the service shall be considered to have been made on the seventh day after the day of mailing unless the person to whom notice is given establishes that he or she, acting in good faith, did not receive the notice until a later date.

"3b(1) A practitioner is entitled to a review of the issue of whether the practitioner has received an unauthorized payment if within 15 days after receiving the notice under subsection 3a(4) the practitioner mails or delivers to the general manager written notice requesting a review.

"(2) The general manager, upon receiving a request for a review in accordance with subsection 1, shall refer the matter to the chairman of the board.

"(3) The chairman of the board may from time to time appoint a member of the board to conduct a review under this act.

"(4) A member of the board conducting a review shall inquire into whether the practitioner has received an unauthorized payment.

"(5) The general manager, the practitioner and the insured person have the right to make written representations to the member of the board conducting the review.

"(6) The member of the board conducting a review shall advise the general manager and the practitioner in writing as to whether, in the person's opinion, the practitioner has received an unauthorized payment and, if so, the amount of that payment.

"(7) If the member of the board conducting a review advises the general manager that the general manager recovered more from the practitioner than the sum of the unauthorized payment, if any, and the administrative charge, the general manager shall pay the practitioner,

"(a) if the member finds there was no unauthorized payment, the total amount recovered; or

"(b) if the member finds there was an unauthorized payment, the difference between the amount recovered and the amount that should have been recovered."

On motion by Hon. Mr. Elston, the committee of the whole House reported progress.

The House adjourned at 6:30 p.m.

June 9, 1986

VISITOR

TABLING OF INFORMATION

SPECIAL WARRANTS

MEMBERS' STATEMENTS

MONTH OF RAMADAN

CANADIAN AUTO WORKERS

COMMITTEE MEMBER

PROVINCIAL PARK

ADULT PROTECTION WORKERS

RECOGNITION OF SENIOR CITIZEN

NOISE BARRIERS

DEVELOPMENTALLY HANDICAPPED

STATEMENT BY THE MINISTRY AND RESPONSE

RECREATION SERVICES

ORAL QUESTIONS

EXTRA BILLING

PENSION FUNDS

BEACH POLLUTION

EXTRA BILLING

SEWAGE TREATMENT PLANTS

HEALTH SERVICES

WORKERS' COMPENSATION BOARD

ASSISTIVE DEVICES PROGRAM

SPECIAL EDUCATION

SENIOR CITIZENS' SERVICES

INTERNSHIPS

HOSPITAL FUNDING

ONTARIO LOTTERY CORP.

PHARMACEUTICAL LEGISLATION

ONTARIO LOTTERY CORP.

SENIOR CITIZENS' SERVICES

PETITIONS

NATUROPATHY

GASOLINE PRICES

MOTION

ESTIMATES AND SUPPLEMENTARY ESTIMATES

ORDERS OF THE DAY

HEALTH CARE ACCESSIBILITY ACT (CONTINUED)