Hansard Transcript 1988-Nov-07 | Legislative Assembly of Ontario

Mr. Philip: The Solicitor General (Mrs. Smith) circulated to the Liberal members of this Legislature a package of information which was to be used in support of her unsupportable Bill 113. This package contained a report on a study entitled The Impact of Sunday Shopping in Alberta, 1982 to 1986, by Clayton Research Associates of Toronto.

I have now received a response to my request under the Freedom of Information and Protection of Privacy Act. The response is that the report does not exist within the ministry. We were further advised that we should contact Clayton Research Associates of Toronto. Clayton Research Associates claims it does not have any such report and that we should contact John Winter of John Winter and Associates. Mr. Winter claims that while he offered to prepare a study on Sunday shopping for the government, the government never accepted his offer.

It is fairly clear that the Solicitor General failed to do adequate research prior to tabling Bill 113. Now that it is equally clear that the one Canadian study used by the minister to justify her case is just another myth and does not exist, I call on the minister to be honest with the public and admit this.

AUTOMOBILE INSURANCE

Mr. Harris: I have a letter of interest to the Minister of Financial Institutions (Mr. Elston). It comes from a Mr. Cochrane, 145 Holditch Street, in Sturgeon Falls:

“Dear Sir:

“I am writing this letter concerning car insurance. I would like you to read this letter in the Legislature if possible.”

It is possible.

Interjection.

Mr. Harris: I know the member is not.

“I have and own a 1986 Ford Taurus V6 four-door (9,300 kms). Last year I paid $454 complete coverage--PL, PDFT comprehensive, collision, passenger. I paid it today--$632. That is an increase of 40 per cent.

“My complaint is, what kind of government are Mr. Peterson and Bob Rae, NDP, running to allow this kind of thing to go on? Robbery in disguise.

“Believe me, this Liberal government is taking us to the cleaners. I am a senior citizen and have a perfect record--50 years without an insurance claim--accident-free. I should get a medal not an increase like that. I’m a six-star client and I want it made clear this is the cheapest my agent could find for me. Imagine, the cheapest!

“I hope this gang of care-for-nothing-but-themselves get the boot next time around and we get our PCs back again in power.

“Thank you.

“Yours truly,

“Edwin Cochrane.”

I am sending a copy of this letter over to the minister. Perhaps he would like to explain his way out of this directly to Mr. Cochrane himself.

4-H CLUB

Mrs. Sullivan: I would like to speak today about the achievements of 4-H club members in the Halton region. I had the honour recently of attending the Halton 4-H awards banquet in Brookville and was very impressed by the young men and women involved.

In a region which has changed significantly over the past 25 years and where the role of agriculture has become part of that change, the 4-H movement remains a strong force. We have a small 4-H in Halton, but we have a very successful one. In all, there are only about 120 members, but they are very active and complete over 300 projects a year.

A good example of their success can be found at this fall’s Royal Winter Fair. The Halton 4-H club will have 19 members competing, more than double last year’s efforts. Last year, we had nine award winners, including two first-place finishers. But the rewards of 4-H go well beyond the tangible awards. Our young rural people, agriculture’s greatest resource, develop skills and interests that will help keep Canada at the forefront of the agricultural world.

I know that many members of the House are former 4-Hers and that they will join me in recognizing 4-Hers, not only in Halton but throughout the province, at the conclusion of this project year.

ELECTRONIC MONITORING OF OFFENDERS

Mr. Farnan: It is unfortunate that the only real alternative to overcrowding in our prisons and to incarceration offered by the Ministry of Correctional Services is the concept of electronic monitoring, which is both dehumanizing and of little rehabilitative value.

The recently announced pilot project, aimed at the early release of low-risk offenders in prison for minor crimes or failure to pay parking fines, is unnecessary. Instead of saying, “We don’t know how to deal with this class of offender so we will incarcerate them in their homes and monitor them electronically,” the ministry should be creating alternatives to incarceration, alternatives which include rehabilitative programs.

In Alberta, for example, a large number of inmates, especially fine defaulters, are released on a temporary absence program and with each year the rate of recidivism for those on such programs decreases. Since 1976, an average of less than one per cent of those released under TAP have committed other offences.

Both Saskatchewan and Alberta have developed successful fine-option programs in which fine defaulters are not sent to prison but are required to do community work. Ontario, by contrast, has a very limited fine-option program in operation. It is sad that the mentality of this ministry continues to focus on incarceration, whether in prison or in the home, and neglects meaningful alternative rehabilitative programs.

FINANCIAL TRUST

Mr. Runciman: On two occasions in the past few weeks, I raised concerns with the Minister of Financial Institutions (Mr. Elston) regarding the province’s $10-million loan guarantee to facilitate the sale of Financial Trust Co. to Central Capital. The minister and his government made this $10-million commitment without any statement of explanation in the House and subsequently failed to adequately answer questions from me and from the financial press dealing with this matter.

In the face of significant regulatory failure, the minister’s only response to my questions has been to attack me for making outlandish statements; statements, I should add, that have been dead on, as revealed in a recent series of articles on this matter in the Financial Post.

With the exception of the Financial Post, questions about the use of public dollars to cover the tails of the minister and his regulators and the breakdown of the regulatory system have been largely ignored by the media, but hopefully that will not stop the government from taking a close took at what happened in this situation,

The Ministry of Financial Institutions deals with some very complex and important matters, and I urge the Premier (Mr. Peterson) to give it the priority he said it rated during the Greymac-Crown Trust affair. In the past three years, both the Treasurer (Mr. R. F. Nixon) and the Chairman of the Management Board of Cabinet (Mr. Elston) have been assigned financial institutions as a secondary responsibility and have treated them that way. It is time to appoint a mister solely responsible for the Ministry of Financial Institutions and I urge him to get on with the job before more serious problems arise.

Mr. Speaker: Thank you. The member’s time has expired.

ST. GEORGE BOARDING HOUSE

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Mr. Kanter: I would like to inform members of the opening of St. George boarding house which I attended recently in my riding. This residence, established by the Supportive Housing Coalition of Metro Toronto and Anglican Houses, will provide affordable housing for 24 adults with a history of psychiatric disabilities.

Renovating and operating St. George required the co-operation of three ministries, Metro, the city of Toronto and several private agencies, but I am particularly proud of the role that local residents, my constituents and neighbours, played in support of this project. I remember when the Supportive Housing Coalition came to a meeting of the Annex Residents’ Association and proposed the project. There was a lively discussion with the residents’ group, not about opposing the project but about the adequacy of the facilities. There was a vote and the ARA supported the project unanimously.

There was understanding and acceptance rather than shouting and pickets. Residents knew their property values would not be threatened, there would be no increase in traffic or parking problems and the staff would not tolerate dangerous behaviour in that house or in the adjacent community.

Today, I want to pay particular recognition to the residents of the Annex neighbourhood who supported this worthwhile project. I would also like to acknowledge the presence of Mary Corbett, the current president of the association, who is in the member’s gallery today, and also note the support of Ila Bossons, the former president of the association.

STATEMENT BY THE MINISTRY

TORONTO AREA TRANSPORTATION

Hon. Mr. Fulton: I want to announce some good news for commuters in the greater Toronto area. As of January 9, 1989, GO rail service on the 50-kilometre Milton line will increase from three trips to five weekday round trips.

This nearly $19-million expansion will greatly benefit commuters from Halton and Peel regions. The upgrading of the service with a number of new bilevel commuter cars also included expansion of the Erindale GO station in Mississauga. The expansion will increase the Milton line frequency from three to five rush-hour trains into Toronto in the morning and from three to four rush-hour trains from Toronto in the evening, plus a fifth home-bound trip for commuters returning in the early evening at about 7:30.

As of January 9, GO Transit will also offer two new home-bound GO bus departures from Toronto, one on the Georgetown GO service and another on the Stouffville GO service.

The new bus service will give Georgetown and Stouffville commuters the same early evening options as the new schedule does for Milton commuters. Buses will run from Union Station in each instance to Malton and Georgetown and to Unionville, Markham and Stouffville.

The buses are an interim measure until GO rail service can also be expanded on these routes. I want to emphasize that this expansion of GO rail and bus service is further evidence that the province is working to meet the growing needs of commuters in the greater Toronto area.

RESPONSES

TORONTO AREA TRANSPORTATION

Ms. Bryden: Naturally we welcome expansion of the GO service to various parts of the ex-urbanite area, because those commuters include both high- and low-income people. The low-income people are those who have been forced to buy beyond the boundaries of Metropolitan Toronto because of the very high prices here.

It is unfortunate that we are producing more urban sprawl in order to solve the housing problem and also, at the same time, encouraging the kind of luxury building that leads to even greater urban sprawl in the ex-urbanite area, because when you service people like this, who are in $1-million or $2-million houses, you are subsidizing close to 45 per cent of the fare for them and encouraging this kind of building. I think the minister should be looking more at limiting the kind of urban sprawl which is going on and also assisting the people in Metropolitan Toronto who are also commuters, in a sense, in that they have to buy in the outlying municipalities.

The Sheppard subway is something which should have equal prominence to this expansion of services for the ex-urbanites. I would like to know when the minister is going to get on with the Sheppard subway. When is he going to increase the subsidy for the users of public transit in the Metropolitan area to equal the subsidy that goes to the users of GO Transit?

Those are the crucial questions he should be looking at, rather than just encouraging urban sprawl further and further afield, with our picking up a large percentage of the bill.

Mr. Breaugh: I cannot miss the opportunity to commend the minister for putting an extra train on. We always appreciate that.

There are two things to bear in mind. People do need some parking accommodation at a number of the GO stops along the route, and he should bear that in mind if he really wants people to use the GO system extensively. He has to remember there are other needs that have to he met as well.

I know he will be out in Whitby in December when they bring the GO train to Whitby, finally, and I will remind him once again that it has to go a little bit further, on through Oshawa. We are still working with him very seriously every day on that.

Mrs. Marland: I know the people in Mississauga are going to be pleased to have some additional trains. I think they would have been more excited had the trains, in fact, been doubled rather than being the number that they are, going from three to five.

Obviously, on the traffic problems on the Queen Elizabeth highway, which I spoke about last week when the minister addressed the subject of the issuance of the twin passes, we feel in Mississauga that this Liberal government is not planning for the future in terms of the commuters from the west side of Metropolitan Toronto all the way through past Hamilton.

There is a tremendous problem for those people who have to work downtown. They cannot afford to live downtown, but because their employment is there they are bound to use what transit there is. The truth of the matter is that because of the parking problems at the existing Lakeshore stops on the GO line, we do not really have a very viable alternative for the people who then have to stay in their cars simply because when they get to the GO station, there is nowhere for them to leave their cars should they wish to commute by GO transit.

While we hear very clearly the minister’s announcement today, I would like to say that we would be more ecstatic had he been announcing the Eglinton or Sheppard line, additional parking spaces or indeed additional stations, which I addressed last week.

If he is sincerely planning for the future of the commuters from the western hemisphere, in terms of southwestern Ontario, we would like to see him look very seriously at electrifying that line which the GO trains use in order that he can heighten the frequency of the trains and the frequency of the stops. I would be more than happy to sit down with him and discuss what the solution is for transportation for the people who live in Mississauga and stops west.

Mr. Cousens: The honourable member for Mississauga South (Mrs. Marland) sets out the situation very eloquently, and I commend her for her ability which enables her to present her views to the Minister of Transportation (Mr. Fulton).

I want to thank the minister. I think the one thing his government has not done since it came to power is destroy GO Transit. The government has allowed GO Transit to continue to develop and serve the people of Ontario. The fact that it has been able to have its hands off and help it do things that are positive is a good sign. I will go a step further, though. I think the fact that the government is now having to put buses on from Union Station to Markham and Stouffville is good, but would it not be so much nicer if we used the rail lines that are there?

The parkway and other methods of getting around Toronto when it comes to roads are just not good enough any more. We have the rail lines there. I know they have to be upgraded; let’s do everything we can. We in the third party will help him in any way possible. We will pass the hat around. We will do anything to encourage this honourable minister to do what he can to expand and promote--

Interjection.

Mr. Cousens: Oh, I will raise his hand in joy. But he should announce another train. That is when he will really start making the heart-strings tug for the people who are commuting from the north into Metro.

If he treats those who are north of Metro the same as he treats those to the east and west, then we will start seeing some more service on the Yonge Street line and some more service to those people who are wanting to use the train service from Stouffville. My friend the member for Durham-York (Mr. Ballinger), who is not here today, would also jump for joy,

Mr. Adams: He is here in spirit.

Mr. Cousens: He is here in spirit, and he is usually here; I do not want to knock the honourable member.

May the minister be put into a position very shortly, from the pressure that is coming from ourselves, to respond to the needs of commuters who want to travel to Toronto more quickly, more safely and more economically using GO Transit train services.

The minister should keep up the good work with the bus service. That is only the beginning. May he make another announcement tomorrow and the next day. Is he making another one this afternoon? We would be honoured and pleased to congratulate him at such a time. In the meantime, he should not rest on his laurels. There is a lot more to be done.

Mr. Harris: The Ontario Northland Transportation Commission built those cars for GO Transit up in North Bay, and what a great job they did.

VISITOR

Mr. Speaker: That completes the allotted time for ministerial statements and responses. Just before I call for oral questions, I would like to inform the members that we have a visitor in the Speaker’s gallery. He is the deputy leader of the Congress (I) Party of India and a member of parliament of India for 50 years. He is Professor Ranga. Please welcome him.

Oral questions, the Leader of the Opposition with the fresh boutonniere.

Mr. B. Rae: Mr. Speaker, you should have seen the smile on the face of the Treasurer (Mr. R. F. Nixon) when you introduced our guest. I think he saw his future stretching out before him for years. He has two weeks to go.

ORAL QUESTIONS

CHILD CARE

Mr. B. Rae: My question is for the Minister of Community and Social Services. The minister will no doubt have experienced the concern and heard very directly of the number of people who are on Ontario’s waiting list for child care. It really is hard for the men and women of this province whose kids are on waiting lists to understand how that could be, at the same time as there are a great many centres, as the minister will know, that have empty places and empty spaces.

The minister today, I understand, told the group with whom we all met that, in fact, he could eliminate the waiting list by spending roughly $30 million of Ontario’s money. We have just heard today that the land transfer tax has increased Ontario’s revenues by precisely that figure, $30 million.

That has been the windfall gain that Ontario has experienced as a result of speculation. I wonder how the minister can justify not moving to help those people on the waiting list at precisely the time when Ontario’s windfall revenues from land transfers and from housing speculation give him the money to do that job.

Hon. Mr. Sweeney: My recollection from our meeting this morning was that I reminded the group that was present that a number of their own delegates had met with the Premier (Mr. Peterson) and me. The $30-million figure was their assumption. I simply shared that with them.

I also shared with them that when we were asked to put in place a number of initiatives, we clearly indicated that if we had to spread the available resources over several initiatives, obviously no one of them could get as much as they would otherwise have received.

I pointed out, for example, that this year, for the very first time, we have introduced the direct grants to improve the wages of day care workers, which the Ontario Coalition for Better Child Care had told us two years ago was one of their top priorities, having indicated to us that the only way we could solve both the wage problem and the parent-fee problem simultaneously was to give direct grants. I indicated that having allocated $60 million, at their request, for wages meant that obviously those same dollars were not available for subsidies. The obvious relationship there is that if we put half as much money into the wage problem, which I was not prepared to do, and allocated it instead to subsidies, we could have picked up the $30-million figure they suggested to us.

Mr. Speaker: Thank you.

Hon. Mr. Sweeney: But clearly what I indicated was that we cannot--

Mr. Speaker: Thank you.

Mr. B. Rae: What the minister is saying is that, in a province as wealthy as ours, he cannot see that child care workers are paid a decent amount of money and assure parents that they will not have to wait on a waiting list for years on end. Surely in Ontario we can do better than that: we can do both those things. Surely that is the issue.

I have raised this issue countless times with the minister. I would like to go back with some very specific examples. Because of the limits that he has placed in terms of child care, many of these people are waiting, and some of them are already getting child care.

Let me give members an example. Lori Foster, who is from Ottawa, has a child in day care and is receiving a full subsidy. If she did not have a subsidy, she would pay $940 a month. She works full-time and earns about $22,000 a year.

In Toronto, Joy Simmonds and her husband work together, earning about $45,000. They have three children, aged one, three and five. The two oldest are in day care and they have a baby-sitter for the youngest. They have a partial subsidy, but still pay $700 a month.

Mr. Speaker: Question?

Mr. B. Rae: Is the minister seriously arguing that Joy Simmonds and her husband, for example, should give up their subsidy in order to allow someone else to get a limited space that the minister himself is responsible for limiting?

Mr. Speaker: Order.

Hon. Mr. Sweeney: To the best of my knowledge, I have not suggested that anyone give up a subsidy he currently has. What I have said, and I would like to repeat it again, is that, for example, in Metro there is a monthly turnover of subsidized spaces approximating about 200. When new subsidized spaces become available, they should be allocated to the people with the greatest needs; some of the people, for example, the Leader of the Opposition brought to our attention a couple of weeks ago and even had in the members’ gallery, a 17-year-old young mother and two or three single parents--I believe they were about 22 or 23--who had very limited incomes, certainly much less than $45,000 or $40,000, who could not get access to one of the 18,000 spaces in Metro.

I will repeat my response again. When those spaces become available--they turn around, from the information I have, at about 200 a month--they should be allocated to the people with the greater need. Not that the people the member described should not be eligible, not that they are not deserving, but when there is a limited resource, it should be allocated to those with the greater need first.

Mr. B. Rae: The whole thrust of the Thomson report is that we should get rid of this notion of deserving poor and nondeserving poor, that we should eliminate these distinctions that turn child care into a welfare system. It should be there as a public service. That was good enough for the Liberals when they were asking for votes in 1987. Why is it not good enough for them in 1988, when they have the money and when they are the government? Just why is it not good enough?

Hon. Mr. Sweeney: There is no quarrel between the honourable member and myself in terms of the difference between deserving poor and nondeserving poor, between low-income parents and higher-income parents. That is not the distinction I am trying to make. What I am clearly saying, however, is that with respect to both the Thomson report and the new child care initiatives, while we are in the process of arriving at the point we all want to get to--and I do not think there is any difference between us on that--surely the resources available have to go first to those most in need.

PROPERTY SPECULATION

Mr. Laughren: I have a question for the Premier concerning the price of resale homes in Metropolitan Toronto. According to the Toronto Real Estate Board on the weekend, prices have gone up rather dramatically once again. I would remind the Premier that in October 1985 the price of an average resale home in Toronto was $112,800; in 1986 it was $153,000; in 1987 it was $194,000, and this October, $249,811--all this going on while the inflation rate in Toronto is running at just slightly over five per cent.

That means that a family with a 15 per cent down payment of $37,000 and a balance amortized over 25 years at the going mortgage rate will need a family income of $86,000 and change, 38 per cent of family income. The Premier should know that--

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Mr. Speaker: We would like a question, please.

Mr. Laughren: --a family such as that is not going to get a mortgage. How long does the Premier intend to sit on the sidelines and watch the price of homes, fuelled by speculation, continue to rise while he does absolutely nothing?

Hon. Mr. Peterson: My honourable friend has discussed this with the Treasurer (Mr. R. F. Nixon) on numerous occasions, and I think he would be very happy to discuss it with the member.

Mr. Speaker: Redirected to the Treasurer?

Hon. R. F. Nixon: I think the reference is a reasonable one, as the honourable member has raised this matter on a number of occasions and normally gets around in his second supplementary to advocating a special tax that would control this.

It is a very reasonable proposal that has been put forward by many people. I think the honourable member is aware that, while everyone is aware also that the rate of increase has been phenomenal, some of the majors in the real estate business-Royal LePage, I believe, about a month ago indicated that a levelling out of the rate of increase was to be expected in the following year.

The second thing is that it is not reasonable to expect the cost of housing in Toronto and the Metro area to be what the honourable member, coming from his community, or I coming from mine, would consider to be reasonable. He may have even spoken to people who have been moved here by their employers--industry, even government--who have found particular pressures. We believe that under these circumstances the market forces are already alleviating the problem, but we should not expect housing in the Metropolitan area of Toronto to be considered cheap.

Mr. Laughren: I do not think anyone is saying to the Treasurer that we expect the price of homes in Metro to be cheap.

The Treasurer referred to Royal LePage. Royal LePage, in a survey of homes across Canada, not just in Metropolitan Toronto, indicated that between 10 per cent and 15 per cent of all purchases are for speculative purposes. I would suspect, and I think the Treasurer would agree, that it is probably considerably higher than that in Metropolitan Toronto, given the dramatic rise in prices. The Royal LePage report goes on to state, and I quote briefly:

“Any factor that increases demand by 10 per cent to 20 per cent puts upward pressure on prices, so although speculation may not create house price spirals or be solely responsible for all of the price increases, it probably contributes to the rising cost of homes.”

That is a very conservative statement by Royal LePage. I wonder if the Treasurer would not agree that, given the particular aspects of home speculation in Toronto, it is time that he moved in with a speculation tax on the resale of homes?

Hon. R. F. Nixon: I do not agree with the honourable member, although I say again that many reasonable people in the industry and the community have suggested that. My own judgement, and it is based on advice from many other sources as well, would indicate that the market forces are reliable under these particular circumstances. This is a very attractive part of the world in which to live, the business community is expanding extremely rapidly and this is the cost of living that is rational in this day and age.

Mr. Laughren: It is clear that the Treasurer expects Toronto to be an élitist city and nothing more.

I want to go back to a couple of quotes, one by the Treasurer and one by the Premier. In June of this year the Premier said, responding to my leader, that “The heat is coming somewhat out of the market;” and he said, “It looks as though there is a downward trend in this regard and we hope it will continue.” At the time, the average house price in Toronto was $232,000. A year earlier, in May 1987, the Treasurer said, “There is every indication that the soaring price of houses has reached its peak and the pressures are subsiding somewhat.” That was $60,000-per-home ago.

When is the Treasurer going to come to the realization that we are dealing here with an acute speculative problem in Metropolitan Toronto, and it is not going to be resolved until he takes the preventive measures necessary; namely, a speculative tax on the retail price of homes?

Hon. R. F. Nixon: I predicted that the honourable member in his second supplementary would call for a land speculation tax and I will give him an answer that is perhaps not as difficult to hear quoted back as the one that he quoted to me a moment ago.

The honourable member is aware that the housing starts in Ontario, and in Toronto particularly, are at an all-time record high. The people building houses are building them as fast as they can be built. The lots are serviced. The allocation for capital for new schools is at an historic high, now approaching $300 million a year. Many of these houses are very expensive and, at the same time, my colleague the Minister of Housing (Ms. Hošek) has a budget that is growing faster than any other budget in rate of increase, to provide assistance and affordable housing for people who, through no fault of their own, find that their resources are inadequate.

Interjections.

Mr. Speaker: Order.

Hon. R. F. Nixon: We feel that this response from the government is an appropriate one, and we look forward to a more rational support from the opposition in this connection.

YOUNG OFFENDER

Mr. Brandt: My question is for the Attorney General. It relates to the situation that occurred on April 12, 1985, when a young offender was found guilty of having murdered Bruce Irwin, his wife and daughter. As the Attorney General is aware, the case at that time was not transferred to adult court, and the young offender was found guilty in youth court, under which the present legislation allows for a maximum sentence of no longer than three years.

The individual in question, whom I am sure the Attorney General is familiar with, is to be freed either on or before February 6, 1989, according to the authorities. Two and a half years ago, the Attorney General said, “I want to assure the House that there will be no risk to the public whatever in this case.”

Because of the apprehension within the community surrounding this case, could the Attorney General enlighten the members of the House as to what steps he might be taking to give them the kind of assurance that they and the public require with respect to this individual?

Hon. Mr. Scott: I would like to thank the honourable member for the question. He recalls well that this was a case in which the crown attorney and the defence counsel had both recommended to the trial judge in the young offenders court that the accused should be found not guilty by reason of insanity, which would have led to a disposition other than the one that took place.

The trial judge, as he was no doubt entitled to do under the Young Offenders Act, but within his powers, rejected that submission, jointly made, and found the young person guilty. At the time, he was sentenced to the maximum sentence under the Young Offenders Act.

A number of members in the House, myself included, indicated that we were very concerned about a number of matters: first, about the constraints that are imposed on the Young Offenders Act in permitting a court to award no longer sentence than three years, even in these extraordinary circumstances. I indicated at the time that the provisions of the Mental Health Act would be available and should be utilized at the conclusion of the sentence to determine whether the young man represents a danger to himself or to other members of the public. That will be done.

Mr. Brandt: As the Attorney General has clearly stated, the maximum sentence of three years is, in fact, unacceptable to a number of us, even though it is the maximum allowable under the current legislation.

Of concern to us as well is the fact that this particular youth apparently refused any form of treatment during the period of his approximate three-year incarceration and up until this time, to the best of my knowledge, has not accepted any assistance from the state with respect to his current condition.

Can the Attorney General give this House any assurance that there will be treatment provided or any aftercare supervision with respect to this individual when and if the individual is released on or before February 1989?

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Hon. Mr. Scott: The honourable member is quite correct. He and I and other members of the House were firmly of the view that the provision in the federal Young Offenders Act that made three years the maximum was absolutely inappropriate as a maximum. It is inappropriate, and this was illustrated clearly by this case.

As the honourable member knows, I went to Ottawa to speak to both the Attorney General of Canada and the Solicitor General of Canada, inviting them to amend the Young Offenders Act. They have persistently refused to do so, even though they have amended other provisions. They rejected our request that an amendment should take place in this act. I am prepared to try again later in November or early in December to see if a more satisfactory resolution of the matter can take place.

When we come to this case, it had best be understood that the young man will have served the maximum sentence that the federal law allows; that he is entirely within his rights to reject medical treatment, as he has done within the correctional facility, and that he will be examined by medical doctors pursuant to the Mental Health Act to determine whether he is likely, upon release, to be an injury either to himself or to the general public. That is the limit of the authority this government or indeed any other government has in law to act until the federal authorities can be persuaded to respond to the public concern and amend their legislation.

Mr. Brandt: We have no disagreement with respect to the Attorney General’s comments on the three-year maximum nor, as I understood what he was saying, in connection with the need in certain cases, specifically this one, where treatment should be provided and where the individual in question should receive treatment during the period of incarceration. Also, I think the Attorney General would agree with me on something that my party has been bringing forward on a regular basis, the need for adequate facilities for young offenders within this province, which is clearly his responsibility and part of this particular case as well.

I would like to ask the Attorney General, by way of my final supplementary, recognizing the very understandable degree of apprehension and concern in the community and the comments that have been recorded from the students who went to school with this individual and the parents who live in close proximity to the area in which this crime took place, can he give us the clear assurance that this individual will not be put back into the community and result in a threat to the lives of the people who have in the past been associated with this individual in some way, shape or form? They are clearly concerned. They are falling back on his commitment of two and a half years ago that he will provide their safety in this particular case. Can we get that assurance?

Hon. Mr. Scott: The honourable member, who has agreed with so much of what I have said so far, would not want to cast doubt upon the efficiency and the facilities at the Syl Apps Youth Centre, named after a well-known liberal in the Kingston area. It was, when constructed, and is now, one of the most distinguished facilities of its type in this country. Dr. Chamberlain, the head of it, is one of the most prominent child psychiatrists that we have in the business.

The problem is not with the facility. The facility was there to offer psychiatric assistance to this young man. He rejected that assistance, as, under our law, he is entitled to do. The time has now come for his release under the federal Young Offenders Act. When I went to Ottawa to meet with the Attorney General, I mentioned my honourable friend’s name on several occasions, but there was no impact whatever in terms of result from that fact. I intend to go later, and I will not mention his name this time but anticipate that we will have better results.

What I want to emphasize is that the only remedy that is now available to deal with this very serious but, in a way, very heart-rending circumstance for all concerned, is to apply the provisions of the Mental Health Act which permit two medical doctors, I think it is two, to conduct an investigation to determine whether the young man is likely to be a danger to himself or the public. If he is, in their opinion, he can be detained, as anybody else can be detained. If he is not, he cannot, and the remedy remains to deal with the Young Offenders Act.

INDEPENDENT HEALTH FACILITIES

Mr. Eves: I have a question of the Minister Of Health. Today we are going to be debating Bill 147 in the Legislature. Under section 26 of her proposed Independent Health Facilities Act, Ministry of Health inspectors are given the authority to enter any health facility, according to section 1 of the act, and that includes a private doctor’s office or a doctor’s private office, however you choose to put it.

This inspector has the authority to take records, charts, blood samples, tissue and interrogate any person in that doctor’s office. Most unbelievable of all, a government inspector can do this without a warrant.

We think this is a violation of the most fundamental principle of patient-doctor confidentiality. My question to the minister is, how can she possibly justify such a draconian measure being included in her legislation?

Hon. Mrs. Caplan: I want to thank the member for his question. We are indeed going to be beginning second reading of Bill 147, the Independent Health Facilities Act, and I think it is important that we understand the premises on which this bill is founded.

It is to give us a legislative framework to expand community-based services across this province and to acknowledge that technology is now permitting us to do many, many services outside of the hospital as safely as in hospital, traditionally those things which could only be provided in hospital. The act as well is to give us the same kind of quality assurance that presently exists in hospital in an independent health facility.

I look forward to discussing this with the member and the members of this House to ensure that this bill in fact achieves those objectives.

Mr. Eves: The minister speaks of independent health facilities, but I think it should be made very clear that there is a distinction between independent health facilities and health facilities. There are two different definitions under the act, and in one a health facility is any doctor’s private office. It may not be a licensed independent health facility, and I am sure the minister appreciates that fine distinction.

There are some other measures in this proposed legislation which we find somewhat disconcerting, to say the least.

Fortunately, this piece of legislation does have a provision for the appeal of a decision made by directors of independent health facilities, and we agree with that. However, the legislation also allows the minister to completely override the appeals process. The minister can decide to revoke a licence, not to grant a licence or in fact to come in and take over an independent health facility with no recourse of appeal whatsoever. The possibility is very real that a Minister of Health could decide for whatever reason, including his or her own personal beliefs or political reasons, to revoke or not grant a licence without any accountability whatsoever for that decision.

Mr. Speaker: Does the member have a question?

Mr. Eves: The vast majority of health professionals--

Mr. Speaker: Question.

Mr. Eves: --across this province are aghast at granting such excessive power to the minister. Can the minister justify this power?

Hon. Mrs. Caplan: Mr. Speaker, to inform you and the members of this House, in the drafting of this legislation there has been ongoing and continuous consultation: consultation with physicians, with nurses, with health professionals and consultation as well with the regulatory colleges responsible for discipline procedures in this province.

I can assure the member that as this bill proceeds through the legislative process, we are all concerned that the basic principles of this bill, which the bill was designed to achieve, should be responded to as we proceed through the legislative process, as I just mentioned.

He might find it interesting to note that this morning, at a seminar, the basic principles of this bill were supported and supported enthusiastically by members of the legal profession and by members of the health professions.

I look forward to that debate. I believe this is an important piece of legislation in the health history of this province.

Mr. Eves: I do not know where the minister is getting her information, but she must be very selective in whom she listens to about what happened this morning, because in fact there are some very real concerns among all kinds of health care providers and on the legal aspect with respect to this particular piece of legislation. A couple of things the lawyers are concerned about are the points I just mentioned to the minister a few moments ago.

Mr. Speaker: The supplementary?

Mr. Eves: A third thing they are concerned about is that currently, under the Health Insurance Act, the Ontario health insurance plan covers all services rendered by physicians that are medically necessary. A complementary amendment in the Independent Health Facilities Act would amend this to read, “Such services...as are prescribed by the regulations.”

What this means is that the Ministry of Health will now determine what is medically necessary, not physicians or medical professionals. Quite frankly, it scares me--

Mr. Speaker: The question?

Mr. Eves: --to think that bureaucrats and not medical practitioners will now be determining what is medically necessary for patients. Will the minister withdraw this complementary amendment and ensure that all necessary medical services will be paid for by OHIP for the citizens of Ontario?

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Hon. Mrs. Caplan: The intention of this act is clear. I think the principles of this act will be debated over the course of the next few days, and I look forward to that debate in this Legislature, so that the final product will in fact achieve the objective of the act.

The objective of the act is to ensure that we have the same quality assurance and patient confidentiality presently available in hospital in community-based facilities and independent health facilities. We want to make sure we have a legislative framework that will allow us to fund insured services in this province in a manner which will allow for appropriate and good planning with the involvement of district health councils, and that we will have a system in place that will respond to the needs in the future as well as the needs we see today.

I want to thank the member for his question, because I believe that this legislation, the Independent Health Facilities Act, is indeed an important step as we proceed to make the changes necessary in Ontario health care.

RETAIL STORE HOURS

Mr. Philip: I have a question for the Premier. This morning, the Coalition Against Open Sunday Shopping held a media conference in this building. This group represents some three million Ontario residents. It claims that it has been trying to get a meeting with the Premier since March 21 and all to no avail.

Why is the Premier so afraid of the representatives of some three million residents of this province that he is refusing to meet with this group to allow it to present its views to him on Bill 113 and Bill 114?

Hon. Mr. Peterson: I am very happy to meet with anybody, but there are the representatives of nine million people in this Legislature. Let’s debate it in this Legislature.

Mr. Philip: Of the more than 300 submissions before the standing committee on administration of justice, 95 per cent were opposed to the local option which is the principle of Bill 113. Recent polls have shown that a majority of the population of this province is opposed to this legislation the government is trying to ram down the throats of the people of Ontario.

Why is the Premier not prepared to withdraw the legislation, meet with the various interest groups he has refused to meet and introduce legislation which is acceptable to the people of Ontario instead of this legislation, which is clearly not?

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

Hon. Mr. Peterson: I say without fear of contradiction that we have endless meetings. The Attorney General (Mr. Scott) has met, the Solicitor General (Mrs. Smith) has met, the member has met, the committee has met. My honourable friend speaks about polls; I would have thought that would be the last thing my honourable friend opposite would want to believe in today.

Interjections.

Mr. Speaker: Order.

METROPOLITAN TORONTO HOUSING AUTHORITY

Mr. Harris: I would like to know if the Minister of Housing approves of a government of Ontario appointee to the Metropolitan Toronto Housing Authority board of directors intentionally turning over internal MTHA documents to a private company for its benefit while that company is involved in the tendering process for a Metro Toronto Housing Authority contract?

Hon. Ms. Hošek: It is up to the board of the Metro Toronto Housing Authority to indicate what the guidelines for appropriate behaviour are for other members of the board. If there are any concerns about that, I think the board can resolve them internally.

Mr. Harris: Does the Minister of Housing, who is responsible for these appointments, who is responsible--surely she would agree--for the Metro Toronto Housing Authority, who is responsible for housing decisions that are being made in this province, approve of that type of action by a provincial appointee?

Hon. Ms. Hošek: Let me clarify again for the member. The members of the Metro Toronto Housing Authority are appointed by three levels of government. Some are appointed by the province, some are appointed by the federal government and some are appointed by Metro Toronto. It is up to the board to work through what the guidelines are for them. It is up to the board members to come to a conclusion together about how they wish to proceed and what appropriate guidelines for behaviour are.

INTERNATIONAL TRADE

Mr. D. R. Cooke: My question is to the Minister of Industry, Trade and Technology. The minister will no doubt be aware of the conclusions and recommendations of the standing committee on finance and economic affairs, which spoke to the federal government’s proposed Canada-US free trade agreement and the future of world trade.

The committee concluded, among other things, that the movement towards an internal European market by 1992 and the current General Agreement on Tariffs and Trade negotiations, which are culminating in significant mid-term reviews in Montreal this December, raise important international trade issues for Ontario and require that the provinces be fully involved in the process.

The committee recommended that Ontario continue to make greater efforts to diversify our trade opportunities, thereby rejecting the federal government’s overreliance on the North American market under free trade.

Can the minister assure the House that the provinces will be fully involved in the midterm review in Montreal?

Hon. Mr. Kwinter: I am sure members of the House will be pleased to know that I have been invited by the federal government to be an official observer at the GATT midterm discussions which are taking place in Montreal December 5.

Before the meetings, we will also be meeting with my provincial counterparts and with the federal minister to make sure they are fully aware of Ontario’s concerns in the areas of agriculture, natural resources, services and any other areas that could impact on Ontario’s economy.

Mr. D. R. Cooke: Recently the Premier of the länder of Bäden-Württemberg in the Federal Republic of Germany, the Honourable Lothar Späth, visited with the minister, the Premier (Mr. Peterson) and other Ontarians as part of a follow-up of a memo of understanding between our two provinces. At the same time Bäden-Württemberg’s trade minister was travelling to Louisiana and Kentucky.

As the minister knows, the finance committee noted in its final report that under the proposed free trade agreement, if the federal government’s trade deal were to be implemented, southern US jurisdictions, with their less stringent labour rules and lower social security costs, might seem more attractive than Ontario for investments such as Bäden-Württemberg is considering.

Can the minister assure the House that efforts to strengthen ties with Bäden-Württemberg will be an important aspect of Ontario’s efforts to diversify our trade?

Hon. Mr. Kwinter: I am sure you know, as all members should know, that we are twinned with Bäden-Württemberg and we have a relationship which I think is going to be to our mutual benefit.

Premier-president Lothar Späth was here last month. He reaffirmed his commitment to strengthening the ties between our two jurisdictions. My colleague the Minister of Colleges and Universities (Mrs. McLeod) led a Premier’s Council committee to Bäden-Württemberg. We are looking at a program which will exchange scientists, engineers and technicians, and I am convinced that we will both benefit from this initiative.

NURSING HOMES

Mr. Reville: My question is to the Minister of Health. A previous Minister of Health made much of the government’s commitment to requiring nursing home operators to file detailed financial statements and to post those statements in nursing homes.

On May 25, 1987, when we had third reading of that bill, the minister said, “We will be working very hard with respect to the development of regulations to further enhance our ability to deal with difficulties.” We still do not have any regulations and that makes us wonder what the government means when it says it is working very hard. Where are those regulations?

Hon. Mrs. Caplan: I think the member knows that the new Nursing Homes Act has gone a long way to ensure that residents of nursing homes actively participate in the quality-of-life provisions in those homes. I want him to know that I am committed to the principles of that act. I am aware that there are regulations which are under review at the present time within the ministry.

Mr. Reville: I asked this exact question in June of this last year so the minister could have a head start on getting on with some of his very serious work. As we can see, nothing has been done.

The minister may remember that the need for these financial disclosure statements is based on allegations which Concerned Friends of Ontario Citizens in Care Facilities and others have made that in private nursing homes residents often go without proper food and that, in fact, the delay in producing these regulations is continuing to put at risk the very people the minister claims to be so concerned about. I would like today to hear a date from the minister as to when we can expect to see those regulations. We have already lost the opportunity to see what the financial year was in 1987. Are we going to miss it for 1988 as well?

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Hon. Mrs. Caplan: I want to assure the member that I take very seriously compliance with the Nursing Homes Act. If he or anyone else in this House has any allegations of wrongdoing in the nursing homes or contraventions of the act, I would ask that he notify me so that I can have the inspection branch investigate. I want him to know that it is my understanding that, in fact, postings are occurring. It is also my pleasure to inform him that the drafting of regulations is ongoing and is presently under review by the ministry.

Mr. D. S. Cooke: And you expect people to have confidence in the new Minister of Health with that kind of dumb answer? That’s really dumb.

Mr. Speaker: Order. I did not recognize the member for Windsor-Riverside.

CHILD CARE

Mrs. Marland: My question is to the Minister of Community and Social Services. The minister will recall that on October 24, 1988, my colleague the member for London North (Mrs. Cunningham) asked him about progress on the release of his promised discussion paper on a new Day Nurseries Act. In response to that very legitimate question from my colleague, he made some reference to a lack of staff in his ministry.

The minister promised this discussion paper in his New Directions for Child Care. He promised it for the fiscal year 1988-89. Can the minister tell us the progress of this paper and when he anticipates its release?

Hon. Mr. Sweeney: My recollection of my response to that previous question was to the effect that, given the number of other initiatives we are working on at the present time, we have not spent as much time on the new legislation as we would like.

My second recollection is that within our New Directions document, which came into effect just a year ago, we would have the new legislation by the end of the first three-year period, which would be 1991 if I am not mistaken.

Mrs. Marland: The minister did say the prime reason was human resources and that he had been under “severe...criticism.” I am quoting his answer from Hansard.

I was very pleased this morning to participate in the Ontario Coalition for Better Child Care’s meeting in the Ontario Room. As the minister knows, the issue of availability of subsidized spaces is a serious one and was the subject of some discussion at this morning’s meeting. I could review the waiting list for the minister, but the thrust of my question on the Day Nurseries Act is not simply dealing with the problems of quantity; this question relates to quality.

While we grapple with the issue of quantity of spaces, I do not think we can let the issue of quality of service slip from the table. Will the minister give this House his assurance today that he will release either the discussion paper he promised or a draft of the Day Nurseries Act before we rise this Christmas?

Hon. Mr. Sweeney: I really wish I could say yes to that question, but I cannot, given the time line that the honourable member has defined for us. What I will clearly say to the honourable member and to all members of the House is that I would like this particular piece of legislation to be handled in a way similar to the Child and Family Services Act, where in fact a draft proposal was made available to all who were interested. We would have a series of hearings so that people could react to that draft proposal before the final legislation was put together.

I will certainly give her that commitment. If I am still minister at that time, I will give her that commitment, but I cannot give her that commitment prior to December.

I would also like to comment on the point that the honourable member made with respect to the element of quality, and that, again, is something that I tried to stress this morning. It is one of the things we have clearly said, along with new licensed spaces, along with additional subsidies, along with improving wages, that the quality and the legislation that is going to back up that quality are an essential component, and that has to be done as well as the others. The honourable member is right. The quality and legislative component is not a matter of numbers.

PROPOSED LANDFILL SITE

Mr. Elliot: My question is to the Minister of the Environment. Reclamation Systems proposes to site, build, own and operate a solid-waste landfill facility in the United Aggregates Ltd. quarry near Acton. This proposed facility will accept municipal wastes and industrial nonhazardous solid wastes from an area that potentially may be province-wide.

Local citizens, along with Mayor Russ Miller and the local council of the town of Halton Hills, are opposed to this proposal. Can the minister assure the citizens that this proposal will be subject to the Environmental Assessment Act?

Hon. Mr. Bradley: I am aware of this proposal, although it is not one that has specifically reached my desk. I can assure the member that of course it would come under the Environmental Assessment Act and the full provisions of the Environmental Assessment Act.

I believe that our ministry officials have said at every public meeting that, in fact, this would be evaluated through the auspices of the Environmental Assessment Act. It is my understanding that the proponent is currently developing his draft environmental assessment document and that it is following the environmental assessment process. I know that has been a concern of the people in the area, the specific municipal officials, and of the member, of course, for Halton North. I give him the assurance that that will be the case.

Mr. Elliot: Local residents also want to ensure that the environmental assessment process is as detailed and thorough as possible. In particular, they are inquiring as to whether or not the level of detail required in an environmental assessment for a private proposal such as this one is adequate to protect the environment. Can the minister assure the House that a private company will have to meet the same requirements of the Environmental Assessment Act as municipal bodies do?

Hon. Mr. Bradley: If the case proceeds, for instance, to the Environmental Assessment Board, it is a requirement that they meet all of the details of the Environmental Assessment Act. When the board looks at these, it determines what has happened within a municipality. For instance, as the member would be aware, Halton has been involved in a very lengthy process at the present time and has two sites before the Environmental Assessment Board in a hearing. I would expect that that hearing will be over in the not-too-distant future and that the decision will be rendered when the Environmental Assessment Board has taken everything into consideration.

But in regard to this, that aspect of what has already been going on in Halton would be taken into consideration. They would also have to look at virtually every aspect of their proposal that they put before the board to satisfy the board. If they were not satisfied that they had gone through all the necessary procedures, then the board would very likely not look favourably upon any such proposal.

POST-POLIO SYNDROME CLINIC

Mr. B. Rae: I have a question to the Minister of Health. Last week I got a call from Anna-Marie Kennedy, who is 62 years old. She had polio in the 1950s, and her legs have been getting weaker all the time. The only facility that helps patients who have had polio and who have now something called post-polio syndrome is a clinic that operates out of the West Park Hospital, which happens to be in the constituency that I represent.

There is a long waiting list. It is the only facility of its kind in Canada. It applied to the ministry back in July 1987 for an operating grant of $200,000, which would allow it to stay open full-time on a yearly basis. I wonder if the minister can tell us what she intends to do to make sure that this clinic, which, as I say, is the only one of its kind in Canada, is, in fact, allowed to operate on a full-time basis?

Hon. Mrs. Caplan: I am aware of the facility that the Leader of the Opposition refers to. I am aware that it was begun two years ago as a pilot project. It has never received funding from the Ministry of Health. It was funded from other sources on a pilot basis. It is my understanding that the evaluation has not been completed. They did apply to the Metropolitan Toronto District Health Council as a new program and were told at that time, I believe, that the application was being reviewed.

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Mr. B. Rae: This facility will close in March 1989--that is what they have told us--unless in fact they can get funding to operate full-time. We are not talking about a huge capital cost. It operates out of the West Park facility, which is a marvellous rehabilitation hospital, as I am sure the minister is aware. We are not talking about a huge cost; we are talking about $200,000 a year.

The concern I have about the district health council being the major source of the minister’s information is that this is not simply a district need, this is an Ontario-wide need, and I might say a national need. There is no other facility in Canada that provides for those people who got polio prior to the distribution of the Salk vaccine in the 1950s. There are literally thousands of polio victims who are now entering their 50s and 60s, in some cases their 70s. There are many, many degenerative problems associated with polio. This facility is ideally suited to deal with them.

I wonder if the minister could at least undertake that she will--what shall I say?--advance the review so that we are all aware well before March 1989 precisely how this clinic can operate, not on a part-time basis, as it now does, with a long waiting list, but full-time, so it can serve the very real demand that is out there in the community.

Hon. Mrs. Caplan: As I said, and for the information of the Leader of the Opposition, this clinic is not presently receiving ministry funding; it is being funded by the Ontario March of Dimes.

I can tell him as well that we have begun a research project in conjunction with this ailment. Some $100,000 in research grants have been made available to a physician looking at this very medical problem.

I can tell him that I will of course be willing to consider this, along with other new and expanded program initiatives that are brought to the attention of the ministry.

ROUGE VALLEY

Mrs. Marland: I have a question of the Premier. A few days ago I asked him what the government’s plans were for the Rouge, in view of the fact that the federal government had offered $10 million towards its preservation and the general plea from Scarborough and the people across the province for its preservation. The Premier said at that time, “it is the government’s intention, and always has been, to preserve the Rouge.”

When one speaks of the Rouge, we include the tablelands. Will the Premier confirm today what his government’s intentions are? Will he preserve the Rouge or just the Rouge Valley, and what is his definition of “preservation”?

Hon. Mr. Peterson: As I told my honourable friend last time she asked me about this, we are looking at that entire quadrant with respect to Seaton and a variety of other things, and when we have it all organized we will tell her all about it,

Mrs. Marland: I am very encouraged that when the government has it all organized it will tell us all about it, because my next question is: Will the Premier deny today reports that I have received indicating that his government, within the last few days, has been discussing plans for a housing development in the Rouge with the private land holders?

Hon. Mr. Peterson: I think I indicated our intentions to the member last time we discussed this entire matter. The Rouge is a very large area. Various people have different definitions of the outside boundaries, and I understand that as well; but, as I said, it is being discussed in the context of the entire quadrant. In terms of our long-term planning, lots of things have to be done, and when all that is completed we will present it to the member for her views.

TEACHER TRAINING

Mr. Adams: My question is for the Minister of Education. I understand that many hundreds of students are applying for a few tens of places in our faculties of education. I am concerned that we take full advantage of this situation to recruit only the best possible future teachers. It seems to me that a policy of simply accepting students with an average of, say, 85 per cent or more is not a good way of identifying teaching ability. What are we doing to ensure that we are accepting the best possible future teachers in our faculties of education?

Hon. Mr. Ward: The question the member raises is indeed timely. We are at a point in the history of this province when there clearly will be a need for hundreds of additional teachers, as enrolment has now ended a 19-year state of decline. We are now getting increasing enrolment, which will extend over the course of the next eight years. With the many new initiatives within our system, there is no question that the focus will be on our faculties of education and the need to produce quality teaching professionals.

Recognizing this quite some time ago, the government put forward a proposal for a teacher education review committee with representatives from the faculties of education, the Ministry of Colleges and Universities and boards of education as well as the professional teacher federations. The report of that committee is due in the very near future and, I am sure, will address many of the concerns the member raises.

Mr. Adams: I thank the minister for that. I am concerned about the quality of future teachers. He touched on it briefly. I do understand that in the next decade we are going to be facing shortages of teachers. What about the matter of quantity of teachers during the next decade?

Hon. Mr. Ward: Again, much has been said about a possible teacher shortage. I think it is important to note that the faculties of education in this province are still producing more teachers than the system can absorb in any given year.

Where the difficulties arise is in specific areas of specialty. Currently there is in fact a shortage of French-language specialists. We expect that with the many new initiatives that this government has undertaken in elementary education, we will have to cope with a shortage of some primary and junior specialists as well. My colleague the Minister of Colleges and Universities (Mrs. McLeod) and I are monitoring the situation very carefully and we are prepared to deal with the situation, through the faculties of education, should the need arise.

ONTARIO DRUG BENEFIT PLAN

Mr. Allen: I have a question to the Minister of Community and Social Services. Sharleen Girouard of Ottawa is in a life-threatening situation. She suffers from epilepsy, cerebral palsy and bladder and bowel disorders that require or entail $900 in monthly medical expenses. Despite assurances she was given when she married a husband who earned $1,142 a month, she was cut off disability assistance and lost her drug card. Now, even with emergency help, the Girouards are surviving on one meagre meal a day and going into debt at the rate of $228 a month just to keep her alive.

Will the minister not raise the income and asset ceilings that are necessary for drug benefit cards immediately and end the intolerable situation that these people are in? Why should Sharleen Girouard’s life be put in danger by the mere fact that she wished to get married to Mr. Girouard?

Hon. Mr. Sweeney: The current legislation dealing with income assistance requires the assets and the income of the entire family unit to be taken into consideration to determine whether a person could be eligible for assistance. When Mrs. Girouard got married, she became part of that larger family unit, and all of the assets and income of that unit were considered. That is the way the legislation is right now and that is the way it is applied.

However, there are two exceptions to that. The first one is, and I am sure the honourable member knows it, that there is a provision in our general welfare legislation for a person like Mrs. Girouard to apply for supplementary assistance at the local municipal level, which can be above and beyond what I just described. There is also a provision, through our ministry and through me as the minister, to apply for an order in council if there is an unusual set of circumstances that cannot be dealt with in any other way.

Finally, the honourable member may be aware of the fact that the Minister of Health (Mrs. Caplan) currently has a review going on with respect to the possibility of people other than those presently defined getting access to a drug card.

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Mr. Allen: If the Girouards have that access, then they have not been advised of it or their situation has not been improved. They have been given emergency assistance, but even so they are still in the situation that I described.

This is not a unique situation, as the minister probably knows, and I want to read briefly from the Thomson report, with his comments on the drug benefit situation and its problems.

“First...people”--as he says--”who leave social assistance are faced with a sudden loss of their drug benefits--functions for many as a disincentive to employment....Second, the working poor”--and this applies perhaps more to the Girouards’ present situation--”who do not qualify for special assistance can find purchasing necessary prescriptions extremely difficult if not impossible. As a result, the working poor may be worse off than social assistance recipients, who have drug benefit cards.” That is their situation.

Will the minister not put in place immediately the recommendation that has been made by Mr. Thomson, namely that the Ontario drug benefit plan be extended to low-income people who do not receive social assistance, particularly people like the Girouards who have higher-than-average drug costs?

Hon. Mr. Sweeney: The honourable member is certainly correct when he draws attention to Mr. Thomson’s report and his reference to the comparability between those who are on income assistance and those who, as he refers to them, are the “working poor.” That is perhaps one of the important contributions that report makes, among many others.

I certainly do not have any difficulty in accepting that premise. I would, however, repeat for the honourable member that the Minister of Health is currently reviewing the application of drug benefit cards to other than those who currently qualify for them. It would be my hope that at some point in time when Mrs. Girouard does not continue to get the kind of supplementary assistance that she is now getting, that a new program, in fact, would be in place.

POST-POLIO SYNDROME CLINIC

Mr. Eves: I have another question for the Minister of Health, taking up on the question that was asked by the Leader of the Opposition (Mr. B. Rae) a few moments ago about the post-polio clinic at West Park Hospital. The minister will be aware that there are an estimated 5,000 postpolio patients in Ontario. If this clinic--which, I grant it, up to now has operated as a pilot project on private funding--is forced to close down at the end of February, 1989, in a few short months, these patients are going to have to go to the United States of America and elsewhere for treatment and, in return, the Ontario taxpayer and the Ontario health insurance plan are going to end up paying for the cost of treatment elsewhere.

Would the minister seriously consider whether it would not be more beneficial, both for the taxpayers of Ontario and, most important, for the post-polio patients, to have them treated here by a clinic that has proven itself to be successful right here in Ontario?

Hon. Mrs. Caplan: I want to assure the honourable member opposite as well as the Leader of the Opposition that, in fact, those are the kinds of criteria that we will be taking into consideration when we look at new or expanded programs and that this is one of the programs that we will consider at that time.

Mr. Speaker: That completes oral questions and responses.

PETITIONS

CHURCH OF SCIENTOLOGY

Mr. Fleet: I have a petition which has been signed by approximately 230 people, mostly in Ontario, about five of whom live in my riding. It says:

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

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

“Whereas the crown in the province of Ontario continues a lengthy, futile and expensive prosecution against the Church of Scientology; and

“Whereas at no time in recorded history has an entire church been charged with a criminal offence for the actions of individuals, and freedom of religion in the province is at risk; and

“Whereas the alleged offences occurred over a decade ago and those responsible have been expelled from the church or rehabilitated,

“We petition the Attorney General and the government of Ontario to withdraw the charges against the church and end this prosecution.”

Mr. Beer: I have a petition which is similar to the one just presented, signed by some 300 members of the Church of Scientology; and I will dispense with the reading of it, as it has already been read out.

MOTIONS

ESTIMATES

Hon. Mr. Conway moved that, notwithstanding any previous order of the House, in the committee of supply, the estimates of the Ministry of Health be considered for 13 hours following the estimates of the Ministry of Government Services.

Motion agreed to.

COMMITTEE SUBSTITUTIONS

Hon. Mr. Conway moved that the following substitutions be made: on the standing committee on regulations and private bills, Mr. Leone for Mrs. Stoner; on the standing committee on resources development, Mrs. Stoner for Mr. Leone.

Motion agreed to.

ORDERS OF THE DAY

INDEPENDENT HEALTH FACILITIES ACT

Hon. Mrs. Caplan moved second reading of Bill 147, An Act respecting Independent Health Facilities.

Mr. Speaker: Would the minister have any opening comments?

Hon. Mrs. Caplan: It is well recognized that in this province we have one of the finest health care systems in the world. To maintain excellence, we must plan for change and we must be prepared to adopt and adapt for future needs and priorities.

We have seen and we continue to see in this province the development of new health professions, expanding roles for traditional care providers and we see new advances in health promotion and disease prevention. These changes have been accompanied by what can only be described as a massive technological explosion in health care sciences. In recent years, there have been major breakthroughs in drug therapies and surgical procedures. We have witnessed a continuing revolution in diagnostic services and equipment, and sophisticated new techniques in patient care and assessment are now commonplace. As a result of these developments, concerns are being expressed about how to meet future health and health care needs.

I believe the Ministry of Health has a responsibility to show leadership in directing these currents of change, leadership that will result in effective health care for the people of this province. It was with this objective in mind that last June I introduced the Independent Health Facilities Act. Today I am moving a motion that Bill 147 proceed to second reading by this House.

The Independent Health Facilities Act will allow our province to regulate and develop community-based health facilities where many of the medical services usually carried out in hospitals may be performed. This act is part of my ministry’s commitment to improve both the level and quality of health care in Ontario and to create a positive shift in the way health services are offered and provided to the people of Ontario.

During the past year, I have travelled extensively throughout this province. During my travels, I made a point of bringing together district health council members, hospital boards and other providers of care. I did this because, to my mind, the whole range of health services in any given community or district must be seen as inter-related and interconnected, as a part of the continuum of care that we offer.

I have had the opportunity in many communities to discuss my vision, my vision of the future, and that vision for the future is this: equity of access to effective, quality health care, the very best that we can afford, as close to home as possible. I believe from discussions I have had in communities throughout the province that this vision is widely shared.

If we are to realize this vision, then we must begin now to create the positive shifts that will move us in the direction that we want to move, and in a planned, orderly and rational fashion. The decisions we make over the next five to 10 years will be crucial ones for the health care future of this province.

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Health care as we know it today is being challenged by economic, demographic and technological forces, three irresistible forces for change, forces for change that demand we come up with new answers: how to manage our precious health resources with the finances available to us, how to provide care and support for our growing elderly population and their needs and how to use, and use effectively, the great technological advances that are now available to us. These are the challenges our government is addressing.

With the great variety of talents and abilities available to us in this province, I believe we have an obligation to the people of Ontario to point the way to a compassionate health care future. The creation of the Premier’s Council on Health Strategy reflects our government’s commitment at the highest level to bring thoughtful, planned and managed change to the way health services are provided in this province. We also have the benefit of three recent studies, the Evans, Spasoff and Podborski reports, that give us a blueprint for future priorities.

Three basic assumptions underlie each of these documents: (1) health services must be more closely focused and integrated at the community level with more co-operation among care providers, care facilities and the professions; (2) health is understood not to be just the absence of disease, but the whole state of physical, mental and social wellbeing, and (3) good health means not only access to good health care, but reaches out to include such areas as housing, social services and environmental protection.

As we now move forward with this plan, it is important to recognize that we have already taken major steps during this time of transition to realize our vision of the future. Last year, Ontario’s nursing home legislation was amended and new funding arrangements with nursing homes were agreed upon. With these actions, the rights of nursing home residents were enshrined in law, nursing homes were made strictly accountable for their financial affairs, staff training and development were strengthened and the quality of care for nursing home residents was improved.

This past summer, the Premier (Mr. Peterson) made the commitment to see a doubling of the number of people served in community health centres and health service organizations in this province. Recently, I was pleased to announce four new community health centres will soon be opening. Before the end of the year, I expect to receive the proposals of the health professions legislation review, proposals for a new omnibus bill that will expand the number of self-governing health professions, effectively regulate the scope of practice for each profession and make the professions more accountable to the public they serve. Indeed, the overall objective of the health professions legislation review is to provide greater protection to the public interest.

The Public Hospitals Act was also recently amended to make utilization committees mandatory in all hospitals in Ontario, so that hospital resources will be used more effectively and the quality of care improved for patients. To assist Ontario hospitals improve their quality assurance procedures, the Ontario Hospital Association, the Ontario Medical Association and my ministry have jointly co-operated to produce the Guide for Hospital Utilization Review and Management in Ontario, which was published in mid-October.

Further regulatory changes will be undertaken to clarify the roles and responsibilities of hospital boards and administrators and to provide greater management involvement for health professionals, especially nurses. I should point out that the recommendations of the Advisory Committee on Nursing Manpower recently cited job satisfaction as being one of the principal issues facing the nursing profession.

Most important, we intend to move ahead with a full examination and review of the Public Hospitals Act to give Ontario hospitals a modem legislative framework, a framework that reflects their operating environment, the mix of professions and technical staff in the modem hospital setting and the types of care hospitals are expected to provide.

I believe we are well on the way to realizing a new vision for health care in this province and I believe the Independent Health Facilities Act is one of the key building blocks in achieving our goal. This proposed legislation is a pioneer effort being undertaken in Ontario. It represents the first legislative approach in Canada for the comprehensive provision of community-based health care services.

During the framing of the Independent Health Facilities Act, there have been extensive consultations with physicians, nurses, hospital administrators and others. Consultations on the new legislation are continuing. Today, the Canadian Institute of Law and Medicine, an organization of representatives from major health provider associations and the legal community, is meeting in conference to discuss the bill with nearly 400 participants registered. I understand that during this morning’s session there was a uniform endorsement of the principles behind this legislation.

In bringing this legislation forward, we have three broad objectives: to develop a more community-based health care system to ensure that patients receive quality medical care as close to home as possible; that the procedures are carried out in a safe, effective manner; and to regulate facilities so that they are appropriately located and established in a planned way.

One of the great advantages promoted by this legislation is that patients will be able to undergo many surgical and investigative procedures without being admitted to hospital. With continuing advances in technology, the number and types of procedures able to be performed in community settings will only increase.

While this legislation lays the groundwork for enhanced community-based health care, our objective is to complement, not to de-emphasize, the role of hospitals. What we want to see is the freeing up of hospitals to do what they do best: provide the patient care and the patient care services that require a hospital setting.

Before any community facility is licensed, however, there must be a demonstrated need for the service or for the range of services to be provided. The usual procedure in applying for a licence will be as follows: A local district health council, community group or medical group will define a need and recommend to the minister that a facility be established; or the ministry may identify a need and then ask one or more of the district health councils to respond with recommendations. If after review the minister agrees that health care and the public interest criteria have been met by the recommendation, the ministry will issue a call for proposals which clearly set out the type of services to be offered. District health councils will review the proposals received, rank the order of priority and make recommendations to the minister. The minister will then choose a proposal based on merit, and the successful applicant will develop the facility.

I should point out that this legislation clearly specifies that in granting licences for community-based facilities, the ministry will give preference to Canadian and not-for-profit groups.

Let me address this last point for just a moment. Every member in this House recognizes that Canadians and all Ontarians feel strongly about universal health care. We are proud, indeed we might say even possessive, about the quality and the level of health care available to everyone in this province, available without regard to a citizen’s financial or economic circumstances.

Canadians have proved to the world that government-funded health care can be successful and equitable. We have built a national consensus in this country that health care is not just another commodity to be traded in the marketplace. We believe health care is an essential resource that is vital to the wellbeing of our society.

In maintaining a market model for health care, our American neighbours have done so at a tremendous cost. Today, US health care costs are far higher than they are in Canada: 10.8 per cent of its gross national product versus Canada’s 8.6 per cent. Yet we see gross deprivations in care for much of the US population and the threat of financial bankruptcy in the event of catastrophic illness. The Ontario government is determined to protect our uniquely Canadian way of health care delivery.

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In granting licences to facilities, the ministry may enter into a variety of funding arrangements. For example, facilities may be funded on a global basis with operating costs, professional fees and medical equipment purchases included; or the ministry may agree to pay a facility fee--in other words, the overhead and operating costs of providing a service--while leaving the physicians free to bill the Ontario health insurance plan for their professional services.

With respect to the issue of quality assurance, the act requires any licensed facility to establish an appropriate method for monitoring, in a manner acceptable to the ministry, the care and treatment it provides. The ministry is also empowered to designate assessors and inspectors to ensure quality of care. Both assessors and inspectors will be governed by the secrecy requirements of section 30 of the act as well as by the patient confidentiality provisions of the professional governing bodies to which they belong. Physician assessors, for example, will be subject to the regulations of the College of Physicians and Surgeons of Ontario. Nursing assessors will be subject to the regulations of the College of Nurses of Ontario.

I recognize that despite the stringent confidentiality provisions already contained in section 30, a number of concerns have been expressed about access to medical and facility records by assessors or inspectors. In response to these concerns, discussions are going on with the college of physicians and surgeons and will include the other regulatory colleges as well, so that inspection protocols and procedures will be developed to strengthen even more the patient confidentiality provisions of this legislation.

I look forward to our discussions as this bill moves forward through the legislative process. As we approach the 20th anniversary of universal health care in Canada, it is my conviction that we must once again rediscover the sense of determination, the political and social will out of which Canadian health care was created.

I believe the Independent Health Facilities Act is an important piece of legislation. It is important to make the best use of proven technology, to plan and manage more effectively the distribution of services, to protect our Canadian values in health care and, most important, to ensure high standards of effective quality care.

The Independent Health Facilities Act gives us the opportunity to join together to usher in a new era of health care for our province. I hope this legislation will receive strong support from all members in this House.

Mr. D. S. Cooke: I am sorry I did not hear the entire speech of the minister, but it was my understanding, as we set the legislative agenda and discussed it over the last couple of weeks among House leaders, that the focus of this entire week was to be on the government’s legislative approach to free trade. Certainly I am astounded that the minister has gone through her entire comments and made absolutely no reference at all to free trade and how this particular piece of legislation impinges on that issue.

I strongly suspect that what has happened here is that the government has reviewed this piece of legislation, plus another bill that we are going to be dealing with later this week--the legislation that authorizes the exportation of water, even though the government says it is a bill to stop the exportation of water--and has found the same kinds of difficulties with this legislation. I would like the minister to respond specifically to that concern.

I would also like to ask the minister specifically what effect this bill is going to have on the privatization of health care across this province. One of the major concerns many of us have had is that what this bill really does is to regulate and then accept privatization in our health care system, which we have seen in the nursing home field. There is absolutely no financial accountability at all. As soon as the government got its majority, it decided not to proceed with the financial disclosure of profit-and-loss statements, which was approved by the Legislature over a year ago in the amendments to the Nursing Homes Act. We have some very real concerns and people in this province who want to see health care in the not-for-profit sector have some very real concerns that I do not think have been set aside or settled by the minister’s comments or by this piece of legislation at all.

Hon. Mrs. Caplan: In my opening remarks, and also in previous discussions in this House, I have stated very clearly that the government of Ontario is determined to protect our uniquely Canadian way of delivering health care services. I have stated very clearly and the legislation states very clearly that, notwithstanding any federal trade agreement, we would show preference for nonprofit Canadian proposals as we move forward with the Independent Health Facilities Act.

Mr. Reville: I want, first, to acknowledge that this is a special moment for the minister. I believe this is the first piece of legislation she has carried for the government in her capacity as Minister of Health. I believe as well that it may be the first piece of legislation she has carried since she has been a minister of the crown. It must be an exciting and fascinating experience for her and, as I think about the process through which this piece of legislation will go, the minister will no doubt have an opportunity to grapple with some of the concerns people will express about the legislation, and perhaps will see fit to introduce a number of government amendments thereto and to entertain amendments that will surely be put by me and, I expect, by my colleague the representative of the Progressive Conservative Party.

That brief, friendly kind of comment having been dispensed with, let me now become mean and vicious and begin to shred Bill 147 into the very tiny pieces it should be shredded into.

The minister has talked about a new era of health care and, of course, we have heard over and over and over again from this Liberal government, not only in the 33rd Parliament but to date in the 34th Parliament, that we are entering a new era of health care in the province and that this is the government that will take us there and begin to change some of the ways in which health care has traditionally been delivered, which traditions are under severe attack, mainly by this government.

The minister has also said, as she leaves the chamber, that she looks forward to our discussions as this bill moves forward through the legislative process. Mr. Speaker, I hope you will forgive me if I suggest that I think it is entirely possible that this is the last day on which we will ever discuss this bill. It may be unknown to you, but the bill is not scheduled for further discussion this week, nor do we have any indication that it is going to be scheduled for discussion at any other time. Even if it were to be scheduled for discussion, in any event we do not imagine that this bill will be dealt with in public hearings before February or March, and it clearly will not be back in the Legislature until the spring session.

If past performance gives us criteria by which to judge this government, and being mindful of the fact that the minister has said that further regulatory changes will be undertaken, and being mindful of the fact, as well, that Bill 147 will involve stacks of regulations, let me predict that, supposing this bill were to pass some time in May 1989, then in November 1990 I would be standing in the House asking the Minister of Health where the regulations to go with Bill 147 are, because that is precisely the experience we have had with respect to the Nursing Homes Act, passed in May 1987. Here we are in November 1988: not a sign of the regulations anywhere to be found.

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It is called a pioneering piece of legislation. I suppose it is a pioneering piece of legislation. There is indeed no legislation like this anywhere in Canada, and I certainly hope there never will be, because it is a very vague piece of legislation that purports to do a lot of things that we cannot imagine it will really do.

In fact, I think it is possible that this is not a pioneering piece of legislation but is, in fact, an old trick that is often employed by governments, has often been employed in the past and, I guess, will be employed often in the future. For various kinds of time-limited political reasons, a piece of legislation will come forward, there will be lots of huffing and puffing about it, there will be trains of rhetoric attached to it and then, once that moment passes, it will never be seen again. In fact, the train of rhetoric will just chuff off into the horizon and we will all wonder where it went.

Clearly, the time-limited event that is important in this connection, and may be behind the government’s decision to introduce this piece of legislation, is the national debate that is under way about what kind of economic relationship this country wants to have with the United States. This is one of the alleged anti-free-trade bills that the government of Ontario has tried to bamboozle the citizens of Ontario into believing is a serious defence of Ontario’s interests against the Mulroney-Reagan free trade deal. I submit that if this is what we are counting on for our defence, we are in a lot of trouble.

In addition to suggesting that this will preserve our uniquely Canadian health care system, the government has suggested that the bill is necessary to ensure community-based health care. I cannot see any evidence that that is the case. In fact, I think the minister often confuses the geographical location of a particular facility with a much more emotional, organizational and ideological meaning of the word “community-based” that cannot be described by merely saying a facility is located in the community on a particular street. That clearly is not what “community-based” means. “Community-based” means that the community has a role in shaping the thrust, objectives and mission of a particular facility. Merely moving a facility out of a hospital and on to my street does not make that a community health centre; that makes it a hospital on my street.

Having said that, I do not think Bill 147, An Act respecting Independent Health Facilities, challenges the free trade agreement; I do not think Bill 147 ensures community-based health care; I do not think it provides an expanded role for community health centres and health service organizations; I do not think it ensures the provision by nonprofit operations of health care; I do not think it ensures access to abortion services; I do not believe that it results in the better use of health care resources, which makes you wonder what it does at all.

I notice that some pages were nodding, wondering themselves what this bill is going to do.

Mr. D. R. Cooke: They’re nodding off, David.

Mr. Keyes: They’re nodding because of your speech.

Mr. Reville: Oh, no. The pages we have here are so polite, they would manage to keep their eyes open even while sound asleep, and you should too.

Mr. D. S. Cooke: They get docked pay if they don’t.

Mr. Reville: That is right.

I just wanted to take members of the Legislature on a little trip down memory lane for a moment to indicate why I have real doubt about the government’s real interest in seeing this bill move forward, and perhaps to compare a previous government’s activity in health legislation with the current government’s activity. It really is quite dramatically different. Some of the members I see in the Legislature this afternoon will indeed remember most of this and a couple of them will not because they were not here then. This will be helpful to them.

If you ever have a chance, Mr. Speaker, you might want to refer to your indices that describe the legislative program undertaken during the 33rd Parliament. In fact, there is this handy section right at the front of your index that describes the government bills, private bills and private members’ public bills. One can see that during the accord period, that period of pioneering, if you will, which some of us will probably not undertake again and some of us may not have an opportunity to undertake again, that in fact there was quite an aggressive legislative program. That, of course, was because there was an actual written document that committed the government to introducing legislation to deal with a number of identified problems in a number of identified areas.

Of course, the most dramatic piece of health legislation that this province has seen for many years was Bill 94, An Act regulating the Amounts that Persons may charge for rendering Services that are Insured Services under the Health Insurance Act, sometimes called the Health Care Accessibility Act. That was one of the key items in the accord that was signed by the New Democratic Party and the Liberal Party of Ontario for action within the parliament.

That bill was introduced and debated for a very long period of time over the first year of that very unusual parliament and it was finally passed into law in June 1986 after an all-night debate. My colleagues and I immediately travelled to Hamilton, flushed with victories that we do not see repeated often enough-although we were quite cheerful about the victory in Welland-Thorold on Thursday; we look forward to lots more byelections to keep our string running. In fact, this Legislature did pass Bill 94, getting rid of extra-billing. We happened to be having our biannual convention at the time, and it was an amazing feeling for me, and I know for my colleagues, having fought against extra-billing for many years, finally to have achieved the end of extra-billing. But let me tell members what then happened.

We passed the legislation. We finally dragged the Liberal government, kicking and screaming, into the 20th century so that it abandoned its policy of saying that extra-billing was a safety valve and finally agreed that it was something that should stop. We find that the 34th Parliament sees a much less aggressive government and a much less aggressive Minister of Health, so that more than two years later, the minister is finally saying the doctors who do extra-bill will finally be called to account for that.

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To talk about a new era of health care, would you not know that in the meantime a new invention has arrived? The new invention that has arrived is called the administrative fee, where a significant number of physicians are requiring that their patients plunk down cash to pay for “uninsured services.” We have heard time and time again from the Ministry of Health and its succeeding ministers that they were going to deal with the question of administrative fees, they were going to take this up with the Ontario Medical Association and do something about it. Of course, nothing has been done about it.

There was another interesting health initiative. This was not an initiative that was encouraged by my party, but it was something that came forward during the 33rd Parliament. Those were Bill 54, An Act to Authorize and Regulate the Payment by the Minister to Specified Persons on Behalf of Specified Classes of Persons for the Dispensing of Specified Drugs, and Bill 55, An Act to provide for the Protection of the Public in respect of the Cost of Certain Prescription Drugs.

Those bills were given royal assent during the second session of the 33rd Parliament and at the end of a very long series of public hearings, through which my colleague the member for Windsor-Riverside (Mr. D. S. Cooke) sat transfixed and which I was able to join on a number of occasions, in which the messiest and sloppiest piece of government legislation that had been seen in these environs for many years was put on the table. It involved literally hundreds of government amendments to Bills 54 and 55 because they were such sloppy draftspersons.

The final upshot of those two pieces of legislation is that, among other things, the cost of dispensing fees has gone through the ceiling. Basically, what the government did to protect the taxpayers of Ontario was to tell pharmacies that they could charge virtually anything they wanted to dispense a prescription, so we are now getting stories of a drug that has the value of 17 cents being dispensed at a dispensing fee of $9.50, so that the total prescription cost is $9.67. This is the consequence of Bills 54 and 55.

The pharmacist is indeed required to post the dispensing fee, and I am sure you have seen this with your own eyes, Mr. Speaker: There is a kind of little cubicle behind which the pharmacist stands and there are all sorts of things kind of stuck up on the walls of the cubicle, advertisements for valium and birth-control tests and what not, and somewhere in among all this paper is the dispensing fee noted. The requirement on the pharmacist is to post this fee, but it does not have to have any relationship to what some kind of reasonable cost would be.

Mr. D. S. Cooke: It is for all the counselling they provide.

Mr. Reville: Yes. It is interesting the counselling they provide when they actually hand over a prepackaged medicine and then hook somebody $9.50 for that pleasure.

Anyway, those were Bills 54 and 55 and we were really glad when that process was over, but we certainly were not happy about the result, because it was a very unfortunate result for the people who are buying drugs.

Of course, if one wanted to undertake an initiative in respect to drugs in Ontario, it would not have been to worry about what the best available price was but to worry much more about who was being prescribed what and why people in Ontario are overmedicated to an extent that is unparalleled anywhere in the world. Of course, the response to that concern has been yet another commission that will report, I am sure, in a year or so. All the while, of course, the government could have been taking action on the recommendations made by its own advisory committee, the Drug Quality and Therapeutics Committee, which the government carefully ignores.

There were a number of legislative initiatives in respect of the Mental Health Act during the 33rd Parliament. In fact, were it not for the seriousness of that legislation and the potential impact of such legislation on people, one would have had to spend several months giggling--I was almost going to say maniacally, but perhaps in this context that would be inappropriate--but the behaviour of the government of Ontario in its work on the Mental Health Act was laughable in the extreme.

Members who were in the 33rd Parliament will remember that a major initiative of this government and all governments in Canada was to take a look at its body of legislation and to ensure that legislation was in conformity with the Charter of Rights and Freedoms, the federal legislation.

That was done in Ontario through Bill 7. The debate in this Legislature was centred on the question of sexual orientation and the Human Rights Code, but in fact the bulk of Bill 7, the vast majority of Bill 7, had to do with the Mental Health Act.

The reason there were so many amendments required to the Mental Health Act was that our Mental Act, prior to Bill 7, was extremely offensive to the Charter of Rights and Freedoms and consequently extremely offensive to the rights of individuals who live in Ontario.

My then colleague the member for Ottawa Centre, who regrettably is not with us any longer following an event on September 10, 1987, moved a great many amendments to Bill 7, not just respecting sexual orientation, although we were proud to move that amendment, but also respecting the rights of people who happen to find themselves labelled mentally ill and incarcerated in institutions in Ontario.

Those amendments were prepared with the assistance of civil rights advocates and lawyers and self-help groups and were not supported, I might add, by the government of Ontario but were supported, thankfully, by those now in the third party. At that time they were in the second party; I hope there is no connection there exactly.

In fact, when those amendments came forward to the Legislature for third reading, they were masked to some extent by the concern expressed in this Legislature about matters of sexual orientation.

Bill 7 was finally passed. At that point, a great shout of dismay went up. The shout of dismay was the shout of anguished members of the Ontario Psychiatric Association, who said, “Wait a minute; you can’t do such a thing. You’ve now tied our hands and you’ve tied our feet and we cannot in fact treat people in Ontario. You can’t allow Bill 7 to stand.”

This threw the government of Ontario into such a tizzy. You would not believe the scurrying around as the representative of the Ontario Medical Association appeared and, immediately, all the senior mandarins from the pink palace danced attendance on the representative of the OMA and draftspersons were set immediately to work. The scratching of the quill pens was deafening in Ontario following the passage of Bill 7, because the government began to introduce, in a frenzy of paper, bill after bill after bill to try to accommodate the concerns of about three psychiatrists who operate in the province.

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It was amazing, the kind of fearmongering that was undertaken by this government when the Minister of Health of that time stood up in this House and talked about thousands of people every month being subjected to forced treatment orders. He said the impact of Bill 7 would be to leave the hospitals clotted and clogged with untreatable people and perhaps people beating down the doors of the Legislature because they were not able to receive some treatment that somebody thought they should have.

So a number of bills were introduced. The government managed this exercise so badly that it had to keep reintroducing bills because the time lines in the bills were not appropriate. So we got, as I say, a flurry of legislation all dealing with one section of Bill 7.

The upshot of it was that Bill 190 did pass in the end, as well as a number of bills which were called, humiliatingly for the government, the mental health amendment amendment amendment act. We try not to crow too long or too loud about such things, but it really is tempting to wonder what kind of a government you are dealing with when you have to bring in a bill to change the date of the previous bill, which changed the date of the previous bill, even while a fourth bill is in public hearings and discussing very serious matters.

As it turned out, of course, again I am grateful that the government accepted a significant number of amendments which I had moved to Bill 190, so that we ended up with probably the best Mental Health Act in Canada, although that had not been the intention of this government in the beginning.

I have mentioned already another piece of legislation which received third reading on May 25, 1987. Of course, that was the Nursing Homes Amendment Act, a very large part of which was written by my colleague the member for Windsor-Riverside. Those were the days when, in fact, a good idea coming from a member of the opposition had some chance of finding its way into legislation because of the fortuitous arrangement of numbers around here.

The member for Windsor-Riverside was successful in getting a bill of rights put into the Nursing Homes Act and successful in requiring that act to require nursing home operators to file full financial statements, a matter about which I was questioning the minister just a bit earlier today in the question period show, and to which I got such unsatisfactory answers; notwithstanding that this minister and this government continually pat themselves on the back for having included a bill of rights for nursing home patients in the Nursing Homes Act when, of course, nothing could have been farther from their intention.

Basically, they were under a political hammer at the time. It was the intervention of the member for Windsor-Riverside, who was then a very brilliant Health critic for our party. He managed to convince the majority that a nursing home bill of rights was necessary. That is why we have one today.

There were a number of other pieces of health legislation, one of which was introduced by a member of the now third party. I think it was the then member for Rainy River who introduced the bill under the Health Protection and Promotion Act, according to which a person who would administer an immunization, give a shot to somebody, would have to actually advise that somebody what the risks entailed by such immunization would be. I think that was called Bill 52, if I remember rightly. I can certainly look it up because we want the record to be absolutely exact.

Yes, Bill 52, An Act to amend the Health Protection and Promotion Act. It got first and second readings in the first session of the 33rd Parliament and third reading and royal assent. It is not very often that we get a private member’s bill that gets royal assent around here. I am happy to say I have one but it was not about health; it was about something else. That was Jack Pierce. I think Jack Pierce was the member for Rainy River at the time.

In fact, the ink was not even dry on the signature of the Lieutenant Governor on this bill when the phone rang again. The phone rang in the pink palace and Hershell picked it up and, goodness gracious, it is Hugh Scully on the phone saying: “What have you done now? Look at this Bill 52. You have to change it.” Back again went the legislative draftspersons and those quill pens again began to kick up quite a racket because, of course, the government again had been asleep at the switch and it had to come back with another bill or Hugh Scully was going to have a temper tantrum. So we get yet another Health Protection and Promotion Act bill from the government that says much the same thing only in words that came from the silver lips and the golden throat of Hugh Scully. That was produced and passed.

However, in September, by regulation of the cabinet of Ontario, did it not suspend the guts of the very bill it was at such pains to have replace the previous bill? It suspended the section that requires the doctor in the nursing home to get consent and to provide information to the people of the nursing home if those people are not competent to make decisions.

Why was that? Because the phone rang in the pink palace and here was Harvey Nightingale saying: “Hershell, what have you done now? We have people in nursing homes and the doctors won’t give them a shot because they can’t be told what the dangers of this vaccination are. This is a terrible situation.” Hershell said: “Never mind. I will get the cabinet to suspend the regulations under this section of the Health Protection and Promotion Act so that everybody can have their shot and the doctors will not be guilty of an assault.”

Why is this necessary? Because this very same Minister of Health (Mrs. Caplan) who wants to take us into a new era of health care cannot get it together to deal with the whole question of substitute decision-making and mental incompetency. She has slowed down to a grinding halt the Fram report, the O’Sullivan report, the Manson report, the McKague report and the Weisstub report. Fortunately, I have only five fingers on that hand, Mr. Speaker, but do not worry, I have other fingers and I have toes. I can rhyme off some more reports for you double quick.

This same government, which cannot get it together to provide any regulations to require financial disclosure for nursing home operators, managed to put through a regulation under the Public Hospitals Act which I think is quite patently as idiotic as some of the other desperate stories I have been telling so far today. That deals with, again, the failure of this government to come to grips with the question of people who are vulnerable, who cannot make decisions on their own behalf, and the Public Hospitals Act designates the public trustee in a way which I do not think will stand up in any court, whether that be a court in Killaloc or a court here in Toronto. We will have to see what happens when these regulations get their test.

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I think that is probably enough history of health legislation. I am sure members are all in some despair at the thought of being protected by the government of Ontario, at least through its legislative history and approach. I hope there are some human activities that can carry on without benefit of health legislation, particularly from this government.

I think among the things that are pretty clear is that Bill 147 indicates that this government, this Ministry of Health and this minister have no plan or program to expand or develop community-based health care, and no plan on how to ensure access to high-quality abortion services, for instance, about which the minister was strangely and ominously silent. I think what it indicates is that the government is content to leave it to the operation of the marketplace to develop service.

The bill does not prohibit for-profit health care. If the government wanted to prohibit for-profit health care, it could do so. I think this bill could as easily lead to a proliferation of publicly funded commercial health enterprises. In fact, one of the dangers I and my party would fear the most is that public dollars will go for private gain in a health industry that is just waiting for this opportunity.

There is no question that the uniquely Canadian health care system the minister described in her opening remarks is not as uniquely Canadian as she would have us believe, nor as we would hope; that, in fact, there already is a significant penetration of the commercial sector into our health care system. The commercial sector already dominates the health services market outside of institutions and is best positioned to take advantage of the proposal calls this bill envisages being made.

When you combine that fact with a government that continues to look for ways to contain or shift the burden of health care expenditures, it means to me that the preference expressed in the legislation for nonprofit proposals carries little or no weight at all. The bill assumes, and I think it assumes profoundly incorrectly, that nonprofit and commercial entities compete on an equal footing. The bill does not say anything about what a preference for nonprofit proposals might mean, nor, for that matter, if we want to wrap ourselves in the Canadian flag, does it specify what a preference for Canadian proposals might mean.

One would think that if the government were serious about putting in the legislation a preference that had some oomph to it, it could have said that there might be a 20 per cent cost preference, that we are going to give an incentive saying, “Okay, your nonprofit proposal can cost 20 per cent more than a profit proposal and we’ll give it to you because we’re so interested in a nonprofit agency running these services.”

The minister says she wants to expand community-based services, including those provided by community health centres and health service organizations, with this bill. There is nothing in the bill that expands community health centres and health service organizations and there is nothing to develop or to facilitate the development of other community-based nonprofit services. For example, the bill does not say anything about capital or startup assistance, it does not stipulate that physicians in new facilities go on salary or on capitation and there is nothing about community boards or accountability to local communities.

Those things would have been easy to include in the bill and would have given more of a ring of truth to some of the claims that have been made by the government for this bill, and I suspect the government is as interested in having its statements ring true as anybody else would be. I think it is worrisome that those kinds of criteria do not appear anywhere in the bill.

There is no question that many of us would approve of initiatives that would take services out of hospitals, where they are quite often provided at very high cost, and provide them in a community-based setting in those cases where they would have a lower cost and be services that are appropriately delivered in the community. The Association of Community Health Centres certainly approves of a movement in that direction; however, it does not see very much in this bill for community health centres and health service organizations.

Community health centres and health service organizations provide ongoing care, whereas the independent health facilities are strictly procedure-oriented. An independent health facility might perform laser surgery on your eye, for instance, and I think that is probably an appropriate kind of procedure to provide in an independent health facility. Indeed, there are such facilities operating as we speak.

CHCs--that is, community health centres--I might point out for the benefit of members who are not as steeped in some of the funding arrangements as I am, operate on a global budget and health service organizations operate on what we call capitation, which means that the health service organization receives an annual fee based on the age and sex of the member of the health service organization. For instance, a 21-year-old man or woman has a fee attributed to him or her that is significantly lower annually than the fee attributed to someone who is 92 and would be expected to require more health services than the younger person. That is what a health service organization is.

The growth of health service organizations and community health centres in Ontario has been snail-like. While I am pleased that in recent days and weeks the minister has announced a couple or three new community health centres--

Hon. Mrs. Caplan: It is four.

Mr. Reville: I am reminded it is four. The government’s goal in this respect--

Mr. D. R. Cooke: If re-elected we’ll have coffee in the Legislature.

Mr. Reville: What if that is not coffee? There are many points to ponder as we go through our daily lives. In any event, if I can interrupt my colleague for a second here and get on with my fascinating speech, the goal that the government has set for itself in respect of community health is a tiny and, I would submit, unworthy goal: to double, over five years, the number of people served thereby, which would take us up to four per cent--I think that is right--of the population being served in that way, and that is just not enough.

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I want to make a few comments about abortion services. I want to make these comments because nobody I can find ever wants to talk about abortion services in this country. I do not quite know why that is. There is no question that there is a lot of debate around those issues. There is no question that there should be debate about those issues. There is also no question that in Ontario, in spite of the rhetoric of the government, there has been no attempt to deal with the gaps in the services. I think it is necessary that we just say a few things about it.

The minister has said more than once, “We have been saying for some time now that we are committed to the provision of reasonable access to the women of this province to needed health services.” She said in December 1987, “We are reviewing proposals from centres and hospitals across this province to meet the needs right across the province.” In the ensuing months and weeks, the government announced four women’s health care centres, one of which had nothing to do with the provision of abortion services at all.

I think Bill 147 indicates that the government has no plans to ensure abortion services across the province. When the bill was tabled, I think the minister said she had no intention to license any free-standing clinics beyond the two that existed. Of course, in the meantime, a third free-standing abortion clinic has opened, this one on Parliament Street.

The government had the Powell report, which showed that in 1985, in over half of Ontario’s counties, the majority of women obtaining abortions had the procedure outside the county of their residence. There are still many areas of the province where women must travel outside their county of residence to obtain an abortion. In 1996, in 21 of 50 counties, the majority of women obtained abortions outside the county.

In December 1987, the government announced $1.5 million for a regional health centre at Women’s College Hospital; 16 days later, on December 17, 1987, just over $500,000 for a women’s health centre at St. Joseph’s Health Centre in Toronto-- which I should hasten to point out was not a health centre that was going to provide abortion services.

On January 25, 1988, it announced funding to expand women’s health services in Hamilton. Chedoke-McMaster gets $250,000 in capital and just under $500,000 in annual operating funds for enhanced abortion services as well as infertility counselling, family planning, premenstrual syndrome and menopause education and support. Henderson General is to get $750,000 in capital and about $330,000 in annual operating funds for family planning, pre- and post-abortion counselling and enhanced abortion services.

One is curious about how much of this money is indeed going to counselling services. There seems to be a duplication of existing services. For example, in Toronto the Women’s College Hospital centre is supposed to be a counselling and referral centre, and counselling is widely available through public health units and community-based clinics.

Since the Supreme Court of Canada decision in the Morgentaler case was handed down in January, the number of abortion procedures performed at the Morgentaler and Scott clinics has greatly increased.

If you look at what really happens in this province, across the province, for women who are seeking abortion services, you find that we still have an access problem. Only 16 per cent of women obtaining abortions in Peel obtained the procedure in Peel region. One hundred and seventeen women from Cochrane district all travelled outside their area to obtain abortions. Women from Timmins have to travel to Kirkland Lake. In Simcoe county, 66 per cent of women who obtained abortion services obtained them outside the county. In Hastings and Prince Edward counties, 74 per cent of women who live in those counties travelled far from home to get procedures they needed.

In fact, I think Bill 147 can be used precisely as easily to prevent access to needed abortion services as to provide it. Again, we see nothing about the government’s intentions therein. I think the government is going to continue to walk this fine political tightrope and leave the women of Ontario still without access after all these years.

The minister had some comments to make about the conference happening this very day, which was sponsored, I guess, by the Canadian Institute of Law and Health. In fact, her ministry officials had a major role to play in the conference, as was totally appropriate. I believe conference delegates had the benefit of speeches by Dr. Barkin, the Deputy Minister of Health, Gilbert Sharpe, the legal director of the Ministry of Health and Dr. Bob MacMillan, who, under the old organization of the Ministry of Health, used to be in charge of community health and probably still is in charge of something to do with community health, although I must admit I am still having a little difficulty understanding the new organization of the Ministry of Health, but that puts me in the same boat as the government.

Dr. Barkin gave the opening address, I am given to understand, and he thought this was just a crackerjack piece of legislation, which sounds as if he is doing his job properly. It is the first comprehensive approach to health care facilities with an open process. According to Dr. Barkin, the ministry will fund needed services, give quality care and regulate facilities.

Contrary to what the minister said today, however, there were a number of concerns expressed by delegates at the conference. It may not be surprising that I am going to tell members what those concerns were, and I know the minister will want to know what they are so she can get busy and amend her legislation appropriately.

Hospital concerns: their exclusion from the legislation; concern that their global budgets might be reduced--I guess they have some good reason to be concerned, given the current climate of ministerial grumpiness towards hospitals; concern about the reduction of programming that they now provide and the relocation of programming. They were very worried that, in fact, they would still be subject to across-border attack because of their concern that federal legislation would override provincial legislation. They thought the government should control nonhospital facilities. They were worried, particularly those who represented teaching hospitals, that they might suffer because programs would be removed from their hospitals and the medical students who were seeking to learn would lose the benefit of that learning opportunity.

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Some of the people from the hospital sector noted with concern the lack of reference to the cost-effectiveness that might be achieved by operating an independent health facility, as opposed to an institutional health facility, and saw therein little incentive for hospitals to facilitate the changes.

There was a lot of concern expressed over the arbitrary powers assigned to the minister and the cabinet. If one reads the bill, one sees that in fact the minister has a bunch of power that is given to the minister under the legislation, and clearly that will be of concern to those who had previously had the power to make those decisions. They will not want to give it up lightly. I know my colleague the member for Parry Sound (Mr. Eves) will have some things to say about all that.

There is a fear that there will be increased pressure on emergency beds in hospitals if a procedure performed in an independent facility then necessitates an emergency procedure. How that will be organized? There was one suggestion that the program should be introduced on a trial basis. It might comfort that administrator to know that I already believe this is very much a trial balloon and a balloon that may just go up and up and never come down.

If, because of the existence of Bill 147, the government feels emboldened to further restrict the amount of money going to hospitals, then of course that will be of major concern to hospitals which are already feeling the pinch most severely.

The Ontario Nurses’ Association had a number of other concerns, which it raised today at the conference, to which the Minister of Health forgot to allude. In fact, the Ontario Nurses’ Association is very strongly critical of Bill 147, in spite of the enormous amount of consultation that, we have heard from the minister, took place in this regard. They are very concerned that extra-billing will be encouraged. They want the word “preference” removed from the legislation and in lieu thereof the words “All independent health facilities will be nonprofit” put; no more wishy-washy preference kinds of stuff, just shut the door.

They also want the door shut firmly on any chance of foreign ownership, which means, again, the minister has to strike out the word “preference” and insert in lieu thereof, “There shall be no foreign ownership of independent health facilities.”

I think one of the other major concerns of the Ontario Nurses’ Association is that the whole question of fee for service is reinforced by this legislation. They are worried about staffing ratios, they are worried about the enormous power that will be vested in the minister and the cabinet, they are worried about the absolute silence in the bill about the resolution of labour disputes, industrial relations disputes.

They are worried about what will happen in independent health facilities if a medical emergency should arise. I would think that in most cases a medical emergency might not arise given some of the kinds of procedures that are contemplated. You are not likely to have a medical emergency if you are doing mammograms, for instance. You could well have a medical emergency if you were doing some kinds of laser surgery. How do those emergencies get dealt with? I assume that the clear answer is that they get dealt with the way medical emergencies are now dealt with. We have heard in recent days that those medical emergencies are not being dealt with very well at all.

This is very interesting, This is a matter that I think my colleague the member for Parry Sound will probably dwell on at some length. It was in fact the Ontario Nurses’ Association which, in its study of the legislation, came up with a very serious concern, almost at the very end of the bill. It is on page 23 under “Complementary Amendments.” It is the concern that has been alluded to already once this day about the disappearance of “medically necessary” and the substitution therefor, for example, of “such services...as are prescribed by the regulations.”

If this were intentional, then of course that marks a departure from the history of the delivery of medical services in this country. I am not sure whether all members of this House would have the same ideological response at being confronted by such a departure. I think what it says is that the cabinet of a government of Ontario gets to decide by regulation what kind of services a patient should have, which flies in the face of the oft-stated--in fact, this is stated so often it begins to sound like a litany, that the Minister of Health does not tell doctors what to do.

If you say in the Health Insurance Act that the services are prescribed by the regulations, does it mean that the Minister of Health advises the cabinet, which then passes the regulation and says you can have one bandage on that size of cut, you can get cardiovascular surgery only if you are under 47? You can imagine the terror that was struck in the hearts of health professionals when it suddenly dawned on them. It dawned on Glenna Cole Slattery first and she called the Ontario Medical Association and said, “Have you read this?” and they said: “No, we missed that, I’m glad you brought it up. We will have to see what they really meant by that because that will be a serious problem.”

The ONA thought perhaps the Ministry of Labour should have been consulted on this legislation. I do not know whether it was, but in view of the fact that most nursing staff in Ontario hospitals is organized, the Ministry of Labour has something to do with the matter indeed.

I do not think anyone can disagree that there are some kinds of health services that very much need to be delivered in noninstitutional settings. I do not think there is any question that we have increasingly expected hospitals to provide services they were never intended to provide.

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One has only to look at the statistics about blocked beds in our hospitals in Ontario to know that is the case: that acute care beds are being occupied by people who require chronic care beds; that chronic care beds are being occupied by people who would be doing better in a nursing home; and that nursing home beds are occupied by people who could manage very well at home if there were some home support services.

One of the things that I think is unfortunate is that the companion ministries of the Ministry of Health have been failing to see that a more adequate job in terms of the provision of home supports would in fact take the pressure off hospitals, the very pressure that is resulting in some of the dramatic health incidents we hear about practically every day. It makes you wonder about whether or not the government really means it when it says that it foresees a future, a future that is coming soon, where we will be dealing with wellness and not sickness.

I would just like to give a small example that really sticks in my craw, because it would have been so easy for the government to do this and it would have demonstrated some kind of commitment to community-based care, noninstitutional care, and it is an example from the mental health field. In 1982, in the municipal elections that occurred at that time, and this was the second term of the mayor of Toronto, one of the things that he talked about in the city hall version of the speech from the throne was the plight of ex-psychiatric patients, which is visibly increasingly in the city of Toronto and elsewhere, particularly in large urban settings in Canada and the United States and Europe.

As one of the things he wanted to do during the course of his term, he caused a task force to be set up, and because he did not want to be seen as just a task force setter-upper, he called it an action task force and he asked Dr. Reva Gerstein to head up that task force. This is the very same Dr. Reva Gerstein who serves on the Premier’s health council and is somebody, I am sure, who is known to the Minister of Health.

Dr. Gerstein eventually assembled a group of advisers and subsequently wrote a report and presented the report to city council, where it was adopted. The report was then sent up the street to Queen’s Park and received a glowing endorsement, I might add, from the then Premier. The member from Brampton, I think, was the Premier in those days--

Mr. Black: Bob Callahan?

Mr. Reville: No, it was a different member for Brampton, somebody sort of wider and greyer, if I recall.

Mr. Mackenzie: It wasn’t the keys to the Don jail?

Mr. Reville: No, although there is an interesting story; I will tell you about that after a while.

One of the things Dr. Gerstein recommended, and it was a recommendation that she made to the then government of Ontario--which, thankfully, was a different government than today, although the similarity between the 42 years and the three years is becoming more marked all the time-was that one of the things you might do for people in crisis was to figure out a way to keep them out of the institutions in the first place, to make sure they did not go to the Queen Street Mental Health Centre, the Kingston Psychiatric Hospital, the Hamilton Psychiatric Hospital or indeed the psychiatric unit at Mount Sinai Hospital or wherever.

One thing you might want to do in a city like Toronto would be to have at least one and perhaps many crisis intervention centres, so that if a person were going into crisis there would be a place where he could go and be safe. It would be small, it might have 15 beds in it. The objective of the people running this centre would be to get you in and out of there just as fast as possible, so that you would not be subject to the kind of dislocation in your life that is such a severe problem for people who have mental health problems.

As things would have it, the Premier at that time, a man named Bill Davis, thought this was just a crackerjack idea. He wrote a lovely letter and said, “Bob will probably want to get on with that right away.” Then there were the realities of May 2, 1985, which were a different set of realities from the realities of March 19, 1981, but just as real. These recommendations all became the property of the Liberal government and the responsibility of the Liberal government, and I am sad to say that at almost the end of 1988 there is no sign of our crisis intervention centre.

The member for Kitchener-Wilmot (Mr. Sweeney), who is now a minister of the crown, and I attended an event together, he in his capacity as the critic for everything of the then Liberal opposition and I as an alderman at the time. We had what was called a Parkdale lunch. I should tell members a bit about this Parkdale lunch, because it might provide some urgency for this government to get on with the crisis intervention centre.

One of the hallmarks of a Parkdale lunch is that when you come in you get a handful of pills, and the pills were represented in this case by Smarties in little bags they gave us. You sat down at your place and there was your little bag of Smarties. Of course, you did not have assigned seating, so when you sat down at my place you did not get your pills, you got my pills; and vice versa. This is one of the hallmarks of a Parkdale lunch, which describes, I think quite graphically, some of the problems we have in terms of expsychiatric patients and the kind of care they still get today in the province.

There were other aspects of the Parkdale lunch: the baloney, the white bread, the mustard, the soup and the aromatic bitters. There were aromatic bitters beside each place, because you do not have an aperitif or a liqueur in the Parkdale lunch. You get alcohol, you get about 40 per cent or 50 per cent, but you have to get that from your aromatic bitters.

Included as guests at this lunch were, as I say, the member for Kitchener-Wilmot and--I do not recall which member from my party was there at the time. Maybe it was the member for Scarborough West (Mr. R. F. Johnston); quite likely. In any event, I wanted to relate that story because I do not want people to think that the recommendations of the Gerstein report were somehow lost and went off into glorious retirement with the previous Premier of this province. In fact, they are there. They are over there at the Ministry of Health. There is four years’ worth of dust on them now. I think it is too bad. I know there was a huge argument about whether this should be a medical model crisis intervention centre or a community model intervention centre. Notwithstanding that, this tug of war over the kind of intervention centre does not appear to have been resolved. In fact, I do not know of any crisis intervention centre in operation in Toronto, so I assume the government’s failure to get on with it is on its head.

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I think it does undercut the protestations of the government that it really is interested in delivering services in independent health facilities noninstitutionally; and quite frankly nonmedically, because I think many health services currently provided and dominated by the medical profession can be delivered most adequately and sometimes better by health professionals who are not medical doctors.

I have indicated to my colleague the member for Parry Sound that I was going to leave him a significant amount of time to speak, but I do not see anybody from the third party here and I am hoping somebody is watching this show so they will come in and begin to speak, then I would be happy to sit down. However, we will just leave that message out there and I will continue speaking for a while yet.

Let us suppose that we have an independent health facility which is providing lithotripsy. I imagine you could do that in an independent health facility. It is pretty expensive to do but there is a great demand for it and it is kind of a neat procedure. In fact, there is one facility that does that. It is in the Wellesley Hospital right now. They do other stuff in there, endoscopy. I cannot say it; it is thing they do to you. It is wicked. I hope I never have that done to me. Anyway, lithotripsy is actually a kind of machine that zaps your stones and kind of breaks them up so you do not require surgery. It is a great idea. Let’s suppose we move that out of the Wellesley Hospital into an independent health facility. What would then happen to that space? Is there any assurance that the hospital would not just increase the number of gall bladders it takes out? How would this legislation or the government seek to deal with that? There is no answer.

I understand one of the things you can do for someone who has glaucoma is to use a laser surgical procedure. That might reduce the number of people getting that procedure in hospital.

Hon. Mrs. Caplan: That is for cataracts.

Mr. Reville: Yes. For glaucoma as well, because one of the problems you have with glaucoma is that the pressure builds up inside your eyeball and you have to kind of poke a little hole in there. You can do that with laser rather than with a knife. That is a procedure which can occur in a facility which is not a hospital. What is going to become of the operating room time that is being replaced? There is no answer to that question.

The minister, I am sure, trembles at the thought, having made comments about it just recently, of having more Caesarean sections done, more gall bladders out, more hysterectomies performed than there already are because quite clearly, the statistics seem to indicate that we are doing far more than other people are doing. Why is that? While I am glad the Minister of Health is pointing this out, I am also surprised that she points this out in quite the way she does, because surely to goodness the minister has something to say about this. To ask, “Is it not amazing that at a quarter to four on a Friday afternoon everybody suddenly has a Caesarean section? and commenting on it as though the minister cannot do something about that strikes me as disingenuous. I think the Minister of Health’s responsibility is to do something about that.

One of the ways the minister could do something about that is to get herself some clinical epidemiology skills. I am not suggesting that the minister herself should acquire them, but that there are people who have them. They can tell you the kinds of things that work and the kinds of things that do not work. Surely, that would be useful to know if you were in charge of a system that is currently getting close to $13 billion in cost and which carries on its back the health of more than 9 million people of Ontario.

I would also suggest that once you know what works, it is also a good idea to know what it costs. That is what a health economist could tell the minister. She might want to see if she could find some of those around. Then after you know what worked and what it cost, if you had some health planners around, you could get the cost and what works all together. It would be amazing, the kind of changes that we would see here in Ontario.

I am going to give my colleague, the member for Parry Sound, a little chance to get all his notes together and just conclude by saying that we desperately want an Ontario in which people have full access to the health care services they need. We do not object to the ministry’s concern about quality of care being delivered in independent health care facilities that exist now or those that may come into operation in the future.

In fact, there are a number of independent health care facilities that we, in this party, would dearly like to see. For instance, I would think that it would be wonderful if the Toronto Birth Centre could be up and running, so that those parents or would-be parents could get to be parents in a noninstitutional setting like a birthing centre. Of course, that is something that has been before the government for umpteen years and which might be facilitated by an Independent Health Facilities Act; but it might not be, we do not know that.

There is nothing in this legislation that indicates what the government’s intentions are or what the government’s mission is in respect of health care delivery. All we have is the trainload of rhetoric that, I must admit, I get really bored by, seeing it pass by day after day after clay.

I would be quite happy to offer amendments to Bill 147 that prohibit for-profit independent health facilities, that prohibit foreign ownership of independent health facilities and that prohibit extra-billing--and amendments that require, as a condition of their licensing in those cases where they are replacing an institutional service, that we actually see the offsetting saving. I would love to see that sort of thing in this legislation

If we ever see it again and it turns out that I am mistaken -- the introduction of this bill at this time are not connected with the federal election, but are connected with something real that the government wishes to do, and in fact the public hearings occur in February and March of 1989, I will sit there with rapt attention as people who are concerned come forward and share those concerns with us--I already have a number of amendments I would be happy to move at that time and I am hopeful that those amendments will receive consideration. I know they will receive consideration; it would also be nice if they received support.

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In conclusion, I do not believe that Bill 147, in its current state, satisfies any of the claims made for it by the government and because of that, my party will not be supporting Bill 147 at the second reading stage. We will fight hard for changes to it, but at this moment this bill does not satisfy any of the objectives we would have for the health care system in Ontario.

Mr. Eves: It is a pleasure to rise and participate in this debate on what I think is a very important piece of legislation with respect to the future of the health care system in Ontario.

I think we should, first, perhaps get on the record what the underlying principles are behind the legislation. I might say at the outset that our party has no difficulty in supporting the underlying principle. I am assuming that the underlying principle, and I believe the minister has said this on a few occasions and I am sure that she will correct me if I wrong, is that it provides a vehicle for the minister and the ministry to develop community-based health facilities through which many medical services traditionally associated with hospitals may be performed, and that the act follows the ministry’s commitment to improve community-based health care in Ontario.

Having said that, this legislation, of course, will certainly enable patients to undergo certain surgical procedures without having to be admitted to a hospital, and it ensures that these patients will receive, I hope, quality care.

Already existing community health centres and health service organizations, or HSOs as we have come to know them, will be able to develop, I presume, expanded roles under this legislation. I believe the legislation is also a recognition that new technology has made it possible to safely perform some procedures in an out-of-hospital setting, and that some independent health facilities have already started to offer such services in Ontario. I believe that creates some problems for the Ministry of Health and the government, as well. The ministry wants to ensure that such facilities are appropriately located and the procedures are performed in a safe and effective manner, and they purport to regulate the delivery of those services and assure the quality of care and standards delivered by them.

From reading the legislation, it would appear that funding would be negotiated on an individual basis with each facility and that the ministry may choose one of two basic options: that is, to fund facilities on a global basis covering their operational costs including professional services; or to partially fund for costs other than salaries, leaving physicians free to bill the Ontario Health Insurance Plan or OHIP for their professional fees.

The ministry would then pay for any of the approved expenses associated with the provision of insured medical services in these licensed facilities. Services which may be provided in such licensed facilities include laser technology, abortions, in vitro fertilization, cataract surgery, radiology, fracture management, and bladder and heart investigations.

The ministry states that it has three broad objectives: (1) to develop a more community-based health care system, with district health councils participating so that the ministry can plan effectively for the future; (2) to ensure that patients receive quality medical care; and (3) to regulate facilities so that they may be established in a manner consistent with a planned health care system.

Facilities would function in a manner similar to hospital outpatient clinics, employing health care providers such as doctors, nurses, technicians and laboratory assistants. They would not keep patients overnight. Any patient needing treatment who requires an overnight stay would have to be cared for in a hospital.

There are a number of facilities that now offer medical services that have been traditionally performed in hospitals. These include, among others, in vitro fertilization, eye surgery and abortion, to name a few. The legislation gives these facilities an opportunity to apply for a licence.

The ministry states that the act will not affect the provision of insured services in a doctor’s routine office practice. I do take some exception to that claim by the ministry, as I indicated during question period today, and I will deal with that at some length a little bit later in my remarks.

The ministry goes on to state that in keeping with the ministry’s emphasis on improving community-based health care, the act will fall under the jurisdiction of the assistant deputy minister of community health and that the ministry will have the authority to appoint trained health care professionals as assessors to review the quality of care offered by a facility.

The method of licensing is somewhat interesting. While the commitment to local district health councils has been made, it is interesting to note that the legislation states that local district health councils may define needs or make recommendations for facilities to the ministry or the ministry may in fact identify these needs and ask district health councils to respond. The ministry will review any district health council recommendation, and if the ministry agrees with the recommendation, it will call for proposals for a facility.

Preference will be given to nonprofit and Canadian proposals, and facilities currently operating may be grandfathered and allowed to continue operating as they are until one year from the day that this act becomes law. During that year, the facility may apply for a licence without going through the competition process. I find that statement a little bit interesting. The ministry will review the application and make a decision based on quality of care, cost and need. Once licensed, a facility will be required to conform to the specified standards.

I want to go back to the point about facilities that are going to be grandfathered. I question why such facilities are going to be granted a licence without going through the competition process that every other facility that will be created, supposedly from here on in, has to go through. I think you could run into not only a few legal problems here, but you could also run into the very basic problem, as I see it, of equity.

In other words, as long as you had the foresight to start your own private clinic and get out there and do some things that the ministry or the government was not particularly happy about before the magic cutoff date, you are going to be allowed to continue to do that in the future without any competitive basis for deciding which clinics will or will not be funded. I think the ministry should certainly give that some second thought, to say the least.

It also brings up the question of the Scott and Morgentaler clinics, among others. I think it is safe to say there are clinics in Ontario that have probably, through one means or another, through their facility fee, been charging for services. Now I suppose really what this act will do, if it passes as drafted, is legitimize that process. Without commenting on the merits of extra-billing or not extra-billing--I am sure we have had that debate on many occasions in this Legislature and we could speak for hours about it--suffice it to say it is somewhat interesting that a government that is committed to eliminating and has in fact eliminated extra-billing, in many instances has condoned it since Bill 94 was passed and now it is going to legitimize it, to some extent, through this legislation.

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“The ministry is consulting with the major health care organizations on this bill, including the Ontario Medical Association, the Ontario Hospital Association, the Ontario Nurses’ Association and the Registered Nurses Association of Ontario.” If in fact the ministry has consulted with all those various groups, as it claimed to have when it first introduced this piece of legislation back on, I believe, June 2, 1989, it may have talked to these groups but I do not know if it has listened to much of what these groups have had to say. This afternoon in my remarks I would like to touch upon some of the concerns that each one of these groups the ministry supposedly consulted with before it even drafted the legislation has with respect to Bill 147 or the Independent Health Facilities Act.

The OMA has some interesting concerns, to say the least, with respect to this piece of legislation. They acknowledge that this legislation is an attempt to create a system to fund health clinics, but at the same time at least some members have concerns that the Ministry of Health is presenting to Ontario’s health care system a threat to doctor-patient confidentiality and that it is going to revise the standards of care in the province of Ontario. They see this legislation as an attack upon the independence of physicians everywhere in Ontario.

The intent of this bill was to provide public funding to clinics which provide procedures, such as we have mentioned, traditionally performed in hospitals. A facility fee would be paid to cover the difference between the Ontario health insurance plan rate and the cost of running the clinic. The OMA supports the expansion of health clinics, but the current bill could have a terrible impact on the practice of medicine in Ontario, unless the government agrees to consider major changes to its legislation.

The Minister of Health has said that the bill does not apply to doctors’ offices. While no one will be forced to work in an independent health facility, one section of the bill will permit ministry inspectors to enter a doctor’s office and determine that he is or is not operating an independent health facility. These ministry inspectors, as I tried to point out in question period today, will not require warrants. They will have the authority to seize medical charts, financial records and tissue, fluid and blood samples. The bill specifically requires all personnel to co-operate with the inspector or face severe fines if they do not comply.

I think we should just think about that power for a moment, I think it is a fairly dramatic, dictatorial, draconian power, to say the least. I tried to get an answer to this question today in question period, but did not get one. I got a statement again of what the basic principle of the act is and about how it is supposedly going to improve the health care system in Ontario.

I have no quarrel with the minister about what the basic principle of the act is. I do not believe that many members of the House do. However, she did not answer the question as to why inspectors under this act should be able to enter into a facility that is not covered by this act, that is not an independent health facility, without a warrant, and be able to seize individual patients’ medical records, doctors’ medical records, samples--blood samples or tissue samples without any requirement as to what those samples are going to be used for, how those records are going to be used, what is going to happen to them. What does that say for doctor-patient confidentiality?

I would think most Ontarians would be shocked and surprised to learn that this power is included in the proposed legislation. I think we should make sure that the public understands, although it may seem like a legal splitting of hairs, the difference between independent health facilities, as defined by the legislation in section 1, and health facilities, because this bill is only supposed to apply, if I understand the intent of the legislation correctly, to independent health facilities, which “means a health facility in which one or more members of the public receive or are intended to receive services that are insured services and for which facility fees are or are intended to be charged, but does not include a health facility mentioned in section 2.”

“‘Health facility’ means a place in which one or more members of the public receive or are intended to receive health services and includes an independent health facility.”

The difference between those two definitions, putting it in layman’s language, is that the health facility includes any place in Ontario where a member of the public is receiving health services, and that includes a doctor’s private office; so even if a doctor’s private office is not covered and is not an independent health facility, it is included in this broad definition of health facility. If that is not the case, then why do we have the need for a “health facility” definition under this act at all? Why does the act not specifically say that inspectors have those rights only when they enter “independent health facilities” as opposed to the terminology “health facilities”?

Even if we were to give inspectors those rights for independent health facilities only, I still have a problem with that. I have a problem with the protection of the doctor-patient confidentiality aspect and I have a problem with inspectors being able to do that without a warrant, without at least reasonably justifying to a justice of the peace or a judge that there are some reasonable grounds upon which and for which an inspector requires the specific items or documentation that he or she is about to seize. This is a democracy and I think we should continue to operate as one.

When the minister introduced the bill she said, “The act also gives the Ministry of Health regulatory authority to assess and enforce standards of quality and care.” At least some members of the Ontario Medical Association are very worried that this will strip away from the College of Physicians and Surgeons of Ontario the responsibility for setting health care standards in the province.

I also note, as I did in question period today, that Bill 147 will change the definition of an insured service. Under the provision of the Health Insurance Act, an insured service is described as “all services rendered by physicians that are medically necessary.” The clause in the proposed Independent Health Facilities Act would amend the insurance act to read, “such services rendered by physicians as are prescribed by the regulations.”

If the meaning is the same, there is no need to change the definition, but I think the meaning is clear. I think the meaning of the Ministry Of Health and this government is that from now on regulation and not medical necessity will determine the provision of insured services in Ontario. I am not so sure that the public of Ontario would agree with that proposed change.

I am sure that if and when this piece of legislation gets to committee, the minister and ministry officials will hear abundant concern, not only in the community of physicians but from health care providers and, more important, from members of the public who use the system, that we are now going to do by regulation what before medical practitioners decided was or was not medically necessary.

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I am sure that should concern all Ontarians. I have some qualms myself, as a legislator, about doing this by regulation. Regulation, as most of us know but perhaps a lot of people in the lay community at large are not aware, is really a means, on occasion, of government circumventing the legislative process and not having to bring specific changes in legislation to this House to be debated in public and sent out to committee, but rather to sort of do it by legal staff in any particular ministry deciding that certain aspects of pieces of legislation should be changed.

Mr. Black: Previous governments used to do that.

Mr. Eves: Yes, previous governments used to do that. That does not mean I condone it.

Some governments and some ministries abuse that privilege more than others. You have governments that govern by legislation and you have governments and ministers that govern by regulation, and I do not think this is a desirable step, especially in such a significant piece of legislation or in the health care field in Ontario.

I hope that when the minister says she is listening to the concerns of people out there, she indeed will listen to some of these concerns, because I think some of them are very, very valid indeed. Admittedly, some of them come from certain aspects of different medical professions or from society and some of them have a vested interest, but that is not to say that their opinions should be cast aside. After all, these people are the people who work in the health care system day in and day out and, with all due respect to both the minister and myself, probably know far more about the health care system than either one of us will ever know on a day-to-day basis.

The Minister of Health will also enjoy sweeping new powers under this legislation if it goes ahead as proposed, She will have the power to revoke, deny or grant a licence for an independent health facility without having to face an appeal process.

If any future minister, for whatever reasons--moral, political or whatever--were opposed, for example, to abortion or to in vitro fertilization, he or she could arbitrarily close clinics providing those services without having to explain the decision to anybody. They are not accountable to anybody and there is no appeal process from that decision.

As a lawyer, I find that a very distasteful way of proceeding with any piece of legislation and I find it a power that I think is totally unnecessary.

Mr. Brown: He forgot where he was.

Mr. Eves: I did not forget where I was.

Interjections.

Mr. Eves: I am not touchy at all today. I can stand here today and all day tomorrow if you would prefer, if they choose to call this bill again and talk about this piece of legislation.

The gentleman to my left, probably both philosophically and physically in this sense--

Mr. Offer: No probably about it.

Mr. Eves: No probably about it? That does not say much for them, I am afraid.

Talking about why this piece of legislation is before us today, they reminded me of a very important point which one should not miss in this debate on Bill 147 today; in fact, why we are debating this bill today.

Wearing one of my other hats as whip for our party in the Legislature, I have the privilege of going to House leaders’ meetings every Thursday morning. It is interesting to note that the government House leader gave us notice last Thursday that there were three of what he called free trade bills that he would like to get on the Orders and Notices paper before the federal election on November 21. He does not want them necessarily to be discussed in detail--heaven forbid--and discuss the merits of legislation, he just wanted to make sure that each one of them got a day in the House before the federal election was held.

I ask you, what kind of leadership and responsibility of government is that when you play politics with an agenda?

Mr. Black: Good leadership, unlike your cousins in Ottawa.

Mr. Eves: Applaud that if you wish. I do not think the overwhelming majority of Ontario citizens would agree that that is a very productive exercise: to know that members are going to debate what the Minister of Health considers to be a very important piece of legislation but we are only going to do it for one day, then the government is going to put it on the back burner for two or three weeks until the federal election is over, then it is going to bring it back.

I do not think that is a very responsible approach to government in Ontario and I do not think it speaks very well of the government, quite frankly, to use those tactics to its federal brethren’s political advantage, without any intention whatsoever of passing the legislation, in these few short days before the federal election. I do not agree, by the way, that it is going to get them anywhere, but I think the very fact they would use that strategy is somewhat disconcerting and certainly does not speak well for the respect these people have for the Legislature of Ontario, I do not think, in what we are doing.

We could have chosen one of those pieces of legislation. In fact, there are pieces of legislation such as the tax bills, which the Treasurer has introduced in the second week of May. Let’s see-June, July, August, September, October, November-six months later, here we are and we have still not dealt with the tax bills. I bet I know why we are not going to deal with the tax bills. I bet they are not going to be on the Orders and Notices paper before November 21.

Do members know why they will not be on the order paper before November 21? Heaven forbid, we would not want the public of Ontario to get the idea that there is a Liberal government somewhere in Canada, in fact, right here in Ontario, that would raise taxes. We have been collecting eight per cent sales tax since May, but we are not going to debate it--heaven forbid--before November 21, when there is a federal election going on. Somebody may actually get the opinion that Liberals also raise taxes. I do not think that speaks very well of the current government, either.

Mr. Reycraft: In politics, timing is everything.

Mr. Eves: Timing is everything? In politics, sometimes manipulation is everything, too, I might say to the member opposite.

Interjections.

The Acting Speaker (Mr. M. C. Ray): Order, please. The member for Parry Sound would like the opportunity to address the assembly in an uninterrupted manner in accordance with the rules.

Mr. Offer: We value your authority, Mr. Speaker, The speech is five minutes and 95 minutes of interjections.

Mr. Eves: Only if they want it to be, I say to the members opposite.

I want to go back to the three questions and the three concerns, which I think are very valid concerns, that I raised in the Legislature this afternoon during question period. Section 26 of the Independent Health Facilities Act gives Ministry of Health inspectors the authority to enter any health facility, and I note very specifically that the section is not worded “any independent health facility,” but “a health facility,” and that includes, unless the minister changes the definition, any doctor’s private office.

The inspector can take records, charts, blood and tissue samples; in fact, can interrogate any person in that doctor’s office, any patient. It says any person present on those premises. Most unbelievable of all, the government inspector can do this without a warrant, without having to justify to the judicial system here in Ontario that there is any valid or reasonable reason for so doing.

As I said during question period today, and I reiterate, I think this is a violation of the most fundamental principle, patient confidentiality. I ask the minister again how she can possibly justify putting such a measure in a piece of legislation. I think the very least the minister should consider is that such authority would only be given with a warrant. I also think such authority should not be given for any health facility. If this act is purporting to deal with independent health facilities, then let these provisions apply only to independent health facilities.

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Gilbert Sharpe, who I understand is the director of legal services in the Ministry of Health, was addressing the conference this morning--my understanding is--and he was running down the clauses he thought were very important, that the people attending the conference should pay attention to.

It is interesting to note, it is my understanding from talking to people who were there, that he skipped over section 26. He obviously did not think it was very important. But it is also my understanding that most of the questions Mr. Sharpe got and most of the comments and questions raised later on in the meeting came about section 26. I do not know how the director of legal services for the Ministry of Health could think this was not a very important section. It is probably one of the most important sections in the entire bill, especially from a legal point of view.

As I said this afternoon, while I find it hard to believe that the government would even contemplate some of the measures contained in the Independent Health Facilities Act, fortunately this legislation does set out an appeal process in which a person can appeal a decision made by the director of independent health facilities. I could not agree more. I think that appeal procedure could perhaps be expanded upon a little bit. I believe it gives the right--I am doing this from memory--to appeal to Divisional Court and that decision is to be final and binding.

I do not necessarily think we had to stop there. If it had not said that was the final decision, individuals in the province who felt so aggrieved could then appeal to the Ontario Court of Appeal. From my limited experience and knowledge in that field, such appeals are not granted very liberally, if I may use that term in a nonpolitical sense, and I do not think there would have been much of a problem with allowing appeals to the Ontario Court of Appeal. However, be that as it may, at least an appeal process is in place in the statute and at least people who feel they are aggrieved and have a concern have the right to appeal that.

However, I am somewhat disturbed by the next section, section 9, I believe, which allows the minister to completely override the appeal process in his or her wisdom. We are not only concerned about the current Minister of Health. In fact, I do not question the current Minister of Health’s motivations about this legislation. I have nothing but respect for the current Minister of Health with respect to her dedication and sincerity about the very onerous portfolio she is in charge of, but members should bear in mind that there are going to be future ministers of health and there are going to be different circumstances and different stressful situations that ministers of health from time to time are going to find themselves in.

The minister is given the power under section 9 to decide to revoke a licence, to not grant a licence, to come in and take over independent health facilities, all of which can happen with absolutely no recourse of appeal whatsoever. I find that very disturbing. I find it disturbing as a matter of equity. I find it disturbing as a matter of law. I find it disturbing, I suppose, that it would even be introduced into a bill that would hit the floor of this Legislature without having been screened out by somebody in the ministry before it arrived on the floor of the Ontario Legislature.

The possibility exists, not the probability but the possibility, for a Minister of Health to decide for whatever reason, and the reason could cover anything from his own personal belief to political reasons, to revoke or not grant a licence without any accountability to anybody whatsoever for that decision, at least not legally, not the way this bill is drafted, not the way section 9 of Bill 147 reads.

I pointed out two examples a few moments ago. What if a future Minister of Health were opposed to abortion for any reason whatsoever? Think of the power he would have under section 9 of this bill. What if a future Minister of Health were opposed, on personal or religious grounds or beliefs, to in vitro fertilization? He can invoke section 9 of this bill.

I do not think that opportunity, however limited it is, for abuse of the political process should exist and be enacted into legislation. I would venture to say that not only the vast majority of health professionals around the province would probably agree with that statement but probably the vast majority of ordinary Ontario citizens would agree with that statement. I would like the minister to think about that as well.

The third major point I thought I would try to make during question period today covers the definition currently under the Health Insurance Act or the Ontario health insurance plan, which covers all services rendered by physicians that are medically necessary. The ministry refers to the section in the Independent Health Facilities Act as a complementary amendment, amending this to read, “Such services as are prescribed by the regulations.”

Basically, what this means is that the Ministry of Health, whatever its intentions, will now determine what is medically necessary, not physicians. Quite frankly, I do not think that bureaucrats should be determining what is medically necessary, as opposed to medical practitioners. I would also like to point out that the Canada Health Act has wording very similar to the Health Insurance Act. I believe that the wording of those two acts as they are now is appropriate and is correct.

I do not think we should change it to “such services as are prescribed by the regulations.” I would ask the minister to think about that, to talk to her officials in the Ministry of Health and to consider whether or not she would like to withdraw this complementary amendment to ensure that all medically necessary services will be paid for, will be provided for to the people of Ontario and will be paid for by OHIP, because I think it is very important to ensure a first-class and quality health care system in Ontario in the future.

I would like to go through the Independent Health Facilities Act and talk a little bit about each one of several specific sections, possible concerns that I can see arising in the future. Then, time permitting, I would like to go on and indicate some of the reactions that we have gotten, not only from the Ontario Medical Association but the Ontario Nurses’ Association and the Ontario Hospital Association as well, with respect to the draft legislation.

Under section 6 of the Independent Health Facilities Act, or Bill 147, the director of independent heath facilities may issue a licence to establish and operate an independent health facility. Subsection 6(2) makes it clear that the director’s power in this regard is entirely discretionary, subject only to the preference for Canadian, nonprofit operations as set out in subsection 6(3). The emphasis upon the discretionary nature of the director’s function will tend to discourage courts from interfering with the decision made by the director under section 6.

We therefore may wish to consider whether or not there are any specific restrictions which should be imposed upon the director’s discretion. I am going to throw out some of these thoughts and some of these points which I believe are at least worth considering, I say to the minister. Hopefully, we will get the opportunity to pursue them at some length in committee.

Section 8 of the act provides for an appeal process with respect to that director’s decision. Any applicants who feel that they are aggrieved by the decision of the director may appeal to the Health Facilities Appeal Board within 15 days after receiving notice of the director’s decision. The board must then conduct a hearing.

Under subsection 8(5), “the board may substitute its opinion for that of the director.” But the board is not permitted to compel the director to do anything contrary to the criteria specified in the request for proposals. On the whole, I suppose, this appeals scheme would appear to be generally satisfactory. I have made my point before about the appeals process. Although I think it could be improved upon, I think it is probably adequate.

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Under section 9 of the act, the Minister of Health may order the director not to issue a licence to an applicant. It is important to note that the appeal provisions set out in section 8 do not apply to such a refusal by the minister.

On occasion, courts have permitted judicial review of the decision of a minister, but I must point out that the criteria for judicial review are extremely limited indeed. I think we can assume legally that the decision of the minister under section 9 will be very effectively final and conclusive, and it does not require the minister to account for why he or she came to that decision. There is really no accountability required by the minister for making such a decision under section 9, other than perhaps the political accountability. which I suppose we all, as elected representatives, and especially members of the executive council, have to fulfil from time to time.

I think also very important is that a decision under this section has no right of appeal established by legislation. I really think it is fundamental to the justice system in Ontario, and I think it is fundamental to this piece of legislation and the health care system in Ontario. I would ask the minister to consider that point very seriously.

There is little apparent justification for section 9, since the application process described in section 8 gives the director very wide discretion to accept or reject any proposal and the director is presumably in at least as good a position as the minister to decide which proposal should or should not be accepted or rejected.

If those provisions are outlined, as indeed they are in section 8, one has to wonder why they could come to any other conclusion with respect to section 9, other than the fact that section 9 is intended to give the minister the right to ignore the entire application and the appeal process as set out in sections 6 and 8. I think we should seriously think about that.

If there are all these protections built into section 6 and section 8, then the director probably is going to be more qualified--if I might say so, without any disrespect to the existing or any future minister--than the minister, because he or she is going to be the individual who, on a day-to-day basis, deals with this aspect of health in Ontario.

If there is an appeal process set up for a decision of the director, then why would there not be an appeal process set up for a decision of the minister. who can override the director and does not really even have to give any reason for so doing? They are not accountable.

I have some comments about taking control of an independent health facility upon or after the termination of a licence.

Section 16 provides that where a licence expires or is surrendered, suspended or revoked or the licensee dies, the director may take control of and operate the facility for as long as a year, during which the former licensee is not entitled to any payment for services provided by the facility but is entitled to “reasonable compensation” for the use of the property. Under subsection 16(4), such an order “takes effect immediately and is final.” The act does not indicate how reasonable compensation is to be determined. No appeal process is set out in the act if the former licensee is dissatisfied with the amount the crown decides is reasonable.

I think at the very least we expect from the ministry some clarification as to how the ministry intends this compensation process will work, because if you look at section 16 on its face, I think it too has some very farfetched powers in that any such orders, as it says, take effect immediately and are final. There is no appeal process set out for that decision, for such an order under section 16, and there is no method of deciding how reasonable compensation is going to be arrived at. I am sure members of the Legislature with legal training will know that the term “reasonable compensation” I suppose could be interpreted to mean just about anything by just about anybody, depending on what tack you are taking and whose interest you are protecting in any specific instance.

Under section 17, “the director may revoke, suspend, or refuse to renew a licence” for reasons set out in detail in subsection 17(1). Under subsection 17(2), where the director believes the facility is being operated “in a manner that poses an immediate threat to the health or safety of any person,” he may suspend the licence effective immediately. Otherwise, he has to give notice. Otherwise, there is the right of appeal to the Health Facilities Appeal Board under section 19. Under this process, the licensee is entitled to a hearing before the board, while section 20 describes the procedure to be followed at such a hearing.

The procedure appears to be, on the surface, generally satisfactory, I would say, although it should be noted that sections 15 and 16 of the Statutory Powers Procedure Act apply to the hearing. The result of that is that the board “may admit as evidence..., whether or not given or proven under oath or affirmation or admissible as evidence in a court,

“(a) any oral testimony; and

“(b) any document or any other thing, “relevant to the subject matter of the proceedings and may act on such evidence.”

I want members to think about that for a moment. The evidence that is going to be acceptable under appeals as defined in this act, in the sections I have just named, does not have to be the same as evidence that is admissible in court. It does not have to be oral testimony or documents that have been proven admissible in a court of law.

From time to time, those provisions do not have to apply to tribunals but I think, in light of the very substantial prejudice which could be suffered by a licensee whose licence is revoked, the appeal process under this piece of legislation is very important. I think we should at least consider asking ourselves whether the ordinary civil rules of evidence apply.

I might point out that in proceedings before the disciplinary committee of the College of Physicians and Surgeons of Ontario the ordinary civil rules of evidence apply. Surely we should expect no lesser standard under a piece of legislation introduced into this Legislature than the College of Physicians and Surgeons of Ontario expects in its own disciplinary committee hearings. I do not really see how the Minister of Health could help but deny that request, seeing as how the college is operating in that way with respect to evidence of its own hearings right now.

It is important to note that under section 18 the minister may order the director not to renew a licence and, as in the case of section 9, there is no right of appeal to the board with respect to such a refusal. As a practical matter, section 18 provides the ministry with a means of bypassing entirely the director and the appeal process. On that basis, I do not think there is any doubt that section 18 should be opposed.

I go back to the same arguments I made with respect to section 9 of the bill. If you have a director of independent health facilities who is dealing with these matters on a daily basis and he or she is brought up to speed on a daily basis with these facilities throughout Ontario and is empowered to make decisions with respect to them, and if the minister is going to be given the power to overrule the director, then surely there should be at least the right of appeal with respect to such a refusal, the minister should at least be accountable as to why he or she made that decision, there should at least be an appeal to the board and there should be an appeal to the Divisional Court as well.

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Speaking of appeals to Divisional Court, section 21 permits a party to proceedings before the board to appeal to the Divisional Court. It must be emphasized, however, that this appeal is 41 on a question of law alone,” meaning that the appeal cannot be based on questions of fact. I should have thought that most of the appeals from a decision of the board would be based on matters of fact rather than of law. I think the section therefore should be amended to read that the appeal may be “on questions of law or fact or both.”

I think this is a very important point, if we are going to allow an appeal to the Divisional Court, which I do think is necessary. As I indicated earlier, I would prefer not to limit it there. I would prefer that the decision of the Divisional Court not be final and binding; I would leave everybody his normal civil right to appeal to the Court of Appeal, if indeed the Court of Appeal felt the matter before it was important enough to accept an appeal.

Assuming we accept the fact that the Divisional Court’s decision will be final and binding, I think that in this particular instance with this particular act and having regard to the types of matters that are going to be before this particular board and ultimately the Divisional Court, it should be appealable on questions of fact and law, or fact as well as law, not just limited to questions of law, because I think most of the decisions of this board will be based on questions of fact,

It is also interesting to note that under subsection 21(3) the ewers of the Divisional Court are restricted to affirming or rescinding the decision of the board or referring the matter back to the board for a rehearing. Many similar provisions provide that the court may exercise all the powers of the board and direct a board to take any action which the board itself could take and the court considers proper. For such purposes, the court surely should be able to substitute its own opinion for that of the board.

I think we should consider that sort of discretion for the Divisional Court under subsection 21(3). I do not think we should tie the Divisional Court down to having either to affirm or rescind a decision of the board or to refer the matter back to the board for rehearing. In many other tribunals, the court has the power to exercise any of the powers that the board could have exercised and make a decision that the board could have reached. I think we should consider making this act conform to other acts which implement tribunals in the province of Ontario.

Subsection 21(4) provides, as I have said, that the decision of the Divisional Court is final. In the absence of such a provision, as I have tried to outline, the parties would be at liberty to apply to the Court of Appeal for leave to appeal the decision of the Divisional Court. As I have said, this kind of leave, as a practical matter, is relatively difficult to obtain, but the restriction on further appeal is unusual and I think at least should be mentioned in this process, in the second reading debate, and also in committee as well.

I would like to go on and talk at some length about the assessment and inspection provision of the act.

Mr. Dietsch: I thought you were getting to the end.

Mr. Eves: Oh, we are not anywhere near the end yet. We are not even near the end of the specifics of the act, let alone the comments other people have with respect to it.

Mr. Wildman: When you say we’re not near te end, is that a metaphysical statement?

Mr. Eves: That is a true statement.

Mr. Harris: We were a little near the end in Welland-Thorold.

Mr. Eves: That is a totally different matter, as the member for Nipissing (Mr. Harris) will know, having caught a cold myself campaigning in the by-election, and it did a lot of good, obviously. I can see that.

Under section 25 of the act, an assessor appointed by the minister may assess “the quality and the standards of services provided in independent health facilities.” The licensee and its employees must co-operate fully with an assessor, including “conferring with the assessor when requested to do so by the assessor.” It is unclear whether this clause would require a licensee or any of its employees to answer all questions put by the assessor. It seems reasonable to assume that this is the intent of this subsection. The powers of inspection set out in subsection 25(3) are broad. I think we should review them as legislators to see carefully whether they are likely to pose practical problems.

Section 26, which I spent some time on in question period and again in this debate this afternoon, provides that an inspector may at any time enter the premises of any health facility--and again I point out that does not say an “independent health facility” as licensed by this act; it says “a health facility” and that includes a doctor’s private office that is not licensed under this act--without a warrant to make an inspection. This section and the powers purported to be given under it are very unusual and, to me as a legislator, clearly unacceptable. I think that not only will our party oppose it, but I would presume that many other members of the Legislature as well would oppose this arbitrary use of power. I think at the very least we should insist that such a right of inspection be predicated upon the issuance of a warrant by the judicial system in Ontario.

As I said earlier, personally I would go a little bit further than that. I would not only say we should have to have a warrant for an inspector to exercise those types of powers, because they are very serious indeed, especially with respect to doctor-patient confidentiality, but I think it should be limited only to the independent health facilities covered by this specific legislation, not by any health facility which is not covered by this legislation.

Then we go on, of course, to the offences and fines section. I would like to point out to members of the Legislature that subsection 31(4) provides that any individual convicted of an offence is liable to a fine of between $5,000 and $10,000 for every day during which the offence continues. A corporation guilty of such similar offence is liable to a fine of $25,000 to $50,000 for each day.

I want to spend a little time now talking about the “Complementary Amendments” section, the proposed amendment to the definition of “insured services” in the Health Insurance Act. At present, clause 1(h) of the Health Insurance Act defines insured services as “such services of hospitals and health facilities as are prescribed by the regulations, all services rendered by physicians that are medically necessary and such other health care services as are rendered by such practitioners and under such conditions and limitations as are prescribed by the regulations....”

Under what is described by the ministry in this particular legislation, and I think quite inaccurately, as a complementary amendment, because I do not think it is complementary at all with respect to the Independent Health Facilities Act, it is proposed to amend clause 1(h) of the Health Insurance Act by replacing the words “all services rendered by physicians that are medically necessary” with the words “such services rendered by physicians as are prescribed by the regulations.”

The effect of this amendment would be to limit the insured services a physician could perform to those set out in government regulations, whereas the previous definition included any service by a physician which was medically necessary. In other words, the ministry now seeks to define by regulation just what is medically necessary and is no longer prepared to permit physicians to make that determination. That will be determined by bureaucrats and civil servants in the Ministry of Health, instead.

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I think this is of fundamental importance to the medical profession, as well as to related health care professions such as nursing. It is indeed interesting that the ministry has introduced this very significant amendment under the guise of being what it calls a complementary amendment to the Independent Health Facilities Act. It is, in fact, no such thing. It is not a complementary amendment. It drastically changes the definition and description of what services will and will not be covered. It changes who decides what services are, or are not going to be necessary.

I think it is also of substantial importance because clause 21(1)(c) of the Canada Health Act stipulates that in order to qualify for federal funding, a provincial health insurance plan “must provide for reasonable compensation for all insured health services rendered by medical practitioners.”

“Insured health services” is defined under that act as including “physicians’ services” which are, in turn, defined in the act as meaning “any medically required services rendered by medical practitioners.” There is little or no difference between the words “medically necessary” in the existing clause 1(h) of the Ontario Health Insurance Act and the words, “medically required” in the Canada Health Act.

I think that both those pieces of legislation--one provincial and one federal--leave no doubt of the type of service that is to be covered by a health insurance scheme in any province in Canada, that is, those types of services which are medically necessary. I do not think the government, in what it calls here a complementary amendment, is being complementary to those pieces of legislation at all. It is drastically changing what services are going to qualify under the Independent Health Facilities Act.

I would now like to move on to a couple of comments with respect to this legislation that we have received from other interested people.

Mr. Black: What about the Ontario Medical Association?

Mr. Eves: We have covered the OMA pretty well, I think. We are going to get off the OMA for a while. I want to impress upon the minister, her parliamentary assistant and other members that there are indeed many people out there in the health profession who have concerns about this legislation, not just the doctors.

The dean of nursing at the University of Toronto, Dr. Pringle, was quoted as saying this morning at the conference that was held that there are excessive ministerial powers in this legislation, that there are no incentives to set up an independent health facility, and that the legislation leaves more to the imagination than it defines. Dr. Patricia Teal of the OMA questioned something about the cost-effectiveness of the whole proposal of the legislation.

Does this mean that we are going to always accept the cheapest proposal? Does this mean that the standard of the world-class health care system, as the minister often refers to it, is that we are going to have cut-rate health care in Ontario?

I think the act is far too vague. I think that, really, the act should he reworked in a much more specific sense, addressing some of the abuses that we have pointed out in the House this afternoon, before it is ever dreamt to send this draft piece of legislation to committee.

Other concerns that came out of the conference today were the role of hospitals. The Ontario Hospital Association does not believe that this bill will not harm hospitals in Ontario and that many ambulatory services may have to close in hospitals in Ontario as a result of the legislation.

Nursing shortages: The nursing profession has concerns. How can the ministry and the government ensure that nurses will be available for the independent health facilities proposed by this act and that standards are kept up? It might be interesting to note that Glenna Cole Slattery, the executive director of the Ontario Nurses’ Association-

Mr. Keyes: A friend of mine.

Mr. Eves: A friend of yours?

She suggested this morning that there be a sunset clause with respect to this piece of legislation and that perhaps it could be introduced on a trial basis, because we do not know if it is going to be a cost-effective procedure or a cost-effective system and we do not know if the standards are going to be able to be kept.

When you are thinking about the basic principles of this legislation, they sound great; and they are good. Community-based health care as a basic principle is very acceptable. But one cannot help but wonder whether in fact, in many instances, we are not going to be duplicating costs in a health care system that is already severely burdened.

We look at the cost of the health care budget. I believe in Ontario this year it is somewhere in the neighbourhood of $13 billion. If we are now going to go into licensing independent health facilities, I know the ultimate intent is that in the long term, hopefully, it will prove to be cost-effective, but at least initially I think the minister and the government would have to concede that there are going to be some substantial initial costs to the Ontario taxpayer in establishing such a system.

I think we should be debating and talking about where that money is going to come from, how we can get some sort of a handle or an estimate of what that cost is going to be, and in the long run is this indeed going to be a cost-effective way of dealing with these problems.

There are vested interests, as we said at the outset, of all kinds of groups in society, not just the Ontario Medical Association and the doctors. There is the Ontario Hospital Association; I have read you a couple of its concerns. There is the Ontario Nurses’ Association; I have read you some of its concerns. The Registered Nurses Association of Ontario has similar concerns.

The Ontario Hospital Association indicates in a bulletin it released today at this conference that it supports the intent of the legislation, as indeed I said at the outset we do, “to improve the balance and the efficiency of the health care delivery system through the orderly development of facilities for ambulatory patients that will be subject to planning, funding and quality-assurance criteria,” as are public hospitals in Ontario.

But the OHA goes on to say that it seeks assurance from the Ministry of Health that public hospitals will have equal opportunity under the act to be licensed to establish these community-based facilities where such a need is demonstrated. They will seek to have the licensing provisions of the bill extended to require that nonhospital diagnostic facilities be subject to the same planning criteria as hospitals are.

I know from talking to members at the OHA that they indeed are concerned, especially that some smaller community hospitals in the province are going to suffer some repercussions and effects from this legislation going through.

I want also to reiterate some of the concerns that Glenna Cole Slattery of the ONA had at the conference today. I believe she was speaking this morning. First of all, she is concerned that the minister and cabinet have excessive and abusive powers. I have mentioned those sections at length, not only in question period but also in the debate here this afternoon.

She has said that the act severely limits the creation of new and lower-cost alternatives to physician in-hospital services. She feels that it leaves the door open for the extra-billing of patients.

She believes that it permits the creation of health facilities on a for-profit basis, which in turn may lead to further privatization of health care services. She states that the act continues to leave the door open for foreign ownership of health facilities. She states that it permits the funding of facilities on a fee-for-service basis.

She is concerned that there is a danger that the standards of operation, including registered nursing staffing ratios, will not be adequate in such facilities. She is concerned that the act does not provide for the resolution of disputes concerning terms and conditions of employment in such facilities. She is concerned that the act does not provide for a mechanism to deal with issues concerning excessive workload and impact of care in such a system and does not deal with the unanticipated events of an emergent nature.

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The minister claims that her officials have drafted this act in consultation with all of these groups. It is apparent that Glenna Cole Slattery says that has not necessarily been the case with respect to the ONA.

I would like to put on the record a letter about the proposed Independent Health Facilities Act, Bill 147, addressed to the Attorney General (Mr. Scott) from a constituent of his, a copy of which was sent to our office, dated September 10, 1998.

“Dear Mr. Scott:

“I am writing to you because you are both my MPP and the Attorney General of this province. As a past, present and future patient, I was shocked and outraged to learn that your government has introduced legislation that can make my medical records vulnerable to what I consider unwarranted, and certainly unwanted, seizure and inspection without my or my doctor’s consent and even without my knowledge.

“Surely no argument should be necessary to persuade you, a defender of civil liberties, that these records, which contain extremely personal, sensitive and potentially damaging information, should be protected, not made vulnerable to abuse. I do not want my medical history open to public inspection and I imagine that you do not want your records to be seized and invaded.

“I understand that one of the current debates between the government and the OMA, the College of Physicians and Surgeons and individual doctors is whether or not the proposed act will apply to private doctors’ offices or just the proposed independent health facilities. I am inclined to support the doctors’ view that the act could apply in both cases and therefore should be rejected. Beyond that, however, I feel strongly that medical records at independent health facilities should not be in a special category. They should not be open to seizure without a warrant and should not be treated differently from medical records collected and kept elsewhere.

“If the government is serious about wanting to encourage the establishment of these new centres and about wanting to avoid a two-tier form of medicine, it should not treat users of these new medical services via their medical records differently from users of other medical services. With respect to the argument that the government needs access to medical records to assess the competence of physicians, I would suggest that there are other ways to test doctors’ competence without invading the privacy of their patients’ records.

“Because I feel so strongly that the sanctity of personal medical records should be protected and strengthened, rather than eroded further, I am sending a copy of this letter to a variety of other members of the Legislature. Please withdraw or amend this potentially dangerous legislation.”

Signed, “Sally Gibson.”

I think that letter says a lot about many of the points I have tried to raise in the Legislature this afternoon and the concerns I have--I think very valid concerns--with this piece of legislation. It certainly, at the very least, opens the door to a lot of potential for abuse in the system. and I do not think that any act of the Legislature that is introduced should contain that potential for abuse within it.

Seeing as how the government House leader--and I see him walking away here--wanted this debate on Bill 147, because somehow he thought it had something to do with free trade. I think we should at least address that point of view before the afternoon is over.

I have in my hand a response that the Honourable John Crosbie has given to a question with respect to this particular piece of legislation and similar pieces of legislation.

“Is Ontario’s proposed legislation governing public financing of private health care services in violation of the free trade agreement?” That is the question that was posed to Mr. Crosbie. His answer, which I shall quote, is as follows:

“The controversy seems to centre on Ontario’s proposal to give Canadian nonprofit providers preference in the establishment of health care clinics. While we have not had an opportunity to review the entire Ontario bill in detail, it does not appear to contravene either the spirit or the letter of the free trade agreement for three basic reasons.

“First, except for the management services relating to health care and certain very specific, wholly commercial operations, the list of services covered by the FTA does not include health care services. Private health care clinics, such as those set out in the Ontario bill, are not on this list, notwithstanding opposition suggestions to the contrary.

“Second, as I understand it, Ontario has for some time provided public sector funding for private clinics. Since such services are not covered under the services chapter, Ontario and other provinces will continue to have the same prerogatives they have enjoyed in the past in the operation and financing of their health care programs. They are under no obligation, under the FTA, to provide support to any particular private sector initiative, Canadian or American.

“Third, in the terms of the investment chapter, while American firms could conceivably invest in health care infrastructure, including clinics, since such health care services are not listed under the services chapter, provinces would retain full responsibility for the conduct and operation of such facilities. If they elect, for whatever reason, to prefer Canadian over American operators or nonprofit over profit operators, there is nothing in the FTA agreement which limits the provinces’ ability to do so.

In short, the FTA simply reflects current provincial practices in the health care area and in no way infringes on their freedom to take steps which they believe are in the best interests of maintaining a world-class system.”

I think that should dispel the rumour mill with respect to free trade and this particular legislation. I think members opposite should listen to some of the editorials about this proposed legislation coming from all parts of the province. There are members in the House in the Liberal Party from all these different parts. We will start with Sudbury because I notice the member for Sudbury (Mr. Campbell) here.

In the Sudbury Star, September 15: “Medical Snoopers. There is no need for new powers by which government inspectors could enter medical offices and seize patients’ and doctors’ records without the consent of the affected parties or a court order.

“The Ontario College of Physicians and Surgeons, governing body for the medical profession, raises entirely valid objections to a section of the province’s new Independent Health Facilities Act which would allow this procedure. Citizens in this information age need more, not less, legal protection of their privacy.

“The new legislation goes far beyond authority now existing under the Public Hospitals Act which requires a search warrant. It would open the way to all manner of fishing expeditions on both the patient and the doctor. Health minister Elinor Caplan says the legislation is designed only to monitor the quality of care provided in private clinics. That explanation does not justify opening the doors to snoopers.

“The legislation needs specific checks on how monitoring is done. Any seizure of records must certainly involve a court order or a search warrant granted by a judge after presentation of convincing reasons.”

That is what the people in Sudbury think of the proposed act.

Mr. Campbell: That’s one point of view.

Mr. Eves: Is the member for Sudbury disagreeing with that editorials

The Deputy Speaker: Order.

Mr. Eves: Perhaps he should say so, if he is. He should go on the record.

Here is the Windsor Star, September 12, 1988. “Health Care: Unwarranted Intrusions” is the head of this editorial--

Interjections.

The Deputy Speaker: Order.

Mr. Eves: The members for Windsor do not want to hear what the Windsor Star has to say about “Health Care: Unwarranted Intrusions.”

On motion by Mr. Eves, the debate was adjourned.

The House adjourned at 6 p.m.

November 7, 1988

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