Hansard Transcript 1986-Jun-19 | Legislative Assembly of Ontario

That in the opinion of this House, the government should extend the use of the Ontario senior citizens' privilege card to all retired and disabled persons to allow them access to reduced or free admission to exhibitions, museums, theatres, provincial parks and other special services now available only to senior citizens 65 years of age and over.

Mr. Laughren: I shall reserve some time for windup because I know that at the end of all the members' remarks, I would like to spend some time thanking them all for their support of this resolution.

At present, all senior citizens aged 65 and older who are permanent residents of the province are eligible for the Ontario senior citizens' privilege card. There are two types of cards: numbered and unnumbered.

You get a numbered card if you are a senior who has lived in Ontario for 12 consecutive months. This entitles you to the Ontario drug benefit card as well as other privileges and discounts such as reduced rates at some hotels and restaurants; reduced admission on certain days or at certain times to theatres and movie houses; free admission to various shows, exhibitions, museums and art galleries; free personal cheques and other special services at some banks and trust companies, and other discounts offered by businesses.

The unnumbered card is issued to seniors who have not yet met the 12-month residency requirement. It does not qualify them for the drug benefit but serves as identification for access to the other privileges and special rates available to seniors. In other words, it identifies them as senior citizens but does not give them automatic access to the drug benefit plan which the numbered card gives to our senior citizens.

The numbered card is limited. The only guaranteed benefit is the Ontario drug benefit. The granting of the other benefits is at the whim of the companies and agencies involved. Our recent experience with the Canadian Pacific Railway and its attempt to take away the rail passes from its pensioners is a good example of how fickle that whim can be. I had some special involvement with the CP rail passes because the campaign to have those passes reinstated, which was successful, was led by some good friends of mine in the community of Chapleau, the Group of 55. They fought and won a major battle against one of this country's largest corporations and a tribute should go to those people in Chapleau.

The card does not guarantee access to the type of privileges and discounts mentioned above, nor is the card necessarily needed for such access. Thus, to extend coverage of this card, as I am calling for in my private member's resolution, is largely a symbolic gesture, but it is an important act of symbolism. I am asking that the Ontario seniors' privilege card be extended to two constituencies: all retired persons and the disabled.

Let us deal first with extending the use of the Ontario senior citizens' privilege card to all retired persons. I reiterate that it is now available to people 65 years of age and more. This would extend it to all retired persons.

There are fundamental changes occurring in our society which necessitate the extension of this card to all retired people. First and foremost is the changing nature of work brought about by the technological revolution, a major structural upheaval that is taking place in our economy. One of the most important elements in this ferment is the huge increase in early retirement, retirement before the age of 65. Early retirement is seen as a way of coping with work-force reductions.

Sudbury is a good example of this. In the last two years, hundreds have taken early retirement as Inco has halved its hourly-rated work force from 12,000 in 1978 to something in excess of 6,000 today. If I go back a little further to when I was first elected to this chamber in 1971, the hourly-rated work force at Inco was around 18,000. It is down to not much more than a third of that.

Since those early retirements have taken place, many through incentives by the company to take early retirement, a strange thing has happened to Sudbury. I say "strange" because people do not normally associate seniors with a release of energy in the community, but when all those people took early retirement, there was a new release of energy. These are not people who have physical problems, they are healthy and robust, but they have taken early retirement, which allows younger people to fill their jobs.

There is an enormous amount of pressure in the community to build workshops for these early retirees. They have an enormous amount to contribute in a volunteer way and in working in machine or woodworking workshops, for example. The whole question of what a community should offer its seniors is being raised in communities such as Sudbury. This resolution would go at least part-way towards making life a little better for those who retire early.

A couple of my friends retired early from Inco. One has passed away now. He was a miner and he singlehandedly built from scratch a large backhoe and front-end loader. He did all the hydraulics and electrical equipment in the machine. Obviously, this man had never achieved his potential on the job, and when he retired he basically became a mechanical engineer, although he had no formal training in that.

There is enormous potential among our retired persons. Another friend, Eddie Pitton, when he took early retirement, turned what was just an ordinary cottage into a beautifully landscaped, year-round home. These people could not do these things when they were working full-time in the mining industry. There is an enormous amount of creativity and energy that is being released as people take early retirement.

It is not only companies that have been resorting to early retirement. Employee groups have been incorporating this option into their deliberations and negotiations. For example, amendments to the Teachers' Superannuation Act which became law on February 12, 1986, allow teachers to retire at 55 if they meet the requirements, such as at least 10 years' credit in the teachers' Superannuation fund. They can retire without a penalty. Until this time, there was a five per cent penalty per year on the pension they would receive, I believe, which was an incredible discouragement to take early retirement. With declining enrolment, this has been a problem in the teaching profession.

Our legislative counterparts in Ottawa are cognizant of this change. There is now legislation before Parliament that would make Canada pension benefits available to those who retire at age 60 instead of the present 65. Closer to home, we are awaiting legislation from the Minister of Consumer and Commercial Relations (Mr. Kwinter) that will, among other things, make it mandatory for private companies to provide an early-retirement option beginning at age 55 for their employees.

This phenomenon of early retirement has significant ramifications in our vision of economic development and strategies for full employment, all of which are obviously beyond the scope of this resolution. However, what is important for us today is that we recognize there is a rapidly growing population of retirees who are less than 65 and are generally between the ages of 55 and 65. The term "senior citizen," meaning someone 65 or older, and "retiree" are no longer synonymous.

10:10 a.m.

This resolution aims to bring the senior citizens' privilege card in line with this reality. At the same time as more and more people will be retiring prior to age 65, the 55-to-64-year-old population is projected to grow at an accelerated rate. Figures published in August 1985 by the office of economic policy of the Ministry of Treasury and Economics project an increase of 44.7 per cent in the 55-to-64-year-old group between 1983 and 2006, 20 years from now. That is far above the average projected increase of 18.5 per cent for the population as a whole. It is projected to grow at 18.5 per cent by 2006, and the population aged 55 to 64 is projected to grow at a 44.7 per cent rate. That will be the breakdown 20 years from now.

In absolute numbers, this group is expected to grow from 849,000 to 1,229,000 in these years. The population in this age group is only slightly smaller than those who are 65 and older. If one piggybacks the phenomenon of early retirement on this projected growth in population, it is clear that there will be many retirees who could benefit from the Ontario senior citizens' privilege card.

I would now like to deal with extending the use of the Ontario senior citizens' privilege card to the disabled -- not only to those people who are under 65 and retired but also to those who are disabled, regardless of their age. As pointed out at the beginning, the only benefit the card guarantees in the present situation is the Ontario drug benefit. This benefit is already extended to residents of Ontario under age 65 if they are residents of an extended-care facility or a home for special care or are recipients of the home care services available from the Ministry of Health. The Ontario drug benefit is also available to those on general welfare assistance or those who receive an allowance from family benefits. The disabled and the permanently unemployable are the largest group of recipients of family benefits.

What we are asking for in this resolution is not to limit the provision of this drug benefit to the disabled in the above-mentioned categories, but to extend it to all the disabled whose needed medications are not covered by other plans; for instance, to those who are in receipt of disability pensions from the Canada pension plan. As another example, in the case of those who have entitlements to workers' compensation, the Workers' Compensation Board pays for necessary drugs, although it does not pay for medication needed for an injury or disablement that did not occur at work. Thus, an injured worker receiving workers' compensation would be able to get the Ontario drug benefit for noncompensable problems.

I know that sounds complicated. However, even a discussion of something such as medication for these people raises the whole question of the desperate need for a universal sickness-and-accident insurance plan. In such a system, the administrative and jurisdictional red tape that the disabled face would not be there.

While extending the drug benefit aspect of the Ontario senior citizens' privilege card would not eliminate all this red tape, it would take a small step towards greater fairness and equity for the disabled. As part of this fairness and equity, the disabled should also have access to other discounts now available only to seniors.

When the new government appointed, for the first time, a minister responsible for senior citizens' affairs, I was pleased. I am not so pleased that he is not here this morning, given the nature of this debate. However, it was a step in the right direction to appoint a minister responsible for seniors. I would issue a warning to the government that appointing a minister does not mean that thinking has changed very much. Earlier this year the Ministry of Natural Resources increased the cost for seniors to visit our provincial parks. The issue was turned around and the policy changed, but only after some rather fierce lobbying to have that change take place.

It still has not permeated the thinking of the government that times are changing out there; that early retirees and pensioners are going to be expecting more from the government. After all, they have paid their way for many years. They now expect to be treated with more dignity and respect in their retirement years.

I have resolutions from the disabled groups in northeastern Ontario, for example, calling for exemption for the disabled from the proposed fishing licences. Those are the kinds of issues to which the government is going to have to address itself.

One would hope that the minister responsible for seniors would be the watchdog and ensure that the government does not backslide and does not increase parks fees and suchlike for seniors when it should be moving in the opposite direction.

The minister responsible for seniors is going to have to get the message out to his cabinet colleagues, because they are not thinking in that way yet. I think they regard that ministry as being neither new nor particularly important and it is one with not very much in operating funds. As a matter of fact, I am not sure that ministry has any actual operating funds for its own programs. I believe it delves into other ministry funds for its programs. That is tokenism.

The ministry for senior citizens is simply going to have to become an operating ministry with its own funds that are voted on in proper estimates in this assembly. The situation has to change.

I would rename this card. In the resolution I have it as the senior citizen's privilege card. I think it should simply be called the Ontario privilege card, so that it does not mention pensioners but is a privilege card that is extended to people who are disabled and to earlier retirees as well as to those we traditionally regard as seniors, people over 65.

In conclusion, we should address the question of cost. There are no costing projections available. Moneys would have to be found to pay for the increased coverage of the Ontario drug benefit plan. However, relatively speaking, the totals needed should not be that great.

The access to other privileges and discounts offered by some businesses, schools, cultural institutions, etc., would probably be at no cost to the system in that such discounts would encourage the disabled and all those who are retired to take advantage of services and the like where they are not currently doing so.

I thank the members for their attendance and I look forward to their contribution to the debate.

The Deputy Speaker: Does the member wish to reserve the last three minutes and 45 seconds?

Mr. Laughren: Yes.

Ms. Hart: I am pleased to rise today and speak to this very important resolution. I am confident that all members share the desire to improve services for the disabled and to assist disabled persons in their full and active participation in this province.

Let me begin by congratulating my colleague the member for Nickel Belt (Mr. Laughren) on bringing this resolution forward for our consideration. I share his concerns that our ageing and disabled citizens require special consideration by this House. Their interests have been too long neglected.

Approximately 3.5 million Canadians have disabilities ranging from loss of hearing, sight and mobility, to emotional or developmental handicaps. In Ontario, more than 10 per cent of the population is disabled, and in Metropolitan Toronto more than 33,000 people suffer from a disability.

As legislators, we have a responsibility to do all we can to assist disabled people by removing the social, physical and financial barriers with which they are confronted daily. This resolution with which we are presented today would be an acceptance of our responsibility.

10:20 a.m.

If I may be permitted a personal observation, constituents in my riding of York East have never been able to visit their member in a facility that is accessible to either the many seniors in York East or the physically handicapped. It is because I have been endeavouring to rectify that problem that it has taken me so long to open a constituency office. Unbelievably, the only place I can find that is fully accessible is not available until December 1986. That signifies to me that our whole way of thinking about and planning our communities must undergo drastic revision.

I am pleased to say that this government has addressed many of these issues that affect our disabled community. To illustrate the high priority our government places on the disabled community, the Premier (Mr. Peterson) appointed a Minister without Portfolio responsible for disabled persons (Mr. Ruprecht). We have expanded the assistive devices program to include all prostheses and respiratory devices for people of all ages. As well, the remainder of the program was extended to all persons 22 years of age and under. We have moved to strengthen many community support services which directly affect the disabled, including the integrated homemaker program for adult handicapped persons.

Most recently, we indicated our intention to provide fairer treatment of disabled people in sheltered workshops and other rehabilitation settings. One initiative includes an amendment to Bill 7 which will repeal section 24 of the Employment Standards Act. This will permit handicapped persons to be paid the minimum wage for the first time.

The second initiative will include an amendment to the Occupational Health and Safety Act which will give disabled persons the same legal protection as all workers under the act. In the recent budget, this government allocated an additional $5 million to expand and enhance housing programs to better meet the needs of our disabled. To assist in integrating the developmentally handicapped into our communities, the Treasurer (Mr. Nixon) has provided $17 million over the next two years. This is not enough; I merely bring it to the attention of the House as a beginning.

Moreover, as I am sure all members are aware, the period 1983 to 1992 has been declared by the United Nations as the Decade of Disabled Persons. To demonstrate our commitment to the disabled, this government has allocated $10 million to permit greater participation and involvement of the disabled. I am sure we all wish to ensure that disabled people have the opportunity to actively contribute to the livelihood of our respective communities across this province.

Our government is committed to assisting the disabled in any way it can. The spirit of this resolution is consistent with that of this government's initiatives over the past year. For these reasons, I am pleased to give my support to this resolution. I am in favour of any program that serves to reduce the barriers that often face our disabled community. However, although I support the spirit and principle of the resolution, I have three concerns I wish to offer for consideration.

First, we must consider the definition of disability. Which definition would be used for the purposes of the card? Currently, the guaranteed annual income system for the disabled program is the only consistent identification mechanism. However, for those who would make an application for privileges, this would not necessarily suffice.

Second, I would want to encourage full and constructive participation of our disabled community in the debate to ensure that such a program would be consistent with its goals. Should we be concerned with privileges or should we be emphasizing access?

Finally, any program would have to be cost-efficient and cost-effective. Would other initiatives be more appropriate to fund? I am sure that we would not want to erode our block of funding and leave other desirable programs wanting. For example, the 1985-86 annual report of the Ontario Advisory Council on the Physically Handicapped outlined a series of priorities affecting the disabled. These include issuing of special licence plates for the disabled, barrier-free-design housing, a further expansion of the assistive devices program and employment opportunities. We may wish to consider these priorities first.

These are just a few concerns that we must consider if we pursue the extension of senior citizens' privilege cards. However, the presence of this resolution will encourage us on all sides of the House to begin dealing with many of these questions and decisions of priority.

Again, let me thank the member for bringing forward this resolution. I am happy to support him in his endeavour.

Mr. Hennessy: I am pleased to have the opportunity to participate in this debate and I support the resolution. I would like to congratulate the member for Nickel Belt for putting this motion on the Orders and Notices paper. It is very worth while. It is something on which we as members of the provincial parliament should focus.

When my party was in government it established the Ontario senior citizens' privilege card. It has been a great success in providing residents of Ontario with special rates on a variety of attractions and services. As the present government is learning, there comes a time when programs must be modified to meet the constantly changing needs of citizens.

The idea of extending the use of the Ontario senior citizens' privilege card to all disabled and retired persons in Ontario is commendable. The provision of this card to these citizens would enable them to get free admission or special rates to attractions, events, transportation, tours and films, and services from travel agents. Ontario abounds in organizations that would be interested in offering such special rates to the needy and deserving in our society.

The government must extend its efforts to ensure that these resources are tapped so that these people can take advantage of them. For the disabled, this card would encourage them further to lead the most full and productive lives possible. Providing the handicapped with these cards would ease the financial strain they face.

Ontario's disabled persons incur many financial hardships that are due in part to the extraordinarily high rate of unemployment among the disabled, who have the highest unemployment rate among Canadians who are able to work.

Furthermore, a disabled person can incur significant extra costs which result from disability. Clothes wear out more quickly, taxis must be taken more often, and attendant care may be required. There are also the costs of aids and devices which are not covered by existing programs. It is the government's duty to recognize the additional costs associated with handicaps and provide some degree of financial relief.

This card would also provide an incentive for the disabled to get involved in the mainstream of society. Because of the physical and psychological barriers faced by Ontario's disabled, they need a helping hand to move forward into areas of shared interest. By making access to these institutions easier financially, disabled persons would be afforded more of the opportunities enjoyed by other people in Ontario.

For instance, benefits of the card include waived tuition fees at many Ontario universities, colleges and vocational schools, and free or reduced admission to theatres, movie houses, shows, exhibitions, museums and art galleries. The privilege card also offers cheaper rates to many recreational facilities. Recreation has much to offer the disabled person. It can be a vital link in the community. It provides an opportunity for the development of social skills, motor skills, self-expression and creativity. It offers fun, satisfaction, success, decision-making, community involvement and a chance to make new friends.

These are all opportunities from which disabled people have been sheltered or largely excluded. The government must recognize this in response to the fact that disabled persons are constantly adjusting to difficulties that many people face only in crisis. We, as their representatives, have the responsibility to minimize these difficulties. We can do so only by providing them with opportunities to lead more full and satisfying lives.

10:30 a.m.

We also have the responsibility to enhance the quality of life for Ontario's retired persons. The retirement years should be enjoyable ones in which one may reflect on the fruits of many years of labour, but retirees face a variety of changes when they leave the work force. Unfortunately, this can be a period of crisis for many people who find it difficult to adjust. Those who are just retiring must make major changes in their lifestyles. About 60 per cent of their waking hours now have to be filled. This can cause as much or even more stress than the working world. The key to adjusting properly is to ensure that those retiring have the opportunity to lead active, independent lives. For many seniors, particularly those who are elderly but well, being self-sufficient sometimes requires a helping hand.

The privilege card provides a massive opportunity to the retired that would enable them to gain access to benefits, bonuses and discounts made available in Ontario. This would make it easier for retired persons to nurture interest in the large amount of free time they have. Furthermore, use of these cards saves the bearer money. This is a significant motive for retirees who face the financial pressures of a drop in income.

This card offers benefits, bonuses and discounts that make financial planning less painful when employment income is drying up. For instance, banks, trust companies and other financial institutions can offer special services packages to the retired. Such packages include no-charge chequing, reduced fees for safety deposit boxes, no commission on travellers' cheques, no service charge on the payment of utility bills, free transfers between accounts and bonus interest rates on savings accounts. Most important, however, it is essential to give something to the people who have given so much to us throughout their working lives. Provision of this care to all retired citizens offers a wonderful opportunity to do so.

From browsing through the Ontario-Canada Senior Citizens Attraction Guide, published by the Ministry of Tourism and Recreation, I noticed literally hundreds of attractions available to senior citizens at discount rates. It is a very informative book and it helps senior citizens to spend their leisure time. Air, train and bus lines offer regular discounts with impressive savings for seniors. Hotels, shopping and recreational and cultural facilities also offer substantial bonuses to seniors.

These types of attractions should be extended to all disabled and retired persons in Ontario. Such an extension would promote awareness of contributions to our society made by disabled and retired persons, men or women, and would encourage their community participation. The extension of the privilege card would substantiate the government's strong commitment to these Ontarians.

The resolution moved by the member says "the government should extend the use of the Ontario senior citizens' privilege cards to all retired and disabled persons." I support that 100 per cent.

Mr. D. S. Cooke: I, too, want to congratulate my colleague for introducing this resolution. We all understand the changing demographics of our province, with an ageing population. At some time, all of us are going to be retiring, some sooner than others. One of the problems we have had is a lack of adequate planning, service and income provided for people so that this option truly becomes available to them.

All we need to do is look at some of the changes that are occurring in industry right now to understand how radically things are going to change and have changed over the past 10 years for many of our citizens. I look at the auto industry and see that one company in my community, Chrysler Canada, before the recession had 14,000 employees working there. After the recession, they are producing more cars but there are now only 9,000 working there. The reality is that technological change and changes in our economy have meant fewer job opportunities. Many individuals, through that recession period, took early retirement.

Another example is Champion Spark Plug Co., also in my riding, which demonstrates even more clearly the changes in the economy. Before the recession, they had 450 employees. After the recession, they have 150 employees. It results from two things in this case: changes in technology of how spark plugs are produced and the fact that we have moved away from eight-cylinder to four-cylinder cars with the demand for spark plugs dropping drastically. As well, we now import about 12 million spark plugs from Japan, whereas before the recession we imported virtually none.

Many of these workers have been displaced from the economy and have been forced to take early retirement. Their retirement income is considerably less in most instances than it would have been if they had been able to work until the normal retirement age. That is why moving some of the considerations that senior citizens were given with the traditional description of age 65 to a lower age would simply recognize the new realities of our province and should have been done some time ago.

As I understand it, the original purpose of these cards was to recognize that income upon retirement does drop; therefore, there should be some things provided at a lower cost for seniors so they can access these programs. That has not happened. The extension has not happened and therefore we have a program that has not changed to reflect the new realities of our province.

I think one specific example that is probably the best is the drug benefit program. We have many examples of a couple who have been married for many years. When the husband retires at age 65 and his spouse is age 60, she does not qualify for the drug benefit program and he does. The result is that even though we know the drug benefit program was brought in to recognize the increased demand for prescription drugs as one becomes older and that retired people cannot afford them, and even though there is only the one income between two spouses, one has the privilege of being able to get those through the Ontario drug benefit program and the other cannot access that program. It seems to me that is just a silly reality that has to be changed.

There are other examples. I gather that if one is on the disability benefits program through the Ministry of Community and Social Services, which is a means-tested program, one can qualify for the Ontario drug benefit program; but if one is on a disability through employment where one worked, or on the Canada pension plan disability, one's income, if one is single, is just high enough that one does not qualify for the drug benefit program.

I have had many cases in my office, as I am sure other members have, of individuals who must buy $30, $40, $50 worth of prescription drugs per month because they are disabled, and therefore they have certain health ramifications from that and prescriptions are one of them; and they cut into their food budget because of that or they end up living in housing that is simply unacceptable.

We have extended housing to disabled people and we have some housing available in the province but the waiting lists are so substantial that in many cases extending housing is meaningless if a person is going to go on a waiting list for three, four, five or six years.

I think the Ontario drug benefit program, if we cannot get it to be a universal program accessible to everyone in the province regardless of age, which is our preference, should be changed to recognize the realities of people on very low incomes and recognize that our retirement age has changed over the last number of years.

I would like to refer briefly to a couple of comments the member for York East (Ms. Hart) made, one of them being about the assistive devices program.

I recognize that is a very valuable program for many disabled people in our province. However, the reality is that right now it affects only those people up to age 22. It was age 18 when this government took over, and it has changed it to age 22. Now there are some other benefits that are going to be available in July.

I would remind the member for York East that in the last provincial election campaign, her leader the Premier answered a questionnaire from the Ontario March of Dimes and he criticized the Tory government for staging the increases in the assistive devices program. He called for an immediate extension, making it a universal program available to everyone in the province, which is what we support. The Liberal government has now gone totally against what it promised the disabled people in this province and it is staging the extension. That action is very unacceptable and it has been regretted by the disabled organizations in Ontario.

10:40 a.m.

One of the points made by this resolution is that we have to start taking a totally different approach to retirement in this province. We have to understand that retirement is not going to be at any magic age. It may be at the age of 70, 65, 55 or even 50; who knows? It will depend upon the benefits that individual is entitled to, his or her circumstances and the changing economics within our province. There should not be any magic age. Retirement should be available to an individual and pensions should be such that the decision is his or hers to make.

The other important thing we have to look at is pre-retirement planning. We all try to improve pensions and improve the financial aspects of retirement but very little is done to improve the quality of life. The way the quality of life for retired people in this province is going to be improved, in addition to financial considerations, has to be through proper planning. I think pre-retirement planning starts not when one is at the age of 50 or 60; pre-retirement planning starts at the elementary school level.

We should be teaching people how to plan over their lives, what the different stages of life are and what types of things one has to do during one's younger years to plan for retirement so that when retirement comes it is not seen as being the end of something but rather as the beginning of a new stage of life.

I am sure all of us have had many friends and neighbours who have worked 30 or 40 years of their lives. He or she has a decent pension coming in but when the individual has been retired for a few months, he dies. He has had no opportunity to enjoy that retirement. I am convinced that in many of those cases it is because of the lack of planning, the lack of any real opportunity to feel that he or she is continuing to contribute to our province.

The whole area of retirement planning is very important. We in the Legislature can do some things financially to try to make retirement better but those other aspects have to be considered and planned for as well.

Mr. South: It is with pleasure that I support the resolution of the member for Nickel Belt. I support it, though, with a note of caution, with regard to what has been discussed previously, that we need better definitions of retired persons and disabled persons.

Does a person retire because he is not working? I know of teenagers who do not want to work. I do not think we would want them to fall into this classification and end up cheapening these cards. The acceptance of these cards by the private sector is going to determine the degree of benefit they will be to the holders, especially to the seniors who hold them now.

With regard to the disabled, I am sure we all agree that there are some members of society who are quick to claim a complete inability to perform any physical task and it is mostly because of a lack of motivation. I want to emphasize the necessity of having good definitions of retired persons and disabled persons.

I also think it is very important that there be full discussion with the disabled groups about their acceptance of this proposal and the conditions under which they would like to have it go forward.

As a society, we are much judged on how we look after our seniors and the degree of compassion we have for the disadvantaged members of society. We all profit by any measures we can take, as a government, which will lessen their burden and give them better opportunities to take full advantage and use their competence and resources to the benefit of our society.

It is with pleasure that I support this motion, with those cautions which I have indicated.

Mr. J. M. Johnson: I am delighted to participate in this debate and support the motion that is before the House. I congratulate the member for Nickel Belt for bringing it forward. The proposed extension of the Ontario senior citizens' privilege card opens the door to a wide range of discounts for the handicapped and senior citizens of this province.

Many men, women and children are deprived of good health or have disabilities that deprive them of using their limbs, voices, eyes, ears and minds in a way that other Ontarians take for granted. These people are entitled to government support that will enable them to participate more fully in our society. By extending the use of Ontario senior citizens' privilege cards to Ontario's disabled, we will be helping them to live a more productive and rewarding life.

Currently, many disabled persons need to be enticed to take advantage of community resources available in Ontario. Because the handicapped are constantly plagued with barriers to equity, participation and integration, it is natural that they want to safeguard themselves by recoiling from the mainstream of society.

The disabled are up against an attitude problem of society as a whole. The image of physical perfection portrayed by the media, society's emphasis on the work ethic as a criterion for usefulness to society and the public's concentration on disability rather than on ability are destructive. To overcome this attitude problem, the disabled must participate more fully in society and barriers have to be removed so that this will be easier.

With increased participation, the general public will become more aware that many disabled persons are self-sufficient and are contributing members of society. Once people realize this, they will focus their attention on ability rather than on disability. Handicapped people do not want to be consigned to the role of observers. All Ontarians have the right to play as full a part in life as they can, and we, as their representatives, must uphold this right.

The extension of the Ontario senior citizens' privilege card is one step towards increasing the integration of disabled persons into society. The provision of this card would go even further to assist the disabled in that it would relieve some of the financial pressures they are facing.

As my colleague has just addressed this specific point, I will not belabour it. However, I emphasize that these people are not in the same position as other Ontarians to acquire funds, but they are in a position where they incur costly expenses relating to their disabilities. The extension of the privilege card would assist the disabled as a cost-cutting mechanism.

It could also help retired Ontarians in the same regard, because their financial resources are also limited. In today's society, the retirement age is not standardized at 65 any longer. Many people are being encouraged to accept early retirement, and the use of the privilege card should be extended to retired citizens below the age of 65. I can think of many members in this House who could take advantage of this card in a few years' time.

10:50 a.m.

A lower age limit should be set that ties into recent federal and provincial pension initiatives. Not too long ago, the federal government announced plans to extend Canada pension plan benefits to people who are 60 years of age, down from the current starting age of 65. In addition, the Minister of Consumer and Commercial Relations (Mr. Kwinter) proposed changes to the Ontario pension law whereby private companies could allow employees to retire on a pension as early as age 55. I believe the age of retirees who are entitled to a privilege card should be in line with these proposals for early retirement.

Although access to a privilege card would be only a small enticement to retire early, we cannot ignore the benefits of early retirement. Encouraging early retirement could open up some opportunities for the baby-boom generation. These people, the demographic bulge currently in their 20s and 30s, are looking for advancement. Many have not been able to get it because of the entrenchment of older people in higher-level jobs.

Early retirement helps to move younger people into the work force. Young workers bring in new ideas and are tomorrow's brain power. Unless employers get them into the work force and train them, Ontario risks not having the skills it needs. The extension of this card to all retired Ontarians presents them with a multitude of opportunities to take advantage of decreased costs during the period of life when they find themselves with much extra time on their hands.

Retirement replaces the cares and the troubles of the working world with other concerns. It is not unusual to find someone who has just retired sitting in front of the television set all day. It is difficult to adjust to this period of life. By taking advantage of the proposed motion, we can make easier the transition from the working world to the retirement world. We can help retirees with this adjustment by offering them the opportunity to keep busy in worthwhile environments. Extending the use of the privilege card to all retired Ontarians is the least we can do for those who have spent a large part of their lives contributing to the economic growth and prosperity of Ontario.

Another benefit provided by the extended use of this card is that the market the senior citizens' privilege card now covers would be enlarged and Ontario industries would be given the opportunity to cater to this larger market. The advantage to commercial outlets is additional trade brought in by these cards. The government should encourage merchants in all areas to participate in offering bonuses to these groups. There are obvious benefits for all those who are involved. This is the perfect opportunity for government and business to collaborate in assisting needy and deserving citizens of our province.

I urge all members to support this excellent resolution brought forward by my good friend and colleague the member for Nickel Belt.

Mr. Laughren: I would like to thank all honourable members who participated in the debate and supported my resolution. I am impressed by the arguments put forth in support of it. It shows that when one does a resolution oneself, one does not think of all the benefits, and contributions from other members are helpful.

I would like to refer specifically to some of them. The member for York East talked about three concerns she had, and they are appropriate. One is the question of the definition of disability and the need to have input from the disabled community. That is very important and would have to be pursued before the privilege card is put in place.

She suggested a cost-benefit study or analysis to determine cost-effectiveness. I have no problem with that. The benefits speak for themselves, and I do not think the costs are that substantial.

The member for Fort William (Mr. Hennessy) appropriately emphasized the increased participation this card would encourage in the lives of our early retirees and pensioners with the discounts that would become available to them, and the fact that people who retire or are disabled almost invariably have reduced incomes and therefore this kind of benefit is of assistance to them.

My colleague the member for Windsor-Riverside (Mr. D. S. Cooke) brought in a note of the harsh reality of this place when he talked about the assistive devices program and the promise made by the Premier during the recent election campaign. Since then, he has reneged on that promise. I am glad the parliamentary assistant to the Premier is here. He will remind his leader of that promise. It is not an extravagant one and it is something we owe to disabled people in this province.

The member for Frontenac-Addington (Mr. South) also stressed the need for full discussion with the disabled and early retirees, and I agree with that. On the other hand, I must take issue with him in that I have yet to meet a disabled person or early retiree who is in that position because of lack of motivation. I do not know where the member gets that idea.

I appreciate the comments of the member for Wellington-Dufferin-Peel (Mr. J. M. Johnson) as well, in particular his concerns about the attitude of society towards the perfect body -- although he did not use that term -- to those who are physically fit. I have often used the expression that we have built a society for the young and swift, mentally and physically. That is what the member was saying in different words. I agree with him 100 per cent. That is the kind of society we have built. We have built a society for those who need the assistance least but who get the most. I also agree with him that if we encourage people to retire early, we open up opportunities for those who are considerably younger and are seeking employment.

I am grateful for the input by all members of this assembly and for their support of my resolution.

TRANSFER PAYMENTS

Mr. Mancini moved resolution 43:

That in the opinion of this House, the federal government's decision to reduce, by two percentage points, the annual growth in per capita established programs financing transfers, resulting in a cumulative loss of $2 billion to Ontario's health care and post-secondary education systems by 1990-91, be condemned as an unfair transfer of the federal deficit to the provinces.

Mr. Laughren: Does the member want to talk about the assistive devices program?

Mr. Mancini: We may be able to do more if the government of Canada changes its mind about withholding this money it is talking about. I think it is particularly appropriate today that we have a matter that discusses funding for our health care system and the lack of commitment we seem to have from the Conservative government of Brian Mulroney.

The critical importance of established programs financing to the maintenance of quality health care and post-secondary education in Ontario is undisputed. Last year, federal transfers contributed 43 per cent of the total cost of health care and post-secondary education in Ontario.

11 a.m.

It should come as no surprise that the federal government's decision to reduce the growth rate of the transfer payment by two percentage points annually is of grave concern. For Ontario it will mean a revenue loss of $114 million this year, escalating to an annual loss of $750 million in 1990-91. At stake is the province's ability to maintain our network of hospitals, universities and colleges and to pay our physicians and teachers.

At the same time, we recognize that we are in an era when fiscal responsibility is also important. Ontario supports the federal government's efforts to restrain the growth of its expenditures and to reduce the federal deficit, yet I question whether the programs and services of such fundamental importance to all Canadians are the place to begin.

The federal obligation to the maintenance of the health and post-secondary education systems is now in question. I am also concerned that this federal decision is going to limit Ontario's ability to adapt to the changing needs of our population, such as the ongoing need for continuing adult education to ensure that Ontarians are prepared for technological change and the need for a health care system that can adapt to the requirements of an ageing population.

Failure to recognize the emerging needs now will mean adjusting to these demands later, a process that promises to be far more disruptive and wasteful. One of the major reasons for developing the established programs financing system of block funding transfer payments was to provide the provinces with enhanced flexibility to respond to changing needs, while at the same time preserving a significant role for the government of Canada in such major program areas.

A brief review of the history and circumstances surrounding the introduction of established programs financing and subsequent alterations to the program may be useful at this point in the debate.

The history of the EPF: Prior to 1977, when EPF was brought in, there were three major shared-cost programs: hospital insurance, medicare and post-secondary education financing. These were 50-50 cost-sharing arrangements, with the federal government reimbursing half of the eligible provincial health expenditures and half of the institutional spending on postsecondary education on a dollar-for-dollar basis.

The federal government was unhappy with these programs because it had no control over its contributions. They were determined entirely by growth rates in provincial programs. The provinces were unhappy because there was too little flexibility in the sharing arrangement. Some felt they were being levered into spending in high-cost areas where cost sharing was available, when they could have been spending in lower-cost areas, many of which were not shareable by the government of Canada.

Compounding these problems was the fact that both levels of government were frustrated with the red tape involved in cost sharing. I understand that at one point the final settlement of a post-secondary education spending claim was as much as 10 years late.

To address these problems, the established programs financing system of transfer payments was introduced in 1977. The basic compromise of the arrangement was that the provinces accepted the risk of having transfer payments grow by the rates of gross national product, expected to be less than the cost of escalation of the health and post-secondary education programs, in exchange for federal funding being provided on a completely unconditional basis. This provided both levels of government with greater flexibility and predictability in planning their expenditures.

Five principles were put forward at a first ministers' meeting in 1976 and formed the basis of the federal-provincial approach to established programs financing.

1. There should be provision for continuing federal participation in the development of policies of national significance in health and post-secondary education.

2. The federal government should continue to pay a substantial share of the program costs.

3. The federal payments should be calculated independently of provincial program expenditures.

4. There should be greater equality in per capita terms in federal contributions to the provinces.

5. The arrangements for the mature programs should be placed on a more permanent footing.

As early as 1979 and 1980, Ottawa began suggesting the provinces were underfunding health care and diverting federal transfers intended for that purpose. In 1984, the government of Canada imposed the arbitrary six-and-five caps on the component of the EPF transfer earmarked for post-secondary education, formally breaking the principle of unconditional block funding. Most recently, of course, there is the federal legislation Bill C-96, to limit the growth of the EPF transfer.

The cumulative effect for Ontario alone will be a loss of $2 billion in the next five years. This province will have to find $2 billion in the next five years to make up for the money that will be deliberately withheld by the government of Canada.

We as Canadians generally support the federal government in its efforts to reduce its sizeable deficit, but Canadians also believe, as the Treasurer (Mr. Nixon) stated in his budget, "It is false economy to try to balance budgets by ignoring society's real needs." We know society's real needs are changing.

It is projected that the part of the population aged 65 and over will grow by 18 per cent by 1990, significantly faster than the five per cent growth rate of the general population during the same time. According to both the Canadian Medical Association and the Conference Board of Canada, the ageing trend will add at least one per cent per year in real growth in health care costs. New technology is estimated to add a further three per cent per year to the health care budgets.

Despite the diminishing growth rate of our younger population, we continue to see post-secondary enrolment remain constant. We are also witnessing a growing number of adults returning to colleges and universities to ensure they remain up to date in their chosen fields.

It is also far from clear that transfers to the provinces are the real cause of the federal government's deficit problems. From 1977 to 1984, total federal spending grew at an annual rate of 12 per cent. In contrast, transfers to the provinces grew at an annual rate of 10.5 per cent.

I recognize that the federal government has adopted an approach that packages issues into manageable components to make them easier to resolve. This is evident in Ottawa's deficit reduction strategy: higher taxes for the ordinary citizens and the elimination of transfer payments to the provinces.

I believe, as do many other members of this Legislature, that the reduction of transfer payments to the provinces will have no real direct impact on the federal government's deficit unless it evaluates its other spending priorities. More important, I am concerned that in dealing with the short-term, pressing issues of the day, such as deficit reduction, we are losing sight of the broader issues facing Canada.

11:10 a.m.

If the federal government were driven entirely by short-term objectives, it would be unlikely to be sensitive to the basic traditions shared by all Canadians. The federal EPF reductions jeopardize such fundamental principles as accessibility and a uniform, high-quality standard across our entire nation. It is these principles that distinguish our country from many others.

However, this does not mean the federal and provincial governments should not work together towards solutions that will restore some measure of fiscal balance to our national books. To do this, we will require more than piecemeal decisions taken unilaterally by one level of government against the provinces. It may require that fundamental decisions about the assignment of responsibilities between levels of government be addressed. It may require that the distribution of taxing powers between the federal and provincial governments be reassessed.

The members will agree that such issues cannot be addressed adequately in a confrontational, ad hoc manner. They require meaningful consultation between our respective levels of government, something the Conservative Prime Minister of Canada promised after he was sworn into office.

Governments must also address the emerging problems of the 1980s and 1990s. Issues such as child care and worker retraining promise to take on even more importance in the coming years. They must be addressed in a comprehensive and meaningful manner, ensuring that full consultation amongst all relevant governments and parties is achieved.

The federal government's decision to limit the growth of the EPF transfers to the provinces is not the approach necessary to resolve this nation's problems. Shifting the problem from one level of government to another is quite meaningless, for those who suffer are the same people.

I am confident this government is not shying away from the problems facing us. Ontario has indicated its desire to discuss in a meaningful manner the problems arising from the difficult fiscal circumstances in which we find ourselves as a nation.

I urge all members to support this government in continuing to oppose any measures that are unfair and may limit our ability to maintain such essential services as quality health care and post-secondary education. Such initiatives serve neither level of government and are contrary to the fundamental premises on which this government has been founded.

I thank the members for their attention. I would like to withhold the remaining time so I can comment after the members have spoken.

Mr. McFadden: If someone had entered Ontario from an atoll in the Pacific, isolated from civilization and without any news media, he might take this resolution seriously.

The issues and concerns that have been raised this morning relate directly to the financial mess in which the federal Liberal Party left Canada when it went out of power in 1984. It is absolutely remarkable that a Liberal member would introduce this resolution with a straight face in view of what was left with regard to the financial operation of this country when the change of government took place in Ottawa in September 1984.

I would like to outline the legacy that was left to this country during the period from 1975 to 1984.

In 1975, the Canadian government showed a manageable annual deficit of $3.8 billion. By 1984-85, that deficit had jumped to $37 billion, more than a 10-fold increase. The accumulated federal public debt stood at $100 billion in 1982, and that number has approximately doubled since then. Indeed, the total national public debt today represents in excess of 30 per cent of the gross national product.

When Mr. Turner left office, the interest payments on the federal debt totalled some $20 billion per year. Today, as a consequence of the debts that had accumulated during the Liberal years at a steady rate of increase year after year, one third of all federal expenditures goes to debt service. It has been only in the past year that some effort has been made to reduce the debt that is being incurred annually. The federal deficit today is slowly but gradually on its way down. Nevertheless, about one third of the total amount of federal expenditure is now committed to the service of debt charges.

This is the genesis of the current difficulties concerning all funding in the federal government.

The honourable member's resolution leaves the impression, unless one reads it carefully, that somehow the federal government is cutting established programs financing grants. Of course, this is not true, and a careful reading will indicate it is not true. EPF funding is increasing, and the increase from the fiscal year 1985-86 to 1986-87 came to about $20 million per annum in the area of post-secondary education funding. Indeed, the federal government is not reducing the base level of post-secondary education EPF transfers. What we are seeing here is to some extent a reduction in the rate of growth.

According to the figures we have been able to secure, EPF cash and tax transfers for postsecondary education from the federal government will increase in the next year by 6.5 per cent. That is about 2.5 per cent in excess of the rate of inflation. I would point out that this amount is in excess of the increase that the provincial government is providing to the universities for operating grants. In the last budget, provision was made for an increase in operating grants to the universities of only some four per cent. Juxtapose that with the 6.5 per cent in transfers from the federal government.

I know some additional funds have been allocated for certain special funds, but anybody who talks to the universities and to the students about the current policy in regard to operating grants for the universities will recognize it would be far better for the provincial government and for the long-term strength of the university system to increase operating grants by 6.5 per cent, in line with the increases in EPF funding, rather than by four per cent, as the province is currently doing.

This resolution seems to try to use a relatively flimsy excuse to transfer blame to the federal government for the failure of the provincial government to provide the additional funding the universities need. We have had two budgets in this House since the current government came to power one year ago. What we have found is minimal increases in operating grants for the universities.

11:20 a.m.

During that period as well, we have seen no response at all from the provincial government with regard to the Bovey commission report. The Bovey commission was appointed while the member for York Mills (Miss Stephenson) was Minister of Colleges and Universities, to look at the whole area of the funding of our province's universities and colleges, because she recognized that we had to look at the whole funding of post-secondary education.

The Bovey commission set out a number of first-class recommendations with regard to how future financing of universities could be dealt with. Not every recommendation of the Bovey commission may be acceptable, but it sets out an interesting, informed and useful blueprint in terms of the future of university funding. What has been the response? The Minister of Colleges and Universities (Mr. Sorbara) has not even talked about Bovey. We have no response whatsoever from the ministry. We have no response at all from this government with respect to long-term financing requirements of universities.

After months of study by Bovey into the problems of universities, and after the work the commission did to submit its report with its excellent recommendations, it is a shame we are sitting here today with no response from the government and effectively no action on the recommendations except in a most piecemeal fashion. Instead of the presentation of this resolution, it would be far more valuable to have a resolution presented to this Legislature urging the government to get on with the Bovey report and to get on with enacting the types of financial arrangements that are recommended which would give the universities the flexibility and additional funding they really need.

While this resolution sets out some concerns that we all have about a reduction in federal transfer payments to the provinces, it fails to recognize the serious problems the federal government was left with when it came to power in 1984. It also fails to reflect the failure of the government to act in a meaningful way in terms of the additional funding that Ontario universities require.

I do not think there is a member of this House who would not want to see unlimited federal funding to deal with the health care issues we have spent weeks debating in this House, as well as post-secondary education, but I do not feel this resolution adds anything to the debate. It has been a red herring in the past, and it appears to me to be an attempt by the Liberal Party to get out of the commitments it made in the last election to enhance funding for post-secondary education.

Mr. Grande: I rise to speak to the resolution of the member for Essex South (Mr. Mancini) and to say that anyone in this Legislature cannot help but support this motion. However, anyone can support this motion on the surface. When the federal Liberal Party started the reductions and cutbacks in the established programs financing, we on this side of the House condemned it for doing that. Now that the federal Tories are continuing down the same path the Liberals started for them, we in the New Democratic Party condemn the federal Tories. This party has always protected the interests of the people of Ontario. We have done so from the very beginning when cutbacks occurred.

I do not want to get into and leave the debate at bashing the federal government. I hear from the member for Essex South that he is more interested in bashing the federal Conservatives. Then I hear from the member for Eglinton (Mr. McFadden) his kind of protectionist urge to protect the federal Conservatives. He brought his information and his statistics to the fore to show that the reduction is required as a result of the federal deficit prior to the Conservatives taking power.

Whether it is the Liberals or the Conservatives in Ottawa who are perpetrating the underfunding, the problem remains in our universities. Prior to this new administration taking power in Ontario in 1985, we had a decade of underfunding in our post-secondary institutions. At the same time, prior to 1977, as the member for Essex South has said, there was a 50-50 split for post-secondary education and health purposes. In 1977, the negotiations changed and a new deal or a new compromise was established -- by the way, it was at the urging of the provinces, as I recall -- and we got into the block funding.

In essence, for 10 years, the block funding allowed the provincial Tories not to pass on the money that came from the federal government to the university sector. They continuously underfunded it to the point that in 1981, we had a report by the committee on the future role of universities in Ontario. At that time, the member for York Mills, who was then the Minister of Colleges and Universities, said, "We will not be able to implement this report on the future role of universities in Ontario simply because the federal government is cutting back on its funding."

In effect, they did what the report said they should not do. They muddled through between 1981 and 1984, and once again the postsecondary institutions were underfunded. As a matter of fact, the provincial share of the operating costs of post-secondary institutions up to 1985 decreased to the tune of 15 per cent. In other words, the province held back federal money intended for post-secondary education and used it for other purposes.

The present Minister of Labour (Mr. Wrye) condemned this in the estimates in 1981. I want to quote a brief line. He said:

"To put it in another way, the management of the Ontario post-secondary system in terms of financial arrangement has been a three-legged affair. Students who have had in the past a small leg of some 15 per cent of the cost of the system have upheld their part of the bargain. The federal government, with a much larger leg, 40 per cent in 1977, finds itself with a much greater responsibility today.

"What is the conclusion we can draw? The natural conclusion, it seems to me, ought to be that what is needed to restore the system to its proper balance, to help return it to its former pre-eminence, is for Ontario to uphold its share in the bargain and put its share of the money back into the system, the money that it has taken out over the last five years."

11:30 a.m.

That has been the story. The Conservatives in Ontario have said of the established programs financing, "The federal Liberals have cut that program, have cut the money, and therefore we will not be able to support the secondary institutions the way we would have liked to support them." At the same time, they cut back to the point that the system was and is breaking up at the seams.

The Minister of Colleges and Universities (Mr. Sorbara) is not doing any better. The present minister is underfunding the college and the university systems and continuing to underfund, just as the Tories did in 1982, in 1983, and in 1984. During last year's election, there was a promise for much more for the college and university systems. As a matter of fact, an editorial in the Toronto Star puts it this way, "Operating funding has been increased by four per cent a year and that is less than generous, particularly for a government that has promised more."

Then the Minister of Colleges and Universities talks about an excellence fund and talks about putting some money into that and saying to the universities, "Here is a pool of money; go ahead and hire new blood into the universities." The universities are asking, "What are we going to do next year and the year after, once we have hired these people?"

The challenge is before the member and his government. They could continue along the same route as the Tories in the past 10 years and underfund the system to the point where it is at the brink of a tremendous crisis, or they could go back to the report of the Commission on the Future Development of the Universities in Ontario and address the major recommendations of that report which is now six years old. The Tories never touched it. They should address that problem, because the problem in our post-secondary system is one of underfunding. As a result of that underfunding, we are going to have limited accessibility in our post-secondary system for students in our province. We are going to continue with the larger classes and we are going to continue with physical plant at the university literally crumbling.

Up to two or three years ago, the University of Toronto had 28 work orders in order to make that plant safe for the students. It is a shame to this province when that occurs. While I am more than happy and prepared to rise in this Legislature and condemn the federal Tories for their cutbacks to the established programs financing, at the same time I say to the government that it should pick up the challenge where the Tories were unwilling and provide the necessary funding to our post-secondary institutions, because, if we do not, the future economic recovery of this province in terms of producing expertise will not come about.

The Tories have left their trail of underfunding in the last 10 years and I would not want to see the Liberal government leaving exactly the same trail.

Mr. Reycraft: I am pleased to have the opportunity to speak this morning in support of my colleague the member for Essex South (Mr. Mancini) and his resolution expressing concern about changes in the established programs financing arrangements for this province. The cloth that binds this country together is one that has a very complex weave. The established programs financing arrangements are an essential element within the weave of that cloth. They assure Canadians that no matter where they live, no matter what province or territory they are in, they will have accessible, quality health care and post-secondary education guaranteed to them.

For a provincial government or the federal government to accept anything less is an abrogation of our responsibilities. It is true, as the member for Eglinton (Mr. McFadden) has pointed out, that we are at a difficult point in our fiscal and economic responsibilities in this country. In carrying out our responsibilities, we are all faced with the need to limit the growth of spending and to do our best to bring deficits under control. That responsibility is shared, whether our area of responsibility is at the provincial level, the federal level or the municipal level.

However, we also have to respond to the serious economic problems that are being experienced in some sectors and regions of our country, including parts of Ontario. The economic resurgence we are enjoying here in southern Ontario is not being shared by all parts of Canada or even by all parts of Ontario. In dealing with the pressing matters of the day, we must make sure we do not lose sight of the bigger picture. We must not consider our decisions out of context with the total issues.

The issues we face involve some basic questions that relate to what level of government should collect what revenues and what level of government is responsible for spending in particular program areas. With the decisions that are made in such forums as the finance ministers' and treasurers' meetings or a first ministers' conference, and the decisions made by the federal government on its own, the economic and fiscal framework of this country is being remade. I suggest it is not being done in a co-ordinated manner. Indeed, it is being done in an ad hoc, piecemeal fashion. Members of this Legislature should be concerned that the results of those reconsiderations are going to be disjointed, irrational and unfair, as I suggest they are in the case of the established programs financing reductions.

It also strikes me that the federal government's priorities are beginning to take on a surprising shape. On the one hand, you have that old government that is reducing its commitment for core health care and post-secondary education. On the other hand, and I refer to yesterday's Toronto Star, we have a Prime Minister who spends more than $800,000 on three short trips outside this country, and I read about a hotel suite that costs $1,200 a night, in which he stayed for four nights. I read of $13,000 being spent in three days for the rental of motor vehicles, and I suggest that we need to be concerned about the priorities these facts suggest.

How can the federal government justify spending more that $520,000 for one week in Paris, while at the same time trimming back Canadian social benefits in the name of saving money? The federal government should review these financial priorities and it should do so quickly. The kinds of priorities that these facts illustrate are not acceptable to the people of this country. Mr. Mulroney is going to find that out when they next get an opportunity to express their opinion of those priorities to him, whether that comes in 1988 or 1989.

From the provincial perspective, the federal legislation to reduce the growth rate of the established programs financing transfer is indicative of our most immediate worry, that the federal government is shifting its deficit to the provinces. At the same time, revenue flexibility is being limited as the federal government intrudes into traditional provincial revenue fields such as the business transfer tax, which we hear people speaking of and which we expect to occur.

11:40 a.m.

If the economic agenda is driven entirely by narrow objectives such as deficit reduction, then it is unlikely it will remain sensitive to the basic traditions and aspirations all Canadians have come to share. It is our concern that the federal approach to cutbacks and the transfers of core health and post-secondary education is going to impact on us most negatively. Both of these are effectively in the provincial jurisdiction, but they are of such basic national significance that the federal government has used its taxing power to help finance these programs for some time.

In this manner, it was possible to ensure the accessibility and uniformly high standard of quality across our nation. It has allowed Canadians in parts of the country where economic prosperity is not being experienced to share in the benefits of that prosperity. The Canadian approach to providing health care and to ensuring access to post-secondary education is one of the factors that sets us apart from our neighbours to the south. It is also, in my view, an integral bond of our federation.

Our government is more than aware of the problems caused by budget reductions in health and post-secondary education. The situation of inadequate hospital facilities and starving universities is not one that has developed in just the last 12 months, as some have tried to suggest. As the member for Oakwood (Mr. Grande) pointed out, it developed over a longer period.

Just as we are trying to rectify the underfunding that health and post-secondary education have experienced, the federal government has announced its plans to remove some $2 billion over a very short period from the established programs financing.

Ontario should continue to stand by the principle of equality of opportunity for all Canadians. The federal legislation to reduce the growth rates of the EPF transfer contravenes this principle and in this light it is unfair.

Miss Stephenson: I rise to participate in this debate of a resolution relatively briefly and from the perspective of historical reference, if I might call it that. The member for Middlesex (Mr. Reycraft) has just suggested that the reduction over time of $2 billion from EPF was in fact initiated by the current federal government. I remind the honourable member that this process was initiated in 1981 by the budget of one Allan MacEachen when he was the Treasurer of the federal Liberal government and the reduction of $2 billion was announced at that time.

I would suggest to the honourable members that we were in not nearly as buoyant economic circumstances in the province in 1982 as we were this year, when the members opposite were handed an economy that was growing rather dramatically, significantly better than in any other part of the country, as a result of good budgetary practices.

As a matter of fact, in April 1982 there was a debate in this House on EPF transfers. I will refresh the memory of the member for Essex South (Mr. Mancini), because he was here at that time. None of the rest of the members was, but he was and he should remember. I will quote from page 1089 of Hansard for April 22, 1982, the statement of Albert Roy, the former part-time member for Ottawa East, who for 12 years spent two days a week in this Legislature as a member of the Liberal caucus.

Mr. Foulds: Sort of like the member for Cochrane South (Mr. Pope).

Miss Stephenson: Do not talk to me about the member for Cochrane South or anybody else; the example was set by Albert Roy. This is what he had to say:

"We have had a succession of Treasurers," in Ontario, "who kept saying to the feds: `Cut your deficit. Do like us. Cut your deficit down. Cut your spending.' At the moment the federal government is doing exactly that on transfer payments and now the Tories are bitching. Now they are saying it is not fair. They are saying: `Do not cut your deficit on our back. We can cut it on the backs of the municipalities. Do not do that to us.' What irony, what hypocrisy on the part of the people on the other side of the House."

It sounds exactly like the member for Essex South.

I would also quote a further statement made by Albert Roy. He said: "In closing, I am not here to defend the federal programs" --

Mr. Mancini: On a point of order, Mr. Speaker: I do not understand who the member for York Mills is quoting. She is throwing out names of members who are in the House today and of members no longer serving in this House. I would like to know exactly who she is quoting.

Mr. Speaker: I believe Hansard will show who the member is quoting.

Miss Stephenson: I did make it extremely clear that the speaker I am quoting at this point is Monsieur Albert Roy, a long-time member --

Mr. Mancini: The member did not say that.

Miss Stephenson: I said it three times. Is the member deaf? Pardon me. I am sorry. I should have said it much more precisely than I did.

I would like to quote another paragraph from his long and somewhat rambling participation in the debate of April 22, 1982. Mr. Roy said:

"In closing, I am not here to defend the federal programs. All I am here to say is, before they start throwing rocks they should get out of their own glass houses. The government should not start blaming the federal government for cutting back on the payments when it is not a cutback on the payments but a cutback on the increase."

It was a cutback on the increase and not a cutback on the overall funding, and that is exactly what is going on today.

Unhappily, the federal government in Ottawa, as my colleague the member for Eglinton pointed out to the House, inherited a very difficult financial situation; a financial situation which ensures that 33 cents out of every dollar collected by the federal government goes to fund the debt for which the government of the Trudeau era was entirely responsible.

Having to do that, there is some need to be rational about the way in which expenditures will grow. In spite of an agreement by the 10 provincial finance ministers in 1983 that they would not accept Allan MacEachen's budgetary activity related to established programs financing, the federal government went right ahead and did it anyway. There was unanimous agreement by all the finance ministers of all the provinces that this should not be done, and yet the federal Liberals went ahead and did it. They did not care. It is just like the provincial government in Bill 94. It does not care. It is just going to go ahead and ruin everything.

At any rate, in addition, the colleague who sits next to the member for Essex South, the member for Haldimand-Norfolk (Mr. G. I. Miller) had this to say on that evening:

"The government has to take a fair look at overall financing and realize the position we have been forced into. No longer can we," as a province, "take 12.5, 15 and 25 per cent increases; we have to be realistic. We also have to co-operate. I am a strong federalist myself. I think we need a strong federal government and a strong provincial government. But we have to be realistic and, when the federal government says we have to accept the cut, we have to be responsible" and accept it.

The tune has changed since 1982. Simply because there is a government of another stripe in Ottawa and a government of a different stripe in Ontario, there is some increased tension surrounding this subject about which the Liberals were blithely supportive of the federal government in 1982.

The situation has changed since 1982, as I have said. The provincial government here enjoys the fruits of a very good economy. It has had a windfall this year unheard of in the 11 years that I have been in this Legislature. I should have thought it would have been able to do much better than to raise the operating grant to the universities by a mere four per cent. That is barely, just barely, skinnily, above the rate of inflation, if it is at all.

I remind the House that for the years 1982, 1983 and 1984, the universities' budgetary allocation for operating grants was significantly above the rate of inflation by at least half a per cent, and on some occasions by one and a half per cent, even in those very difficult years when we were already being cut off at the knees by Allan MacEachen's budget.

The rate of inflation increase in Ottawa during those years was fairly significant, and the transfers which came to Ontario increased at barely the rate of inflation during those years. We managed to keep the allocation to the universities above the rate of inflation.

However, what is happening this year? The federal transfer is increasing at twice the rate of inflation and all the government has managed to do is to increase it at the rate of inflation.

11:50 a.m.

Interjection.

Miss Stephenson: What is the member talking about? He should not be such a hypocrite. Pardon me. He should not let his words sound so hypocritical, because they are, in fact when compared with those uttered by the members of his caucus.

I would like to give one final quotation. I will do it rapidly. This is significant. I quote from a member of the Liberal caucus. "I do feel that this whole approach towards blaming the federal government for all of our provincial difficulties, our economic inadequacies, is a serious attempt to mislead the electorate into removing the pressures from the government of Ontario for the problems it is going to be facing in the next few weeks when it is forced to bring down a budget."

Mr. Breaugh: Who would say a thing like that?

Miss Stephenson: The member for Brant-Oxford-Norfolk (Mr. Nixon), who is now Treasurer of Ontario. The shoes may have changed, the mindset obviously has changed with the shoes, but reality remains exactly the same. To bring this resolution in is indeed specious, spurious and absolutely inconsequential.

Mr. Breaugh: That was a little wishy-washy, but it is okay.

Miss Stephenson: Sorry.

Mr. Foulds: In the two minutes and 30 seconds left to me I feel it is my job to introduce, as the New Democratic Party always does, the voice of reason and facts to this debate. I want to start in the most calm, rational way by saying to both the Liberal and the Conservative parties, a pox on both your houses.

By the way, we are supporting this wishy-washy, politically motivated resolution because it does have a kernel of truth in it and because the speakers from the Conservative Party have been so wishy-washy in defending their position. I want to point out the facts very briefly.

In 1976-77, the last time before the system of EPF grants was established, there was a 50-50 split. Under the Liberals in 1977-78, the federal government picked up 48.7 per cent. Under the Liberals in 1978-79, it picked up 49.6 per cent. In 1979-80 -- and remember that was when the Liberal government was defeated by the Conservatives and there was a Conservative federal government for nine months -- it was 49.9 per cent. It was almost back up to 50 per cent.

With the Liberals in 1980-81, it was 48.9 per cent, but in 1981-82 it dropped dramatically to 46.7 per cent. With the Liberals in 1982-83, it dropped even more dramatically to 42.6 per cent, and in 1983-84 again it was 42.6 per cent. So the Liberals have nothing to be proud of.

During that whole time, where were the voices of the Premier and the member for Essex South? They were silent on condemning the federal Liberal government.

The federal Tories have been trying that even more draconianly. Where is the voice of the Premier? It is through the squeaky voice of his parliamentary assistant. Similarly, the Premier gets headlines on free trade but he has never said "No" to Mr. Mulroney on free trade. The Liberals and Conservatives are as weak on this issue as they are on the issue of free trade.

Mr. Mancini: I may be accused of many things but this is the first time I have ever been accused of having a squeaky voice.

The member for Port Arthur (Mr. Foulds) was very original, as always. Who has ever heard the saying, "A pox on both your houses," before today? I do not think we have ever heard that before today.

I want to make comments to the members who had an opportunity to make some relevant comments on the matter of the established programs financing, such as the member for Oakwood (Mr. Grande), the member for York Mills (Miss Stephenson) and the member for Eglinton (Mr. McFadden).

First, to the member for Oakwood, while he condemned the excellence fund, he did not even know how much money is in it. He was unaware that it was $50 million last year. He was unaware that it is $80 million this year. In fact, he thought it was for only one year. There is $130 million in the excellence fund over a period of two years, of which he was unaware and upon which he completely failed to comment.

Furthermore, it appeared he was unaware of the improvements we had made in the Ontario student assistance program of upwards of eight per cent.

I want to turn my attention to the member for Eglinton. He was very original also. He took the time to blame all of Canada's problem on a government that has now been out of office for nearly three years. He did make a point about the Bovey commission, although while he was talking about it, he forgot to mention the tremendous increase in tuition fees it suggested. He also forgot to mention that places for potential students in our university system were going to be drastically reduced by the Bovey commission. I want the member to think about that for a while as he takes this opportunity to talk about the Bovey commission.

The member for York Mills was entertaining, as always. She still harks back to the days of Allan MacEachen, when it was still fashionable for Conservative governments to win majorities in Ontario on the backs of federal Liberals. It is unfortunate that those days are gone. I think what bothers her most is that under the new regime in Ottawa, under Conservative leader Brian Mulroney, we have been able to compare the leadership of this government to the governments that preceded him. The Canadian people, through the opinions they have expressed in the Gallup polls, have shown the member for York Mills just what they think of the government that is now starting its third year in office.

She attacked a member who is no longer a member of this House and is unable to stand and defend himself. All of us who served with Mr. Roy know that if he were here, he would have been very able to defend himself, even against the very impressive member for York Mills.

She forgot to mention a very important point. The criticism that came from Ottawa against the Tory government at that time was that it was not using the money that was being transferred to it for health care and education for those respective purposes; it was using the money for other purposes.

We know that Ontario is going to have a difficult problem maintaining the quality of our health care system and our post-secondary education system if the Conservatives in Ottawa continue to proceed with the cutbacks they have announced. It may not seem like a lot to the member for York Mills or to the member for Eglinton, but I say to the Tories across the floor, this year we will be losing $114 million, next year $250 million, the year after $390 million, the year after that $560 million, and in 1991 we will be losing $740 million, for a grand total of $2 billion which will be removed from the Ontario Treasury by their Conservative friends in Ottawa.

They have shown their colours by the support they have given them here today. They have shown they are more interested in saving the pants of Brian Mulroney than in providing better health care for the citizens of Ontario and by providing better post-secondary education for the students and adults who need to use these systems.

I did not expect anything different from the Conservative Party.

ONTARIO SENIOR CITIZENS' PRIVILEGE CARD

Mr. Speaker: Mr. Laughren has moved resolution 25.

Motion agreed to.

TRANSFER PAYMENTS

Mr. Speaker: Mr. Mancini has moved resolution 43.

All those in favour will please say "aye."

All those opposed will please say "nay."

In my opinion the ayes have it.

Motion agreed to.

Mr. Speaker: I remind the members of the wish of the House as of yesterday that we resume sitting at 1 p.m.

The House recessed at 12:02 p.m.

AFTERNOON SITTING

The House resumed at 1 p.m.

Mr. Grossman: We have all tried to co-operate in making unusual arrangements for today. I see only three ministers present. Oh, here is the Premier (Mr. Peterson).

ORAL QUESTIONS

EXTRA BILLING

Mr. Grossman: My question is of the Premier. Given the events of the past two days, can he tell us whether he still believes that all that is happening out there is an inconvenience for the patients of Ontario?

Hon. Mr. Peterson: I do know that the ministry has emergency plans in place. There is no question that there is inconvenience. There have been specific cases reported, as the member knows, from a variety of sources, from members of the House, the media and others. I can assure the member that each one of those is being followed up in substantial detail. I know the minister is on top of the individual circumstances of the vast majority of them.

I caution my honourable friend not to create the impression that there is an emergency or a situation that is in any way out of control. That is not the situation at all. There are physicians in the hospitals, people are being attended to and physicians are fulfilling their professional responsibilities. As the member says, however, it is very inconvenient to a number of people.

Mr. Grossman: I want to go further. I believe that to each individual, to the parents with a child who needs urgent attention, at least in the parents' view, and to the patients themselves who have anything from heart to cancer difficulties, it is more than an inconvenience. They see it as a frightening circumstance. As an average citizen of Ontario, I am worried, scared and, on occasion, maybe even frightened about what is happening.

Interjections.

Mr. Speaker: Order.

Mr. Grossman: My question to the Premier at this 11th hour is this: Does he not agree that, setting all other considerations aside, now is the time, with no loss of reputation or face, to buy some time and send everyone back to work tomorrow morning by asking for a mediator?

Hon. Mr. Peterson: We have had this discussion in the House on a number of occasions. I am very much aware of the member's point of view on the matter. I presume he thinks we should withdraw the bill and mediate, negotiate or do something else.

This has been going on for almost a year now. The bottom line of the many discussions and meetings, formal and informal, is that there is a difference of opinion. The Ontario Medical Association does not want to end extra billing, and I believe it is the will of this Legislature and of the people of this province that they do want to end extra billing.

These strong clashes of opinions bring me no joy as Premier, but on the other hand, I do not think we can walk away from these problems or postpone them for ever. There is a judgement call when one does the various things that have been done. In my view, the minister has handled this situation with exemplary judgement and fairness.

It is a difficult situation, and I acknowledge that, but I do not think one can always buy peace. I do not think one can walk away from every single problem one has in life or in politics. That is why we are moving on this bill. We think we are obeying the law of the land, the Canada Health Act. We are conforming, as a lot of other provinces are.

It is too bad this confrontation had to come about. Our very strong preference was to have negotiated this. We have used our very best efforts to negotiate a solution. We were not able to do that, and that is why we are proceeding as we are today.

I ask again for the co-operation of the honourable member and his party to pass this bill. We all know what is going to happen with this bill. It is going to pass through this Legislature. I ask the member and his colleagues for their co-operation in passing this bill so we can get all get on together and pick up the pieces and address --

Interjections.

Mr. Speaker: Order. Final supplementary.

Mr. Grossman: I believe the Premier has misjudged and underestimated the anger and resentment out across the medical profession on every single turn over the past several months. He has to acknowledge at least that he is as worried as I and others are that there may be very many doctors out there who are going to take action, not at the direction of the OMA but out of anger over what has happened.

Given that circumstance and given the indication by the OMA yesterday that passage of the bill will not deter its members from their activities, does the Premier not agree that the kind of co-operation he should be seeking now is the kind of co-operation that a mediator can bring to the circumstance?

In asking that question, I indicate to the Premier that if he wants to propose any solution whatsoever in terms of the speed of passage of this bill or anything else, any solution that involves the appointment of a mediator, the Progressive Conservative Party of Ontario will give him the co-operation he requested.

Hon. Mr. Peterson: Our judgement at this point is that we cannot mediate the basic principle. Walking away from that and withdrawing is just running away from the inevitable in this situation. It is a good theory, but in the circumstances, in my view, it will not work.

As the member points out in his question, I recognize the anger of a number of members of the profession, but I believe they are mature professionals. As much as they dislike the vast majority of what we are doing, we will be able to sit down, I hope not too long from now, and sort out and work out together some of the problems that face not only the professionals but also all the people of this province in the health care delivery system.

My sense is that the vast majority will fulfil their professional responsibilities in that regard. We are prepared to sit down with them and address their concerns about freedom and some of the things that have been raised over the long term.

Mr. Grossman: My second question is for the Premier as well. Given what he has just said, and because of the harsh words that he, the Attorney General (Mr. Scott) and the Minister of Health (Mr. Elston) have used over a period of months, it will be difficult for a mediator -- I acknowledge that -- but I want to appeal to the Premier at this 11th hour.

If a mediator has one chance in 10, or one chance in 100, before inconvenience, to use the Premier's word, turns to tragedy, it is worth the one chance in 10 or 100 to bring in a mediator to try to get the doctors back to work. Why will he not take that small chance that mediation will work and get everyone back to work tomorrow?

Hon. Mr. Peterson: I disagree with my honourable friend on two points.

First, I do not believe the Attorney General, the Minister of Health and I have used so-called harsh words in this discussion. The member has seen a minister carry an extremely difficult situation with great temperance and great judgement as harsh voices were flying all about in this debate. There were very strong reactions on both sides in this House, and I do not need to quote back the things that have been said in this House previously. The minister, who is charged with the responsibility of carrying a very difficult load, has shown exemplary leadership, great self-discipline and patience in the circumstances.

1:10 p.m.

Second, to go back to the suggestion that there is one chance in 10 or one chance in 100, or whatever, of a mediator solving this problem, I do not share my honourable friend's view of that situation. We have had many meetings with these people; they are in favour of extra billing, and the government is against extra billing. That is not to say there are not many common concerns we do have; those were discussed and will continue to be discussed in the long term.

It is not as if we are mediating between a four per cent raise and a six per cent raise, where we can compromise at five per cent and everybody wins and loses equally. It is not that kind of situation. It is a situation where there are two strong differences of opinion and they are polarized; they are strongly felt on both sides.

Ultimately, as I am sure my friend will agree, the will of the Legislature and of the elected people has to predominate in this discussion. I ask the member again for his co-operation in moving ahead and not delaying this any more than necessary.

Mr. Grossman: The Premier cannot today, could not yesterday and will never be able to get away from the reality that his blind determination to push this legislation and have it all his way has been the single determining factor in the withdrawal of services we have today. He will never get away from that, because that is the reality. If the Premier wishes co-operation from this party and, more important, from the doctors of this province, there is only one way to get it: The OMA has told him clearly to put in a mediator.

Given the fact that more than just short-term damage has been created, and more than harsh words and rhetoric -- and the Premier is right that they are not words used by the Minister of Health, but words used consistently throughout this piece by the Premier -- have so dramatically alienated the OMA that he will never be able to do anything in the health care system, will the Premier consider supporting the reasonable amendment we have put through this afternoon? It is his last chance. Will he support the appointment of a mediator? He can have everything else his way, as he is determined to have, but will he give us a mediator this afternoon?

Hon. Mr. Peterson: I do not agree with the honourable member's characterization of my words as harsh. I recognize in a difficult situation such as this that he will be attacked personally. The minister has been attacked; he has been attacked more in this House, personally and every other way, than I have seen in a long time. When one takes on a responsibility, one has to accept that.

On the one hand, some people think the government has been too slow; on the other hand, some think we have been too fast. These are judgements that have to be made. I think exemplary leadership has been demonstrated on this issue in a fair-minded way. I do not feel the Conservative amendment will do anything except defer problems. One of the functions of leadership is to face problems squarely and not to defer them. In my judgement, the ministry has done that.

Mr. Grossman: The true test of leadership is not to prove the Premier has power. Everybody knows that. The true test of leadership is not to show he can beat a group or have his way. Everyone knows he has and everyone knows that, one way or another, he will have his way. That is not the true test of leadership. The true test of leadership is not how tough he can be, but how fair he can be.

Mr. Speaker: Order. Does the member have a supplementary?

Mr. Grossman: The true test of leadership is not whether he can change the system; it is whether he can change the system and keep people together.

Interjections.

Mr. Speaker: Order. Please, a supplementary immediately.

Mr. Grossman: Does the Premier not agree that the ultimate test of leadership is the degree to which a leader can see through his way and his goals while keeping the majority of the population united and the key people who make our society work, not agreeing but understanding and working together with him? The Premier has failed in that, and that is why we have --

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

Hon. Mr. Peterson: I do not want to get into an academic or philosophical debate with my honourable colleague opposite with respect to the nature and definition of leadership. If one of his criteria is fairness, that has been demonstrated at all turns in the situation.

One of the things we try to do in this party and in this government is not to speak for special interests. Our responsibility is to speak for the broad population. The member knows, as I do, the will of this Legislature and, I suspect, the will of the majority of people. I suspect when judgement is rendered on this situation, as difficult as it is, the vast majority will say the government handled it in a fair-minded and even way.

Mr. Grossman: Absolutely no one would say that. Only the Premier's foot soldiers would say that.

Hon. Mr. Peterson: I know the member opposite disagrees, and I know his colleague the member for York Mills (Miss Stephenson) disagrees; that is fair enough. Some time in the not-too-distant future this matter will be put to the people of this province. I will be very happy to explain how we have handled the situation and how the minister has handled it, because I have the utmost confidence in his judgement and in the way he has done it.

Mr. Rae: I have a question for the Premier. It concerns various events and statements that have been made by members of the medical profession in the past 24 hours.

I will quote to the Premier a statement that is on the front page of the Oshawa Times, dated Wednesday, June 18, 1986. This is the president of the Durham Medical Society talking: "`What that means to me is sitting on the curb and watching ambulances pull in the front door and watching the funeral directors pulling out the back door,' said Dr. Joan Atkinson, president of the society."

That is a statement made by a supposedly reputable and elected official of the Durham Medical Society with respect to the withdrawal of services. We all know what effect that withdrawal of services has had at the Ajax and Pickering General Hospital in the past 24 hours.

What does the Premier intend to do about the complete collapse of discipline within the profession? What does he intend to do with respect to the withdrawal of services, in many instances depriving patients of care they are legally entitled to get in Ontario? What does he intend to do to stop this kind of absolutely unacceptable and preposterous threat being made to the people of this province?

Health care does not belong to the profession. It does not belong to the doctors. It belongs to all the people. What is the Premier going to do to stop this outrageous misconduct?

Hon. Mr. Peterson: I share my honourable friend's distaste for statements such as that, because I do not believe they are representative of the profession. Sometimes in highly charged emotional situations people make remarks they later regret. If they have not, I surely have in my own circumstances.

One has to view this matter evenhandedly. There have been a great number of statements, charges and countercharges, many in this House, that, if I were a censor, I would view to be a little extreme. But I am not. It is still a free country, and people have the right to express themselves as they see fit.

That being said, she, like all other doctors, has professional responsibilities, and they are being monitored on a daily basis by the college and by the ministry. In spite of the difficulties, it is working. As we are coming, I hope, closer and closer to a conclusion on this matter, I ask my honourable friend not to inflame the situation more than it already is.

Mr. Rae: I did not say this; it is this doctor who said it. The public is entitled to know the kind of outrageous and completely unacceptable remarks that are being made almost as a matter of course after an organized political meeting.

1:20 p.m.

Let me quote further: "Asked specifically, `Will people die?' `I hope not, but they may have to,' said Dr. Atkinson." This was said by a professional licensed by the College of Physicians and Surgeons of Ontario to practise medicine, a trust that is given under the laws of this province. She is saying quite openly that patients may have to die for the cause of the doctors continuing to extra bill and continuing to take actions against the government of the province.

Further to statements made yesterday, Dr. Gary Willard, the former chief of surgery at the Etobicoke General Hospital -- that is the hospital where a doctor who tried to practise had his office Krazy-Glued by some of his colleagues -- said, "If one doctor is disciplined" -- presumably by the college of physicians and surgeons -- "then hospitals will close, because there would not be any doctors prepared to work at them."

I would like to ask the Premier what plans he has, not to deal with some hypothetical situation but to deal with very real threats and statements that are being made by doctors who have occupied positions of authority within our public hospital system and within our health care system? What plans does he have to ensure that we will return the health care system to the people whom it really belongs to -- the people of this province, not these extremists who are making self-serving comments?

Mr. Speaker: Order.

Hon. Mr. Peterson: If the honourable member's point was that the Krazy Glue would better be applied to some people's mouths than to door locks, I probably would not disagree with him in the circumstances.

It is a country where people say what they want to say. The responsibility of the college is with respect to how they conduct themselves professionally in fulfilling their professional responsibility. I do not think it would be constructive for me or the minister to threaten them or anyone else.

We are watching the provision of medical services. It is still going on in very strained circumstances, but I cannot help my friend any more than that.

Mr. Rae: It is not simply what doctors are saying in instances such as this; it is what doctors are doing and what they are not doing. That is what is at stake here. It is not simply the idle comments that are made; it is what is being done for patients.

I would like to ask the Premier again, because I do not think he has answered the question. What plans does he have to address the denial of services to people who have come to expect those services in this province and who need those services? They are not merely being inconvenienced but in many cases they are being put into situations that are threatening and excessively risky. At least the Premier will agree with that.

Yesterday we all received a warning with respect to events at one hospital in this province. For God's sake, let that be a warning and not the precursor of something else that might and could happen unless the government is prepared to act and take the steps that will ensure that the health care system is returned to the people, who are the real beneficiaries of the system and not any one self-interested party who works in that system.

What plans does the Premier have to ensure that doctors stop holding patients to ransom in this province?

Mr. Speaker: Order.

Hon. Mr. Peterson: My honourable friend knows my concern is to get this bill passed as quickly as possible in this House. We are going to need the co-operation of all members to do so; then my concern obviously is to try to pick up the pieces from a very difficult situation. The doctors have raised some concerns. We are going to try to address those. At the same time, they have to recognize their professional responsibilities.

I say to my friend, if he is asking me to issue threats or to speculate on what we may or may not do in some situations where he feels someone is violating his professional responsibilities, I do not think that is constructive towards the two goals I have just shared with him. I am not prepared to speculate about that. I am not prepared to threaten. It is the responsibility of all of us to try to pick up the pieces. We will be working on that in the long term.

SOUTH AFRICAN INVESTMENTS

Mr. Rae: I want to ask the Premier some questions again about Ontario's and Canada's relationship to South Africa, and the government's relationship to South Africa.

I am sure he will have been advised of this morning's press reports with respect to South African liquor and the intention of the Canadian agent for South African Paarl wines, Sainsbury and Co., to organize a large shipment of these wines for sale in Ontario by placing a private order through the Liquor Control Board of Ontario. Does the Premier intend to allow this private order to be placed?

Hon. Mr. Peterson: I was not aware of the situation until I read that article today. I checked the situation. In the past, I gather, people were piggybacking private orders on the large LCBO orders being placed; that was the previous way the system worked. I looked at the situation. It looks as if somebody, whoever it is, is trying to exploit a loophole. There will be no loopholes; that will not be allowed. We will prevent it. Whoever did issue the instructions this morning, that fiddling around will not be allowed.

Mr. Rae: I am delighted to hear that.

Can the Premier tell us what plans the government has to deal with the five Ontario-based corporations specifically named by Commissioner Hart yesterday in his first report to the Parliament of Canada? The Premier will be aware that those five companies have been named; they are Bata, Massey-Ferguson, Dominion Textile, Moore Corp. and Falconbridge. They were all named specifically because they were paying lower wages than was regarded as fair even according to South African standards.

Bata has a contract with the Ministry of Community and Social Services. Dominion Textile has a large contract with the Ministry of Correctional Services. Moore Corp., as a supplier of business forms, has many different contracts, at least one of them with the Ministry of the Attorney General. Does the Premier intend to sit down and discuss with these companies their basic choice: either clean up their act or no longer deal with the government of Ontario?

Hon. Mr. Peterson: I have not had a chance to see that report of Commissioner Hart's, but I was generally aware of it. The member could have added in his question that the taxpayers of this province are shareholders in Massey-Ferguson. We have conveyed our views, as shareholders and as the government, to the management of Massey-Ferguson in this regard, and those views will be brought up at the shareholders' meeting.

I will certainly analyse the facts brought forward by my honourable friend. We will look at the companies named and what business they are doing and see where we can exert our influence. We are looking now at canvassing ways to make sure that the will and views of this government are reflected in its transfer agencies and other groups it deals with.

Mr. Laughren: Let me help the Premier in his deliberations. Since Falconbridge is one of the companies and since Falconbridge now receives from his cabinet an exemption from the processing requirements of the Mining Act, will the Premier make a commitment to end those processing exemptions to Falconbridge so that, rather than shipping its ores to Norway, it simply must process them at source here in Ontario and thus put some teeth into the sanctions against apartheid in South Africa?

Hon. Mr. Peterson: I have sat in this House with my honourable friend for more than 10 years now, and he makes that point about Falconbridge and the processing allowance regularly each week or two. He put a new twist on it today, and it is an interesting new wrinkle on the suggestions he has made in the past. As I told the member's esteemed leader, we will look at how we are dealing with the situation and at how we can bring our moral influence to bear on the situation.

1:30 p.m.

EXTRA BILLING

Mr. Pope: The Premier today three times has used the phrase "pick up the pieces" and in so doing has admitted the health care system has been torn apart to the detriment of the people of Ontario by this dispute. Can the Premier tell me and my constituents in the riding of Cochrane South why he will not appoint a mediator when he knows the appointment of a mediator will end this tragic strike?

Hon. Mr. Peterson: We both recognize that there are some people of strong views who are upset about what we are doing; that is quite obvious. Our intention is to work with the medical profession, because we have so much in common with it, in a determination to solve our problems in the long term. The member has asked a question that was asked by his leader three or four times today, yesterday and the day before. There is not much I can add to the answer I gave him.

Mr. Pope: The people of my riding of Cochrane South do not believe the passage of Bill 94 will end the strike. They are worried. They feel the strike will escalate. Does the Premier not understand that his refusal to appoint a mediator is not acceptable to the people of Cochrane South, whom I represent, who are no longer receiving adequate medical care?

Hon. Mr. Peterson: I appreciate my honourable friend's assessment of the view of the people of Cochrane South. There is no better person to interpret their feelings than he. I know a number of people from Cochrane South who have a different view from that of the member, so he does not speak for everyone when he puts that view to the House. I admit there is a difference of opinion about this. I have expressed my views to my friend very clearly.

SOUTH AFRICAN INVESTMENTS

Mr. Foulds: I would like to put a question to the Premier about South Africa and Ontario's relations with it. The Premier stood in his place on May 30 and told Bishop Desmond Tutu that the problem of South Africa is "one of the most troubling issues of our time."

Yesterday, the United States House of Representatives passed a very strong bill advocating sanctions against South Africa. Yesterday, the federal government released a report indicating that three companies with which the government of Ontario does direct business by purchasing from them violate even Canada's weak code of conduct. Yesterday, at great risk to himself, from inside South Africa, Bishop Tutu called for sanctions by the international community. When will the Premier live up to his words given to Bishop Desmond Tutu in this House on May 30?

Hon. Mr. Peterson: I understand the honourable member's deep belief in what he is putting to me, because I share a number of his views and his very passionate commitment. I want to remind the member that this government moved way ahead of a lot of other governments. It is becoming very fashionable now, but we made the moves when they were tough. We provided leadership to a lot of the people who now are starting to recognize that leadership. It is all very well for the member to stand up and say that, but we were there at a far more critical time than now, when it was less popular to do what this government did and had the courage to do. My friend should stand up and acknowledge that.

I have discussed some of the additional moves we are taking with the member's leader. I have not had a chance to analyse yesterday's report, but we take it seriously. We will be looking at our relationship with those people and asking ourselves what we can do to make our view felt, not just there, but with our transfer agents as well.

Mr. Foulds: When the going gets tough, the tough get going, and the going is very tough in South Africa today. The Premier is doing absolutely nothing to help the cause in South Africa today. Last September, the Treasurer (Mr. Nixon) told the Brantford Kiwanis Club that the government earns more than $9 million on South African products and that this "kind of markup would bring a smile to any businessman's face." When will the Premier stop smiling about the blood money the Liquor Control Board of Ontario earns and put that money into a fund to help the cause of anti-apartheid in this province and throughout the world?

Hon. Mr. Peterson: I appreciate my friend's view, but his rhetoric is getting a little overblown. It was this government that invited Bishop Tutu to speak here. The bishop told me that one of the most important things we could do was to give him the legitimacy of speaking in our Legislature. He was very grateful and appreciated that. We provided leadership long before the member brought these matters up in this House. I am not questioning his sincerity. The member is quite entitled to make all the speeches he wants. We are moving on these matters and we have been moving on them for a long time. There are many objective observers around the world who have a great deal of respect for the leadership this government has provided in this matter.

EXTRA BILLING

Mr. Brandt: My question is for the Premier, who is having a busy day.

Hon. Mr. Peterson: I am glad I came today.

Mr. Brandt: We reset the time just to make sure he was going to be here today.

Surely the Premier is aware that the level of anger, hostility and bitterness in the medical community is the highest it has ever been in the history of this province. Recognizing that one phone call from him to indicate he will appoint a mediator will end this strike virtually instantaneously, will the Premier agree to our appeal to appoint a mediator to resolve this issue today?

Hon. Mr. Peterson: I have answered this question many times. I wish the honourable member would use the phone to make his point a little more poignantly. Why does he not send the phone over to me? I will keep it for sure this time.

Mr. Brandt: The Premier will not send it back; that is why.

Hon. Mr. Peterson: We sent it back because it had to be returned that night to Motorola. That is why. He said, "Oh, it is not my phone. Please give it back to me so I can give it back to my friends," so we sent it back to him. I am glad to see it here every day. It reminds me I should have kept it.

I have answered that question to the member's leader, the member for Cochrane South (Mr. Pope) and many others. My honourable friend may not agree with me or may not understand the point, but if he really thinks this is a matter of one phone call, he has sorely misjudged a very complicated discussion that has gone on for a year.

Mr. Leluk: Appoint a mediator.

Hon. Mr. Peterson: He should stand up and ask me to back off. If he is asking me to back off, the answer to my friend is no.

Mr. Brandt: I suggest the Premier has sorely misjudged this issue. If he thinks that by pressing on with Bill 94, all is going to be well the day after that bill is passed -- if, in fact, it is passed -- he is sorely misjudging the people of this province.

Will the Premier indicate to my constituents in the community of Sarnia why he will not appoint a mediator, recognizing that the day this mediator is appointed, health services in this province will again be restored to a level somewhat in line with what we have come to expect in Ontario?

Hon. Mr. Peterson: I am answering the same question again, but I will happily answer it again to my honourable friend. It is because one cannot mediate the situation that has presented itself. It is that simple.

Mr. Brandt: How does the Premier know if he does not try?

Hon. Mr. Peterson: Let me tell the member the situation. One cannot mediate the Canada Health Act. It is that simple.

The member has characterized the Tory view for 42 years: because there is a little resistance, back off and avoid the problem. That is his view and I respect that. The Tories did reasonably well for 42 years in avoiding these kinds of things. We have told the people of this province where we stand; it should come as no surprise to the member. We are doing what we said we would do. We are conforming with the law of the land. That is what we are doing.

I am sure my honourable friend, like myself, has had a number of difficulties in life; we have had lots of people who disagreed with us. But I am sure my honourable friend has not achieved his high status in life just by blowing like a reed with every little breeze that comes along.

He knows where we stand. It has happened in almost every other province. Surely he is not surprised about this situation.

Interjections.

Mr. Speaker: Perhaps the Attorney General (Mr. Scott) and the member for York Mills (Miss Stephenson) would discontinue their discussion.

Once again, I will remind the members that you are wasting the time of other members who wish to ask questions.

1:40 p.m.

FREE TRADE

Mr. Mackenzie: I have a question for the Premier. Can he tell the House which wing of the Liberal Party he belongs to, the Lloyd Axworthy-John Turner wing, which is increasingly concerned about the free trade talks going on, or the Donald Johnston-Michel Robert-Donald Macdonald wing, which seems to favour such talks?

Why did his provincial government give away access to the security industry to the Americans without anything in return? This is a move comparable to the Tories giving away the Foreign Investment Review Agency, the national energy program or cruise missile testing when they could have used them as bargaining chips?

Hon. Mr. Peterson: First, I want to say how delighted I am that I showed up at one o'clock today. In response to my friend, I cannot speak for the various wings of the federal Liberal Party which he defines. The member knows where we stand on some of these issues.

Mr. Foulds: It is becoming increasingly difficult to ascertain.

Mr. Speaker: Order.

Hon. Mr. Peterson: I was listening to Ed Broadbent the other day. He is now in favour of sectoral free trade arrangements. It is tough to know any more. Let me ask the member, is he on Ian Deans's side or Ed Broadbent's side of the great free trade debate? I have no idea. I think the question was about reregulation of the securities industry and my friend is concerned that perhaps we should not have done it. That is not in any way related to those discussions. It is a move to make our securities industry more competitive internationally. The securities industry does not belong to the United States any more than it belongs to Tokyo, London, Geneva or Toronto. It is all of those places and it is moving fast.

What we have done by moving on deregulation of the industry is to allow our financial industries to be world-class so we can build a bright future in this province. That is what we have done.

Mr. Mackenzie: Peter Murphy, the US negotiator, has made it very clear that the auto pact is on the table in comprehensive negotiations. The Prime Minister of this country is either so badly briefed or deliberately wrong that he equates the auto pact with free trade. Given the devastation that could result from the loss of jobs if there are changes in the auto pact arrangement with the US as a result of free trade talks, can the Premier not now see the advisability of doing away with these comprehensive talks and maybe taking a look at whether we should look at issues sector by sector?

Hon. Mr. Peterson: I appreciate my honourable friend's advancing the new position of the New Democratic Party on this matter. I always like to keep up in these situations. The member should never put me in a position in this House where I have to defend Peter Murphy or the Prime Minister in this regard because I have no idea what they are doing, what they are saying or what they mean that particular day.

As the member knows, I have put the importance of the auto pact to the Prime Minister in very forceful terms. I was delighted that he recognized the importance of that document. The member will note that in his speech the other night, when he said these discussions were like creating the auto pact, he said it was such a wonderful thing and that the progressives of the day were denounced by the nay-sayers, the NDP and Conservatives of the day, which is an interesting story because he thought it was a Conservative initiative, but it was really a Liberal initiative that served this country very well.

I do not know what those guys are saying today or yesterday, but my position is clear and constant and it will continue to be. We are going to protect those auto workers and I know the member will help me in that job.

EXTRA BILLING

Mr. Baetz: My question is also for the Premier.

Hon. Mr. Peterson: Give me a break.

Hon. Mr. Conway: This is your day.

Mr. Baetz: This is Premier's Day. We appreciate his being here and we hope we will eventually get a good answer from him.

Could the Premier please tell the people in the riding of Ottawa West, my riding, why he will not appoint a mediator when he surely must know that such an appointment will end this tragic strike?

Hon. Mr. Peterson: I appreciate the thoughtfully worded question my friend has put to me. What do they do? Do they pass around a slip and just change the names of the ridings on it? Is that how it works over there?

I am going to Ottawa this afternoon, and that is why I appreciate very much your being here a little early to accommodate that, because we are going to share with the people of Ottawa a major new commitment to health care in that great community. We are going to continue our fight for quality medical care for everyone, as I did yesterday in Scarborough. The member for York Mills (Miss Stephenson) was there and she was excited by the major new contribution. It had been started by her government, but we are very proud of it. They even put a former member's name on the door just to make sure nobody forgot. Margaret Birch's name is there.

Miss Stephenson: Was there another doctor there? Tell the truth.

Mr. Speaker: Order.

Miss Stephenson: Not one.

Hon. Mr. Peterson: I do not know if any good doctors came, no.

Mr. Speaker: Order. No one was listening to the answer.

Mr. O'Connor: What answer?

Mr. Speaker: Order.

Mr. Baetz: In view of the fact there is now a very clear consensus among the people in Ottawa West -- in fact all of Ottawa-Carleton, as the Premier will establish this afternoon when he goes there to dedicate the program we began -- that the best way to end this strike is not by a forced and arbitrary passage of Bill 94 but by the appointment of a mediator, why does the Premier continue to refuse to recognize and accept this collective wisdom of the people of Ottawa-Carleton and stubbornly refuse to appoint a mediator?

Ms. Gigantes: On a point of personal privilege, Mr. Speaker: This member purports to speak for the people of Ottawa-Carleton in reporting a consensus when it is only a foolish notion that the bill should not go ahead. He does not speak for people in Ottawa Centre or --

Interjections.

Mr. Speaker: Order. I believe you finished your supplementary.

Mr. Baetz: I was interrupted. Why does the Premier refuse to recognize and accept the collective wisdom of the people of Ottawa West and stubbornly refused to appoint a mediator? Why does he go against the collective wisdom of the people when he is the champion of open government?

Hon. Mr. Peterson: It is very curious that the people of Ottawa West are all of one view and the people of Ottawa Centre are all of another view.

Ms. Gigantes: Ottawa West people have called me and said, "Pass the bill."

Hon. Mr. Peterson: Ottawa West people are calling the member for Ottawa Centre and saying they disagree with the member for Ottawa West.

I think we have answered this, but I am going to Ottawa this afternoon and I invite the member to come with me. I will be leaving in about 15 minutes. We can go up and discuss this matter with the people of Ottawa West and we can both form our own conclusions about what they really think. I am prepared to go to Ottawa West, or Ottawa anywhere, or anywhere else in this province to tell the people where we stand on this issue. That is why I do not agree with the member's assessment of how they are feeling at this moment.

OCCUPATIONAL HEALTH AND SAFETY

Mr. Martel: I have a question of the Minister of Labour regarding the death on June 16 of Hector Goulard, a 36-year-old miner who was killed at Strathcona mine as a result of ground control problems.

The minister will recall that June 20 was the anniversary of the deaths of four miners at Falconbridge two years ago. The government established the Stevenson commission, which reported back in February. People thought there would be some action. To our knowledge, to this time not one recommendation has been adopted. Can the minister tell us when he will put some substance to the words he has been spouting about the Stevenson commission since it reported, when there has been no substance to this date?

Hon. Mr. Wrye: I share with the honourable member genuine sadness at the tragic death of Mr. Goulard on Monday of this week. A full investigation of that tragedy at Falconbridge, at the Strathcona mine, is still under way.

I was in the member's community yesterday, as he probably knows, and spoke to the Mine, Mill local. I also had an opportunity to speak with the president of Local 6500 of the United Steelworkers and I indicated to him that we are accelerating our activity and our review of the substantial and troubling increase in the number of rockbursts, particularly at Inco.

As far as the review of the ground control and emergency preparedness report is concerned, we are about ready to move. We have been reviewing it thoroughly and we are about ready to move on activities. The very first thing we will do, and we are doing this right now, is to move towards getting additional ground control engineers. As the member knows, there are only two in the north now. We agree with the Stevenson report that is inadequate and I give the member a commitment that we are moving as quickly as possible on that.

1:50 p.m.

Mr. Martel: I am sure the minister is aware that in the past 20 years 82 miners have lost their lives from ground control problems. In the past year alone, there were 106 rockbursts in Ontario. I appreciate that the minister is going to hire more engineers. Will he use his good offices to convince his colleague, the minister responsible, that the school concerning rockbursts that has been advocated by Cambrian College should go to Sudbury rather than falling into the trap of allowing the University of Toronto or Queen's University to get that type of facility when they do not even have a rock in their backyard? Can he guarantee that the school is going to be established in the Sudbury area by next fall?

Hon. Mr. Wrye: I am not in a position to give guarantees on behalf of my colleagues. I recognize the member's concern and, more particularly, I recognize his deep concern.

Mr. McClellan: Take the money from the Industrial Accident Prevention Association and put it into the school. I know where the minister can get $14 million.

Hon. Mr. Wrye: In spite of what my friend the member for Bellwoods says, it is properly placed in terms of rockburst activities. I was speaking to the president of Local 6500 of the Steelworkers' union about the whole issue of rockbursting and what he considers to have been some near tragedies. As the president of Local 6500 said, I, as well, do not want to be lucky in terms of rockbursting. I want to ensure that absolutely everything is being done to protect the miners of northern Ontario -- indeed all the miners of Ontario -- from the kinds of dangers that can lead to tragedy, which we have seen all too often in our province.

EXTRA BILLING

Mr. Partington: My question is for the Premier. I have a copy of a letter dated June 13, addressed to the Premier and signed by George Goldford, chairman of the board of governors of the St. Catharines General Hospital, in which he states, "It is time to bring a mediator into the dispute and I am urging you to take this step immediately." This board is charged with a major part of health care delivery in St. Catharines. Will the minister listen to the board's call and appoint a mediator and end this dispute before he destroys the very health system he claims to be protecting?

Hon. Mr. Peterson: I am sorry that I have not seen the letter. It may be in my office. I am sure the member can appreciate that we are getting a lot of mail these days. Will the member be so kind as to convey to the chairman of the board that I appreciate his advice very much? Perhaps the member will describe the position this government is taking in the matter. I am sure he will understand the reasons after they are conveyed to him.

Mrs. Marland: Since the Premier has said this afternoon that he is very much aware of the opinion of the leader of the Progressive Conservative Party, why is he not aware of the opinion and needs of the people of Ontario, and in particular of those of the more than one million people who reside in the regions of Peel, Halton and Niagara? These people know that the passing of Bill 94 will be equated with putting gasoline on a fire and they are as concerned as the board of governors of the Credit Valley Hospital who have also asked the Premier to appoint a mediator. Will he now meet that request?

Hon. Mr. Peterson: I appreciate the member's view. As I said, we are not prepared to withdraw the bill if that is what my colleague is suggesting. What shall I mediate? Will she go ahead and pass the bill? Why does she not go ahead and help us to discuss and pass the bill in the House? We will then sit down properly with the medical profession and discuss and work out any issue it wants to discuss. However, if she is asking me to withdraw the bill -- the member is shaking her head; I have no idea whether she means by that she is in favour of withdrawing the bill or not. We are not going to withdraw the bill. If she can convey that to the people of Halton, Burlington, Peel and Niagara I will be very grateful.

SINGLE-INDUSTRY COMMUNITIES

Mr. Morin-Strom: I have a question for the Premier in regard to an important recommendation from the Rosehart committee report on resource-dependent communities that relates specifically to the Premier's stated support for the development of new technology in Ontario. To be clear, the recommendation states: "That there be established in the north a northern technology research and development institution to provide technical support for northern development initiatives. It is suggested that such an institute would have a close working relationship with the Ontario Research Foundation and that the work done have direct benefit to the development of secondary manufacturing in the north."

Does the Premier support this recommendation, and if so, when will it be implemented by his government?

Hon. Mr. Peterson: The Rosehart report was a first-rate piece of work. I congratulate all the members who participated in that. A number of very far reaching --

Interjection.

Hon. Mr. Peterson: My friend the member for Kenora (Mr. Bernier) is telling me there are 80 recommendations and we have done nothing. Can one imagine that guy saying to me that we have done nothing about the north? That guy is the reason we needed the Rosehart report. There is the single walking disaster. There is an example of why we should never ever give one man too much power. He fouls it all up.

Mr. Speaker: Order.

Hon. Mr. Peterson: We have been picking up the pieces for his shortsightedness since we came over here. I do not want to be personal, but he is the last person in this House who is qualified on northern issues.

Interjections.

Mr. Speaker: Order. Once again, I tell the members that I will just wait. The time is going on. Members are wasting the time of other members.

Mr. Morin-Strom: I sympathize with the Premier's sentiments in that regard, but I do not think he addressed the question I asked. I asked about the northern research and development institute that was proposed for northern Ontario to support technological development in the north. Will the Premier support that recommendation so we see that technology is developed in northern Ontario that will support the development of secondary industries that will enable us fully to utilize our resource potential and also the people potential we have in northern Ontario?

Hon. Mr. Peterson: It is a very reasonable suggestion. I apologize that my friend the member for Kenora started getting unruly over there and disrupting the House again.

We are analysing all of those recommendations and are hoping to make a response in the very near future, in a week or two or three, in that time frame. A number of those things will be addressed.

As the member knows, we need short-term as well as long-term responses. Like the member, we are interested in addressing some of the structural problems that exist there, including the infrastructure with respect to education, technology and technology transfers.

Interjections.

Mr. Speaker: Order.

Hon. Mr. Peterson: I appreciate my honourable friend's concern. He will see that we will be addressing those things.

Interjections.

Mr. Speaker: Order. All interjections are out of order. I will wait.

CRIMINAL CODE

Mr. Callahan: My question is for the Minister of Consumer and Commercial Relations. Was Ontario consulted by Mr. Crosbie in determining the proposed amendments to the Criminal Code dealing with obscenity and pornography?

Interjections.

Mr. Speaker: Order.

Hon. Mr. Kwinter: It is my understanding that the Ministry of the Attorney General was in consultation with the federal minister and made representations and suggestions that were incorporated in the government's recommendations.

Mr. Callahan: Assuming these amendments are passed, what effect, if any, will that have on the present censor board, the Ontario Film Review Board?

Hon. Mr. Kwinter: We have generally been supportive of the recommendations with one exception, and that exception is a relatively broad basket clause that describes activities in a very broad sense. We feel there has to be some narrower definition. Otherwise, it will be very difficult for the film review board to function, because it will not be able to identify what is meant by that.

ALCOHOL TREATMENT CENTRE

Mr. Villeneuve: I sent a note to the Minister of Health last Tuesday regarding the Mount Carmel House Treatment Centre. I am still awaiting a reply. Will the minister let this alcohol treatment centre close down? It was not able to meet its payroll last Thursday. Is the minister going to let it close down, or will he give it some help?

Hon. Mr. Elston: Under the auspices of the member for Prescott-Russell (Mr. Poirier), the honourable member and I made interventions near the end of our fiscal year in March, and we have already given help to Mount Carmel House by providing more than $30,000 to assist it at that stage. It is on the list for funding, having been reviewed by the district health council in the area. We are looking at that possibility.

The member's letter, dated June 11, said the centre could not meet its payroll on June 12. That did not give me much time to react to the situation. The member for Cornwall (Mr. Guindon) has also been in touch with me, and I can tell the members of the public that each of the members in the area, the questioner, the member for Cornwall and the member for Prescott-Russell, have expressed their concern about this project, and the district health council's review of this matter is extremely important to all of us.

2:02 p.m.

MEMBERS' STATEMENTS

EXTRA BILLING

Mr. Jackson: On June 17, the emergency department of Joseph Brant Memorial Hospital was closed for the first time in its 25-year history. It was closed because many of the doctors in Burlington saw no choice. They do not want to withdraw their services but have been forced into it by a government that refuses to negotiate or accept mediation.

When I learned of the plans to close Joseph Brant's emergency department, I immediately arranged for volunteers to come to my constituency office for the day to help handle the telephones. Each one was provided with lists of treatment facilities that would be open, and each was made aware of what to do in cases of calls from people seeking medical attention who did not know where to turn. Emergency numbers were kept at hand so that quick telephone service could be provided.

We did that because in Burlington South, health care is considered too important to be shrugged off with a wink and smile as the Premier (Mr. Peterson) did in the Legislature on Monday. My staff was also asked to listen carefully to the concerns expressed by citizens who called, to answer questions if asked but not to push a point of view, and certainly not to hang up on people as we have learned the Premier's office did.

Not everyone in Burlington South may agree with my position, but I am not afraid to listen to them on this issue, as the Premier evidently is. The calls in my office were not unanimous, but about 82 per cent of them had a message they wanted to send to the government. It is up to the Premier to please call in a mediator. Let us get our health care system working again.

SOUTH AFRICAN INVESTMENTS

Mr. Foulds: In this province today, we are facing a crisis in our health care system brought on by the deliberate and provocative acts of some members of the Ontario Medical Association. However, in my statement today I would like to focus on a different crisis; that is, the international crisis in South Africa.

Let us for one minute set aside our parochial interests, important though they may be, and contemplate our responsibilities as part of the brotherhood of man. This morning, I tabled a resolution outlining seven positive concrete actions that this government, the Premier (Mr. Peterson) and his Liberal colleagues could take to influence the course of events in South Africa.

I remind the government of what the Premier said to Bishop Desmond Tutu when he visited here on May 30. I take it to be a solemn commitment. The Premier said the problem of South Africa was one of the most troubling issues of our times. I ask the Premier to live up to that commitment. I ask him to stop doing business with companies that are doing business with the government of and trade with South Africa.

I ask him to support the tough resolution that I introduced on Orders and Notices this morning. If he is unable to do that, I ask him at least to put the profit for the past year from the sale of South African liquor into a fund that would fight apartheid.

EXTRA BILLING

Mr. Cordiano: I would like to make a few comments regarding the opposition's performance -- and I do mean performance -- in this House over the past few days. Telephone calls and other gimmicks do nothing to advance the debate in this House on the important issue of extra billing.

I cannot understand how the Leader of the Opposition (Mr. Grossman) can stand in his place, as he did yesterday, and profess to care about Ontarians and that Ontarians may be affected by partial withdrawal of health services by some doctors. How can members of the opposition profess to care about the best interests of their constituents when they state publicly that they are willing to preen and posture -- that is what they are doing, preening and posturing for days on end -- to bring the democratic process to a halt?

Despite this, it is still not clear where the Leader of the Opposition and his party stand on this issue. Are they in favour of extra billing or are they against it? Where do they stand? We truly wonder in whose interests is the Leader of the Opposition speaking. It is not clear. It is not in the best interests of the patients of this province.

Interjections.

Mr. Speaker: Order. I remind all members that this is a time for members' statements. Please show respect to the other members.

ALZHEIMER'S DISEASE

Mr. McLean: I would like to make the Legislative Assembly aware that in Simcoe East we have the staff and the facilities to deal with a very serious affliction that affects 93,000 middle-aged Ontario residents. Alzheimer's disease, as members know, is a disorder of the brain that causes loss of memory and serious mental deterioration over a period of two to 20 years.

As well as the 93,000 residents of this province who suffer its effects, 300,000 Canadians are affected, which will give members an idea of how widespread this problem is. In the riding of Simcoe East, we have the Huronia Regional Centre. Within this organization are the facilities and staff to deal with patients suffering from Alzheimer's disease.

This is a serious affliction, as one can imagine. It is devastating not only to the victims but to their families as well. Today it is not a treatable disease, and considerable research is required to get to the actual cause. Medical care and proper guidance can assist the person and the family in coping with this incapacitating illness.

I urge the minister to consider making use of the facilities at the Huronia Regional Centre as a care centre for those suffering from Alzheimer's.

EXTRA BILLING

Mr. Hayes: I have a statement about extra billing. I want to remind members of the House of the reason Bill 94 was introduced. It was to protect patients from being charged by their opted-out doctors at higher rates than they will be reimbursed by our health insurance plan.

Bill 94 was intended to protect people such as one of my constituents, whose name I do not have permission to use because of fear that the doctor will not agree to continue to perform needed surgery. The constituent received a bill for $2,500 but was reimbursed just over $1,300 by the Ontario health insurance plan.

In this case, the doctor's bill for $2,500 carried a notation that OHIP would repay approximately $1,825, meaning the patient's family would have to pay an extra bill of $675. However, it turns out the submitted fee was $1,825, of which OHIP's schedule of benefits provides only $1,303.50. My constituent is faced with an extra bill of $1,196.50.

Bill 94 is about stopping the doctors of Ontario of Ontario from sticking it to the patients with extra bills.

FAMILIES FOR CHILDREN

Mr. Reycraft: Today I would like to pay tribute to the outstanding achievement of the Families for Children organization. Families for Children was founded in 1971 by two Canadian housewives. The organization helps to care for orphans who have been abandoned, who are ill or who have been abused and to find families for them. It also operates seven homes for orphans in three Third World countries.

On June 21, this Saturday, Families for Children will be holding its House of Hope auction in the Middlesex village of Dorchester. Since the sod-turning ceremony there on November 2, 1985, numerous volunteers have worked tirelessly throughout the winter to construct, furnish and landscape this beautiful home in the Vista Woods Estates of Dorchester.

In particular, I would especially like to mention Chris and Charlene Rijnen of Dorchester, who not only donated the lot but, along with Audrey Timmerman of London, have also spearheaded this project. The house is now complete, with furnishings added for good measure, all donated by area tradesmen.

Families for Children expects to raise $150,000 from the auction. The money will be used to build a children's village or complex in Podanur, India, for orphans. I believe this is an exemplary example of the spirit of our rural communities. The dedication, generosity and commitment that have been demonstrated are truly worthy of special recognition by this House.

Mr. Speaker: I recognize the member for Durham-York for 30 seconds.

EXTRA BILLING

Mr. Stevenson: I will use Durham region as a classic example of how the handling of Bill 94 has destroyed a good health care system in Ontario. In Durham region, two doctors out of several hundred are opted out. Yesterday, the emergency area of the Port Perry hospital was closed. Those doctors have not extra billed ever and likely never will.

Mr. Speaker: The member's time has expired. That completes the allotted time for members' statements.

I remind the member for York Mills (Miss Stephenson) and the Attorney General (Mr. Scott) that question period expired quite some time ago.

2:13 p.m.

STATEMENTS BY THE MINISTRY AND RESPONSES

FOOD PRODUCERS AND PROCESSORS

Hon. Mr. Riddell: In keeping with this government's commitment to the agricultural industry --

Mr. Speaker: Order. Once again I will ask the members to refrain from their private conversations and to listen to what is being said in the House.

Hon. Mr. Riddell: In keeping with this government's commitment to the agricultural industry, I have two more programs to announce this afternoon.

As members know, Ontario agricultural producers and food processors have an excellent record of providing quality products for consumers both at home and abroad. To maintain and improve upon this record, Ontario producers and processors must keep up to date with the latest technological developments and discoveries.

I am pleased to inform the members of the House of two new programs that will help producers and processors employ the latest technologies in their efforts to provide quality products for sale to the consumer.

The first, the fruit and vegetable quality program, will assist fresh fruit and vegetable growers, packers and storage operators to buy capital equipment to enhance the quality of their products. The technology of storage is evolving quickly. The industry has been adapting to an increasingly competitive market by providing a steady supply of the best-quality products. This $6 million, three-year program will cover up to 40 per cent of the applicant's capital cost of storage, cooling and produce-conditioning equipment. The program will increase employment and benefit consumers by improving Ontario's ability to supply its markets with high-quality produce.

The second initiative, the Ontario small food processors assistance program, will help small food processors increase efficiency and expand facilities. This $6-million, four-year program will provide grants to help viable companies improve their access to market information, strengthen their business planning and invest in new technologies and facilities. This program will increase employment while also benefiting consumers by improving food quality, increasing the availability of Ontario-produced speciality products and increasing the supply of some products in smaller markets.

Quality in production and processing and quality for sale to the consumer are the emphases in these two measures to improve fruit and vegetable quality and to boost small Ontario processors. It is part of the continuing commitment of this government to the agricultural community and to the consumers of the good things that grow in Ontario.

Mr. Andrewes: I regret the Minister of Agriculture and Food is practising his shoot-and-run tactics again. Maybe he is embarrassed because basically the two programs he announced today are simply a continuation of the creative programs announced by previous Progressive Conservative governments, one in 1981 and the second, the small food processing program, in the spring of 1985. I am sure the industry will be pleased with this announcement. Those were creative programs. They were well received. I am delighted they have now been reintroduced as a result of the Liberal government finding itself following a brief hiatus.

It is interesting this is part of the new image of the Liberals now that they are solidly in office, or they assume so. They now take on all the benefits of previous governments and claim them as their own. However, I congratulate them on their wisdom.

Mr. Ramsay: It is a pleasure to stand up and comment on the statement made by the Minister of Agriculture and Food. I am a little disappointed he was not able to remain for the statement. In that seat, a minute ago, there was a similar view of the top of a head from my angle; I thought the minister was still there, but it was another member who has a bald head.

The minister may have missed some of the points of this good program he has brought in. The reason we need better-quality storage of fresh Ontario fruit and vegetables is to enhance a program of import replacement. I do not know why he did not make that point; it should be made. Not only would the produce be in better shape but also we could rely more on indigenously grown produce rather than importing from other countries. This is pertinent because many of the apples and grapes we have come from Chile and South Africa. It is more important than ever to rely on Ontario-produced food.

MINIMUM WAGE

Hon. Mr. Wrye: I am pleased to announce today a revision in Ontario's general minimum wage from the current level of $4 per hour to $4.35 per hour. This change will take effect on October 1. This is an increase of 8.75 per cent since the minimum wage was last revised in October 1984. It more than provides for past and anticipated increases in the cost of living and wages generally during that time.

The special minimum wages for liquor servers, students under 18 years of age, hunting guides, learners and domestics will also be revised by 35 cents an hour on the same date. The minimum wage for harvest workers will be raised by 35 cents, to take effect on January 1, 1987.

Our review indicates the special minimum wages for construction workers and site guards and the weekly minimum for ambulance service workers have no meaningful role and are little used. These minimum wages are being revoked, and the employees covered by them will be subject to the general minimum wage.

Employers of domestics are currently permitted to charge a maximum of $55 weekly against minimum wage earnings for room and meals, while employers in industry generally are allowed $4 per week less. This higher charge is inequitable to domestics, and I am thus standardizing the maximum room and meal allowance at $55 per week, applicable to all minimum wage earners.

In addition, legitimate concerns have been brought to my attention about inequities in the current provision which permits an employer to deduct the full amount of the room allowance regardless of whether the employee is given a private room or shared accommodation. Therefore, $20 of the $55 weekly allowance will be permitted as a room deduction only if the minimum wage worker is provided with a private room. A new maximum room allowance of $10 per week is being introduced to be applicable in instances where the live-in employee is not supplied with private accommodation.

Finally, I wish to announce that the level of the minimum wage will be reviewed annually. Any changes will take effect on October 1 for workers generally and on January 1 for harvest workers. This will help to remedy past deficiencies where long intervals between revisions resulted in a progressive erosion of purchasing power of minimum wage earners. We have consulted on this matter with employer representatives. We recognize their need to remain competitive interprovincially and internationally, and they have not objected to a more predictable, more regular system of minimum wage revision.

I also wish to inform the House at this time that my colleague the Honourable Pierre Paradis, Minister of Labour of Quebec, has today announced an increase in the general minimum wage for that province similar to that of Ontario.

The minimum wage is a recognition that Ontario requires certain minimum standards of employment compensation. These standards must reflect the delicate balance we all recognize between the need for a competitive economy and the basic protection all workers are entitled to. The measures we propose today will preserve that balance.

Mr. Gillies: I am going to say a couple of heavily qualified positive things about the Minister of Labour's statement. Anyone who cannot stand it can cover his ears.

First, we were due for an increase in the minimum wage. The rate the minister is increasing it by is roughly the rate of inflation over two years and is probably appropriate. The minister will know I raised the question of the minimum wage with him in estimates last fall, and he said an increase was going to be announced in a number of weeks. This is indeed a number of weeks later; none the less, here it is.

The minister is probably right in announcing an increase, first, for October 1, which should not disrupt businesses that have planned an amount of money to hire students this summer, and second, for January 1, which in the case of harvest workers should not provide any unexpected hardship for farmers and the farm labour required in this harvesting year.

I am also pleased it is the minister's intention that this matter be reviewed annually. It is good for the business community to be able to plan ahead with some rough approximation of the increases it can expect on an annual basis.

There are those in the business community who, whenever there is an increase in the minimum wage, raise the concern that it will cost jobs and lead to unemployment. I am not one of those who believe that happens. As long as the increases are reasonable and are done on a periodic basis, they are appropriate and I welcome them.

Mr. Mackenzie: I would like to say to the Minister of Labour that workers are generally appreciative any time there is an increase in the minimum wage. The 35 cents an hour he has announced as of October does help. I wish to make it clear that it is appreciated.

I also want to make it clear that, unlike the Labour critic for the Conservative Party, I do not consider it adequate. The last increases that went through increased the workers' minimum wage by 14 per cent. In the previous period, there had been an increase of 24 per cent in cost of living alone; so they were already 10 per cent behind when they got the last increases.

I do know why we are waiting until October 1 to bring in this increase. I do not know why, whether it is tourism workers or harvest workers, they have to be shortchanged for another session of the House. The increase is nothing but catch-up and should have been considerably more. It also does not meet the minister's commitment that we would have indexing.

I grant him that having a yearly review is better than nothing, but for the last yearly review we had, the minister told us last summer he hoped to have the increase in the fall. It is coming the next fall. It took him one year to meet what he said in this House last July about getting an increase in the minimum wage. If we have that kind of review each year, then I pity the workers in their hopes to have an increase in one year's time.

The increase is certainly needed and long overdue, but it is not adequate in terms of the cost of living today. It amounts to a wage for a worker -- sometimes a worker who will work darned hard -- of $9,048 a year, considerably less than any standards we have for the poverty level in this country.

PUBLIC COMPLAINTS LEGISLATION

Hon. Mr. Scott: I have two statements on a connected matter.

Later today, I will introduce legislation which will permit the expansion of the office of the public complaints commissioner of Metropolitan Toronto into other parts of the province.

The Metropolitan Toronto Police Force Complaints Act has been a significant success since its establishment in 1981. The office, under the able leadership first of Sidney Linden and now of Judge Clare Lewis, has brought a new degree of openness and accountability to police discipline matters.

Members of the public in Metropolitan Toronto have the benefit of an outside, impartial review of the way in which their complaints about police misconduct are handled. At the same time, police officers against whom an improper allegation is made can be cleared in a process that is open, visible and credible to the public.

The legislation I will introduce today will make this important justice initiative available to municipalities that choose to opt in to it, subject to cabinet approval. The system in Metropolitan Toronto owes its origins to the request of the six mayors who were in office at that time, and we are satisfied that expansion should continue to take place on the same consensual basis that was the origin of its original success.

Accordingly, once the legislation is passed, any municipal council, subject to cabinet approval, will be able to elect to have the office of the public complaints commissioner exercise jurisdiction in respect of local complaints. The system will not be imposed on municipalities that are satisfied with the present method of responding to public complaints.

Under the proposed legislation, a local office of the public complaints commissioner would be established in each municipality that opted into the system. At that office, individuals from the community would file their complaints, and from it, investigators would oversee the investigation of complaints by the police force.

Investigations in the first instance would be conducted by a specially designated unit of the local force, as they are now, and decisions on appropriate action would be made by a designated senior officer.

Where residents were not satisfied with the resolution of their complaint by the local force, they could request a review by the public complaints commissioner. Following a review, if the commissioner determines the complaint should be heard by a board of inquiry, its members will be drawn from a panel established from the local region.

The costs of extension into each municipality will be shared by the province. At present, we pay 50 per cent of the costs of the operation in Metropolitan Toronto.

To ensure consistency, one individual will serve as commissioner for the entire province. Clare Lewis, who currently discharges this responsibility in Metropolitan Toronto, will assume the responsibilities of commissioner for all jurisdictions.

We believe the method outlined in the bill will provide consistency in policy and program activity while ensuring that local circumstances are taken into account in all cases.

I believe this is exceedingly important legislation. It exemplifies our commitment to providing practical and effective access to justice for everyone.

The second statement is with respect to an amendment to the present bill.

Today, I will introduce an additional bill which does not concern expansion but which amends the existing public complaints legislation.

The existing legislation contemplates that boards of inquiry, when required, will be drawn from a panel of persons appointed by the Lieutenant Governor in Council.

One third of the members of the panel are lawyers whose appointments have been jointly recommended by the Solicitor General and the Attorney General. Another third are individuals recommended by the council of the municipality of Metropolitan Toronto. The final third is required to be composed of individuals nominated jointly in writing by the Metropolitan Toronto Police Association and by the Metropolitan Board of Commissioners of Police.

Regrettably, since the new act was passed in 1984, the Metropolitan Toronto Police Association has refused to make appointments to the panel. This is so despite written requests from my predecessor, Roy McMurtry, and from me.

The existing law does not provide any recourse where one of the nominating bodies refuses to make a nomination.

The amendment I am proposing will provide that where the police association and the board of commissioners fail to make joint recommendations, the Attorney General and the Solicitor General may make the recommendations to the Lieutenant Governor in Council. In these circumstances, consideration will be given to any nominations that have been made by either the board or the association alone.

Should the Metropolitan Toronto council ever decline to make recommendations, which it has not done, the Solicitor General and Attorney General would have the same powers.

I regret very much that the intransigence of the Metropolitan Toronto Police Association has required this amendment. However, it is important to ensure that the legislation continues to operate. Therefore, I ask my colleagues on all sides of the House to provide its early passage.

Mr. O'Connor: In reply to the Attorney General, I might say we are delighted he has finally moved in an area where we have been urging him to take some steps for the past year. As early as last year's estimates, I am clearly on record as urging the Attorney General to expand the concept of a public complaints board beyond the boundaries of Metropolitan Toronto to the balance of the province. The Attorney General knows that very well.

We are delighted with the thrust. However, as I see it, there are two problems with the statement made by the Attorney General. The first is his reference to the option of municipalities and local forces to set up a complaints board, which would then be subject to cabinet approval; in other words, at the whim of the cabinet, which may or may not allow a municipality to establish its public complaints board. Why not give them the right outright to opt into a plan such as this? Why is it subject to cabinet approval? Is there some suspicion because there is no further indication herein that there are criteria that must be met or not met? The Attorney General indicates it is a matter of money. Of course it is a matter of money.

Second, the plan as proposed provides for local forces to continue investigating themselves. That is the difficulty we want to get around. The plan provides for a special unit of a local force; since some forces are very small, we will have friends investigating friends. Surely the purpose of a public complaints board is to avoid that suggestion and the suspicion of friends investigating friends. Why not bring one's complaint directly to the public complaints board, which is a much more satisfactory arrangement? One can have the investigations of other forces completed by the Ontario Provincial Police so there is not this apparent conflict.

Subject to amendment of the legislation in those two areas, we are delighted to see this initiative.

Mr. Warner: Regarding the Metropolitan Toronto Police Force Complaints Amendment Act, there are a couple of things in the announcement that were disappointing, although I certainly welcome the principle.

First, some mention should have been made of the person who pioneered this type of legislation in this assembly for many years: James Renwick, the former member for Riverdale.

Second, the minister is aware that the reason the police association does not participate is that, unfortunately, the process does not involve due process of law for the officer involved. Our bill had included that. As well, there is the basic principle that the police should not be investigating themselves when there are complaints.

I hope we can address these oversights when we get to deal with the bill.

Ms. Gigantes: We welcome the statement by the Attorney General, as my colleague the member for Scarborough-Ellesmere (Mr. Warner) suggested, to expand the police complaints commissioner mechanism across the province.

I am sure there will be questions during the course of discussion of this legislation about the application of the bill, whether we should be leaving it to municipalities to choose to come under the complaints commissioner process and, further, about the balance of the process itself and the questions that have been raised around it in Toronto during the past few years.

It is a process that has been far better than nothing, but it still raises a good many questions. Now we have a chance to review the balance of the structure, and we welcome that opportunity.

VISITORS

Mr. Shymko: On a point of privilege, Mr. Speaker: I know it will be embarrassing for you, but I am most honoured to welcome, in the Speaker's gallery, the charming wife of our Speaker and his family.

Mr. Speaker: I will look mad, as I have before.

PETITIONS

NATUROPATHY

Mr. Warner: I have a petition addressed to the Honourable the Lieutenant Governor and the Legislative Assembly of Ontario from Eric Shrubb, chairman of the board of directors of Drugless Therapy Naturopathy. The undersigned, some 40 constituents, beg leave to petition the parliament of Ontario as follows:

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

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

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

EXTRA BILLING

Mr. Hennessy: I have a petition from the Patients for Freedom in Medicine, a citizens' association founded on the principle of civil liberties.

"This association believes Bill 94, the Health Care Accessibility Act, is a violation of both patients' and physicians' civil liberties. If Bill 94 becomes law, doctors will be completely controlled by government and health care will be completely controlled by the government. This association believes medical care should be based on medical need, not determined by government budgets.

"As a citizen of Ontario, I do not agree with this legislation and request that Bill 94 be withdrawn."

ADULTS-ONLY APARTMENTS

Miss Stephenson: I have a petition I wish to present regarding Bill 7. It is addressed to the Premier (Mr. Peterson).

"While no one can argue against the need for family rental accommodation, there should be recognition of the rights of all tenants to choose their own lifestyle.

"We, the tenants of 745 and 755 York Mills Road, strongly oppose the provincial government's plan to abolish adults-only apartment buildings. A small group of people has succeeded in imposing their view on the government. We do not want them to dictate our lifestyle."

"This petition is not discrimination against children; it is against violation of our right to choose our lifestyle."

The petition is signed by 200 tenants in the riding of York Mills.

REPORT BY COMMITTEE

STANDING COMMITTEE ON THE LEGISLATIVE ASSEMBLY

Mr. Breaugh from the standing committee on the Legislative Assembly reported the following resolution:

That supply in the following amount and to defray the expenses of the Office of the Assembly be granted to Her Majesty for the fiscal year ending March 31, 1987:

Office of the Assembly program, $67,251,500.

Mr. Breaugh: This will probably restore one of the great issues of our time and bring back proper coffee cups in the east and west lobbies.

2:40 p.m.

INTRODUCTION OF BILLS

METROPOLITAN TORONTO POLICE FORCE COMPLAINTS AMENDMENT ACT

Hon. Mr. Scott moved first reading of Bill 90, An Act to amend the Metropolitan Toronto Police Force Complaints Act, 1984.

Motion agreed to.

METROPOLITAN TORONTO POLICE FORCE COMPLAINTS AMENDMENT ACT

Hon. Mr. Scott moved first reading of Bill 95, An Act to amend the Metropolitan Toronto Police Force Complaints Act, 1984.

Motion agreed to.

WINE CONTENT AMENDMENT ACT

Hon. Mr. Kwinter moved first reading of Bill 97, An Act to amend the Wine Content Act.

Motion agreed to.

Hon. Mr. Kwinter: I am pleased to introduce today the Wine Content Amendment Act, 1986. The purpose of the act is to extend legislation allowing the limited use of non-Ontario grapes and wine in Ontario wine production for the period of one year.

The act was initially passed in 1976 to help the Ontario wine industry meet the trend in consumer demand for dry, light table wines while giving Ontario grape growers time to convert to higher-quality grape varieties. This conversion is a slow, expensive process and is not yet complete.

The present enabling legislation expires on August 31, 1986. The original sunset date of 1980 was extended in the past, and I am requesting members' support for a further one-year extension.

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.

On section 5:

Mr. Chairman: When we left off yesterday and reported to the House, we were on the amendment of the member for Lincoln (Mr. Andrewes) for a new section 5. Is there any member who wishes to speak to this amendment?

Mr. Jackson: Before the debate was adjourned last night, I believe I was the last speaker on this subject.

Mr. Chairman: This is committee of the whole House, so there is no retaining of one's place.

Mr. Jackson: Thank you for your clarification. Yesterday, when responding to this amendment, I made reference to the fact that I was fortunate enough to be a member of the standing committee on social development, which was responsible for conducting public hearings on Bill 94 during the course of three and a half months.

It occurred to me it would be appropriate when offering reasons that a call for a mediation component to this bill would be essential if we were to look for concerns that were expressed by members of the community at large who presented themselves before the committee.

Yesterday, I referred to points of support for a mediation framework from such groups as the Ontario Public Service Employees Union, the Canadian Union of Public Employees and the Ontario Nurses' Association. I also read one reference from the Ontario Health Coalition.

I again advise members of this House of a statement made before the committee on March 6 by Dr. Rachlis of the Ontario Health Coalition. Dr. Rachlis said:

"We recommend to the government and the practitioner organizations that the dispute resolution process include conciliation and mediation and, as a last resort, submission of all outstanding issues to mutually agreed on binding arbitration. We further recommend that upon entering into a contract, the contract be binding on all parties and the negotiated dispute resolution process be appended to the regulations of the act."

There were further clarifications based on questions from the all-party committee, and the health coalition went on to state:

"The Ontario Health Coalition asserts that all workers, regardless of job classification or occupational status, have the fundamental human and labour rights to bargain collectively, negotiate remuneration and working conditions, and to withdraw their labour, which is to strike.

"Therefore, we recommend that a committee comprised of representatives of consumers, government, health practitioners and workers be established to define a package of essential health services that must be provided in the event of job actions or strikes. Essential services should be designated in the regulations. The government and the professional association or bargaining agent concerned should be jointly responsible for ensuring availability and delivery of designated essential services in every community. In the event of job action, a publicly accountable task force should be established to monitor availability and delivery of essential health services."

I point out this section from the Ontario Health Coalition. It is significant because, as members know, the Ontario Health Coalition attended the hearings in support of Bill 94. It had no idea the conflict between the government and the medical practitioners in which Ontario currently finds itself would escalate to the degree that it has.

It somehow seems fitting that even those groups the Minister of Health (Mr. Elston) called upon to support and endorse his bill are in turn setting out a program for the minister to follow in case there is job action, which we have seen, or in case there is dispute, which we know is there. It is not just on fees; it is on working conditions and terms and conditions of employment.

As I stated yesterday, there is also concern that Bill 94 has changed its shape in the past two weeks as it has been involved in committee of the whole House. What the public understood Bill 94 to be six months ago tomorrow, when it was introduced --

Miss Stephenson: It was six months ago today, the 19th.

Mr. Jackson: Six months ago today, I am advised; it was on the 19th.

Most of the groups that came forward before the standing committee on social development made some reference, and in some way a positive reference, to a mediation model or recognizing at least the very simple fact that when a dispute escalates to the level that this dispute has, the government has a rightful role in seeking out a position that is nonconfrontational.

We believe very strongly that our amendment to the bill achieves that. It allows the Premier (Mr. Peterson) the option, even though he says it does not, to deal with the Canada Health Act. Not the prohibition of extra billing but the penalties to the practice do not become absolute and irreversible until April 1987. Clearly, the 90-day time line is not in violation of anything the government has indicated is its primary concern.

2:50 p.m.

In closing, I invite the members of the New Democratic Party to support our amendment in the spirit and tradition they have always set out to be their principles. I ask the members of the NDP to support this amendment on the eve of their perhaps historic, maybe even fateful, congress, which is occurring in the great community of Hamilton this weekend. I ask the NDP to set aside its rhetoric and to support this nonconfrontational amendment.

In doing so, I advise the members that the voice of reason does emerge from the New Democratic Party from time to time; even I am willing to admit that. It was ably and succinctly put by its Health critic, the member for Windsor-Riverside (Mr. D. S. Cooke), on several occasions when the groups in support of Bill 94 came forward and the issue of mediation-arbitration as a package was presented.

I refer to a statement the member made during committee hearings back on March 6. The member for Windsor-Riverside said:

"Would it not make more sense to allow access to binding arbitration to be automatic, after we have gone through conciliation, mediation and a whole process similar to Bill 100, which sets out the parameters for negotiations for teachers? That kind of a process might make sense. As a final resort we would have binding arbitration, but either party could request it."

The deputant at that time responded very shortly, "You are not suggesting the right to strike would be removed for this particular group?"

The member for Windsor-Riverside stated: "They," the doctors, "do technically have the right to strike. However, we are not going to be coming to grips with that in this committee. I am not sure I would want to see doctors have the right to strike. But I am looking at a negotiating process in how we ultimately get to some third-party resolution if they cannot come to a negotiated settlement, even with the assistance of a conciliator or a mediator."

That is quite unusual. We have references by my friends from the New Democratic Party that even they admit doctors may have certain rights in this province. More important, they themselves are on record as suggesting that third-party resolution is ultimately a better route to go, a better course of action, a better stance of leadership in these difficult times. They have even called for the assistance of a conciliator and a mediator as a possible mechanism by which this can be achieved.

We know they are in a difficult position with their principles, but we implore them to treat seriously this very simple but, we believe, very effective and necessary dose of legislative medicine, which will help turn the tide of the dispute that has come across our entire province.

I remind the members of this House that this amendment specifically says, "The mediator shall bring the parties together to develop and recommend the structure of the relationship between the government and the physicians in the delivery of health care in Ontario."

I believe fundamentally that we are not far from agreement with our doctors. I believe the gap is not as significant as the media and certain political parties would have the public at large believe. We know that through the Ontario Medical Association, the doctors have agreed to the terms of an agreement, if this government will at least listen and be open, that would allow for the complete elimination of the practice the government finds so offensive, for all citizens over the age of 65. It would call as well for certain guarantees for emergency services. It would provide assurances for patients who are receiving any form of financial assistance in this province. It would also agree to a formula that would allow a patient access anywhere in Ontario to a free choice for an opted-in or opted-out physician.

I am stressing the point that a mediator would not have to move the parties far to seek an amicable and peaceful resolution. We believe that even when this bill has been approved, this model would allow the Premier this option to bring in a mediator.

It is unfortunate we have a Premier who has not learned the lessons of history, that when dealing with a public trust one does not take a hard position because one cannot move to a softer position. It is unfortunate the citizens of my community in Burlington and the citizens of Ontario are having to learn this lesson of lack of mediation and nonconciliation and pro-active confrontation.

I implore the members on my left, based on their statements, to support our amendment to section 5a, which would call for an immediate mediator.

Mr. D. R. Cooke: On a point of order, Mr. Chairman: I wish to announce that the Solicitor General (Mr. Keyes) has just become the proud grandfather of a nine-pound grandson. The baby was delivered by the chairman of district 9 of the Ontario Medical Association.

Mr. Brandt: On the same point, Mr. Chairman: On behalf of our party, I would like to extend very best wishes to the new grandfather. We trust the child will be raised in a manner that is in keeping with the type of philosophy we have on this side of the House.

Mr. Jackson: I have completed my remarks, but I extend my congratulations as well. Having become a father recently myself and having enjoyed the excellence of the health care profession in this province in the delivery of that child, I know that today we agree on that point. Congratulations.

Mr. Chairman: Does the Solicitor General have anything to add to this point of order?

Hon. Mr. Keyes: I want to assure the member for Sarnia (Mr. Brandt) that the debate here today prevents me from being in his fair city tonight to deliver a magnificent speech on many other factors. I accept his congratulations today and those of the other members and assure the members that Dr. Pancham said to my daughter there was no problem; he had to be here in Toronto yesterday for very important business, but he would do a delivery today, which he has now brought about in the past few moments.

3 p.m.

Hon. Mr. Nixon: On a point of order, Mr. Chairman: I would ask the permission of the House to revert to motions.

Mr. Chairman: I am sorry; we are in committee of the whole House.

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

Hon. Mr. Nixon: Mr. Speaker, I request permission of the House to revert to motions.

Mr. Speaker: Is there unanimous consent by the House?

Agreed to.

MOTIONS

TIME ALLOCATION

Hon. Mr. Nixon: I have two motions. Perhaps I should indicate the gist of the motions. If the motions are agreed to, it will permit the House to sit beyond 6:30 tonight. It will also order the business so that all the debate and votes pertaining to Bill 94, the bill which bans extra billing, will be concluded by one o'clock tomorrow afternoon.

Mr. Speaker: Hon. Mr. Nixon moves that notwithstanding any order of the House, the 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, by the committee of the whole House be concluded not later than 6:15 p.m. today, at which time the chairman shall put all questions necessary to dispose of every section of the bill not yet passed, and to report the bill, such questions to be decided without amendment or debate; should a division be called for the bell to be limited to 10 minutes;

And that the Speaker put the question for the adoption of the report forthwith without amendment or debate, and if a division is called for, the bell to be limited to 10 minutes;

And that the bill be called for third reading immediately after the adoption of the report and that the debate thereon be concluded not later than 1 p.m. on Friday, June 20, when the Speaker shall interrupt the proceedings and put the question, without further debate, and if a division is called for, the bell to be limited to 10 minutes;

And that in the case of any division in any way related to the proceedings on this bill prior to the bill being read the third time, the bell be limited to 10 minutes.

Is it the pleasure of the House that the motion carry?

All those in favour will say "aye."

All those opposed will say "nay."

Mr. Harris: Hold it. Is there no debate on this motion?

Mr. Gillies: Of course there is debate on the motion.

Mr. Speaker: Order.

Mr. Gillies: It is the intention of the official opposition to say a few words of debate about this motion before it is put to a vote.

I will say first, as many of my colleagues have said during the debate on Bill 94 itself, that the situation to which we are brought today is for no other reason than the horrible mishandling of this issue by the government, by the pigheaded attitude of the Premier (Mr. Peterson), by his unwillingness over a protracted --

Mr. Polsinelli: On a point of order, Mr. Speaker: The honourable member has definitely used unparliamentary language. He should stick to the rules of this House and the traditions that have been established here.

Mr. Speaker: Order. It is somewhat abusive and insulting language.

Mr. Stevenson: It is true.

Mr. Speaker: Order. Was I correct in hearing the member say pigheaded?

Mr. Gillies: I said pigheaded.

Mr. Speaker: Will the member withdraw that?

Mr. Gillies: I will withdraw it. However, in so doing, I will say this to the honourable member --

Mr. Speaker: Order. I understand the member withdrew it. Will you please continue with the debate on the motion?

Mr. Barlow: On a point of order, Mr. Speaker: I recall very distinctly when I was chairman of a committee about four years ago the member for London Centre (Mr. Peterson) came in to the committee and called me pigheaded. He was not asked to withdraw it at that time.

Mr. Speaker: Order. The honourable member is referring to something that took place quite some time ago. Will the member for Brantford please continue with discussion on the motion?

Mr. Gillies: I will indeed speak to the motion. In speaking to the motion, in the context of the interjection by my friend opposite, in recent weeks the members of the opposition have endured every conceivable insult from the Premier and the ministers of this cabinet. One has to have a pretty thick skin in this business, and if my friend cannot take the heat, perhaps he should get out of the kitchen.

I do not hop up and down like a jack-in-the-box every time the Premier calls me sleazy or a guttersnipe or anything else. I do not think it is worthy of attention and neither should he. That kind of conduct is all the worse coming from the leader of the government, the Premier of this province. If he thinks it does him any great service in this province, he is wrong.

In speaking to this motion, I want to indicate that our party will be opposing it. We feel the current situation has been brought about by the mishandling of this issue. This government has refused to consider the very constructive options put forward by the leader of my party that could have averted the necessity for this motion, could have averted the doctors' strike and could have averted the chaos we find our health care system in today.

For weeks, we have been asking whether this government would take the rudimentary and, one would think, the more than reasonable steps of calling off its current battle with the Ontario Medical Association and of appointing a mediator to see whether there was common ground and whether there was any way this crisis could be averted. The Premier has repeatedly failed to listen to the arguments put by the leader of my party. He has refused to listen to reason, and so we find ourselves in a situation where doctors are on strike and emergency wards of our hospitals are being closed, where further and more drastic actions are being heralded by the medical association and where the government ploughs on none the less.

For the record, and in the context of this motion, I think it well to read a communication put before every member of this assembly today by the Ontario Medical Association. It is dated June 19 and reads:

"Dear Member of Provincial Parliament:

"It came to our attention earlier this morning that some MPPs have not been made aware by the party leaders of the OMA's latest position at the bargaining table with the Peterson government.

"On behalf of 17,000 doctors and eight million Ontarians, we appeal to you to read the enclosed document detailing such a position."

Lest there be any misconception by the members of this House and the people of this province about the position of the OMA, perhaps it should be reinforced right now. I quote:

"Concessions Offered by OMA to Government in Context of Bill 94 Dispute:

"In discussions prior to and since the introduction of Bill 94, the Ontario Medical Association has offered the following in an effort to reach an acceptable compromise:

"1. No patient over the age of 65 would be charged more than the OHIP rate.

"2. No patient receiving treatment of an emergency nature would be charged more than the OHIP rate.

"3. No patient receiving financial assistance from your government would be charged more than the OHIP rate.

"In a further effort to honour both your concerns and ours, we offered to work with government to guarantee that every citizen of Ontario would obtain medical services from an opted-in physician or from an opted-out physician, at the choice of the patient."

3:10 p.m.

I happen to believe those concessions are reasonable and fair. I believe the concessions would address the problem or the perceived problem, as a result of which the government has introduced Bill 94 in its misguided attempts to come to grips with what it sees as a crisis.

As far as we can see, as members of this assembly who talk to our constituents on a regular basis, the crisis is here not because of extra billing but because of the determination of this government to win a political victory over a significant group of professionals in this province.

With that background, we have tried to make reasonable amendments. My colleague the member for Lincoln (Mr. Andrewes) has worked hard and diligently for weeks with the able support and advice of members such as the member for York Mills (Miss Stephenson). Who in this assembly would we dare to say knows more about health care in this province and the requirements of our people in terms of their health care than the member for York Mills? These people in our health care system, learned, caring and knowledgeable as they are of the needs of our people, say Bill 94 is wrong. It is the wrong approach. It should not have been pushed this far by the government, yet here we are.

Now we are faced with a closure motion; now we are faced with the guillotine. I look at some of the past arguments made by members of the Liberal Party and the New Democratic Party about the arbitrary and undemocratic nature of closure, about the throttling down of parliament. If the members of the third party vote for this motion, they should have very red faces indeed because of their about-face, their inconsistency and their absolute bafflegab after years of prattling about this sort of motion.

I have to quote some references to closure motions in the past. In December 1982, the leader of the third party said, "No minority in this parliament, no opposition party in this parliament, can ever give up its right to convince the majority that it just might be wrong, for all its smugness and for all its self-assurance that this kind of resolution is perfectly in order because it was typed in time and handed in on time," etc.

The leader of the third party, the member for York South (Mr. Rae), with all the powers of persuasion and all the eloquence that is so often at his disposal, speaks about a minority of parliament being brought to heel by the majority with all its smugness and all its self-assurance. For once in my life, I agree with the member for York South. The minority view in this parliament, which to quote the member for York South just might be right, is being brought to heel by the majority of this parliament with all its smugness and all its self-assurance.

There are other instances when we as the governing party had to endure the concerns of members of the opposition parties, as they were then, about closure motions. I remember the long and angry debates that took place at that time. I remember the efforts of both the Liberal Party and the New Democratic Party in their turn and in their time to frustrate the will of parliament. I remember the efforts to prolong time allocation and closure motions through procedural tricks in the past.

On behalf of the official opposition, I want to indicate it is not our intention to indulge in any procedural tricks at all. For days, our approach in this debate has been to try to convince the government of the wisdom of our suggestions by reason. Unlike the Liberal Party, we will not be leaving the members of this assembly hanging around the building all weekend while the bells ring. Unlike the New Democratic Party on Bill 141, we did not come in here and read from the government phone directory.

Mr. McClellan: Neither did we.

Mr. Gillies: Oh, yes. I remember the debate well and the members who used the directory.

We did not frustrate the will of this parliament by any procedural trick. We tried to use the weight of reason and rational argument to convince this government of the wrongness of its course. It would appear that the government is determined none the less that it must proceed.

The Progressive Conservative Party will be voting against this closure motion. The Progressive Conservative Party regrets that the government of Ontario feels it must come in with such an undemocratic measure, described in its time by the member for York South as smug and self-assured. We regret that, but we will not try to frustrate the will of this parliament by procedural tricks. If our efforts to persuade the government by reason have failed, then so be it.

Lest the government think we will forget this day, lest the government feel we will forget the first day it came in here -- a government appointed to office, not elected -- and ground the members of the official opposition and their right to speak in this assembly into the floor, I say to my friend the government House leader, we will not soon forget that. We will not forget it at all.

Mr. D. S. Cooke: I am going to be very brief.

Mr. Davis: That ought to be hard for the member.

Mr. D. S. Cooke: It is something those characters could learn on this particular bill. For three weeks we have been dealing with this issue in clause-by-clause. For three weeks there have been $1.1 million a week of extra bills and a strike by the Ontario Medical Association that has been aggravated by the Progressive Conservative Party of Ontario.

Interjections.

Mr. Speaker: Order. I must remind the members that interjections are out of order. If the member is going to point his finger, would he point it, as well as his remarks, at the Speaker.

Mr. D. S. Cooke: A short examination of what has happened during the last few weeks is in order.

I want members to recall some of the votes we have had in this Legislature and some of the motions we have been debating. We have been debating for hours and days points such as how many people should be on the appeal board set up under Bill 94, whether the current appeal board should be extended from having nine or some other number, and absolutely silly questions from every single member of the Conservative caucus who was in this House about what kind of people are appointed, how much they are paid and how many days a year they work. We know that under the former administration the kinds of people who got appointed were those who had PC membership, but under this bill the PCs have frustrated totally the democratic will of this province. That is why, unfortunately, we have to deal with this kind of motion.

The majority of the people in this province want an end to extra billing. The majority of the people of the province are going to see under this motion that this is what is going to happen. There will be a ban on extra billing in Ontario. The whole purpose of the Conservative Party's stalling during the past weeks and months is to defeat Bill 94 and to protect one interest group, the doctors of this province. Our purpose is to defend the patients of this province and to make sure extra billing is banned, and it will be banned.

3:20 p.m.

The member for Essex North (Mr. Hayes) brought this debate back to a little bit of sanity today when he read a statement in the House about a constituent of his in Essex North who has been extra billed by something like $900. That is what this bill is all about. This bill is to bring back equal, universal accessibility to the health care system of this province. We will support this motion because the Conservative Party is attempting to frustrate the democratic majority of the Legislature by its tactics in this House, which have been nothing short of irresponsible.

What we have here today is a result of that Conservative Party action. The strike by the doctors that is currently under way in Ontario has been encouraged, continued and extended because the message the Conservatives have been trying to get out of the Legislature to the people and to the doctors of this province is that if the strike has escalated, the bill will be withdrawn. It is now clear the bill will not be withdrawn. The bill will be passed, because we have had to bring in time allocation. We will support the motion because we support a ban on extra billing.

Mr. Polsinelli: I am also going to be very brief on this. I am rising in support of the motion. I am also rising to express my outrage at the continued attempts by the Conservative Party, and I use the term "progressive" loosely, to delay the passage of this bill.

My friend opposite talks about democracy. The Liberal Party, as much as any other party in this democratic country, believes in democracy. If we are talking about democracy, let us look at this bill which was introduced on December 19, 1985, after six months of consultation with doctors, the OMA and members of the public.

Since the bill was introduced, it has had 24 days of debate in the Legislature and 18 days of debate in the standing committee on social development. This bill has been debated and amended in committee of the whole House for more than 20 hours since June 2. Because of the stalling tactics of the Conservative Party, I have been told that it seems as though the bells have rung for more than one half of the time that the bill has been debated in committee of whole House.

I cannot talk about the community of Ottawa West or the community of Brantford or the communities that are represented by the members opposite. I can talk about my own community. My community is sick and tired of further delay. The government's position on this bill is a simple one. Patients should not be required to pay extra for insured services in this province. That is all this bill is going to do, and that is the will of the people of this province. Doctors and patients want this debate ended. Further delay serves absolutely no one and is in no one's best interest.

Enough is enough. Let us finish the debate today. Let us sit all night; let us sit tomorrow if we must; let us get this bill through. The people of Ontario deserve nothing less.

Mr. Grossman: I regret that this day, June 19, at exactly 3 p.m., the Liberal government finally was forced to show what its view of power is all about. We can spend a lot of time, and we are going to spend a lot of time, at least as much time as the Premier will allow us, to put forward our very strong views about how this bill is going to harm the health care system. I want to reflect on how we got here. It speaks more to why we end up with closure than anything else.

Mr. Callahan: If it is closure it is not debatable.

Mr. Grossman: This is closure. I want to say to the member for Brampton (Mr. Callahan), so he knows what he is going to have to face in his riding next election, that he is not going to be able to take the position that the people for whom he so proudly stands are a group of people who, like the member for Yorkview (Mr. Polsinelli), believe in democracy.

If the member thinks we made up the word "closure," I want him to look up Erskine May on page 454, where it talks about time allocation, which no one denies this motion is, and refers to it as "the guillotine." Those are not my words; they are the words of Erskine May in his book on Parliamentary Practice.

The member will have to explain to his constituents why his government took not its promise to abolish Ontario health insurance plan premiums, not its promise to do away with the tax on meals under $4, not its promise to provide pay equity for women, not its promise of a $100-million job creation program, but its ban on extra billing as the single thing that the people of Ontario voted for that is somehow non-negotiable and must be implemented because it is the view of the people of Ontario.

The member for Humber (Mr. Henderson) shows that not all the people in Ontario believe that is what they voted for, nor did any of them require that the government heavy-handedly push through this piece of legislation while ignoring all the other problems out there and all the other promises.

Let us talk a little bit about the history, because it speaks eloquently to why we are facing a closure motion. The government that came into office was appointed to office in June 1985 and introduced this bill not during the fall session for some debate on second reading and thought, but on December 19, 1985, right at the end of the fall session; not to allow some discussion or dialogue, but right at the end so the Liberals could go home for Christmas and list a whole number of things they had put on for first reading.

What happened between June 26 and December 19, 1985? Was there discussion with the doctors about accessibility, an indication to the OMA that accessibility was non-negotiable and that full accessibility had to be provided for every patient to every doctor or extra billing would be banned? Was that discussion held?

The Minister of Health (Mr. Elston) will have an opportunity between now and tomorrow to stand in his place and say, "Yes, we invited the OMA to satisfy us that there was a fully accessible system." He cannot say he did that. No, that did not occur between June 26 and December 19, the date on which the minister stood up and introduced a bill and then the government said, "Let us go home for Christmas," and we went.

The bill got second reading and went to committee. Did the Liberals get impatient with clause-by-clause study in committee? Yes, they did; and they jumped it back into the House. Did they decide to let the parliamentary system work, even though it is inconveniently slow for the Premier of this province? No. They said, "Let us pull it back into the House." Mr. Peterson's fuse was getting a little short. He was fed up with the heat he was taking out there, which was a lot worse than he thought.

They said, "Let us ram it out of committee and let us get it back into the House." They stood down other important legislation. Bill 30 was shoved aside, the bill the Minister of Education (Mr. Conway) said was such a priority and had to be put in place. No, not for the impatient Peterson, who said, "We will set that aside, get Bill 94 out of committee and put it into the House."

Let us talk about the impatient bully, David Peterson, during the negotiations.

Mr. Speaker: The reference should be to the Premier.

Mr. Grossman: It is not adequate for the Premier to stand in his place and say he had negotiations. No one in the OMA will say that the bill to ban extra billing was being discussed. Other things were being discussed. What was being discussed? The Minister of Health went to small communities throughout this province and said: "You know your hospital wing? You know the chronic care beds that are not here? If we get that $50 million from Ottawa, your hospital will be built here with that money."

Let me tell members what was happening at the negotiating table. In writing, on paper, this same government at the same time said to the doctors: "If you will sell out your principles, if you will sell out what you believe in, if you will sell out your independence and your freedom, we will take that $50 million and hand it to you. We will hand it to you under three different, separate funds; but here, it is all your money."

3:30 p.m.

That was the money the Minister of Health was promising to small communities as he tried to scare people into believing that Bill 94 was somehow the key to getting their hospitals built. That was the most cynical exercise I have ever seen, while the real Minister of Health was conducting the negotiations and writing that cheque, offering all that money to the doctors of this province in a crass attempt to buy them when their principles were not for sale.

Those negotiations were not finally terminated by the Ontario Medical Association which said this afternoon, yesterday at its council meeting, a week ago at its council meeting and every day that it wanted further negotiations. It did not end the negotiations.

Mr. Haggerty: They have been negotiating since 1982 and the member knows it. He had that problem. He should not tell us this. He should be honest and put it all out.

Mr. Grossman: Yesterday that member's doctors in Erie said the strike would end if the government would enter into negotiations.

The Minister of Health was on television with Dr. Railton. He was asked by Denise Harrington what it would take to end the strike. The answer was not that the Premier should abandon his principles. It was not the complete withdrawal of Bill 94. It was not that the federal government should revoke the Canada Health Act. He certainly did not say it would be the passage of Bill 94. It was none of those things. What he said was that the government should enter into meaningful negotiations.

Those words will stand for ever outside the emergency wards that are locked. Those words will stand for ever and be etched in the minds of the patients who have had cancer surgery cancelled and who have had open heart surgery cancelled for weeks and months. Those words should stand in their minds for ever. All it takes, Dr. Railton says, is for the government to enter into meaningful negotiations. The government will not do it.

The history of this bill is six months of nondialogue, with a late introduction prior to adjournment at Christmas, no significant negotiations, a misleading set of circumstances when they promised money to doctors, the hoisting of the bill out of committee because they got impatient with a democratic procedure and worried about the public reaction and the doctors' reaction; and finally, the bringing of the bill into the House.

Mr. Polsinelli: It has had 20 hours in the House since June 2.

Mr. Grossman: As the member for Yorkview has just said, it has had 20 hours in the House since June 2. Imagine that: 20 hours of debate on the most important piece of legislation to impact the health care system. Twenty hours is too much for the Premier. Let us be clear. Twenty hours of debate on a bill the government forced back into this House was far too much for the Premier of this province. Negotiations were far too much. The prospect of appointing a mediator, which is the only thing that will end this strike, is too much. Why is it too much?

Just as the Premier cannot tolerate the fact that someone other than he is able to control and influence the debate in this House, he is equally irritated by the fact that perhaps a mediator will come in and someone other than the Premier will have some impact on Bill 94. He finds that he somehow cannot tolerate that thought. He somehow cannot accept the reality that leadership is not dictatorship.

He is going to dictate the speed at which the bill goes through the House. He is going to dictate how long the committee will deal with the bill. When he is tired of it, it will come out of the standing committee on social development and into the House. When he is tired of the debate, when he is worried about the confrontation in society, about closed emergency wards and cancelled surgery, when he is worried that his collar is getting too tight because he is in way over his head and there is a massive overreaction, then he will decide that he has had enough.

How does he solve the problem? It is not by calling people in. It is not by saying, "Let us cool it for a few weeks." It is not by saying, "Let a mediator see whether he can do better than I did." To the Premier of this province, no one can ever do better than he can. He cannot tolerate or accept that thought.

What is his response? His response to the medical profession is this: "I kicked you down four stairs last December when I introduced legislation without discussion. I kicked you down four more stairs when it came time to have negotiations. I got tired and I ended them. I kicked you down four more stairs when I said I was tired of the social development, so get up into the House and we will do it in the House."

Now there are four more stairs left and he is going to kick them all the way down the stairs. Every time he has kicked the doctors a little farther down the stairs, he has said to the public: "Do not worry. I can kick them as hard as I want, but I do not think they will react." Every time he has kicked them and insulted them, they have reacted. Mr. Speaker, they have reacted as you would, as lawyers would, as teachers would, as plumbers would and as office workers would. They have responded as proud individuals, as citizens with some rights in this province. I have believed they had an option at all times as to whether they wanted to be tied up and to work for one employer or not, but not to this government.

They reacted every time they were kicked down four more stairs and now the Premier, in a determination to get them all the way downstairs, has kicked them into the cellar. He says again to the public, "Not to worry; I can kick them all the way down and nothing will happen." Every time he has kicked them, they have kicked back.

As the government pushes through this closure motion, I want to say it is precisely consistent with the dictatorial attitude of this Premier. He is fond of standing up in this House and giving us lectures about leadership, "You cannot bend in every breeze." Perhaps in London he thinks it is just a breeze that is happening out there, but I know the people in London. I know the fine doctors in London and I say to all the members from London that I know they are as worried, as scared, as anyone else in the province. This is not a breeze. If the government whip wants to go to London and say his leader felt this was just a breeze, then I will be into his riding to talk about this breeze next time and he can defend guillotines and he can defend his leader saying, "It was just a breeze out there."

Leadership is not a question of bending to the breeze. Leadership is a question of being able to get where one wants to go by bringing the public along. Leadership is a question of keeping peace and harmony out there, a social compact if we want to have it.

Dictatorship is to say, "I have the votes and it is going through." Dictatorship is to say, "You have until tomorrow afternoon at one o'clock and the bill is going to pass." Dictatorship is when he says to doctors: "It is going to be my way. The fines will be what I say the fines are." Dictatorship is when he says, "You are all going to work for the government." When the OMA says, "You will soon be telling us how much to bill and where to work," like every dictator -- can you believe it? -- the Premier says, "Trust me." That is what he says to the doctors.

I will read some words from the current government House leader when he was serving as opposition House leader. The occasion was February 15, 1983. He said, "There are those...who felt that the delay in the passage of that particular bill might have...forced the government to at least move some form of closure, abhorrent though I personally found that and continue to find that to be." It is not very abhorrent to the Treasurer (Mr. Nixon) and the Premier when they are in the powerhouse, when they are in control.

3:40 p.m.

Let us be clear, he was not alone. The present Minister of Education, the member for Renfrew North (Mr. Conway), said in that same debate, "...we are now faced with the iron heel of a majority government which is forcing a bill of great sensitivity and import through this House in what are, apparently, the dying days of this winter session."

Twenty hours of debate in committee on a bill that is going to change the entire shape of health care in this province is not too much. There was one chance only to get the doctors back to work and this Premier is too proud, too tough, too full of power to take that chance.

In winding up my contribution, I say to him that closure is the ultimate weapon. The member for Yorkview had the gall to say a moment ago that he represents a party that believes in democracy more than any other. He represents a party that has introduced closure of debate, federally and provincially, far more than any other party in the land. We have the list. There is nothing new about closure to the Liberals and there is nothing new about impatience, intolerance and bully tactics to the Premier of this province.

I say, on one of those rare occasions when a member of an assembly says something he believes to be true but hopes to be wrong, I hope I am wrong. The one thing that will work is mediation. For the Premier to play brinksmanship, to play tough guy, to play a game of emergency ward chicken with the Ontario Medical Association is very high stakes. No one can deny the fact and I know the Premier does not deny the fact. One can look at the faces of the government members. They remain concerned, worried and, yes, some of them are frightened. They cannot deny the fact that they do not know what is going to happen after Bill 94 passes. They know they do not know. They know they are worried about what will happen after Bill 94 passes.

I hope I am wrong. The OMA has indicated that things are going to get worse. They have given their president the authority to make them worse, and I hope and pray I am wrong when I say that is a real possibility. There is only one certainty: The government will have to acknowledge there is a real possibility that they are wrong and we are right, that the OMA may make it worse after Bill 94 is passed. They at least have to acknowledge the possibility.

The one thing that is certain is that if the Premier of this province has the maturity to pick up a telephone, call the OMA and say, "Will you participate in a mediating process or will you just entertain more negotiations?" the strike stops, operating rooms open tomorrow, parents can take their children into emergency wards and get them looked after, open heart surgery proceeds and cancer tests and treatment proceed. That is the only certainty.

Of course, it is high stakes with democracy when one brings in closure this way; we all know that. More important than that, it is high stakes when one gambles that closure, pushing through Bill 94, will stop the strife out there. There is only one certainty today. The one certainty is that the only option that would certainly have ended the strike has been smirked at, winked at and refused by the Premier.

In closing, let me say that this party has been outraged by the handling of this bill. This party has been outraged at the crude way in which the Premier and the Minister of Health have treated the medical profession. This party has been outraged at the failure to enter meaningful negotiations. This party has been outraged at the attitude displayed in this House in the midst of a most serious crisis. This party has been outraged by the Premier talking about the health care system being inconvenienced when there is real strife out there and real problems out there.

This party is outraged but not surprised at the final nail in the coffin. That final nail was struck by the government House leader on behalf of the Premier, who has the nerve and the gall this afternoon to be celebrating the opening of a hospital project he had nothing to do with, where he will be basking in someone else's glory while the health care system is threatened, while emergency wards are closed and while this government deals the final, tough, mean-spirited blow to the medical profession.

Mr. South: On a point of order, Mr. Speaker: I do not think any emergency wards were closed in this province.

An hon. member: This is nonsense. The member should sit down.

Mr. Davis: Where did they find the member? Under a rock?

Mr. Brandt: That shows how much he knows about what is going on.

Mr. Speaker: Order.

Mr. Grossman: As the government House leader knows and as our party has been reminded by the government and the third party on many occasions, they have the votes. We know that. We know they enjoy it. We know our friends to the left particularly enjoy it. They have the votes and they will have their way. For our party, we will fight the bill. We will fight closure. We will support what I expect to be the next motion of the government House leader to sit all night, not because we enjoy that, not because we look forward to it, but because we believe we must take every opportunity, use every minute he will deem to allow us, to fight this legislation.

We see now that we will lose. We see the attitude that might is right and that power and votes count for everything. Most of all we see the difference this afternoon between real leadership and real dictatorship. It is a sad day for the doctors, the patients and the citizens, and a sad and a crushing day for the Ontario government and another kick for democracy for a government that celebrates one year in office with closure in the House, closure in the hospitals and insults spread throughout the province. Crisis, insults and closure; that is the main theme of this government. It is a black and dark day. We regret it.

The government will have its way. It will have its closure. It will have its bill. We will have our principles. We will stand up and be counted for the citizens. We will face the tough politics and the government members will face their guillotines, their closure motion, their insults and the strife and war that they have created in the health care system. We will talk about it in every riding of the province. Let this hang around their necks together with the strife, closure and crisis. It looks ill upon them. We walk out of this House with our heads held high. They bow theirs.

Mr. Polsinelli: On a point of order, Mr. Speaker: may I comment upon the remarks made by the previous speaker, or does that not apply in this situation?

Mr. Speaker: If you read the new provisional standing orders, you will see that is in other debates and not on motions.

Mr. Polsinelli: Thank you for that clarification, Mr. Speaker.

3:50 p.m.

Mr. Rae: I will be very brief. We stand at a very special time. It is a difficult time in the life of the province. There are some principles I hope still stand out.

The first is that health care and the health care system do not belong to the doctors. The health care system does not belong to the nurses; it does not belong to the dietary aides; it does not belong to any one group in the system. The health care system does not belong to the Tory party; it does not belong to the Liberal Party; it does not belong to the New Democratic Party.

The health care system of this province belongs to the people of this province. That is the principle that moved our party 50 years ago to begin the fight for universal health care. That is the principle that took the courage that led Tommy Douglas to bring in health care insurance for the first time in Saskatchewan.

We in our party know the cost, the difficulty, the challenge and the vested interests that were there when medicare was first introduced. We know the position the Canadian Medical Association, the Ontario Medical Association and, yes, the Conservative Party took when it came to the introduction of medical care, when it came to ensuring that everyone would have access.

Now we are taking this next step. The Premier said it has taken a year. It has not just taken a year; it took the biggest petition campaign ever launched in the history of this province, by the New Democratic Party, against extra billing. It took a major campaign following on from the 1981 election right through the period of the Davis government, when we brought up case after case.

It took the conversion on the road to Damascus by my friends opposite, who in 1982 or 1983 were saying it is a safety valve, and then they had a caucus meeting. We all would have loved to have been flies on the wall in that caucus meeting. The leader of the Liberal Party came out of it and said: "We have changed our position. We have changed our minds. Now we recognize that extra billing is a problem."

We went into the election campaign. Our party campaigned on that issue from one corner of the province to the other. We came out of that election campaign with 25 seats. We signed an accord with the Liberal Party insisting that it live up to its conversion and that it do the decent thing for the people of this province.

Just today my friend the member for Essex North raised the case of somebody being extra billed for $1,200. I say to my friends in the Conservative Party and the Liberal Party, this debate has gone on for 42 days. It took six months for the Liberal Party to get up its courage to bring in the legislation, which is mild compared to the fact that it was in 1919 that the Liberals originally embraced the notion. What is a mere 65 years finally to get this thing through?

The House has been debating this matter for 42 days. We are not in the middle of an ordinary debate; we are not in the middle of an ordinary time. We have doctors who are licensed to practise in this province who say, "Oh well, we will have ambulances driving up to the front door and funeral directors at the back door." Somebody licensed to practise in a public hospital is seriously putting that forward as his expression of what public policy in this province should be.

We had a pregnant woman having a miscarriage who was told at a hospital: "I am sorry. You will have to go. Your bleeding is not sufficiently serious for you to stay here." These are not ordinary times, and this is not an ordinary issue.

There are those who say, "Mr. Rae, you cannot say you think the doctors should be working, because you have always opposed back-to-work legislation for nurses and other people." Let me make this very clear: no nurse, nursing home worker or dietary aide practising in this province, no one working in a kitchen of a hospital, has ever suggested for a moment that his or her group somehow has a unilateral right to shut down the whole health care system. Not one of them would and not one of them has. It has never been put forward as a proposition by any of their leaders or by any of their unions, not one.

Miss Stephenson: That is not true.

Mr. Rae: There is not a dispute.

Miss Stephenson: On a point of order, Mr. Speaker: To be factually correct, employees of a hospital in this city did attempt to shut down a hospital within the past decade.

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

Mr. Rae: I do not mind the member for York Mills getting exercised, but I say to her there has been a basic tradition in our party of which I am very proud. When government acts in ways that are draconian and completely unfair, such as a back-to-work order from the Tories two weeks before a strike was ever even anticipated, as they did with the Toronto Transit Commission workers before Pope John Paul was to come --

When it comes to health care, my view is that no group in the health care system has a right to shut down the whole system. I do not care what group it is, and I have said this to every union. Inconvenience in order to exercise one's right to withdraw one's labour is something that can be discussed. It can be discussed with the OMA. If they want to have a serious discussion about the future of industrial relations in this province as it affects the health care system, I will be proud to have that discussion. I have tried to have it on several occasions with the leadership of the OMA. They are not interested. They say, "We are not a union, we do not want to be treated like a union and we do not want to be part of this."

As a Legislature, we have a very difficult choice. We are facing a situation today where the leadership of the OMA says, "If they shut down an intensive care unit, that is not what we are authorizing, but if that is what they decide to do, it is okay with us." This is leadership? This is the definition of people taking responsibility for the actions of their members? If any elected union official were to do that, he would be decried by every labour relations board in the land.

We know precisely what would happen. We know precisely what steps would be taken. They were taken. They have been taken. To those who say, "You cannot touch the medical profession because it is different," we only say no one in this province is above the law. No one in this province is above the rules. Everyone has to play by the same rules. If health care does not belong to the medical profession and does not belong to Joan Atkinson, Joan Charboneau or Ed Moran, it belongs to all citizens in this province who want to make use of that system because they are sick. That is who it belongs to and not to the OMA.

We are faced with a choice today. I take pride in the fact that we have consistently been the ones to say to the Liberal Party, "This is the next step you are going to have to take." If this is what it takes to get the bill through, then we are prepared to see that gets done. If at the end of the debate tomorrow we have the completion of third reading and if at the end of third reading we have proclamation, which I am also assuming is going to take place, it will be a historic day in the life of this province.

It will be a step which finally states that health care is not a business, health care is not a commodity, health care is not for sale and health care is not for private profit. It belongs to all the people who need it because they are not well and because they need the ministration of a doctor, nurse or any other professional working in the system. That is why we are going to support the resolution moved by the government House leader today.

4 p.m.

Hon. Mr. Nixon: I do not use the word "abhor" -- it does not sound appropriate -- when I say I am uncomfortable in putting forward this bill. The Leader of the Opposition (Mr. Grossman) is correct in his quote. It does not make very much difference that I was on the opposition side when I said the words quoted. I can recall three fairly recent occasions when time allocation, a type of closure, was put before the House by the government of which the Leader of the Opposition was a part. I can remember being very concerned that the opposition had not had sufficient time to contribute to the debate.

There was, however, an understanding that these motions are part of the parliamentary procedure and part of the rules of this House. Perhaps they have been used more than they should have been, but in this instance the government is convinced that its policy is correct. We do not see how we can negotiate the matter further. It is time the democratic process is brought to bear and the members are asked to vote on the bill.

The Leader of the Opposition has referred to the inadequacy of 20 hours of committee review in this House. Not that this justifies the actions, but he must surely recall that on least three occasions the former Conservative government brought in closure much sooner than this motion before the House.

It is not worth spending a lot of time on this, but as justification for myself as House leader and for my colleagues, I remind the Leader of the Opposition and other members that in 1982 the total time spent on Bill 179 was 123 hours and 21 minutes, with seven hours in committee of the whole House. In 1983, 96 hours were spent on Bill 127, with 13 hours in committee of the whole House. On this bill, there has been a total of 147 hours: 36 1/2 hours on second reading; 63 hours and 27 minutes in the standing committee, and 26 hours in the committee of the whole House to date. Since the Leader of the Opposition used that number as something that ought to embarrass us, I ask that it be compared with the 13 hours and the seven hours on the bills that have been referred to in that brief statistical review.

I agree that these numbers do not mean anything other than that I believe I can say as House leader to anyone who questions me that this motion has been brought to the House only after there has been ample review of the principle and the details of the bill. All professional organizations and most individuals who wanted to express their views had every untrammelled opportunity to do so. The bill now has been before the House for amendments for almost 27 hours. In my opinion and in the opinion of the government that is presenting this motion, any further extension beyond the limits of this motion would be unreasonable.

I am not among those who believe carnage of the bill will end the strife in the provision of medical services. I am not naïve. However, I do believe the doctors and the citizens are looking for firm action by this government. The Premier has repeatedly risen in his place and indicated without equivocation that we intended to proceed with this bill. This motion simply means we are keeping our promises put to the people in the election more than a year ago.

We have undertaken to meet with the representatives of the OMA through a variety of cabinet ministers and other procedures. It appeared that while there was an exchange of views, there was no agreement to an alternative to this bill. In my own view, and I state it personally, I do not know how one can mediate or argue about a bill that ends extra billing.

It was not put to me today, but it is true that the Liberal Party's strong position on this, presented to the people of the province last year, is one that was not advocated by me when I was the leader some years ago. I say in defence that since that time the Parliament of Canada, by its unanimous vote, as far as its powers go, has outlawed extra billing in this country. Any province that persisted in allowing extra billing was penalized on a formula. This may not be precise, but it reduces the transfers from the government of Canada to the government of Ontario by just over $50 million a year. We can argue that this is an insignificant amount of money since we are allocating about $10 billion this year, a full third of the province's budget, to the provision of health care, hospitals, doctors and so on.

However, the $50 million is a penalty of significance. We now have two years of that penalty being withheld from the Treasury of the province. If we were to proceed with further discussions and all the ancillary approaches that would not settle this matter, which should have been settled previously, there is a real danger that we would lose penalty moneys. As Treasurer, I have no difficulty whatsoever in defending the importance of those dollars and recognizing that the Parliament of Canada -- correct with Liberal leadership but with the unanimous support of the federal Progressive Conservative Party and the federal New Democratic Party -- has passed this legislation, which is the law of Canada.

I believe the bill, having been presented by my colleague the Minister of Health before Christmas, and it has been extensively debated for the hours I have indicated, should come to some finality. We are indicating that the debate can continue if necessary, and it seems unreasonable to me that it would be necessary, until one o'clock in the afternoon tomorrow.

The Leader of the Opposition is correct when he indicates I have a second motion, which would mean that the House can continue past the regular adjournment time of 6:30 p.m. this evening. That means there is a limit on the debate, but it is a tremendously extensive limit. It is almost an unreasonably large limit, but we are quite prepared to listen to the views of the members.

With the passage of this motion -- and I strongly recommend that it be passed -- the debate will end no later than one o'clock tomorrow afternoon with the opportunity given to vote on all provisions leading up to third reading. In order that there is no misunderstanding, the provisions of the motion also require that the committee report passage at the committee stage by 6:15 p.m.

With that explanation, which I believe is sufficient and valid and I hope is compelling, I ask that the House now approve this motion.

4:36 p.m.

The House divided on Hon. Mr. Nixon's motion, which was agreed to on the following vote:

Ayes

Allen, Bossy, Bradley, Breaugh, Bryden, Callahan, Caplan, Charlton, Conway, Cooke, D. R., Cooke, D. S., Cordiano, Curling, Elston, Epp, Ferraro, Fontaine, Foulds, Fulton, Gigantes, Grier;

Hart, Hayes, Johnston, R. F., Kerrio, Keyes, Knight, Kwinter, Laughren, Lupusella, Mackenzie, Mancini, McClellan, McGuigan, McKessock, Miller, G. L, Morin, Morin-Strom, Munro, Newman, Nixon, Offer, O'Neil;

Philip, Poirier, Polsinelli, Pouliot, Rae, Ramsay, Reville, Reycraft, Ridden, Ruprecht, Scott, Smith, D. W., Smith, E. J., Sorbara, South, Swart, Sweeney, Van Horne, Ward, Warner, Wildman.

Nays

Ashe, Baetz, Barlow, Bennett, Brandt, Cousens, Davis, Dean, Eves, Fish, Gillies, Gordon, Gregory, Grossman, Guindon, Harris, Hennessy, Jackson, Johnson, J. M., Lane, Leluk, Marland, McCaffrey, McCague, McFadden, McLean;

Mitchell, O'Connor, Partington, Pierce, Pollock, Rowe, Runciman, Sheppard, Shymko, Stephenson, B. M., Sterling, Stevenson, K. R., Taylor, Treleaven, Turner, Villeneuve.

Ayes 64; nays 42.

ADJOURNMENT TIME

Hon. Mr. Nixon moved that, as provided by standing order 3(c), the House shall continue to sit today beyond the normal adjournment time of 6:30 p.m.

Motion agreed to.

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.

On section 5:

Mr. Chairman: Order. If you are leaving the chamber, please clear the chamber now. Somebody will likely wish to speak.

When the committee rose and reported, we were on an amendment to section 5, Mr. Andrewes's motion for a new section 5 of the bill.

Mr. Gillies: The members will know that in committee of the whole House we are debating the amendment of my colleague the member for Lincoln (Mr. Andrewes), the excellent Health critic for the official opposition.

Without wishing to repeat the motion, I will remind members, or perhaps inform some members who were not present for the earlier part of this debate at the committee-of-the-whole stage, that this amendment would have three effects.

First, section 5 of the bill, which members know is the part of the bill that stipulates the commencement, as it reads unamended, simply states, "This act comes into force on a day to be named by proclamation of the Lieutenant Governor."

Under the amendment proposed by my colleague the member for Lincoln, section 5 would be amended by adding three features. One is that, notwithstanding the commencement date stipulated by the Lieutenant Governor, the act would come into force 90 days after the parties referred to in subsection 5(2) received the mediator's report, which would be made public within three days of its receipt.

In other words, if the very reasonable proposals put forward by the Ontario Medical Association, which I will review with the House, are not accepted and it is the determination of the government to proceed with Bill 94, notwithstanding those and with the support of the third party, this party proposes to try to ameliorate the effects of it by injecting into this bill a mediation process: "A mediator agreed upon by the government and the Ontario Medical Association representing physicians shall be appointed immediately upon passage of this act."

We want to review the ramifications of this in view of the motion agreed to by the House a few moments ago.

Mr. Chairman: Order. I am sorry. It is most unfair to the member for Brantford. He is really fighting a losing battle against the noise.

Mr. Wildman: There is no question about that. He is fighting a losing battle all right.

Mr. Chairman: Against the noise. The members will please sit down or have their conversations elsewhere. Perhaps they would like to sit beside the person with whom they are conversing.

Mr. Gillies: I know the member for Algoma (Mr. Wildman) did not mean that. I am not unused to losing battles, but I say on this one that if it is losing on the principle of the right of members of this assembly to speak on important legislation, we did lose it; but perhaps we still do not mind, because we were on the side of freedom and democracy. However, I know my friend the member for Algoma was just kidding; so I will not get into it.

In view of the motion recently agreed to by the House, I think the amendment proposed by my colleague the member for Lincoln becomes particularly pointed and appropriate. The determination has now been made by the House, over the objections of our party, that this bill will be rammed through and voted on by 1 p.m. tomorrow.

I ask my friend the minister, whom I believe to be an honourable and reasonable person, can he not see the value of amending this bill such that, on proclamation by the Lieutenant Governor after passage of the bill tomorrow, a mediator would be appointed? This government would have yet one more opportunity to come to an amicable agreement with the OMA. What could be more reasonable?

The minister could have a vastly improved situation. He has his bill, but he could have a bill that allows one more opportunity for a neutral third party to attempt to bring the two sides together and arrive at a negotiated settlement to the current crisis, the doctors' strike. I ask the minister to think about this. I ask the minister to consider the wisdom of this amendment, particularly in the context of the closure motion with which we are now faced.

The third feature of the amendment of my honourable colleague the member for Lincoln is that "the mediator shall bring the parties" -- the government and the Ontario Medical Association -- "together to develop and recommend the structure of the relationship between the government and physicians in the delivery of health care in Ontario."

Again, Bill 94 does not address that. Bill 94 does one thing and one thing alone. Whether or not one agrees with the principle, all Bill 94 does is end extra billing. With the amendment proposed by my friend the member for Lincoln, Bill 94 could do much more; it could do something much more positive and constructive.

With the amendment proposed by our friend the member for Lincoln, Bill 94 could go far beyond the current argument about extra billing. Bill 94 could set the future tone and the future relationship of the medical profession with the government in Ontario. The current crisis and the current situation indicate that, perhaps at this time more than any, such a review of that relationship is necessary.

Does the minister want to walk away from this debate merely having vanquished the opponent? Does he want to walk away from this merely having achieved the political priority of banning extra billing? Or does he want to seize upon an opportunity to bring together the parties in a very positive and, we hope, forward-looking review of the relationship between the OMA and this government, a relationship that has never been worse or more damaged than it has been by the government's actions and the current debate?

4:50 p.m.

I cannot imagine a more constructive amendment in view of the events of the past several hours. It is one more opportunity, as part of Bill 94, to bring the parties together to attempt to work in some sort of co-operative way and to ameliorate the effects of the very bitter and confrontational debate in which we are embroiled.

The mediator, at his or her option, would be able to consider everything that has been put forward. The discussions the Minister of Health (Mr. Elston), the Attorney General (Mr. Scott) and the Premier (Mr. Peterson) had with the OMA, which have been secret to this point, could be put before the mediator. They could be scrutinized by an impartial third party who could go over everything.

The mediator could look at the concessions that were put forward by the OMA. For example, the mediator could consider the OMA's offer to end extra billing for patients over the age of 65 and its offer that a senior citizen in this province would never be charged more than the Ontario health insurance plan rate in the medical system of this province.

The mediator would be able to consider the other proposals by the OMA, such as that no patient receiving emergency treatment would ever be billed more than the OHIP rate. I am sure most, if not all, of our doctors operating in our emergency wards across the province would be quite happy to -- I am being distracted by the Minister of the Environment (Mr. Bradley).

The mediator would be able to consider that very reasonable offer by the OMA to make sure that our emergency facilities are available to all as part of the OHIP system and that extra billing would never take place in an emergency room.

I ask every member of this assembly, when does this make more sense than at a time when emergency wards are closing and emergency services are being denied to the citizens of our province? When is this proposal more appropriate than it is now?

The mediator could look at the proposal put forward by the OMA that no patient receiving financial assistance of any kind from the government would be extra billed. He could look at the OMA's very rational proposal that any person could obtain medical services from an opted-in physician or an opted-out physician at the choice of the patient and receive services at the OHIP rate.

The mediator could consider all those things in the context of Bill 94. I am being charitable, because the individual members of this assembly have no real way of knowing what proposals were put on the table by the Minister of Health, the Attorney General or the Premier. Being charitable for a moment, I am sure they too had proposals on the table that could be examined beneficially by a mediator and taken into consideration and deliberation by that mediator.

As the Ministry of Labour critic for the official opposition, I am well aware of the tremendous success that can be achieved by mediation and conciliation services. The Ontario conciliation and mediation service of the Ministry of Labour deals with more than 3,000 contracts a year. For those members who are not overly familiar with labour negotiations, when a contract comes to an end and the parties are not prepared immediately to enter into another contract, the conciliation and mediation service of the Ministry of Labour is there to assist them to achieve a settlement.

As citizens of this province, we read about and see picket lines on our television screens at night. We see strikes from time to time. But we should be very proud that in Ontario, the vast majority of contractual disputes are settled between labour and management before a strike ever occurs. The Minister of Health will be aware that more than 90 per cent of such disputes are solved without the necessity of service withdrawal by the unionized employees. That is an enviable record; it is a record that stacks up very well with just about any other jurisdiction in the western world of which I am aware.

Frankly, I am mystified by the attitude of the Premier, who has said to this House repeatedly that he does not believe a mediation process would assist in the current dispute between the OMA and the government. I am mystified that he is not willing to give it a try. What do we have to lose when we know from our experience in labour negotiations that 90 per cent of disputes are solved by the mediation and conciliation services? What on earth do we have to lose by giving it a try in the midst of this very bitter and divisive dispute?

Does the minister have to take my word for it that this would be valuable within the context of the current crisis? No, he does not. We have the word, given publicly by officials of the OMA, that the minute the government announces it is willing to appoint a mediator, the strike will end. My leader said it very well in his remarks this afternoon. The mediator is appointed and the parties are brought together to work out a mutually agreeable conclusion to this matter. The minute the mediator is appointed, the OMA doctors would go back to work, the emergency rooms would open and the other extraordinary --

Mr. McClellan: And extra billing would continue.

Mr. Gillies: My friend the member for Bellwoods says, "And extra billing would continue." I say to my friend the House leader for the New Democratic Party, how can we prejudge that? The current dispute is over Bill 94. We are not saying an arrangement could be mediated and agreed to between the OMA and the government that in the vast majority of cases would end extra billing. We know that is possible. Why do we know it is possible? Because Dr. Moran --

Mr. Polsinelli: What about the 1979 agreement?

Miss Stephenson: There was not an agreement.

The Deputy Chairman: Order.

Interjections.

Mr. Gillies: No, Mr. Chairman. I blame myself --

The Deputy Chairman: Order. Will you take your seat for a minute? I would like to remind my colleagues --

Mr. Sterling: Do I have to be here all night?

The Deputy Chairman: Order.

Mr. Gillies: Mr. Chairman, I blame myself when my friend the member for Yorkview and my colleagues get into a debate, because I obviously have not yet persuaded my friend the member for Yorkview. I am going to have to try again, and so I will.

I say to my friend the member for Bellwoods, why do we necessarily assume that a mediation process could not arrive at an end to extra billing in large part? We do not know that at all, because Dr. Moran has already said, and I say it again: "No extra billing for patients over 65. No extra billing for patients in treatment of an emergency nature. No extra billing for patients receiving financial assistance."

I quote Dr. Moran again, "In a further effort to honour both your concerns and ours, the government's and the OMA's, we offer to work with government to guarantee that every citizen of Ontario would obtain medical services from an opted-in physician or from an opted-out physician at the choice of the patient." In the vast majority of cases, I would think we could see the practice ended through mediation.

5 p.m.

I say to my friend opposite, who appears unconvinced, and to my friend the member for Bellwoods, in the present situation, with the current acrimony between the OMA and the government, would it not be better in large part to try to achieve what the government has set out as a political priority by way of a mediation and negotiation process as opposed to bringing down the jackboot the way it did today? Would that not be preferable? I have to think it would. Who is to say? One must remember that the Ontario Medical Association has said: "Bring in a mediator. We will end the strike" Who is to say that the mediator may not recommend even more than this? The mediator may say, "Yes, we think that the recommendations put forward by the OMA should be accepted and, further, that you should take the following steps."

However, it would appear -- and I again blame my own powers of persuasion as limited as they may be -- I have not convinced either the members of the Liberal Party here present or the members of the New Democratic Party that it is better to negotiate and reason with people than it is to back them up against a wall, draw the line and say, "You are cooked." If I cannot convince the members of the wisdom of that, then obviously all that our party has tried to do through the hours of debate on this bill has been in vain. It is a very sad day because I believe the amendment being put forward by my friend the member for Lincoln is entirely reasonable and constructive and will not receive the consideration that it deserves by this committee of the whole House.

Mr. Foulds: Then the member is doubly deceived.

Mr. Gillies: I am not doubly deceived because I try, as do most members of this House, to review legislation very carefully when it comes before this House and judge it on its merit. I am absolutely convinced that this amendment would result in a better bill. Are we not in committee of the whole House to improve the bill? Believe me when I say to my friends in the government party that this would improve the bill. The government will have its way. It will pass Bill 94. I believe they have very little to lose and a lot to gain by entertaining this amendment and I wish they would.

I leave that on the floor in the hope that in the next while some of my friends in the other parties may be convinced of it.

Mr. Gordon: Perhaps more than any other member of this House, I have had the opportunity of watching what happens in this province when people go out on strike. On one occasion in Sudbury, we faced a strike of approximately nine months between Inco and the Steelworkers. I recall another strike, as well, that occurred between the teachers in the Sudbury region and the board of education. I could not help but think at that time, and I still maintain this belief, that the strike could well have been avoided if there had been mediation.

One of the very disturbing features of what is going on today in this Legislature with the introduction of closure is the attempt by the government to suggest that somehow it is my party that is holding up the bill and is not being responsible in this discussion.

When I picked up the Globe and Mail this morning and glanced at the front page, I noticed an article from which I want to read a few lines.

"Doctors Extend Strike into a Second Week; Escalation Possible."

"The Ontario Medical Association's council voted yesterday to take the doctors' strike into a second week and give the OMA president power to escalate the action as he sees fit.

"The withdrawal of services, and restrictions on elective surgery and emergency departments, will continue even if the proposed ban on extra billing becomes law, Dr. Richard Railton, president of the OMA, told a Toronto news conference."

Colleagues, it is a sad day in Ontario when the government, with all the power and all the clout it has, cannot find a way to mediate and resolve this dispute with the doctors in a way that would be satisfactory to all.

Instead, we see a public which is becoming increasingly anxious about what is happening in the province at present. We see a medical profession which feels it is under attack, a profession which feels it is being misrepresented by the government and one in which the majority of those doctors do not opt out, and yet they are against this bill being brought in by this Liberal government.

One has to question why the thousands of doctors who have not opted out would be so vociferously against this bill to end extra billing. One has to recognize that when the group which has not opted out reacts so strongly, perhaps it understands something other people do not see as clearly right now. Perhaps those doctors recognize that the health care of this province, and its accessibility, is what is paramount and ranks as being most important.

I wonder whether part of the reason the doctors in this province are so upset is that the first minister of this province called those doctors overrated and overpaid and told them he was going to do something about it.

I can understand any individual, any group, being incensed about being approached in that manner. Or perhaps the medical profession is upset because it has looked at the track record involved in bringing this bill before the House today.

First reading took place on December 19, 1985. The second reading was debated on January 14, 17, 20, 21, 23, 24, 27, 28, 30, 31, February 3 and 4 and carried on February 11, 1986. The bill was referred to the standing committee on social development for public hearings and then, before clause-by-clause debate took place in that committee, it was yanked back into the House.

When one is going to make such a change in dealing with the medical profession, in dealing with the health care of this province, one has a responsibility to sit down with those people and attempt to negotiate and mediate.

I heard the member for Port Arthur (Mr. Foulds) talk about the number of days that were involved. There have been many more days of negotiations that have gone on in circumstances where there has been a dispute between two parties in this province. There have been many more days than that. It is quite obvious that the doctors in the province recognize there is something very serious and of grave concern when it comes to this bill.

5:10 p.m.

Let us look at the system in Great Britain. The National Health Service, the NHS, was introduced on July 5, 1948, by the post-war majority socialist government. In the fall of 1984, there were 675,000 patients on the NHS waiting list for beds; one year later, there were almost 800,000. Fifteen to 20 per cent of nonemergency surgery is performed privately so that patients can avoid the waiting lists. The average consultation in a doctor's office in Britain lasts six minutes. Forty per cent of all visits to doctors are by people who, it is suggested, have real health problems; and 15 per cent of Britons go to accident and emergency departments when they need treatment because their general practitioner cannot be reached.

This is not surprising. A study in the British Medical Journal found that the time Manchester GPs spend seeing their patients ranges from a low of five hours a week to a high of 46 hours a week. Thirty-six per cent of all Manchester GPs spend less than 16 hours a week seeing patients. In Britain, 70 per cent of all doctors belong to the British Medical Association, a union that is said to be one of the most influential in the country.

Perhaps the medical profession in this province is aware of what is going to happen in the future. Perhaps it is thinking about what state medicine will mean to the public. They are thinking about more than themselves in this. They are thinking about the impact of this act on the public of Ontario and about what it is going to be like a year from now.

It is really sad when our leader and our party have said: "We are not asking you to withdraw the bill. We are asking you to mediate. Take the time to mediate;" and on the other side of this House they are stonewalling. I hate to predict this, and I hope it will not happen, but I fear a great deal that the accessibility of our health care system and the availability of the profession in the coming years are going to be seriously undermined by this action, this refusal to mediate.

It is sad to say this, but I think the third party has perhaps had a little too much influence in pushing the government to bring the debate on this bill to a close.

If one talks to doctors in Sudbury, they will say a little about extra billing. They will say, "In Sudbury, six per cent of the doctors extra bill," yet 85 per cent of the doctors are on the streets opposing Bill 94. It is really interesting. Apparently some of the doctors went to the various shopping centres to talk to the public to try to explain why they were so concerned about this bill and what it would do to the accessibility of health care and the future of medicine in this province. Within 15 minutes to half an hour, they had a petition objecting to this bill with more than 1,000 names.

That is not to say that many of those people in Sudbury are in favour of extra billing. That is not what we are saying here. We are saying that the public in Sudbury and across the province are becoming increasingly concerned about how the government is handling this issue. That is the point. Those people are saying, "That is my doctor and I want him to be free to consult with me and to look after my ailments, whatever those ailments might be." The public is beginning to question, first, the direction from which this government is coming and why it has brought this bill in; and second, whether the health care system is going to be as good in the months and years to come.

When one is sick, one wants the best health care. We have always had a first-rate health care system in this province. When any surveys have been done, it has been pointed out quite clearly that the people of Ontario believe they have the best health care system in the world. The second thing they will say is that they do not want anyone to tamper with that health care system or make it less than it is today.

This is where the government has made a real mistake, a big error. They should have sat down with the doctors, taken the time to mediate, taken the time to work with them and to work out a system that would be satisfactory to the public and satisfactory to the medical profession in this province. That is not too much to ask.

I have sat on committees of this Legislature. I have spent five years in this Legislature. I spent five years before that as mayor of the city of Sudbury and I spent at least seven years before that as a municipal councillor. I have never yet seen a situation where if one had a problem and one took enough time and enough dedication and was responsible about it, one could not work out some kind of compromise.

I fear for what we are seeing here today. It is a real shame. This new government looks good sometimes, as any government does, but it is a new government. Yet within a year we have this new government bringing in closure and cutting off debate because it wants to get this bill through. It wants to end any more discussion on the bill. It does not want to have mediation, and we must have mediation. The only way this is going to be resolved is through mediation.

People have a right to seek health care and to contract with their doctors without government interference. If the government does not treat the doctors as professionals, can it expect them to continue to act as professionals? Can it expect them to continue to make all the extra phone calls, house calls and do investigative work? That kind of dedication to quality care is going to evaporate because the doctors will not co-operate with a government-run insurance plan that is merely a monopoly. The government is bringing in state medicine, and there is no compromise.

Why does the government not mediate? Call in a mediator. The doctors have been telling the government all along that, in the health care disciplines, a lot depends on the quality of the provider. This government, in one fell swoop, will destroy for at least a decade any goodwill felt towards the government by the medical profession. That co-operation will be destroyed. The doctors will not work under a government that believes in tyranny or oppression.

I put it to the government on this basis. People must have the right and the freedom to get the health care they want. Under Bill 94, the public will not be able to buy the health care they want. It is the freedom of the public that is being trespassed against here as much as the freedom of the doctors.

What are we going to be faced with in Bill 94? A situation where the government will say, "Okay, we will fund you for 100 kidney transplants." If a hospital uses up that quota, even if a group in the community gets together to raise enough money for that hospital so it can provide for one more kidney transplant for one little girl who needs it, the hospital will not be able to do it because of this bill.

5:20 p.m.

The other thing the medical profession worries about is whether this government, down the road, because of so-called money restrictions, is going to decide that it is too bad but it cannot fund this hospital or that specialization in medicine, or that after a certain age the amount of money it spends on people should perhaps be limited. That is the way the medical profession views this. They have a lot of concerns.

Do not let the New Democrats tell members that everybody is in favour of this bill. Everybody is not in favour of this bill. As a matter of fact, I am sure that in the past week many members have had increasing numbers of calls from people who have told them: "We want to see mediation in this. We want a mediator brought in."

I have an example of what it means to be a professional. I would like to talk about one doctor in Sudbury. I have not chosen him for any particular reason; he is just an example. We have a cardiologist in Sudbury who has been working for 20 years in our area. He does not extra bill; he has never extra billed, but this doctor is opposed to Bill 94.

This man works from 7:30 in the morning until eight o'clock or sometimes even 11 o'clock at night, five or six days a week. He gets paid for his office hours, but he does not get paid for the outreach services he provides. He travels at his own expense to New Liskeard and South Porcupine, 200 miles away, and no one but he pays the salary of the nurse who attends him. He does this because we now have in Sudbury an open heart unit that is supposed to service all of northeastern Ontario. But if it is to be viable, he feels as a professional, as a doctor who cares about his patients and about the health of the people of northeastern Ontario, that he has to reach out and get those referrals to the Sudbury hospital. He travels. He provides these outreach services. He does extra investigative work at night. He does not charge anything. It is free, and he does it because he is a professional.

The people in this government are not willing to mediate. Do they expect to keep this kind of goodwill in the medical profession? Are they going to tell me that, without mediation, the medical profession will have the same dedication as it has had in the past? They should think about it.

This doctor believes in his professionalism. He is a dedicated health care provider and he cares about health care accessibility. This doctor opposes Bill 94 vehemently, and he does not extra bill. Does that not raise some questions about the medical profession? Why oppose something that supposedly has nothing to do with you? He does not extra bill, yet he opposes the bill. Does the government not think it should sit down with people such as that doctor and inquire about why they feel so strongly about it? He believes he will no longer be free to negotiate anything with his patients if he should so choose.

Ever since the Ontario health insurance plan was introduced, the doctors had a balancing mechanism they believed they could avail themselves of: the right to opt out of the system. If the government of the day said, "We are cutting you back by 30 per cent, because we need money for something else," the doctors had a mechanism through which to protest.

Now what are they left with? They are left with the mechanism of the strike. We in this House all know that strikes are not the way to solve problems. A strike occurs because people are unable to come to a compromise, because one party or another just will not take the time to think things through clearly. We need mediation.

The doctors have always had a mechanism through which to protest. As I said, they could opt out. Now their only resource, the only way they can protest, is to go on strike, and we all know what strikes do. I have not seen a strike yet that has not first radicalized those people who voted for it and then embittered many of those people who did not agree with it, people who were part of that bargaining unit in the first place.

The effects of strikes go on for years and years. They affect the people who are part of the strike and they affect the people who are around them, their families, friends, relatives and the public. Yet this government says, "We have spent a great deal of time on this bill; we do not have time to talk about it." It says: "We must pass this bill through today. This is the only way to end the confrontation."

I do not believe everything I read in the newspapers, but this morning I read that the Ontario Medical Association has said that it has nothing to do with what we do here today, there has to be mediation.

I talked briefly about England at the beginning of my talk. I would just like to say this about England. Even the unions in England do not want health benefits under the government program now. They want private insurance because the national health system has such long waiting lists, as long as three years.

Do members know where Harold Wilson goes now when he needs medical attention? He goes to a London clinic. He does not go to the national health system. He goes to a private clinic because the British health care system is breaking down.

Is that what we want for Ontarians? Do we want doctors cutting their visits by half and giving half the care they give now? Do members think this is what the medical profession foresees? They are professional medical people, so they know a little bit about the business they are in. Would they like to talk about it?

But it is not negotiable. Nothing is negotiable with this government. Because it has said nothing is negotiable, we have chaos out there right now in the health care system. The public is becoming very fearful; I am fearful. This could have been avoided with mediation.

If doctors are treated like civil servants, the government is going to discourage the kind of personal commitment these people have to their profession. They will not treat it like a profession, they will treat it like a job. Come five o'clock in the afternoon, that is it. Close the doors. That is all for today.

In Sudbury, in northern Ontario, if that were to happen, it would have a devastating effect. We already have problems getting specialists. The doctors we have are very dedicated people who put in long hours above and beyond what they could possibly be compensated for financially. It is that kind of dedication we need in the north.

5:30 p.m.

I am very fearful that the approach this government is taking is going to destroy that kind of commitment in the hearts of many of those doctors. It will not destroy it in all of them because, as I said, they are professionals. Professionalism is very hard to beat out of someone but there are many who are going to be so incensed that the after-effects of the way they have been treated and the way they have been portrayed is going to have far-reaching effects and I am fearful those far-reaching effects are going to affect the health care of the people of Ontario.

To call Bill 94 an accessibility bill is a misnomer. The most accessible part of the system is the physician. The least accessible part is the hospital bed. If that is the speech of the member for York Mills (Miss Stephenson), then I think this shows her intelligence and foresight, perhaps more than that of the member for Sudbury.

The government is going to interfere with health care. I would like to give one more example from Sudbury. I will give an illustration because we have to have a balanced view of what is going on here. Six years ago in Sudbury, a group of doctors proposed to a hospital that diagnostic ultrasound equipment be bought to service the public better. This equipment at that time was available in the United States and was state-of-the-art equipment. The hospital told them they had no money and could not get the money from the Ministry of Health, and the hospital had neither the space nor the personnel. It simply lacked the budget because the health dollars were restricted. One of the doctors took out a loan of $200,000 and bought one himself. That equipment services the people of Sudbury region and northeastern Ontario today. That equipment would not have been available under the rigid budgetary control of government.

This is what has happened in Quebec. In Quebec, the insurance plan will not pay for this kind of service outside the hospital building. Doctors in this province look down the road and see that kind of thing on the horizon for Ontario. The medical profession in the Sudbury region is very concerned about what kind of health care system we are going to have in the future and what kind of budgetary policies are going to be followed by this government. They are very concerned about what other steps taken by the government will directly affect the medical profession and the kind of health care the people of Ontario are going to receive. This is why I am so distressed that there has not been the kind of meaningful mediation that would have helped to bring some kind of a resolution to this problem.

The Deputy Chairman: Are there any other members who --

Miss Stephenson: The member for Scarborough-Ellesmere.

The Deputy Chairman: I could not see you.

Mr. Warner: It is difficult to tell when I am standing but I am, in case you are wondering, Mr. Chairman.

Before beginning my remarks on the amendment which addresses itself to the question of mediation, my observation is that while this debate is probably the most significant and difficult one we have faced in this Legislature since the election, I do appreciate the level of civility which exists in and outside this chamber amongst the members of all three parties. It is encouraging to know we can have a civilized discussion on this issue.

I am intrigued by the logic on the issue of mediation that has been put forward by a couple of the Conservative speakers. I would ask them to reflect for a moment on the concept of mediation and what one is attempting to achieve from mediation.

My understanding of mediation is that where one believes there are workable grounds, where there is an opportunity to achieve some consensus, one then brings in a third party. The two parties then place before the third party the essence of their disagreement as well as those areas upon which there may be agreement. The mediator then attempts to work with those two sides and come up with some form of compromise.

Unfortunately, I am an outsider who is not part of the government. I was not privy to the discussions that took place between the government and the Ontario Medical Association. It appears to me the government has said, "We have a certain principle that we wish to put into legislation," and the OMA has said, "We do not agree with that principle." We have a fundamental parting of the ways. One side has the principle and the opposite side disagrees with that principle. In that situation, I do not understand what use it is to have a mediator. Both sides are at odds on the fundamental point of the legislation and they cannot reach a common ground. There is no common ground on that principle.

I believe the Conservative Party will agree, upon reflection, that this is not a new issue. To me, the issue is 15 years old. I remember fighting for the end of extra billing 15 years ago. The approach is that we have reached this impasse very quickly, so we need a mediator at the last minute in a last-ditch effort to save things. I ask the Conservative Party to stand back a little bit and look at the events as they have unfolded. Even if we discount the previous 12 years, we had notice of the changes to take place in the Canada Health Act, and those changes took place with three-party agreement. The entire country was notified that there was going to be a change.

Naturally, since health is a provincial matter, the changes would take place province by province. The federal government instituted the only sanction it could. If a province did not agree to end extra billing, that province would be penalized dollar for dollar for the extra billing as best as could be determined. We all realize it is not possible to come up with an accurate accounting of the level of extra billing, but the federal government made a reckoning and determined approximately how much money would be withheld. In turn and at various stages, each of the provinces has decided to end extra billing in one form or another, and each in its own wisdom has adopted a particular mechanism.

5:40 p.m.

This mechanism, which was announced some time ago, was modelled most closely after the Nova Scotia model than any other, but it was the choice of the government of the day. Some negotiation took place between the OMA and the government. At those negotiations, the OMA made it clear that the principle of the bill, called Bill 94, was simply not acceptable.

Quite frankly, I understand that, and I respect the right of any organization to reject the principle of a piece of legislation, just as I respect the right of any individual to withdraw his or her services. Our service is really the biggest and most important thing that we as human beings have, and if we withdraw it, that is probably the biggest statement we can make.

Doctors, like most people but not all, have the right to withdraw their services. Ironically, the people who clean the hospitals do not have this right. I am not persuaded they have the right in law to deny care to patients, but they do have the right to withdraw their services, and many have done that quite systematically -- not all.

Again to address the question of mediation and why it could not be successful, there is not an atmosphere in which mediation could succeed, and I will explain why. Quite honestly, I think the Ontario Medical Association has backed itself into a corner from which there is no way out. It has managed to persuade many of its colleagues that this bill is somehow the first step to something that is worse, something that is more horrible --

Miss Stephenson: There is no doubt about that.

Mr. Warner: They have even persuaded the member for York Mills, and I did not think she could be so gullible. She is not normally known to be a gullible person.

Miss Stephenson: I am anything but gullible.

Mr. Warner: That is right. That is why I am surprised she has succumbed to their arguments.

Miss Stephenson: It was not their arguments.

Mr. Warner: Oh, no. The fact is that the bill addresses itself to one item and one item only, and that is the privilege of charging above the prescribed rate. Some doctors take that to be extremely important and others do not. Even the member for York Mills realizes there is a group of doctors in Ontario who are against the practice of extra billing.

I would not pretend for a moment that the Ontario Medical Association or any other group is a monolithic structure. Within the OMA, as within any other group, there is a diversity of opinion. In this situation there is a diversity of opinion over the withdrawal of service. There is a diversity of opinion over extra billing. As the member knows, figures have been bandied about a bit, but somewhere in the neighbourhood of 12 per cent of Ontario's physicians bill above the rate. However, that amount --

Miss Stephenson: No. Twelve per cent are opted out; five per cent extra bill.

Mr. Warner: If so, that is even scarier, because that percentage accounts for $1 million a week, which means that individually it is quite a sizeable chunk of money.

I happen to believe quite honestly and quite firmly that this bill addresses itself to the privilege of extra billing and nothing else. There is no hidden agenda. The idea is to provide equal access for all citizens, all residents of Ontario, to health care -- not two systems, not one for the rich and one for the poor and not one that is based on a means test.

Mr. O'Connor: Read their offer. Anyone who wants can get an opted-in doctor.

Mr. Warner: I understand their offer and, quite frankly, it is not good enough. Not charity medicine, thank you.

My observation from discussions I have had with several doctors, some of whom I count as friends --

Mr. Villeneuve: Used to.

Mr. Warner: No, still. I would not reveal their names, because that might knock them down the social ladder a bit. I count some of them as friends, and in fact close friends, and they are concerned about losing a privilege. In some cases they do not extra bill but believe their colleagues should have that opportunity to extra bill. I do not believe there is a group in our society that ever lost a privilege who were happy to lose the privilege. Naturally the doctors are upset. Through whatever speeches were made or whatever went out to the membership, they have become concerned that somehow terrible things are going to happen beyond Bill 94 and if they do not stop this bill, something horrible will take place. I do not know what we can say or do to assure them that is not the case.

I wish some of the members, especially the member for York Mills, would reflect for a moment on certain other parallels which exist in our society, for example, the one used by the doctors on the Canadian Broadcasting Corp. the other morning. Health is not the only area where figures are regulated. Bell Canada cannot raise rates to the public without going before the Canadian Radio-television and Telecommunications Commission. It is a regulatory body. That regulatory body hears the proposal by Bell and then makes a determination of the rates.

Miss Stephenson: Is the member suggesting that we are a public utility?

Mr. Warner: I have lost her attention. I will carry on for the rest.

Miss Stephenson: For ever.

Mr. Warner: I do not believe for a moment that any employee of Bell Canada considers himself or herself to be a civil servant because their rates are regulated and because they negotiate their rates with the federal government.

Miss Stephenson: Oh, do not be foolish. The government does not provide money to them.

Mr. Warner: The government negotiates the rates and the government okays the rates. The government of Ontario will okay the rates for Ontario health insurance plan payments. They will negotiate the rates for OHIP payments with the doctors, and they will then send the money on. When the negotiations are completed, that is the fee which is paid and the doctors have a mechanism by which they can negotiate that. By no stretch of the imagination would anyone say that they are civil servants. That is crazy.

Bell Canada people are not government employees. They are not civil servants. Neither are doctors. But neither, on the other hand, are they independent business people. We are not running a business; we are running a health care system and its design is to deliver health care to the people of Ontario. It is not a business. It is divorced from the free market. That may be a philosophy which is not acceptable to some people who are in the medical profession, but it is the philosophy of our program. That is what we have developed in this province. We should be proud of that, not ashamed of it.

Mr. Villeneuve: Why destroy it?

Mr. Warner: No one is destroying it. This is where I become concerned about the extreme rhetoric which has been used by some members of the assembly. No one is destroying the health care system. No one is attacking the doctors. I become concerned when I hear some of the rhetoric from doctors.

There are quotes right out of the newspaper, straight quotes from the doctors. The member for York Mills will recall from last Saturday's Star the quote from the doctor who said, "I will do anything short of killing patients in order to get what I want." That is extreme language. To use extreme rhetoric does not serve the doctors' cause well, it does not serve the patients well and it does not serve us well.

It will be more meaningful if we pass the bill which takes away the privilege of charging above the OHIP rate and sit down with the doctors to negotiate their genuine concerns. Their concerns are not only financial. I understand that. I believe the doctors have a genuine interest in rewarding excellence and experience and I think there are creative ways to make that happen.

5:50 p.m.

Miss Stephenson: The member cannot do it in the unions. How can he expect to do it in medicine?

Mr. Warner: As the member for York Mills realizes, extra billing is not in itself a reward for experience or excellence. A graduate out of medical school has the same opportunity to extra bill as a doctor with 20 years' experience. There is a more creative way and a better way to reward excellence and experience than the present system.

Miss Stephenson: The member is going to make that decision.

Mr. Warner: No, the doctors negotiate that. I understand the member for York Mills may want to take away that right from the doctors. I do not think that is appropriate. The doctors should have the right to negotiate their concerns with the government. The member for York Mills would take that away from them, but I believe it is their right and their privilege to negotiate a more creative response.

Miss Stephenson: I would not take it away from them. The member would take it away from them.

Mr. Warner: The medical profession rightly has a concern about the state of the hospitals. I remember from a couple of tours I did through northern Ontario that doctors in isolated communities have a concern about their ability to update their skills. How does a doctor arrange for leave if he is the only doctor in town, or there are only one or two doctors? How do they arrange leave so they can update their skills? How do they ensure that the local small hospitals can have up-to-date equipment? How can they best serve in the specialty areas in remote parts of our province? They do have serious concerns.

Interjection.

Mr. Chairman: Order. It was pointed out to me by an interjection here that the member is straying at this point from section 5.

Mr. Warner: It is really fascinating how members of the Conservative Party can talk on at great length about anything they want, but the rules must apply only to me.

Mr. Chairman: No, I do not believe that is in order. I would say that most of the time when my attention has been brought to a member straying, it has been a member of the official opposition straying.

Mr. Warner: I was addressing myself to the question of mediation which, I believe, is the amendment itself.

Hon. Mr. Curling: On a point of order, Mr. Chairman: You said it was pointed out to you by an interjection. I thought if something is pointed out to you, it is through a point of order. Are you reprimanding the member by an interjection?

Mr. Chairman: In explanation, sometimes I do not hear interjections but sometimes I do hear interjections, and they are from all sides.

Ms. Gigantes: Disregard them, Mr. Chairman.

Hon. Mr. Curling: Disregard all interjections.

Mr. Chairman: Yes. Back to the section 5 amendment.

Mr. Warner: I know the chairman was listening intently to my speech. I was attempting to address why mediation is not appropriate at this time. I was explaining how I believe that instead of mediation, what we should be addressing is negotiation which, I hope, will begin as soon as possible, in as constructive an atmosphere as possible, to address the legitimate concerns of our medical profession and the concerns of the public about the total health care system and the delivery of our health care services.

To conclude, I come back to where I started, that is, I think of mediation when there are negotiable grounds. The official opposition must realize, as much as anyone else, that on the principle of this bill, i.e., to remove the privilege of extra billing, there are no negotiable grounds on either side. The government has made it clear it supports that principle. The OMA has made it clear it opposes that principle. I do not know what there is to mediate. There is nothing left.

I hope -- and I make it almost as a plea -- that we tone the rhetoric down, that the services to which people are entitled be maintained, that our public hospitals not be closed, that emergency wards not be closed and that we have negotiations once again between the Ontario government and the OMA so calm is restored. People do not like this, and I do not like this. I do not think there is a member in this House, regardless of his or her position on this bill, who likes having the system or individuals upset.

Miss Stephenson: Does the member think doctors like it?

Mr. Warner: I do not think so either, but through whatever has transpired, there have been unfortunate remarks made by some members of the medical profession and some very unfortunate actions taken.

Miss Stephenson: I suppose the member has had nothing to do with that.

Mr. Warner: No. I am not the one who went and stirred them up and suggested they go on strike. Those folks over there did that. Those folks helped to promote that one, not me.

Mr. O'Connor: On a point of privilege, Mr. Chairman: The member has implied motives to us, that we have gone about stirring up the doctors encouraging them to strike. That is entirely untrue, and I ask that he withdraw that.

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

Miss Stephenson: It is factual information.

Mr. O'Connor: It is imputing motives. He cannot do that.

Mr. Chairman: Order.

Mr. Warner: While the amendment may be put forward in good faith, I frankly do not believe it will solve anything. I ask instead that we dispense with the motion. In fact, the members of the official opposition might consider withdrawing the amendment if they realize the logic and wisdom of the words which they have heard, and let us get on and pass the bill.

Mr. Henderson: I appreciate the comments of the member for Scarborough-Ellesmere, in his near-concluding proposal, that we tone down the rhetoric. That is precisely what I have in mind. I have only a few brief remarks to make by way of stating very briefly why I will support this amendment.

I took great umbrage at the member for Burlington South (Mr. Jackson), who is not here at the moment, for encouraging his colleagues and the New Democratic caucus a little while ago to support this amendment and not encouraging any Liberals to do so. I am being a little facetious but not entirely. One of the reasons I am a Liberal is that liberalism as a political ideology has always defended individuals and the freedom of individuals.

In my opinion, this is what this difficult issue is all about; that is, the freedom of a very small minority of patients who want to deal directly with their physicians at arm's length from government, and the freedom of an even smaller minority of physicians -- perhaps as small as three per cent if one speaks of physicians who are fully opted out, and a further nine per cent if we include physicians who are partly opted out. Across the board, only five per cent of services in Ontario are billed opted out.

The freedom of that small minority of physicians and likely a small minority of patients to deal with each other directly at arm's length from the state is, in my opinion, ideologically very much what liberalism is all about. This amendment, which proposes 11th-hour crisis mediation, seems in line with my political beliefs and therefore is an amendment I can support.

6 p.m.

I am also a Liberal because I believe such principles as flexibility, compromise and a willingness to negotiate are important characteristics and attributes of good government and good administration. That too seems to be the thrust of this amendment.

In some ways, I am not crazy about this amendment. It seems regrettable that as legislators we should have to consider appointing a mediator. We ought to be our own mediator. We ought to be able to sort these things out ourselves and try to find some consensual middle ground that would be reasonably acceptable to us and tolerable by the physicians.

I feel very badly that physicians feel driven to actions that are highly uncharacteristic, and I feel badly that they feel pushed to rally and show a solidarity that is rather unprecedented for physicians. I feel especially badly because Ontario faces a crisis in health care services. We are into the eighth day or so of it. I feel most distressed because I believe people are going to be hurt or worse and because I cannot find any evidence that passing this bill is going to improve the situation; if anything, it will be the contrary.

I am not crazy about this amendment, because we ought to be able to do our own mediation in this House. It is a little late to start talking about mediation. It is regrettable to imagine that we are contemplating mediation after the passage of the bill, but better late than never.

I cannot agree this is a black and white issue that admits of no middle ground and therefore admits of no prospect of successful mediation. Statistics show that of the order of three per cent of physicians are fully opted out, nine per cent are partly opted out and five per cent of services being billed are opted out. If we could fine-tune those figures and correct the distribution problem in the way I proposed in my amendments, surely that would be a significant enough step towards the objectives the Liberals have set forward to be well worthy of a trial. I have no doubt whatsoever that those figures could be adjusted, that groups which should not be extra billed could be spared and that distribution problems could be corrected through the efforts of a successful mediator.

I offer these remarks by way of saying that while I think the hour is late and while I am not happy that it seems necessary for us to look to mediation, I support this amendment in much the same way that I offered my own revised amendment to section 4. I did not like it very much, but it seemed a worthwhile 11th-hour attempt in the direction of avoiding a health care catastrophe.

I will support this amendment, which I consider to be ideologically close to the mainstream of liberalism. I am not crazy about the circumstances and the situations whereby we are contemplating mediation, but I believe it is well worthy of a further try.

Mr. Chairman: All those in favour of Mr. Andrewes's amendment to section 5 will please say "aye."

All those opposed will please say "nay."

In my opinion the nays have it.

Motion negatived.

Mr. Chairman: Shall section 5 stand as part of the bill? All those in favour will please say "aye."

All those opposed will please say "nay."

In my opinion the ayes have it.

Section 5 agreed to.

Hon. Mr. Elston: Mr. Chairman, I wonder whether I might have the consent of the House to revert to section 1, which includes the definitions that were to be moved in relation to amendments that have been delivered to the bill. As you will recall, we had agreed to go through the substantive sections and then return to section 1 at the end. In order that we can make the amended sections function, I would be pleased if I could place on the record the amendments under section 1.

Mr. Chairman: Is there unanimous consent for the minister to move the amendments to section 1?

Mr. Gillies: Our party has one more amendment to move. Of course, we are under the deadline of 6:15 p.m., but assuming the minister can be very expeditious, we will agree.

Mr. Chairman: Is there third-party agreement? Yes, there is.

Agreed to.

On section 1:

Mr. Chairman: Hon. Mr. Elston moves that section 1 of the bill be amended by adding thereto the following definitions:

"`Board' means the Health Services Appeal Board under the Health Insurance Act.

"`General manager' means the general manager appointed under section 4 of the Health Insurance Act.

"`Minister' means the Minister of Health.

"`Practitioner' means a physician, optometrist or dentist.

"`Unauthorized payment' means the amount of money by which the amount a practitioner has charged and been paid for rendering an insured service to an insured person exceeds the amount payable under the plan for rendering that service to that insured person."

Does the minister wish to make any statement?

Hon. Mr. Elston: It is not necessary. We discussed the substance of the sections before. These are part of the definitions required to provide the substance to those sections as amended.

Mr. Chairman: All those in favour of Hon. Mr. Elston's amendment will please say "aye."

All those opposed will please say "nay."

In my opinion the ayes have it.

Motion agreed to.

Section 1, as amended, agreed to.

6:10 p.m.

On section 6:

Mr. Chairman: Section 6 is the only remaining one we have in front of us.

We have a motion that has been tabled, but it will not be moved, I am advised. Thank you.

Miss Stephenson: It is unfortunate the phrase used as a short title is still within this bill. For the practitioners who have attempted to deliver health care in this province with a great degree of responsibility, it is simply a further insult that the short name for this bill should be the Health Care Accessibility Act when it addresses one minuscule portion of accessibility.

I remind the honourable minister that accessibility to health care encompasses a great deal more than the very small number of patients -- and it would have been even smaller under the type of arrangement the OMA suggested -- who would be billed at any level beyond that of the OHIP benefits.

The member for Scarborough-Ellesmere has suggested there is all kinds of range and scope for negotiation with the physicians after this bill is passed. I thought the member, as a former schoolteacher, would have understood a little something about human relationships, attitudes and the ways in which one fosters good relationships, good attitudes and functional and effective co-operation.

This act, as it is currently written and particularly with its insults in the last section of the act, will not in any way encourage the practitioners of this province to co-operate effectively with the government in the delivery of health care. In fact, I would suggest the minister might be moved to delete section 6 completely. There is no point in having a short title to this act when it is so absolutely misleading, so totally wrong and so completely distressing in terms of the health care practitioners who are involved in this.

After all the hearings and discussions, I would have thought the minister might have made that amendment himself. This act does not need a short title. He has already done enough damage with the long title. Let us not murder the corpse, for heaven's sake, with the short title that is included here now. I strongly suggest that there be reasonable consideration of at least one of our motions as far as this bill is concerned.

The Treasurer (Mr. Nixon) is gesticulating wildly to the minister, "Do it and get her to shut up and sit down." I can hear him from here and I can read his lips. That is exactly what he said. I have a great understanding of his attitudes, words and sentences. I watched the faces of the Minister of Education and the Minister of Colleges and Universities (Mr. Sorbara) and the consternation on the face of the Minister of Health, and I knew precisely what he was saying.

It would be a reasonable suggestion if it were one of the small concessions -- the only concession -- made by this government, which the Financial Post editorial board has described as hamfisted and bullheaded. It would be the only concession it would have made with regard to the type of reasonable --

Interjection.

Miss Stephenson: The Financial Post. Has the member not read it? The Financial Post editorial board described the government in this action as hamfisted and bullheaded.

Mr. Chairman: Order. I remind the member that the member for Brantford (Mr. Gillies) said you had an amendment to move.

Miss Stephenson: My amendment is that the minister delete this section of the act.

Mr. Mancini: We do not take advice from anybody.

Miss Stephenson: Oh, really? The government takes it from the New Democratic Party.

Mr. Chairman: That amendment is not proper. You vote against the section.

Miss Stephenson: I am aware of that, but I was trying to encourage the members opposite to consider seriously voting against section 6 so it would not be included in the act since there is no need for it. It is redundant and unnecessary.

Mr. Chairman: The time now being 6:15 p.m., we must ask the question under the motion passed earlier today in the House.

Section 6 agreed to.

On motion by Hon. Mr. Nixon, the committee of the whole House reported one bill with certain amendments.

6:26 p.m.

The House divided on whether the report of the committee of the whole House should be received and adopted, which was agreed to on the following vote:

Ayes

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

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

Nays

Ashe, Baetz, Barlow, Bernier, Brandt, Dean, Eves, Fish, Gillies, Gordon, Gregory, Guindon, Hennessy, Jackson, Johnson, J. M., Lane, Leluk, McCaffrey, McCague, McFadden, McLean, O'Connor, Partington, Pierce, Pollock, Rowe, Sheppard, Stephenson, B. M., Stevenson, K. R., Taylor, Treleaven, Villeneuve.

Ayes 66; nays 32.

HEALTH CARE ACCESSIBILITY ACT

Hon. Mr. Elston moved third reading of Bill 94, An Act regulating the Amounts that Persons may Charge for rendering Services that are Insured Services under the Health Insurance Act.

Hon. Mr. Elston: This has been a rather extended piece of work. We have taken almost a year in dealing with an issue that is and has been described appropriately by members of this House on all sides as sensitive. It is one on which we spent a considerable amount of time trying to come to grips with the predominant question of how one might reconcile the needs of a government to fulfil a mandate to end extra billing in the province to comply with federal legislation that prescribes we must end extra billing in the province or suffer holdbacks in the total amount of $53 million per year. That figure currently stands at around $100 million.

We spent 10 or 11 months speaking to the profession informally. A series of 11 formal meetings took place and we found that we could not come up with a negotiated settlement, as had occurred in some of the other provinces in this great country of ours. People know that we now are one of only three provinces in this great country of Canada that have not complied with the Canada Health Act, which have not complied with the directive unanimously passed in the federal House and in the federal Senate that indicated extra billing must end. We know others are making plans to follow suit.

It has not been easy; it has been very difficult. It has taken a lot of time and effort, but the members here, the public of our province and the people across the great nation of Canada who use the health care facilities in this province, recognize that we have institutions that provide for us great opportunities for ensuring the health of people in Ontario, Canada and internationally as well.

I assure the people of this great country, the people and the practitioners of this province, that with the passage of and the implementation of this bill, it is not our intention to stop addressing the critical issues of health care and the needs of the system in this province.

The commitment of this government and of this minister to the people of this province is not only that we will be diligent in pursuing an end to some of the problems which have been pointed out during the great public debate that has surrounded the implementation and the passage of this bill. We also will be paying great heed to the future advice and wisdom provided to us by those people participating in the system who in the past have provided us with advice and expressed concern about certain areas in which we could provide some improvement so the people of the province could be better served. We will continue to strive after programs such as the announced $850-million capital program which came from the Treasurer's (Mr. Nixon) budget statement in May.

We shall proceed to look at the questions of how we might address concerns about honouring those people who provide us with excellence in service to the medical profession in this province. We shall look at the great questions of how we deal with ensuring that seniors receive good quality care as has been partially addressed already and is continuing to be addressed by my colleague the member for London North (Mr. Van Horne).

Together as a government, we shall pursue those goals of excellence in the provision of health care, with the assistance of the professions which are involved in providing health care to the people of this province. We shall work overtime to come to grips with some of the concerns that have been expressed on the question of freedom, which has been raised time and again by members of the profession who have some concern that this government has a secret agenda. There is no secret agenda. This bill speaks only to the question of extra billing.

It has been and it continues to be our position, and it is the position of the people of Canada, that the citizens of this great country must be assured of receiving the best medical care and have equal opportunity of receiving medical care without regard to their ability to pay. That being the case, we in this party and in this government realize that work does not stop with the passage of this document, this legislation. In every sense of the word, our work is only beginning.

I commit myself to the people of this province to work to ensure the continued expansion and improvement of the provincial health care system, working co-operatively with the professions which provide us with excellent care in this great province of ours. I commit myself to the people that this is not the end but merely a first step to ensuring that the people will have improved facilities, that the practitioners can work with me to discuss the issue about which they have spoken so eloquently in a number of their meetings, the question of freedom. We can ensure that patients will have a choice of physicians.

6:40 p.m.

It has been a long time in debate. Most of us as legislators are pleased to be here. At times, it has been difficult for the public of this great province. Although some have said that the passage of this bill will cause more dissension, in speaking to practitioners in the medical field and others and in speaking to the public at large, the indication is that it is best for us all: for the profession, for patients and for this Legislature to move to pass this bill finally. It will remove the stresses which have caused, in my opinion, undue pressure on the interpersonal relationships in the medical profession, on those people who provide support services in hospital facilities and on those professionals who work in those facilities -- nurses, physiotherapists and others. It is time now to put this discussion well behind us.

Once having assured the public of this great province that we will ensure equal access and that they do not have to unroll their bank accounts or bare their credit rating before they have access to a practitioner, let us all commit ourselves to moving ahead to improve facilities, and to look at how we can improve the practice and provision of services in the province.

I would have preferred it if this bill had not been brought to this House. I would have preferred if something such as the situation in Prince Edward Island or Newfoundland had occurred here: a negotiated settlement, or a consensual elimination of extra billing. That has not been possible. In my opinion, that would never have been possible in this province. The result is that we have needed legislation and we indicated our commitment to legislation. We have now fulfilled the commitment to providing legislation, and I look forward to the passage of this piece of legislation tomorrow.

Mr. Speaker: I wish to inform the members, in case any are interested, that the dining-room is open until 8:30 tonight.

Are there any comments or questions related to the comments by the Minister of Health? If not, the member for Ottawa West.

Mr. Baetz: It is an honour for me to begin this marathon debate imposed by an autocratic government. Before I begin my remarks, I would like to pay tribute to my colleagues the member for York Mills (Miss Stephenson) and the member for Lincoln (Mr. Andrewes) who have for so long, so bravely and so intelligently tried to convey to the rest of this House and to the public those issues that we deeply believe in as they relate to this piece of legislation.

This is a very sad occasion for the people of Ontario, for the citizens of this province, who over the years have become accustomed to enjoying and reaping the benefits of one of the finest health care systems in the world. That has been acknowledged time and again by the newly formed government. It is a sad moment for all the people of Ontario. Sooner or later we all require the benefits of the health care system. It is a sad time for all of us. The events of today and the decisions taken by this House today will trigger a whole sequence of events that will not be in the best interests of the people in this province who seek the care of our health system.

It is a sad day for the parliament of this province and the people who believe in the parliamentary system because, as we and as most people in Ontario know, closure is a nasty word. It is a dirty word. Closure is something that creates a knee-jerk reaction in all the citizens where a parliamentary system is predominant.

In general, citizens do not care too much about the parliamentary system, its fine-tuning and how it works in detail, but people who live within a parliamentary system know one word and that is closure, or guillotine, whatever. It is something they loathe. It is alien to them. Closure is the ultimate weapon. It is the last resort of the parliamentary system. Closure is used when every other measure has been tried and has failed. Then and only then do people in the democratic system accept that there is such a mechanism as closure and that the government of the day should have the power and responsibility to impose closure because we recognize that eventually government must govern; it must rule. But closure is used only as a last resort.

We have here a situation where consistently, over the past few weeks, we have urged, encouraged and begged this government to take one final step, to try one more way to bring about a settlement through the appointment of a mediator. Time and again, the government, in particular the Premier (Mr. Peterson), has stonewalled. It has refused to take this one step to appoint a mediator.

Why would the government not at least try this last final step before it takes the ultimate step of guillotine or closure? Why not appoint a mediator? In a month or six weeks from now, the mediator may come back to this House and say, "I am sorry but it is simply impossible to bring the two sides together." At that point, the government surely could have legitimately reached a decision. It could have said: "We have now tried everything and we must now impose the guillotine. We must impose closure."

That one big, interim step was not tried, and the people of Ontario are going to remember that. The people of Ontario are not militant people. They are not the type of people who, in the first instance, want to settle issues with a fight, with a knock-down, drag-out confrontational type of approach. The people of Ontario want peace. They want to resolve things through agreement, through consensus. Frankly, the people of Ontario are going to be offended that closure was imposed before this government had taken the final step of trying to resolve this problem in a very peaceful way.

6:50 p.m.

It is a sad day for the Ontario government which is now going to celebrate its first anniversary, this government which came into power with all the fanfare and all the beautiful talk about being an open government. Did we not see it all here out on the lawn at Queen's Park? Everybody was invited to come and join, and the Premier kept saying: "My office is open. I want to talk to everybody. Things are going to be very different with openness, a new government, a new era. Behold, I make all things new." That was one year ago.

Now, on the anniversary of this open government, there is closure and guillotine. Enough is enough. People have to learn. It is a very sad day for this government.

I sensed this afternoon that it is an extremely sad day for a very good friend of mine in this Legislative Assembly. It is a sad day for the Treasurer (Mr. Nixon), the House leader of the government, because we all have respected the House leader as a great parliamentarian, a man who knows and understands the importance of something such as closure.

He abhors it; he said so this afternoon. He does not like it. He fights it. Because he is a great parliamentarian, he knows this is a last, terrible step and he did not want it. I guarantee that if the private person, the member for Brant-Oxford-Norfolk (Mr. Nixon) and government House leader, could speak to us today, he would have to admit that this was forced on him, that he did not like it, that it cut against everything he believed in and has been talking about in this House for the many years he has been here, and for which we have respected him. It is a sad day for him.

This decision by the government on closure and the guillotine rests with the Premier and his office. It confirms a suspicion that has been growing over the past few months, that the ultimate and only centre of power in that government is in the front office of the Premier and that most of the members of his caucus are nothing more than trained seals. It is an indication that this Premier, this Rambo -- he is a Rambo, a macho; he loves it -- is a man who says, "By God, I have to be firm and strong and I will do this and this, and I know what is best for the people."

That is the personality of our great Premier, this macho Rambo. That, unfortunately, is fortified and strengthened by a gaggle of nameless, faceless, power-hungry individuals who never need to go to the people to be elected who support him. I can see this gaggle around the Premier, these power brokers, these power-hungry people, saying to him in the past few days: "Give it to them. Knock the medical profession apart. Destroy them. Enforce legislation on them."

He is going to win this round. This is a 10-rounder and there will be a knockout. We know that. This is not the way to govern and especially not to govern very civilized, intelligent, wise people such as the people of Ontario. One does not ram things down their throats. That is the Premier's approach. He is a boxer. One does not have mediators between boxers. One boxer tries to knock out the other one. That is the one and only objective; to destroy the other.

The Premier's approach was to fight the medical profession. It started on day one. There was no consultation, no asking: "What can we give? What can you give? Let us try to reach a common ground." No. The approach has been one of saying: "Tough. I will knock you out. I am the boss. I am the winner." Unfortunately, this has now led to this situation where the guillotine will be imposed in a matter of hours. The time is indeed running out on us.

Of course, he has been supported in all this. He would never be able to exercise this kind of coercive, Rambo type of power if he had not been supported by the party down here to my left, a party which has been only too willing to give up some of its own principles. If this were a trade association or a union of any type trying to say to the world: "We too have a place. There are such things as collective bargaining powers," and so forth, that party would have supported it to the end.

In this situation, that party was simply a part of the Rambo approach by the Premier and it gave him that power. The people of Ontario did not give him this type of power. The Premier would like to believe that he has a massive majority of members in this House because he has a massive majority of electoral support. He is a mistaken man; he has 49 members. He has a minority government, but with the help of a so-called accord, he is able to muscle, to power his way into subjecting the doctors.

It is interesting that today, during these final hours of debate, the Premier decided, typically, that he would go to my riding to open a hospital which the previous administration had planned, worked for, made available and financed. Instead of staying here and entering the debate, the Premier decided to take off to Ottawa and pretend to be the big boy for the occasion. He is the Joshua.

Moses led the children of Israel through 40 years in the wilderness. Those were tough years and just as the children of Israel were about to enter into the land of milk and honey -- we all know the story -- God took Moses aside and said: "There it is. There is that fantastic land of milk and honey. After 40 years of hardship, the children of Israel are about to go in; but I have bad news for you, Moses. You are not going to go. You are going to die out here in an unmarked grave. Nobody can even build a citadel for you, a marker or anything. Joshua is going to lead the children of Israel into the promised land."

I can almost hear Moses asking: "Joshua? Joshua who? What did he ever do?" But Joshua went in there. He led the children of Israel into the promised land. Was he not a Mr. Big Shot? Was he not something?

7 p.m.

Today, the Premier will go to Ottawa and preside over the ceremony at the Royal Ottawa Hospital and say, "What a big boy am I." Joshua, that is who he is. We are Moses. After 40 years in the wilderness, we brought the people to the promised land, and Joshua led them in. The Premier should remember the moral of that story; leaders come and leaders go but nations and people go on forever. If the Premier continues to carry on the way he has over this issue, this is going to be one leader in the history of Ontario who will not be around for a very long time.

It is most unfortunate that we have so very quickly resorted to this extreme measure to bring this great debate to a halt. We are told it had to be done in the interests of the people. It had to be done, because we are losing $50 million a year. That is what the federal government said. The federal government, which was in the hands of the Liberals for so many years, through the Canada Health Act said we had to conform to that act. This government is saying we must do it quickly.

Quickly? This is June 1986. We have until April 1987 to make a decision as to where we go on this matter of extra billing before we permanently risk losing the benefits under the Canada Health Act. We have from now until next April. We have time for a mediator to sit down with the doctors and the government and bring the two together. There is plenty of time, and this province would not have lost one cent in this whole thing. Why now this tremendous urge to finish it by one o'clock tomorrow, in the middle of June? It is almost a whole year before we have to meet the deadline. It is again the Rambo touch, the touch that says, "You are going to settle when I say you are going to settle." This is most unfortunate.

Perhaps the Premier does not quite understand. Perhaps the Minister of Health (Mr. Elston) does not understand that a mediator is in a far better position than the Minister of Health or the Premier himself or the doctors who have been calling each other names. Frankly, the Minister of Health has been somewhat more moderate in his approach to the doctors. I have listened to my colleague the Minister of Health in many debates in public. He has had a somewhat more moderate approach, but even then there has been this feeling of confrontation, inflexibility and name-calling, to the point where the two sides have reached a position where they simply cannot give one more inch without loss of face. That is important for both the medical profession and the government. We understand that.

We have a little intrusion here. The member for Renfrew North (Mr. Conway) is not in his seat. He is sneaking around behind the Speaker's chair.

In this situation, we are convinced a mediator could have brought this to a mutually acceptable conclusion. As the Premier said time and again, "There is nothing more I can do." I can appreciate that. After having called the doctors everything under the sun -- gougers, hungry people who have no sense of whatever, all kinds of very unfortunate, belligerent, militant kinds of accusations -- it is no wonder the Premier feels he is at the point where he can no longer negotiate in any kind of constructive way with the medical profession.

We have heard in this House that some doctors have made some rather intemperate statements. It has been upsetting, but frankly, I am convinced the vast majority in this assembly and the citizens of Ontario recognize the medical profession is, collectively, a very noble profession. The Hippocratic oath does mean a great deal to doctors. It does mean something to them.

One simply cannot write them off as being only interested in making more money or in being the parasites of sick people. We know the medical profession is far above and beyond that. This is an intemperate, boxer-like approach by the Premier. We know he is a boxer. He prides himself on being a boxer, but that is not the way to run this province -- by coming on heavy, by coming out of his corner saying: "Come on now, members of the medical profession, my one objective is to put you on the canvas." That is not the way to run a province as civilized as this one. Somebody was talking about kicking. Perhaps he was talking about kickboxing, but that is not the way this province can be run, and that is not the way he is going to subject the medical profession.

There is altogether too much of a feeling here, and it came across again this afternoon when the Premier was here, that if they can give them the knockout sock, if they can get them on the deck, they are done. The Premier feels he is going to administer the final blow to them. He is going to pass Bill 94 and bang, that will be the end of the medical profession. The fight will be over, the game will be over and he will be the victor.

That happens in a boxing ring, but that is not the way to deal with the people of Ontario and certainly not with one of the finest service professions we have. Long after that Premier has gone -- and it may be sooner rather than later -- the medical profession is going to be here. In 10,000 different ways they are going to look after the health needs of the people of this province, in very personal, intimate and highly sophisticated technological ways. They are going to do it in a way they feel comfortable with and in the way they want. Frankly, if they can work in that kind of atmosphere, the social environment they want to feel free working in, surely that is so much better than having the doctors feel they have been coerced and flattened on the canvas and that they now have to hand out their services. That is not going to happen.

7:10 p.m.

I cannot help but believe that by one o'clock tomorrow, when the government is going to render the knockout blow, the Premier, the boxer, thinks that suddenly it will be all over. It will not. The troubles will only begin. That is my concern, and that is why we, in this party, feel this is a sad day. We had the means at our disposal. We had the means right there, namely, the appointment of a mediator, to make one more effort to resolve this dispute and our differences, to establish a consensus, to bring the two sides together, for their mutual advantage and, above all, for the advantage of the people of Ontario who must rely on the medical profession for help.

It is an honour to lead off in this discussion tonight, this so-called marathon. When one thinks of it, it just epitomizes the vindictive attitude of this Premier, the knockout guy, the boxer, who says, "You guys want to discuss this any further? By God, I will put it to you. You are going to discuss it all during the night," instead of saying, "You can do it for another one, two or three days. We know eventually you are going to have to bring this to an end," but it is the spirit of vindictiveness, the spirit of the knockout blow, the low blow, that says, "You confront me and I will give you a shot. You can talk all night."

I will tell members one thing: Our party is pleased to talk all night if that is the way it has to be, but the people of Ontario do not think too highly of this young, open government that says, "You are going to talk all night." Some of the security guards have to be up all night. This is open government. It is a joke.

I know the people of Ontario have a long memory. The next time we consult with the people, I think they will remember this. They will especially remember it because by that time they will know that because of this coercive approach to the health care system, they are getting worse health care than they ever got before. They will understand that. I can see the Premier having totally offended the medical profession of Ontario. Having thoroughly offended them, he will then have to feel that he has to pay them a little extra after this is all over.

It is not the Premier's or the Liberal government's money he is handing out, but he is going to have to hand out a lot of the taxpayers' money to reconcile the medical profession a little bit. The cost of health care will go sky-high. To bail himself out and in an effort for the Premier to try to reinstate himself, he is going to be prepared to spend hundreds of millions of the taxpayers' money. The taxpayers are not that stupid. They know whose money the Premier will be spending. It is theirs.

Anyway, my colleagues and I quite happily are prepared to talk the whole night through here to try to get our point across. As I say, this is indeed a dark moment for the people of the province. It is a dark moment, especially for that government of Ontario that said, "We are the new open government." This is not open government on the eve of its first anniversary -- closure. We are prepared to continue to discuss this with the people of Ontario.

Tonight, the Premier is probably in Ottawa -- I do not know where he is -- with his gaggle of power brokers in the back room, many of them imported here from the Trudeau regime. I worked with the Trudeau regime and I know the arrogance and the centralism that were there. Everything ran out of the Prime Minister's Office. That same kind of attitude is coming into this young government here with a vengeance. We smell it, feel it and see it all over and the people of Ontario also are going to sense it very quickly. They have had a beautiful example in this closure tonight on Bill 94.

Mr. Guindon: I am pleased, in a way, to rise tonight to speak on Bill 94. I want to make it clear right from the start that in Cornwall there is not one doctor who extra bills. Yet they are among the most militant in the province. There must be a reason the doctors in Cornwall and the surrounding area, Stormont, Dundas and Glengarry, do not extra bill. There is also a reason they are mad. They are upset because this bill digs right into the root of the very reason that most of the Europeans from the older countries come to this country. It is for freedom, the freedom of choice and the freedom of work: the freedom of working for whom they want and when they want. This bill will not permit the doctors to have the freedom they need.

What we need in Cornwall is access to services. Eastern Ontario is a little bit more remote and a little farther from the heavy population of Ontario. We do need more services; for instance, a computerized axial tomography scanner or even an electroencephalogram machine. We need better ambulance service. I am not saying this because we can remedy this in 15 days or 15 months, but because it is a problem for us. Right now, we do not have in our area an ear, nose and throat specialist. Currently, there is one available in Brockville. He comes to Cornwall once a week, and if patients need surgery, they have to travel to Brockville or go to Ottawa or Kingston.

What makes those doctors upset is that most people think it is because of the money. I have been told many times that money is not a big factor in it. It is a factor, I agree, and I must admit right here that I am not one who is in favour of passing a bill or voting to give somebody else the privilege to make more money. What stands out in my mind much stronger is the freedom they are going to lose. I am prepared to vote against Bill 94 for that reason.

We must not forget that in Ontario, and it is probably the same in other provinces, we make laws right here in Toronto mostly for the area which has the greatest problems. I said at the beginning that Cornwall does not have a problem in extra billing but Toronto might have it. Why is it that in this province we have to pass laws, whether for housing, medicine or health care, that are basically designed to serve one area, the Golden Horseshoe, all the time forgetting the smaller centres? We exist too.

I am asking myself how is it going to be five or 10 years from now with the new crop of doctors coming out? Are top-notch students going to be interested in medicine or will they choose engineering, business or other professions? If they feel they will not get the treatment they deserve for the work they put in, we will not have the doctors we deserve; or we will have the doctors we deserve but not the doctors we really need.

7:20 p.m.

I am going out on a limb here and am predicting that 10 years from now, instead of 17,000 doctors in this province, we are going to have 34,000. Instead of costing 30 per cent of the budget, it will probably cost close to 50 per cent of the budget. I say this because everything the government has put its hands on and tried to operate has failed. I grant there are some responsibilities that government has to look into but they will always lose money on them.

The example I want to use here is, thank God, a federal problem. The biggest example of failure, poor service, disarray and confusion is the mail service. I do not want my health care system in Ontario compared to that, but if we are not careful, that is what is going to happen. We are going to have doctors who will not work on Sundays, Saturdays or holidays. Then we are going to have to make a deal with the doctors and compensate them for working at nights after six o'clock or on Saturdays, Sundays and holidays. That is going to cost a lot of money and is not going to help the system get any better.

Maintenant, j'aimerais prendre quelques instants pour m'adresser à la Chambre en français. Je dois dire qu'en premier lieu, je suis pas mal déçu du fait qu'on soit obligé de bousculer les docteurs de cette façon. Je crois sincèrement qu'en mettant un peu d'eau dans leur vin, les deux partis auraient pu en venir à une entente, sans être obligés de voir nos hôpitaux à l'envers, nos docteurs qui semblent refuser de donner les soins médicaux et les patients et les commettants de mon comté qui s'inquiètent, qui s'excitent et qui ont peur d'être malades, qui ont peur d'affronter leurs docteurs. Puis encore, ils ont peur de ne pas obtenir de services; parce que partout, il y a des gens malades et des gens qui ont besoin de services.

Quant aux tactiques dont les docteurs ont décidé de se servir pour se faire comprendre, je ne suis pas tout à fait d'accord avec elles. C'est seulement qu'on fait affaire ici avec des gens qui ont peur de perdre leurs chances de réussir dans la vie, à leur façon et comme ils le méritent.

La plupart des docteurs à Cornwall ou aux alentours de Cornwall qui sont très fâchés, qui sont les plus militants, sont des docteurs qui viennent, pour la plupart, d'autres pays. Ils viennent de pays où ils ont servi sous un système social, où la médecine était controlée complètement par le gouvernement. Ils ont choisi de venir ici parce que, d'après eux, quand ils regardaient le Canada, ils se disaient: "Ça, c'est un endroit où on est libre, c'est un endroit où, si je fais mon ouvrage et si je le mérite, je serai payé en conséquence."

C'est pour ça qu'à Cornwall les docteurs sont tellement mécontents et tellement inquiets. C'est parce que d'après eux, ils se trouvent à avoir perdu tout idéal, parce que lorsqu'on prend une décision dans la vie pour aller dans quelque métier que ce soit, plombier, pharmacien ou politicien, l'idéal compte pour beaucoup. Lorsqu'on éteint les lumières sur cet idéal, il y a plusieurs gens qui se posent des questions, qui s'inquiètent, qui ont des réactions qui ne sont pas toujours avenantes à leur personalité et qui causent souvent de l'inquiétude parmi les gens, surtout en ce moment, par les services réduits des docteurs.

Mr. Speaker, with your permission I would like to read some excerpts from a family physician who is a friend. I think you will appreciate his thoughts.

"The new Health Care Accessibility Act, 1985, with its punitive riders is no more than a procedure to achieve the enforced enclavement of the medical profession and, when further examined, the enslavement of a patient public. This is the beginning of the enforcement of state control of everything, and the ideology appears to be the establishment of a totalitarianism system of government.

"It is the medical profession and patients today but, like some spreading cancer, the state, by its very nature, will invade and then capture every nook and cranny of society.

"The economic implications of the financial crisis, the advances of medical technology and the populist expansion of the totalitarian welfare state exaggerates this tendency. Increased cost is taken by the state as an excuse to exercise authoritarian controls over medical practice -- which is what is happening now. No longer will the ethical standards of medicine and the independent judgement of its practitioners be the main goals of state medicine. Now the ledger entries of the planned economy take precedence. The very complexity of the totalitarian welfare state will offer an alibi to the planners for the implementation of their preconceived ideologies. If this act is passed, the state will gradually strangle medical practice and patient care, just as it will ultimately stifle the economy....

"This whole question of extra billing is a blind -- the intention is to acquire totalitarian control of society. Under the guise of looking after the public's interest, there are the manipulations and manoeuvrings intent on acquiring power.

"These same honourable people who cry out that patients have a right to access to medical care are the ones who are limiting access and availability, thus denying medical care, while at the same time presenting themselves as great benefactors. Have they stated that they have already instituted proceedings which will limit the number of doctors in an area and that there will be punitive repercussions if hospitals grant privileges to new doctors coming to their area, even if the area is in great need of such doctors?

"Have they told you that there are constraints being enforced whereby hospital staff, and so service, is to be reduced -- these honourable people who shout about job creation? Have they mentioned that there are in many areas an ageing doctor population which will need to be replaced in the next 10 years? Have they told you that they are already taking steps to limit certain types of procedures in outlying hospitals?

"And these are the honourable people who talk about accessibility...."

7:30 p.m.

"Both the Canada Health Act and the Health Care Accessibility Act, 1985, pertain to the political term `extra billing.' Where does health care come in? What care is being offered in return for insurance paid and where? The patient public must ask these honourable benefactors: What care? By whom? Where? When will I get the care I need and want and from a person of my choice, or will I get the care a political presidium dictates is good for me?

"The patient public must realize that when their care is paid for in whole or in part by a totalitarian government, they ultimately will have no right to choice of doctor, no right to choice of treatment. They must also realize that when medicine is completely controlled by the state, the doctor has no right to render care. Likewise, the patient in such a system has no right to receive care. Both rights will depend on the government's largess.

"In their freedom, doctors would like to continue giving personalized service to their patients. With loss of freedom, patients must expect only a socialized service.

"It must be pointed out that all state systems of medicine have failed, both behind and in front of the Iron Curtain. In the UK, the government has seen fit to encourage private insurance and private, non-NHS-participating hospitals so as to gain relief from the increasing financial burden of state medicare. From its inception, the NHS ledger has always been in the red and, no matter what our -- socialist? communist? -- benefactors do, OHIP will always be in the red. However, by denying or limiting accessibility by legislating availability, our honourable benefactors may achieve a plus balance. Only they are not honest enough to point out to the public that the machinery for limiting availability is already in motion.

"It has been stated that the fundamental failure of all state systems is that the individual -- patients and their doctors -- become careless. The individual becomes careless of his own standards -- the state will always provide; this is what was promised. He/she couldn't care less about the problems of others; it's the state's problem. But the state will see to it that more pressure is placed on the volunteer and charitable organizations. In the end, these will not be able to do any more, because charity will become a dirty word and because the state promised to provide and it is the state's responsibility. Not having money of its own, the state will confiscate through taxation.

"The intent in the destruction of doctors appears to be the achievement of equality, and the instigators of this pogrom are avid worshippers of equality. They know the only way to achieve equality of outcome is to damage the best, hinder the productive and enslave the creative. They will not see nor accept, however, that in the end the best won't bother, the productive won't produce and the creative will use their talents to avoid helping their captors. They will expect all to kowtow, and if anyone dares to attempt to come out from underfoot, they will be accused of being irresponsible, immoral, unethical or whatever adjective could be found to ensure conformation by humiliation.

"Inherent in this aggrandizement of public service and denial of monetary self-evaluation of a group is the instilling of fear in the mind of the public: the fear that no other system would work and emphasizing this by denying other insurance coverage; fear that they cannot afford medical care if this punitive action is not taken; fear that adequate treatment cannot be expected from a money-greedy doctor so they must be enslaved and have no freedom of choice; fear that if the system is not supported, they would be cast aside and left to die; fear that without the welfare state, there will be no life worth living; fear that if the welfare state gets into trouble there would be no more freeloading.

"The main substance in both acts has been the presentation that all the ills of the health care system have been due to the greedy, money-hungry, money-oriented doctors. As evidence, there has been the presentation that the average doctor earns $120,000 a year (it varies according to what impact on the public is intended). It is quoted that this figure is from Revenue Canada.

"You well know that only those facts and figures are used which appear to support an argument, and no debater is going to present facts and figures unfavourable to his/her argument. Why not be honest and present the whole range of incomes? Why only the top-bracket earners? Why not present the fact that, on an average, that top-bracket earner has to work 86 to 96 hours a week, which works out to about $28 an hour? After overhead expenses, which include rent, heat, light, telephone, building tax, staff salaries, equipment, stationery, medications, patient conveniences, he still has to pay back to the government in taxes the sum of about $38,000.

"Why doesn't the government tell the public how much money they confiscate back from doctors and what they do with it? Any plumber, electrician or motor mechanic working those hours can earn that money. Will they, however, be at the beck and call of their clientele 24 hours a day, year in and year out? Will they always get out in any sort of weather to go and attend to someone? Will they take on the overwhelming responsibility of looking after human lives?

"Will they tolerate sacrificing their families, friends and private lives for the sake of a patient? Will they be willing to sacrifice earning time to attend departmental and committee meetings at the hospital without remuneration? Will they sit up nights reading journals or listening to educational tapes to keep abreast with medical knowledge? Will they take unpaid leave to attend conferences and seminars? What about volunteer work with service clubs and various medically related community societies?

"I very much doubt that they would. Furthermore, no lawyer will work for $28 per hour, nor for that matter would the honourable members of the presidium. Yet doctors are persecuted and presented to the public as being a greedy, money-oriented group.

"With all the hooha and shouting, you would really get the impression that the honourable members place a high value on human life. Is this really so? No! An emphatic no. Their evaluation of human life is reflected in the pittance they offer for services, and they are hell-bent to forcibly enslave and conscript doctors into accepting this evaluation of human life.

"Please read and reread Bégin's -- as far as I am concerned, dishonourable -- Canada Health Act, for in it lies all that is required to establish a state system of medicare that is to be totalitarian. Not concerned with public welfare but concerned with political existence, the honourable members saw fit to give it easy passage. The evil that `man' does for power: it is well charted that power corrupts and that total power corrupts totally.

"Over the years, there has evolved a gnawing suspicion that the doctor of medicine was envied by persons from other walks of life. This envy at times is presented as resentment to the fact that the doctor by his calling and practice had control over people's lives.

"Because of this envy and resentment there arose a retaliatory desire to control and subjugate the doctor. They have discovered that the best way to do this was to control the doctor's freedom to practise, his relationship to his patients and his independence. The Canada Health Act and the Health Care Accessibility Act were brought into being to achieve this purpose."

That was signed by Indra Deepan, a doctor in Cornwall.

Encore une fois, il me fait plaisir de parler dans ma langue maternelle. Je voudrais seulement terminer en disant que je vais appuyer mon parti et je n'appuierai pas le projet de loi 94. La raison principale est que ça enlève les droits qui ont été acquis par des gens qui, avant de se lancer dans la médecine, n'avaient aucune idée de ce qui les attendait. Donc, avec ça, je voudrais vous remercier, Monsieur le Président.

7:40 p.m.

Mr. Brandt: I rise to join in this debate and perhaps to amplify some of the comments made by my colleagues with respect to our opposition to Bill 94 and the principle that is outlined in that bill.

I spent most of the time during the course of my earlier remarks addressing the question of whether a mediator might, in effect, have some influence on the matter that is not resolved between the government and the Ontario Medical Association. It has been the position of our party consistently, as members are aware, that we endorse the concept of bringing a mediator into the dispute with the specific purpose of attempting to break the present logjam.

I want to say to the members opposite and to the members of the third party that we have some very serious concerns in regard to what this bill is going to do to Ontario and to health care in our province. I want to take a few moments this evening, in the opportunity that is presented to me, to articulate a few of those positions and views and to continue to make an appeal to the government to look at this whole matter in an intelligent and open-minded way.

First of all, the OMA has put before this House, not only today but in early negotiations with the government, a position it has agreed to that would effectively wipe out extra billing in this province. It has said it would not extra bill those senior citizens who are 65 years of age or over; it has indicated it would not extra bill emergency cases or individuals who were on a limited income, either welfare recipients or persons on low incomes.

To put that into context for the members opposite who have created this problem by bringing in Bill 94, at present about 10 per cent of the physicians in this province are involved in the process of extra billing. Of that 10 per cent, when one takes a look at the total fees for doctors in this province, something on the order of about three per cent is the actual total amount that is extra billed. That was before the OMA agreed to certain other negotiated changes that it and its membership have brought forward in an attempt to find some middle, negotiable ground with the present, intransigent government.

What would happen would be that the three per cent -- and that is the figure we are talking about -- would in all probability go down to about one per cent or maybe 1.5 per cent. That is the problem that was created by the third party when it signed the accord with the Liberal Party in an attempt to get extra billing banned for the entire province.

What they have done with this bill is to shroud it in a number of words that bear no resemblance to what the net impact of this bill is going to be. The first thing they have done is to completely mislead the people of this province by talking about a Health Care Accessibility Act. That is a misnomer if I ever heard one. It borders on misleading, Mr. Speaker, to use a term that I know is now parliamentarily acceptable because you allowed it to go past today, and it borders on misrepresenting not only the people of this Legislature but also the more than nine million citizens of Ontario.

I say that because for 15 years I have been involved in a profession I thought very highly of until this bill came forward -- the profession of politics. In that profession, we have always looked at trying to deliver to the public truisms, statements that bear some resemblance to the truth. Some might argue that position, but I am going to attempt to do that in my address tonight. My colleagues opposite should have done that when they talked about accessibility to health care in this province, because there was no lack of accessibility. I say that because of the 15 years I have spent in this profession, which I think is an honourable one.

I have yet to receive one phone call from one citizen of this province, in my riding or elsewhere, indicating that he had difficulty getting access to the services of a medical practitioner, a doctor. That says something for what has happened.

I am glad the member for Wentworth North (Mr. Ward), the parliamentary assistant to the Minister of Health, is here. He has moved up to the front row. I do not know whether the parliamentary assistant has received a promotion, or whether he is just acclimatizing himself to the day when he is going to move up to those hallowed benches in the front.

An hon. member: It is purgatory.

Mr. Brandt: It certainly is purgatory for the minister he is now assigned to and for the Premier (Mr. Peterson), who normally sits just a couple of chairs opposite the member.

There is something we have to draw attention to with respect to what has happened with this bill. First of all, it has misled entirely, or bordered on misleading entirely, the people of this province because it talked about accessibility when there was no problem with accessibility.

I challenge the parliamentary assistant to tell me the number of calls he received during his very short stay here in the parliament of Ontario. I challenge him to tell me about the great number of calls he received in his constituency office from people who were desperately in need of a doctor and could not find one who would not extra bill or could not find one because of the specialty they required at a particular time.

I have to tell the parliamentary assistant that in all probability he received absolutely no phone calls whatever, because that is the experience I had. He nods in the negative. If he wants to stand up on a point of order and explain that he has received a great number of phone calls, I want to tell him before he does so that I want the names of those individuals and their phone numbers. I want to get back to them, and I want to qualify what he says in defence of the challenge I have just thrown out.

An hon. member: If I give the member names, does he promise to call everyone back?

Mr. Speaker: Order. The honourable member is not in his seat.

Mr. Brandt: Yes, I promise to call everyone back.

The other thing that has happened in the context of this bill is that, in addition to the problem the government has created in the minds of some members of the public about accessibility, it has put forward an age-old socialist principle known as something for nothing: the free ride, the free lunch, the free whatever the service or program might happen to be, without anybody having to pay for it.

Interjection.

7:50 p.m.

Mr. Brandt: I have to tell the member for Hamilton West (Mr. Allen) and the other members of the third party that if I honestly believed there was something in this world that was entirely, totally and unequivocally free, I would probably join the member and his party, or others, who really believe that on a point of principle. They believe that, somewhere along the line, these things are delivered totally free without responsibility, obligation or payment of any kind.

With the greatest respect to my friends across the way, I say that by removing the very limited amount of extra billing that is going on in this province, the very finite amount of money supposedly hurting this system, and creating, I might add, a two-tiered system -- and I want to talk about that in a moment -- if in fact that is the problem, what is going to occur as a result of this new, totally free, one-tiered health system the government is promoting within the context of Bill 94 is that the costs of health care in Ontario are going to accelerate very rapidly for a number of reasons.

The so-called transfer funds the government is going to get from the federal government are going to evaporate absolutely within the context of a whole series of other actions that are going to occur. The government is going to end up costing this province and the taxpayers of this province a great deal of money for a system that already extracts 30 per cent out of the total budget we all have to work with. Thirty per cent of the total budget of Ontario is shifted directly into health care. It is going to move even more quickly. I promise that in the short months and years ahead, this 30 per cent will take an ever-increasing percentage of the total budget.

An hon. member: It is 33 per cent.

Mr. Brandt: The parliamentary assistant corrects me and says it is now 33 per cent. The shift has already occurred. As I stand here and speak, it has gone up by three per cent. As I stand here and speak, he can see how quickly it is accelerating.

I see the worried face on the Minister of Colleges and Universities (Mr. Sorbara), who is desperately trying to get more funds for his programs. He sits there with a look of scorn and a look of real concern on his face because he knows there is not going to be any money left for universities. Were the Minister of Education (Mr. Conway) here, he would have the same concerns, because that is exactly what is going to happen, and it is going to happen because the government has taken some of the responsibility out of the system. It has removed the very limited amount of responsibility that was there.

It has done that with the concurrence, support and some of the yahoo statements made by the members of the third party. The parliamentary assistant can look up the definition of the word "yahoo."

An hon. member: I just wondered whether it is parliamentary.

Mr. Brandt: It is probably in Webster's; it will be near the end of the book, somewhere under "Y."

I say to him and to the members of his party that a very dramatic shift has occurred on the part of the government of the day. It was only a few short years ago that the present Premier, the member for London Centre, indicated extra billing was not a problem in this province. Extra billing was not a serious or significant situation that had to be addressed by the government. He made public statements.

Now, all of a sudden, there has been a change of attitude on the part of the Premier and I have to ask why. The answer, very quickly, we all know. Those of us who are members of the party I so proudly belong to realize it came about as a result of a very small short document, with about a dozen features on it, known as an accord.

That accord said: "From this day forward, extra billing shall be banned. Whether it is justified or not is not the question; extra billing is going to be banned because we are going to create this bugaboo of accessibility. After accessibility, we are going to talk about the problem of the transferability of the moneys from the federal government. We are going to tell the people" --

An hon. member: Why does the member disagree with his federal counterparts?

Mr. Brandt: I will get to that if the member likes. I would be most happy to, because the constitutionality of those transfer grants has not yet been established. Whether in fact the federal government, which the government is holding up as one of the reasons for --

An hon. member: Oh, no. You are holding it up.

Mr. Brandt: If the member wishes to speak, I will be glad to give up my place. He is constantly interrupting me, Mr. Speaker, and you have not yet drawn attention to the fact that he is doing this.

An hon. member: I am not in my seat.

Mr. Brandt: He is not even in his seat. That is the other thing.

Mr. Speaker: I did inform the member for Wentworth North that he should not speak or make any comments or interjections while not in his seat. I can continue if you want a little rest or anything.

Mr. Brandt: No, not at all. I am anxious to get on. I want to get into the main body of my address here and I am just warming up to it.

The fact of the matter is that the constitutionality of the $53 million a year and the sum total of about $100 million a year has not yet been firmly established. The government again is right on the borderline of misleading the public of Ontario by suggesting that money is lost.

When the member for Windsor-Riverside (Mr. D. S. Cooke), who has been the key spokesman of the third party for health issues, stands up and talks about the fact that $1 million a week is being lost by this province and that the extra billing is amounting to another sum of about $1 million a day, I think those statements are going to be proven to be modestly inaccurate. There is no proof whatever that any dollars are lost to the system or to the taxpayers of Ontario. It is a nonstarter of an issue.

Two of the key reasons the government brought in the kind of draconian bill we have before us and are fighting so hard to defeat -- the pillars, the foundation upon which its entire argument is based -- are actually without substance, and that is what bothers me. Why are the Conservatives in the Legislature of Ontario fighting as hard as we are? Why are we prepared to debate and to argue this issue throughout the night and throughout the day tomorrow and for as long as we are allowed to speak with respect to this issue? Is it only because we are defending 17,000 doctors in Ontario?

Sometimes politicians are accused of doing things for votes only. When we are fighting for the 17,000 doctors, we are not looking for votes. We are fighting for the freedom, the fairness, the respect and the professional independence that deserve the kind of support we are giving them in the Legislative Assembly of Ontario.

We are fighting for a group of individuals who, through self-sacrifice, dedication and commitment to their profession, have risen to the top of a professional group. They are practising medicine and providing in our province a good level of health care that we have grown to appreciate as a system that is probably second to none in the entire world. They should be well paid and they should be defended.

I make no reservation and no apologies whatever about the fact that I am prepared to fight, in spite of the fact that when one looks across this great province of ours there are not a great number of votes. There is a very key principle involved, and that principle is the right to practise one's profession as an independent practitioner without government intervention. That is a very key principle, and on whatever bills are brought forward by that government, this party will continue to fight for that principle, whether it applies to doctors, lawyers or virtually any segment of our society that is being beaten by a government that is as insensitive and as uncaring as the government that has brought in Bill 94.

The thing that bothers me most about Bill 94 is a matter I would like the members of the government who are present -- there is only a scattering of them in the House this evening; they are probably all out sitting around the table talking about the --

Hon. Mr. Sweeney: Look behind you.

Mr. Brandt: The Liberals are the ones who asked for this all-night debate and they are going to get it. I know these words of wisdom will perhaps fall on deaf ears, but I want to share them with members opposite in any event. I hope members of the government, whatever their professions, whatever their callings before they took seats in this House, will listen carefully to what I am about to say.

What concerns me most about Bill 94 and what concerns me most about what has happened with respect to the very difficult road we have all travelled, which has led to closure today and to the vote that will inevitably take place tomorrow, is the attitude of this profession after this whole thing is all wrapped up, after it is all over with.

8 p.m.

Have members thought about that? Have they thought about being on an operating table after Bill 94? God forbid that one would tell the doctor one was a Liberal or a New Democrat if one were on that operating table, if one's life hung in the balance and one were lying there totally at the whim of that independent practitioner of the science of health and he knew full well that the right to practise as an independent professional had been taken away, had been rustled away from him; a right that they are fighting for to their last breath as a result of what that government has done.

Hon. Mr. Sweeney: That is the most insulting thing you have said about doctors all night. You are insulting doctors when you say that; that is an insult.

Mr. McGuigan: That is the most insulting thing you have said yet.

Mr. Brandt: Oh, sure. What the member, his Premier and the Minister of Health (Mr. Elston) are doing is playing on the professional integrity of doctors to look after their patients no matter what. That is what they are counting on happening. They are saying that the doctors are not going to go on strike and are not going to close emergency wards. The member and the members of his party think they have them over a barrel because when push comes to shove, the doctors are going to be there to look after their patients.

They might be right. I give the doctors every degree of respect and I have every admiration for them if that is their decision, but they are fighting with whatever limited tools they have currently at their disposal. I would be fighting as well, if I were in their position; I would be doing everything to resist this kind of legislation, this kind of creeping socialism into a professional group.

Hon. Mr. Sweeney: You would fight on the operating table; do not be so ridiculous.

Mr. Brandt: If the Minister of Community and Social Services (Mr. Sweeney), as a teacher, had his professional independence taken away in quite the same way --

Hon. Mr. Sweeney: I would not take it out on the kids; I tell you that.

Mr. Brandt: Oh, no. The doctors have not taken it out on their patients, either.

Hon. Mr. Sweeney: That is what the member is suggesting. He is suggesting someone is going to be on an operating table and someone is going to take it out on him.

Mr. Brandt: I am suggesting the attitude of doctors --

Hon. Mr. Sweeney: Do not be so damned silly.

Mr. Brandt: The minister should not be so damned silly. They brought in the stupid act, not me.

Mr. Speaker: Order.

Hon. Mr. Sweeney: That is an insult to any doctor.

Mr. Speaker: Order. The member for Sarnia has the floor.

Mr. Brandt: The members of the government are counting on the professional integrity of doctors to continue their dedicated service to their patients. That is their ace in the hole, the only one they have on that side of the House. They know that when it comes right down to the bitter fight, the doctors are going to continue to look after their patients. That is what it is all about. But I come back to the point I made earlier, I concern myself with the attitude of doctors.

Will they be quite so eager to work 17 or 16 -- whatever number -- of hours a day? Will they be quite so eager to put out their time, expertise and abilities on weekends? Will they be quite so eager to spend the amount of time away from their families that they do at the present time? I know very few doctors, if any, who work a 40-hour or a 50-hour week. The vast majority of them put in an absolutely unrealistic number of hours in an attempt to serve the people of this province and to provide a tremendously high level of health care. The vast majority of doctors are dedicated. They put in those numbers of hours and that kind of service to the people of this province because they hold their profession in very high esteem. Over the years, they have provided a level of health care that is second to none.

I listened with great interest today to the knowledgeable members of the government. During my leader's windup remarks on the closure measures that were introduced by the government House leader, a member in the third row got up. He sits very close to the Minister of Health's parliamentary assistant, the member for Wentworth North, who surely could have leaned over and held the man down. Just as my leader got into the closing seconds of his address, the member for Frontenac-Addington (Mr. South) rose on a totally inappropriate point of order.

He said -- can members believe this -- "No emergency wards have been closed in Ontario." That is how up to date some of the members are on that side of the floor. He has not picked up a newspaper. He has not had one of his colleagues whisper anything in his ear. He has not had any kind of communication with anyone to let him know that we have some serious problems with health care in this province as a result of what the government has done to date and as a result of what is going to happen if and when Bill 94 passes.

Hon. Mr. Sweeney: There was a doctor in every one of those wards.

Mr. Brandt: I can tell the member that to send patients to another ward, to assess the patient and to see if the patient could go to --

Hon. Mr. Sweeney: A doctor was there.

Mr. Brandt: I will give the member a hospital where the ward was closed. Try Sarnia General Hospital in my riding. All the patients who went to that emergency ward were transferred to St. Joseph's Hospital, where the numbers of patients doubled and tripled over the course of the last couple of days, where the amount of time required for the patient to receive service went up two and three times and the waiting period was two or three hours -- now four, I understand.

Hon. Mr. Sweeney: An assessment is a medical procedure. There was a doctor there.

Mr. Brandt: Oh, cop out and tell us about assessment being a medical procedure.

Mr. Speaker: Order. Will the member for Kitchener-Wilmot (Mr. Sweeney) control himself?

Hon. Mr. Kerrio: You are right, Mr. Speaker. I cannot hear what he is saying.

Mr. Turner: Which one?

Mr. Speaker: The member for Sarnia.

Mr. Brandt: Thank you, Mr. Speaker, for bringing a degree of civility into this House. It is much appreciated.

I would suggest very strongly to the parliamentary assistant to the Minister of Health, the member for Wentworth North, that he perhaps enlighten his benchmate, the member for Frontenac-Addington, with respect to what is going on with health care.

In the most recent assessment announced in the media today, the past president of the Ontario Medical Association, Dr. Ed Moran, indicated that the actions taken by the OMA are fully supported by 75 per cent to 80 per cent of the doctors of this province.

Whether that figure will grow, and what the net impact of that is going to be in terms of patient care and future hospital closings, whether on a cyclical basis or whatever, I cannot say. All I know is that the disruption and chaos, and the problems we are faced with today in the health system of this province, are the worst in its history. They bear no resemblance to the very small problem that was supposed to be in evidence a year ago -- according to what the government indicated -- when we first heard that the accord was going to call for a ban on extra billing.

If the government wants to upset doctors, to upset the leading edge of what health care is all about in this province and to destroy the high quality of health care to which we have grown accustomed in this province, one could not find a better mechanism, quite frankly, than the way this government has proceeded during the course of the recent, very limited debate we have had on Bill 94 and during the time leading up to that debate, when the government told the doctors what it was going to do to them.

What the doctors are trying to fight is not all about money. I have heard it said -- and talk about irresponsible statements. There have been some totally irresponsible statements. When doctors are looking after their patients and trying, at the same time, to indicate their displeasure with Bill 94, some members of the Legislature have talked about doctors being money gougers, interested only in the almighty dollar. That is not what it is all about.

Interjection.

Mr. Brandt: Maybe the member did not say it, but there are other members who did say it. Why does the member not ask the Premier what he said to the doctors in some of the negotiating sessions? Why does the member not qualify some of the statements -- he could refute them if he wants to -- made during the course of some very bitter negotiations, when there was no way the two sides could be brought together to even sit down around a table and to find out whether there was some common ground?

8:10 p.m.

When our party suggested that the only logical, reasonable, realistic, intelligent solution was to bring in a third-party mediator to solve this thing, the government rejected it out of hand.

Does the member know what we said at that time? We said: "Set aside Bill 94. Do not cancel it or pull it back completely. Simply set it aside." The Ontario Medical Association has indicated very clearly that if the government will appoint a third-party mediator to this dispute, it will immediately put all doctors back to work. It will open all hospitals. All services will be right back at 100 per cent level, and the dispute, as far as the OMA is concerned, will be mediated in a proper, established setting for a negotiated settlement.

What we in this party were attempting to do was break the logjam. If the government thinks that was simply an impediment to the passing of Bill 94, if it thinks we were looking for some kind of indefinite stoppage of Bill 94, we know full well it is not about to be convinced by any arguments that would suggest this. What we were looking for was to stop some tragic developments in the health care field from occurring as a result of 75 per cent to 80 per cent of the doctors supporting some kind of strike action, and as a result of some emergency wards being closed down on a rotating basis.

Even in the best of circumstances, Mr. Speaker, you and I know full well that even with all doctors operating and all hospitals functioning at their best capacity, a life-threatening situation can always develop in which someone's life could hang in the balance, even with the system proceeding forward on all cylinders and without any impediments or problems. How much more risk is injected into the system; how much more chance does one take when these patients are put at further risk, recognizing that hospitals are going to be closed on a rotating basis and that a large number of practitioners are simply going to be elsewhere than in their offices or in hospitals?

What are the doctors fighting about if they are not fighting about money? There are members of the third party and members of the government who would like to have this whole argument focused on more money for doctors. When they extra bill, they put all of this extra cash in their pocket; when they extra bill, they take advantage of the poor, the sick and the elderly. That is hogwash. That is not what is happening. There is no two-tier system of health care in this province, and if the government wants a two-tier system of health care, then it should listen carefully to the next part of my remarks, because I am going to tell it how to get there.

The two-tier system of health care, after Bill 94, can proceed very comfortably in the direction of the British health care system. That ought to frighten members a little bit. Look at Britain at the present time. This is one of the things that has concerned the medical profession, one of the things it is fighting for on a point of principle rather than on anything to do with dollars. Where we have injected a form of socialized medicine into --

Mr. Wildman: Hear, hear.

Mr. Brandt: I knew that member would agree with it.

Where we have injected a form of socialized medicine into the system, what we end up with, first, is the understanding -- and this is the basis under which it is sold originally -- that it is free and that one can get to see a doctor, irrespective of qualifications, just by knocking on his door and going into his office. It is a very simple way to get one's health needs looked after.

But the reality is that it does not work. The reality in Great Britain at the present time is that one does not get to choose one's own doctor in quite the same way as one does in Ontario.

Mr. Wildman: Did Margaret Thatcher write this?

Mr. G. I. Miller: We are not in Great Britain.

Mr. Brandt: The reality is that in Great Britain, if one wants to see a doctor or if one wants to go to the hospital to have elective surgery, one has to wait a year and a half or two years in some instances.

Mr. Wildman: Is Margaret Thatcher responsible for this?

Mr. Brandt: No. A party which very closely resembled that member's party brought in that form of socialized medicine, which I want no part of.

Mr. Wildman: What has Margaret Thatcher done about it?

Mr. Brandt: Mr. Speaker, I am being badgered again.

One can see what happens when one has socialized medicine. What they have done now in Great Britain is that certain individuals have extricated themselves from that so-called one-tier system of health care.

Mr. G. I. Miller: That is scare tactics.

Mr. Brandt: Scare tactics? This government has a lot of people in this province frightened, and when the member talks about scare tactics, Bill 94 has scared more people than he perhaps realizes.

Let me tell members what has happened over there. The very rich go to a fully opted-out doctor, someone who is outside the system, where one can afford the very best of medical care, the very best and the élite of doctors. One goes and pays the cash out of one's pocket with no reimbursement from the government. One goes to that kind of doctor. They have private hospitals in Britain at present that cater to the very rich.

If the government wants to take this province by the hand and lead us through the maze of socialism that it is raining down on our necks with virtually every piece of legislation it can bring forward, then as sure as I am standing here it is going to end up getting a two-tier health system in this province. The fact is that Bill 94 is not clearing up a two-tier health system; it is going to lead to a two-tier health system.

Hon. Mr. Sweeney: Name one Canadian province that has that; never mind Britain.

Mr. Brandt: In British Columbia, doctors now are told where they are to practise.

Hon. Mr. Sweeney: I asked, where is there a two-tier system in Canada?

Mr. Brandt: Does the member not think that is an unnecessarily --

Interjections.

Mr. Brandt: Let me cite as an example what happened in Quebec when it brought in the mirror image of Bill 94. We all know that at the time that bill was brought in in Quebec, hundreds of doctors, primarily and specifically specialists, left the province to go elsewhere. Where did they go? They went to --

Hon. Mr. Sweeney: Where is there a two-tier system in Canada? Where do they have one?

Mr. Brandt: There is worse than a two-tier system there. When specialists left that province, they came to Ontario where they could practise their specialty freely, without interference by government.

What they have is worse than a two-tier system. Let me tell the member what that system is. There are many municipalities, communities and regions where specialists are not available. They are not available because they have left. You cannot beat up on doctors, pound them into the ground and take advantage of their professional integrity; they leave the province. That is what they did; they left the province to serve elsewhere.

Mr. Wildman: Are there no specialists left in Quebec?

Mr. Brandt: I heard from the back reaches of the third party that I was supposed to have said that they do not have any specialists in Quebec. I did not say that at all. I specifically said that hundreds of specialists left that province to practise where they could do so without government intervention, where they could practise freely with a relationship they chose to have between patient and doctor. I see nothing wrong with that. They left that province because they did not want to have government control over their lives, their profession and the relationship they have with their patients.

They came to Ontario, which was going to be an area where their professional freedom was protected. While there was a government that respected their professional freedom --

Interjections.

Hon. Mr. Kerrio: Mr. Speaker, I cannot hear a thing.

Mr. Speaker: Order. I cannot hear a thing either for some reason. Question period has not commenced yet. It will commence on Monday.

Mr. Brandt: When question period commences again and when people start to answer questions, it will not be with the current government on that side of the House.

Mr. Wildman: Why does he make such specious arguments?

Mr. Brandt: The members of the third party will have every opportunity to speak immediately following the conclusion of my very brief remarks. When I have concluded my very brief remarks, the members of the third party will have every opportunity to stand up and set forth the principles they stand for. I give them credit for only one thing. At least they have said consistently to the people of Ontario, which is something the other party cannot say, that they are against extra billing. They have said that all along. I understand that position. I do not agree with it. I think it is a backward, shortsighted and unnecessary position, but they have a position. It is not a very good one, but they are stuck with it.

8:20 p.m.

The johnny-come-latelies across the way have a position on this issue only as a direct result of having signed an accord, an accord the government is trying to weasel out of in some respects these days. They are trying to remove themselves from some of the --

Hon. Mr. Sweeney: The member should check his former leader's position in 1971.

Mr. Brandt: What is the member opposite cackling about, Mr. Speaker? I am trying desperately to hear what he has to say and to ferret out of him some intelligent comments.

Hon. Mr. Sweeney: The member is talking about changing positions.

Mr. Brandt: If he wants to stand up, he too has an opportunity to stand up immediately following an address from the members of the third party. At the moment, as you well know, Mr. Speaker, according to the rules of this House, I have the floor for a few very brief moments to share some of my thoughts and principles with you.

The principle contained within this party has been consistently that the small amount of extra billing, the very limited amount of extra billing that has gone on in this province, has not created a two-tier health system, and it allowed the doctors at least an element of professional freedom that Bill 94 takes away from them.

That should concern the members of the government because of the attitude it is going to create within that very esteemed profession, a profession that takes a lot of self-sacrifice, dedication and commitment to get to the point where one finally gets out into the working world, practises one's profession and starts to earn a living. At that time, big government comes along, Big Brother comes along and says, "Thou shalt no longer extra bill, the very limited number of you who do extra bill."

Hon. Mr. Sweeney: What did the federal Tories vote in 1984?

Mr. Brandt: I am going to stay in this House and listen to the comments of the Minister of Community and Social Services because he has such a great deal to say. I must be touching a nerve over there, because he keeps interrupting. He knows he is on very shallow ground and on a very shaky foundation with respect to this bill, which I predict is going to come back --

Hon. Mr. Sweeney: This bill is a result of 1984 federal legislation.

Mr. Speaker: Order. Could I ask the Minister of Community and Social Services to use a little Velcro?

Mr. Brandt: I would like to predict that Bill 94 is going to come back to haunt the government through the months and years ahead in a way it cannot even envisage at present. They are going to have difficulties beyond belief. They have taken something that was perhaps not a perfect system of health care, but something that worked and functioned extremely well.

It was the model that people looked at as being the way to deliver health services to the citizens of this jurisdiction. It was a health care system that encouraged and motivated Senator Kennedy from the United States to come here and study it, so he could take back some of the good ideas we had here and perhaps introduce them into the US in some fashion. Why did he come to Ontario? He came for one very simple reason. We had the model of health care.

Hon. Mr. Sweeney: The Canada health system, the Canada Health Act.

Mr. Brandt: We had the absolute ultimate in health care compared to any other jurisdiction virtually anywhere in the world. My friends in the third party have asked, "What about the American system of health care?" I do not happen to like the American system of health care. I do not like that flat-out, free enterprise system of health care that can bankrupt a patient. That cannot happen in the Ontario jurisdiction because people are provided for under the type of health care we deliver. They are not provided for in the US.

This is where the Liberals have lost sight of the whole question in their party. We have developed a very sensitive, balanced system of health care that took the best of an element of freedom for that profession, such as they have in the US, and balanced that against the flat-out, so-called free health care they have in Great Britain that has been proved not to work. We have found ourselves somewhat in the centre, delivering health services that provided adequately for the needs of the people of this province. That is the kind of health care system we had. That is the kind of health care system members opposite say, with grins on their faces, they are going to destroy through Bill 94. They will rue the day they brought in this bill.

The government is supposedly fighting for certain principles: to get rid of a two-tiered health system; the problem of accessibility; to stop the doctors from gouging -- the member's words, not mine -- some of their patients; to get rid of all those bad features of what we have at the moment. In the process it is going to create a monster that will make those so-called bad features seem like nothing in the short period ahead. We in this party are fighting for the principle we would fight for irrespective of what the professional group might be, because we happen to oppose unlimited powers on the part of government.

We oppose, as some of the government party do, government intervention in all phases, walks, segments and sections of life. We do not believe that government can do everything better. We in this party do not happen to believe that one has to put the total control of a profession or a service or whatever in the hands of government to make it work well. The reason we are Conservatives and the reason we believe that so strongly is we have seen time and again that when one gets this kind of heavy-handed government interference in virtually anything -- in our society, in our economy, in whatever -- it ultimately ends up being operated at a level and at a quality below what it started at. Governments, through their bureaucracies, through their inefficiencies and their uncaring insensitivity and because of their very size, lose sight of the fact that there are some key matters in this world worth fighting for, such as the special relationship between a doctor and his patient.

Mr. Wildman: And his wallet.

Mr. Brandt: May Hansard record that once again we have heard this issue is one of the doctor's wallet. It has absolutely nothing to do with the doctor's wallet. If that were the case, why are 90 per cent of the medical practitioners of this province fighting against Bill 94 when they do not extra bill?

Mr. Philip: Oh, would you like an answer to that? Give me the floor and I will give you an answer.

Mr. Brandt: The member is going to have his opportunity very shortly. If he wants to have the opportunity to speak to that issue, let him mark it down on a piece of paper and we will listen quietly while he responds to whatever remarks I am going to make during the very few, short moments I am going to take with respect to this issue.

We have had a number of days of debate on this issue in committee and in committee of the whole House in this Legislative Assembly. During those debates, we brought forward a series of amendments in the hope we could get the government to shift ever so slightly toward the kind of position that would be acceptable to both the medical profession and to the government, recognizing that the government does have a role to play in this whole matter. If they were going to move towards some form of ban on extra billing, perhaps some compromise position might be possible.

What did the government do with virtually every one of the amendments put forward by this side of the House? They rejected them out of hand. I recall with some interest that I sat here one evening and the Minister of Health indicated he wanted to bring forward an amendment.

8:30 p.m.

Do members know the amendment he brought forward? Even after rethinking the issue, after looking at it very carefully, he had to amend a part of the bill that was so bad, that created such negative signals for the professional community the bill addresses he had no other choice but to change it. That was the fine of $10,000 when a doctor did not comply with the articles contained in Bill 94. The minister brought forward a change in that section and reduced it to a somewhat more acceptable figure. I say somewhat more acceptable because I do not think the fine is acceptable in any form, but at least he brought that down to $250.

That gives some indication of the kind of thinking on that side of the House, that one can bring in a law, hammer somebody into submission and force him, through bills and legislation, to do whatever one wants him to do. With the medical profession one cannot do that, because one is talking about independent professionals who want to practise, not necessarily without government guidelines, not without rules and regulations, but on an independent basis with the type of contractual relationship they have historically had between patient and doctor. That historical relationship has served us very well.

Under Bill 94, they have tried to drive, and may well drive, a wedge in that relationship, which, as I predicted earlier in my comments and will restate again, is going to cause a deterioration of health services in this province. Let them mark my words. That is the reason we feel strongly about this bill.

We would rather be spending our time doing something else on a lovely evening such as we are all sharing here together in Toronto. We would perhaps like to be watching the evening news or joining our families for dinner or doing a number of other things, but we are here because we feel very strongly about this legislation. We feel very strongly about this bill and we are going to fight this bill until the time at which the coalition that exists under the form of the accord between the other two parties passes Bill 94 and even after that.

The wounds, the scars, the problems and the difficulties this bill has created are not going to heal overnight and I doubt very much if they will heal during a period of years, if ever again in this province until this legislation is either cleared up, rolled back, modified or changed in some way, because it is bad legislation. It is bad legislation because it interferes in what I consider to be almost a sacred trust relationship between a doctor and his patient, and it has nothing to do with that sacred wallet relationship of which the members of the third party keep wanting to remind me.

It is interesting to note, and I just have to make a comment about this, that we have now moved in almost a step-by-step form from very difficult legislation as proposed under Bill 94 to the point where, if the doctors still do not comply, with government coming down in a very heavy-handed way on their profession --

Mr. Grande: Of course, you hope they do not.

Mr. Brandt: No, I am not hoping for anything. I am hoping for one thing. Let me sum it up in one phrase because this is something the member and I can agree on. Whatever happens, I hope the people of Ontario get the best health care of any place in the entire world. That is what I hope for. I believe it can be done through a different methodology than is being proposed in Bill 94.

I believe some modifications would have been realistic and those modifications are contained in a letter members received. I am not going to suggest the members of the third party did not read this letter but I saw a whole stack on their table in the back that did not even look like it had been touched. They happened to be distributed to each and every member of our party.

I will read it into the record, because I think it is important, and I will get back to the third party in a moment.

The title is "Concessions Offered by OMA to Government in Context of Bill 94 Dispute." It reads:

"1. No patient over the age of 65 would be charged more than the OHIP rate.

"2. No patient receiving treatment of an emergency nature would be charged more than the OHIP rate.

"3. No patient receiving financial assistance from your government would be charged more than the OHIP rate."

That removes just about everybody who cannot afford to pay. The people the member normally identifies as Conservatives, the rich he always talks about, the people who are supposed to be supporters of my party, the elitists, the ones who have all the money in the world -- that is how he has identified our party in the past -- are about the only ones left who would be extra billed. My goodness gracious, here we are arguing for a principle that in all probability would affect some of the very people who have historically supported our party in one shape or another. It just does not make any sense.

Let us take a look at what is going to happen as a result of the passage of Bill 94. If the doctors do not comply at that time, if they do not agree to follow the outline of what is called for in Bill 94, let us send this message out to the medical practitioners of this province. Let us send out to the public the next message that is coming from this government and the third party, because although they have not used these words yet, they have used everything short of it, and it will be some form of "back-to-work legislation." I do not know how one goes about bringing in back-to-work legislation for a professional group that can all of a sudden close its office door and decide to take a vacation.

Mr. Breaugh: The member's party has done it with everybody else.

Mr. Brandt: They are privately employed professionals, under a government plan, admittedly, but if they decide they do not want to earn any income, they can lock their office doors and go south, north or east or perhaps west to Vancouver to take advantage of the fair that is going on in our sister province.

Mr. Wildman: Did the Leader of the Opposition (Mr. Grossman) not say he would support back-to-work legislation?

Mr. Brandt: The government and the third party are on a road map at present which leads from point A, being Bill 94, to point B, which at some point is going to force some other kind of heavy-handed legislation down the throats of the doctors. Something is going to have to be done, when 75 per cent to 80 per cent of the doctors of this province, based on Dr. Moran's figures as of today, are in agreement with the OMA and are in some fashion or another not practising their profession at present because of their violent disagreement with what the government is proposing to do within the course of the next few short hours.

I know it is too late to get the government to change its position. I know it is too late to get it to modify or even amend bad legislation, but predictably, it is going to cause even more deterioration in health services than what we have experienced over the course of the past two or three days. The effect of this is going to be directly in the government's lap and directly on its shoulders.

Mr. Grande: Is that what the member wants?

Mr. Brandt: In response to my friend from the third party, no, that is not what I want. I wish this whole thing were over. I wish we could bring Bill 94 to an end in some fashion that would be acceptable to the two groups. I wish we could find a way to negotiate some form of settlement. That is why, in a spirit of goodwill, we reached out across the way and said: "If you will bring in a mediator, we will stop the debate. We will draw back from the position our party has taken, and we will allow the Minister of Health and the Premier to find some method of resolving this dispute."

On its side, the Ontario Medical Association indicated quite simply that everybody would go back to work as soon as a mediator was brought in. All the hospitals would reopen the minute a mediator was brought in. That is taking a very dramatic step on its part, because the Minister of Health knows fully as well as I do, that through mediation we could end up in exactly the kind of position we are in here today. The mediator might be unsuccessful. That is the chance one takes.

All forms of mediation have been attempted in this province. Some are successful, some are not. As I said to the Minister of Health when he was in the House during the course of the brief remarks I made the other night, I can recall that when I was the Minister of the Environment, I brought in environmental mediation; and guess what? Surprise; it solved some problems. Environmental mediation had never been attempted in this province before. Some people looked at it as an enlightened move towards some form of resolution of a problem where there are two sides that cannot agree.

It was used in the area of Perkinsfield, because there it had an application that made some sense. I can recall people at that time saying, "Environmental mediation is not going to work." In Perkinsfield there were 16 or 17 special interest groups that all had to sit down around the table and resolve a very sensitive, delicate issue. The surprise was that they resolved it, and it worked.

My colleagues in this party are asking me, even as I speak, why we do not use mediation. I guess that is the big question mark that has occurred over the past couple of days.

8:40 p.m.

Mr. Wildman: Why did the member for St. Andrew-St. Patrick (Mr. Grossman) not use it in 1982?

Mr. Brandt: We resolved 1982, my friend.

Mr. Wildman: By giving them all the money they wanted.

Mr. Brandt: No, the doctors of this province are not paid in any way, shape or form out of context with the way medical practitioners are paid in other jurisdictions.

Mr. Breaugh: It took quite a bit of skating to get to the end of that sentence.

Mr. Brandt: Not at all, sir. The fact of the matter is that a mediator has worked not only in environmental cases, but also I look at municipal disputes over boundaries where mediators have been appointed by the government to attempt to get a city and a township, or a city and a county, to sit down and work out and resolve boundary disputes.

We have a long litany of success stories through mediation. It has been offered, handed on a platter to the government. The Ontario Medical Association has pleaded with the government to accept mediation as a way out of the fixed and inflexible position it has taken. At that particular time, the OMA indicated all the other caveats to which it would adhere with respect to its position. All it wants is a third party to be brought in to help resolve the problem.

What has the government said? The government has said, "No." It does not want to resolve this issue in a responsible way. What it wants is a fight. Is that what it wants? I say that because of some of the statements that have been made and because of some of the comments that have got back to the doctors both publicly and behind closed doors.

Because of the attitude, environment and atmosphere of hostility it has created, we have a polarized situation that cries out for the introduction of a third party. It cries out for some form of resolution that is perhaps beyond the scope of either the OMA or the government at the present time. That is what a mediator is all about.

Let me address myself, if I might, in as gentle a way as I know how, to the third party, which -- if it were any other group, organization, trade union, whatever, that was going to have back-to-work legislation -- would be standing up for the so-called rights of that particular body, whatever they might happen to be. It would be fighting for those rights, as well it should.

It should not take exception to our party when we fight for the rights of a group it has ignored. We want all the people of this province to receive fair treatment. Because this does not happen to be a group that the third party feels supports it -- and I doubt that is the case, because I am sure there must be a misguided doctor somewhere in this province who supports the third party --

Mr. Wildman: Yes, he is working.

Mr. Brandt: If I find him, I will identify him and introduce him to the members. I do not know who that might be, but there must be one of them out there.

The fact of the matter is, it has already indicated -- in a quiet sort of way, without using these words -- that if it comes to the point where the doctors refuse to go back to work after Bill 94 is passed, as well it will, it is prepared to support the government in whatever fashion necessary to bring calm and peace back to the health care system in Ontario. That is naïve beyond belief.

Mr. Wildman: I thought the member for St. Andrew-St. Patrick (Mr. Grossman) was in favour of back-to-work legislation.

Mr. Brandt: The member for St. Andrew-St. Patrick does not want to get to back-to-work legislation, because he does not want to see Bill 94 passed in its present form, and the member knows that.

Back-to-work legislation would not be necessary if the government were to follow some of the sage advice we are offering, which it has rejected out of hand because of the close-minded attitude it has in connection with Bill 94.

Here we have an organization, a group of professionals, that has made an appeal to the government to find a way to resolve this issue through mediation, and the government has rejected it out of hand. I cannot understand that. I cannot comprehend it. I find it baffling when the third party is prepared to take the next step, and perhaps the government is as well.

What I concern myself with, and I am going to close off very shortly --

Mr. Wildman: Go ahead.

Mr. Brandt: All right. I could speak for a while. I thank you for encouraging me. Perhaps I should share a few other thoughts with respect to this whole issue.

Having listened to some of the speeches, we in this party have some concerns about the post-Bill 94 period. We want to share our opinion with the rest of the members. We want to offer to the members an opinion that we feel is a sensible and realistic overview of what is going to occur in the days ahead. We feel the anger, the hostility and the bitterness the government has created among a very responsible professional group will be with us for a long time to come. What bothers me is that I have to look at it from my perspective and ask: "Are we going to get a better level of health care in this province? Are we going to have a better quality of health care as a result of what the government is doing?"

Very quickly I come to the conclusion that no, that is not going to happen. It has brought in this legislation which has angered the doctors who have such intense feelings that I do not know how the government can ever again go to the medical profession and ask for its co-operation, for its continued dedication and for the type of commitment it has had to the people of this province throughout the history of health care in Ontario.

I am going to wind up at this point by saying that I am looking forward to the balance of the debate. My colleagues have a number of issues they want to address and a number of points they want to bring forward in the hope that we can get some change across the way on the part of the government to look at this bill in a somewhat more sensible fashion. We make that appeal during the context of our remarks this evening.

The Acting Speaker (Mr. Morin): Are there any questions or comments?

Mr. Breaugh: I cannot help but compare this with what happened the last time there was a disruption in hospital services in my community. The Progressive Conservative Party then formed the government, and the disruption concerned the hospital workers. At that time, the government declared that hospital workers, people who cleaned the floor, were providers of essential services. This Legislature was not tied up for weeks on end debating a bill. The government did not bother with a bill. It did not bother with the Legislature at all. It went to the courts and sought injunctions. The first time it tried it failed, but the second time it got its injunction.

I remember it well, because I walked the picket line that morning with the hospital workers. At 11:30 in the morning, the Ontario government got its injunction to stop that strike. By 12:30, it had the union leaders on the way to jail. By the middle of the afternoon, it was chasing my tail for daring to go and talk to my constituents on that picket line.

That is quite a stark contrast. In one instance, this government seeks to stop the practice known as extra billing and does so by means of legislation, a long and arduous route. In that process, we have had some disruptions in hospitals. However, there have been none in my community. My doctors are too responsible and reasonable to take it out on their patients. They understand that arguments with the government belong with the government, but in other communities there have been disruptions.

I cannot help but compare the two reactions by two different governments. This government chose to bring in legislation and take it through at an agonizing pace. The previous government chose to avoid the Legislature meticulously, to seek its mandate to do something outside of this territory altogether, to jail the leaders of the strike -- not to sanction them or fine them, but to put them in jail. It did just that. It had its way.

I cannot help but say that stance reeks of hypocrisy. There is no other way to express that. If there is a need for a mediator, it is a mediator within the Tory caucus to get the members to come to one conclusion or one position on the bill. There is no need for any other mediation. The comparison between the approach taken by the previous government and this one leads one to feel very strongly, as I do, that if this situation involved hospital workers and the previous government were still in place, it would have the leadership of the union in jail by tonight.

The Acting Speaker: Any other questions or comments?

8:50 p.m.

Mr. Wildman: I listened very carefully to the member for Sarnia (Mr. Brandt) and would like to ask a number of questions raised by his comments.

He indicated mediation is always necessary to resolve the problem. I would like to know how the Conservatives believe we can mediate the Canada Health Act. How does the proposal made by the doctors not to extra bill seniors or people on social assistance in any way meet the requirements of the Canada Health Act to end extra billing? How will that make it possible for the province to recover the $82 million that has been held back by the federal Conservative government?

Mr. Brandt: It was brought in by a Liberal government.

Mr. Wildman: It was brought in by a Liberal government, that is true, and supported by all parties in the federal House.

I wonder whether the Minister of National Health and Welfare, the Honourable Jake Epp, would accept the argument that the promise not to extra bill seniors and not to extra bill people on social assistance would in any way meet the requirements of the act for which he is responsible.

I also wonder why doctors should be put in the position of analysing the financial as well as the medical state of their patients. Why should a doctor have to analyse whether a particular patient is able to pay an extra bill? In my view that is completely outside his purview, and he has no business getting involved with the financial state of his patients.

Finally, I have a question with regard to the back-to-work legislation of which the member so carefully accused our party of being in favour. The member for Brantford (Mr. Gillies) and the Leader of the Opposition indicated both in this House and outside it in public that they favour back-to-work legislation. How can this member get up and say it is the third party that is responsible for any proposed back-to-work legislation?

It is very unfortunate that throughout this process, the Conservatives have prolonged the debate to the point that the doctors have become ever more isolated and embittered. It has reached a point where the doctors are doing things that a few weeks ago they never would have indicated they would do and never would have thought of doing. Unfortunately, the Conservative Party has encouraged the irresponsible approach of the medical profession in Ontario, and I would like the member to comment on that.

The Acting Speaker: Your time is over.

Mr. Philip: I would like to comment on the remarks the honourable member made concerning the doctor-patient relationship and the suggestion that somehow a mystical relationship is developed by allowing a doctor to ask the patient to open up his wallet -- to bare his financial soul, if you want, and say: "Doctor, forgive me, for I have sinned. I happen not to be a wealthy person. I happen to be an injured worker. I do not earn the $120,000 take-home pay that you do, and therefore I want you to forgive me of this levy, this extra fee, which you in your arbitrary way have decided is good for me to pay."

The member talked about how it could not possibly be a matter of dollars and cents because, after all, all those doctors out there who are not yet part of the extra-billing syndrome are somehow supporting the present strike and atrocities that we are seeing in Ontario. I ask the member to explain how that is -- or did he not know about it? Would he like to hide the fact that the Ontario Medical Association promised to support the general practitioners in narrowing the gap between them and the specialists, many of whom are earning in the vicinity of $300,000 a year? In exchange, Dr. Tom Kerr, the chairman of the OMA's general practice section, told the OMA that if it did not agree to support the GPs raising their base and narrowing the gap, then they would not support the strike and would not support them in their war.

What has happened is purely financial. They have been bought off by the promise of narrowing that gap between the $300,000 or more a year that some of those specialists earn and the paltry, poor little $90,000 and $100,000 a year the others are earning. Explain that.

Mr. McGuigan: This debate has gone on for many months and I know we have honest differences of philosophy and opinion as to the right and the wrong of this. We have the Canada Health Act as the basis for this and it is on that basis that I rest my case.

I say in sadness and in sorrow that in the nine years I have been here, we have been through teachers' strikes and some serious matters, but I do not believe I have ever heard people maligned as much as I heard tonight when the member for Sarnia suggested that if a member of this Legislature were on the operating table and were being serviced in the way physicians have carried on their profession over the centuries, following the oath they all take, he would have to fear for his life.

I find that particularly offensive. In the nine years I have been here, I cannot recall anyone being so maligned. I do not believe it for one minute. I do not know a doctor of my acquaintance and I do not believe anybody here knows a doctor of his acquaintance who would for vengeance put at risk the life of a member of this parliament or of any citizen of this great province. On behalf of the listeners here, for what it is worth, I want to offer my apologies.

Mr. Brandt: I want to respond quickly to the last speaker. I will try to get to the other comments as quickly as I can. There is no way that I intended to imply that a doctor would take someone's life as a result of being in opposition on a political issue. I made a clarification with respect to that remark.

Had the honourable member listened carefully to what I had to say, he would have known I was talking about the attitude of doctors, which I personally would want, and I believe the member should as well, to be as positive as possible during the carrying out of their responsibilities. I do not believe it serves any of our interests that they be upset, that they be at war with the government or that their attitude be negative, irrespective of whom they might be serving at the time. I say to the member, and I mean this very sincerely, if I implied something other than that I apologize. It was not my intention to do so.

With respect to the position that the members of the third party have discussed relative to the Canada Health Act -- and let me say this briefly, because I want to answer as many questions as I can; unlike the government during question period, I will try to get to all the questions --

Mr. Breaugh: Unlike when the member was a minister.

9 p.m.

Mr. Brandt: When I was a minister, I attempted to answer all the questions, as the member well knows.

The constitutionality of the federal government's position with respect to the transfer of these funds has not as yet been challenged and it may well be that the position the OMA has put before us would be acceptable to the federal government. The members do not know that and I do not know that at the present time.

I see I have very limited time and there will be some questions I cannot address. However, I want to address back-to-work legislation. With respect to that, our party will take a position on that when we get to the post-Bill 94 period. However, I have to say again that if health services break down to the point where there is perhaps no other alternative, there may well be a position where we will have to join with the government to bring the medical fraternity back to work. I cannot say that at this time.

Mr. Partington: I am pleased to rise and join the debate in opposition to the so-called Health Care Accessibility Act. It is difficult to follow such an outstanding speaker as the member for Sarnia (Mr. Brandt) with his wisdom, his style, his understanding and his speaking from the heart. Although members opposite may find it difficult to admit, I am sure they must be moved by his logic and his compelling reason.

I am opposed to the so-called Health Care Accessibility Act because I have real concerns, as do the members of my party, that the result will be far less accessibility than we have under our current system. I say the Health Care Accessibility Act is so-called, because that is a little akin to calling an anchor a lifejacket. I want, as I am sure all members of this House do, a top-quality, first-rate health care system, the type of system we have enjoyed in Ontario for as long as we can remember.

I believe we have the finest health care system in Ontario at present. If there are some defects in the system, if there are some defects in the delivery system, if there are some complaints about the manner in which some doctors from time to time deal with some patients, just as there can be complaints from time to time about how we deal with constituents, about how plumbers deal with plumbing problems and so on, these matters should be addressed within the present system. To threaten the destruction of a system that has worked so well for so long to remedy some minuscule problems that are bound to occur in any system is the wrong way to proceed.

As has been mentioned earlier, the Ontario Medical Association in addressing this issue has suggested some changes to meet difficulties that may be perceived in the system as it now exists. One of those is not to extra bill individuals over 65 years of age. That is one of the areas of our health care system the government should be addressing.

What do we do with the fact that there will be a 55 per cent increase in the number of elderly people in our society by the year 2000? I think the answer is that limiting extra billing or banning it for those who are over 65 will go one way to ensure that the system will be delivered to individuals over 65 fairly, quickly and without concern on their part. They can continue to rely, as they have up to date, on fairness, equity and service by their doctors at any time, day, night, holiday, weekend, whenever.

At present, our senior citizens represent 40 per cent of days in general hospital care, 79 per cent of days of inpatient chronic care and 93 per cent of extended care in nursing homes. As elderly people grow in numbers, it will become more important that we try to provide care for them at home rather than in institutions.

This growing need for our senior citizens will require tremendous additional training and tremendous additional numbers of doctors in the geriatric field as well as additional training of nurses and other home care workers. It will be important to retrain doctors and to provide them with some incentives to equip themselves to handle this need, which is on our doorstep now. Introducing the Health Care Accessibility Act is not one way of providing an incentive to get doctors to take extra education when they may not need to do so.

The OMA has also suggested there would be no extra billing of those on government assistance, no extra billing for emergency treatment and that it would look at other situations to ensure that in any community no one would be deprived of service at Ontario health insurance plan rates because there may be a monopoly of opted-out doctors.

In Canada and in Ontario, no one can go bankrupt under our present system. Everyone has health care services provided to him, and that is something we can be proud of. I remember personally in my family a grandfather and an uncle who spent a year in the Toronto General Hospital with no insurance, with the result that most property was lost. That should not happen to anyone. It cannot happen in Ontario. We have a system now that makes sure this does not happen. The government may be going down a path that may lead to the destruction of the system that provides this safeguard.

In the United States, that fear certainly does exist. One can be severely financially strapped and perhaps cannot obtain proper medical services because of a lack of funds or because of having failed to purchase a private plan.

The public generally has been well satisfied with doctors, who, as I indicated before, are available at all hours of the day and night, on holidays, at two o'clock in the morning, any time. Doctors work long, irregular hours, not because they are workaholics and not because they do not like recreation but because when called upon to serve, they always rise to the occasion. In so doing, they are under the added pressure, as most of us are not, of dealing with human life: people who are ill, people who are injured in accidents, people who are dying. That service has always been provided to the people of Ontario, and we should make sure this service continues.

A comparison with other jurisdictions might suggest how a change in the system might jeopardize the level of service to which one might be accustomed. In Britain, a study in the British Medical Journal found that the time Manchester general practitioners spend seeing their patients ranges from a low of five hours a week to a high of 46 hours. Thirty-six per cent of all Manchester GPs spent less than 16 hours a week seeing patients.

In Quebec, after state health was introduced, there was a decline of 15 per cent in the average number of hours a day worked by doctors. The number of physicians working 12 hours a day or more dropped from 37 per cent to 17 per cent, and the number of doctors working less than eight hours a day rose from 18 per cent to 28 per cent. Of course, the average time spent with each patient during visits has dropped by 16 per cent.

Mr. Philip: Is the member in favour of 12-hour days for doctors?

Mr. Partington: No.

Mr. Philip: It is always good to have an operation from a doctor who has worked 12 hours.

The Acting Speaker (Mr. Morin): Order. The member for Etobicoke (Mr. Philip) does not have the floor.

Mr. Partington: The member should have the same commitment the doctors have. They perform admirably.

Mr. Philip: I work a lot harder, and I do not expect to be paid out of the public purse.

The Acting Speaker: Order. Address your remarks to the chair.

Mr. Partington: Yes, Mr. Speaker. Maybe we should refer the member to the rules of conduct on interruptions while a member is speaking.

As I say, the average time spent with a patient dropped by 16 per cent. That is not accessibility. Prior to the introduction of state health insurance, patients waited six days to see their physicians. After the introduction of the state insurance system, it jumped to 11 days, an increase of 80 per cent -- again, not accessibility but a reduction in accessibility.

9:10 p.m.

In Sweden, where 90 per cent of the doctors are employed by the state at hospital clinics, doctors work from nine until five, and they take from three to five months' holidays a year. I guess the answer is, "All we do is double the number of doctors." But we are trying to keep our medical costs in line. It is better to have doctors who are happy in the system, working efficiently with the government to keep costs under control and to deliver an efficient, high-quality system, a system we can be proud of and they can be proud of. State health insurance does not do that. It is a sure path -- a crumbling, stony path -- to ultimate deterioration of the system.

I have had several letters lately from people in my riding who are very concerned about this issue. It may surprise members of the opposition that I have had more letters supporting the doctors' position than opposing it. I will read one letter from a Robert Munson, who is a former superintendent of the parks department in the city of St. Catharines. He writes to me, saying:

"I am concerned about the work stoppage by the doctors of this province. I personally do not favour social medicine. I would like the market to be able to bear the quality of the service that they are given. My observations seem to indicate the problem is lack of communication, and I would ask that you request the government of this province to initiate immediate discussions with officials of the OMA. The withdrawal of services of the medical profession is most unfortunate as I believe that the citizens of this province deserve this service. It would be most appreciated if you could communicate with the government of this province and express my concerns."

This man, Robert Munson, who spent most of his life in St. Catharines, wants the government to negotiate and discuss with the officials of the OMA. We have heard time and again that the government cannot do it and will not do it; mediation will get nowhere. They are polarized. Interestingly enough, that was the position before the election and nothing has changed.

I submit that mediation is and should be the answer and that at this late date, a lot of people would feel a lot better if the government were prepared to moderate its stand and attempt mediation, deal with the federal government and work at solving this problem. It is a very difficult problem, perhaps the most difficult one the House has had to face. I am sure the test of the government would be if it could take the reasonable step, succeed with mediation and with the federal government, so that the system we have, which is proven, can continue in the best interests of the people of the province.

I would like to refer again to a letter I received on June 13 from Mr. Goldford, chairman of the board of governors of the St. Catharines General Hospital. He attaches two copies of letters he sent to the Premier and Dr. Richard Railton on June 13, 1986, and January 24, 1986. In his letter to me, he states that the letter reflects the viewpoint of a concerned board comprising men and women who sincerely strive to fulfil their obligations to the community.

St. Catharines General Hospital is a very large, very revered, long-standing institution in St. Catharines delivering a major part of the health care services in our community, along with the Hotel Dieu. Mr. Goldford states, "These board members are watching in disbelief while the opposing parties in this dispute dismantle a system that has been so effective over the years." That is the point: We have a system that is effective.

When people questioned the health care system, only seven per cent were concerned with extra billing. The issue has been invented by this government as an election issue. It reminds me of Sunday shopping or beer and wine in the corner stores. If someone is asked if he wants shops to be open on Sundays, he will say yes. In England, 65 per cent said yes to that question. If it is followed up with the question, "Are you prepared to work on Sunday?" the 65 per cent becomes 25 per cent.

With beer and wine in the corner stores, if people are asked if they want beer and wine in their corner stores, they will say, "Yes, out of convenience." When we talk about impaired drivers, under-aged drinkers, Canadian breweries being put out of business, breweries located in Ohio and perhaps the destruction of the wine industry, people say, "Maybe not."

It is easy to say to the people of Ontario, "We will fix this health care system; we will ban extra billing." That is very simple, but it is not the answer and it is unnecessary. The system works. Do not change the system. Fine-tune it, but do not change it. If we change it, we run the risk of destroying it.

I will get back to the letter from St. Catharines General, which warns against dismantling a system that has been so effective over the years. There is no question that if the board and one of the unions showed the same inflexibility with the result that the hospital became ineffective in meeting its role, there would be a hue and cry from the public and the government and the latter would intercede quickly to protect the citizens.

Mediation is essential. We urge the government to use whatever power is at its disposal to persuade those in a position of making decisions to take immediate steps to ensure this is done. The party should be reminded that its stubbornness is not a sign of strength.

I might refer briefly to the two enclosed letters. Mr. Goldford, the chairman of the board, says in his letter to the Premier:

"Gentlemen,

"On January 24, I wrote to you on behalf of the board of governors of the St. Catharines General Hospital asking that both the government of the province of Ontario and the Ontario Medical Association back off from their respective entrenched positions in this dispute before they destroy the very health delivery system they claim to be protecting."

That is the bottom line. We want good health for everybody in this province, but why destroy a system? Eleven per cent of the doctors in Ontario extra bill; they extra bill 25 per cent of the time. Five per cent of OHIP premiums are the total amounts incurred in extra billing. That can be answered in a way suggested by the OMA and by our party some time ago. I do not think the system has to be changed to satisfy that problem. As others have said, there are problems far more important in the health care system today than extra billing.

Chronic beds are required, as is more psychiatric care, more care for the mentally retarded and mentally handicapped, ad infinitum. The members know the pressures are there, and they are there.

Mr. Philip: It was the member's government which created that problem.

Mr. Partington: The members should realize life is evolutionary and we solve the problems as we go. We do not go back 42 years.

The Acting Speaker: Order.

Mr. Partington: Mr. Speaker, I will carry on. I get tired of listening to people going back 42 years. I am sometimes amazed when people talk about pollution existing for 42 years. Pollution in some form has probably existed for hundreds of years, because certainly the washing-away of dirt from a bank is pollution. The fact is that most international books dealing with international rivers and international waterways never mentioned the word "pollution" as late as 1964.

Mr. Ferraro: What does that have to do with extra billing?

Mr. Partington: I am referring to the comments about looking back. Let us solve today's problems today. Forget the past; the past is gone.

In some ways, we should be proud of the past. The past represents strong, good government in this province on which we should move forward and build an even better society for the people of this province. Let us be proud of it. The government sometimes talks about members being critical about what they are doing. Let us not be critical of something that was so good in this province for so long. Let us be proud of it.

I know that when the member for St. Catharines (Mr. Bradley) is asked of the great accomplishments of the Ministry of the Environment, he talks of cleaning up the phosphorus in Lake Erie. That was a great accomplishment, and it was accomplished by the government here when we sat on that side of the House.

9:20 p.m.

Mr. Breaugh: One would think the Conservatives would at least have the decency to talk about this bill when they are going to make us sit all night.

The Acting Speaker: Order.

Mr. Partington: If the members would not interrupt, I would be able to stay on target.

Mr. Breaugh: The member could not stay on course for a lobotomy.

Mr. Partington: Some people here might need a lobotomy.

Mr. Breaugh: I know a doctor who will do it for the member cheaply.

Mr. Partington: In any event, as I try to ignore that voice that has little logic, the board want on to say:

"The government must discontinue its insistence on forcing Bill 94 through at any cost, and the OMA must discontinue its desperate tactic of indirectly fighting the government by counselling its members to deny fulfilling their hospital responsibilities.

"It is time to bring a mediator into the dispute and for the parties to work together in good faith to arrive at an equitable solution. Both of you will be applauded for substituting rationality and reason for the anger and distrust which symbolizes the current tone of the dispute.

"On behalf of the citizens of St. Catharines, we urge you to take these steps immediately. It will be difficult enough to dispel the bitterness that has already been imposed on the relationships. If you compound this further by continuing down the present path, it is inconceivable."

I urge the government to heed the words of the board of governors of the St. Catharines General Hospital and at this late date consider mediation, not the imposition of this bill, as it is doing.

No one wants to see a disruption of the system of health care we have had in the province, but it is obvious the doctors are angry. In their minds and in the minds of many people they are justified, although there are others who hold a different view.

If this act is passed, I assume we will have continued disruption in the system. Even worse for the long term would be adopting the Swedish example of doctors who work seven to nine months of the year, 15 to 20 hours per week, and reduce the patient load and the time they take to see patients. That would be tragic for the people of this province and burdensome to the budget of our health care system. On the other hand, I am sure it would provide an opportunity for the infusion of many more doctors into our system, as they would be required to do the same work currently being done by the doctors we have.

Another concern we should share, and someone spoke of this earlier, is the view our very talented young people will have towards the practice of medicine. Medicine tends to be a commitment like no other activity. One can go into teaching, the law, become a tool and die maker, carry on almost any job --

Mr. Ferraro: Why would anyone want to be a lawyer?

Mr. Partington: The member is right; certain people think that these days. Such people can pursue other activities of a social, recreational or economic nature. They may buy pizza parlours or apartment buildings or get involved in commercial enterprises. By and large, doctors are prohibited from doing that. Medicine seems to be so intense and of a much shorter duration that a doctor has to devote his or her full time and attention to the job, a job of great pressure. Doctors deserve to operate in that job with a feeling of freedom from state control. That freedom is economic as well as being free from too many regulations.

One of the further aspects of this legislation is that there seems to be a thrust behind it to suggest that some doctors, in making a living from treating the sick, are somehow not doing quite the proper thing for society; they are being selfish in charging people for treating their wellbeing and their health. To that, I can only say the practice of medicine may be the most honourable profession in our society.

There is certainly nothing to be ashamed of -- in fact, there is much to be proud of -- in charging fair rates for keeping people from dying, for healing the sick and for keeping the people who are healthy well, because there is a difference between just being and being sick. It seems to me important that we do not destroy this atmosphere, but I am sure the destruction of this atmosphere is destined, if this act passes.

The members can compare what is happening here with what is happening in Britain, where 1,500 patients with kidney disease die each year because they do not receive treatment. Patients can wait up to three years before getting an outpatient appointment at a National Health Service hospital if they suffer from such nonfatal diseases as cataracts and hernias. Patients with diabetes are likely to die 10 years earlier than average and have a higher chance of going blind and an increased likelihood of kidney failure. If we institute state medicine, if we go down the road from where we are now to where the British have been, we will destroy the high-quality health care we have had in this province for so long.

I urge the government to respect the professional perspective of the doctors. Trust them, as the Premier has said, "Trust us." There should be some mutual trust. Doctors care for their patients. They care for the system, they know what works well and they are prepared to meet in a spirit that will provide a settlement in the best interests of our society. It will keep medicine on the high plain where it has been and will encourage our young to go into medicine and to stay there. It will avoid the perils of the American system and the stagnation and the mediocrity of the British system.

I invite the government, at this late stage, to try mediation and not to pass Bill 94.

Mr. Breaugh: I listened with some care as the member for Brock (Mr. Partington) deviated somewhat from the bill that is before us. I suppose that is to be anticipated during the course of the evening, which is liable to be a long one.

I wondered whether the member would comment on the fact that many of our home bases have physicians who have stayed within the agreed-upon fee schedule and have not extra billed. During the course of this disruption, they have not taken out on their patients what our government is trying to do. They seem to have a clear understanding that this is a bill that does one thing: it ends extra billing. It brings us into conformity with the Canada Health Act, and it removes the penalty clauses against the province that the Canada Health Act imposes.

Can he explain for us why that has always been a reasonable thing for many of our physicians? One's association negotiates with the government of Ontario a fee schedule, and one adheres to that fee schedule. That is seen by all trade unionists as being fair and reasonable; it is seen by most academics as being fair and reasonable, as it is seen by most professionals as being fair and reasonable. In some way, people organize themselves to represent their profession or their occupation and they negotiate an agreed-upon rate; then they adhere to that rate. In trade union terms, if one does not, it is called a wildcat strike, an illegal strike, a breaking of a contract.

In many ways, I feel very sad that many physicians who have not extra billed have somehow become embroiled in this dispute and have tried to expand it into far wider things. This is, after all, a simple bill, consisting of five or six clauses. It has a singular purpose: to end extra billing. By doing that, we will bring ourselves in conformity with the other provinces in Canada; I think seven out of 10 have already done it. It seems to me that is fairly straightforward.

9:30 p.m.

Mrs. Grier: I have listened to the member for Brock and many other members of his party tell this House that they think a mediator ought to be appointed to mediate this dispute. However, I have yet to hear from the members of the Conservative Party as to the direction in which they think the mediator ought to be mediating. We know quite clearly the position of the government and of this party, that extra billing ought to be banned. Is it the position of the Conservative Party that extra billing ought to be continued?

It does not appear to be so, because they say senior citizens and the poor ought not to be extra billed. I think they have some obligation to spell out for this House how they see that happening. By what mechanisms do they expect that to occur? What do they expect the mediator to mediate? There is no mediation if one position is to extra bill and the other position is not to extra bill. If there is something in between, let us hear what it is. Let us hear what they would do if they were the mediators. If we are going to stay here all night and talk about it, they have some obligation to make that plain and to tell us where they stand.

Mr. Gregory: I want to compliment the member for Brock for a very clear and concise picture of the Conservative position in regard to this. The member for Lakeshore (Mrs. Grier) has obviously missed the entire gist of the arguments when she questions what mediation is about. Obviously, members of that party have no conception of what mediation is about. She wishes to start from a position of intransigence, not move from it, and say: "What can you mediate? This is a position and that is a position." With great respect, the member for Lakeshore does not seem to understand, despite her close affiliation with unions, what conciliatory treatment is about, what negotiation is about.

Mr. Breaugh: A lesson from the member for Mississauga East on being conciliatory.

Mr. Gregory: Certainly. I can be. Obviously, I am more conciliatory than the members of that party because they will not start on any kind of basis of negotiation at all. They say: "This is one position. That is another position. What is the point of having a negotiator? Nobody will move."

My good friend the Attorney General (Mr. Scott) has probably been part of more negotiations than anybody in this House. He has to be. He is a very clever lawyer and lawyers negotiate. That is what they do with judges, I believe; they negotiate. What do they call it in the United States? I cannot recall. They call it plea bargaining or something such as that.

I am trying to make the point that the member for Brock made it very clear. If it was too difficult for the member for Lakeshore to understand, that is her problem and not that of the member for Brock.

Ms. Bryden: I have been listening with great care to all the arguments put forward tonight by the party to my right. I have not heard any justification for hijacking our hospitals and our emergency wards, which is the tactic that is being used by a group that has monopolistic power in the medical profession. They are licensed by an agency of the profession. They are licensed to carry out service to the public under certain conditions. Does closing down emergency wards fit in with providing that service? Are they allowed to threaten to not refer patients to clinics that do not go along with the strike? This seems to me to be a naked use of power that no profession, group of employees or independent entrepreneurs should have.

Does the member who just spoke believe the democratic will of the Legislature of this province should come ahead of the wishes of a small professional group with a great deal of power in its hands?

Mr. Partington: First, with respect to the comments and the question from the member for Oshawa (Mr. Breaugh), I acknowledge, as I think I did in my statement, that most doctors do not extra bill. Only about 11 per cent do.

I have talked to some individuals. I can think of one in particular, a very sincere, hardworking and caring surgeon whom I know -- and there are many; I am sure the member is aware of that. This man spends much time; his main concern is the welfare of his patient, not how many patients he can see or how much money he can make.

He may find on occasion that because of the extra care he gives his patients -- because he is not subject to the pressure of having to see so many patients in an allotted time or to perform so many operations in a day, which probably would be detrimental to his patients if he happened to do so -- he has to extra bill in order to afford them the care and time he wants to give them in those particularly difficult cases.

I suggest this is an example of where that small minority of doctors -- and they tend to be surgeons or specialists -- may feel they need to charge more than the OHIP rate in order to provide the time and attention the patients deserve, and perhaps at the same time impress upon their patients the necessity or importance of the surgical procedure.

With respect to the last question of the right of a doctor to overcome the will of a democratic society --

The Acting Speaker: Your time has expired.

Hon. Mr. Scott: I should tell the honourable members that I have never had occasion to speak in a general debate in this House. I know the honourable members opposite will pay me the traditional courtesy of listening patiently to the few words I have to say on this occasion.

I speak early, because the word in our lobby is that the Minister of Education (Mr. Conway) will speak later, and I expect to be home safely in bed on that momentous occasion. As all members who have heard him and his history lessons know, if one is here during them one will spend the balance of the night sleepless as the historical allusions pile over and over again in one's mind.

For the record, let me say that I am delighted on this first occasion to see so many of my cabinet and caucus colleagues behind me to hear my words. I am more flattered than I can say to see the opposition lobby doors opening and members of the Conservative opposition entering in twos and threes with their NDP colleagues as the House fills up for this occasion.

I am more flattered and honoured by that attendance than I can possibly say, and I want to record my thanks in an official way for the enormous outpouring that has greeted my initial words. I hope the honourable members -- because we cannot be here all night, surely -- will not interrupt any more with applause, as it will restrain the path of my thought and only waste valuable time.

9:40 p.m.

Let me say that it is traditional in these debates to say this is a historic and important debate. Of course, it is also a curious debate for the very reason that the member for Lakeshore (Mrs. Grier) noted.

We have been debating this bill for some days. There have been speeches, and there will be dozens of them tonight from the official opposition, but there is nobody in this House or in this province who can tell us what the Leader of the Opposition (Mr. Grossman) believes about extra billing. There is not a word from his lips anywhere about whether he favours or opposes it. His caucus colleagues --

Mr. Haggerty: If Mulroney did that --

Hon. Mr. Scott: We will come to the Prime Minister in a moment; he at least exhibits the virtue of unconstrained candour.

At the end of this debate the Leader of the Opposition will have told nobody, unless he confides in his caucus, where he stands on this important issue. Is he in favour of extra billing or is he opposed to it? We will never know. We know he favours delaying the bill so that it will not be rammed through. We know he favours mediation as a policy. We know he has various concerns about health care in the province generally. However, from him and from the leaders of his caucus we know nothing about where they stand.

Is it not remarkable? There must be few occasions in Anglo-Saxon democratic history when a critical issue of public importance is being discussed vigorously in the middle of the night when the viewpoint of the official opposition on the issue of principle cannot be ascertained. The one virtue of this debate, a virtue that will become apparent, is that as we go later into the night we find out that the Leader of the Opposition has not always been able to cast this cloak over his colleagues.

Tonight, I think the member for Brock (Mr. Partington) told us that he is in favour of extra billing. One by one, the members of that party will stand up and tell us where they stand. I can hardly await the speech, probably to be delivered at a quarter to four this morning, by the member for St. George (Ms. Fish), who I am certain will tell us where she stands on the subject of extra billing, because her constituents want to know.

Why do we not know where the Leader of the Opposition stands on the extra billing issue? Why do we not know? There can be only two possible reasons. The first is that he has not made up his mind. The second is that he does not want to tell us. Why would he not want to tell us in a debate that has run for days? He would not want to tell us so that one impression can be gained here and another impression gained there. In my respectful submission to the members of the House, that is not an attitude that is worthy of the official opposition. We are entitled to know.

I know we will hear from the member for Brantford (Mr. Gillies) whether he favours or is opposed to extra billing. Tonight, when the Conservative members of the opposition make their speeches one after the other, I hope somebody here will stand up in the question period just at the end of it and say, "Honourable member, wonderful speech, but can he tell me in a word, does he favour extra billing or is he opposed to it?" My guess is that every one of them will shrink from that question as quick as a wink. They will not answer it because they dare not.

I want to make a couple of points about this bill, but before doing so I want to pay tribute to my colleague and friend the Minister of Health (Mr. Elston), who from the beginning of this tortuous, difficult, complicated and important exercise has behaved as a model of conciliation, moderation and propriety. I was here when he was mocked in this House as carrying my bags. I was here when the opposition laughed at him, when it tried to make fun of him and demean him although he was about a public work. What did he do? He did what the Globe and Mail said this morning: he turned his cheek and he kept on his course. I want to testify on the record that I think his performance has been remarkable and I am proud to be his friend.

Before we come to the subject of the bill, let me make my bias absolutely clear. I have spent almost all my professional life as a lawyer working for doctors. I have acted for extra billing doctors and nonextra billing doctors. I was counsel to the College of Physicians and Surgeons of Ontario for almost 20 years. I acted for the Ontario Medical Association and the Canadian Medical Association. There is no one in this House who has a greater, firmer and more profound respect for the medical profession of this province than I do. I cede that territory to no one. I have great confidence in the ability of this profession to serve the province and the public with dedication, zeal and honour because I have seen it.

What has happened here is that in 1962 in Saskatchewan, and later across the country, it was decided that because the delivery of medicine was an essential service it should be paid for by the taxpayer. We have moved through a process in this country in which that principle has come to general acceptance. The culmination of the principle occurred in the Parliament of Canada a few years ago when the Liberal government of the day introduced the Canada Health Act. That act represented the federal government's effort to go as far as it constitutionally could to ban extra billing across the country.

What happened in that debate? The honourable members can remember there has never, in my lifetime, been a debate that so consumed the country than that debate about the propriety of the Canada Health Act, which was tantamount to making extra billing unlawful, or at least subject to penalties, in the country. The Conservative Party of the day was racked by dissension confronting that bill. The doctors were concerned and made their concerns felt.

I remember watching on television the day, to the surprise of millions of Canadians, when Brian Mulroney, now the Prime Minister of Canada, led his party, I think almost unanimously, to vote for the Canada Health Act. Much can be said about Brian Mulroney, some of it good. I do not intend to get into any of it. What can be said about Brian Mulroney on that day is that he did something that has not been done here by the opposition. He stood up on an important public issue and said, "I am opposed to extra billing and I carry my party with me into that lobby."

I challenge any speaker for the opposition, as we go along, to tell us where his party stands. We are entitled to --

Mr. Gregory: The minister knows exactly where we stand.

Hon. Mr. Scott: The member is in favour of mediation; we will come to that. I ask the member for Mississauga East, and we will cede the floor, is he in favour of extra billing or opposed to extra billing?

Mr. Gregory: We are against the banning of extra billing.

Hon. Mr. Scott: We do not get an answer.

Mr. Brandt: You just got an answer. The answer was that he is against banning extra billing.

Hon. Mr. Scott: All right. Can I ask the member for Sarnia how he feels?

Mr. Brandt: The same way as my colleague.

9:50 p.m.

Hon. Mr. Scott: Now we are getting it. By the end of tonight, we may have it clear that the members of the official opposition are in favour of extra billing. Then we will have learned something.

Let me make a number of other points. The members of this party were elected committed to a principle: that is, to enforce the principle of the Canada Health Act in this province as it had been enforced in seven other provinces and as it will shortly be enforced in the balance. Every member of this party came to government with those words on our pamphlets. They were there. We were committed to that and we made plain, as I recall it, from day one that was what we were going to do.

We also made perfectly plain that we were prepared to discuss with the OMA or anybody else any viable method to achieve that objective. The objective was fixed because that is what party politics is about, but the avenue that would lead us to that objective could be discussed. Initially, as members will recall, the position of the OMA was that there would be no discussion at all. Then, because there was no discussion, there was no suggestion as to what we might do. Since we were being told to do nothing, we introduced a bill.

Again, we said, "We will discuss any viable method of achieving the objective and complying with the Canada Health Act that the doctors want to discuss." What was their response? Their response at that stage was, "We will discuss nothing until this democratic parliament withdraws its bill."

Finally, we got to some discussions. There were 10 or 11 meetings to which I had the honour of accompanying the Minister of Health. At those meetings, we put on the table every viable method that has been devised in Canada to meet compliance with the Canada Health Act and we said: "We will discuss any of those. If you want to extra bill, a way to do it has been devised in Quebec. We do not particularly approve of it, but we will discuss it. If that is what you want, it can be considered." They replied, "We will discuss none of those things until you withdraw the bill." That is where the discussions ended.

What has happened since is it has become apparent, and the OMA has said so, that the discussions were unproductive because we would not withdraw the bill and would permit the members of this House to vote on it. In the end, that was intolerable, that the bill would be voted on. According to the association, meaningful discussions could only occur if the right of honourable members in this House to vote on the bill was withdrawn for the time being.

That is the situation in which we find ourselves now, and it is said by my honourable friends we should have mediation. The member for Mississauga East (Mr. Gregory) has been good enough to concede I may know something about mediation. My practice had a lot of mediation involved in it. What one does when one mediates, of course, is one takes two extreme positions in which both parties have represented that they will move off their extreme positions and see if there is a middle ground where principle can be ignored and practical compromise achieved.

It must be obvious to everybody that the question of whether this province will comply with the Canada Health Act is not such a question. One either complies with the Canada Health Act or one does not. One cannot say, "We will comply halfway with the Canada Health Act." That, of course, is why mediation is not possible.

I also ask if it is even desirable. What we are dealing with here is not something that should be accomplished by a mediator. We are dealing with an important issue of public policy that should be decided by the people and their representatives. That is the challenge we have in this debate and in the vote that, pray God, after these days, will come tomorrow.

Let me make a number of other points, because it is very important to put this debate in perspective. This bill does one thing and one thing only. It must be one of the shortest bills we have. It says that a doctor cannot extra bill his patient. It does not say anything about where he shall practise his profession. It does not say anything about the number of patients he may have. It does not say anything about the way he shall practise, what he shall prescribe or how he shall make his medical assessments. It deals with one question only, a question that has already been satisfactorily dealt with in seven other provinces. Even Alberta, that paragon of progress, has announced it will be taking steps shortly to ban the practice of extra billing in the province. That is all this bill does. I challenge any honourable member to point to anything in it that goes beyond that.

Of course, it has been said there is a secret agenda and that this bill is the thin edge of the wedge and a symbol of what will come down the line. This afternoon, the Minister of Health made clear his position on that. Even if there were a secret agenda, and there is not, would it not be time enough to deal with those issues when they arise? If some government of the day, two years, five years or 10 years from now, were to deal with the question of where members of the profession could practise, it would be time enough then to deal with the issue. Why can we not now do what the other provinces have done? Why can we not now comply with federal law? It is said we cannot do that because of something that may happen two, five or 10 years from now.

What has happened is that many members of this noble profession -- and that it is -- have been led to believe that hidden in the recesses of this bill, written between the lines if you will, is some kind of threat. The bogyman is there. Like all good bogymen, he cannot be seen, but he is there none the less. That is wrong. The reality is that those who have led the members of this noble profession to that view have much to answer for, in my opinion. It is the view that the bill provides something it does not provide and restricts something it does not restrict that has led to much of the difficulty we have seen during the past couple of days. Those, whoever they may be, whether doctors or politicians, who have led the members of this distinguished profession to think that have much to answer for, in my respectful view.

10 p.m.

I know, because she said it to me on the way out of the House tonight, that tomorrow the member for York Mills (Miss Stephenson) will say this bill is the destruction of a noble profession. She is a noble, almost a monumental, professional. The bill is not the destruction of a noble profession. Let us be realistic about it and let us get it in perspective. The noble profession that exists in British Columbia, Alberta, Saskatchewan, Manitoba, Quebec, Nova Scotia, Newfoundland and Prince Edward Island is just as noble now as it was before their restriction on extra billing was undertaken. There is no destruction of a noble profession in this bill. The nobility of the profession is its independence. What is the heart of its independence? Do we really believe, if I am a professional, that the heart of my independence is to send a bill to somebody? Of course not. The heart of my independence and of the doctors' independence is our training and our commitment to make independent judgements about people's lives. That is what it means to be an independent professional. That is what it means to be an independent lawyer --

Hon. Mr. Nixon: Right.

Hon. Mr. Scott: -- if the Treasurer (Mr. Nixon) will permit and acknowledge -- and that is what it means to be an independent doctor: skill, training and the capacity to make an independent judgement about a person's condition. The doctors in Ontario have that now and will have that tomorrow. I cannot believe, knowing them as I do, that the independence of doctors to assess, to prescribe, to treat and to counsel will be altered one whit by virtue of the fact that their bills will be governed in the same way as the bills of almost all doctors across the country.

People who tell the doctors of our province that this is what the bill means -- and I pray there is no one in the official opposition who has been saying that -- will have a lot to answer for if this profession, led to that view by others, falls on its own sword. That, and not this bill, will be the destruction of the profession. I pray, because I value them and recognize their importance to our society, that no one, out of an excess of political or organizational zeal, will allow that to happen. The independence of this profession is not now and never was at stake in this bill and I challenge anybody to assert seriously, by pointing at the paragraph, that it is.

Let me say one more thing. What has happened as this bill has been introduced and presented is that an atmosphere of hostility, to use the words of the member for Sarnia (Mr. Brandt), has been created. He says it has been created by the government; the government that, after all, took the same step the federal government, supported by his own party, took within its power; and the government that took the same step six, and soon eight, other governments in the country will take. He says we have had a part to play in that atmosphere of hostility by taking a step that almost every government in the country has taken or will take.

I care not -- though I have a sense of responsibility, I hope -- how the atmosphere of hostility was created. I do care enormously that this atmosphere of hostility abate. Every honourable member knows in his heart of hearts a mediation that is doomed to fail will not abate that hostility. What will abate the hostility is to tell the doctors what I believe and what I think honourable members believe: that we value their independence, we recognize the importance of their role, we recognize the importance they have in our community lives and we want them to continue to be independent in their judgement, assessment, prescription and so on.

We want them to make those judgements with complete freedom, but the bill must be passed because it represents the policy of this country. It is what separates this country from other countries. It is what separates us from the United Kingdom, where there is a two-tiered medical system and where doctors can opt out and ask for money and make themselves unavailable to people who do not have it. It is what separates us from the United States, where people are obliged to submit to crushing economic burdens in many cases.

The characteristic of this country since 1962 is that we have turned our back against the British two-tiered system and the American system. What have we turned our face towards? We have turned our face towards the proposition that our citizens, wherever they come from, whatever their background, whatever their economic resources, can go, without fear of economic consequence, small or large, to any doctor who will serve them. That is a wonderful goal. We in this country are very close to realizing that goal and when it is realized it will be a mark of our civilization.

I hasten to add, because I respect them and value their work, that we must be very careful to see that our physicians and surgeons are adequately and fully compensated. Honourable members will not find me carping about fees on this matter or that matter. I believe they must be not only adequately but also generously compensated in so far as the taxpayer can assure it.

Mr. Ferraro: The Treasurer is grinning.

Hon. Mr. Scott: I am sure the Treasurer agrees. We are getting him to approach generosity in a more open spirit than has been typical of Treasurers under the old government.

It is very important to indicate to the doctors that their independence is not at stake in this society. It is not at stake in Alberta, it is not at stake in Nova Scotia, it is not at stake in Ontario, but the taxpayers and voters of our country want every citizen to be able to go, without fear of economic burden, large or small, to any doctor who will serve them.

Much has been made, and will be made, by the third party about whether we are being tough enough on the doctors. I think the member for Oshawa (Mr. Breaugh) made reference to the fact that the most recent time health care workers attempted to close a hospital, in 1982, when there was a province-wide strike of health care workers -- not doctors but hospital workers -- the government went to court to declare them an essential service and put the leader of the association, Grace Hartman, in jail. The member for Oshawa suggested that might be one of the appropriate responses. I do not think it will be necessary to do that.

Mr. McClellan: I doubt he said that.

Mr. Grande: He did not say that; come on now.

Hon. Mr. Scott: He may not have said that.

Mr. McClellan: I do not think that is a very fair suggestion and you know it.

Hon. Mr. Scott: I was here and the honourable member was not.

Mr. McClellan: I was listening and the honourable member was not.

Hon. Mr. Scott: I make no point of it. To be fair to him, I think he was contrasting the attitude of this government with the attitude of the previous government.

Mr. McClellan: The double standard perhaps.

Hon. Mr. Scott: All right. That, of course, is the previous example to which he referred.

I believe when this bill is passed the doctors of the province, who are democrats and our fellow citizens, will recognize that this Legislature, like the seven other legislatures in the country and like the Parliament of Canada, has spoken to the issue, and, whether they support the policy that has been selected or personally reject it, they will comply with it because they are citizens and professionals. I know all members of all parties want to encourage them to do so and want to say in this debate nothing that is designed to exacerbate their difficulties, to inflame their passions or to heighten unnecessarily or improperly their anxieties. When all is said and done, the democratic assembly has a right to speak to this issue and must speak to this issue, and I pray tomorrow will be the day.

10:10 p.m.

Mr. Gregory: I can easily appreciate the words of the Attorney General. He is quite a spellbinder and I can appreciate he sways many people, many juries and many judges. It is quite marvellous, except that he tends to twist words just a bit. Let me hasten to assure the Attorney General there is no doubt about where this party stands, no doubt whatsoever. We have made it very clear. We are against the banning of extra billing. I do not know how I can say that any more clearly. We are against the banning of extra billing.

The government chooses to say that the opposition party is in favour of extra billing, tending to give the impression that we want every doctor to extra bill. That is not so, and the member knows it.

The government makes the point that it has done a great job of negotiating. It is difficult to negotiate when the government party begins from a position of rigidity. When the government spots its position and says "We will negotiate, but we will not vary from that position," that is not negotiation in any way. The member should be ashamed of himself for taking that position and trying to sway this audience the way one would sway a jury.

I ask just one question of the Attorney General. What would his position be if a government -- not necessarily his, because I do not think he is going to be around that long-decided it would treat lawyers the same way? In other words, lawyers would not have the right to determine their fees, as they do now. I do not think he can argue that point.

I respect his words, but, frankly, I think he has tried to twist what we have been saying. He was very clear on our position. We have stated it. How many times do I have to say it? I will spell it out, or speak very slowly, so he can understand. There is no difficulty in where we stand. We are not in favour of the banning of extra billing. Has the minister got that now?

Mr. Grande: First, I want to congratulate the Attorney General on a good maiden speech. I hope he is not going to deteriorate from this point with respect to his speaking.

I want to ask the Attorney General a few questions. While he was asking the official opposition, "Are you in favour of extra billing?" I listened very carefully and noted that the minister never answered the question himself.

He talked about the fact that every member of his party was elected with that in his brochure, in his election platform. However, during the Attorney General's speech -- and perhaps I am wrong or I missed it; personally, I did not hear it -- he did not say whether he was in favour of extra billing. Perhaps he could answer that and put it on the record to complete an otherwise excellent speech.

Mr. Brandt: I have a couple of questions for the Attorney General.

One is with respect to the comments he made about compliance with the Canada Health Act. In his remarks, he indicated we are simply moving towards the same position other provinces have taken. Could the Attorney General, in his answer, perhaps indicate whether the modified position as put before this House, and the one we received today from the OMA, would be in compliance? If not, why not?

The whole constitutionality of the federal government's withholding of any transfer payments from the individual provinces is also a moot question I would like him to respond to.

Second, the question of the independent professionalism of doctors was an issue he raised. He indicated it would not be compromised in any way as a result of the passage of Bill 94.

This is not a hypothetical question, but a very real one that he touched on briefly in his remarks. If, at some future point, the government decides to negotiate with the doctors and the parties reach a position where they are not in agreement as to the settlement of the doctors' wages under the Ontario health insurance plan fee schedule, could he indicate what kind of leverage a doctor might have at that time, since the opportunity or alternative of extra billing would be removed from whatever arsenal of weapons doctors might have to negotiate with the government?

How would a doctor negotiate for what he perceives to be an adequate wage when he can no longer extra bill, even to the very limited extent that extra billing is allowed today? Does the Attorney General not feel that this removes some element of the individual ability of doctors, under those circumstances, to negotiate what they consider to be an adequate wage?

Mr. Taylor: I listened very attentively to the member for St. David (Mr. Scott), the Attorney General --

Mr. Baetz: Attentively, not tentatively.

Mr. Taylor: Attentively -- and I can understand why he has mesmerized his members and why they are so unified and arbitrary in their posture on this bill.

However, may I point out that the bill itself causes some confusion in the title and then, of course, in the short title. In the one case we are talking about extra billing and in the other case we are talking about accessibility. To me, those are two matters that we should be able to negotiate and settle, whether we are talking about them in the abstract or in the real. We are talking about money. We are talking about the accessibility of the public to the health care system.

There is another aspect of this bill that has really instilled fear into the hearts of the medical profession. It is a concern that has been generated by my New Democratic Party colleagues. I do not want to be unkind to them, but there is concern about that hidden agenda. There is concern about the future of the medical profession. That is more than perception; it is reality. Members talk about dealing with the reality. The perception is the reality here, and that is the issue we have to penetrate.

It is going to be very difficult to dignify a perceived deception of a bill where we have issues that are not seen as the crucial issues among members of the medical profession and, I suggest, some members of the public.

Hon. Mr. Scott: There are more questions than I can possibly answer. I am glad to know where the member for Mississauga East stands. He stands in favour of permitting doctors to extra bill. I will be interested to hear the Leader of the Opposition and the member for St. George say that tomorrow, because I have to get out my householder mailing as soon as possible and I want to have a quote from each of them in it.

The member for Mississauga East refers to lawyers. The point to note here is that lawyers are generally not paid from the public purse, except in one case where they are regarded as essential. Legal aid lawyers are paid from the public purse, and for my profession it has always been the law, introduced by the former government, that a legal aid lawyer paid from the public purse cannot extra bill and that it is an offence to do so. That is the analogy.

May I now deal with the member for Oakwood (Mr. Grande). I support this bill. If there were any doubt about it, I could not have stood in this ministry and I could not have made the speech I did tonight. I am surprised he exhibits any doubt about it.

With respect to the question the member for Sarnia asked, I do not believe that the plan proposed complies with the Canada Health Act. The Canada Health Act makes it plain on its terms that it does not comply. Mediation is an important process, and if there should be in the future a dispute about what the OHIP tariff should be, between $10 for a visit or $7 for a visit, that is an appropriate subject of mediation because there is a middle ground to which both parties can go and meet their objectives.

Mr. Brandt: Does the bill guarantee that?

Hon. Mr. Scott: No.

10:20 p.m.

Mr. Dean: I do not intend to be either as long or as erudite as the previous speaker. The first thing I want to say is that we are facing and we are discussing bad legislation. Let us not make any fancy words about it. It is something that has been set up by a government, for some strange reason, taking leave of what I would call a Liberal or middle-of-the-ground stance, to take a very stubborn -- we were warned this afternoon that we cannot call it pigheaded; I will say as stubborn as a pig might do if he were doing this.

Mr. Brandt: Muleheaded.

Mr. Dean: Muleheaded, not pigheaded. Boneheaded maybe, but very stubborn.

Mr. Gillies: I tried that word.

Mr. Dean: The member likes "pigheaded."

It is a very stubborn attitude on something, principally, I suspect, because they were egged on by another group somewhat to the left of this party. I believe that may be the way in which it came about. I am loath to think the majority of the members of the government are so stubborn on the wrongheaded direction the government seems to be taking right now, because I know there are some very honourable people among those of the government.

Mr. Brandt: Name one.

Mr. Dean: Name one? Let me think. I might not want to exceed my time limit by taking the time to think of one.

Because the issue that is alleged to need attention is extra billing, one cannot be surprised that a lot of the members of the public are becoming increasingly puzzled about why the government is attacking with such vehemence, with such an overkill process, a relatively minor defect, if indeed there is a defect.

Mr. Baetz: The Rambo mentality.

Mr. Dean: Rambo?

It has been said by many previous speakers, and I think it was mentioned by the most recent one, that the percentage of physicians who opt out is relatively small among the total. I believe it is in the neighbourhood of 11 to 12 per cent. Of that group, the number practising extra billing is much smaller; probably about five per cent of the total.

Mr. McLean: It is three per cent.

Mr. Dean: Only three per cent? It is going down every day.

Mr. McCaffrey: It is going down by morning and by night.

Mr. Dean: My colleague the member for Armourdale (Mr. McCaffrey) points out that by the time this debate ends, there may indeed be no physicians who are extra billing. Of the group which occasionally or generally extra bills, the total is a very small percentage of the aggregate billing that is done.

One cannot help but agree that the outsider, not having been exposed to as much of this as the members of the House or the members of the two parties who are fighting, remains puzzled over such a fuss surrounding a prerogative which most doctors do not choose to use in any case.

With a heavy-handed force, the government has retreated from its traditional liberalism and has attempted to beat the doctors into submission. What would one expect the reaction of the doctors to be? It would be similar to the reaction I would have. I know the Treasurer, in any of his many capacities, present, future or past, would be horrified if he were faced by someone who was trying to beat him into submission for something that only about two per cent of his colleagues were engaged in. I would be horrified. We would react with resentment. We would say it was a bum rap, a phoney charge. We would fight for our freedom. We would not want to be accused of that. We would not want to be punished for something that is not adequate. Both the Treasurer and I would do that.

We would also wonder whether this was just the first step for something else. If it is an attempt to correct something that is not there, as we perceive it and as I know many physicians perceive it, then what other rationale is there for this kind of legislation?

Expressing that feeling quite well, Dr. Richard Railton, the president of the OMA, is quoted recently -- I am sure members have all read it, but I want to get it on the record -- commenting on the government; that is, those people over there, those nice guys and gals with whom we speak so chummily. When the members of the government get together they are not quite the same as the sum of the parts. Something else is added.

Dr. Railton said: "The government has backed us," that is the physicians, "into a corner. The only way we can get at the government is by expressing our position, our case and our needs to the public." That is one of the unfortunate realities of life. When one fights a government, one has problems. That is a difficulty many of us in our own municipalities have heard people express, "We cannot fight city hall." It is a defeatist attitude. One thinks government has all the resources and one is beaten before one starts.

The resources of the government of Ontario are certainly formidable and even a profession, a group of our fellow citizens, highly respected by us all, as the physicians are, and well-heeled as some people like to think they are, with the intelligence and the organizational capability to mount a campaign against this, even those people must feel they have an unequal opponent.

They have to resort to the only way they can, especially when they have been repeatedly told, and we have heard it told to us in the most silver-tongued eloquence we expect to hear this evening by the previous speaker, the government has no intention of doing anything of a conciliatory nature. The physicians cannot help but feel they are against not only an unequal opponent but also a completely intransigent one with no desire to approach them in a reasonable way.

We are further informed by speakers for the medical profession that we should not expect and the government should not expect them just to roll over and play dead because the government is giving them a hard time even if this bill is passed. The principle on which the doctors are making their stand will be just as alive and just as important 24 hours from now as it is now. They will be very strongly tempted, very strongly influenced to continue the kind of very public, very visible and very effective opposition to the government's program and policy they have already begun.

It is for that reason that many people have said and continue to say exactly what the Attorney General (Mr. Scott) said could not be done. One has to beware the silver-tongued orator because he can put the accent upon the right syllable and convince people who do not really want to be convinced that what he says is right. I do not necessarily subscribe to that. Maybe I have been in politics too long.

However, there have been a lot of calls, and not only from our party. I am sorry the Attorney General saw fit to go out. Maybe he was exhausted by his performance. I am surprised he had any doubts as to what the stand of our party was on this issue and that he did not give more credence to what has been said by our leader and by many speakers from our party over the days this has gone on.

Mr. McLean: He is not always here.

Mr. Dean: The member for Simcoe East has made a good point. The Attorney General is not always here when these --

Hon. Mr. Kerrio: How would the member for Simcoe East know?

10:30 p.m.

Mr. Dean: He would know because he is here all the time. He is our Simon Legree.

We have made it very clear that we believe there is a place for mediation, for the middle ground; and that by definition, the government has set itself up as something that cannot be mediated. It said, "Here is where we stand, we are not going to do anything else." That makes the job of the mediator very difficult. Somehow, the mediator would also have to be willing to try to convince a stubborn government it was being too stubborn in this case.

There have been calls for mediation, not only by our leader, the member for St. Andrew-St. Patrick (Mr. Grossman), but also by many members of the public, not just the physicians. For example, of all people, the editor of the Hamilton Spectator, a newspaper in general circulation in my riding and in all the other areas around the region of Hamilton-Wentworth, said twice within a week to call in a mediator, referring to the doctors and the government. It is very unusual for that newspaper to make this sort of emphasis.

I wish to read a few sentences from the most recent editorial on this topic: "The current impasse and pending showdown between the Ontario government and the province's doctors is totally out of proportion with the problem at the heart of the bitter dispute. While there is still time" -- and this was not written today, it was a few days ago -- "both sides would do well to seek the help of an experienced mediator in a final attempt to settle their differences before innocent bystanders get hurt.

"What appears to have been firmly established in the public mind by now is that the Ontario doctors, out of the blue, have demanded from the government the right to charge their patients more than the fees paid by OHIP and that the government has turned down that demand. This is a misconception which props up the government's stance as defender of the sick and paints the doctors in a greedy corner." That misconception is encouraged by many of the statements the government's representatives have made.

"The fact is, the doctors have had the right to extra bill all along, but the large majority of them never did and operated within the OHIP fee schedule. They firmly believed that having the right guaranteed their independence."

I could quote more, but I do not think it is necessary because it repeats what our party and our leader have been saying all along. I am repeating those phrases deliberately, because I was really aghast that the Attorney General had the, I will not say ignorance, but lack of being informed to be able to say with a straight face that he did not know what the stance of our party is on this.

As for statements by the Premier (Mr. Peterson) about mediation, he has been quoted as saying on more than one occasion, "There is nothing to mediate." That sounds like the same party line we heard half an hour ago in this chamber. Does he believe there is nothing to mediate in the situation which has come about because of that stubborn stand, which has resulted in the temporary closing of certain parts of the hospital services, of emergency departments? Even as recently as today, we have been informed that emergency departments in eight hospitals have closed.

I do not know what the Premier means by "nothing." Perhaps he regards those occurrences as unimportant. I do not think so. Members of our party do not believe it is unimportant, when our excellent health care system is being threatened by the actions of a stubborn government that refuses to admit there is any need to move.

Contrast that with the very courteous attitude of the doctors and other staff at a function the Premier attended yesterday in Scarborough. Although the doctors must have detested the fact that this representative of a group which is trying to grind them down was coming into their hospital, they did not stand around and hurl stethoscopes or even invective at him. They were very courteous. They probably did not kiss him on both cheeks but they carried out their regular duties and ignored the fact that he was intruding.

The chairman of the board of governors of the hospital, Mr. Abel, was quoted in the news reports explaining his stance as chairman of that board. "We have to call for a truce this afternoon and celebrate the fact that something has gone right and we have a fine new facility." Members who were here earlier in the afternoon will recall that the member for York Mills (Miss Stephenson) pointed out that what Mr. Abel was referring to was that there is a much-needed and well-constructed addition to that hospital which --

Mr. McCaffrey: What is that called?

Mr. Dean: It is called the Scarborough Centenary Hospital. It was started some years ago, fortunately, before the present government got in to gum up these things. It was also finished before the present government took over.

Mr. McCaffrey: It is not the Margaret Birch wing, is it?

Mr. Dean: It is called the Margaret Birch wing. She is a very fine lady and it was the privilege of both the member for Armourdale and myself to follow her in a certain role in government in years past; that was a very classy act to follow.

Mr. Abel, chairman of the board, called on the Premier to appoint a mediator in the extra billing dispute. This is not some starry-eyed innocent, it is not a politician speaking, it is the chairman of a board of a large hospital in Metropolitan Toronto. The Premier said afterwards, "There is nothing to mediate." However, we did not expect him to agree to the appeal of even someone of the stature of Mr. Abel.

There is another illustration of the wrong-headedness of the action the government is proposing in this bill. This one comes from comments made by a group which is probably as close to the physicians of Ontario as anyone. I do not mean the registered nurses but rather the medical secretaries who have also seen the need and are very close to the physicians of the province in the everyday operations of the offices. They have effectively issued a call to the barricades protesting the proposed action of the government. They feel that all of their members should stand up and tell the story as they know it as to what happens in a doctor's office.

To quote one of the secretaries, "What really happens bears little resemblance to the claims by the Minister of Health, Mr. Elston, that pensioners and others are held hostage to extra-billing doctors." One of these medical people said, "I would like to know where all these patients are because I see thousands every year and I have never seen anything like that." She added, "We have never extra billed anyone over 60 years of age. They can come in wearing a mink coat without being billed above the amounts of OHIP rates, provided they are senior citizens."

10:40 p.m.

Another of the Minister of Health's comments was that the people of Ontario gave him a clear mandate to ban extra billing. One of the same group, a medical secretary, said of this, "I voted Liberal and I did not vote for that." The whole group appeared to be unanimous that patients are not shy about revealing their financial needs. Another medical secretary, who would meet all kinds of patients frequently, said, "People are not afraid to say, `I cannot afford it.'" The doctor who is opted out of OHIP quite readily does not extra bill patients on welfare, senior citizens or single mothers.

There was general agreement among the group that the New Democratic Party had blackmailed the Liberals into becoming socialists. "We just want the people to see what is happening before it is too late", said the lady from the group of medical secretaries who was quoted here. "People do not realize that if this bill goes through, it is only the first step." We see the unease, the concern and the fear of what may be lurking behind what seems to be a rather trivial bill when one looks at the problem it is designed to cure.

My constituents include many physicians, all of whom are opted in, but those who are opted in are as vehement in their rejection of the need for this bill and of the way the government has gone about imposing it as if they were opted out. These physicians say their freedom is threatened. In spite of the circumlocution the Attorney General gave us as to whether freedom is really threatened if one prevents people from doing things, they have genuine, sincere apprehension about the effect this ill-conceived bill will have on their freedom to deal with their patients as they see fit.

The patients of these doctors in my riding, which I believe is typical of most of the ridings in Ontario, respect those physicians not just because they are their personal physicians, although that is a great bond between them, but also because of the tremendous contribution physicians make to the community in so many ways. I do not want to give the impression that they are the only professional people who do that; of course, that is not so. However, they are people who live in the community, who take on their share of community activities and are some of the first we call on when we are looking for some good works outside regular professional activities.

The people with whom we are dealing clearly are not fly-by-nights or excitable paranoids. The physicians of this province are responsible people. Our party, of which I am proud to be part, is most comfortable in supporting the physicians of this province in their struggle to maintain their professional freedom and integrity and, above all, to be consulted and treated like people of equal importance and intelligence, rather than being bludgeoned into submission to a very large degree in an attack on what is alleged to be a problem, but one that is not really like that.

The vast majority of doctors do not overbill. In spite of the cleverly contrived alternative title to this bill, the doctors are accessible to patients at the moment. I have tried to demonstrate that and many of my colleagues did so earlier in this debate. It is a disgrace that the government has brought on this senseless confrontation. Even at this late date, I call upon it to realize that either there should be some changes or the bill should be withdrawn.

Mrs. Grier: The member for Wentworth, in his comments, has portrayed exactly what is wrong with extra billing by calling upon doctors in their offices to make a decision as to whether their patients can afford to pay over and above OHIP. In his response, perhaps the member will explain to the House why he thinks it is appropriate for a doctor to be privy to the income status of all his patients so that he can make a determination as to whether a certain patient can afford to be extra billed. By what type of means test does he envisage the doctor making that decision?

I also found it interesting that the member felt he needed to assure the House that not all doctors were excitable paranoids. It is a fascinating phrase, not one I would have thought to have used. As he uses it, however, it calls to mind some of the exhibitions -- Krazy Glue on fellow doctors' doors and beating against the barricades outside this House the other day. Perhaps the member will explain to us why he found it necessary to use that phrase.

Mr. McGuigan: I rise to ask the member, in a purely thoughtful way, why he would choose to say that the honourable members of this party were blackmailed.

I take some offence at that. Why should people who were elected openly and democratically, who represent the people who elected them and chose to follow the policies against extra billing they had clearly enunciated in the election campaign, be labelled -- in association with the third party -- as "blackmailers"?

I always thought we had the respect of each other in this chamber, that we were all honourable members. I feel that I am an honourable member, and I know very well that the member for Wentworth is an honourable member. I ask him to reconsider the phrase, in making the charge that we were "blackmailed."

We were not blackmailed. We followed the Canadian way in following the Canada Health Act. We are working on and living up to the law of this land. There is not one shred of evidence with which the member for Wentworth, or anybody else on that side of the House, can point to blackmail. I put that to him.

Mr. Taylor: I rise in partial defence of my colleague. I believe the member for Kent-Elgin (Mr. McGuigan) was quite extravagant in his remarks. I believe he interpreted the expression too severely, too critically and too much out of context.

If I am not mistaken, what was said was that the Liberal Party was levered into this position because of an accord. That was the sense, the context of what I heard. He was not talking about blackmail in the criminal sense. To give the expression that meaning is unfair, and certainly not something I would have expected from the member for Kent-Elgin.

As the Attorney General mentioned, there is a concern in this bill -- and it is a legitimate one -- about a hidden agenda. I believe that is more real than some of the government members are prepared to admit. Perhaps that is a reason that a mediator is not invited to pursue this matter.

If it is a question of extra billing, where is the extra billing? That can be addressed. If it is a question of money, that can be addressed. How many people are extra billed? Just a handful of people. If it is accessibility, how many people do not have access to our health care system? I do not have one medical doctor in my riding who extra bills, not one single doctor. However, the doctors are afraid they are losing their freedom, and that is a genuine, sincere concern, from the heart. It is their belief. If they have that belief, there is something wrong. There is something in this bill that conjures up that fear. I suggest that the members pursue and admit that.

10:50 p.m.

Mr. Lupusella: I rise to express my position in relation to the statements made by the previous speaker.

I feel very strongly that the revolutionary approach taken by the doctors and specialists across Ontario is the result of years and years of frustration. I want to make it clear.

If you recall, Mr. Acting Speaker -- I do not think you were around then -- in 1980-81, the province as a whole felt the effects of extra billing. The position of the New Democratic Party then was very clear, and a petition with 250,000 signatures addressing the problem of extra billing was presented to this chamber. The question I would like to raise with the previous speaker is why the Progressive Conservative government in 1980-81 did not take any action in relation to the issue of extra billing in Ontario, when the doctors felt so uneasy about the situation?

Mr. Dean: First, I would like to be sure the member for Lakeshore (Mrs. Grier) heard me correctly. In one of her comments, she said that I said, "The doctors are not all excitable paranoids." I did not say that. I said, "The doctors are not excitable paranoids." There is a difference. It is like the difference between saying, "Half the opposition are asses," and saying, "Half the opposition are not asses." There is a slight difference.

Hon. Mr. Sweeney: Not much.

Mr. Dean: No, I agree in the case of the minister.

Mr. Brandt: Have you got the distinction?

Mr. Ward: We cannot say that.

The Acting Speaker (Mr. Morin): Order.

Mr. Dean: The other, more significant question asked by the member for Lakeshore was why the doctor should be privy to the income status of the patient. The member may not be as familiar with doctors in small communities as I am, but for a long time there has been almost a tradition that doctors in those communities were very considerate about whom they charged more. There is nothing wrong with being charitable to one's neighbours.

I want to assure the member for Kent-Elgin, who was offended by the word "blackmailed," that I was quoting from an article which in turn was quoting medical secretaries who said, "There was general agreement that the New Democratic Party had blackmailed the Liberals into becoming socialists."

I thank the member for Prince Edward-Lennox (Mr. Taylor), who has left temporarily, for his lucid explanation of some of the aspects of what I was saying.

The member for Dovercourt (Mr. Lupusella) raised the question of 250,000 signatures, but I do not think he asked me a question. People will sign a petition that looks as though it is good, even if they do not have a personal interest in it.

Mr. Gillies: I want to join this debate on third reading of Bill 94, I hope constructively, and perhaps with a few thoughts that we have not heard this evening. I may do so at some length because I did not speak on second reading of this bill. I did not speak during the committee stage of the bill until this afternoon when we were debating the motion put forward by the government House leader, but there is a lot I want to say about this bill.

Going back to the remarks made earlier by the Attorney General (Mr. Scott), I have held myself somewhat in reserve over this bill because -- and I want to start with a premise -- I do not particularly care for extra billing. The Attorney General asked us to state our position on the bill and perhaps a bit of thought and a bit of philosophy about it. I want to start with the premise that I do not particularly care for extra billing, but I fear far more the consequences of Bill 94 than I fear the consequences of extra billing.

I want to quote to the assembly some remarks of which I hope the Attorney General who spoke earlier might avail himself at a future date, because they state some of the problems more articulately than I could. I will quote some comments by his colleague the member for Humber (Mr. Henderson).

The member for Humber has had a very difficult decision to make in the position he has taken with regard to this legislation. I am sure his colleagues in his party would agree with members of other parties that for a member to break ranks on a piece of government legislation on what is clearly a matter of closely held conscience for that member is a very serious matter indeed. We all know how things work around here. I see three of my colleagues, sitting in close proximity, who came into this chamber the same day I did in 1981. In those five years I have not voted against a position taken by my party. I have done what many of us have done in the past. If one does not like a position that has been taken, one goes for a walk or one finds oneself strangely unavailable for the vote.

But to dissent openly and ultimately to vote against an action put forward by one's own party is not very common around here and is rather serious. It is with this in mind that I want to quote into the record some of the comments made by the member for Humber on January 28 of this year, speaking in the second reading debate:

"Liberal candidates in May 1985, and I was one of them, campaigned on the promise of negotiations with the OMA to take action on extra billing. As a physician-candidate long troubled by the abuses of extra billing, I did not have difficulty standing on our party's platform. However, to me one of the operative words in our promise was, and is, `negotiate.'

"The problem with extra billing, in my opinion, is that some patients may not be able to obtain treatment services in certain areas and in certain fields of practice except from practitioners who extra bill substantially. Some physicians have shared my concern about this and some were pleased with, though wary of, a government that promised the situation would be addressed."

So in good conscience the member for Humber embraced that policy, offered himself as a candidate for election under the Liberal banner in the last general election and won his seat. He has proved himself not only on this legislation but also on other matters that have come up for debate before this House to be a member of great intelligence, common sense, sensitivity and professionalism.

I go on to quote our colleague, again on January 28:

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

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

"The apparent permanent civil conscription of virtually an entire profession in peacetime is a serious and disturbing matter. I feel conscience-bound to oppose it."

We are listening to the words of a man who has practised an honourable profession for many years, who is recognized in his field and who stood in good conscience for what he thought he understood to be the policy of the Liberal Party in May 1985. On the production before this House of Bill 94, he feels, in all good conscience, constrained to oppose the legislation.

Let me go back to the earlier comments of the Attorney General who, with all the powers of his intellect and his peculiar ability to articulate, put forward the proposition that in Bill 94 the government was putting forward a clearly understood policy from the election of May 1985. I would say to the Attorney General, in his absence, only that this was clearly not the understanding of his colleague the member for Humber, and I would venture to say it was not the understanding of many, many people in this province who voted for the Liberal Party in May 1985.

11 p.m.

In fairness to the members of the New Democratic Party, their position on this issue has been consistent for as long as I can remember and remains consistent.

But the NDP did not put this legislation forward; it was the Liberal Party. A Liberal Party --

Mr. McClellan: The member is wrong there.

Mr. Gillies: Ultimately, the name of the Minister of Health (Mr. Elston) is on the bill, but my friend the House leader for the NDP (Mr. McClellan) raises the question of who actually put the bill forward. I can only concur with him. In that construction, who really did put the bill forward?

None the less, we are faced with government legislation which, it would appear, was not the understood policy of many in the Liberal Party leading up to May 2, 1985. It was not the understood policy of many who may have supported the party at that time. I venture to say to the government members that if there has been growing support for what is colloquially known as the doctors' position as this debate has unfolded over the months, I suggest to them that this is why.

It is very easy politics and it sounds good to say that if one took office one would ban extra billing. Just the sound of the words: "Ban extra billing. Do away with an extra cost," is great politics. However, I am not persuaded that the way this government has gone about it, as good politics as it may have been perceived, is good government or good legislation.

I also say, as I mentioned earlier, that while we have known the clear and consistent position of the members of the NDP, we have not known a clear and consistent position by the Liberal Party. Not so many years ago, under the leadership of the member for London Centre (Mr. Peterson), the Premier, the Liberal Party favoured extra billing and spoke out on platforms across this province in previous elections about its concerns with eliminating extra billing and the problems it could cause.

It strikes me as more than passing strange that when 19 per cent of the physicians in this province extra billed, the Liberal Party supported extra billing, but now, when only three per cent extra bill, it finds itself opposed. Often party positions change because a problem grows worse. Often a party has to change a position to meet a problem that has become exacerbated. In this case, precisely the opposite has happened. The Liberal Party has changed its position, for whatever political goal or aspiration, as the incidence of extra billing has dropped dramatically.

It causes me and my colleagues some annoyance that the government has chosen for many months to champion this cause within the health care system when we do not believe it is the real problem within that system. We all have to draw on our own experiences within our own constituencies. I have reviewed my files very carefully because, like any of us, I would not want to be accused of misleading the House. Since the day I walked into this chamber in March 1981, I have had well over 100 complaints, either by letter, telephone or personal visit into my constituency office, about issues regarding health care, such as a shortage of beds, the availability of chronic and long-term-care beds, the problems of surgery being postponed because of hospital overcrowding and so on.

Before I hear a chorus of members saying, "Yes, yes, you were the government, it is all your fault," I want to say that I do not raise that in a partisan sense. The health care system had problems and strains when we were the government, and those problems and strains continue.

Mr. Offer: Here is your chorus.

Mr. Gillies: My friend the member for Mississauga North said, "Here is your chorus." I do not raise that in a partisan sense, I raise it because it is the real problem regardless of which party sits in the Treasury benches.

I also looked back through those five years of records in my constituency office to see how many problems had been brought to me regarding extra billing. In five years, I have found one problem. One. I looked at the file in the particular case and it was definitely an abuse. When the constituent brought it to me, I contacted the physician and the matter was taken care of.

That is one case in what I assure my friends in the House is a very busy constituency office. We run a pretty busy operation in Brantford. My predecessor from the New Democratic Party did and any member representing that riding would have to. I have had one problem in five years about extra billing, but more than 100 problems of genuine accessibility to our health care system.

When I see Bill 94 being called by the short title of Health Care Accessibility Act, 1986, I say the short title of this bill is misleading. It is misleading because I know what some of the accessibility problems are in our health care system and I do not believe this bill takes steps to ameliorate them. I do not think this bill addresses health care accessibility in this province. The title of the bill in itself is misleading.

Like several other members of the assembly, I was not born in this country. I was born in England. I am very proud of my birthplace and I go back whenever I can. I may not be as quick to criticize the British health care system as many are. There are some very fine aspects to it, but the strain, the problems, the delays in surgery, the backups, the misery that surrounds the National Health Service in Britain is something we would never want to see in Ontario.

I grew up in England, in a small village 60 or 70 miles from London. My father was a working man. He always worked until his retirement in factories and at various things. We were not the kind of family during my youth that would ever see a Harley Street specialist in England. We were not the kind of family that would ever have access to the private health care system in England.

If the government members believe this legislation is going to help to steer our province away from a two-class health care system, I am utterly unconvinced of that. I believe very strongly that this kind of legislation does quite the opposite. It takes us one step closer to two-tier health care in this province.

This kind of legislation takes us one step closer to physicians feeling they cannot meet their aspirations within the framework of state health care, and it will drive them out to set up practice in the private health care system, when truly we will have an increasing accessibility problem and there will be a class-based health care system in our province. I believe that.

I believe the evidence is clear in Britain, where, since the National Health Service was put in place, there has not been a reduction in the growth of private health care. In fact, there has been a growth and a proliferation of private health care, which is utterly inaccessible in any way to people of modest incomes, utterly inaccessible to any but the middle and upper classes and those of higher incomes. I have had this argument many times with friends of mine in the third party. I know they do not share my assessment of that. It is just a point over which we will have to disagree, but I do believe it.

All that takes me back to my original premise. I believe in accessibility to our health care system for our people in this province in every respect. I believe the physicians of this province, or at least those with whom I have spoken or those I know, passionately share that belief with me. Their concern and my concern is that this kind of legislation, Bill 94, will have quite the opposite effect to what I believe the government intends in bringing it forward.

11:10 p.m.

I believe in accessibility. I do not particularly care for extra billing in medical services, but then I do not particularly care for the affordability problem of people requiring access to dental care. I do not particularly care for the affordability problem of all the people of this province needing access to some aspects of nonmedical health care. If I may say philosophically, I do not particularly care for the affordability problem of our citizens wanting first-class legal assistance, first-class housing and first-class access to all the benefits of living in a society as free and as wealthy as ours in Ontario.

For all of that, I do not see an answer in emasculating a noble profession. I do not see an answer in causing a rift and an anger in the medical profession, the like of which we have never seen in Ontario. I do not see an answer to accessibility and affordability for our citizens in Bill 94.

The effect of this legislation would be deleterious in many ways. I have spoken already of my belief it will lead to an increase in private, profit-motivated health care in our province, as has been witnessed in Britain and other countries that have moved to state medicine. Also, this kind of legislation can serve to drive out of this province some of our best physicians, our most highly trained professionals and our most learned specialists.

Without meaning any disrespect to any other province in this great confederation, Ontario is not Prince Edward Island or Nova Scotia. We are the great metropolitan province in this country: the largest, the most powerful, the wealthiest. As a result of that we have health care facilities, especially in our great cities, that are not rivalled anywhere else in Canada.

Again intending no disrespect for the ability of physicians practising across this country, I cannot imagine there are specialists more highly trained, more highly regarded in the profession and more able to serve in very fine points of specialization. I have my doubts that they will be found in any great numbers anywhere in this country as they are in Ontario.

Through this kind of legislation, we can serve to offer such a disincentive to practise medicine to people in this province that we could serve to chase them away. We have had some experience with this in the past. The brain drain of our medical talent is nothing new. The past government was accused at various times by the medical profession of contributing to it, with perhaps as much vigour on the part of some doctors as in the current circumstance.

I know an excellent physician from Brantford who practised medicine in this country for a great many years. Some 10 years ago he packed up his family and moved to Texas. When I asked him why he was doing it, he said he feared the encroachment of state medicine and some of the reforms that had been brought in. He hopped it to Texas. He is probably making far more money there. If I may draw the analogy, his departure hurt our community. He was one small part of the collective expertise and wisdom of the medical profession in my community, and his departure hurt.

My own family doctor, who has been my family's doctor since we moved to this country 26 or 27 years ago, told me he and his family left Quebec when they saw the drift towards state-controlled medicine in that province. They settled in Ontario because they thought there was a better climate here for him to practise his profession with integrity. Now, although this is a physician who never has and never will extra bill, he is upset by what is going on.

He is the mildest, most pleasant and professional man to whom I could ever introduce my friends in this chamber, Dr. William Buller of Brantford. He is a great friend of my family and of our community.

He is very upset. I swear to you, he is not a man who is prone to the discussion of politics in his office. I could count on one hand the number of times over the years he has even ventured to suggest that he votes for me -- and I think he does. However, he has been driven to a great sense of frustration and anger by what is going on.

Hon. Mr. Nixon: My doctor says he does not vote for me.

Mr. Gillies: My friend the Treasurer says that his doctor says he does not vote for him. If we could only recruit about 10,000 of his friends in Brant-Oxford-Norfolk we might knock him off. I do not hold out that much hope.

This is the problem. I want to talk about my own community, again, for a moment. In Brant county, we have somewhere between 130 and 140 practising physicians in every field of practice, from the specializations to general practice and so on. Two of them -- two, out of 130 -- extra billed.

At the same time that people in my community have been on waiting lists for chronic care and long-term care beds for a number of years; that we face bed shortages and cancelled and postponed elective surgery; that our county does not have a single child psychiatrist to serve 100,000 people; that we have difficulties keeping psychiatrists in our community at all because we are not large enough; that we do not have a university and we do not have some of the advantages that a highly-trained specialist looks for -- at the self-same time that all of these real problems in our health care system continue, this government has chosen to attack one perceived problem in the health care system. What do they do? They bring in Bill 94 and try to end extra billing.

I happen to believe that the position taken by the Ontario Medical Association during the negotiations to which the Attorney General alluded earlier was a reasonable one. I want to restate it for the record. It bears restating. Then I want to come back, if I may, to a few of the other remarks made by the Attorney General.

The OMA said: "1. No patient over the age of 65 would be charged more than the Ontario health insurance plan rate.

"2. No patient receiving treatment of an emergency nature would be charged more than the OHIP rate.

"3. No patient receiving financial assistance from your government would be charged more than the OHIP rate."

Finally, as restated to every member of this assembly in a letter dated today from Dr. Moran, the OMA said, "In a further effort to honour both your concerns and ours, we offered to work with government to guarantee that every citizen of Ontario would obtain medical services from an opted-in physician, or from an opted-out physician -- at the choice of the patient." Every citizen in Ontario. Everyone. Voluntarily offered by the medical profession in this province.

Faced with that, I listened to the remarks made earlier by the Attorney General, in a very powerful speech indeed, in which he again utterly rejected the suggestion of the official opposition that the government take a step back from this legislation and even now, at the eleventh hour, appoint a mediator to try to arrive at a negotiated settlement.

I say this to my colleagues who may have missed this earlier. To my astonishment, the Attorney General stood in his place and said: "We could not have meaningful negotiations with the OMA because it said that to carry on meaningful negotiations we had to withdraw the bill. We were not going to withdraw the bill, so there were no negotiations, and that was the doctors' fault."

11:20 p.m.

Other members, please interject if I am misstating the facts. That is the construction I put on the words said earlier by the Attorney General. It does not ring true to me. The OMA walked in with a very conciliatory package of positions.

I take the Attorney General at his word. Rather than saying, "Let us put Bill 94 aside for a second and talk about that and see what we can work out," by the Attorney General's own admission tonight it was the government representative who said: "We are not talking about withdrawing the bill. If you will not negotiate unless we set the bill aside, then there will be no negotiation."

I know a little -- and I admit it is a little -- about labour negotiations, and it sounded to me very much as though the government was not bargaining in good faith. It sounded to me as though it was the government representatives who walked into the 11 sessions with the OMA with their minds made up; who were not prepared to move on Bill 94; who said to the medical profession, "Here is the line and we are not budging." It was Dr. Moran and his colleagues who walked in with the proposals and it was the OMA that walked in with a possible compromise, not the Attorney General and not the Minister of Health.

I hope the Attorney General will review what I have said. if he disagrees with me, if he feels I have put an unfair construction on what he said earlier, I invite him to challenge me. That is what I believe I heard and I do not believe it indicated a willingness to have meaningful negotiations on the part of the government. Let there be no mistake. The nonconciliatory, adamant and inflexible position taken by the government through the course of this dispute has led to the current crisis in our health care system. The inflexible attitude exhibited has led to the current strike and to the situation we are faced with in this province, which can only be described as truly horrible.

It is a situation of people being denied emergency services, of hospital emergency wards closing, of knowledgeable and humane professionals feeling compelled to withdraw their services and of threatened escalation. Lord knows, we could be faced with the closing of intensive care units; we could be threatened with the closing of entire hospitals. As my leader has said, the fault and responsibility for that has to lie squarely on the shoulders of the government.

Earlier, I quoted the words of our respected legislative colleague the member for Humber (Mr. Henderson). I do not believe I am putting a misconstruction on what he said when I say he did not understand the Liberal position in May 1985 to involve inflexible and draconian legislation on the issue of extra billing. Inasmuch as I followed the platforms of the other two parties during that election campaign, that was not my understanding either.

It is not so much the end that is so very painful about this whole debate, it is the means. It is a very sad day for our province when we see not only a noble profession pitted against its government, the government of all the people of this province, but also our citizenry so bitterly split on an issue of this kind. It is a question of responsibility and civil liberties balanced against a government that feels, in my opinion wrongly, it is doing the right thing and only it has the answer.

That is the feeling I get from these people. I do not think the Liberals are particularly evil, but I do think they are awfully obstinate. I am not accusing individual members, but as a government they tend to have a terrible case of tunnel vision. They tend to take the concerns of those who oppose or disagree with them a little lightly. Ultimately, I believe these tendencies will be the failing of the government. They are the government's biggest flaw.

When we were the government, we were accused on occasion of listening and consulting too much. I remember that accusation from members of both other parties. Listening and consulting too much is better than listening and consulting too little. The government dropped this one on the medical profession like a 10-ton weight. From the day it brought the bill into the House with next to no consultation, it has ploughed ahead like the Titanic. It is a kind of Rambo politics that will get the government into a lot of trouble.

We are in a situation where the debate on the bill will be ended by closure. I can well understand the uncomfortable feelings of many members of the House when such a motion comes before us. I know the Treasurer (Mr. Nixon) and government House leader was sincere in expressing his discomfort about the motion when he did so earlier. None the less, the government has done it. The Liberal Party used to rant and rail and scream dictatorship whenever the previous government was constrained to put forward such a motion, but it is doing it. I venture to say the government lost a bit of its virginity this evening. Nevertheless, the government will have its bill.

I want to turn to the amendment put forward by my colleague, the Health critic for this party, the member for Lincoln (Mr. Andrewes). Knowing as we did that the government was unmoved by our arguments and would not set aside Bill 94 to move to a mediation process, a process dismissed by the Premier and the Minister of Health, and by the Attorney General in his speech tonight, our last-ditch effort was to see whether we could include the mediation process as part of the legislation. My colleague the member for Lincoln moved his amendment, the so-called new section 5a. It would have built in a mediation process as part of the bill, and even after the passage of this legislation would have allowed one last-ditch effort to bring in a mediator within a certain period of time to see whether the dispute could be solved with any degree of satisfaction to the medical practitioners in this province.

The government would not even be moved to consider that amendment. The government would not show even an ounce of reason or flexibility about including that amendment as part of its bill. It would not allow for the appointment of a mediator and a 90-day process to be gone through. That process might or might not have borne fruit, but that is what mediation and conciliation process is all about. The government would not even be moved to allow that last-ditch effort as part of its legislation and voted against the amendment this afternoon.

11:30 p.m.

Day after day, we have heard the Premier say in this House in reply to repeated questioning from my leader and other members of this party, "We do not believe the mediation process would bear fruit and therefore we are not prepared to consider it."

Nobody can say with any degree of certainty that mediation would bear fruit. That is part of what negotiation is all about. It does not always bear fruit. However, I am glad my friend the Minister of Labour (Mr. Wrye) is here because I am going to speak with pride and in a complimentary fashion about the very excellent mediation and conciliation services provided to that part of our work force in this province which is organized by the Ministry of Labour.

I ask the minister to correct me on my figures because I do not have them in front of me and I am going from memory, but to my recollection, more than 3,000 contractual disputes are brought to the mediation and conciliation services of his ministry. About 90 per cent of them are solved at that stage. Only about 10 per cent, as I recall -- I hope the minister will correct me if I am wrong -- go to a strike.

Hon. Mr. Wrye: It is less under my government.

Mr. Gillies: The minister should take great pride in that. He says, "It is less under my government." Good for him. That is his compliment for the month.

More than 90 per cent of the disputes within the framework of labour negotiations are solved by mediation and conciliation. I say to the Premier, "Yes, you can hang your hat on that. We are not sure that it would cause the problem that we have." We are not sure, either. When those contracts all go marching in to the Ministry of Labour, they are not sure they will avert a strike either, but more than 90 per cent of them are averted. That is a tremendous success rate. Yet the Premier and the chief negotiators for the government would not consider that option. They would not even take the chance that it would have a chance of success within the context of the current dispute. That is a great pity. It is almost shameful that the government would not consider that.

Our honourable friend the Attorney General spoke earlier in glowing terms of his support for the legislation. I hardly need remind the minister, as others have done, that his attitude was quite different when he was acting for the Canadian Medical Association and when he offered that association a legal opinion that the Canada Health Act could well be unconstitutional. He seems to have changed his opinion, but I am not going to be overly critical of that. As my dear mother sometimes says, "Consistency is a virtue in only a small mind." We are all allowed to change our minds, but I just put that on the record because I know the Attorney General, with all his powers of persuasion, could have argued the other side of Bill 94 just as easily as he could argue in favour of it. I pass that along to him as a compliment.

Hon. Mr. Sorbara: The member probably wants to do that as well.

Mr. Gillies: I said earlier, for the edification of my friend the Minister of Colleges and Universities and Skills Development (Mr. Sorbara) -- I always add that because it is such an important portfolio in any government -- I am more than comfortable to stand with my colleagues and my leader in this House tomorrow at 1 p. m. and vote against third reading of Bill 94.

I will restate for the minister something I said at the very beginning of these remarks. I am not crazy about extra billing. I am not wild about it, but I will tell the minister what I fear a lot more than extra billing. I fear the consequences of Bill 94 for our health care system. I fear the consequences of taking one more giant step towards the kind of state-controlled medicine they have in Britain and in other countries. I do not want to see it here in Ontario. When the effects of that are felt, my honourable friend will not want to see it in this province either.

The debate will end at 1 p.m. tomorrow. The motion of the Minister of Health will pass in this House with the support of the members of the New Democratic Party. Our party will oppose it. I believe there has been a bit of chicanery involved with some of the statements being made out of this chamber with respect to the position of our party and the effect it was having on the health care system. I want to talk about that for a moment or two.

Members of the government and the NDP made the association that by having a full debate of this bill, by opposing this bill as vigorously as we could, we were contributing to the current difficulties in the system and the current strike situation. I believe that to be a complete and utter misconstruction of the facts. I want to state for the record that the rift that has been caused in the health care system of this province by this government, with its shortsighted and draconian legislation, will only worsen after the passing of Bill 94. It will not improve.

I want to say here and now that my colleagues and I have done the right and democratic thing in our vigorous opposition to this legislation, and I want to say clearly that my colleagues and I are not responsible for the current difficulties across Ontario.

Mr. Haggerty: If the member were the Minister of Labour, he would have them back to work tomorrow. That has always been the position over there.

Mr. Gillies: I say to the member for Erie that the responsibility for the current problems in the health care system in this province must rest squarely on the shoulders of his government.

Perhaps the air will be cleared somewhat on the matter of this misconception tomorrow at one o'clock when the upset and the anger continue, and it will become very evident that we were not the problem. With every passing hour that this regrettable upset continues, it will become more and more apparent that the government is the cause of the problem, and it will bear the responsibility, as any government does, for the legislation it brings into the House and the effect it has.

Mr. Haggerty: Is the member saying he is opposed to the Canada Health Act?

Mr. Gillies: I have stated my position several times in the speech. I will not state it again for the member. I suggest he grab the Hansard if he really cares that much.

I want to conclude by quoting a few more remarks by the member for Humber, whom I quoted earlier. The member said in debating second reading in this House:

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

"Do we really want the practice of medicine to become a state monopoly? Let us think about what we know about state monopolies on this continent and elsewhere, how they work and how they do not work. Is that the kind of family doctor one wants to have? Is that the kind of surgeon or anaesthetist one wants to have? Does one want his or her physician to be a man or woman who feels alienated, angry, constricted, legislated, regulated and stifled? I hope one does not.

"I defend the right of any citizen or group to freedom from conscriptive state control, whether it be physicians who want to be free to practise their art, smelter workers who want a safer, more hospitable work place, machinists who want to fight for a fairer wage or workers who simply want to bargain and negotiate in good faith with an employer who is willing to bargain with a sense of openness and fair play."

11:40 p.m.

It must be the impression of that honourable member, as it is the impression of this honourable member, that this is not the approach being taken by the government with this legislation, that it is not the kind of co-operative and negotiation-based health care system that we have built. Bill 94 is not a move that is going to bring people together in this province; it is a move that increasingly is going to drive people apart.

The current difficulties will probably be ameliorated with the passage of time, but I do not believe they will ever go away completely. I do not believe many people practising medicine in this province will ever again completely trust their government or completely wish to cooperate with certain other health care initiatives this government may want to take.

I do not believe the message the government is sending out in Bill 94 is one we want to see extended into other parts of our work force. I do not believe the government would want to bring in legislation tightening control, particularly on other noble professions. I do not believe any government of Ontario, to paraphrase the member for Humber, would want to conscript lawyers, pharmacists, advertising people, smelter workers and workers in farm-equipment manufacturing plants. I do not think any government of Ontario, made up of any one of our great parties, would want to do that.

This is a very clear message that has been put out to the physicians in this province and it is the wrong message. The message being put out by this government, which in all its newness could take such advantage of opportunities to bring people together, is the wrong one. It is a message of control, a message of regulation, a message of Big Brother.

I want to conclude by saying I think this government could have worked long, hard and co-operatively with the medical profession in this province towards reform on a co-operative basis. I believe it did not do so. I believe the approach it has taken is the wrong one and that many of the concerns we have raised about Bill 94 -- Lord only knows, I hope I am wrong -- will come to be.

I believe the step this government will take tomorrow at one o'clock serves to weaken and not strengthen our health care system. I urge the government, even at this 11th hour, to think again. if it cannot withdraw the bill because of the political priority it has put on this legislation, then I wish it could at least, perhaps even with unanimous consent, take another look at some of the amendments that were put forth; take one more look, however it can do it, at a negotiating process; take one more look at a mediation process; take one more look at trying to work it out together with the medical profession. Then the government would do a great thing for this province.

If it does not, I fear the consequences of what it will do tomorrow at one o'clock. I will stand quite proudly with my colleagues in voting against this bill.

Mr. Philip: I have a question of the member for Brantford (Mr. Gillies). He and several of his colleagues referred to the British system. He talked about how the system in Britain had developed into a two-class system, one part of which was a completely private and élite system, completely out of the medicare system, completely separate from any kind of government system. He said that somehow this bill would lead to that kind of thing.

Perhaps I have missed something in the Canada Health Act or something in this bill. Can the member tell me how, under either this bill or the Canada Health Act, one can possibly set up that kind of elitist system in this province? The legislation simply does not allow it, and I suggest the member should read the bill.

Mr. Ward: I was very interested in the comments of my friend from Brantford in regard to the British health care system. His comments were not particularly original. Those arguments were put repeatedly in the mid-1960s when the system of medicare was introduced in this country. It seemed to be a favourite tactic of Conservatives who did not support a publicly funded system of medicare for the people of this country to keep pointing to problems in the British National Health Service.

I, like him, was born in Britain. In fact, my father was employed as a professional health care worker there so I grew up with stories of the horrors of the British health care system. Perhaps the most fundamental difference between health care here and there is that in this province the government has supported a substantially better system of health care with substantially more funding. That is not on the basis of the whim of any party or any government; it is because the people of this province demand it.

I would like the member to answer this question specifically: How can we come to a two-tier system of health care similar to what is in Britain through the passage of this legislation when this legislation prevents any physician from billing other than at the plan rate, whereas in Britain there is a national health care system at a plan rate and physicians who operate outside that system? Will he tell me how does this leads to a two-tier health care system?

Mr. Lupusella: The member for Brantford made reference to the title of the bill being misleading. I remind him that the phraseology used by the Conservatives in Ottawa about free trade is misleading the public. He also talked about the inflexibility of Bill 94 in relation to the NDP and the government. I remind him that the former administration was very inflexible in relation to Bill 179, the Inflation Restraint Act. While injured workers were picketing on the steps of the Legislature in winter over the bills related to the Workers' Compensation Board, the Conservative government was firm and inflexible in letting them down.

Considering that a mediator will not be appointed at this time, can the member at least recognize that part of the problem is the result of years of frustration on the part of the doctors that was caused by the previous administration?

Mr. Charlton: To continue the questioning that the member for Etobicoke (Mr. Philip) and the member for Wentworth North (Mr. Ward) started, it was either the member for Brantford or his leader who this afternoon very clearly documented in this House proposals that had been put by the OMA and the doctors of this province in opposition to the legislation we are debating tonight. The proposals talked about no extra billing for senior citizens and no extra billing for those on social assistance in Ontario. I ask the member who talked about the two-tier system of medicine in Britain how he can stand up and abhor that this evening while advocating it this afternoon, either himself or through his party leader, because that is exactly the road down which he is headed with the proposals set by the OMA.

11:50 p.m.

Hon. Mr. Sorbara: When I interjected with my friend the member for Brantford, suggesting that he could argue the other side very well, he admitted frankly that he is not a great fan of extra billing. What was of interest to me was his comment that he had a great fear. I hope he will acknowledge that the whole basis of the arguments of his party in this debate is one of fear.

I hope he will also at least acknowledge that historically in this country all of the great measures of reform, generally brought into parliaments by Liberal governments, have been resisted with calls of fear. I could list many, but something as symbolic as the flag debate in Ottawa was resisted by cries of fear about what this would lead to. Indeed, the greatest measure in the past 50 years, our Charter of Rights and Freedoms, was resisted by his colleagues in Ottawa with questions of fear about what would happen. Historically we have seen that.

I challenge my friend the member for Brantford to set out what, in his view, will really be the consequences of this. He knows full well that, come one o'clock tomorrow afternoon, this province's health care system will be healthier, and thereafter it will be even healthier than it was prior to one o'clock tomorrow afternoon.

Hon. Mr. Wrye: Let me --

Mr. Speaker: Order. I am sorry. I was watching the clock and it was a little slow. There is no remaining time for any further comments. The member for Brantford has up to two minutes to respond.

Mr. Gillies: That was really unfortunate. Do members know how long the Minister of Labour has been waiting to ask me a question? Maybe another time.

In response to a couple of the points made, first to my friend the member for York North (Mr. Sorbara), I do not believe at all that our party has engaged in this debate by raising the spectre of fear. I may have used the words, "I fear the actions of this government," and Lord knows I do. But I do not fear them, and I do not think my colleagues fear them, nearly as much as do the thousands of people across this province who are going to be affected by the legislation.

If my honourable friend opposite thinks I am afraid, he should talk to some of the doctors who are up in the gallery. Then he will not see politicians who are afraid; he will see some people who are going to be affected by the actions of this government and they are afraid. My friend should not accuse me of fearmongering, because it is the actions of his government that are leading to fear in this province, not us.

My friend opposite referred to a record of reform by the Liberal Party. I strongly suggest he read a little history in Ontario. The Liberal Party in this province has been the agent of virtually no reform in the past 100 years. If he is talking about health care reform in this province, the Ontario health insurance plan was introduced by Mr. Frost and the Ontario medical services insurance plan was introduced by Mr. Robarts. To talk about a few other areas, the Human Rights Code was brought in by Conservatives and the Bill of Rights for Canada was brought in by Conservatives. In most of those instances, Liberals had absolutely nothing to say about it. If anything, they were occasionally prodded by the NDP.

Mr. Philip: I would like an opportunity to say a few words on this bill. I find it interesting that the previous member, the member for Brantford (Mr. Gillies), was unable to answer the questions of three members about the doom-and-gloom picture he has painted that somehow we will develop the kind of two-tiered system Britain has developed, which has, of course, worsened under the Tory government with the cutbacks to hospitals and to the system.

The fact is that under our Canadian system, under the Canada Health Act and under this bill, there is no way in which that kind of completely private system can develop here in Ontario. There is no way -- under this bill, at least -- in which any doctor who has opted out can charge above the OHIP rate. Thus, the suggestion the Tories have made over and over again that somehow one can create a carriage-trade kind of medicine in this province is simply not true -- unless, of course, the Conservatives by any chance were ever to get back into power and implement that kind of laissez-faire system, which they seem to think is so workable in the United States.

I have heard a lot of gobbledegook that somehow allowing patients and doctors to discuss their fees can improve the doctor-patient relationship. The point is somehow made that there is a kind of bond, a human relationship, created by this ability of a patient to bare his financial soul, open wide his wallet and say:

"Forgive me, Doctor, for I have sinned. I have not in this society earned the kind of money that you earn and therefore I ask that you not charge this extra levy that you have decided you somehow deserve but that no one else has adjudicated.

"I am sorry, Doctor, for I have sinned. Somehow I am a worker who has been injured, and it is hard enough for me to pay the mortgage on my home, let alone pay extra bills to the doctor; therefore, I hope you will be understanding. I am not going to pay that extra $300.

"I have sinned. I must come to you, therefore, and you will act as my confessor, as my banker, and you will decide, you who are so well trained in understanding finances, understanding banking and understanding my personal life and in understanding, of course, my style of life. You, at one time, were a working man. You know what it is like to be laid off, I am sure. I am sure you came from that kind of family. You in your $300 suit should be able to adjudicate this."

Somehow he should be grateful when the kindly doctor puts his hand on his head and says: "You are forgiven, my son. I am not going to charge you that $10. I am not going to charge you that $20."

There is a magnificent book written. Members who may be interested in theology should be sure to read the work of Harvey Cox, if they have not read it. Harvey Cox talks about the helping professions. He talks about the pendulum between the priestly role and the prophetic role. The prophetic role is helping the person to be independent, the asking of the questions, the working with the person. Of course, the priestly role is the doing of something to someone.

I had an interesting workshop a number of years ago in which I worked with some students who were soon to be chiropractors but, none the less, were in the helping profession. I said to them, "Look at that pendulum and ask yourself where would you most like to be on the pendulum. We assume that perhaps a psychiatrist working in the hospital might be somewhere in the prophetic role and somebody who may be doing quick emergency surgery might be further along the scale on the priestly role. Where would you most like to spend your time?" Invariably, all of those students said, "More towards the prophetic role, the helping role." I said to them, "Where does the billing system, even the present billing system, fit into it?" They had no answer.

Even our present billing system does not solve that problem. If we allow extra billing, we put in an extra barrier between the relationship of that doctor and his ability to concentrate on working with that individual, of helping him to be more independent.

12 midnight

If we look at the helping professions, the members of the Conservative Party and, indeed, the doctors say: "Let us be like all other professions. Lawyers are allowed to extra bill." In most cases, lawyers are not in the essential profession that doctors are. If we look at the really essential professions, perhaps education is one; literacy training certainly is. The right to know is an essential profession in a democratic society. The right to have protection, not to be mugged and killed or have one's money stolen means policing is certainly an essential profession. The ability to have someone come and help one if one's house is on fire so that one's kids do not get burned to death makes firefighting an essential profession. All those over the years have at some point extra billed in some form.

If we look at the historical roles, not so long ago, only the rich could afford any kind of education, because people went through a billing system. If we go further back, the fire department came if a person had a fire in his house and the person paid to have the fire put out, unless it was a volunteer fire department; but these developed later. If one did not have the money, the firefighters might well stand around and say: "Too bad, Charlie. Nice blaze, is it not?" Going further back, if one really wanted to protect one's person and property, then one had to hire a personal army or develop some kind of clan system.

Society has developed beyond that. We have said education is a right. We have said we should not pay for it. Indeed, we are going one step further in a few days with Bill 30 in saying that to all or most students in Ontario.

Yet the Conservative Party and the medical profession are not willing to take that extra step. Do members not see that we have a historical progression based on need and based on the right? The moment we charge, we interfere with that right, the same way as those people did when they argued that if we did not charge to go to school, kids would not appreciate it or we would get an abuse of the system. That is what is happening.

If we want to carry the Conservatives' argument to a logical conclusion and if charging extra to the individual client somehow improves the relationship with the helper, then it would make sense to say other essential helpers should also be allowed to charge. Then people will appreciate the service they get and there will be a closer relationship.

One should go to any university professor I know -- to my wife who teaches in the health sciences division of a college or any of her colleagues -- or to people who are teaching in the medical faculties of the University of Toronto and say: "We want to improve your relationship with your clients. If you as a profession want to be really professional and if you do not like the salary that has been negotiated or the fee that has been negotiated with the university, the college or the College of Regents, then we think you should charge extra to any student who comes into your room because that will really create a bombshell. That will help the student-teacher relationship." That is the logical conclusion of the argument the Conservatives are making.

If it works for one helping profession, why would it not help all others? I see the member for Kitchener-Wilmot (Mr. Sweeney) nodding his head over there. Why should the social worker not charge a client a little bit more, using the reasoning: "They will really appreciate my work as a social worker. I will charge them a tiny bit every time I do something for them."

The argument is ludicrous. The reason is that the Conservatives and the OMA do not want to talk about the real issue, which concerns money. That is what it is. The issue is about money; it is also about power and the status that goes with it. I will not go through Maslow's hierarchy of needs entirely, but power and status are fairly close together.

Michael Wilson from Etobicoke, that great defender of the average man who is so popular with the senior citizens' associations across the province, did not get far when he stated that Canada needed more millionaires. The Conservative Party and the OMA understand that they cannot get very far with the economic argument. They cannot get very far with saying, "We want to keep our doctors in Ontario, so we have to let them extra bill or they will go south of the border." They know that does not hold. Research is against that.

We have heard a daily litany of the problems of the present system. We know there is a scarcity of hospital beds. We know that at Etobicoke General Hospital every day there are 50 people occupying active treatment beds when they should be in extended care, chronic care or other facilities where they could have more freedom and where they would not be occupying active treatment beds. The people who are arguing about the terrible system at present are the very people who underfunded and who put all their dollars into the same kinds of baskets. They did not look at the alternative programs and they created this problem in the first place.

The one thing the Conservative members cannot answer is how stopping extra billing will add one hospital bed to Etobicoke General, will add one chronic care bed anywhere in the west end of Metro where beds are so badly needed, will add one home care or support system or will add one dollar to improving the health care delivery system in Ontario.

Hon. Mr. Sorbara: On a point of order: I hate to interrupt my friend but I have just received a very important message from Peggy Sweeney, who is in the gallery and who points out that it is her father's birthday. I think we should take note of that as it is just after 12 o'clock.

Mr. Speaker: That is a very interesting point of information.

Mr. Philip: If I had the talent to sing the way I have at least some talent to play the violin, I would sing "Happy Birthday" to the member. Since I do not have a violin present, I will say "Happy birthday" to the member for Kitchener-Wilmot on behalf of all his children -- whether there are one dozen or two dozen; they are so numerous I do not think I can count them all -- on behalf of all the obstetricians who have probably extra billed him over the years for all those beautiful children and on behalf of all his family. All of us in the House think he is a fine fellow and we wish him many happy years, not in this Legislature but in this province.

12:10 a.m.

A few minutes ago I was talking about the historical development of the helping professions. I recall it vividly because I prepared some tapes dealing with this organization. We are paying $200 to have them copied. In 1902, Albert Mansbridge understood the issue we are talking about. Bishop Gore as Archbishop of Canterbury understood what the issue was in his sermons, some of which I have read several times.

These people, in setting up and in looking at the educational system, said one cannot have second-class education. It is not good enough to have one kind of system for the poor or the working class and one kind of system for the wealthy. Education and health are intimately connected, because they are connected to the individual and his or her right to stand tall and to have the same quality and services that the rich and the carriage trade have. They had the slogan, "The best that Oxford can give." Indeed, in their early days, while they were talking about education, many of them also developed the basis for the thinking of such programs as adequate nutrition in the schools and other preventive types of health care.

Conservative members of the House have argued that more negotiations are needed. If negotiations were so easy to come by for people with differing views on health care, why is it that in the nine months in which the Progressive Conservative Party remained the government here while the Mulroney government was in Ottawa, it did not call for an independent mediator between it and the Mulroney government to get back the $1 million per week we are losing in subsidy payments as a result of allowing extra billing? If negotiations were so easy, why was it not able to negotiate with its federal counterparts so that we would at least have the $50 million per year we are losing? Part of the motivation in this bill, in addition to the arguments I have made, is also the money we are losing.

If negotiations were so easy, why could the Conservatives not negotiate with the leader of their own party in Ottawa, the Prime Minister? They have not. We heard arguments in the House over and over again. "Why does the Premier not pick up the phone and call Brian Mulroney and negotiate so that we get our payments?" Where were they for nine months? The member for St. Andrew-St. Patrick (Mr. Grossman) obviously has a phone; he sent it across the House. Why did he not use that phone then to call his friend Brian Mulroney? We did not see him do it. In fact, there was not a whisper.

If we look at the arguments that are made over and over again, they are the same trite arguments that were made when T. C. Douglas introduced the idea of medicare in Saskatchewan so many years ago. To use the words of the member for Brantford, we hear that there is a draconian, totalitarian system being dropped on. Those same words were used then. They were even more inflammatory, if one reads the history of what happened in Saskatchewan at the time medicare came in.

I thought it would be useful to look at what the founder of medicare in Canada had to say about the differences between a totalitarian type of system and a social democratic system, because essentially what we are dealing with in the bill is a social democratic program. Some years before he had an opportunity to introduce medicare, in 1944, he said there were four points of difference between a totalitarian system -- and he used the term "communist system," but we know he was talking about totalitarianism of either the right or the left -- and the Co-operative Commonwealth Federation or the social democratic philosophy, as we would call it.

First, we believe in a parliamentary government. Second, we oppose any type of one-party government. There must always be a place for opposition parties and free opportunity for any group to form a political party. The third difference is that the end does not justify the means, and the means are tremendously important because they shape the ends. Using illegal or inhuman means to attain an end would result in finding that the end was not what it was initially attempted to achieve. The final distinction was that as democratic socialists, and particularly as Christian socialists, we do not believe in a materialistic interpretation of life. Physical wellbeing and material gain are not ends in themselves but simply a means to an end.

If you look at this bill, it essentially falls under the four qualifications of the difference between a democratic socialist policy -- a social democratic policy, if you prefer those words -- and a totalitarian policy.

It is being dealt with in parliament by elected people. There has been adequate debate. It is not being imposed on anyone in a unilateral way. There is more than one party here expressing different points of view. Essentially, it deals not only with a material problem but with a spiritual one.

When a senior citizen in my riding has to say to me, "I am afraid to talk to my doctor about my retarded son, and about the fees he is charging to operate on him, because the next time he may take less interest in me," you are dealing not just with a physical problem but with a spiritual problem. That is what this bill is all about.

Eliminating a few of these problems, for example, saying that seniors will not have to be extra billed, does not remove the basic cancer that exists. It is a cancer which says that one person has to be subservient and come genuflecting and bowing before the golden calf that Harvey Cox would talk about, saying, "Forgive me, Doctor, but I do not have the money." That is a spiritual problem; it is not just a physical problem.

My father worked all the way through the Depression and lost a major business. In 1944, my brother was born with a blockage in the oesophagus. In those days there was no hospital care -- at least, not in Quebec. There was very little assistance, unless you wanted to go pleading into the charity wards.

We never owned a home; we always rented. When a social worker came and said to my father, "You spent thousands of dollars" -- and in those days, thousands of dollars was an awful lot of money; you could buy a brand-new car for a lot less than my father paid for the numerous hospital visits, doctors' visits and operations that my brother had -- and when she said to my father, "I can get you some assistance so that you do not have to pay the remaining hospital bills," he said: "I am going to pay my way the same as anyone else. I am not taking charity."

That is the same pride we all have. It is basically a spiritual problem we are facing. One man should not have to genuflect at the altar of another man, pleading that somehow his wallet is empty and he has to have some kind of special service, that he has to be treated differently from other men.

12:20 a.m.

If one looks at the claims and arguments the doctors have made, one can see that, even on a factual basis, they do not stand up; even if we accept that it is not important from a spiritual point of view to tell people that they should not have to genuflect to the doctor and say, "I cannot afford to pay," and even if one says that people should bury their pride, go ahead and do it. Research shows, and every research study being done in the city of Toronto has shown this in recent years, that if we look at the people who are below the poverty line, large percentages of those people, in any given year, have been extra billed and have paid those extra bills.

One can have the most benevolent doctors. One can have the most caring doctors. One can have the best advertising scheme in the world saying one does not have to pay if one is on welfare or is a workers' compensation victim. However, we all know that they do pay. All the research has shown that. The OMA argues that extra billing is not a barrier to getting access. However, the research has shown that it is.

Doctors argue that there should be some reward system for the exceptional and experienced doctors. Yet every research project we know of shows there is no relationship between either experience or expertise and extra billing. I know of certain doctors who are outstanding specialists in their fields -- presidents of the associations in their specialties -- who refuse to extra bill and who have never extra billed. Yet I can find some young guy out of medical school, who extra bills because he operates in the city of Toronto, can get away with it and wants to be richer earlier, or for whatever reason.

We have said, and to the credit of the government it has said to the OMA, that if certain specialties are not being paid adequately, we will negotiate that. We will look at that. We are willing to do that. I do not believe that a talented heart specialist, who has worked for eight hours on a patient, should have to feel that for some kind of economic reasons he has to operate again the next day. That is absolutely foolish. Nor do I want a pilot, who has been up in the air 12 hours, to feel suddenly he has to do the return trip. That is absolutely absurd. Those things are negotiable. One does not have to extra bill to be adequately compensated. That is the position we have taken. That is the position the government has taken. To say somehow that extra billing will solve that problem is simply not true.

The OMA has tried to scare patients by telling them that if doctors are not allowed to extra bill, there will be assembly-line medicine. The fact is, every study has shown there is no basis for the argument that a doctor who extra bills spends more time with the patients than one who does not. Any research that has been done shows there is absolutely no correlation whatsoever.

A recent advertisement by the OMA points out that there is a long list of patients waiting for access to hospital beds. Ontario is currently losing $50 million a year. The delays and the filibuster of the Conservatives have added weeks and weeks to this, at $1 million a week. Some of that money could be used for the type of services that the doctors are complaining about in their expensive ads.

The underlying whisper campaign one hears is that somehow if one lets the poor, or the ordinary people, go without extra billing there will be abuse of the system. Suddenly the people will run to doctors over and over again, even though they do not need to. If one uses that kind of logic, then I guess priests should charge extra, or charge an extra bill, every time someone goes to confession. It would stop the abuse of the system, would it not? It is an absolutely illogical argument.

The fact is that it is not the patients, but rather the doctors, who decide whether a particular medical procedure is to be carried out in a hospital, whether lab tests are to be done and whether X-rays and referrals to specialists are to be done. It is not the patient, but the doctor, who decides that. There is nothing in this bill that changes it in any way.

The actions of the doctors, who are members of the highest-paid helping profession in this province, have created a scare, with the help of the Conservatives. A constituent came into my office early the other morning when I was there working. She happened to be in the building and took the chance that I might be in. She was on the verge of tears. She said, "Please do not vote for Bill 94." I asked why and she said, "This doctor has made me walk again." Those were the words she used. What she meant was that he had helped her to walk again. She said, "He tells me he will go off to the United States if Bill 94 is implemented."

I recall the kind of scare tactics that were faced in Saskatchewan at the time Douglas and the Co-operative Commonwealth Federation introduced medicare in the first place. I said: "You tell that doctor that maybe he will have the same kind of experience that some of those Saskatchewan doctors had when they went to the United States. They were very quickly back in Saskatchewan or back in Canada, because the American system, with all its free enterprise, is not such a great place to live or to practise professionally."

I have been to the US, and I have seen what the free enterprise system of medicine does down there. Allowing extra billing, allowing the thin edge of the wedge into that system, allowing the privatization of health care, as the Conservatives started here in Ontario before we got rid of those rascals from government, is very expensive. If one looks at the percentage of the gross national product that is spent on medicine in the US, it is very expensive compared to what we spend here. If one looks at the kinds of service they have in comparison, the contrast is even greater.

While the Conservatives argue that the present system is accessible, I ask members what kind of accessibility a person in my riding has who suddenly gets hit by a car or has an accident and goes to the Etobicoke General Hospital. Does one argue with the anaesthetist when one is in pain and ask, "Are you going to extra bill me?" All the anaesthetists at Etobicoke General Hospital extra bill. Not one is not extra billing. If one is in pain and on the operating table, one is not going to negotiate with the doctor and say: "No, Doctor. Instead of my taking your treatment, I will send somebody out for a couple of bottles of gin because, after all, that will cost only $20 and you are going to charge me $300 in extra billing for the anaesthesia." It is an absurd situation.

If one looks at specialists, one is not going to say, "No, I am going to have the taxi driver deliver my baby because, after all, he will not extra bill, or he will give me a better deal than the gynaecologist will," particularly if he happens to be the only one in town.

12:30 a.m.

The Conservatives ask for a delay in the bill. Less than a month ago, Dr. Moran said, "We are prepared to meet until the cows come home." Every time we meet, the more they meet, the more we meet; the clock is ticking; it costs an extra $1 million, and more and more people are being extra billed. It is in the interests of the medical profession. If I were in their shoes and had the kind of objectives they have, I would be willing to talk for the next five years.

The Conservatives are allowing themselves to play into that kind of manipulative hand. They are allowing the OMA to act as their ventriloquist. When any group gets so much in the control of one other vested interest group, then it is a very sad day indeed.

Let the Conservatives go home and tell the patients, those people who are receiving bills for $10, $20, $50, $100, $200 or $300, that at this very moment they want to delay this bill even longer so the patients can have an opportunity to be extra billed some more. Let them go home and tell their constituents that, and they will see how popular their position is.

Every week is an extra week that is costing the taxpayers of Ontario more. Every week is costing the people of Ontario a greater loss of dignity. Many years ago, Tommy Douglas said, "The basis of a democratic government is that the law applies to all, whether rich or poor, high or low, and especially to those who are pledged to enforce the law."

The doctors are in that kind of privileged position. As we pass this bill tomorrow, I trust that they will behave in the kind of law-abiding manner that is becoming of a professional and that they will react to their patients in the professional manner one has come to expect of them over the years but about which one has been somewhat disillusioned over the past two weeks.

Mr. Bernier: I listened to the honourable member for considerable time, and I heard him constantly make reference to the figure of $50 million and to the $1 million per week that is being withheld by the federal government. Can he tell us exactly where that figure came from? Is there any factual or audited information that it is $50 million? Or is it just something he pulled out of the air because he has heard everybody else speak about it?

Mr. Breaugh: I am sure the previous speaker knows full well that is the estimate used by the Ministry of Health in Ontario. The number was produced for Ontario by the federal government under the Canada Health Act. Unless this bill is carried within the first three-year period, we will lose slightly in excess of $50 million per year in revenue for Ontario.

That estimate is said by some to be a little on the low side. It is a number that is said by some to be insignificant. Where I come from, $50 million is a lot of money. Over a three-year period, a total of $150 million or more that would be lost to the Treasury of Ontario is something I believe to be significant and something we have to be concerned about.

More than that, though, the institution of a health care act across the country brings into play some measure of conformity for the provision of Canadian medicine. That is a reasonable thing to do, and that is the basis upon which there was a three-party consensus formed in the Parliament of Canada. I dare to say that even if the member's party had managed to hold on to power, it would begin to think a bit about numbers of that size. That is a large amount of money.

It should not be lost on all the members here that this legislation simply brings us in conformity with federal legislation. It removes the penalty clauses that would apply to Ontario. If on no other grounds than that economic impact on Ontario, it is important and wise that members heed that advice and allow Ontario to conform, as seven other provinces have already done.

Mr. Harris: I want to comment on the $50 million as well. Something has bothered me about the figure that has been thrown around so loosely; it may be a moot point. I have heard figures as low as $25 million; that is not an insignificant figure either. However, let us say it is $25 million. If the offer of the OMA had been accepted as to all the people it had offered not to extra bill, including the accessibility, most estimates are that would cut it to less than half.

Now we are down to about $10 million. That is still a significant figure, and it is important to the Treasurer, but what does it mean to the taxpayers of Ontario whom we represent? The taxpayers pay about 40 per cent of the federal tax bill. If the federal government kept $10 million, that is $10 million it does not have to raise, of which we pay 40 per cent. Now we are down to about $6 million.

When I talk to taxpayers about their taxes and federal-provincial sharing and co-operation, most of them say: "The federal government and the provincial government grab our money and then they transfer it back and forth. What difference does it make?"

Hon. Mr. Bradley: They will spend it on something else.

Mr. Harris: That used to be the case with the federal government, but it is not the case now that there is some sensible control of the federal government's spending. It does not take long to get the figure down to $5 million or $6 million. I agree that is significant, but it is a long way from $50 million.

Mr. Ward: On the last point, the amount that is withheld in federal transfer payments is not a hypothetical amount; it is a fixed amount. It is $53 million a year. It is based on estimates that some people may dispute, but that is the amount of money withheld.

Mr. Bernier: If it is an estimate --

Mr. Ward: The member for Kenora (Mr. Bernier) knows that as well as I do, and so does the member for Nipissing (Mr. Harris). With respect to the proposals put forward by the OMA in relation to how much that would cut the amounts withheld, by the ministry's estimates the OMA proposal would eliminate only approximately 30 per cent of the extra billing that goes on. It is estimated that $40 million a year would still be withheld.

Mr. Swart: I want to comment on this briefly, especially as the Conservatives indicated it is not a figure of $50 million. The total figure is at least $100 million, because we are talking about not only the $50 million that is lost in transfer payments from the federal government but also about $50 million extra that the public of this province has to pay in extra billing until it is banned.

Let us make no mistake about it. The total figure, the cost to the people of this province through extra billing and the loss of transfer payments, is in excess of $100 million annually. There is no other figure that is correct. Even if the member were to try to prove that his figure of $25 million on lost transfer payments was right -- it is not; it is more than double that, as has just been pointed out -- the total loss to the people of this province is more than $100 million annually.

12:40 a.m.

Mr. Sterling: If the Treasurer (Mr. Nixon) is so worried about the $50 million, all he has to do is add about seven cents to the price of a pack of cigarettes and he would make it up just like that. It would save a lot of health problems because it has been proved that the consumption of tobacco is reduced as soon as taxes are raised. On the one hand, a lot of health care problems are saved; and on the other, the $50 million is raised, just like that.

Mr. Philip: I found it interesting that the previous speaker's solution to the problem of our losing $100 million a year for the taxpayers both by extra billing and by the $50 million in transfer payments was to raise taxes even more. I find that to be typical of the solutions he might well come up with.

I am pleased that so many members decided they wanted to answer my question, but when Mrs. Scrivener came before a committee of the Legislature on which both the Minister of Education (Mr. Conway) and I were serving -- and he will find this particularly interesting -- she was the first one to be so incensed at the amount of transfer payments that were being lost as a result of Monique Bégin's policy.

Then we had nine months of Conservative Party rule under a Conservative government in Ottawa and the figures were still there. We did not see the Leader of the Opposition pick up one of those portable phones to call Brian Mulroney and say: "Hey, Brian, we are losing $50 million. Why do we not have an independent negotiator?"

Why could the Leader of the Opposition not pick up the phone and say the Conservatives wanted an independent negotiator because Margaret Scrivener does not think it is a good idea to lose this $50 million? But he did not listen to Margaret. He did not listen to anybody. He is still not listening. He will not even pick up that phone. Where is he tonight? We have to call him by phone to find out whether he is in favour of extra billing.

[Continued in No. 36]

June 19, 1986

ORDERS OF THE DAY

PRIVATE MEMBERS' PUBLIC BUSINESS

ONTARIO SENIOR CITIZENS' PRIVILEGE CARD

TRANSFER PAYMENTS

ONTARIO SENIOR CITIZENS' PRIVILEGE CARD

TRANSFER PAYMENTS

AFTERNOON SITTING

ORAL QUESTIONS

EXTRA BILLING

SOUTH AFRICAN INVESTMENTS

EXTRA BILLING

SOUTH AFRICAN INVESTMENTS

EXTRA BILLING

FREE TRADE

EXTRA BILLING

OCCUPATIONAL HEALTH AND SAFETY

EXTRA BILLING

SINGLE-INDUSTRY COMMUNITIES

CRIMINAL CODE

ALCOHOL TREATMENT CENTRE

MEMBERS' STATEMENTS

EXTRA BILLING

SOUTH AFRICAN INVESTMENTS

EXTRA BILLING

ALZHEIMER'S DISEASE

EXTRA BILLING

FAMILIES FOR CHILDREN

EXTRA BILLING

STATEMENTS BY THE MINISTRY AND RESPONSES

FOOD PRODUCERS AND PROCESSORS

MINIMUM WAGE

PUBLIC COMPLAINTS LEGISLATION

VISITORS

PETITIONS

NATUROPATHY

EXTRA BILLING

ADULTS-ONLY APARTMENTS

REPORT BY COMMITTEE

STANDING COMMITTEE ON THE LEGISLATIVE ASSEMBLY

INTRODUCTION OF BILLS

METROPOLITAN TORONTO POLICE FORCE COMPLAINTS AMENDMENT ACT

METROPOLITAN TORONTO POLICE FORCE COMPLAINTS AMENDMENT ACT

WINE CONTENT AMENDMENT ACT

ORDERS OF THE DAY

HEALTH CARE ACCESSIBILITY ACT (CONTINUED)

MOTIONS

TIME ALLOCATION

ADJOURNMENT TIME

HEALTH CARE ACCESSIBILITY ACT (CONTINUED)

HEALTH CARE ACCESSIBILITY ACT