Hansard Transcript 1986-Jun-10 | Legislative Assembly of Ontario

Mr. Speaker: I would like to inform the members that last Thursday the member for Brantford (Mr. Gillies) rose on a question of privilege with respect to details of legislation being disclosed in the press before being disclosed to the House. The member also stated that an assistant to the Minister of the Environment (Mr. Bradley) and an assistant to the Minister of Housing (Mr. Curling) had violated their oaths of secrecy and had demonstrated contempt for the House by discussing with the press details of actual legislation and amendments before the House.

Standing order 18(b) states, "Whenever a matter of privilege arises, it shall be taken into consideration immediately." Once a claim of a breach of privilege has been made, the duty of the Speaker is to decide whether, on their face, the facts raised could reasonably be held to constitute a breach of privilege that would take precedence over the other business of the House. It is not the Speaker's duty to decide whether a breach of privilege has been committed. This is a question that can only be decided by the House.

It may be useful for me to review the nature of parliamentary privilege once again. Parliamentary privilege relates to the rights and immunities that belong to parliament, its members and others, which are essential for the operation of parliament. These rights and immunities allow the Legislature to meet and carry out its proper constitutional role, members to discharge their responsibilities to their constituents and others properly involved in the parliamentary process to carry out their duties and responsibilities without obstruction or fear of prosecution.

The principal privileges of the House and of its members include the right of free speech in parliament, immunity of members from arrest, detention or molestation for civil causes during defined periods, immunity of members from the obligation to serve on juries, the power to regulate its own proceedings by establishing its own rules or standing orders, the power to order the attendance at the bar of the House of persons whose conduct has been brought before the House on a matter of privilege and the power to order the arrest and imprisonment of persons guilty of contempt or breach of privilege.

It is only in very rare circumstances that a legitimate matter of privilege can come before the House on the basis of the real, accepted and traditional definition of parliamentary privilege.

I understand the distinction the honourable member has attempted to draw between announcing outside the House policy statements on matters which are not before the House and statements with respect to specific amendments and legislation before the House. However, it is clear from the precedents in this House and in other jurisdictions that parliamentary privilege does not extend and never has extended to requiring policy statements or announcements to be made in the House, regardless of the importance of the subject.

Further, in examining the authorities, no case can be found which indicates it is a breach of privilege for representatives of the government to publicly announce its intentions with respect to amendments and legislation before the House. Indeed, this practice has been a common occurrence for many years. As my predecessors and I have stated, such statements made outside the House may constitute a legitimate grievance and certainly involve a question of courtesy to or respect for the House and its members. However, they do not constitute a question of privilege.

Whether or not assistants to the ministers of the Environment and Housing have violated their oaths of secrecy is a question of law and a question upon which the authorities indicate the Speaker shall not give a decision. Such a matter could, if justified, give rise to an action in the courts; however, it is not one with which the Speaker is able to deal.

In finding that no prima facie case of privilege exists, further consideration by the House is not prevented. The effect is to refuse precedence to this matter as a question of privilege, but it does not prevent the presentation of this matter in different circumstances, for example, by setting it down as a private member's notice of motion.

I hope many of the members will read this on a number of occasions as I have tried to spell out what parliamentary privilege is.

Mr. Gillies: On a point of order, Mr. Speaker

Interjections.

Mr. Gillies: If we can determine what order is.

Mr. Speaker: On this point or another point?

Mr. Gillies: May I speak to this point?

Mr. Speaker: No.

2:07 p.m.

MEMBERS' STATEMENTS

INSURANCE AGENTS

Mr. Runciman: It has come to my attention that the Minister of Financial Institutions (Mr. Kwinter) plans to introduce a ban on part-time insurance agents very shortly. As I understand it, the point of the ban is to prevent the A. L. Williams company from operating in Ontario. One of the concerns is that part-time agents will not be trained properly. I think that is a valid point, but surely the minister could address that through strict testing requirements. That suggestion was made by the Canadian Life and Health Insurance Association, and I hope the minister will consider it.

There is increasing movement towards the use of part-time workers in a number of areas, especially in financial institutions. As I stated last week, many of these workers are women who may not be able to work full-time because of other commitments. The next time the minister goes to his bank or trust company, he should ask how many of the staff are part-time workers. He will be amazed. It is the way of the future. That is why members of this party consider his proposal to be a step in the wrong direction. If the minister has problems with A. L. Williams, he should deal with that company directly. I urge him to withdraw his proposal and find a cure that fits the ailment.

ENVIRONMENTAL PROTECTION

Ms. Gigantes: On June 2, I asked the Minister of the Environment (Mr. Bradley) why his ministry had not taken action to ensure that the Lees Avenue site of the old Ottawa Gas Co. was not turned into a construction site without prior and adequate cleanup control. That site has been one of many sitting on the ministry's list of hazardous sites since 1980.

He said the regional municipality of Ottawa-Carleton could have looked into the history of the site, but did not, which we knew. He said the region decided to use it for a transitway station, which we knew. He said it was an industrial site and not a waste site, which is a great help. He said the site was not without problems, which has to qualify as one of the euphemisms of the year. We did and do have a problem which his ministry did nothing to prevent on the Lees Avenue site.

On June 3, my colleague the member for Etobicoke (Mr. Philip) asked the minister about provincial support for 15 municipal waste incinerators in the face of documentation that municipal incinerators are the major contributors to furan and dioxin fallout. He said some of the 15 proposed incinerators were going virtually nowhere. Apparently one in St. Catharines is going virtually nowhere, but in Ottawa-Carleton it is going full steam ahead.

On June 6, CBO Morning revealed that raw sewage is being pumped by the hundreds of thousands of gallons into the Ottawa River by the city of Ottawa. This ministry has set up a situation where Ottawa-Carleton is reaping the result of provincial neglect in the environment.

MEMBERS' ANNIVERSARIES

Mr. Epp: All members will be interested in knowing that nine years ago yesterday, on June 9, 1977, 13 members were elected to this Legislature. Those members were subsequently re-elected in March 1981 and again on May 1, 1985. Although many more members were elected at that time, 13 are still serving.

Those members are the member for Durham West (Mr. Ashe), the member for Ottawa West (Mr. Baetz), the member for St. Catharines (Mr. Bradley), the member for Hamilton Mountain (Mr. Charlton), the member for Windsor-Riverside (Mr. D. S. Cooke), the member for Durham East (Mr. Cureatz), myself, the member for Fort William (Mr. Hennessy), the member for Armourdale (Mr. McCaffrey), the member for Kent-Elgin (Mr. McGuigan), the member for Cochrane South (Mr. Pope), the member for Carleton-Grenville (Mr. Sterling) and the member for London North (Mr. Van Horne).

For those members who keep box scores, there were seven Progressive Conservatives, four Liberals and two New Democratic Party members.

ROMAN CATHOLIC SECONDARY SCHOOLS

Mr. J. M. Johnson: My riding of Wellington-Dufferin-Peel contains several one-school communities. These communities are deeply concerned that some of their high schools may close as a result of the extension of full funding to the separate school system. I have received calls from many residents of the Mount Forest and Arthur areas; people such as Mayor Alec Watson, councillor Ralph Martin, school trustee Bob Hill, Ethel McEwen and Jean Curtis have all expressed fears over the possible closing of their schools.

The people in these communities want to be reassured that schools will not be closed because of any shift in enrolment to the separate school system, that their high school will not be transferred to the separate school system, forcing students to leave their community to attend a public high school. As Bill 30 is now written, it does not contain any assurances for these people. The legislation does not offer any protection for single-school communities.

Although the Minister of Education (Mr. Conway) has said on many occasions that no single-school community will lose its school as a result of the extension of full funding to the Roman Catholic separate school system, he has put nothing in the bill to give these communities any such guarantee. I ask the Minister of Education to reconsider his position and to provide these communities with statutory protection for the public high schools. Only a guarantee in legislation that no community with a single public high school will lose that school will finally put the fears of the residents of these communities to rest.

HEALTH SERVICES

Mr. Swart: I want to take this opportunity to bring to the attention of this House, and particularly the ministers concerned, the shortage of chronic care nursing home beds in the Welland area.

On any day, an average of 37 chronic care or nursing home patients are backed up into the hospital's 243 active treatment beds. From Monday to Thursday, up to 15 admissions daily are being held in the emergency area for hours, sometimes for days, before they can get regular hospital beds. The Niagara Regional Health Unit recognizes the need for more chronic care and nursing home beds in the Niagara region, and it is time the government acted on its recommendation.

The situation is aggravated by the delay in proceeding with the 30 extended care beds for the francophone Richelieu Residence. The Minister of Health (Mr. Elston) and the Minister of Community and Social Services (Mr. Sweeney) will recall they gave approval for that project eight months ago. I know progress has been complicated by Canada Mortgage and Housing Corp. changing its policy so that funding for the nonprofit sector involving another 30 residential beds at the Richelieu Residence now goes to Ontario Housing rather than directly to nonprofit groups. However, that is not sufficient reason for the delay after the commitments that had been made by this government.

Money should be provided immediately by the Ontario Housing Corp. I urge the ministers to get on promptly with the Richelieu Residence project so the francophone community will get the service it deserves and so relief can be provided.

WORLD CUP SOCCER

Mr. Rowe: I rise today to give special recognition for our Canadian national soccer team competing in Mexico at the World Cup. This young team went three games and held three of the greatest soccer nations in the world to five goals. They accomplished truly an amazing feat.

We as Canadians found we can compete with the world's best and we know we have the stuff that will allow us future wins. As today's Toronto Sun sports columnist Terry Jones stated, "We came, we saw and we did not get humiliated." With any breaks at all, l am sure the team will go on to compete in the World Cup in Italy in 1990.

We on this side of the House congratulate Tony Waiters and his entire team and say, "Well done, Canada."

GREAT LAKES WATER QUALITY

Mr. Allen: We in this party have been raising questions about the ongoing problem of the pollution of beaches around the Great Lakes system. I call to the attention of this Legislature that at the McMaster University faculty of engineering, a professor by the name of Dr. William James has developed a very impressive high-technology system for monitoring and controlling the runoff in the storm sewer and sanitary sewer systems. It is a non-capital-intensive, low-cost system which makes it possible for present installations to be developed with minimum modification to handle a very serious problem.

Dr. James has found virtually no support and very little interest from the Minister of the Environment (Mr. Bradley) or the Minister of Industry, Trade and Technology (Mr. O'Neil) as far as this project is concerned. He has found more interest in the United States and in Europe in its applications. Norway has a complete system in one of its cities based on his design.

Why is it that our ministries in Ontario appear to be so little interested in solving a major environmental problem and using it as a means of developing a local industry in Hamilton which would become the focus of an industry that is concerned with environmental repair and pollution control which is growing in the US?

2:17 p.m.

STATEMENT BY THE MINISTRY AND RESPONSES

PORTUGAL NATIONAL DAY

Hon. Mr. Ruprecht: It gives me great pleasure to introduce leaders of the Portuguese Canadian community and distinguished representatives of the government of Portugal: Consul General Tanger Correa and members of his diplomatic corps.

[Remarks in Portuguese]

On behalf of the Premier (Mr. Peterson) and the government of Ontario, I rise for the purpose of recognizing an important event that dates back 406 years and has been celebrated as Portugal National Day since 1880.

The celebration of the national day of Portugal is special and unique in the pages of history. Unlike some dates that commemorate an important political event, such as a declaration of independence, on this historic occasion we ask the people of Ontario to join our Canadians of Portuguese heritage in the remembrance of a great, world-renowned poet and writer, Luis de Camoes. Although he passed away more than 400 years ago, Camoes left a living legacy of meaningful poetry of immortal beauty that has not withered with age.

We are all cognizant and appreciative of the tremendous contribution that our Portuguese friends have made to the development and growth of our province and country both in economic and cultural fields. Yet, as important as the economic contributions are, the attention of Canadian Portuguese children today is focused not on the prosperity and wealth that opportunities in Canada create but on our democratic system of government, which allows the people in our multicultural society of Ontario to celebrate a national literary hero of their forefathers' original homeland as a right.

Indeed, Luis de Camoes is an intellectual giant whose footsteps have crossed centuries of time and the Atlantic Ocean, to implant into Canada a great heritage of love for literature, poetry and education.

May this Portugal National Day inspire us to pause more often to study and admire our writers and poets. Perhaps we might recognize that a new Luis de Camoes could be inspired as a result of paying tribute to the eternal de Camoes whose remembrance we are honouring today. Therefore, in recognition of this special day, the Ontario government proclaims June 10 as Portugal National Day.

Mr. Grossman: On behalf of the Progressive Conservative Party, I should like to join in recognizing the national day of the Portuguese. For us on this side it is a special occasion, as are all these types of days. It is largely due to the efforts of the member for High Park-Swansea (Mr. Shymko) that we have these opportunities in the assembly, and today is a specially important one for us.

Those members who have served so well in the community for so long will know of the special opportunity, and I have considered it a special opportunity to have been able to represent large numbers of members of the Portuguese community since they came to Ontario and located in the great riding of St. Andrew-St. Patrick.

Having worked with them, practised law in the midst of the Portuguese community and having had the opportunity over 11 years to represent them in this assembly in large part, together with my colleague the member for Bellwoods (Mr. McClellan) and others, I can report first hand their enormous contribution in bringing their tremendous heritage and their linguistic and other traditions and customs from Portugal to Canada, Ontario and Toronto.

It has been extremely important. Lest we believe on days such as this that this is all focused in Toronto, we should remember that the Portuguese have made a tremendous contribution in many other ridings and in many other cities such as Oakville, Hamilton, Burlington, Mississauga, Cambridge, London, Thunder Bay, Ottawa, Kingston and Oshawa, to name just some of the communities in which we have had a tremendous presence by the Portuguese community.

They have established their own recreation clubs, credit union, social service council, cultural associations, their own services to newcomers, the Terra Nova home care for seniors, as well as CPRC-FM, Ontario's and Canada's first Portuguese-language radio station.

I say to our friends in the gallery that my party is proud to join in recognizing their tremendous contributions to date. We join them in celebrating this very important day. I urge all of us to continue to recognize the enormous efforts that the Portuguese community has made here in Ontario as we, as legislators, jointly applaud and congratulate the community on this tremendous day.

Mr. Shymko: I join the member for Parkdale (Mr. Ruprecht) and the leader of Her Majesty's opposition (Mr. Grossman) in their comments in looking at the very important moments of such occasions where, in a very nonpartisan fashion, we recognize the contributions that Canadians of Portuguese descent have made, not only to this province but also to our nation. In these moments, we must realize some of the difficulties the ethnocultural communities and newcomers to our province have in the area of labour, employment and the ghettoization sometimes of women of immigrant background, and we must address them as well.

These are moments of reflection that all of us, both on the government side and on the side of the opposition, must realize. In looking at the sacredness of these occasions, we must remind ourselves of the problems of some of these ethnocultural communities. The precedent that has been set by the former Premiers, Mr. Davis and the member for Muskoka (Mr. F. S. Miller), is being followed by the present Premier (Mr. Peterson) in officially proclaiming these national days.

I quote the member for Parkdale who, during the debate when I was privileged to introduce a motion, said, "What I would like to see is that these anniversary celebrations, as they are exercised, are independent, nonpartisan and nonpolitical." I complimented him on those remarks then, and we should be reminded of that today.

We welcome these delegations. May they be blessed with continued endeavours and success as they share with us the challenges of our society and as they share with us the success they have achieved as a model example in many respects to other communities in this province.

Mr. McClellan: On behalf of the New Democratic Party, I welcome Dr. Tanger Correa and the other distinguished guests to the Legislature today and offer our own congratulations on the occasion of Portugal National Day.

The Portuguese community has been associated with Canada for as long as this anniversary, for more than 400 years. In the past 25 years in particular, Ontario and Toronto have been privileged to become the home to a large and vibrant Portuguese community which has made a tremendous contribution to the physical redevelopment of our capital city and, more important, to a redefinition of our own society towards that of a vibrant and pluralistic multicultural society. The Portuguese community has made an extraordinary contribution to that process of redefinition.

We should reflect on an extraordinary fact that I do not think is common to very many countries. Portugal celebrates its national day, not in the memory of a battle, a war or some imperial conquest, nor in honour of some ferocious monarch or potentate. Portugal celebrates its national day in memory of its national poet. That is consistent with the traditions of a country, the symbol of whose revolution is a red carnation. We welcome the delegation that is here today in the spirit of this cultural tradition and offer our best wishes again to all Portuguese Canadians on the occasion of Portugal National Day.

2:28 p.m.

ORAL QUESTIONS

EXTRA BILLING

Mr. Grossman: My question is to the Premier. We are two days away from an indefinite withdrawal of services by the doctors of this province. Will the Premier consider simply picking up the phone and calling the Ontario Medical Association to see if there is any possibility that this strike action can be averted?

Hon. Mr. Peterson: The honourable member may have some information that I am not aware of, that there are things we could do to prevent the strike from coming about. If there were, short of withdrawing the bill, which I guess the member would like to see us do, I would be happy to chat with the OMA. As the member knows, the OMA has my private numbers. They are quite well aware of the fact that any time they want to chat with me, I am open and accessible.

Mr. Grossman: I remind the Premier that just a few days ago he was quoted in the papers with regard to who is going to call whom first. He said something like: "What is this? A children's game to see who is willing to pick up the phone first?" Does he not agree it is his responsibility to do everything possible to avoid the cancellation of elective surgery, to avoid all sorts of inconvenience and maybe some of the problems he himself referred to in the newspapers this morning? Does he not think, as Premier, he should not simply say, "You can call me"? Does he not think it is his responsibility to pick up the telephone and see if he can avert a strike of the doctors?

Hon. Mr. Peterson: I did not say it was a children's game. I said it was like a dance in grade 8. My honourable friend would have experience with those. It is where one group stands on the one side and says, "Are you going to ask her to dance first or is she going to ask you to dance first?" That was the analogy. I am sure the member would agree with me in that regard.

A number of people feel they have solutions to the problem, dramatically oversimplified in a number of quarters, but we stand open and ready to chat with the Ontario Medical Association on any subject. The member knows where this government stands on the question. We have said we want to come to a situation where no patient pays extra. If the OMA is prepared to discuss ways to implement that, then we will be very happy to do that. Extensive meetings have gone on over the past many months. The minister has discussed all the areas of possible agreement, but if those arise in the future, we shall be very happy to pursue them.

Mr. Grossman: Would the Premier not agree that some people in this province are going to face potential health risks as a result of what is going to happen? He must, having read his comments in the morning paper. To use his own analogy, would he not agree that the Premier of the province ought to be willing to be the person to cross that dance floor to break the standoff, to see if there is any point in having further discussions or a mediator? Why would he not simply be the first one to move and rise above this dispute?

Hon. Mr. Peterson: If it were that simple, it would have been done a long time ago. I understand the honourable member's wanting to be constructive in this situation, but if he examines his own idea, I am sure he will see how frightfully simplistic it is in the situation. He went through extensive negotiations with the OMA some years ago. He will recall them, because I recall those days in the House very well. I need not remind him of the discussions he conducted with them at the time. If solving the problem were as simple as a telephone call, it would have been solved a long time ago.

I stand ready, willing and able to chat with the OMA at any time we can make progress, but if the member is asking me to hold up or withdraw the bill, the answer is that in life sometimes one has to face problems and sometimes one cannot defer them for ever. The previous government had experience with those situations. We are trying to face them in as sensitive and humane a way as we possibly can, and I think we are doing so.

Mr. Grossman: I want to emphasize to the Premier that my question today had nothing whatever to do with withdrawing the bill, which we think would be appropriate, and nothing whatever to do with what he just answered. Today it is a simple question related to why in the circumstances the Premier would not simply pick up the telephone and ask the OMA if there is any point in having further mediation or meetings? Can the Premier inform the House what he has to lose by picking up the telephone and asking the OMA a few questions with regard to mediation or further meetings?

Hon. Mr. Peterson: I would never want to accuse my honourable friend of being naïve because he is not naïve. If he examined his suggestion today in detail, he would know that is not going to bring a resolution of the problem. We believe we have exhausted every reasonable avenue and we are getting a great deal of pressure from some of our friends in this House to move ahead immediately. Other advice was to do nothing. The government chose a course of action we believe was fair-minded and conciliatory and we genuinely were searching for a negotiated settlement to this situation.

I remind my friend the member for York Mills (Miss Stephenson), who is glaring at me over the top of her --

Hon. Mr. Nixon: Like Vesuvius.

Hon. Mr. Peterson: Like Vesuvius, just about to erupt. Here goes.

Interjections.

Mr. Speaker: Order. Please disregard the interjections. They are out of order.

Hon. Mr. Peterson: It is completely predictable, is it not, Mr. Speaker?

We are searching for a solution. We have not been able to find one, unfortunately. The member will be aware there were points in the discussion where we felt, and I think others from the OMA felt, that we were close to a negotiated settlement. They brought in an adviser from the west, Mr. Trevino. I gather the member went to the mat with Mr. Trevino some years ago. I guess they assumed on the basis of those discussions that the same result would follow this time with this government. Unfortunately, we were not able to work it out.

Mr. Grossman: The Premier absolutely refuses to answer the question as to what he has to lose by picking up the phone and calling the OMA to ask some simple questions about mediation.

If he will not answer that question, I will ask him this one. Given the fact that last year the Ministry of Labour's conciliation and mediation service resolved 2,413 disputes or almost 90 per cent of all the disputes involved --

Interjections.

Mr. Grossman: I am sorry; those were 1984 figures.

Mr. Speaker: Question?

Mr. Grossman: Given that in many of those circumstances, not involving services as important as essential services such as doctors supply, the standoff seemed at least as serious as this one, does the Premier not consider it appropriate to call up the OMA today and say, "Let us see if we can get one of the mediators we have used previously to take a few weeks or months to talk about it"?

Mr. Breaugh: Peter Puck. Get Pocklington.

Mr. Grossman: Yes, they are the Peter Pocklingtons in this matter.

Hon. Mr. Peterson: I think I answered the question the first time. I do not think there is anything to lose, but there is nothing to gain. It will not solve the situation. That is where we are. If he believes it will solve the problem, let me tell my friend he is being horribly naïve in these circumstances. This has been going on for almost a year. If he thinks a simple phone call will solve the situation at the moment with the help of conciliators, his conciliators or our conciliators, or his mediators or our mediators, I can tell my friend that in my opinion the world is not quite that simple.

If my friend opposite can control his left-winger from yapping so much and wants to listen to this, I can tell him this is a basic disagreement on principle; it is not a matter of a few details. Unfortunately, the majority will of this House is at odds with an important group. It is not one of those situations that can be solved by a phone call.

Mr. Grossman: If there is one death, heaven forbid, one major problem in the health care system on Thursday, Friday or Saturday, or Sunday or Monday of the coming week, the Premier will be responsible for the fact that he would not pick up the phone and call the OMA, which has indicated that if it receives a request from the Premier of this province to enter into a mediating process with a mediator, it will seriously consider and likely accept that proposal. Therefore, if the Premier reads later this week of some untoward event, some tragedy occuring in the system, he will know a simple phone call from him to the OMA would have averted the strike totally.

Mr. Speaker: Was that your supplementary? Is the Premier aware?

Mr. Grossman: My final question is this.

Mr. Speaker: Briefly.

2:40 p.m.

Mr. Grossman: In view of all that, the Premier said on May 28 with regard to the appointment of a negotiator, "The onus is on him," meaning the Leader of the Opposition, "to prove it would be helpful in some way or other." Is that still his position?

Hon. Mr. Peterson: The rhetoric in the member's question is irresponsible. I say to my honourable friend as kindly as I can that his attempt to be relevant in this discussion is about as helpful as his previous ideas of tipping doctors and a number of others.

I am surprised that suggestions as naïve as the ones he has come forward with would be put forward by a former Minister of Health in a situation where a strike was going on. I am surprised he would oversimplify this to the extent he has. I am sure that when he is in private conversations, he will realize that this is a different situation now to what it was then.

Mr. D. S. Cooke: I have a question for the Minister of Health. The minister has been saying up until now that the withdrawal of services by doctors is fine as long as emergency services are provided within this province. Does he consider a withdrawal of services that will result in the cancellation of cancer surgery, heart bypass surgery and other types of surgery that are considered to be elective to be acceptable under the health disciplines legislation in Ontario?

Hon. Mr. Elston: The role of delivery of health care services in this province has always between the physician and his or her patient. The member knows, as I do, that one of the strongest arguing points on the part of the OMA executive is that government ought not to trespass into that area of discussion and delivery of service. We have not trespassed into that area. Discussions between a physician and his patient with respect to this surgery are the appropriate way to go.

I have been assured by physicians as I have talked to them around the province that they will not be abandoning their patients, that they will be providing their services and will not compromise health care. From that standpoint, I have seen that physicians have undertaken to provide their patients with care and I am not moving into discussions about the delivery of service by physicians to their patients.

Mr. D. S. Cooke: The minister will understand that under the health disciplines legislation of this province the bottom line is that he as Minister of Health has the responsibility to guarantee that patients have access to and quality of care in our health care system. Does the minister not realize that this health disciplines legislation was designed to deal with individual instances where doctors broke the health disciplines legislation and that it never contemplated a strike by doctors across this province? What meetings has the minister arranged with the College of Physicians and Surgeons of Ontario to guarantee that the health care of the people of this province is protected?

Hon. Mr. Elston: I have not arranged a meeting, but I have been in close personal contact with the college. The member is rightly putting the case that the health disciplines legislation, as far as physicians are concerned, is governed by the College of Physicians and Surgeons of Ontario. It has provided me with undertakings that it will fulfil its mandate to ensure that the public interest is protected.

Mr. D. S. Cooke: Perhaps the minister can tell us how, as of Thursday of this week, the college of physicians and surgeons is going to survey Ontario properly to make sure the health care of the people of this province is guaranteed.

Hon. Mr. Elston: The college of physicians and surgeons develops its own networks for reviewing what is appropriate to its role. As the member knows, this body is at arm's length from the minister and the ministry. It carries out the mandate of protecting the public interest under that legislation separate and apart from me.

I know it did provide phone contact and lines for people to call in with respect to any concerns that were expressed by members of the public. A referral network has been set in place to deal with these concerns among the Ontario Hospital Association, my ministry and the college of physicians and surgeons. It has indicated it is prepared to carry out its role and to deal with the concerns that are expressed by the public.

BEACH POLLUTION

Mrs. Grier: I have a question for the Minister of the Environment. Yesterday the minister expressed the concern that had also been expressed by all his predecessors about the closure of beaches on the Metropolitan Toronto waterfront. I am sure the minister is aware that during the past 20 years there has been considerable lakefilling, which has created embayments and prevented the dispersal of the outflows from the rivers and from the sewage treatment plants.

Only one of the 10 lakefilling projects in Metropolitan Toronto has been the subject of an environmental assessment. I ask the minister whether he supports and intends to continue the policy of the previous government that allowed exemptions from the Environmental Assessment Act for lakefilling.

Hon. Mr. Bradley: First, the member has identified what many people today see as one of the contributing factors to the pollution of beaches. I think it was felt at one time, for instance, that even some of the work that was undertaken that was remedial in nature even, and not simply landfilling, would have been detrimental rather than beneficial to what has happened.

Be that as it may, and the member wants to know about the environmental assessment, I am giving serious consideration now to changing that policy in order that we may have a better assessment of the impact of those landfill developments on the waterfront, particularly in the light of the fact that there is some increasing evidence, I believe, that they do contribute to pollution.

Mrs. Grier: Given what the minister has said, will he undertake to stop any further landfilling projects until he has completed a comprehensive study of the impact of lakefilling on water quality in the vicinity of Metropolitan Toronto?

Hon. Mr. Bradley: I would probably have to evaluate the stage at which each of these projects is at present. If the member is asking about new projects, obviously, in the light of the relatively recent evidence of the impact of the landfilling and even of other so-called remedial measures, it would be wise to do that before giving permission for any new ones. Some projects may be in various stages at present such that I could not give an undertaking to stop at this time, but the member's suggestion about new landfill projects is a very good one.

Mrs. Grier: If the concern the minister has expressed today is a real one -- and I have no reason to believe it is not -- I regret we have not seen some initiatives from him to monitor and to stop these lakefilling projects before now. This is the second summer he has been in office and the second summer the beaches have been closed, and we have witnessed a steady deterioration in water quality. Can the minister tell us why he has taken no initiatives and what studies he has undertaken to monitor the impact of this lakefilling as it has occurred up to now?

Hon. Mr. Bradley: The member would know that --

Mr. Shymko: What about the Junction triangle?

Hon. Mr. Bradley: One at a time now. The member for High Park-Swansea (Mr. Shymko) has to wait his turn if he is going to ask a question.

There is the Toronto area watershed management strategy study, which is dealing with a number of these items. I happen to think the results of that study will provide us with some good direction for dealing with these problems.

I note, for instance, that the member says the results in some cases are better and in some cases are worse. Of course, she would mention the ones that are worse; that is what one does when one is in opposition. When one is in government, one mentions how much better it is.

2:50 p.m.

Let me tell the member I am not satisfied. However, I notice that on the Humber Bay east beach there was a fecal coliform count three years ago of 8,000 per 100 millilitres. We had what we consider to be a very high one this year, which was 840 fecal coliforms per 100 millilitres of water. It was 10 times worse three years ago. That is one specific instance, but I am sure there would be others to counterbalance that.

IDEA CORP.

Mr. Gillies: My question is for the Premier. It has been well known since the government took office that it was the Premier's intention to wind down the Innovation Development for Employment Advancement Corp. On February 19, the Minister of Industry, Trade and Technology (Mr. O'Neil) announced the corporation would be wound down on June 30.

Since the Premier took office, he has approved more than $18.5 million for new proposals that have gone through the IDEA Corp. Why would he put so much new money into an operation he is winding down, an operation which, I might add, the Treasurer (Mr. Nixon) described in his budget as an inappropriate vehicle for economic development?

Hon. Mr. Peterson: The honourable member is aware of the history of the IDEA Corp. In the preamble to his supplementary, he may want to enlighten his colleagues who are not aware of some of the administrative problems that developed there over a long period. There were management problems that prompted the member's previous leader, now the member for Muskoka (Mr. F. S. Miller), to voice his displeasure with the IDEA Corp. when he was the Treasurer.

When we came into the government, we came with a clean slate. We looked at the viability of all these organizations, one of which was the IDEA Corp. There were some aspects of financing that were worth while, particularly in the pre-venture capital area. We will continue that under a different structure. We do not believe it is our responsibility just to create bureaucracies to address problems, and find out they do not really address those problems. We believe more in the function than in the bureaucracy. One function of the IDEA Corp. we think is worth salvaging is in the pre-venture capital area. That is why it is being handled in a different form, through the ministry, without that great apparatus, all the offices and that kind of thing that went on in the past.

Mr. Gillies: Let us talk about the government's clean slate. I want to draw to the Premier's attention the two largest investments made by the IDEA Corp. since he took office. First, there was a $5-million grant to Graham Software Corp. I am sure the Premier knows Terry Graham, a former partner of his friend Abe Schwartz. The second largest was a grant of $3 million to Wyda Systems Inc. of Scarborough, a company that retains as its financial consultant the spouse of one of the Premier's senior cabinet ministers.

Will the Premier disabuse me of the impression he is using the IDEA Corp. as a slush fund for the Liberal Party and reaffirm our wish he is using it as a legitimate engine of economic development for this province?

Hon. Mr. Peterson: My honourable friend has been standing in this House and coming very close to making allegations I suspect he would not make outside it. I have never heard of this guy Graham. I think the member as a gentleman should have the honour not to participate in the sleazy politics I have seen from some of his colleagues. It is amazing to see a young man, who is supposed to be filled with some ideals, being sucked into the gutter the way he is.

Interjections.

Mr. Speaker: Order.

RENT REVIEW

Mr. Reville: I have a question for the Minister of Housing. New Democrats have been pushing for years for a rent registry to protect tenants from illegal rents. Where rents are found to be illegal, it would be natural to assume tenants would get their money back. Will the minister explain why his legislation will allow landlords who have overcharged to pocket the money?

Hon. Mr. Curling: The landlords and tenants advisory committee recommended we should not go on a witchhunt. At some stage, we will set up the rent registry and set a date on which to start moving forward in getting all rents registered under the rent registry process. There are conditions under which we will charge people who have charged people in excess of the legal rent.

Mr. Reville: If the minister will unsheathe his copy of the bill, he may notice that under subsection 63(1) one can get some money back, but only back until August 1, 1985. Illegal rents may have been charged for years before that. Why does the minister think it is appropriate to finance retroactive forgiveness for cheating landlords with money that belongs to tenants?

Hon. Mr. Curling: The honourable member knows that the effort to retrieve those moneys might be extremely difficult with landlords who were not keeping proper accounts. If this system were in place --

Mr. McClellan: So crime does pay.

Mr. O'Connor: They should all burn their books now.

Mr. Speaker: Order.

Hon. Mr. Curling: I know how anxious the members are that this system should have been in place years ago, but it was never acted upon. The previous government suggested a rent registry, but it did not have the guts to bring it forward. We now are bringing it forward. We have decided to look forward instead of going on a witchhunt. We know this system will be fair from here on.

POLYCHLORINATED BIPHENYLS

Mr. Reycraft: My question is for the Minister of the Environment. It results from a telephone call I received yesterday from the mayor of Strathroy. He was extremely upset because he had just been told by ministry officials in the regional office in London that they expect Ontario Hydro to receive approval to store materials contaminated with polychlorinated biphenyls at Hydro's depot in Strathroy. The problem is that Hydro's depot is located just a few hundred feet from one of the wells that provide Strathroy with its source of municipal water and also that the depot is located adjacent to a Canadian National Railway line.

Mr. Speaker: And the question is?

Mr. Reycraft: What is the minister doing to protect Strathroy's water supply from the danger of contamination by those PCBs?

Hon. Mr. Bradley: I would like to thank the member for the question, I think.

Hon. Mr. Peterson: But you will not.

Hon. Mr. Bradley: I will not thank him for it, but I think he has raised a legitimate concern. As is the case in the temporary storage of PCBs until such time as we have in effect in Ontario the capacity for the mobile destruction of PCBs -- we have the regulation at the present time -- in this specific case all the PCBs to be contained would have to be in double containers. Whether it is soil or other material, it would first be in a barrel and then would be inside yet another container to ensure the material did not escape. This is the manner in which we deal with it. I understand there have been some problems in the past. As a result of much that we have learned and the information we have gained about PCBs, there has been a rather significant change in the manner in which we deal with them. That is why they now are dealt with in this secure manner.

Mr. Reycraft: The minister refers to the storage facility as temporary. According to today's London Free Press, Ontario Hydro has admitted it has been using the storage site for some four years now. How mach longer are we going to have to wait until we find a permanent solution to this problem of the disposal of PCBs?

3 p.m.

Hon. Mr. Bradley: For those who have suspicions about these questions, they should be allayed today. I can assure the member of two things in this regard.

First, before any final decision is made as to the establishment on a permanent basis -- a permanent temporary basis; let us clarify that -- a temporary basis of a site to retain and store PCBs until such time as there is the potential for the destruction of them, I can assure the member that I will review all aspects of this before any approval is given for that site.

Second, I want to emphasize the fact that as a result of the commission that was set up and had public hearings, a regulation was developed on the issue of PCBs and their mobile destruction. The regulation is now in effect, and those companies that wish to bring forward their proposals for the destruction and testing facilities are welcome to do so at this time. I expect they will be moving very quickly on this. Some have already indicated an early interest. At that time, we will have the mobile destruction dealt with. Also, within the mandate of the Ontario Waste Management Corp. --

Mr. Speaker: Order. New question.

TECHNOLOGY FUND

Mr. Gillies: I have another question for the Premier, who thinks it is sleazy to question his fast-and-loose disposal of millions of dollars of public funds. Last week he said I was negative to question his right to hand out $17.5 million from a technology fund that does not yet exist. When did the executive council of the technology fund make its decision to fund the Exploracom project, and exactly who is on this executive council?

Hon. Mr. Peterson: The member has every right to question every penny we spend, but he does not have the right to make ill-founded allegations about people's reputations that are based on no knowledge, the way he just did. There are certain rules, if the member knows of something that is going on. Apart from the parliamentary rules, I think my friend's personal sense of honour would prevent that kind of thing in the absence of proof, I would assume. If there is any proof of collusion, obviously it should be exposed. However, the member is just skirting around the edges. If he has an allegation, he should be a man and stand up and make that allegation in the House.

Interjections.

Mr. Speaker: Order. Response, please.

Hon. Mr. Peterson: If the member has allegations about the Innovation Development for Employment Advancement Corp., I will take them to the chairman, Ian Macdonald, whom the Tories appointed. We did not appoint him. Any grants that were made by their appointees to the IDEA Corp. were made with no interference from this government. I do not even know about the grant the member is talking about. I will take this to the member's colleagues, their appointee, their Ian Macdonald, if he is suggesting collusion.

I beg to differ with my friend with respect to the creation of the technology fund. If he read the budget, or had someone read it to him, he would realize it was created in the budget of some months ago. It is all there.

Mr. Gillies: I will repeat with pleasure out in the hall anything and everything that I have said in this House. I want to make it quite clear that I am not questioning the way the Premier's friend Mr. Schwartz and the others do business. I am questioning the way the Premier does business.

We have spoken to the Premier's assistant, Hershell Ezrin, and we have spoken to the assistant to the Minister of Industry, Trade and Technology (Mr. O'Neil), and to the assistant of the Deputy Minister of Industry, Trade and Technology. They all said the same thing: the technology fund is not operating and no meetings have taken place.

Why was my office told that no submissions could be made to the technology fund until early fall when somebody -- and the Premier will not tell us who -- approved one $17.5-million grant to a venture that is headed by a friend of his? Does the Premier not see it in the best interests of this House and of the government to get this all out in the open?

Hon. Mr. Peterson: I remind the honourable member that everybody is a friend of ours now and his party does not have very many left. That is one of the realities of the situation.

If the member is questioning the way the IDEA Corp. does business, I will take his suggestions, his attacks on the integrity of Ian Macdonald and the former government-appointed board to Mr. Macdonald, because those decisions were made by the IDEA Corp.

To repeat, that fund was announced in the throne speech and created in the budget. We will be having announcements very shortly on the composition of the council. It has had an enormous amount of interest. We decided to get moving.

To disabuse my friend about the ultimate responsibility, the council will be advising on these matters, and he will see it is a very impressive group of men and women who will be serving the province, but the ultimate responsibility will be taken and decisions made by the executive council, by the cabinet of this province, as they properly should be. That is where the decisions were made, are made now and will be made in the future. Surely the member understands that.

Interjections.

Mr. Speaker: Order. I will wait if you want to waste the members' time.

FOREST REGENERATION

Mr. Laughren: I have a question for the Minister of Natural Resources. The minister will recall that in 1985 he renewed some forest management agreements in the fifth year of their anniversary. Before signing, he was to assess the kind of regeneration done on cutover lands since 1980 through 1985. Can the minister tell us why his officials assessed only 22 per cent of that cutover land before he signed those agreements for yet another five years?

Hon. Mr. Kerrio: I will have to take that kind of question as notice and get the particulars for the honourable member. I cannot tell him more than that at this time.

Mr. Laughren: I am disappointed to hear that, because I put that question on the Orders and Notices paper five months ago. The minister responded that only 22 per cent had been assessed by his ministry, and he could not give me an assessment of even the 22 per cent that had been done by his ministry officials. Why can he not give me even the stocking levels or the survival rate on the 22 per cent that was done? Is he ashamed of the figures? Does he not know the figures? Does he not care about the figures? Why would he sign those documents without that information?

Hon. Mr. Kerrio: After many years of forest management, the government has decided it is finally going to bring in an independent person, Dr. Baskerville, to assess the forests and the methods we have to respond to such questions. I am surprised the member does not realize we have a commitment. He is talking about some of the very things that are ongoing. However, I want to share with him, and I think it must be said, that any documentation my ministry has will be shared with the member or any other member of this assembly.

3:10 p.m.

TARIFFS

Mr. Mancini: I have a question for the Minister of Agriculture and Food. In the Saturday edition of the Toronto Star, there was a brief mention of the most recent United States trade threat, this time to the Canadian cut flower industry, some of which is situated in my constituency. What is the minister or his ministry doing to assist the Ontario cut flower producers in the face of this new protectionist threat from the US?

Hon. Mr. Ridden: I am pleased to report to my colleague that I am well aware of the petition submitted by the US cut flower industry to impose countervail action or antidumping duties on imported cut flowers.

I should point out that Canada and Ontario are not major exporters of cut flowers to the US. Once again, the close relationship between the Prime Minister of this country and the President of the US finds Canadian producers are caught in a crossfire between the US and other trading bloc nations.

I have written to my federal counterpart, the Honourable John Wise, to impress upon him my concerns over this proposed action and the real need for the government of Canada to act decisively to defend Canadian interests. The federal Minister of Agriculture has a number of options open to him to defuse this situation.

DAY CARE

Mr. Cousens: This question is of the Minister of Community and Social Services. Ontario is the only province in Canada that uses a means test to determine eligibility for subsidized day care and child care. These tests are intrusive and degrading. Means tests are applied inconsistently across the province. They involve a great deal of discretion. They are difficult for immigrants and non-English-speaking families to use. Is the minister going to eliminate means testing and replace it with income testing?

Hon. Mr. Sweeney: We have had several discussions with the federal government about the possibility of Ontario moving from needs testing to income testing. The only difficulty we have is that at present the federal government will not allow us to acquire or use subsidized spaces in commercial day care centres if we use the income test.

The member might be aware of the fact that despite our movement to fund more nonprofit centres, at present approximately 50 per cent of all the day care spaces and subsidized spaces in Ontario are in commercial centres. It would be literally impossible for us to operate if the federal government is not prepared to make a change in that direction.

Mr. Rowe: While the minister stalls on his infamous white paper, eligibility for subsidized day care continues to be dependent on one's location in this province. Families in Toronto, North Bay and Perth find it easier to qualify for subsidy than do families in Barrie, Windsor and Essex. If the minister does not introduce income testing, will he at least standardize eligibility criteria to provide equal access to subsidized child care?

Hon. Mr. Sweeney: I am sure the member realizes local municipalities currently contribute 20 per cent towards the cost of subsidized spaces, with the province picking up the other 80 per cent. Because of that, a number of municipalities have refused to pick up subsidized spaces. As a matter of fact, it is approximately 40 per cent at present. Granted most of them are smaller municipalities, but that happens to be the fact.

We have the difficult situation of having larger municipalities such as Toronto and Ottawa that will gladly accept every subsidized space we offer. On the other hand, we have the difficulty of literally going out to beg and plead with other municipalities to take them and not have such restrictive requirements.

As a result of that situation, the review we are in the process of conducting clearly takes a look at the role of municipalities in the cost-sharing of day care spaces. At this time, I cannot tell the member what the result is going to be, but we recognize the problem he brings to our attention.

INSURANCE RATES

Mr. Swart: I have a question for the Minister of Financial Institutions. I would like to bring to his attention the case of Fran Bates of 69 Madison Avenue in Toronto, a responsible, single woman in her 40s who last fall obtained a certificate from a driving school and then got her licence. Early this year, she secured a 1984 Topaz.

Would the minister believe that after trying more than 20 insurance companies and agents, she took the cheapest coverage available and had to pay a yearly premium of $2,740? Does the minister not think it is grossly unfair that she be charged a premium three times the going rate just because she is a new driver? Does he not believe a person should be considered innocent until proven guilty?

Hon. Mr. Kwinter: I trust the member has his information correct, but I have no way of responding because I do not know the situation and there may be extenuating circumstances. I will be delighted to check into it for him if he will send me the information.

Mr. Savart: A detailed check with Autopac, which is the Manitoba Public Insurance Corp., showed that she would pay $534 for the same coverage other than no-fault, which would be higher. Is it not amazing that in the 600 pages of the Slater report, no comparison was made of the rates of the public plans in the west versus the Ontario cost? Is it not true that neither Slater nor the minister, because of his philosophical bias, wants to know the savings of a public plan? If the minister denies that, will he have such a comparison made by Woods Gordon or some other reputable firm?

Hon. Mr. Kwinter: Contrary to the member's statement, Dr. Slater did compare all the plans and did say there was some merit to it. However, in his overall consideration, it was his recommendation that this government should not be in the car insurance business.

DAY CARE

Mr. Cousens: I have a question for the Minister of Community and Social Services. I fear that in his answer to the last question he failed to understand that Ontario is the only province that has means testing. I wish he would do his homework on that matter. It is the only one, and it is time some action was taken.

Mr. Breaugh: How did that happen?

Mr. Speaker: New question.

Mr. Cousens: Many municipal governments in this province --

Hon. Mr. Nixon: Are you going to answer the question "How did that happen"?

Mr. Cousens: Does the member want the floor? He is such a delight to listen to at times.

Mr. Speaker: I am sure the member for York Centre has a question.

Mr. Cousens: Many municipal governments in the province are unable or unwilling to fund subsidized child care spaces. Does the minister know that there are no subsidized day care spaces in Haliburton, Lennox and Addington or Gananoque? Is he going to do anything for the low-income families in these areas who need child care?

Hon. Mr. Sweeney: I think in my previous answer I indicated to the member that there are municipalities that are unwilling. I am not sure I can use the member's word "unable," but certainly they are unwilling to pick up the subsidized spaces offered to them. We have a number of offers around a number of those same municipalities around the province at present. The member may also be aware that in some situations where a municipality truly is unable, the ministry can set up a different kind of local structure and put in subsidized day care spaces without using the municipality, but it truly has to be a case of "unable" as opposed to "unwilling."

Mr. Cousens: We would like to see the minister do something to provide equality for all across the province. As part of an effort to maintain low taxes, London has reduced its number of subsidized child care spaces by 13 since January. London funds no municipal day care centres, nor does it subsidize school-age child care. Can the minister please tell us what he is going to do or is doing to encourage or mandate municipalities to provide adequate subsidized child care?

3:20 p.m.

Hon. Mr. Sweeney: I think the honourable member would agree with me if I were to say that surely the city of London is able to provide subsidized spaces, or its 20 per cent share, should it wish to do so. I appreciate that they are obviously unwilling to do so. There is no doubt that the review being conducted -- and I am not prepared to indicate what the result will be -- will have to look at the possibility of stronger incentives to some municipalities or to all municipalities. I am not sure what form they would take, but I concur with the honourable member that what he describes will continue as long as the optional provision is there.

UNEMPLOYMENT

Mr. Morin-Strom: I have a question for the Minister of Northern Development and Mines regarding the economic crisis which continues to face the community of Sault Ste. Marie and the district of Algoma and the fact that more than six weeks have passed since we held an emergency debate in this House on this issue.

The community continues to wait for action from this government. In the meantime, we have had specific depositions made to the minister, to the committee of deputy ministers which came to northern Ontario and to members of the standing committee on resources development. These depositions proposed specific opportunities for development in Sault Ste. Marie and actions the provincial government could take. Can the minister tell us when this government will announce an action plan to deal with the crisis facing the community of Sault Ste. Marie?

Hon. Mr. Fontaine: We are not going to have an answer tomorrow. We have been working on it for about three weeks. The honourable member knows that, because I discussed it with him personally. It takes time. We do not want to put a Band-Aid on this. We want it to be long-term, and it will be before the middle of July.

Mr. Morin-Strom: I thank the minister for that somewhat specific answer. One question currently facing the community is the issue of the unemployed workers' help centre. I believe the minister very recently received information on this centre and the difficulty it is having with the Ministry of Skills Development in applying formulas devised for southern Ontario unemployment problems in the context of the severe problems being faced in northern Ontario. It must be obvious to the minister that these formulas do not apply to northern Ontario and that special consideration has to be given.

Has the minister looked at the situation facing the unemployed workers' help centre, and what is he proposing to do to ensure that it gets immediate funding for its operation?

Hon. Mr. Fontaine: On this subject, there is some discussion going on with the Deputy Minister of Skills Development. We will try to find a solution to the problem in Sault Ste. Marie.

BOXING REGULATIONS

Mr. Mancini: I have a question for the Minister of Consumer and Commercial Relations, who is responsible for the Ontario Athletic Commission. All of us who are fight fans were able to witness the unfortunate defeat of the best fighter in Canada in the welterweight division, Shawn O'Sullivan. We were also somewhat surprised by the way the fight ended

Mr. Andrewes: He looked better than I did.

Mr. Mancini: Yes, he looked much better than the member for Lincoln (Mr. Andrewes). It was stated after the fight concluded that the fighter's life could have been in jeopardy because Ontario does not have a provision for a standing eight count, where a referee can stand between the two combatants and prevent the --

Mr. Speaker: Your question is.

Mr. Mancini: It is coming.

Interjections.

Mr. Mancini: The only person here who needs a standing eight count is the Leader of the Opposition (Mr. Grossman).

Mr. Speaker: Order. I will continue waiting.

Interjections.

Mr. Speaker: Order. Now place your question, please.

Mr. Mancini: Boxing is a licensed sport, and people's lives are in jeopardy in some situations. Will the minister review the provisions in the Ontario law or regulations which deny a referee the right to give a standing eight count, which would provide some type of protection for the fighters?

Hon. Mr. Kwinter: There is no doubt this is something that has been debated as a result of the match between Shawn O'Sullivan and Simon Brown. I do not know the position on it. I will be happy to refer it to the commissioner, Clyde Gray, and get back to the member.

Mr. Mancini: Since there will be other fights between now and the time when Mr. Gray has a chance to review this and since we are vitally concerned about the safety of fighters, can the minister have Mr. Gray expedite his review of this situation and confirm a date to the minister so he can report to the House and make the necessary changes?

Hon. Mr. Kwinter: I will be happy to take it up with the commissioner and get back to the member.

SLO-PITCH ONTARIO

Mr. Partington: My question is to the Minister of Tourism and Recreation. Why has the minister refused to consent to the incorporation of Slo-Pitch Ontario as a nonprofit athletic association, among other things blocking the creation of 125 jobs in Niagara?

Hon. Mr. Eakins: There has been some discussion by Softball Ontario and Slo-Pitch Ontario with the people in our ministry. Slo-Pitch Ontario is looking for a separate identification in a case where we fund one major sport association. Anyone who has played both sports, as I have, will find that slow pitch is simply a part of Softball Ontario. Discussions are taking place, and I think the matter will be resolved.

Mr. Partington: The minister knows Slo-Pitch Ontario does not challenge the authority of Softball Ontario in the hierarchy, but his refusal to consent is holding back and may destroy the creation of an 11-diamond, $8-million slow-pitch complex in the Niagara region, which would bring millions of dollars in revenue, sports and recreation annually, as well as the 1988 championships.

Will the minister act today and give his consent so this facility can get under way and create jobs and recreation for athletes and spectators in this province?

Hon. Mr. Eakins: We want to bring together our sport associations, not divide them into more associations. As I have told the member, discussions are taking place, and I am quite optimistic that we are going to arrive at a mutually acceptable conclusion.

PETITIONS

NATUROPATHY

Mr. D. R. Cooke: I have a petition signed by 50 constituents, asking the Legislature to introduce legislation that would guarantee naturopaths the right to practise their art and science to the fullest without prejudice or harassment.

Mr. Speaker: Again I have to remind the members that private conversations are creating difficulties for those presenting petitions.

FIRE CREW

Mr. Wildman: I have a petition signed by 76 residents of the township of Thessalon.

"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:

"We, the residents of Thessalon township, strongly object to the removal of the Ontario Ministry of Natural Resources fire crew from the Little Rapids office for the following reasons:

"1. The lack of protection to private land and bush lots.

"2. The lack of protection to the Kirkwood plantations, a valuable resource.

"We take exception to the Ministry of Natural Resources argument that adequate initial attack can be provided by Blind River fire crews, a minimum of 40 minutes away, and request that the decision to remove the crew be reversed, as there are numerous crews in the Blind River office to draw from for the Peshu Lake base."

3:30 p.m.

ABORTION CLINICS

Mr. Ferraro: I have a petition signed by 60 constituents of mine. It indicates:

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

"We, the undersigned, are opposed to the operation of abortion clinics in Ontario. Abortion is not only an irresponsible means of birth control but also the taking of a life."

HIGHWAY TRAFFIC

Mr. Poirier: I have a petition signed by close to 200 people in my riding, which reads:

Nous, soussignés, demandons au ministre des Transports et des Communications de l'Ontario, ll'honorable Ed Fulton, qu'une étude soit entreprise dans les plus brefs délais afin d'améliorer la circulation routière sur la Route 17, entre Rockland et Ottawa.

We, the undersigned, request of the Minister of Transportation and Communications, the Honourable Ed Fulton, that a study be done within the shortest possible delay to improve the vehicular traffic on Highway 17 between Rockland and Ottawa.

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: Order. Could the various conversations either be carried on outside or discontinued? Various members are going to try to debate this amendment.

When we stopped yesterday, the minister had just read an amendment to add new sections 3a and 3b. He had just read them into the record; then he moved that the committee rise and report. The minister may wish to make comments on this amendment.

Hon. Mr. Elston: I do, Mr. Chairman. My comments will be brief because there has been a great deal of discussion in relation to these amendments. They are designed to provide us with the opportunity of protecting patients from having to pay extra and find out after the fact that they have paid extra with no way of recovery.

It is designed to make this legislation so-called patient friendly. It will have as a result that the money will be withheld once there is a determination that there has been, in the opinion of the minister, an extra payment or, as is defined in the legislation, an unauthorized payment to a physician.

The money will be held back by the general manager from payments that are to be extended to the practitioners from money that is generated out of so-called opted-in practice. We have seen that this particular mechanism will provide the bill with an administrative procedure that will be designed to make the focus of attention not on the patient but specifically on the government, which we think is an appropriate place to have the attention focused. We want to take the pressure off patients in relation to the operation of this particular statute.

In addition, we feel section 3b, which, as the Chairman noted, is being introduced for consideration along with section 3a, provides for the review of the withholding by the general manager and provides that a procedure can be put in place whereby money is returned when it is not determined to be an unauthorized payment within the meaning of that term.

The unauthorized payment, just for the benefit of the people who will be looking at and reading this section, is to be defined in section 1 of the legislation and is included in an earlier amendment to the statute that we decided to step down until we dealt with the substantive sections.

The situation is one where this procedure will protect against withholding on a whim, as it were. It makes it specific that there has been a payment made on the part of a patient to a physician. Withholding an equal amount plus an authorized administrative charge will put the onus on the government and the physician to work out any details of difficulty.

The review mechanism is designed to use the Health Services Appeal Board and one of its members to resolve any questions of concern which may be raised after notice has been given by the practitioner. That being the case, we think there is a built-in safety mechanism to prevent any inappropriate withholding on the part of the minister.

I urge all members of the House to support this administrative procedure. I think it accomplishes a couple of things we would like to see accomplished in this legislation. One is to relieve some of the concern that was expressed about the criminal nature of the fine sanction alone. This will provide us with the opportunity to discover whether the extra billing has been carried out or whether there is some other reasonable explanation without going through the courtroom procedure.

In fairness to the people who are gathered here to listen to this debate and discussion, I must advise that we expect there are about 400 physicians to whom the mechanism will not apply because they have no so-called opt-in practice. For those people, we have the fine mechanism, which is provided, unamended at the current time, and which has been brought to the attention of the Chairman and members of the Legislature, to enforce the provisions of this legislation.

In addition, we think the adoption of the amendment introduced by the member for Windsor-Riverside (Mr. D. S. Cooke) will provide a salutary effect on the breach by the approximately 400 physicians who do not have any opt-in income from which we could withhold payment if we determined extra billing was taking place.

With these three items, the mechanism of the bill will be much more workable, will become much more patient friendly and will provide us with an administrative procedure to take the degree of criminal onus from the legislation, as was put to us on more than one occasion by people who appeared before our committee.

With that, I urge all members of the House to support this mechanism.

Mr. Lupusella: I would like to make a few points in relation to this section. I do not think this party will have any objection to its contents. However, perhaps I can take the opportunity to raise with the minister a concern I have under subsection 3(1). I hope the minister will be able to give me an explanation of why the Minister of Health has the discretionary power indicated by the use of "may". He "may enter into agreements with the associations." Why is "must" or "shall" not used?

I hope the minister is paying a bit of attention, because I think in subsection 3(1) there is a loophole which can be used by the associations if they do not want to enter into an agreement. I hope the minister can explain to this Legislature why he wants to use the discretionary power of the verb "may" instead of using "must" or "shall."

3:40 p.m.

The other point I would like to bring to the minister's attention is what is going to happen in case the minister is not able to enter into an agreement with the associations mentioned in subsection 3(2) of Bill 94. The reason I am raising this particular concern is that I foresee problems deriving from this particular subsection. I perceive problems that are ongoing in the present negotiations between the Minister of Health and the Ontario Medical Association. Apart from dealing with the OMA, I am sure other groups, as prescribed in Bill 94 under subsection 3(2), may take some position not to enter into an agreement with the minister. I would like to know what steps the minister will undertake in case the associations do not want to bargain with the minister to reach such an agreement. I hope the minister will be able to reply to my question.

Hon. Mr. Elston: Although the questions pertain to a section that was passed yesterday, I have no problem with respect to dealing with them again. We did talk a little bit about this yesterday. I appreciate that the member may not have been able to participate in that discussion when it occurred.

What I have to convey to the honourable member, particularly with respect to our deliberations with the OMA, is that we do have a mechanism that is working to resolve the dispute. A presentation was made in committee by that association and its representatives that indicated they were happy enough with what is called the Joint Committee on Physicians' Compensation for Professional Services to resolve disputes. We need to sit down and talk about any other changes that may be desired in those dispute resolution mechanisms. From my standpoint, the goal of this legislation is to generate those discussions rather than take away the discussions by putting in some kind of predetermined, formulated and unilateral mechanism that might not be acceptable to the groups.

I thank the honourable member for some of the concerns he has raised. We will continue to use the resolution mechanisms that are available to us to meet and discuss with those groups the way in which we can come to agreement whenever that is necessary. Leaving the bill to generate that discussion is probably essential from my standpoint. I am actually looking forward to sitting down in the aftermath of passage of Bill 94, either to proceed with the continued use of the the joint committee on physicians' compensation with the OMA or to generate some new mechanism in consultation with it.

Mr. Andrewes: I want to seek some clarification on one or two issues. The first one is the issue of the 400 practitioners who have no opt-in provision. I take it that the minister is satisfied that the penalty, which I assume will be amended subsequently, the penalty of $250 in the first instance, will provide the incentive by which the force of the bill can be brought to bear on the practitioners. Am I correct in assuming that?

Hon. Mr. Elston: That is what I indicated. Where there is no opt-in practice, obviously the fine section is the only way of enforcing the provisions of the legislation if someone is determined to violate the law of Ontario.

Mr. Andrewes: Then is it not with this group of 400 that the minister would anticipate having the greatest problem?

Hon. Mr. Elston: There is not necessarily any problem being anticipated. I think most people in the province are law-abiding. I am just saying it to be fair to the members so that they understand the coverage of the proposed amendment. There are some 400 physicians who do not have an income from an opted-in practice for which this mechanism would be of use in an administrative enforcement of the act. I was putting that right up front so the members knew it before they got to discussing it.

However, it does cover well over 17,000 people practising in the province now who have some degree of opted-in income. I look at this administrative mechanism as being a patient-friendly mechanism that would be appropriate and important in dealing with some of those inadvertent situations that people have told us ought not to go before the courts. This resolution mechanism is an appropriate way to provide us with the flexibility of not necessarily having to go through the court route if it can be cleared up otherwise. It is an appropriate mechanism to make sure the patients are not shouldered with a heavy load. The onus and responsibility then focus the problem on to the government and do not violate the relationship between patient and physician.

I have to leave for a short time. My parliamentary assistant will be here. I will return shortly after I go to a long-standing, pre-arranged event at which I expect to see the member for Don Mills (Mr. Timbrell). I will return as quickly as I can to take up the discussion. Perhaps I may excuse myself for a few moments.

Mr. Andrewes: I will be delighted to carry on this dialogue with the member for Wentworth North (Mr. Ward). Maybe I will get an answer.

Mr. Lupusella: Can I go there?

Mr. Andrewes: Sure. That was not part of the accord. That was the part they rejected.

My point is that they have gone through a very elaborate process that the minister said is designed to be patient-friendly. That is a nice term. I assume that is the same terminology one uses with computers that are compatible. It is designed to benefit the patient rather than benefit the physician. I can understand why he has chosen that terminology and why he has moved in that direction, but what I do not understand is that the doctors who are opted out, I assume, are opted out so that they can bill above the Ontario health insurance plan fee. Is that true?

Mr. Chairman: Excuse me. Before we carry on, is it the agreement of the House that the parliamentary assistant can speak from a seat other than his own?

Agreed to.

3:50 p.m.

Mr. Ward: With regard to the last point made by the member for Lincoln, most opted-out physicians are opted out for the purpose of extra billing, but not all are opted out for that reason. Some physicians who are opted out of the plan still charge only the OHIP rate and prefer to be opted out so that they can be in a bill-direct situation as part of their patient-doctor relationship. Testimony in the committee hearings and by other deputations has clearly underlined the fact that some physicians are opted out not for the purpose of extra billing but to have that direct relationship with their patients.

Mr. Andrewes: I am glad to have that on the record, particularly coming from a government member. If the parliamentary assistant has not already gathered it, my point is that the government has gone through an elaborate process to try to set off any instances of extra billing, to provide for a mechanism to collect back from a physician who violates Bill 94. It has gone through a very elaborate process of setting up an administrative procedure, probably adding a level of staff and a new set of computers in Kingston or up wherever that is

Mr. Ward: Grimsby.

Mr. Andrewes: No, I am quite sure it will not be in Grimsby. There will be a new set of computers on Overlea Boulevard in York East.

The member is telling me the mechanism the government is designing here is going to miss a good number of those physicians who desire to opt out and may be those who are currently extra billing. Is that what the member is saying?

Mr. Ward: I think the minister indicated clearly and was up front that there are 400 physicians in Ontario who are opted out, bill directly and do not receive any reimbursement whatsoever from OHIP. The mechanisms provided here would not permit the ministry any opportunity to be involved or to stop the practice of extra billing in that regard.

For the other 17,000 physicians, if the amount they extra bill is going to be withheld from their payments and the physician is not receiving any payment from OHIP, then there is no opportunity to withhold those funds. In that case, the penalties provided for in the legislation are the deterrent.

Mr. Andrewes: Then I suggest to the member for Wentworth North that his amendment is somewhat redundant. However, the government seems determined to carry on. I will go to section 3b. This is the review section. It says:

"(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."

I take it this is the first level of review to which the practitioner is entitled under the bill. The member is nodding. Is that an affirmative answer? The review will be conducted by a board called the Health Services Appeal Board. Am I correct in that?

Mr. Ward: I believe the member is correct.

Mr. Andrewes: In the minister's words, he indicated the purpose of the review was to prevent the minister from inappropriately withholding funds owed to practitioners in the light of some complaint that had been registered.

Mr. Ward: It is to determine whether the payment was unauthorized.

Mr. Andrewes: That is right. I believe there is a section here which allows for adding additional members to the Health Services Appeal Board. It is my understanding the minister is saying we do not want to be in the business of withholding funds inappropriately, so we are putting this appeal mechanism in place. It is also my understanding the Health Services Appeal Board is some two years behind in hearing appeals. How is the government providing an appropriate mechanism of appeal if the Health Services Appeal Board is already two years behind in hearing appeals?

Mr. Ward: I am sorry. I have no awareness of the board being two years behind in its hearings.

Mr. Andrewes: Before we call the question, perhaps I can have that point clarified by one of the learned members of the Ministry of Health staff who are under the gallery.

Mr. Haggerty: You should know them by name.

Mr. Andrewes: I know some of them. Brief though our acquaintance was, I know some of them.

Mr. Laughren: Was it a good experience?

Mr. Andrewes: Oh, it was wonderful.

Mr. Breaugh: Was it good for you?

Mr. Andrewes: It was great.

Mr. Foulds: I hear limousine nostalgia coming on.

Mr. Andrewes: I only wish I had been there long enough to become infected with limousine nostalgia.

Mr. Breaugh: This is the best speech you have ever given.

Mr. Andrewes: I have nobody to give it to at the moment.

Mr. Chairman: The member should carry on with his debate while the parliamentary assistant is out, because the House cannot wait, unless the member would like to sit down and let some other member carry on.

Mr. Andrewes: I will do that for the moment.

Mr. D. S. Cooke: I have a couple of questions for the parliamentary assistant. This question may have been raised when I was not in the chamber. Under this amendment, OHIP or the ministry is expected to withhold payment from opted-out doctors who extra bill. However, since opted-out doctors do not get paid by OHIP, how can the government withhold money that is not paid to an opted-out doctor?

Mr. Ward: That was the point of the entire discussion initiated by the member for Lincoln (Mr. Andrewes). As the minister indicated before he had to leave, there are approximately 400 doctors who direct bill and do not receive any reimbursement whatsoever from OHIP. All their practice is on a direct-bill basis. The fines provided for in the legislation are the deterrent in that regard.

Mr. D. S. Cooke: What will the difference be in the process? I assume there are some opted-out doctors to whom some payments are made and, therefore, that is the enforcement mechanism.

Mr. Ward: The mechanism is the fines provided in the legislation as a deterrent.

Mr. D. S. Cooke: I understand that is the enforcement, but I want to know what the process is. Who takes them to court? Under this mechanism, my assumption is that the ministry will become aware of it and take responsibility for going the legal route.

Mr. Ward: That is correct.

If I can respond to the member for Lincoln's concerns about the review board and its backlog, there has been a backlog during the past couple of years. I am advised it is diminishing. Let us not view it as a permanent state of affairs. The ministry will take steps to address that backlog.

4 p.m.

Mr. Andrewes: That is of some comfort, because when the minister was saying the purpose of the review process was to prevent the minister from withholding funds inappropriately, then the review mechanism has to have some expeditious force to it. If, as we are given to understand, a backlog exists within the Health Services Appeal Board, it would seem logical that has to be dealt with fairly expeditiously as well in order to make the whole thing function reasonably and fairly.

I come back to my previous point, which was followed up by the member for Windsor-Riverside. It is my understanding that currently only the Minister of Health can determine whether or not a doctor has opted in or opted out. is that correct?

Mr. Ward: Yes, that is correct.

Mr. Andrewes: Okay, and the administrative machinery or the ministry itself is unable to determine who is extra billing or how much is being extra billed. Is that correct?

Mr. Ward: That is correct. There have been estimates done, as the member is aware, but it is not a finite art.

Mr. Andrewes: So this process setting off what was described as being patient-friendly is only effective if the patient makes a complaint.

Mr. Ward: That is correct.

Mr. Andrewes: Now we are being joined by the heavyweights. I can see now that the member for Wentworth North (Mr. Ward) is in some difficulty.

If the patient does not complain, does not register a complaint with the general manager, then all of this mechanism would fail to click in.

Mr. Ward: I am sorry, I missed that.

Mr. Andrewes: If the patient does not raise the issue of being extra billed with the general manager, then all of this mechanism will not take place.

Mr. Ward: That would be correct if there was no awareness. By the same token, however, with the amendment that was put forward by the member for Windsor-Riverside, as well as the other provisions in this legislation, I cannot foresee a circumstance under which a patient would not know that he is being extra billed.

Mr. Andrewes: Does the parliamentary assistant have any idea at this stage of the game what the added costs of administering this amendment would be?

Mr. Ward: I am advised by the ministry officials that we do not anticipate there will be very many claims in this regard. We have no firm estimate at this point of the additional administrative costs.

Mr. Andrewes: The general manager described in Bill 94 is the same general manager that is described in the Health Insurance Act. Is that right?

Mr. Chairman: I think the member for Wentworth North is nodding his head indicating yes.

Mr. Andrewes: He is nodding his head? Is the parliamentary assistant saying the costs and numbers of live bodies needed to put this mechanism in place would be minimal and would be dictated to some degree by the number of complaints?

Mr. Ward: Yes.

Mr. Andrewes: That is a little reassuring. I would not want to think that such a mechanism might start to chew into those $50 million that the ministry is anticipating receiving from the government of Canada --

Mr. Haggerty: We have not got that yet; not until the bill is passed.

Mr. Andrewes: -- once it brings its legislation in line with the Canada Health Act. I would be glad to start making those arguments over again, but I will not do it at this stage of the game.

At this juncture, we will not support this amendment. It probably comes as no surprise to the member for Wentworth North. First, we feel that, philosophically, we are opposed to the bill and therefore it would be inconsistent with our position on the bill to do anything but oppose this amendment.

We see some pitfalls in the amendment itself. It does not provide a mechanism for protecting those patients who appear to be the ones who are most liable to need the protection. It puts in place and administers a process that appears to be somewhat redundant.

I am somewhat reassured that the appeals process could be tidied up, but it would appear there is a chance that the appeals process would be protracted, would be delayed, because of the number of appeals currently before the Health Services Appeal Board and those that might follow. I assume the opportunity always exists for a practitioner to take a further appeal to the courts, which could protract it further and add additional costs.

Mr. D. S. Cooke: We will be supporting this amendment in that one of our concerns with the original version of Bill 94 was that the enforcement mechanism was nil and it put all the responsibility on the patient who had been extra billed. This alleviates that concern to some extent.

I have one question for the parliamentary assistant with regard to a follow-up to the member for Lincoln. I assume that if a large number of practitioners in this province decided to opt out and violate the law, then under subsection 2 of this amendment the ability to set the administrative charge by regulation would result in the taxpayers not having to pick up the increased cost from the administration of this section of the act.

Mr. Ward: Again, the administrative charge that is contemplated would be commensurate with the costs that are associated with the process; so I think that is a fair assumption.

Mr. D. S. Cooke: I have just one other question. I think it would come under this section of the bill. I am not sure it would really come under any section of the bill, but it deals with one of the angles that some doctors in this province are now using, which some of us would refer to as protecting themselves or the financial aspects of their business through another method of extra billing. I want to know whether the ministry is contemplating any action under this section or any amendments in the regulations or negotiations with the practitioners. I am specifically talking about the annual fees.

4:10 p.m.

I am getting from practitioners an increasing number of these notices of annual fees. This one which came from Dr. Porter, Commerce Court Medical Centre in Toronto, is the largest one I have seen so far. He is asking for an annual fee for what he refers to as uninsured services of $50 per person and $75 per family on an annual basis. This other one from Dr. Irwin from Kitchener is asking for $45 for a family and $25 for a single person.

I am sure the ministry has received complaints similar to this because it is obvious that a fair number of doctors will try to destroy the legislation by using this annual fee. I wonder what the response of the ministry will be, since I assume it would not be considered extra billing under this section, because they are labelling this as uninsured services. The reality is that if we look at $75 per family in a reasonably sized family practice, we are talking about $25,000, $35,000 or $40,000 that could be generated through this annual fee, probably far in excess even of what was done with respect to extra billing for some general practitioners.

Mr. Ward: Again, the member raises an issue we are aware of. Even within my own constituency, I have been forwarded copies of letters such as that from GPs who are opted into OHIP and do not extra bill.

However, the matter the member for Windsor-Riverside is referring to relates to uninsured services. The member will concede that the letters and the issues that are before him concern an annual fee for services that are not insured. Bill 94, I remind the member, deals only with insured services. I suggest that if the member wishes to pursue it further with the minister, it is an issue that is divorced from Bill 94.

Mr. D. S. Cooke: I am not sure it is entirely divorced from Bill 94 in that there was an expectation up until now that most doctors understood that the total fee schedule package dealt with these items. Although it did not have an item in it for the renewal of prescriptions, in the fee schedule we all understood that if one went to the doctor and had a diagnosis of an infected throat, if that prescription had to be reissued, then it was already covered with the initial visit to the doctor.

It is obvious this is a new twist that a large number of doctors are now using and it could, if it were carried out on a large scale, have a substantial negative impact on the effectiveness of Bill 94. What policy alternatives is the government now considering on an item that I think is extra billing?

Mr. Ward: I have to disagree with the member about those being items that represent extra billing. The letters and the situations I have been made aware of regarding telephone prescriptions and other items covered in this annual payment per patient are not insured services. Medical services are still performed that are not covered by the plan; they are not insured services.

The member is asking me to speculate on what the policy of the minister and the ministry may be with regard to that issue. I say to the member, with respect, that although it is a legitimate issue, it is not an issue that I believe is directly related to Bill 94 in that Bill 94 deals with insured services under OHIP.

4:52 p.m.

The committee divided on Hon. Mr. Elston's motion to add sections 3a and 3b, which was agreed to on the following vote:

Ayes 59; nays 35.

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

"3c. The members of the board shall be paid such remuneration in respect of their services in connection with the administration of this act as the Lieutenant Governor in Council determines."

Hon. Mr. Elston: This is to provide for remuneration for the members of the board who will be appointed to act in review. They will be required under the new section 3b. I think it appropriate that we make provision for their remuneration.

Mr. D. S. Cooke: Before all members leave to go to committees, I wonder whether we could ask something of the Conservatives. Since we might be voting on a few other amendments, to facilitate the committees, could we stack the rest of the votes until 6:30 this evening?

The Deputy Chairman: Is it the wish of the House? No.

Are there any questions or comments on the amendment proposed by the minister?

Mr. Andrewes: I have one brief question to the minister. Is it planned that the remuneration of the members of the board referred to in the amendment, the health services board, will be different from that of the current members? Why is this needed in this bill?

Hon. Mr. Elston: The provision for remuneration should be made for people sitting in a different set of circumstances to the appeal board, if that were necessary. We want to make sure it is quite clear that when we move to have more members appointed, we have the authority to provide them with remuneration at the same time. It is for relative ease of administration. I think it is an appropriate section.

5:17 p.m.

The committee divided on Hon. Mr. Elston's motion to add section 3c, which was agreed to on the following vote:

Ayes 56; nays 36.

Mr. D. S. Cooke: On a point of order, Mr. Chairman: I ask the members of the Legislature again whether we can have permission to stack votes until 6:30 p.m. to facilitate the two committees.

Mr. Chairman: Is there unanimous consent to stack votes?

Some hon. members: No.

Mr. Chairman: I hear "no" over here. There is not unanimous consent.

Interjections.

Mr. Chairman: Order. The minister wishes to move another amendment. As the members leave the chamber, will they please do so quietly?

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

"3d. Despite subsection 44(1) of the Health Insurance Act, the general manager and each person engaged in the administration of this act may furnish to,

"(a) a member of the board;

"(b) the person to whom insured services were rendered or where a person other than the person to whom the insured services were rendered was charged for those services, the person who was so charged; and

"(c) any other person, with the consent of the person to whom the services were rendered,

"information pertaining to the nature of the insured services, the date or dates on which the insured services were provided and for whom, the name and address of the person who provided the services, the amounts paid or payable by the plan for such services and the person to whom the money was paid or is payable, for the purpose of enforcing this act."

Hon. Mr. Elston: This section is required so that information may be made available to various people for the purposes of enforcing the act. We want to be able to provide the dates, times, amounts and the names of the people for whom and by whom the services were required. That information is all needed to ensure that a judgement can be made with respect to sections 3a or 3b, which were just passed, or sections on fines and otherwise.

I think it is important to put this section in to ensure there is a guideline available to those who are looking at enforcing this act, to provide for the release of information that is required in limited circumstances. We can view this section as providing the definitive group of people to whom the information is made available, the type of information to be made available and the purpose for which it is made available. We will then see that the information will be protected from being provided outside the requirements of subsection 44(1) of the Health Insurance Act in the limited circumstance of enforcing this act.

The requirement is needed to make sure we have guidelines as to whom and for whom the information is to be made available. We have the information about the people to whom it is to be made available so they can carry out their role and function as required under the legislation. Without this disclosure of information section, we would find it difficult to run through the administration of this act in a tidy and and comprehensive fashion.

I urge members of this House to support this section and look forward to that support when the vote is taken.

Mr. Andrewes: In his comments regarding this amendment, the minister talked about a definitive group which might have access to the information and might be releasing the information. He talked about limited circumstances under which the information might be used. Section 3d essentially says, "Despite subsection 44(1) of the Health Insurance Act, the general manager...may furnish to," and it lists a whole series of situations. Are there clearly defined guidelines under which the general manager may issue that information? Did I hear the minister talk about guidelines other than clauses 3d(a), (b) and (c)?

Hon. Mr. Elston: No. The section sets out the people to whom the information will be made available. We have printed it in relation to subsection 44(1), which provides other circumstances under the Ontario health insurance plan. This is determined to give us the authority to release information out of OHIP for the purposes of this act only. That is why this section is required.

Mr. Andrewes: Going beyond the general manager, when we talk about "each person engaged in the administration of this act," I assume that covers virtually every employee in the Ministry of Health.

Hon. Mr. Elston: I am not sure it would cover every person. It would probably come from the general manager and down. Generally speaking, the general manager of the health insurance program and his designees are the ones who would have access to this information, but it would not be every employee in the Ministry of Health. Not all the employees of the Ministry of Health have access to that information, nor would they be in a position to make a determination or release it. We are not looking at every person in administrative health to be administering this act.

Mr. Andrewes: In his desire to cover a definitive group which can release information under limited circumstances, the minister may want to be more definitive than to talk about each person, because the minister himself is not in a position right now to tell me who those limited persons are.

Hon. Mr. Elston: I do not have the names of those people. I am sorry. Does the member mean the capacity in which they serve? For instance, they would serve under the Health Insurance Act, but I do not have the names of all those people at this point or the names of their capacity as clerks or whatever. I can probably see if we can get a list for the member at some point, but I do not think that is what is indicated here. The people who will be involved in the administration of this act will be more clearly defined as the act takes shape.

It is obvious that anyone who is involved in the administration of this act, or the general manager, who was named, would not be entitled to release information. People will be designated and will be available to be seen. One will be able to find out, in the sense of that being a defined group of people.

Mr. Sterling: I am interested in the same line of questioning being pursued by the member for Lincoln. How many instances does the minister envisage in which information will be shared with any of these three categories under this act?

5:30 p.m.

Hon. Mr. Elston: I do not think it will be used that often, but there are some circumstances where it may be required for people to make a determination on their own. In some cases, it may be necessary to have that information available to the people to whom the service was rendered. For instance, it may be of use when it is one of the physicians who form that group of 400 physicians we talked about earlier who have no opted-in practice, for which the administrative mechanism will not function, I would think it would be of limited use. However, it is essential for the use of those people who may require that information to make a determination about proceeding on the basis of an unauthorized payment.

Mr. Sterling: What I cannot understand is why the minister, when he is dealing with personal information, which we are talking about here and which is of the most private kind in terms of dealing with health statistics and records, does not limit this to the general manager and say the general manager alone has the right to release this information, and take out all the members of the administration, which leaves the possibility of a very wide number of people who could deal with this particular matter.

Hon. Mr. Elston: One of the people who would be involved in the administration of this act is the minister. We would have to make available some information to the member of the board on the basis of the determination we made under section 3a, which was just passed. That would mean we would have to have some information available as to how we made a determination in the original event.

That being the case, I think it would have to be much broader than the general manager. It seems to me we have to make sure we cover those people who are administering the act so we can verify, if a review is requested, why we acted and on the basis of what information we acted, particularly with respect to the board member. In addition to that, I think we would probably want to be able to advise a person who had received the service or otherwise about the nature and the dates, times and places of the services that were rendered.

Mr. Sterling: Surely the number of occasions on which the minister will get these particular complaints, particularly after this act is in effect, are going to be very minimal. The minister is talking about prosecutions or the possibility of a prosecution.

My concern with the section is that there is no notice to the hospital patient or the doctor's patient as to the fact that some person in the administration in that great monolith over there is sharing this information with some other people without permission. I am not satisfied that this amendment deals with it, even as thoroughly as Bill 34 does in terms of dealing with access to information and privacy matters, which are now before the standing committee on the Legislative Assembly.

First, I would like to see a restriction on who has the right to share this information. Second, I would like to see some notification provision where the patient is getting notice that this information is being shared with whom and that it is not going any further. While this appears to put some restriction on the general manager, what happens if a member of the board shares that particular information outside of his mandate?

Hon. Mr. Elston: I think it is unfair to suggest that the members of these boards which deal with very sensitive items are going to be divulging this information to the public. They do not divulge material under the board work they do now, and I would think they do not and would not divulge material which is sensitive in nature. It is not fair to suggest that the board member would violate the undertaking to carry on the work in the best traditions of people who have served over the years in these public boards. I guess I would also have to indicate to the member --

Mr. Chairman: Order. Excuse me. The noise here is a little much. I cannot hear you and I am sure the member for Carleton-Grenville (Mr. Sterling) cannot.

Hon. Mr. Elston: It has obviously been a rather long day for some. I would like to say to my colleague the member for Carleton-Grenville that the section which appears here is virtually the same as now appears in the Health Insurance Act as well. That is why it takes the form it does. It parallels that particular piece of legislation, from which we are going to be taking a good bit of the information.

That is one reason for setting out those people. It is a limited circumstance, I agree, but it is a circumstance which we must have if we are going to ensure that the information is available so we can act upon it and so the members of the public, if they wish to know, can also act upon it.

Mr. Sterling: I wonder whether the minister would consider an amendment to his amendment to provide that the general manager and perhaps one or two designated people would have the right to release this information. That way, a person would know whether his rights in dealing with his privacy had been abrogated by a number of individuals in the bureaucracy of the Ministry of Health.

That is one of the methods I put forward in Bill 80 to deal with sensitive information dealing with the law enforcement area of this province. I left it up to a number of designated individuals who could release or deal with this information.

Hon. Mr. Elston: As I said to my colleague the member for Lincoln, it will become well known who is involved in the administration of the act. The general manager is quite visible. Following along the lines of the Health Insurance Act, it is nice to continue the parallel nature of this act with the Health Insurance Act since it is dealing with information derived from there. Those people will be well identified, and that should allay some of the concerns of my friend the member for Carleton-Grenville.

Mr. D. S. Cooke: I have only one comment. My understanding from what the minister said is that we are not proposing any major change in the way the information is now accessed. Obviously, there has to be access to the board. If the member for Carleton-Grenville has a specific amendment to place on the floor, we will be willing to consider it.

I find it interesting that this week the Conservative caucus is particularly interested in confidentiality when last week it moved an amendment to another section of this bill that would have sent out annual statements of everything to do with an individual on OHIP, with 14 million OHIP numbers and only eight million people living in this province.

The member for York Mills (Miss Stephenson) said last week that confidentiality was one of the things that might have to be sacrificed to provide information to the people of the province. I am glad the Conservatives are now interested in confidentiality, but I would have expected that if they had a concern about this amendment, they would come prepared with an amendment to the amendment.

Mr. Sterling: I have an amendment to the amendment. If the member would like me to state the amendment, I will put it forward.

Mr. Chairman: It should be in writing.

Mr. Sterling: I just got the amendment in front of me at this time.

Mr. Chairman: The member for Oakville (Mr. O'Connor) wishes to speak to this amendment. While he does, you might prepare whatever it is in writing.

Mr. Sterling: In response to the member's remarks in regard to our concern about confidentiality, when one is talking about confidentiality and privacy, one is talking about control of information about oneself. If I receive information about the number of insured services that have been supplied to me by OHIP, that is not a breach of privacy or a breach of confidentiality. I still have control of that information myself.

In this matter, we are talking about the sharing of information about somebody else with another group of individuals, about which I am very much concerned. One of the responsibilities under Bill 34, which was also included in Bill 80, is a review of all the confidentiality provisions in all the different statutes in Ontario, which I understand include 110 different statutes. I am sure the Health Insurance Act will be one of the statutes we go through and deal with in terms of privacy matters. Therefore, there is no conflict between the idea of sending a patient his own record and the matters of concern today.

5:40 p.m.

Mr. D. S. Cooke: I suggest the member for Carleton-Grenville would have understood the debate if he had been here last week. The issue in debate last week was confidentiality. The member's proposal was that for every OHIP number an annual statement would be sent to the home. The reality is that in many cases we do not know the home addresses. Concern was expressed that they could go to wrong addresses, that we might not be able to track down individuals and that persons holding the OHIP numbers, for example, parents of 17-year-olds, might get annual statements. There was no guarantee of confidentiality.

The member's caucus recognized there were problems with his amendment having to do with lack of confidentiality, but last week was prepared to sacrifice confidentiality in the name of what, from last week's amendment and the comments by the member for York Mills, I can only read of trying to weed out all the abusers of OHIP, as described by the member for York Mills.

The approach the member took last week was that it was a matter of confidentiality. There happen to be 14 million OHIP numbers in this province and only eight million people.

Mr. Sterling: The member for Windsor-Riverside insists on carrying this debate further.

Mr. Chairman: Do you want to make sure it is on the point?

Mr. Sterling: Yes. We are talking about the confidentiality concerns I have about this bill. He is concerned about the confidentiality provisions we dealt with last week.

The motive behind sending a person his bill is none other than to let that person know the cost of the insured services the individual received from his doctor, his hospital or his clinic during any particular period of time. It is nothing more and nothing less. It is to ensure the person is conscious of the economics of the situation and that he is appreciative of the very good health care system in this province. The motive is nothing more and nothing less.

Mr. O'Connor: I share some of the concerns of the member for Carleton-Grenville in regard to the confidentiality problems that may exist in this section.

Mr. Breaugh: As opposed to the concerns of the member for York Mills.

Mr. O'Connor: To answer the comment from the cheap seats behind me, I think this has been explained with regard to the positions taken last week. As was pointed out by the last speaker, all we proposed was that an accounting of the services provided and their cost be sent to each OHIP cardholder in the province. It was nothing more and nothing less.

This section deals with the release of the full medical records of each patient, which is a much more comprehensive package than a simple listing of the service provided, the date and the amount of money involved. It is a totally different thing. I think the members know that.

The way the section is worded at present is dangerously loose in that it refers to any "person engaged in the administration of this act." The minister cavalierly says, "We know who that is and it does not include everybody," but with that loose wording it potentially includes everybody in the Ministry of Health. Everybody is potentially involved in the administration of the act; sure they are. Further, it leaves it to the discretion of the general manager or every "person engaged in the administration of this act" to furnish or not to furnish it. By the use of the word "may," discretion is left with the person who has control of the records.

Given that circumstance, I ask the minister whether he does not think it wise to provide some criteria to the general manager or other persons having control of the records to guide and direct them as to when they should and when they should not release records to the member of the board or the other people listed in clauses (b) and (c). Further, will he consider limiting the number of people who may be involved in this activity? Surely to limit it to only the general manager would mean that if someone wanted to release it upon request, it would have to filter up through the general manager, who would then make a decision on whether it was an appropriate case for release. Further, based on the criteria that would be provided in the act, he would release it or not release it.

Hon. Mr. Elston: With deference, while the member for Oakville was jumping up and down, he may have missed part of the explanation to the member for Carleton-Grenville. I mentioned specifically that the general manager does not do all the administration of this act. He has other duties, but there may be information required in enforcing this act by the board member who has to do the review from which he will require information.

To limit it to the general manager would not be appropriate. The minister is also involved in administering this act, particularly under sections 3a and 3b, for which the member was not here for the vote and which was passed. The general manager is not necessarily involved in the entire operation. The minister makes the determination, and there is a holdback by the general manger. To be sure, I think the people will be well served by the drafting of this act. They have been well served in the past by the Health Insurance Act. In many respects, this parallels that act. That system has worked rather well. I think this one can work as well.

For the purposes of responding just a little to the member for Carleton-Grenville, the two categories of people to whom information is being provided under sections 3b and 3c are actually the persons for whom the services were rendered or their designee. From that standpoint, that is information under the control of that particular person. That answers the question raised by the member for Carleton-Grenville.

The other person to whom information is made available is a very specific person, the board member who will be delegated the review at the request of the physician. Since the board member is operating on the request for review by the physician, it is appropriate that they be there. It is a pretty limited group of people to whom this information is to be made available, and it is quite worth while to follow this and make it a parallel section to that which is already in existence under the Health Insurance Act.

Mr. O'Connor: I agree with the minister that the persons to whom the information may be released are limited. The concern is at the other end, that the number of persons who have access to those records is unlimited; it is virtually everybody in the ministry. Given the very sensitive nature of the information we are dealing with, medical records on people, what is the upside, what is the purpose in leaving an open discretion such that these people may or may not release it?

With the use of the word "may," what that means is they may or may not release it. There may be a clerk who is administering certain records, and when a request is made to him or her by one of the people listed in 3a, 3b or 3c, that clerk may decide for whatever reason, because there are no guidelines or no discretionary terms set out in the act, not to release that information. If we presume the information is fundamental to the rights of the person who is appearing before the board or the doctors appearing before the board, why are we leaving this open, total discretion to such a large number of people to grant or not grant access to a file?

Hon. Mr. Elston: First of all, this is OHIP information and very few people have access to that. The general manager will, obviously, and he is named specifically here with respect to that plan. The other people who are included in this are the people who are administering this act. That is a very limited number of people, although I guess the member could say they are not determined now and it could be any number, but he is going much too far.

These people cannot reveal information other than for the purposes of this act to these three categories of people. That is a very limited group of people indeed. As he has heard from the member for Carleton-Grenville, he anticipates, as I do, that it will be very few cases in which this information will be required. That being the case, however, we must make provision for those few cases.

Mr. O'Connor: Granted for the moment, I will accede to the minister's argument that there are very few people who have access to the information who will have the authority to grant it. Let us take, for instance, the general manager who, using the discretion given him in the section, refuses to grant the information requested by a member of the board or a patient. What is the remedy then of the people listed in (a), (b) and (c) to get the information, should that refusal be inane?

5:50 p.m.

Hon. Mr. Elston: Presumably, they could take the same route they would take if the general manager refused them information under the Health Insurance Act. I can get the honourable member more specifics on that if he wishes, but there may be some circumstances in which some information is sent to the health insurance people on the basis that it is of some degree of concern on the physician's part that not all of the details of the information be released. That is probably why the "may" is in there. In the circumstances of this section, we have set out as best we can the discretion to provide the information required for this act alone. There is a determination and discretion by the general manager to provide enough information to allow the administration of the act. The general manager has functioned very well under the auspices of the Health Insurance Act so far and has used "may" sections to release information. Unless the member can cite a situation in which he has found difficulties or problems, we should allow that system to continue.

Mr. O'Connor: Interestingly, at this very moment in the standing committee on administration of justice, we are engaged in a heated debate with the Attorney General (Mr. Scott) about the disclosure of medical information to patients at their request, specifically under the terms of the Mental Health Act. The argument being made is that under Bill 7 there should be a general disclosure of medical records to people who ask for them, and that only in very specific, enumerated cases where it is harmful to the patient or perhaps physically harmful to those around him should information not be released. There are specific guidelines and criteria set out in that act determining when information should be released. The onus is on the doctor or the hospital that does not wish to release the information to establish through a review board that it should not be released.

Why should not that same philosophy, as enunciated by the Attorney General, prevail in this act? Why does it not require the general manager to adhere to some criteria if he should choose not to release the information? Surely we should start from the premise of Bill 7, the Freedom of Information and Protection of Privacy Act. That grandiose legislation of this new government states that everyone has access to his or her records unless there is some reason he should not. Why should we not carry that philosophy forward with this section and provide, first, a statement that information shall be released "unless," and then set out limited criteria when it should not be? Leaving it totally discretionary by the use of the word "may" opens it up to arbitrary hospital directors, arbitrary general managers and arbitrary persons engaged in the administration of this act to refuse the information.

Hon. Mr. Elston: The honourable member has probably gone a bit too far in terms of hospital administrators, for instance, although he may be casting his mind to the committee stage of another bill. This section deals specifically with information generated out of OHIP. There are a limited number of people who have access to that information, including the general manager, who is named here and who has functioned extremely well, unless the member knows of situations where he has not functioned well. If that is the case, then he should tell us exactly why he has determined that.

The situation has been that under section 44, as I understand it, certain people can request a list of information with respect to some of the details of treatments. What we need here is some check, and this is a check on the number of people who can have access to this information and the people to whom it is to be given. This is a limited number of people. There are really only two: the person who has received the service or the board member. Otherwise, one ends up having the person who received the service or his designated person. In any case, we have heard from previous statements that this person is still in control of his own information, which is exactly consistent with what we want to see happening.

Obviously, the member of the board needs information, or he or she cannot fulfil the mandate of doing the review requested by the physician. This will do what is required to allow us to administer the act. If the member has an amendment he would find much more helpful in the sense that he wants to broaden the information that is made available and in that sense believes there should be more provisions in here, he should make a suggestion.

Mr. O'Connor: No, I do not want to broaden the information or the number of people who should have access to that information. I simply want to take away from perhaps arbitrary civil servants, or as the act says, "each person engaged in the administration of this act" -- it could be a broad number of people -- the discretion to refuse people access to their files.

As I pointed out, at this very moment in the standing committee on administration of justice, we are debating what the Attorney General referred to as "a whole new era." The minister has been referring to another bill which he says has worked fine in the past. I would simply comment, that is the past. We are in the new era of freedom of information where people now have additional rights under the Charter of Rights and Freedoms of access to their files and their records.

In the spirit of that act, I suggest we should take away some of the discretion from the general manager and other civil servants in the ministry to withhold information or, alternatively, if they are to withhold it, then build into the section some criteria to guide them in the circumstances when they can withhold it. Failing that, if we go ahead with this section as it is, I warrant that we will be back amending this section within a very short period of time at the request of the minister's own Attorney General to comply with the Charter of Rights and Freedoms.

The member's colleague the member for Wentworth North, who is sitting in the House, will confirm that is what is going on in the justice committee. Those are exactly the issues we are discussing.

Mr. Chairman: The member for Wentworth North indicated he would like to speak.

Mr. Ward: Just briefly, I appreciate the points the member for Oakville is making, but I do not think the situations are at all analogous in any way.

Mr. Breaugh: On a point of order, Mr. Chairman: I do not want to be too touchy, but the member for Wentworth North --

Mr. Chairman: Yes, correct, the member for Wentworth North really should have returned to his seat upon the minister's return and made his comments from there.

Mr. Ward: I thought in committee we did not have to.

Mr. Breaugh: Mr. Chairman, if you knew that, why did you allow it?

Mr. Chairman: I just noticed it as you were rising to your feet.

Mr. Breaugh: Your eyes are going the way of your ears, Mr. Chairman: faulty.

Mr. Ward: I thought we were in committee. I will pass.

Mr. O'Connor: As I pointed out, the member for Wentworth North has been involved in the justice committee hearings in the past several days, and I feel he has a valid contribution to this very point. I invite him to return to his normal seat and provide that contribution. I for one would like to hear it.

Mr. Chairman: Does any other member wish to speak on this amendment?

Mr. Sterling: I have a couple of questions about clause 3d(b). First of all, I would prefer that the consent of the person to whom the services were rendered be required in every case, whether it goes to the board or to any other individual. I want to try to explore which other people under clause (b) would receive the information. Basically, under Bill 34, one cannot reveal information about an individual unless one tells the individual why one is collecting that information in the first instance.

6 p.m.

The information we are dealing with here, which relates to a patient's condition or the prognosis or other medical information, was being collected from him in a totally different environment, and he did not expect this information to be coughed up at a later date. For instance, if he received a medical service for some kind of operation or treatment which he did not want to share with the world, he has no control over that information if it spills out either to a member of the board or to whomever is included in clause (b) of this amendment.

Maybe the minister could tell me who would fit into the category of "other than the person to whom the insured services were rendered was charged for those services." Who else would be the person who was so charged? Maybe the minister can enlighten me on that.

Hon. Mr. Elston: A parent might pay for the services rendered to a child; that is one person who would have been charged for the service being rendered. That person would then be the one to whom the unauthorized payment would be reimbursed.

Mr. Sterling: Are there any other situations other than those dealing with minors?

Hon. Mr. Elston: I am not sure what the member means.

Mr. Sterling: Are there any other people the minister would be sharing the information with, other than the parent or guardian of the child?

Hon. Mr. Elston: If there was a guardian situation where someone had taken authority for the child, obviously one gets into that situation, the idea being that we would have a situation where the person who had paid for the service would obviously know about it to begin with. That having being done, we would have to reimburse the person who actually made the payment. A parent-child situation is the most usual circumstance I can think of at this point, but it could be a situation where somebody was acting as a guardian or whatever for a child or some other person who was not capable of acting for himself, perhaps a committee for someone who was delivered a service but who was not able to act on his own behalf.

Mr. Sterling: Would it include social agencies that would require this information and that would have paid for that service?

Hon. Mr. Elston: Such as what?

Mr. Sterling: Would a social agency that had paid for dental surgery be included in clause (b)?

Hon. Mr. Elston: What we are looking at is a person. Anybody who would be defined as a "person" would have access to that. The information at this stage is being made available to a person who already knows the service has been delivered because he made the payment. The indication in this section is that this basically operates as a consent situation; in other words, they already know. For instance, one can bring a case about an operation for someone, that it should not be revealed to anyone other than that person or the person who actually paid for the service to be delivered. He already knows it has taken place because he made the payment.

Mr. Sterling: I believe the minister has a copy of my amendment. Before I put the amendment forward, I am not married to one other person; it could be two other people or whatever.

Hon. Mr. Elston: You are not monogamous? You are not married to one other person?

Mr. Sterling: I am married to one person.

Hon. Mr. Elston: I am sorry, I misunderstood.

Mr. Breaugh: And that is only temporary. It is getting shakier as the afternoon goes on.

Mr. Sterling: The member for Oshawa (Mr. Breaugh) knows something I do not know.

Mr. Breaugh: He knows a lot you do not know.

Mr. Sterling: I do not know what is the matter with the member for Oshawa this afternoon.

I am trying to get some kind of handle on the amount of information that is going to be shared. I want some people to be responsible for handing out that information. When the minister says in a general way "each person engaged in the administration of this act" may hand out information to several categories of people, that concerns me. Therefore, I have put forward an amendment to the amendment. I believe the Minister of Health is having some talks with his officials as to whether two people can adequately handle this funnel of information or whether he needs three or whatever number.

I would like the thrust of the amendment to the amendment to say that the control of this personal medical information would be in the hands of the general manager and one or perhaps two other people who would be designated by an order in council, so the world would know which individuals were responsible for giving out this information at any specific time.

Therefore, I ask for the indulgence of the minister in accepting this amendment as being a reasonable method of trying to control the flow of personal information dealing with medical records.

Mr. Haggerty: Would the member want the Ontario Medical Association to do it?

Mr. Sterling: It is not a question of who gets the information. It is a question of who has the information in his hands and has the right to give it out. It is very important to control that aspect of the communications process.

I do not know whether the minister would like to give me any indication of how many he needs or whether he totally rejects the proposal. Therefore, I move that the amendment to section 3d be amended by deleting "and each person engaged in the administration of this act" and adding thereto instead "one other person engaged in the administration of this act and designated by order in council."

The flow of the information will be controlled by the general manager plus one other person appointed by the government, who is also involved in the administration of the act.

Hon. Mr. Elston: I have no real problem in taking a look at it.

The Deputy Chairman: Order. The member has just presented an amendment.

Hon. Mr. Elston: I was just about to speak to it.

The Deputy Chairman: I will read it first.

Mr. Sterling moves that the amendment to section 3d be amended by deleting "and each person engaged in the administration of this act" and adding thereto instead "one other person engaged in the administration of this act and designated by order in council.

Mr. Breaugh: Mr. Chairman, before you begin this debate: before we started last week, the leader of the Tory party said he was going to deny the civil servants their paycheques if he did not see in advance in writing all the amendments on this bill. Do you mean to say that today there has been such a dramatic reversal by that party that its members will come in here, scribble amendments on a piece of paper, hand them around and you are going to accept them?

The Deputy Chairman: The motion is in order and the amendment to the amendment is in order.

Mr. Breaugh: Is not the Leader of the Opposition, the member for St. Andrew-St. Patrick (Mr. Grossman) going to come in here in a rush this afternoon and scold us all for proceeding with amendments in this manner without prior notice, as is required under the standing orders?

The Deputy Chairman: That is not a point of order.

Hon. Mr. Elston: I have no real difficulty with the essence of the amendment. Designating somebody by order in council makes it a little bit more difficult, but I would not be averse to having somebody being designated by the minister, for instance. That also limits and sets out some of the concerns that were expressed by the member for Lincoln and the member for Oakville, who is obviously tired from standing up and sitting down so often while trying to get on the floor.

If the member wanted to have that written, we could put it as "such other person as the minister designates in writing." If that is an acceptable idea, that might be more agreeable.

Having heard the member for Oshawa mention the back of cigarette packages, I understand it was Bill 100 that attracted similar activity in the chamber at another time. However, this is not that bill; this is Bill 94. I would be prepared to have words along the lines of those I just said replace what the member for Carleton-Grenville placed in front of us.

6:10 p.m.

Mr. Sterling: Mr. Chairman, I would like to withdraw my amendment to the amendment and replace it with "one other person engaged in the administration of this act and designated in writing by the Minister of Health," if you will accept it when it is not in writing.

The Deputy Chairman: Can you put it in writing and send it to the table.

Mr. Andrewes: While we are waiting for the amendment, this point is not on the amendment, but I wonder if I could just clarify one thing with the minister, with your permission, Mr. Chairman.

The Deputy Chairman: Yes.

Mr. Andrewes: In the body of the minister's amendment, the wording is almost identical to subsection 44(2) of the Health Insurance Act, except it begins by saying that the general manager can make available to these people "information pertaining to the nature of the insured services."

Why is the last paragraph of the amendment broader than subsection 44(2) of the Health Insurance Act, where the wording is almost identical, except that it says in this section "information pertaining to the nature of the insured services, the date or dates on which the insured services were provided" and so on. The section is a little more definitive here in terms of the information, because it deals with the nature of the services. What was the minister's intention in broadening it?

Hon. Mr. Elston: The information on the nature of the services is required if we are going to advise the board member what the payment was under the OHIP schedule of benefits and what was actually charged. We cannot make a determination about the charges and whether there were unauthorized payments unless we know the nature of the services.

Mr. Andrewes: Why?

Hon. Mr. Elston: Because the nature of the services determines what the schedule of benefits pays under OHIP.

Mr. Andrewes: We have services that are defined by some code. Clearly, the judgement that the appeal board will be making will be based on whether the fee charged for the services, as defined by the code, is higher than the fee that is allowed.

If I keep talking, the minister may find his way back to his seat. Should I start reading the Health Insurance Act? I have it here in front of me. I could start by reading section 44. It is a moot point anyway.

I simply want to know, when the board is sitting on an appeal, why does it need to know the nature of the services? Surely all it needs to know is whether a fee above what OHIP allows to be charged for the services was charged.

Hon. Mr. Elston: That is right, except the board has to examine whether the nature of the services provided complied with the schedule of benefits. The board cannot make a determination other than on the basis of the services that were provided. That is the information that is needed. I do not know how else to describe it to the member. If the board does not know what services were provided, how does it know where to look in the schedule of benefits? It must know the nature of the services.

Mr. Sterling: While we are waiting for the amendment, I would like to clarify this. When we are talking about the nature of the service, which was not formally under section 44 of the Health Insurance Act, as I understand it, that part of the service could not be disclosed. Can the minister follow through what would happen if there was a charge over and above what a doctor was supposed to charge under this act and a prosecution resulted? Would that information eventually come out in a public court hearing?

Hon. Mr. Elston: Like any other court proceeding, I would think it could, but with respect to the courtroom procedure, somebody could ask that the information be dealt with in a sensitive way in a courtroom setting. One of the reasons sections 3a and 3b were so necessary was to ensure there was an administrative mechanism by which we could enforce the act and which might obviate the necessity of going in front of the court. This will provide us with a lot of opportunities to get away from the courtroom proceedings.

The member will understand, as I do, that we want to take all possible options to make this a patient-friendly statute. This information, under the disclosure of information section we are moving, does that and limits the circumstances in which that information will get out into the public. It limits it in the original review situation to that board member.

Mr. Sterling: For instance, if there had been a service to a young woman to receive a therapeutic abortion and the doctor, clinic, hospital or whatever overcharged, and then a charge was laid under Bill 94 resulting from the amount paid to the surgeon who dealt with this particular matter, is the minister telling me that information through this section could pop out in a court somewhere? Is that correct?

Hon. Mr. Elston: If there is a court situation, it would have to be made available for a judge to make a determination, but there is also room, as the member knows, for a motion that the information not be made public out of the courtroom. There could be a motion that there be no reporting of sensitive information. I presume it could be done in a fashion similar to that which is already carried on under the Young Offenders Act or otherwise.

Mr. Sterling: I would like to move an amendment to the amendment.

The Deputy Chairman: Mr. Sterling moves that the amendment to section 3d be amended by deleting "and each person engaged in the administration of this act" and adding instead thereto "and one other person engaged in the administration of this act as designated in writing by the minister."

Mr. Sterling: I think I have adequately explained my concerns. I would just like to thank the minister for his understanding and cooperation .

Hon. Mr. Elston: In terms of having one person, it makes it a little more difficult if the person is ill, but I think usually the way we do it is "such other person as the minister designates." I am not going to argue over one or two. Presumably the minister would also be entitled to provide information to the board member. Is that the understanding of the mover of the amendment?

6:20 p.m.

Mr. Sterling: To clarify this, if the minister reads the amendment in context with the section, it names the general manager and one person; so that makes two people who can divulge the information. It is a matter of contracting it from everybody to two people. This section would not allow the minister to divulge that information, as far as I know. Even under his section, I do not believe he would have that right.

Hon. Mr. Elston: I am such a person under that section in the administrating act.

Mr. Sterling: Is the minister engaged in the administration of the act?

Hon. Mr. Elston: Yes. Presumably, I would be making a decision under section 3a, which says, "Section 3(1) shall be deemed to be complied with if the minister has entered -- "

The Deputy Chairman: Will the minister please rise?

Hon. Mr. Elston: Do I have to?

The Deputy Chairman: Yes.

Hon. Mr. Elston: I am sorry, I was just going to read subsections 3a(a) and (b) here. The minister has a function in the administration of this act. I was reading the amendment of the member for Lincoln and not my own.

In 3a(1) it says, "Where the minister is satisfied that a person has paid an unauthorized payment...." So the minister is involved in administering the act. I am not saying the minister should not be precluded. Maybe it should be one other person and the minister. I had not looked at that part of the opposition's section when it was drafted.

Mr. Sterling: I have no objection to the minister being included.

Mr. Breaugh: They are not paying him by the hour. Is this an hourly rate?

Mr. Sterling: To the member for Oshawa, the hour is getting late.

Mr. Chairman, I would like to withdraw the amendment to the amendment and replace it with the amendment which I will forward to you immediately.

Mr. Breaugh: Mr. Chairman, on a point of order: I never thought I would live to see the day, but it finally has happened. The Legislature of Ontario has ground finally and conclusively to an immediate halt. It has happened by means of members simply strolling in, writing amendments by hand, arguing about them for some time, withdrawing them and putting in amendments to their withdrawn amendments. This is totally ridiculous.

Mr. Sterling: It was the New Democratic Party which was so anxious to get this matter back to the committee of the whole House because it deemed the matter would be dealt with much more rapidly here in the Legislature. Our party took the position --

The Deputy Chairman: Order. You have an amendment. Will you please introduce it? Do you have an amendment?

Mr. Sterling: Yes, I do. It is right in front of you.

The Deputy Chairman: Did you withdraw your previous amendment?

Mr. Sterling: Yes.

The Deputy Chairman: Mr. Sterling has withdrawn his previous amendment.

Mr. Sterling moves that the amendment to section 3d be amended by deleting "and each person engaged in the administration of this act" and adding thereto instead "the minister and one other person engaged in the administration of this act, as designated in writing by the minister."

Are there any further comments or questions with respect to this amendment?

Motion agreed to.

The Deputy Chairman: Hon. Mr. Elston has moved an amendment to add section 3d, as amended, to the bill.

Motion agreed to.

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

The House adjourned at 6:27 p.m.

June 10, 1986

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