Hansard Transcript 1993-Nov-02 | Legislative Assembly of Ontario

Mr Bernard Grandmaître (Ottawa East): On a point of order, Mr Speaker: I think my colleague has a very important statement to make and I think a quorum should be present.

The Speaker: Would the table determine if there is a quorum.

Clerk Assistant and Clerk of Committees (Ms Deborah Deller): A quorum is not present, Speaker.

The Speaker ordered the bells rung.

Clerk Assistant and Clerk of Committees: A quorum is now present, Speaker.

MEMBERS' STATEMENTS

NORTHWESTERN ONTARIO

Mr Frank Miclash (Kenora): Mr Speaker, I would just like to let you know that the statement is directed to the Premier and the cabinet, and I see three members of cabinet here.

The Northwestern Ontario Associated Chambers of Commerce are travelling from the northwestern portion of the province to address their resolutions to the Premier and cabinet tomorrow; that's if they can find them.

As many people will know, the chamber is an important voice for the citizens of northwestern Ontario. It is represented in 24 communities stretching from Manitouwadge to the Manitoba border.

This year, the resolutions will be broken down into four groups dealing with crown land public policy; environmental regulations; small business, economic development and taxation, and of course transportation and human resources.

These are all important areas that are vital to growth in northwestern Ontario. It is sincerely my hope that the Premier and cabinet will give the Northwestern Ontario Associated Chambers of Commerce their attention on all of the resolutions as presented.

As well, my leader, Lyn McLeod, and I look forward to meeting with the chamber tomorrow to discuss these most important issues.

I have been asked, on behalf of the president and the delegates, to invite all members to attend this evening at the Chestnut Park Hotel to discuss and share the chamber's new focused direction for northwestern Ontario issues. I do hope all members will take time to attend this reception and discuss these issues.

SOCIAL ASSISTANCE

Mr David Johnson (Don Mills): In the 1982-83 fiscal year, Ontario spent $930 million on social assistance. This year it is expected to spend more than $6.3 billion, with a staggering 1.3 million people receiving help.

Yet the technology, the computer system, to handle this growth has not changed significantly. It is not surprising, then, that the Provincial Auditor, in his 1992 report, concluded that 10% of the $6.3 billion spent on the welfare budget was inappropriately allocated.

Two test cases in Metropolitan Toronto identified 16% fraud, which implies that there is a $1-billion problem across the province of Ontario. This situation is an outrage to all taxpayers, including the majority of welfare recipients who are legitimately receiving assistance and who are desperately seeking employment.

In the absence of provincial leadership, Metropolitan Toronto has proceeded with a $28-million on-line system that will have the capacity to automatically check the welfare rolls of other jurisdictions and other systems, such as immigration, and will pay for itself in less than two years.

The Ministry of Community and Social Services has a choice: to chase after all the many cases of abuse that are identified on a daily basis, or to implement an across-the-province system using current technology to eliminate the abuse before it begins.

BANKING SERVICES

Mr Larry O'Connor (Durham-York): I'm on my feet today to speak on behalf of some small business owners and people from the business community, perhaps even the chamber of commerce, because the CIBC, the Canadian Imperial Bank of Commerce, has decided to close a couple of small branches.

Now, I don't know why, when the Canadian Imperial Bank of Commerce decides that it's going to do a little bit of restructuring, it always reaches out into rural Ontario and decides to close a couple of small, profitable banks.

The reason I'm raising this today is because these branches are in Woodville and Little Britain. There are people in those communities who have banked there for over 40 years on a daily basis; like the IGA, for example. They go in there on a daily basis and the bank has decided: "We're going to do some corporate restructuring. We're going to close a few of those rural banks."

That's not good enough. The people of rural Ontario think that if they're going to decide to do some restructuring, they ought to start right down at Bay and King, wherever their headquarters are, and maybe close a couple of those top floors. It would surely, probably, save every rural bank right across the province, because these small, rural banks are a very integral part of the communities they're a part of. They make money for them. The people up at the top making hundreds of thousands of dollars aren't the ones who are turning the profits for the ones in the small branches in rural Ontario.

My colleague over here talked about the chamber of commerce, and I'm sure the chamber of commerce fully supports keeping rural banks open in rural Ontario.

REGIONAL GOVERNMENT RESTRUCTURING

Mr Robert Chiarelli (Ottawa West): Last May, MPP Evelyn Gigantes met with Ottawa regional mayors and MPPs to discuss regional reform legislation. At that time, she undertook to have second reading by the end of June, in recognition of the serious time restraints for implementation before the next municipal election. This has not happened.

Evelyn Gigantes and the NDP have an obligation to the citizens of Ottawa-Carleton on the most significant bill since the Regional Municipality of Ottawa-Carleton Act was introduced in 1968.

The Minister of Municipal Affairs, Ed Philip, is shutting us down. If there are honest disagreements with respect to this legislation, then the government has the obligation to allow full and fair debate.

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I would remind the minister, on the point of whether regional mayors should be on or off a revised regional council, that both the Bartlett report and indeed the NDP's own investigator, Graham Kirby, recommended that regional mayors stay on regional council, and 10 of 11 municipalities in the region and the Association of Municipalities of Ontario want the mayors represented.

We know the game the minister is playing: to sit on this legislation as is, and then ram it through at the last minute and blame the opposition for being obstructionist.

The Minister of Municipal Affairs and Evelyn Gigantes must allow for full and fair debate on the most important legislation for Ottawa-Carleton in 25 years.

Come clean, Minister. Your undemocratic trickery won't wash with the people of Ottawa-Carleton.

CHILD POVERTY

Mr David Turnbull (York Mills): Yesterday, I was presented with hundreds of postcards from constituents calling for the elimination of child poverty that had been collected by the Body Shop. I was pleased to be able to tell them that our leader, Mike Harris, has continually urged the NDP government to establish a breakfast program in elementary schools.

A breakfast program in partnership with the corporate sector is an innovative way of addressing child poverty at little or no additional cost to the taxpayer. Hungry children, tired and uninterested in school, tend to do poorly and are more likely to drop out of school in later years.

The Conference Board of Canada estimates that, because of low literacy and numeracy skills associated with unacceptably high dropout rates, $4.2 billion is lost annually due to employee mistakes and lost productivity.

The NDP government has spent $17,812 to create a trade union song and $30,000 for 20 Canadian auto workers to attend a seven-day workshop on labour humour. The Daily Bread Food Bank in Toronto estimates that that sum of $57,812 could have provided a three-day supply of food for 2,569 children.

The NDP promised, during the 1990 election campaign, to eliminate the need for food banks. It hasn't, but its frivolous expenditures continue.

GOVERNMENT'S RECORD

Mrs Karen Haslam (Perth): It's been said that you shouldn't hide your light under a bushel, but that's exactly what this government is doing. We have brought in many innovative pieces of legislation and continue to restructure the delivery of many other government programs. So, in the absence of upbeat and proactive news reporting of these projects, I plan to spend considerable time in the future reminding opposition members, my colleagues and the people of Ontario about the very good, very efficient programs and changes we are instituting.

We all know that 90 seconds are not nearly enough time to adequately address these items, but I will try, and when my time runs out I'll stop and take it up again next week when I stand to make a statement. That way, over the next weeks, possibly months, I will be able to cover everything.

To begin with, since November is the month we pause to consider violence against women, I'll start with these initiatives: "No man has the right to assault a woman" is the theme of the annual public education campaign each November during Wife Assault Prevention Month. This campaign is repeated in May, declared Sexual Assault Prevention Month by Ontario's NDP government.

The NDP government supports zero tolerance of violence against women. Whether she is a teenager on a date, a wife and a mother, an employee or a senior citizen, a woman has the right to live, work and travel free from the fear of harassment or violence.

Since taking office, the NDP government has supported this commitment with significant funding and program support.

Interjection: Time.

Mrs Haslam: My colleagues say "Time." I shall continue this the next week.

COMMUNITY RECREATION FUNDING

Mr Hugh O'Neil (Quinte): My comments are directed towards the government and especially towards the Minister of Culture, Tourism and Recreation. Today, they deal with her responsibility for recreation within the province of Ontario.

The recreation and sports communities are very concerned as to the erosion of government services and financial support to recreation in the province of Ontario. To quote some of the groups:

"The innovation and leadership in recreation that was once provided by the ministry within the province served as a model to be emulated by other provincial jurisdictions across Canada. That leadership is no longer evident. Financial programs and services developed by the ministry to support the advancement of recreation, sports and fitness have been systematically raided to support the spiralling cost of other government operations. Unless a balance is restored, government support to recreation will be reduced to little more than the financing of its own ministerial infrastructure instead of the required support of community development activities."

One example given is the Hockey Development Centre for Ontario, where overall grants for amateur hockey in Ontario have decreased 22% from 1992-93 levels. The same picture is taking place with other sports bodies.

Will you agree today to direct your deputy minister, Elaine Todres, to set up meetings with yourself and groups such as the Ontario Municipal Recreation Association and the members located at the Ontario Sports Centre to discuss this crisis and to take action to restore recreation to its rightful place of importance in the province?

TEACHERS' DISPUTE

Mr Ernie L. Eves (Parry Sound): I rise in the House today to bring members up to date on the strike of the elementary panel of the East Parry Sound Board of Education. The strike is now in its 19th day and I'm continuing to receive telephone calls and letters from concerned students, parents, ratepayers and educators expressing their concerns about this matter. There's an overwhelming concern in east Parry Sound that the students' education is being jeopardized.

I know everyone in the House will be pleased to learn that the teachers and board will return to negotiation with a mediator tomorrow. I would like to take this opportunity to impress upon both sides the need to bargain in good faith. Both sides in this dispute must be prepared to compromise. The primary responsibility of the board and the teachers is the education of our students. It is imperative to get the students back into the classroom.

I firmly believe that no one wins in these situations, especially the students. That is why I am again asking the Minister of Education and Training to closely monitor these negotiations. If mediation fails, I would ask the minister to impose binding arbitration and legislate the teachers back to work.

SENECA COLLEGE CAMPUS

Mr George Mammoliti (Yorkview): For the umpteenth time, I stand in this place and try and get the Minister of Colleges and Universities to try and understand our position in Yorkview when it comes to our proposal for the proposed Seneca College site at Jane and Finch. Quite frankly, I'm getting a little antsy. I've got a report in my hand from Seneca College that, as far as I'm concerned, doesn't say anything in regard to where the Seneca College site should go.

We all know there's only one place for that Seneca College to go, and that's at Jane and Finch. No other community is organizing like Jane and Finch; no other community wants the site. From what I can gather, there isn't any other community that's organizing around this. This is the only community Seneca College should go in.

There's ample land in the Jane and Finch area for this site to go into. I'm asking again for the umpteenth time for the Minister of Colleges and Universities to try and understand the needs of the Jane and Finch community. I cannot sit by idly and watch statistics such as that 65% of individuals living in public housing and who are on social assistance are actually single parents. These people want a college and they want a college at Jane and Finch. I think it's time for us to make a decision and I'm quite anxious for the minister to listen to what I'm talking about today. I hope the announcement will come soon.

The Speaker (Hon David Warner): It is now time for oral questions and the honourable Leader of the Opposition.

Mr James J. Bradley (St Catharines): Where are all the ministers?

Mrs Elinor Caplan (Oriole): How can you ask questions? There's nobody here.

ORAL QUESTIONS

ONTARIO DRUG BENEFIT PROGRAM

Mrs Lyn McLeod (Leader of the Opposition): Fortunately, my question is for the Minister of Health, who is in the House today. Minister, yesterday I asked how you could even consider user fees for the cost of drugs for cystic fibrosis victims and their families. You told me essentially, "Don't worry, those are just proposals." You were going to consult very widely about the impact of the proposals and certainly consult with the families of cystic fibrosis victims.

Today I want to ask you about the impact of the $10-million cut that you have already made to the special drugs program. On September 27, your ministry sent out a memo telling hospitals that this special drugs program had been cut by 25%. The memo tells the hospitals that if projected expenditures for the program appear likely to exceed the program budget, the ministry may have to cease providing 100% reimbursement.

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The Canadian Cystic Fibrosis Foundation wants to know what this cut will mean for its patients. They want to know if patients are now going to have to pay for their drugs if the hospitals exceed the budget you've set for them. Minister, will you tell us today what is going to happen to these patients and to their families as a result of these cuts? Are they going to have to start paying for their drugs?

Hon Ruth Grier (Minister of Health): I'm happy to assure the Leader of the Opposition and the families of people who are benefiting from the special drugs program that no, there is no intention that they would have to start paying for their drugs.

Mrs McLeod: I am extremely concerned that, maybe even without your own awareness, this is a back-door way to user fees for the drugs needed by cystic fibrosis patients. I know of no other way to explain what the memo from the Ministry of Health to the hospitals means when it says, "If you can't meet your expenditure cuts, we will not be able to provide 100% reimbursement." I simply don't know in what other way the cystic fibrosis foundation can interpret that.

I don't know what other way the Kidney Foundation of Canada can interpret that, and I don't think the kidney foundation is going to be really reassured, Minister. They've written to you because they feel that these cuts are going to affect kidney transplant patients, who now receive their anti-rejection drugs through the special drugs program. They have received no response. They have received no assurance from you that their patients will not have to pay user fees for the drugs that they need to maintain functioning transplants.

Your ministry has said that the $10-million cut can be achieved through better administration, through eliminating waste. Do you really believe that you're going to find waste and inefficiency totalling 25% of this program? What evidence do you have that these cuts will not affect access to needed drugs and that there will not be a requirement for the users of these drugs to have to pay user fees for them?

Hon Mrs Grier: I think it's important that I perhaps explain to everyone in the House that the special drugs program is a program whereby people suffering from a specific disease can have their drugs provided through a hospital. The program has been in place for some time. The program is very open-ended and based on need.

In an effort to provide better management for the entire health system, which is very much part of our government's approach to maintaining and protecting the services that the people of this province so cherish, we had an audit done of the special drugs program, and that audit indicated that there were many hospitals -- not all -- where there was not a clear line between the drugs that were provided for inpatients in the hospital and the drugs that were provided on an outpatient basis.

It showed that there were improvements that could be made in the purchasing practices for the drugs and it showed that improvements could be made in maintaining the inventories of the drugs and a distinction between those drugs that are part of the special drugs program.

In an effort to provide that better management, we have been working with the hospitals to improve their practices. As a result of that, we believe that there are considerable savings to be made in the special drugs program: savings that will be made through better management administration and practices, not savings that will be made by dint of denying anybody who needs the drugs the drugs that they need.

Mrs McLeod: Minister, exactly. You had a management audit that indicated that there could be some savings. You have, to the best of our knowledge, no indication that those considerable savings you have just talked about could equal 25% of the program.

You say that you're working with hospitals. The memo to hospitals telling them that this program had been cut under your expenditure control plan by 25% went out on September 27, which was already six months into their fiscal year. Six months into their fiscal year, you are telling hospitals that they are to find $10 million by eliminating waste and inefficiency in their program, and you can stand in the House today and tell cystic fibrosis patients, kidney patients, AIDS patients, that there will no impact on their access to the drugs they need because hospitals will simply be able to find this $10 million.

Minister, the special drugs program, I'm sure you agree, is an important program. It was put in place because people cannot manage the financial burden that they already face when they are victims of these diseases. Yesterday I asked how you could even consider a $2,000 user fee for the victims of these diseases and their families and you said it was just a proposal. Now we found that you have introduced cuts which could well lead to user fees. Your memorandum clearly states that is possible.

Minister, once again I ask when you will stop making arbitrary decisions that affect the life and the health of the people of this province. Will you give the cystic fibrosis patients, the kidney patients, the AIDS patients of this province an absolute assurance that you will cover 100% of the cost of these drugs?

Hon Mrs Grier: Let me say to the Leader of the Opposition, as I said to her yesterday, that we are looking at all of our drug programs. We have put out a discussion paper, which is predicated on how do we make it a more comprehensive and a fairer program for everyone involved and at the same time contain the costs. We have made no decisions with respect to those changes or with respect to the consultation and the feedback that we got. We are taking very seriously all of the comments and all of the responses that we heard.

I don't even think the Leader of the Opposition believes that we can continue to increase the drug programs at 14%, 16% per year, when we know that there are ways of managing them better so that we can both contain the costs and provide the services. I have no hesitation in saying to the recipients of the special drugs program that we have made no decisions that will change their eligibility as it now stands.

If they are getting those drugs now, regardless of however much was put in the estimates or what we estimate the savings will be, it's part of an open-ended program and the costs will be covered. But I have a responsibility, if we are to be able to maintain and continue these programs into the future, to make sure that I don't do it on the basis on which it was done in the past, which was that the Ministry of Health merely wrote the cheque without having any regard as to how it was administered, how it was managed and how we can make it cost-effective.

Mrs McLeod: Now the Ministry of Health simply makes the cuts without any consideration of the impact on the life and health of people of this province, and that is totally unacceptable.

JOBS ONTARIO TRAINING FUND

Mrs Lyn McLeod (Leader of the Opposition): My second question, in the absence of the Minister of Education and Training, will be to the Deputy Premier. Minister, I'm sure you are well aware that your government has promised to fill 100,000 Jobs Ontario Training positions by September 1994. That date is less than 10 months away and you may be interested to know that you still have nearly 80,000 jobs to go.

To fill all those jobs in such a short time, the Jobs Ontario Training program would have to place approximately 8,000 applicants per month. Unfortunately, you're nowhere near filling that many jobs per month. In fact, Jobs Ontario Training is only filling about 1,300 jobs per month. At that rate I would suggest there is no way you can meet the self-imposed and well-publicized target.

Minister, let me just simply ask, what do you believe are the problems with the Jobs Ontario Training program? Why do you think it's such a dismal failure?

Hon Floyd Laughren (Deputy Premier): There is no question that the Jobs Ontario Training program is more complex than other job creation programs that have been attempted by other governments -- no question about that -- because it involves a child care component, it involves a training component, it involves getting people who are on social assistance or whose unemployment insurance benefits have run out and it involves a broker who helps arrange for a job, at which real training occurs on that job. So there's no question that this is a more complex training program than has been attempted by any other government.

I am very proud of the Jobs Ontario Training program. For the first time -- certainly the first time in this province in my memory, which goes back a ways -- a government has decided that it is going to do something about the obstacles that face women who have children at home, single mothers, to allow them to get into the workplace, and recognized that the unavailability of child care is an obstacle to that. This government is doing something about it in an attempt to give people the kind of training they will need so that they can get off social assistance, which the vast majority of them want to do, unless of course from time to time somebody tries to talk them into doing otherwise.

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Mrs McLeod: It may well have been a complex program, Minister; it's also a completely unworkable program, and it simply is not working. The program was created, I remind you, supposedly to provide training and to create new, long-term employment for people on social assistance, just as you have suggested. Over the past 18 months that the program has been in existence, we have cited many examples of problems with the program. We've suggested that the jobs are mostly low-skill jobs rather than the high-tech and high-skill jobs that are touted by your advertising. We've pointed out that the jobs are not guaranteed to be permanent jobs and in fact many are short-term.

I want to give you the most recent example of our concerns. Three months ago, Heaton Custom Goalie Equipment in Harrow, Ontario, hired several workers under the Jobs Ontario Training program. These people were put to work manufacturing hockey equipment and the employer received funding from the program, supposedly to pay for the training they received.

Last Thursday, Heaton had to lay off four permanent staff, all of whom had been with the company for a period of time. Those people are now on UIC, and yet every Jobs Ontario hiree was kept on. Company representatives have told us that they had to make a business decision to keep the Jobs Ontario people on and let the others go because the Jobs Ontario Training money was being used to subsidize their wages. It was cheaper to keep the Jobs Ontario Training workers and lay off the regular staff.

Minister, I ask you, does it make sense to you to have a job creation program that ends up replacing existing workers with the Jobs Ontario Training workers that you are supporting?

Hon Mr Laughren: No, I don't believe that's appropriate and we will have that investigated. But I can tell the leader of the official opposition that she may speak derisively of the Jobs Ontario Training program, but I'd ask her what she would do in order to help single mothers get off social assistance and get back into the workplace trained for employment, because I can tell you what she did when she was in office: absolutely nothing.

I can tell you that I'd expect there to be some problems when you try to develop a program that is more complex, more meaningful, innovative, has never been tried before. Of course there are going to be some difficulties associated with that. But I can tell the leader of the official opposition that there's been in excess of $60 million saved, avoided in welfare costs, since this program began.

The leader of the official opposition, having come through the 1980s where they spent money like there was no end of it, may not think that $60 million in savings on welfare costs is significant, but I can tell you this government does.

Mrs McLeod: There's a very easy answer to what I would do. I would provide real training programs that work for the people who need them. That is not Jobs Ontario Training. We have said and we will say again that we believe Jobs Ontario Training is not a training program; it is providing wage support for people in jobs where no training is needed. I do not believe that Jobs Ontario Training is the job creation program you keep describing it as.

We've seen today and we've tried to show through this example that this program is causing people who already have jobs to lose their jobs to Jobs Ontario Training workers. Minister, I say to you, if these dollars are genuinely supposed to be for training workers, why don't you set up a program for training that really works? If this is in fact a wage subsidy program, call it a wage subsidy program, and then let's debate whether this is the best way to provide support for the jobs we want to see created.

Hon Mr Laughren: I think the leader of the official opposition misses the point entirely. What makes Jobs Ontario Training a valuable program is the way it brings the different components of the problem together. It provides assistance for child care. That's never been done before. Certainly you didn't do it when you were in government. It also is targeted to people on social assistance and whose unemployment insurance has run out. You didn't do that either. The leader of the official opposition can stand in her place and say, "We would have done this and we could have done that." That may be true, but you didn't.

WORKERS' COMPENSATION BOARD

Mr Michael D. Harris (Nipissing): My question is to the Minister of Labour. Minister, I have today obtained a draft copy of the management proposal on the WCB to the Premier's Labour-Management Advisory Committee. According to this document prepared for the management committee, you and the government and all of us are no longer facing a WCB unfunded liability of $31 billion by the year 2014; in fact, as a result of changes that the Liberals made in 1989 -- the impact of which, I might add, was supposed to be neutral -- the unfunded liability at the WCB will reach $52.5 billion. Minister, if this is true, we are clearly facing a crisis at the WCB of astronomical proportions.

Could you confirm for us today that if no changes are made to the policies of WCB, we are facing an unfunded liability of $52.5 billion by the year 2014?

Hon Bob Mackenzie (Minister of Labour): No, I can't confirm that this is what we're facing in the way of a liability. We knew there was a possibility of $31 billion without any action being taken. Some action is being taken, and we have not yet had the reports from either the trade union group or the management group from the Premier's labour-management council.

Mr Harris: I do have a copy of the report from the management portion of that committee and I suspect that it was sent to me in fear that the labour representatives or you as minister or your party or cabinet would deep-six it.

The unfunded liability of the WCB is growing at a rate of $2 million a day. This cannot be allowed to continue without completely bankrupting the system. The time for reform clearly is long overdue.

The proposal I received today outlines a series of reforms which, if implemented, will reduce the astronomical unfunded liability to zero by the year 2014. Included in this is a reduction in the benefit rate to 85% of net, a reduction in the cost of future economic loss awards and a modification of temporary compensation. These changes, as recommended by the management committee, will reduce the liability without significantly reducing benefits to injured workers and, as they say, will leave injured workers in Ontario at equal to or a higher rate than any province in Canada and any state that we have to compete with.

Are you willing to endorse these changes that will take the unfunded liability from the $31 billion that's now $50 billion-odd to zero by the year 2014? Will you endorse these changes?

Hon Mr Mackenzie: The leader of the third party should be aware that we recognize difficulties at the board. I've admitted it in this House many times. We recognize four or five main problems we are trying to deal with. One of them is the unfunded liability, which is the side that management usually comes at. The injured workers come at it at the side of the older workers' pensions, where they're very limited and inadequate to live on today. There is a question of the governance at the board, which we are taking a serious look at. There's a question of deeming, and there is also a question of enlargement or extension of any of the benefits that are available.

The concerns that are there were taken to the Premier's Council, both the union side and the management side, and presented to them. We asked them both for a report back to the Premier and that report is in the process of being prepared. I know it's finished from the management side, or at least a series of recommendations. The union side has not yet reported. Both of them will be reporting back within the next week or 10 days, and at that point in time we will look at what's in their recommendations and we will decide if there is something there we can work with or if this government then is going to have to take the initiative in what we do.

It was an effort, to begin with, to try and get the two sides involved in the process, looking at the problems that existed at the board.

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Mr Harris: Very similar reforms and proposals have taken place across this province -- under effective leadership by the New Brunswick government. Similar changes as proposed by the management committee here were in fact made, and that's because employees and employers, management and union leaders alike, understood that by allowing the unfunded liability to escalate without reducing costs, you are only going to hurt injured workers in the long run.

The Premier asked for proposals and the Premier has received a proposal from the management working group. Their proposal recommends changes to leave injured workers in Ontario at least the highest paid in North America and in many cases higher paid than any others. In no case do these changes recommend that any province or any state have benefits to injured workers in excess of Ontario. That's what they propose.

They also propose these changes to reduce the unfunded liability to zero by 2014. While you are dithering, $2 million a day in new unfunded liability is being added.

I would ask you this: Do you agree with the goal that the unfunded liability can't be allowed to go from $31 billion to $50 billion? The goal is zero. Do you agree with the time line of 2014, and do you have the courage to implement this plan or a similar plan to reduce this unfunded liability to zero in a reasonable time frame? Can you tell us that?

Hon Mr Mackenzie: Surely the leader of the third party would want to have the recommendations from both sides in before we quickly jump on to the one side that has the recommendations he's referring to and the documents he has. Surely the two groups should meet back again with the Premier and we should assess whether or not there is any further movement or any further ability to reach some kind of consensus agreement. That's exactly what we're try to do.

Mr Harris: They're all out busy forming their own party. Get on with changes now when they're before you.

The Speaker (Hon David Warner): Order. New question.

Mr Harris: My second question --

Mr Paul Klopp (Huron): It must hurt.

Mr Harris: Yes, it hurts me to see the formation of this new labour party. I thought they were all going to support me. But anyway, Mr Speaker, my second question --

Interjections.

The Speaker: Order.

Mr Harris: Well, I thought they should. I'm the only one fighting for the brothers and sisters in this province. I'm the only one fighting to get them back to work, to get fairness in the WCB. I don't know why they wouldn't support me.

The Speaker: And the leader's second question?

HEALTH CARDS

Mr Michael D. Harris (Nipissing): My second question is to the Minister of Health on an issue that I notified her office about earlier today.

I have a copy of a letter from Lisa Harkness and Dr Chris Guiltinan. Just after their son Eric was born in August, they applied for his health card. Eight weeks later, it had not arrived, so they contacted OHIP. They were told that a card had been mailed to their Bathurst Street address four weeks earlier and that the card had already been used extensively. Minister, the Guiltinans have never lived on Bathurst Street and they had never seen Eric's health card. I wonder, Minister, since my office contacted your office today, if you have determined just how much money the health care system lost during the four weeks this card was missing.

Hon Ruth Grier (Minister of Health): Let me say thank you to the leader of the third party for giving us notice of his intent to raise this issue. I cannot at this point tell him whether in fact a card that had been sent in error to the wrong address has been used. I can tell him that the card was sent out on September 22. A replacement card was issued on October 22, at which point of course the first one was cancelled. So we are looking, as he said, at a four-week period.

Interjections.

The Speaker (Hon David Warner): Order.

Hon Mrs Grier: I asked, as soon as I was aware of this information, for an investigation into whether or not the card had been used, but I'm unable to give him that information at this point.

Mr Harris: They were told, when asked of the ministry, that the card had "already been used extensively," so the ministry had enough information to tell the parents that. I'm astounded that they haven't been able to tell you the same information, since clearly they know something had gone amok earlier on and you specifically, as the minister, have asked.

Not only, by the way, was the health card sent to the wrong address, but according to your ministry records, Eric's parents were living at separate addresses. This is also incorrect.

Obviously something is dramatically wrong with the whole computer system and in the issuance of health cards. Either an error was made by OHIP or someone has deliberately attempted to defraud the system. Have you determined which of these is the case, and what have you done to ensure that it does not happen again?

Hon Mrs Grier: I acknowledge that obviously an error occurred, and I say to the honourable member that in a system that has 11 million clients and that processes 10 million claims a month, errors do occur. It's unfortunate but it is also the fact. What has happened is that I have asked for an investigation of whether or not this card was used. If so, I can assure him that if it has been used and used inappropriately, it will be investigated and referred for charges if charges are warranted.

What has happened in order to make sure it doesn't happen again are the improvements to the system that I have outlined in this House on a number of occasions, which are still in process and which are designed to make sure that we take the existing system, which we have all acknowledged is not as effective as it might be, and upgrade it so that we have a secure system. That's what we all want to do.

Mr Harris: Minister, we know that's what we all want to do, but Ontarians are increasingly getting little reassurance and have little faith in your efforts to crack down on fraud.

Last Tuesday, a Scarborough emergency room doctor discovered that a patient had three health cards in her possession. Each card had a completely different number but a similar name. The doctor later called the fraud hotline to report this. Your staff told this doctor they would not investigate unless he sent them a photocopy of these cards. This is the same response my staff received when they recently called an Owen Sound OHIP office to verify duplicate cards.

We have people calling the hotline. We have doctors, we have people reporting cases, and basically the answer from OHIP is, "Hire a private investigator, go out and seize all the cards, invade everybody out there." Nobody seems to be prepared to follow up on these.

Is this how you're dealing with the allegations of health card fraud in Ontario? If so, it's no wonder it's going ahead increasingly with immunity.

Hon Mrs Grier: Nothing could be farther from the case. As the member well knows, investigations have led to charges, which have been laid for the first time. But I want to say to him that to give a complaint over the phone and not provide evidence that in fact you have an inappropriate health card --

Mr Harris: They gave the name, they gave the patient, they gave the address, and they were told they had to go and investigate it.

The Speaker: Order.

Hon Mrs Grier: I think many of us in our constituency offices --

Mr Harris: You think doctors have got time to run around and investigate peoples' homes?

The Speaker: Order, the leader of the third party.

Hon Mrs Grier: -- in dealing with any complaint, seek to have a copy of the letter or the facts that are being complained about.

I want to say to the member that I am delighted that doctors are taking responsibility and reporting when they believe there may be misuse. I hope his members will be supporting the amendments to legislation that are currently being discussed around Bill 50 which relieve doctors of liability should they report and which require them to report. That's one of the concrete steps our government is taking to deal with this issue, and I look forward to having the support of his members when that amendment to the legislation is dealt with both in committee and before the House.

VISITOR

The Speaker (Hon David Warner): I would invite all members to join me in welcoming to our chamber this afternoon a long-serving member who served here during the 1950s and 1960s who is seated in the members' gallery east: Mr Allister Johnston, the former member for Parry Sound.

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PROTECTION OF PRIVACY

Mr Sean G. Conway (Renfrew North): My question concerns justice policy and therefore will be directed to the minister of justice and the Attorney General.

Yesterday, Mr Tom Wright, the Ontario Information and Privacy Commissioner, tabled quite an interesting report. In that report and speaking to his report, Mr Wright, among other things, observed, quoting now from his press release attached to the report, that, "Ontario is in danger of developing a 'Big Brother is watching you'" attitude, that "Unchecked technological development is becoming a major threat to personal privacy" in this province and elsewhere, and he went on in many ways in the report to point to an Orwellian intrusion into the daily lives of the citizens in this province.

In your capacity as minister of justice for the province of Ontario, I was wondering how you respond to Mr Wright's observations and many of the recommendations contained in his just-released report.

Hon Marion Boyd (Attorney General): The Freedom of Information and Protection of Privacy Act is under the auspices of the Management Board secretariat, not the Ministry of the Attorney General, and I would expect that any detailed response to those recommendations is best directed to that minister.

Mr Conway: My question is about justice policy and it properly goes to the Attorney General. I want her comment about the delicious irony of, on the one hand, yesterday having this report tabled by Ontario's Information and Privacy Commission warning the province about an increased tendency to an Orwellian intrusion into the daily lives of this province and its citizens, and, on the same afternoon, this Legislature dealing with Bill 47, which contains a provision for photo-radar in this province.

Is the minister not aware that her government's policy providing for photo-radar is an exact example of the kind of Orwellian intrusion about which Mr Wright is properly warning the province? Is not the minister of justice, responsible for the civil liberties of us all, concerned that on one and the same day we have Mr Wright's report warning us about this kind of invasion of individual privacy and on the same day, we are debating in this Legislature an obnoxious piece of government policy which clearly depends on covert intrusion into the lives of citizens?

Would she not agree that one very positive step in response to Mr Wright's concerns yesterday would be to withdraw those portions of Bill 47 --

The Speaker (Hon David Warner): Would the member conclude his question, please.

Mr Conway: -- which deal with photo-radar? Clearly, they violate something fundamental in terms of the political culture of this province.

Hon Mrs Boyd: My answer simply is absolutely not. The job of any government is to balance the rights of its citizens, and surely those citizens who are injured and killed year after year by aggressive, speeding drivers are of concern to any government. We are not intruding into the privacy of citizens of Ontario. We're intruding, as you describe it, and I would say we are taking care of the safety of Ontarians, and that is our job.

Mr Gordon Mills (Durham East): Incredible. A billion dollars a year it's costing all of us, and you say --

The Speaker: Would the member for Durham East please come to order. It's not good for our health to be upset.

New question, the honourable member for Etobicoke West.

Mr Chris Stockwell (Etobicoke West): The safety of the citizens, and I'm sure $200 million has nothing to do with it. I move on.

BOBLO ISLAND

Mr Chris Stockwell (Etobicoke West): My question is to the Treasurer, the Finance minister of Ontario. Yesterday, I asked you about Boblo Island and the transaction that took place, the $800,000 tax deferment, and I got some answers from you that I've reviewed today. I don't understand the sense they made, to be quite honest, considering that the transaction took place just a few months ago and we talk about five-year deferment, $800,000.

What I would like to ask you today is very direct. There was a deal that was made between you and the parties who bought the land.

Hon Floyd Laughren (Minister of Finance): There was no deal.

Mr Stockwell: Well, I have a copy of the mortgage here, and in that mortgage there is a deal that was talked about between a deferment of $800,000 on the purchase of this property subject to certain conditions.

I, and I'm sure some other people in the province of Ontario, particularly those in the Windsor and Essex area, would like to know what is in that deal, that contract. Could you please table that contract you signed with the proponents who bought the property so we may know once and for all what exactly they had to do to get the $800,000 tax deferment from the beleaguered taxpayers in the province of Ontario?

Hon Mr Laughren: First of all, I didn't sign any contract with anyone on this matter. Secondly, the member for Etobicoke West should understand that when the non-resident made application to purchase this particular property, there was on it a bankrupt theme park, amusement park. If a piece of property is zoned recreational or agricultural, then the former Ministry of Revenue, now Ministry of Finance, has to determine some conditions under which that can be sold and on which a land transfer tax of 20% could be applied if certain conditions are not met.

Because that property was zoned as recreational, therefore a deferment is traditional in this matter and is dealt with by ministry officials -- it never came to my attention or the attention of my personal staff whatsoever -- and the condition was that they had to operate the amusement park, which is fairly traditional, that they'd have to operate it for either a year or in this case the season; as it was a seasonal operation, that was the condition under which it was granted the deferment, which is perfectly normal.

Mr Stockwell: That's exactly what I asked yesterday and that's exactly what the developer told me yesterday, that he had to operate it for 75 days to get a deferment, and it was explained to me by the Treasurer how incorrect I was, that in fact it was a part of the Land Transfer Tax Act process that was put in place.

Let's be clear about this: An American developer from Seattle has walked in and made a purchase of some $3.7 million. They've received an $800,000 deferment from the provincial government. It's zoned recreational. They are now before the local council applying for rezoning to residential, thereby valuing the property in the neighbourhood of $20 million, $30 million, $35 million.

This from the party talking about speculation tax days in the early, middle and late 1980s. You're allowing an American developer to walk in, buy a piece of property for $3.7 million, give them an $800,000 tax deferment, allow them to flip it for $20 million, $25 million, $30 million, and the beleaguered taxpayer gets nothing in the way of land transfer tax that was put in place to protect against exactly that.

If this developer rezones it residential and flips the property, what protection does the taxpayer have in getting back the $800,000 deferment that you gave an American-based developer?

Hon Mr Laughren: The member for Etobicoke West is trying to make a big issue out of this, but I would just remind him that if that non-resident had gone in and bought a recreational activity classified as a commercial theme park and operated it, it could then sell that for residential purposes without ever having paid any kind of extra --

Mr Stockwell: But he did it.

Hon Mr Laughren: If the member would just listen for one minute -- without paying any kind of 20% penalty, because the 20% is a penalty for people who buy land and hold it and do not develop it. If they buy the land with the purpose of developing it, there is no 20% tax.

Mr Michael D. Harris (Nipissing): Yes, there is.

Hon Mr Laughren: No, there's not. If the company had come in, bought the property and said, "It is our intention to develop this property into condo development," for example, there would not be a 20% tax on that property. Those are the requirements under the Land Transfer Tax Act. I don't expect you to live with the burden or the guilt of legislation that your party brought in, but I would simply say to you that if --

Mr Harris: You gave them free money to operate it for a year.

Mr Stockwell: This is like Bill Player's flip.

The Speaker (Hon David Warner): Order.

Hon Mr Laughren: Look, if the member opposite --

Interjection.

The Speaker: Order, the member for Burlington South.

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HIGHWAY CONSTRUCTION

Mr Norm Jamison (Norfolk): My question will be directed to the Minister of Transportation. As you're probably well aware, there's an issue in my riding involving transportation, and that is Highway 6, new.

I know you've met with the community economic development committee that's been structured and put together in the county of Norfolk to hear their concerns about this particular new highway. The new Highway 6 linkage is essential to ensure the continued prosperity of the region. It enhances badly needed access to the multibillion-dollar industrial park complex; transportation is so vital to the future expansion of that facility.

Will the minister give the people of Haldimand-Norfolk and the business community in our area the assurance that Highway 6, new, will go through as scheduled?

Hon Gilles Pouliot (Minister of Transportation): Let me begin, with respect, by saying with all the sincerity at my command that this member, when it comes to development, creating jobs, addressing and sufficing the needs of the good people of Haldimand-Norfolk, has been a catalyst. He has been nothing short of a tower of strength. His diligence daily has made the development of Highway 6 a priority with this government.

What are we looking at? We're looking at $125 million of taxpayers' money returning to the riding of Haldimand-Norfolk. We're looking at hundreds of jobs. We're looking at innovative ways to do business by having one whole contract done. But before we do this, we have to do the pre-contract work. We have to do some engineering. We have to do some design. We also have to accumulate properties. Property acquisition -- one, two, three -- leads us to 1994. That's when shovel-in-the-ground takes place. That's when the money returns to people --

The Speaker (Hon David Warner): Could the minister conclude his response, please.

Hon Mr Pouliot: -- to provide, through the diligence of their member, that most essential of services, transportation; $125 million to make the roads better in the province of Ontario.

HEALTH BUDGET

Mrs Elinor Caplan (Oriole): My question is to the Minister of Health. I have in my hand a refrigerator thermometer that was hand-delivered to an Ontario doctor from your ministry. At a time when health care resources are so scarce and your ministry's direction, priority-setting and leadership are so very important, why are you spending your money on refrigerator thermometers?

Hon Ruth Grier (Minister of Health): That is a very good question. I don't know why we are spending money on thermometers. I undertake to find out what the purpose was and get back to the member as soon as I can.

Mrs Caplan: This refrigerator thermometer cost about $2. There are almost 20,000 doctors in Ontario. You have wasted thousands of dollars on refrigerator thermometers.

I know that a dialysis machine costs about $25,000. I know that pacemakers, which are in short supply, cost about $6,000 each. I know that an IMED pump used for cancer chemotherapy costs about $5,000. Each of these items that I've mentioned are badly needed by patients and by hospitals throughout this province.

Your ministry is spending money on refrigerator thermometers that are not even manufactured in Ontario. Why are refrigerator thermometers your priority? Will you commit today to review your capital spending in the ministry and ensure that taxpayers' money is properly used to make sure people get what they really need?

Hon Mrs Grier: Absolutely.

BUS TRANSPORTATION

Mr Ted Arnott (Wellington): My question is for the Minister of Transportation and it's of great interest to our tourism sector. You've promised Ontario's tourism operators that you'll be introducing legislation to allow for 45-foot motor coaches or tour buses on Ontario's highways. What are you doing to meet this commitment?

Hon Gilles Pouliot (Minister of Transportation): Surprise, surprise, but not for the Minister of Transportation. Members opposite, when using terminology -- when defining the subject matter at hand, members of the opposition will say "the fullness of time." With us, the fullness of time means very soon. You're getting your legislation --

Interjections.

Hon Mr Pouliot: Are you listening? The member opposite has asked me a very direct and pertinent question. He will have, I'm sure, the decency, the courtesy and the decorum to at least listen.

Interjections.

The Speaker (Hon David Warner): Order.

Hon Mr Pouliot: You're getting the longer -- we don't even have to go through legislation; we can do it through regulation. Consider it done. Buy a ticket, board the bus, they will accommodate you and your colleague and the bus will be yet that much bigger. No problem; it's done.

Mr Arnott: The minister has known since June that the motor coach association and Motels Ontario, who are having their convention tomorrow in Niagara Falls, where I'm speaking -- that this is an important issue involving the tourism sector. If it's so easy to introduce interim permits, why haven't you done it?

Hon Mr Pouliot: I wouldn't wish to place myself, but more importantly, the ministry, the government, under a state of siege. When the member addresses the convention tomorrow I know what he will say. I can quote verbatim what he will say. He will say that because of his diligence, because of his representation, he is able to deliver the good news. What's the food at the convention, because you do so many of them and you do it so well? Give them the good news that they have a chance to be like all other jurisdictions, have their rightful place under the sun. There is no impediment to progress of transportation. The buses are getting longer. From June to November is a few short months. We have to do things right. We have to do things reasonably and consistently. It's good news; bring it to them.

ACUPUNCTURE

Mr David Winninger (London South): My question is to the Minister of Health. My question concerns the rights of qualified practitioners of acupuncture. A week ago I attended the opening of an acupuncture clinic in my riding of London South. The clinic is operated by Sayeeda Hosein, the first person trained and certified in Canada to practise traditional Chinese medicine, following four years of training. She will provide these services in a medical walk-in clinic where traditional and modern medicine work together and side by side to treat and heal illness and to promote wellness.

In provinces such as Alberta and Quebec, appropriate legislative provisions have been made for utilizing acupuncture in their health care systems and for utilizing suitable professional titles for practitioners. In Ontario, acupuncture is still an unregulated discipline. In light of the fact that acupuncture is a cost-effective and successful form of healing and in order to provide potential patients with a valid standard for choosing practitioners, when can we expect licensing for acupuncture?

Hon Ruth Grier (Minister of Health): As I'm sure the honourable member is aware, it is the Regulated Health Professions Act in this province that is the mechanism by which professions are regulated. I hope, and I think I have the support of all parties, that we move towards proclamation of that legislation by the end of this year. Under the Regulated Health Professions Act, there is the Health Professions Regulatory Advisory Council and that has already been set up. It was formed under the new legislation and it will be addressing issues of which additional professions might perhaps be regulated once the legislation is proclaimed.

I should say to the member, though, that when the Regulated Health Professions Act was passed, an exemption was written into it that allows acupuncturists to continue to provide the service that they do so that the service can continue to be provided within Ontario. The question of whether or not the public interest needs to be protected by legislation or regulation is what the Health Professions Regulatory Advisory Council will determine.

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Mr Winninger: Minister, in the meantime, pending the review by the Health Disciplines Review Committee, when will qualified practitioners of acupuncture be able to use the term "acupuncturist" or "doctor of acupuncture" or "doctor of Chinese medicine" or abbreviations thereof before or after their names?

Hon Mrs Grier: The title of "acupuncturist" is not a protected title. Practitioners can use that title now and will be able to continue to use it after the Regulated Health Professions Act is proclaimed, but let me say again that if the Health Professions Regulatory Advisory Council concludes that it is in the public interest to regulate practitioners who practise acupuncture, then it would follow that the issue of title would be looked into. What is critical is protection of the public interest, and that's what the Regulated Health Professions Act is designed to do.

FOREST INDUSTRY

Mr Michael A. Brown (Algoma-Manitoulin): I have a question for the Minister of Natural Resources. As the House would know, the forest industry employs about 64,000 people in this province and is worth nearly $10 billion in income to the province of Ontario. On a regional level, forestry is vital to the economic and social wellbeing of this province and particularly the north. Fully 77 out of every 100 manufacturing jobs in the northwest are forest jobs.

Your government has no coherent policy to acknowledge the importance of this industry to the north and to the overall economy of this province. Instead, your government has increased stumpage fees by 43%, raised area charges by 100% and at the very same time cut back reforestation programs in our forests. Your failure to take positive action has placed Ontario's competitive position in the forest sector in serious jeopardy.

Minister, what do you have to say to the people of northern Ontario who work in and depend on the forest industry for their jobs, for their children's jobs and for their grandchildren's jobs, which your government has battered?

Hon Howard Hampton (Minister of Natural Resources): I don't know where the member gets his facts from, but allow me to correct them.

The province, through the period 1985 to 1990, did very little planning for the forest industry. As a result, very soon after 1990, we faced the spectre of the Spruce Falls paper company closing down, Abitibi Provincial in Thunder Bay closing down, St Marys and a number of sawmills. Our government has helped the industry turn those operations around. Spruce Falls today is producing a profit. Provincial Papers is breaking even when for years, when those folks were the government, the warnings kept coming out that the time was drawing near.

When those folks were the government, they signed energy purchase contracts with the province of Manitoba worth over $13 billion without ever inquiring as to whether we needed the power. That has put Ontario Hydro in a terrible position. We are the government that has frozen hydro rates. We are the government that has taken action to help the forest industry.

Mr Brown: That's an interesting opinion held by a majority of one.

In northern Ontario, the present unemployment rate is 16%. Fred Miron, who happens to be the vice-president of the loggers' union, the IWA, was recently quoted about this very same issue, saying, "Maybe we should give them" -- that's you -- "a shot of Geritol and get them moving." Tim Gray, who is the executive director of the Wildlands League, has urged your government to make policy, saying: "This is the last chance. Our forests don't have a future unless we act now."

My question is, when will you recognize the economic and social importance of the forest resource in Ontario and implement policies that ensure its continued role within our society?

Hon Mr Hampton: Again, when we became the government in 1990 and we looked around for a forest policy, we could not find one. We have had to work very hard in three years to consult with environmentalists, to consult with the pulp and paper industry, the lumber industry, first nations, the tourism industry, and to consult internationally with those people who buy our products about what our forest industry in the 21st century ought to look like. Someone should have been doing that before. We, upon becoming the government, have had to pick up the pieces.

Let me go further. What is implicit in the member's statement is that somehow we should give away our timber resources, our forest resources in this province. Alberta does not give away its natural gas and its oil; Saskatchewan does not give away its uranium and its potash; Manitoba does not give away its hydro. Our forest resources are valuable. Whoever utilizes them must be prepared to pay a market price for those resources.

LEGAL AID

Mr Charles Harnick (Willowdale): My question is to the Attorney General. Yesterday I asked you if you thought it was right that a person convicted of drug smuggling by our courts should have an application for refugee status in this country paid for by the taxpayers of Ontario. Yesterday you did not answer that question. Minister, I will ask you again today, do you think that this is right?

Hon Marion Boyd (Attorney General): The legal aid plan is one of the key elements in the justice system which ensures fairness. Anyone who is accused of a crime or who requires legal help has the ability, as do all people who live in Ontario, to apply for legal aid. Then the Ontario legal aid plan, which is run by the law society, makes a determination as to whether or not that person is eligible under the rules that have been set up independent of the Attorney General's office in order to ensure that there is an arm's-length relationship between access to the justice system through legal aid and the political arm of government.

When the member asks me this question, I answer to him exactly the same as I did yesterday. My job is to reinforce the necessity for us, as a province, to ensure access to the legal system for those who are eligible under the plan.

Mr Harnick: Minister, you are sounding more and more like a lawyer every day and I'll tell you something: The job of the Attorney General is not to reinforce what an act says. The job of the Attorney General is to change it when the act is wrong.

What I want to know from you is, will you take concrete steps to ensure that government funds are not used by convicted drug smugglers to finance refugee applications in this province?

Hon Mrs Boyd: As I said yesterday, no, I have no intention of taking that action, because that would then mean the political arm of government was making a decision that a certain group of people were not eligible to access the legal system in this province. The decision will be taken by the immigration court as to whether or not a person has genuine refugee status.

When people are convicted of crimes, that does not in any way infringe on their other rights as people who live in this country, so it is not appropriate for the member to suggest that this is just. I will say the member sounds less and less like a justice minister or a lawyer who is supposed to be an officer of the court in this province when he makes such a suggestion.

CHILD POVERTY

Ms Jenny Carter (Peterborough): My question is to the Minister of Community and Social Services. We're all aware that child poverty is a problem in Ontario. All children need a healthy environment in which they can grow and prosper. I can think of no more important issue than the future of our children.

The Body Shop in Peterborough presented me with postcards that express a concern about child poverty in Canada and encourage me as their representative and us as a government to develop innovative strategies to combat this problem. Could you tell us what you are doing to deal with this issue?

Interjection.

The Speaker (Hon David Warner): The member for York Mills is out of order.

Hon Tony Silipo (Minister of Community and Social Services): I thank the member for the question on an issue that she says is a very important issue and a problem which unfortunately has got worse because of the recession that we are all living through.

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As the member knows, what we are trying to do as a government is deal both in the short term with what we can do now -- and I would point to some things such as the increase in subsidized child care spaces we are putting together and that we've put into the system 8,200 spaces over the last six months alone -- and secondly, tackling the broader issue of poverty in terms of the supports we need to provide to people of low incomes to be able to support themselves and their families.

In that, certainly the initiatives under the social assistance reform, particularly the focus on addressing through a child income program a benefit that would be provided to all low-income Ontarians for their children on a monthly basis, is also a clear indication of one of the ways in which we believe we can tackle and make some inroads in tackling the issue of poverty in this province.

PETITIONS

INFERTILITY

Mr Gary Carr (Oakville South): I have a petition to the Legislative Assembly of Ontario:

"Whereas infertility is a disease which affects approximately one in six couples; and

"Whereas treatment of infertility is already a two-tiered system; and

"Whereas delisting of this valuable service will escalate the situation; and

"Whereas patients already pay fees for services not covered by OHIP; and

"Whereas drug coverage is often very limited; and

"Whereas infertile people are entitled to the same level of health care as the general population,

"We, the undersigned, respectfully petition the Legislature of Ontario to continue to list infertility as an insured service under OHIP."

ANTI-RACISM ACTIVITIES

Mr Drummond White (Durham Centre): I have here a petition with some 1,500 names on it brought forward by the CAW, Local 222's human rights committee. It says:

"To the Legislative Assembly of Ontario:

"Whereas with the increasing number of racially motivated beatings and hate-related attacks on people of ethnic minorities by neo-Nazi thuggery and white supremacist groups like the Heritage Front;

"We, the undersigned, petition the Legislative Assembly of Ontario to pass tough legislation without delay outlawing the distribution of any form of hate literature or taped telephone messages based on racial or ethnic superiority or hatred by any individual or group, and also ban the display of flags bearing swastika and the wearing of Nazi regalia in public.

"We further demand that any individual or group found guilty of violating such anti-racism laws be subjected to severe penalties up to and including three-year prison sentences."

We have here representing that committee Dave Patterson, the vice-chair, Ramesh Syal, Dave Patterson's wife, Roberta, and son Daniel and one of our pages, Patricia, also of the Patterson family. I sign this petition with great pleasure and dedication, as it is a significant action with petitions from all across our country and all across our province.

GAMBLING

Mr James J. Bradley (St Catharines): I have a petition from a number of people concerned about gambling.

"To the Legislative Assembly of Ontario:

"Whereas the New Democratic Party government has not consulted the citizens of the province regarding the expansion of gambling; and

"Whereas families are made more emotionally and economically vulnerable by the operation of various gaming and gambling ventures; and

"Whereas creditable academic studies have shown that state-operated gambling is nothing more than a regressive tax on the poor; and

"Whereas the New Democratic Party has in the past vociferously opposed the raising of moneys for the state through gambling; and

"Whereas the government has not attempted to address the very serious concerns that have been raised by groups and individuals regarding the potential growth in crime;

"Therefore, we, the undersigned, petition the Legislative Assembly of Ontario as follows:

"That the government immediately cease all moves to establish gambling casinos and refrain from introducing video lottery terminals in the province of Ontario."

I will be affixing my signature to this petition as I'm in agreement with its contents.

HIGHWAY SAFETY

Mrs Elizabeth Witmer (Waterloo North): Even though the Minister of Transportation indicated today in the House to me that no one cares about the median barriers on the Conestoga Parkway except me, I have a petition here that supports the coroner's jury recommendation to install these barriers now before any more deaths occur. I have letters from municipal councils and the Waterloo County Board of Education asking for the immediate installation of barriers, I have petitions here that have been signed by over 1,300 people and we've received hundreds of other signatures.

This comes from two boys, Ryan Short and Derek Fiddler, friends of the boys who were killed in the latest accident, and it reads as follows:

"We, the undersigned, hereby petition the region and the province of Ontario to immediately invoke and follow the jury recommendations arising out of the death of Laurie Brain, which occurred on the Conestoga expressway, and more particularly for the installation of median guard rails and reconstruction of the roadway to make it safe for the travelling public of Ontario."

I hereby affix my signature to a petition which is of great importance to the people of my community, and I hope the Minister of Transportation will respond.

PICKERING AIRPORT LAND

Mr Larry O'Connor (Durham-York): I've got a petition here to the Legislative Assembly and to the Lieutenant Governor of Ontario.

"Whereas the previous Conservative federal government intended to dispose of surplus lands on the Pickering airport site that are agriculturally rich and environmentally sensitive; and

"Whereas the residents have not been informed of the last federal government's plan of sale; and

"Whereas they did not include them in the process;

"We, the undersigned, petition the Legislature of Ontario as follows:

"Therefore, that the provincial government of Ontario request that the new Liberal federal government of Canada initiate a public review by panel of the federal Minister of the Environment to ensure an organized disposal protecting these rural resources and the community of residents therein."

I am pleased that the newly elected MPs that are part of the Liberal government also support this, and I affix my name to this.

EDUCATION FINANCING

Ms Dianne Poole (Eglinton): I would like to read a petition from my constituents of Eglinton riding. It is addressed to the Legislative Assembly of Ontario:

"Whereas the Metropolitan Separate School Board educates 29% of the students in Metropolitan Toronto but has access to 20.7% of the residential assessment in Metro and only 10.7% of the corporate and commercial assessment; and

"Whereas the current per-pupil cost of operation at the Metropolitan Separate School Board is significantly less than the comparable per-pupil cost of operation in the Metro Toronto School Board," and then they give specific statistics for both elementary and secondary panels;

"We, the undersigned, petition the Legislative Assembly of Ontario to introduce a bill to reform education finance so that every child in the province of Ontario has the same access to equal funding and quality education."

This is signed by 90 parents of Blessed Sacrament school in North Toronto, and I will affix my signature.

VITAL SERVICES FOR TENANTS

Mr David Turnbull (York Mills): I have a petition addressed to the Legislative Assembly of Ontario and it reads:

"Whereas tenants suffer undue hardships when landlords break an obligation to provide vital services such as electricity, gas and hot water; and

"Whereas most municipalities are not fully empowered to compel such landlords to rectify the matter;

"We, the undersigned, hereby request the government of Ontario to enact David Turnbull's private member's bill, An Act to amend the Municipal Act in respect of vital services by-laws, to give Ontario municipalities the authority to quickly restore vital services to occupants of rented premises when landlords fail to do so."

I too affix my signature to this, and it is signed by many dozens of constituents from my riding.

INFERTILITY

Mrs Margaret Marland (Mississauga South): I have a petition to the Legislative Assembly of Ontario with regard to the OHIP funding for infertility.

"Whereas infertility is a disease which affects approximately one in six couples, or 500,000 Canadians; and

"Whereas treatment of infertility is already a two-tiered system; and

"Whereas delisting of this valuable service will escalate the situation; and

"Whereas patients already pay cyclical fees for services not covered by OHIP; and

"Whereas drug coverage is often very limited; and

"Whereas infertile people are entitled to the same level of health care as the general population,

"We demand that infertility continue to be listed as an insured service under OHIP."

Mr Speaker, I'm happy to add my signature and support to this petition.

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OPPOSITION DAY

CANCER TREATMENT

Mrs McLeod moved opposition day motion number 3:

Recognizing that, since taking office, the NDP government has failed to put in place appropriate mechanisms for the increased demand for cancer treatment; and

Whereas the number of Ontario residents being diagnosed with cancer is growing at about 45,000 per year; and

Whereas two out of three families will have a family member diagnosed with cancer; and

Whereas there are concerns that patients will receive timely treatment; and

Whereas physicians are performing procedures such as surgery due to concerns that less invasive treatment, such as radiation, may not be available on time; and

Whereas the government has set no standards with respect to radical cases as opposed to palliative care; and

Whereas 85% of all cancer cases occur in people over the age of 55; and

Whereas lung cancer continues to be the leading cause of death among all cancer patients, yet despite its commitment in 1991, the NDP government has taken no action on its proposed tobacco act; and

Whereas waiting lists at cancer units in Ontario frequently exceed the standards for optimum care set by the Canadian Association of Radiation Oncologists; and

Whereas the Minister of Health has repeatedly said that hospitals must find the money to perform bone-marrow transplants within global budgets without providing any funding assistance; and

Whereas the government has not undertaken human resource planning to ensure an adequate pool of radiation oncologists, radiation therapists, and medical physicists; and

Whereas the NDP government has created a climate that is encouraging more and more physicians to leave the province,

Therefore the Liberal caucus calls on the NDP government to admit its failure to develop a coherent, effective, cancer strategy; and to initiate a broad cancer care program ranging from prevention to long-term care in a province-wide coordinated approach; and to start work immediately with hospitals, communities, cancer centres, and patients to take all necessary steps to clear up the backlog of treatment cases in the province and ensure no further backlog occurs and that all residents of Ontario receive the cancer care they need when they need it.

Mr Murray J. Elston (Bruce): On a point of order, Mr Speaker: I believe the agreement has been made that the three parties will split the time equally. Mrs McLeod is to lead off, and we'll then go in rotation.

The Deputy Speaker (Mr Gilles E. Morin): Before we start, permit me to read the following procedure. Pursuant to standing order 34(a), the member for Renfrew North has given notice of his dissatisfaction with the answer to his question given by the Attorney General concerning photo-radar. This matter will be debated today at 6 pm.

Mrs Lyn McLeod (Leader of the Opposition): We raise this issue today because as members of the Liberal caucus we are hearing a great many concerns from people across the province about access to cancer treatment in Ontario. We hear about delays in receiving the treatment that's needed. We hear from those who are forced to travel great distances for treatment because it's not available in their own communities.

I can tell you that as a member from northern Ontario, we're used to having a concern about having to travel distances to receive medical treatment, but in this case we're talking about people from the greater Toronto area, who could reasonably expect that the treatment would be available here in this city, but who ironically are having to leave this area to travel to northern Ontario for cancer care.

We're hearing about the shortage of trained specialists to be able to deliver care. This week, we have been particularly concerned to hear, from reports and from a study that has been done by the Institute for Clinical Evaluative Sciences, of decisions to provide more radical surgical treatment than would be necessary because of the delays that people are experiencing in waiting for radiation therapy.

We in our caucus believe it is unacceptable that we should not be able to provide access to cancer care that people need when they need it. We believe the people of this province need reassurance that care will be available when they need it, when a family member needs it, when a friend needs it. We all know that almost every one of us has in some way been touched by the reality of cancer and the terrible toll that it takes on both its victims, on families and on friends. That is why we believe this has to be the highest priority for government even in these difficult financial times.

Responding to the need, and an increasing need, for cancer care is without doubt a challenge. It's a challenge that has been building for a very long time. I think the statistics actually tell much of the story. In 1993, an estimated 116,200 new cases of cancer will be diagnosed in Canada and an estimated 59,700 deaths will be caused by cancer. This compares with 1991, just two years earlier, when 21,565 new cancer cases in men and 20,207 new cases in women were diagnosed in Ontario. In that year, 21,400 deaths were caused by cancer. You look at those statistics and you realize that is only two years ago: just half the numbers of new cases and half the deaths that we are told we can expect from cancer this year.

By the year 2000, mainly due to an aging population, the Ontario Cancer Registry predicts that there will be 30,000 new cases of cancer in men and 28,000 new cases in women in the province of Ontario.

Those statistics alone are cause for concern and demand a response from government. But I have to tell you that our concern has become even greater when we see that the minister, rather than deal with the need for response to these very real challenges, appears more ready simply to blame the doctors of this province than to determine what the problem is and what the government can and should be doing about the problem.

The hospitals and the cancer treatment centres of this province have become more and more frustrated as they try to respond to a growing need with less and less resources, and this government just chops away at their budgets and responds to every crisis by expecting the hospitals simply to do more.

We have raised a concern about a decision that the Princess Margaret Hospital was faced with to discontinue doing bone-marrow transplants, and the response of the minister was to say, "Well, I will tell the Princess Margaret Hospital that it will simply have to do them."

We expressed a concern about too many mastectomies that were being done because of a lack of access to radiation therapy. The minister's initial response was to say that she would pressure the hospitals and doctors into doing more lumpectomies. At the last moment she has now provided -- and we're appreciative, glad to see it -- a million dollars to be able to hire the radiation therapists who were about to graduate and have no jobs to go to in the province of Ontario, as desperately as we needed those radiation therapists to provide the radiation therapy that these patients will need.

We asked very recently why the Bayview cancer centre was going to be shutting down for two days, a day in October and a day in November, and why, in shutting down in October, it was going to be turning already-booked patients away. We were told that it wasn't the social contract that was causing the clinic to be shut down; it was just regular maintenance of its equipment. We had to wonder why anybody would cancel already-booked patients to carry out regular maintenance of their equipment. Again, this minister and this government refused to understand the reality of the problem that our hospitals and our cancer centres are trying to deal with.

We've tried to talk about the concerns of people in isolated communities as well as in the greater Toronto area, the concerns of people who have to travel long distances to be able to get the care they need, and in the case of cancer care, who have to do that on a repeated basis, and we're told that somehow we just don't understand what's happening.

Well, we want to understand. We want to find out what the facts of this situation are, because we are genuinely concerned. We want to find out where there are problems. We want to know what they are. We want to know why the problems exist. We want to know, if there is a growing crisis, what can be done to respond.

That is exactly why we have set up a task force on cancer care, which will begin its hearings tomorrow in Kingston. The goal of our task force is to find out the facts of the situation and to bring back to this government recommendations that we will urge the government to take action on to restore faith in access to cancer care in this province.

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There are some facts that we already know. We know that the Canadian Association of Radiation Oncologists has set a standard of four weeks between diagnosis and treatment as the maximum waiting period. We know that while most serious cancers such as brain and spinal cord receive treatment within this time frame, many cases of radiation therapy for prostate and breast cancer exceed this four-week period. We know that three quarters of those with cervix, larynx and lung cancer have to wait longer than a month for radiation treatment.

We know that over the past decade, the waiting lists for treatment of cancers of the breast, cervix, larynx, lung and prostate have doubled. We know that women in the Metropolitan Toronto area awaiting radiation treatment are being given two choices: Wait and risk further development of the disease or travel to northern Ontario for six weeks, largely at their own expense, to obtain timely treatment. We know that the waiting list for radiation treatment in Hamilton is six weeks, two weeks longer than that recommended by the Canadian Association of Radiation Oncologists.

We know that the minister has said, in what we consider to be yet another crisis response, that she will seek an exemption on foreign-trained cancer specialists so that they can practise here, and yet we know that only four of 11 radiation oncologists who graduated in this province in June 1993 have chosen to stay in Ontario to practise.

We know all of these facts and we believe that we should be asking why and that we should be asking what can be done about it.

As we raise these issues today, I want you to know that this is not some new-found cause that our caucus has just recently decided to advocate. I want to take you back to 1989 and 1990 when we were in government, when our colleague, who was then Minister of Health, was working with cancer care providers to set out a cancer strategy and a proposed new cancer act.

I recognize that this was some three, four years ago, and that we were already concerned at the time with the realities of the increasing demand for cancer care and that we were concerned about how we could respond. I want to take a moment to just indicate what was being achieved, what was being put in place at that time.

The Liberal government of that day was responsible for instituting the breast cancer screening program which one of my colleagues will speak to in greater detail later. The cancer patient referral office was established in October 1989 to help ease the temporary pressure on the system caused by a shortage of radiation therapists. The office closed on March 30, 1990. Referrals were down, more radiation technicians had joined the system and more machines had come on stream. The Ministry of Health committed more than $200 million to the Princess Margaret Hospital to create a state-of-the-art facility for cancer research and treatment.

In 1989, the Liberal government announced $42 million for expansion, improvements and equipment for the province's eight regional cancer centres, and this funding included $18 million for construction and radiotherapy equipment at the Ottawa Regional Cancer Centre, the expansion to be completed in 1993.

The funding also included $2.5 million in annual operating costs to the Kingston Regional Cancer Centre, and $779,000 in one-time funding allowed an additional 500 to 600 radiation therapy cases to be handled in Kingston per year.

The Ministry of Health at that time established a cancer manpower committee to evaluate the radiotherapy technologist needs and to study cancer manpower needs in general, and this committee was to have reported to the minister in May 1990. The Ministry of Health asked the federal government to speed up immigration proceedings for radiotherapy technicians from Britain and the federal government had given its approval.

Mr Speaker, I would suggest to you that under the Liberal government, cancer care was indeed a priority. It was one of the specialty areas where the ministry knew, where we knew, that we had to commit our resources.

We were particularly concerned to put in place the planning and the processes that would allow for a coordination of cancer care services in this province. We were concerned to work cooperatively with all the partners to provide quality, cost-effective care. The goal of that kind of planning and that kind of coordination, the goal of committing these kinds of resources to what we consider to be an urgent critical priority, the goal of that was to ensure that future challenges could indeed be anticipated and would be addressed.

That was three years ago, and today I am concerned that in spite of the early efforts that were made to provide for coordination and a cooperative planned approach to deal with the demands that we knew were building, we still have a crisis response and no one in the health care provider field knows how they're going to cope with whatever is going to come tomorrow.

I do not believe this is good enough. I don't believe it's good enough for the people of this province. I don't believe it's good enough for those who are cancer patients, for their families, for their friends, for all of us who know that this disease could affect any one of us or our families or friends. Even in tough financial times we have to make quality health care a priority and we have to act to restore confidence that our critical health care needs will be met.

The Deputy Speaker: Any further debate? The member for Mississauga South.

Mrs Margaret Marland (Mississauga South): Mr Speaker, we're not having questions and comments in this debate?

The Deputy Speaker: No, it's opposition day and there are no questions or comments. Do you wish to take the floor? Do you wish to make an address?

Mrs Marland: Will we miss our time if I relinquish the floor at this point, or will we still have our whole hour when the rotation comes around? Because I wasn't scheduled to be the first speaker.

The Deputy Speaker: I'll go to somebody else.

Mrs Marland: We still have the time?

The Deputy Speaker: Yes. I'll go to somebody else. Any further debate? The member for Port Arthur.

Hon Shelley Wark-Martyn (Minister without Portfolio in Health): I want to begin by saying that our government feels that this debate is not a time to play politics. This issue is too important to be used in such an opportunistic way. This is a frightening disease that, sadly, we see all too often. I think it is self-evident that every member here wants to see cancer wiped out. I think there is not a member here who does not hope for science to find a key to cancer and the cure. We are all united in that, I have no doubt. I am equally sure that no other member of the Legislature speaking today will want to use this debate for anything but the most serious and honourable of purposes.

There is not one of us here who has not been touched in one way or another by cancer, who has not seen the suffering and anxiety it causes a person and his or her family and friends. Sadly, our experiences with this awful disease are growing more frequent, for as the population ages we are seeing more Ontarians develop cancer. It is partly a result of modern medicine's ability to keep people alive longer that we see an upsurge in the incidence of cancer. The longer people live, the more likely they are to develop cancer, and the rate at which people die from cancer rises sharply with age too.

Two out of every three people who die from it are over 65 years of age, and there are those types of cancer that develop more often with age. Men over 65 are more likely to develop prostate cancer. Women over 65 are more likely to develop breast cancer. There are, of course, other factors besides age that can account for whether a person develops one or another type of cancer: family history, hormonal or other biological changes, diet, tobacco and alcohol use, workplace exposure to carcinogens, and there are more. We are daily gaining knowledge about this and others, and from that knowledge we are learning the wisdom of prevention, we are learning the value of early diagnosis.

I side with those who believe cancer can be beaten. I equally side with those who know some cancers can be prevented. For the past 40 years efforts to deal with cancer here and around the world have been devoted to research, treatment and the search for a cure. In 1992, the Ministry of Health spent more than $1 billion on cancer treatment programs and services. We will spend that much again this year, but our government has recognized, and the Minister of Health has stated publicly many times, that prevention of disease and promotion of healthy living needs more effort.

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Our government knows that for people to have longer and healthier lives we must work together to avoid the behaviours and conditions that lead to the disease. We must lessen the number of times a family doctor has to tell a patient that he or she or their loved one has cancer. Not to increase our efforts in this direction would be irresponsible.

There are places to start on prevention. There are cancers to reduce: 25% to 30% of all fatal cancers are caused by tobacco. Lung cancer rates in women are up. Lung cancer is the leading cause of death overall, but tobacco does not stop its grim toll there. It is linked to cancers of the lip, tongue, soft palate, larynx, oesophagus, pancreas, kidney and bladder. Moreover, the link between exposure to secondhand smoke and cancer have been cited time and again.

Our government continues to provide money to public health authorities to help people quit smoking. The public health branch of the Ministry of Health devotes great effort in this same direction, and recently our government unveiled in this House our tobacco strategy. The ministry's targets for tobacco use which were adopted by the government in 1992 include the elimination of tobacco sales to minors by 1995, making all workplaces, schools and public places smoke-free by 1995 and reducing tobacco sales in Ontario by 50% by the year 2000.

To achieve these targets, the Ministry of Health is developing a media and public education campaign, funding resource centres to assist local groups, providing additional funds to local boards of health for tobacco use prevention, supporting the Ontario tobacco research unit, producing educational resource materials and, yes, anticipating the introduction of legislation in a timely manner.

It is our sincere hope that the honourable members of the opposition and other members will recognize the need for quick and effective legislation and in consequence lend their support thereto.

These new commitments will be backed up by new funding of some $12.4 million to reduce tobacco use throughout the province.

Our tobacco strategy is based on scientific research. Part of the way we will prevent it is through legislation, but that is only one component. A similar program in the United States is the National Cancer Institute stop-smoking intervention study. This program shows that a comprehensive program must be based on different approaches such as media campaigns, policy development and program services. It must be delivered in different settings such as schools, homes, health care places, workplaces and wherever else possible throughout the community.

Tobacco causes five times more deaths each year in Ontario than AIDS, traffic accidents and suicides combined. While smoking has declined steadily in Ontario in recent decades, we need to see more happen.

We know that in 1990, 32% of men in Ontario smoked and 27% of women smoked. We cannot let those numbers stand. Our government is determined that they will not stand. Helping people to quit smoking or, better yet, never start, is encouraging people to develop healthier ways of living.

What we put inside our bodies, be it smoke or anything else, of course has an impact on our health. Alcohol is not often thought of in terms of cancer, but we know its links with the disease. About 10% of fatal cancers are linked to alcohol, among them cancers of the larynx and the oesophagus. Recently it has been linked to increased risk of breast cancer.

Our government is progressing with its strategy on substance abuse. Alcohol abuse is a primary component. Prevention again is our best opportunity for reducing illness and early death.

There is already a good deal of our government's energy being used to promote healthy lifestyles and healthy communities. Just to mention a few, the Ministry of Environment and Energy has developed standards and regulations that reduce or eliminate exposure to hazardous substances in the environment.

Mr Chris Stockwell (Etobicoke West): On a point of order, Mr Speaker: I think we should have a quorum for the debate.

The Deputy Speaker: Would you please check to see if there is a quorum.

Clerk Assistant and Clerk of Committees (Ms Deborah Deller): A quorum is not present, Speaker.

The Deputy Speaker ordered the bells rung.

Clerk Assistant and Clerk of Committees: A quorum is now present, Speaker.

The Deputy Speaker: The member for Port Arthur may continue.

Hon Ms Wark-Martyn: The Ministry of Labour carefully regulates the use of hazardous substances in the workplace, and there is our government's forthcoming Environmental Bill of Rights. Controlling the use of toxic and hazardous substances will help to prevent cancer in the future.

They combine with the work of the Ministry of Health. There is a growing body of evidence linking some kinds of cancer to dietary fat. Healthy lifestyles and heart health promotion programs are funded by the ministry and organized by communities. They encourage Ontarians to eat less fat, drink less alcohol and to consume more fibre. These programs have the potential to prevent, delay or reduce a range of chronic diseases, including cancer.

In addition to providing funding, the Ministry of Health is active in creating programs and providing other community supports. Public health departments also run the Sun Smart campaign. This is an education program telling people about the risk of exposure to ultraviolet radiation. This timely initiative attempts to change our attitudes about suntanning. It discourages exposure to sun and encourages sunscreens, protective clothing, hats and sunglasses. The Ministry of Health supports this program through its funding of public health departments.

I must not leave out the Ministry of Health public health and AIDS programs, through which it actively promotes healthy sexuality. It provides Ontarians with information they can use to protect themselves from sexually transmitted diseases and the cancers associated with sexual behaviour

The efforts of government and community workers in all these cancer-fighting programs produce enormous benefits for Ontarians, and as we seek to further expand our programs we look for public input. We have already held consultations in the development of our cancer strategy in Thunder Bay, Ottawa, London, Oakville and Toronto, and we continue to do so. For instance, between 80 and 100 people from northeastern Ontario can expect to receive invitations in the next few weeks to offer us further advice on how we should be dealing with cancer. This consultation will use video satellite technology to link people in Sault Ste Marie, Sudbury and North Bay.

I would ask, at the same time as we have done this and gone to these communities and the opposition has started to do the same thing, that we have some respect for the people whom we will be inviting to these consultation meetings. They will be the specialists who are working with the patients and the families; they will be the patients and the families and the consumers of our system. Perhaps in this Legislature we could all use the information we've gathered, that we don't have to travel to the same communities to gather the same information but that we can use it to develop a strategy for cancer control here in Ontario.

We are also pleased with other efforts under way in the north. The Thunder Bay Regional Cancer Centre, to name just one example, is coordinating a project to monitor and evaluate cervical cancer prevention programs in northwestern Ontario and to define user requirements for a computerized database for cervical screening.

I'm also proud of the funding which they received from the Ministry of Northern Development and Mines, over $1 million to see their cancer centre in Thunder Bay grow, to see the cancer centre in Thunder Bay able to start to do some research locally, so that it can get the specialists it needs to do the work around cancer research and also have them staying there.

In conclusion, I want to say we are all aware of the importance of proper cancer treatment. What we all must become even more aware of is cancer prevention. Our treatment programs assist Ontarians who have developed cancer. Prevention programs help everyone. They have the real power to save lives. Smoking, drinking alcohol and eating fatty foods are behaviours we can change, each one of us. Our government is committed in the most vigorous way to encouraging those changes.

Government's responsibility goes further. It is our duty to eliminate exposure to carcinogens wherever they are encountered. We are working hard to see that more research money goes into finding the causes of cancer so that we can best use our prevention strategies and then evaluate their outcomes. All of this work will benefit every one of us.

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The Deputy Speaker: Any further debate?

Ms Dianne Poole (Eglinton): I rise to join in the debate today as the Liberal critic for women's issues. As critic for women's issues, I'm going to focus on one type of cancer, and that is breast cancer.

The fear of every woman is that she will find a lump in her breast. It is a frightening thing as a woman. I guess the good news is that eight out of 10 lumps are benign, which means they are non-cancerous. But the rest of the news is not as good.

Breast cancer affects one in nine women. In 1960, breast cancer killed one out of 20 women; in 1977, one out of 13. The latest statistics we have are equally frightening. There were an estimated 15,700 new cases of breast cancer diagnosed in 1992. Breast cancer is expected to kill 5,400 Canadian women this year alone. It is the number one cancer killer of women between the ages of 35 and 54. That's an age that comprises the majority of women in this House, and I know in at least one instance that it has struck very close to home. But many of us have friends, have family, know other women or in some cases have experienced breast cancer ourselves.

It is also frightening to note that Canada has one of the highest rates of breast cancer in the world, basically exceeded only by the United States. According to Statistics Canada, the cases of breast cancer in Canada are expected to rise 20% this year among women under 45. According to the most recent available data for cancer incidence in five continents, rates for breast cancer in Canada are among the highest in the world and are exceeded primarily by those in the United States.

There is no known cause, and therefore no known cure, for advanced breast cancer. At best, early-stage breast cancer can be controlled. Now, in 75% of the women who get breast cancer, there are no known risk factors. However, researchers suspect the high rate of breast cancer can be partly attributed to a high-fat diet, delayed childbirth and having fewer children. They suspect this is why we are seeing the baby boomers as targets more and more in cases of breast cancer.

Mammography is the best-known method of early detection, but 60% of women over the age of 40 have never had a mammogram. Only 20% of all physicians recommend mammograms. It is estimated that the mortality rate would decrease by 30% if every woman who should be screened for breast cancer did get a mammogram. You can tell by this that early detection is crucial.

The previous Liberal government did in fact have initiatives which related to breast cancer. They initiated a province-wide breast cancer screening program in May 1989. There were 36 sites chosen across the province in which to institute this breast screening program. Experts believe that the Ontario breast screening program, which is a network of standardized breast screening clinics throughout Ontario, will reduce cancer deaths by 40% each year.

These statistics are alarming and frightening enough, but women are even more alarmed to find that there are now problems in getting treated in a timely way. The waiting list for breast cancer treatment in Toronto is overflowing, forcing many women to go to northern hospitals for treatment. Between June 1992 and February 1993, 114 women were sent hundreds of miles away for treatment. As the Leader of the Opposition, Lyn McLeod, stated, as a northern Ontario member she has seen this happen many times to northern Ontario women, when they had to travel great distances to get treatment. But now we're seeing that in southern Ontario, women are again forced away from their families at a very vulnerable time.

Women who have been sent north for treatment have to spend four to six weeks away from home, all because they need a daily radiation zap that lasts 20 seconds or less. Metro women face a 12-week wait for radiation therapy if they remain in Toronto. Doctors say the optimum time frame for radiation treatment following referral and surgery to remove either a cancerous lump or a breast is four weeks, so that 12-week wait in Toronto is just totally unacceptable. This is shared by waits in other, although not all, parts of the province.

But I would point out that women with family responsibilities and with job responsibilities often cannot travel extensive distances for treatment. Other women prefer not to leave their family; the social and emotional support networks are in place in their homes. Think of the psychological trauma of having a disease for which there is no known cause and therefore no known cure. Think of looking at the fact that there is a waiting list of 12 weeks when you know the optimum time from diagnosis to treatment should be four weeks, and think of the frightening aspect of having to leave your family and your support system at that time to go several hundred miles away and spend four to six weeks at the most vulnerable time in your life away from that support system.

The provincial government's one-time funding allotment of $567,000 to pay transportation costs to send women north for treatment ran out during the summer, so women are now forced to pay about $360 for a round-trip air ticket to Sudbury or Thunder Bay to receive treatment. It's called adding insult to injury.

Women are asking, what is the cause for this delay in treatment for women with breast cancer? It is the opinion of many experts in the field that there is a shortage of oncologists and a shortage of machines. However, this should come as no surprise to the government when it could have been foreseen by looking at enrolment figures several years ago. Lyn McLeod, the Leader of the Opposition, has raised a number of things that the Liberal government did in order to ensure that there was planning for the treatment of various cancers, including breast cancer. So this could have been foreseen.

Marie Winter, who is a 68-year-old woman who lives in the Kitchener-Waterloo area, recently told her story in the Kitchener-Waterloo Record. She waited 14 weeks for treatment.

"She is not blaming the doctors she has seen, nor the overworked staff at the centre. She says she knows the shortage of radiologists is one of the reasons why there is a province-wide problem. But she questions the planning that caused the current backlog.

"'In London, the (radiology) machines are sitting idle. They won't pay for people to run them. If they had told me, can you come in the middle of the night (for treatment), I would have said yes,' she said."

That talks about some of the vulnerability and frustration of the women who are waiting for that treatment.

A question I have to ask is, why aren't publicly funded medical schools encouraged to concentrate on oncology? This is something that should have been in place long before today. I also believe that the NDP government's introducing policies to limit the number of doctors practising in Ontario has had an impact on the psychological wellbeing of doctors who wish to practise in this province. Many oncologists are going to make the decision that they don't want to practise in Ontario. In our caucus we have raised the story that of the 11 radiation oncologists graduating this June, seven have chosen not to practise in Ontario. Now, in a last-minute reaction to a last-minute crisis, the NDP government says it's going to import oncologists.

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Notwithstanding the announcement that was made just yesterday by the Minister of Health, again a delayed reaction to a long-standing problem, it is predicted that by the year 2001 there will be a shortage of 140 radiation therapists, 84 radiation oncologists and 50 medical physicists. Up until the minister finally made the announcement yesterday to provide $1 million in assistance, there were 18 radiation therapists available for work in Ontario, but Princess Margaret Hospital didn't have the budget to hire them.

As we look at the policies of this government towards the new doctors, that ill-fated proposal which had so many people up in arms that in the practice of family medicine, paediatrics and psychiatry they would limit the new doctors in those particular fields to only 25% of the billings in most of the overserviced areas, fortunately they rethought that policy, but the damage has been done. The damage has been done by the cutbacks from the social contract and the expenditure control plan so that the resources aren't there in hospitals. Health care in general has had enormous cutbacks through this government that have made physicians question the wisdom of wanting to practise in this province.

To compound these problems, we've just had the recent release of information contained in a study by the Institute for Clinical Evaluation Sciences in Ontario. According to their study, many Ontario women with breast cancer are receiving more disfiguring mastectomies than is medically warranted. The rate of lumpectomies, which is only a partial removal and only removes the cancerous section itself and does not impact on the tissues and the structure of the breast, and the rates of mastectomies vary very differently from one Ontario county to another. Of the women surveyed, 57% of those who had surgery had mastectomies, while 32% had lumpectomies. From 1989 to 1991, according to this study, lumpectomy surgery ranged from a low of 11% in some hospitals to a high of 84% in other hospitals across the province.

Although the Minister of Health denied this yesterday, it was also reported that there was a higher rate of mastectomies done on northern Ontario women. Doctors suggested this could be attributed to a number of factors, including the long drive to obtain radiation therapy after receiving lumpectomies and also because the women were not able to see a doctor soon enough after diagnosis.

This is the kind of evaluation that the women of this province have been waiting for. Many women have believed for years that too many mastectomies were being performed when the lumpectomy, which has a very, very good success rate, could have been performed instead, but until now we didn't have the proof.

I call on this Minister of Health to take a leadership role. She has not done it to date, but now that we have a medical study that confirms the fears of women, the ministry has an obligation to act decisively and quickly.

This minister has been very quick to blame the doctors. The Minister of Health has said:

"It's obvious from this study that some doctors haven't responded quickly enough to changes in medicine....We must ensure that no matter where people live, they'll have the same choices and the same level of care. That's their right. Perhaps we can transmit the message to some outlying communities where doctors aren't attuned to the changing medical practices."

I find it unconscionable to blame the doctors. Where was the leadership of this Minister of Health, and the previous Minister of Health, in this regard? I call on her to take leadership now. It may be belated, but she can take it now. She should form a committee of specialists that can set out the protocol and set out the steps for action so that it can occur quickly.

I have the privilege of being a member of the task force on cancer treatment that my leader, Lyn McLeod, has called to travel the province and to look for creative solutions. We are looking for solutions. We are looking for a very positive way to ensure that the women and the men of this province get timely, efficient, effective access to cancer treatment.

There are solutions; there are solutions available and the patients of this province, the physicians, the care providers, those who are in the specialties of radiation, oncology, those who are in the hospitals are the people who can provide us with some of those answers.

I reiterate what my leader said just scant moments ago: cancer treatment has to be a priority of this government. Yes, we recognize that times are tough, but surely in a vital area like this, and cancer will affect one in three Canadians in their lifetime -- one in three, They are horrifying statistics and we cannot possibly not act in this regard.

I call on the Minister of Health to show the leadership. We are demanding it and the people of Ontario are demanding it.

Mrs Marland: On a point of order, Mr Speaker: This is a very important discussion in this House and right now there are 12 members, eight of whom are women. I think the men should be here to hear this debate and be part of it.

The Deputy Speaker: Are you asking if there is a quorum?

Mrs Marland: I'm suggesting there are 12 members here and a quorum is 20.

The Deputy Speaker: Are you asking for a quorum?

Mrs Marland: Yes, Mr Speaker, I am.

The Deputy Speaker: Could you please check if there is a quorum.

Clerk Assistant and Clerk of Committees: A quorum is not present, Speaker.

The Deputy Speaker ordered the bells rung.

Clerk Assistant and Clerk of Committees: A quorum is now present, Speaker.

The Deputy Speaker: Any further debate?

Mrs Elizabeth Witmer (Waterloo North): I will be joining the debate today in support of the Liberal opposition motion which recognizes that since taking office, the NDP government has failed to put in place the appropriate mechanisms for the increased demand for cancer treatment. That takes into consideration the fact that the number of Ontario residents who are being diagnosed with cancer is growing at an alarming rate of some 45,000 individuals per year.

We also know now that two out of three families in this province will have a family member who is diagnosed with cancer, and there is widespread concern throughout the province that patients are not receiving treatment in a timely manner. There is also great concern that physicians are performing procedures such as surgery due to concerns that less invasive treatment such as radiation may not be available on time.

Therefore, the PC caucus is pleased to support the motion which calls on the NDP government to admit to its failure to develop a coherent, effective cancer strategy and to initiate a broad cancer care program ranging from prevention to long-term care in a province-wide, coordinated approach and to start work immediately with hospitals, communities, cancer centres and patients to take all the necessary steps to clear up the backlog of treatment cases in this province and ensure that no further backlog occurs and that all residents of Ontario receive the cancer care they need when they need it.

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Certainly I can attest to the fact that there is growing concern among my own constituents in Waterloo North concerning the availability of timely treatment and also concern that they're not getting the best treatment for the cancer that they have.

I raised one issue with the minister for women's issues in the standing committee on estimates on October 13. I addressed at that time the growing concern in this province about breast cancer. This, as we know, is the most common cancer among women in this province. It is a most dreaded disease, and we are all acquainted with someone who has either had the disease or does have it at the present time.

We are all concerned, and I expressed it that day, on October 13, that the waiting list for breast cancer radiation treatment in the city of Toronto in particular was overflowing. I expressed my concern about the women, who are extremely vulnerable and who are very emotionally dependent on their families and their friends at this time in their lives. I expressed my concern about the fact that these individuals were being forced to go elsewhere for therapy. Unfortunately, they were being forced to go alone, without their families and without the support of their friends. They were going north because the service was not available in their home town.

Unfortunately, we know that as a result of a lack of service, there are breast cancer patients who are undergoing disfiguring mastectomies instead of having the breast-conserving lumpectomies combined with radiation treatment. This is happening because doctors in this province today fear that the long wait for treatment could result in the loss of life.

We also know that 20% to 25% of the breast cancer patients will get a recurrence in the same breast. However, it's almost impossible to determine which patients will have this recurrence. That is why breast cancer patients receive the radiation. That is why the radiation services are so necessary in this province, because it is a tool that is used to kill any remaining abnormal cells after surgery.

Yet in this province today we have women who are waiting for this most necessary radiation treatment. As I indicated, they are being given two choices: You can wait until the facilities and the personnel are available, in Toronto in particular where there has been a wait, or you can risk letting the disease develop further; or you can travel to northern Ontario for six weeks in order to obtain the treatment in a timely manner.

We also need to remember that those patients who are forced to travel north must bear the transportation costs themselves. In essence, we have here again a two-tiered system, because some people will obviously not have the financial resources to travel to a northern community.

As I talk about women travelling north, I think it's important to indicate that I would also be concerned about women from the north who are forced to travel to southern centres. We need to become more sensitive to the issues of women's health care, particularly in the area of cancer and breast cancer, and we need to ensure that the treatment is provided in a timely manner and that it is accessible to the patient and takes into consideration the emotional trauma that these individuals are going through.

I want to just remind the House that I did write to the minister in February of this year regarding the entire issue of breast cancer and the long waiting list for breast cancer radiation treatment. I asked the minister at that time for immediate action by the provincial government to address the lack of breast cancer prevention and treatment programs and facilities in this province and the inadequacy of our health care system's response to breast cancer. Yet, until yesterday, we had seen absolutely no improvement in this situation, even though my request was noted and sent in February of this year.

In fact in estimates this year, on October 13, I asked the minister these questions regarding the elimination and the treatment:

"What action was taken earlier this year to meet the demands for breast cancer radiation treatment? What action has been taken recently, since we learned about the problem again in September? What action or plans are being made to avoid waiting lists for radiation treatment in the future? What assurances is the minister prepared to give to ensure that services will be made available here in Toronto? Could the minister also table a list of locations in the province that provide services for women with breast cancer and the amount of money that was allocated to those sites this fiscal year? Could the minister table a list of sites in the province that have facilities to detect breast cancer and the amount of money allocated this fiscal year?"

It is absolutely essential that in the area of women's health care, particularly the area of breast cancer, which is the leading killer of women in this province as far as cancer is concerned, action take place by this government. Unfortunately, we simply haven't seen any action.

In referring to one other section within the opposition motion today, it says, "Whereas lung cancer continues to be the leading cause of death among all cancer patients, yet despite its commitment in 1991, the NDP government has taken no action on its proposed Tobacco Act."

I want to tell you, Mr Speaker, that I have received numerous letters of concern regarding the inaction by this government. In fact, I want to mention to you a letter from Mr Paul Van de Kamer, the president of the Lung Association, Waterloo Region, who wrote me in September and expressed his concern about the ministry's policy regarding the need for the enactment of an anti-tobacco strategy for Ontario to reduce or eliminate smoking in this province and his concern about the government's recent announcement that it would not be proceeding with changes to the legislation regarding the distribution of tobacco products in the future.

This is despite the fact that a 1991 report of the medical officer of health indicated that tobacco use is the leading preventable cause of premature death in Ontario. It's responsible for more than 13,000 deaths per year. Tobacco users have a higher risk of developing diseases such as cardiovascular disease, cancer, lung disease, stroke, cancers of the mouth, throat, oesophagus and bladder, and we know that secondhand smoke has been linked to lung cancer in non-smokers and respiratory problems in young children and infants.

We also had a poll that was conducted in September 1992 by Environics, which found that Ontarians support tougher anti-smoking measures, including restricted sales and generic packaging for cigarettes. People in this province want to see anti-smoking measures, yet this government has indicated that it will not take any action on this issue.

My colleagues in the Ontario Progressive Conservative caucus have long advocated that tobacco control policies be tightened. Our leader, Mr Harris, has consistently called for a balanced and comprehensive approach to reducing the threat of tobacco to our health; Mr Norm Sterling introduced a private member's bill in 1985 to control smoking in public places and in the workplace; and my colleague Dianne Cunningham called on the Minister of Health in 1992 to introduce anti-tobacco legislation as quickly as possible. Yet today we now hear from the minister that there will be absolutely no changes to the legislation regarding the distribution of tobacco products in the future.

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I want to now take a look at a report that was written by our Health critic, Jim Wilson, the member for Simcoe West. He has expressed his concerns time and time again about the lack of treatment, and he says:

"With each negative headline, Ontarians grow more anxious and fearful about the survivability of their once Cadillac health care system.

"Since the establishment of medicare in 1968, the people of Ontario have faithfully contributed their tax dollars with the expectation that the province's health insurance plan would respond when they needed it the most.

"However, for some individuals" -- and this issue was raised in the House last week by our leader -- "such as Don Porter of Orangeville, their faith" -- in our system -- "has not been rewarded and their worst nightmares have come true. Mr Porter, 64, was diagnosed with lymphatic cancer and given six to nine months to live. His only hope for survival was to have a bone-marrow transplant."

He was denied this opportunity in Ontario for this lifesaving treatment, and he was forced to receive the treatment not in Ontario but in Rochester, New York. Mr Porter from Orangeville was forced "to sell his house and his business to pay the $150,000 for the transplant. He can be excused if he is bitter towards the Ontario health care system -- maintained in part by his tax dollars -- which turned its back on him in his critical hour of need." This is how people in this province who have cancer are being treated.

"One of the five principles enshrined in the Canada Health Act is access to health care for everyone. But what about access for Mr Porter and for thousands of cancer patients in Ontario who find themselves on growing waiting lists for treatment.

"Since 1982, the average waiting time -- from diagnosis to treatment -- for patients with larynx cancer increased from 15 days in 1982" to an alarming 40 days in 1991.

"In the past decade, the waiting lists for breast, cervix, larynx, lung and prostate cancer treatments have doubled. The Canadian Association of Radiation Oncologists says the gap between diagnosis and treatment of cancer should be a maximum of four weeks. However, waiting lists at virtually all cancer units in Ontario exceed this maximum four-week requirement." That's why we need to take a look at what's happening in this province. That's why we need to develop a coherent, effective cancer strategy.

I want to cite another example from what has been written by my colleague the member for Simcoe West. We heard about Judy Thompson, from my own community of Kitchener. She had the agony of waiting for breast cancer treatment and this was exacerbated by her encounter at a London, Ontario, clinic. While she was being told she would have to wait for three months for treatment, when she arrived at the clinic in London she encountered a woman from Port Huron, Michigan, who was also receiving radiation therapy at the London Regional Cancer Centre. This woman couldn't understand why cancer patients in Ontario were complaining about having to wait for treatment. She openly boasted about getting cancer treatment after waiting only one week.

We have a health care system that is more responsive to the Americans than it is to those Ontarians who are paying for it. It is a system that is in desperate need of corrective surgery. "Don Porter from Orangeville, Judy Thompson from Kitchener and thousands from all across this province agree. Waiting months for treatment while staring straight into the teeth of one of Ontario's leading killers is an experience that no one in this province should be forced to endure."

Yet it is happening in this province today and "in the process, lives are being lost, savings are being wiped out, Americans are jumping the waiting lists, and the Canada Health Act is being violated as access to care is being denied to the people who live and pay taxes in this province."

My colleague goes on to explain why perhaps cancer patients are not getting the care they are entitled to receive from their health care system.

Before I read the second part of his report, I want to quote Dr William Mackillop, cancer specialist. When asked on October 16, 1993, "What would you do if you were placed on a waiting list for larynx cancer treatment?" he said: "I'd panic like hell. And then I would go to Buffalo."

"Panic is the product of poor management. And poor management is the root cause of the problems that currently plague Ontario's health care system.

"A great deal has been written in recent weeks regarding the difficulties encountered by cancer patients in receiving life-saving care in Ontario. Many Ontarians -- whose tax dollars pay for the province's health care system -- are waking up to the realization that this system may not be there for them when they need it the most.

There is a growing uncertainty in this province about the availability of treatment, and it is very frightening to many individuals.

Why is this occurring? The answer is not to throw more money at the system. "The Ontario government will spend $17.5 billion on health care this year, which represents 35% of the provincial operating budget. On average, provincial governments in Canada spend $1,595 per person for health care. However, in Ontario, our figures are significantly higher. The provincial government spends a staggering $1,725 per person for health care each year.

"Either people in this province are less healthy -- therefore needing more care -- or the government is doing a poor job of managing the dollars it presently spends on health care."

Certainly there is every indication that there is more evidence to support the latter argument, that the government is doing a poor job of managing the dollars it spends on health care. As a result, we have this increased demand for cancer treatment not being fulfilled in a timely manner.

There is evidence, and we've seen it, that there's a clue as to why Ontario's health care costs tower over those of other provinces. "We have an identification problem in Ontario. Police have revealed that a crime ring is selling valid Ontario birth certificates to refugee claimants and illegal aliens in Toronto. The importance of this discovery must not be ignored," because when you have a birth certificate you can also get a health card. "With a birth certificate and health card, the same individual can also apply for welfare benefits." It is the birth certificate that is "the key that unlocks the vault that contains our tax dollars.

"What is even more disturbing is the response given by the government to the ease with which birth certificates are being obtained." Ted Kelly, Ontario's deputy registrar, said, "There's no practical way to prevent this type of abuse." Yet it is this type of abuse that is costing the health care system dollars, which is leading to a denial of services to those who pay for the system.

The government is telling us it cannot "effectively manage our social programs, because it has no way of identifying who is entitled to social services and who is not. Not surprisingly, this government has absolutely no idea how much health care fraud is occurring" in this province. "This fraud ranges anywhere from $250 million to $900 million annually" -- far too much.

Our Health critic for the Ontario Progressive Conservative Party has stood up in this House on 12 separate occasions and he has urged the government to deal with the serious problem of health care fraud. In fact our leader, Mr Harris, spoke to the same issue today when he talked about individuals receiving more than one health care card and the fact that the officials at OHIP seemed totally unconcerned about following up with the concern he was expressing. Each time this government attempts to discredit and to downplay any concerns that the opposition members have.

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"Now officials in the same government have openly admitted they have no way of guaranteeing that only people who are born in this province have Ontario birth certificates. Consequently, if this government cannot control birth certificate fraud, it has no hope of containing fraud in our health and welfare systems.

"Most people agree there is enough money in our health care system. What we don't have" in this province "is good management of the resources and the system as a whole."

Therefore, I support the motion that has been put forward today. It is time that this government be made accountable. It is time that this government take a look at how it is managing the health care system, particularly in response to the increased demand for cancer treatment, especially when we hear about the growing numbers of individuals who will be diagnosed as having cancer. As I indicated at the outset, we're going to see the rate growing at about 45,000 individuals per year, and every two out of three families in this province will have a family member diagnosed with cancer.

Yes, our party is very pleased to support the motion which calls on this government to develop a coherent, effective cancer strategy. It is high time that the people in this province received the timely and necessary treatment that will allow them to deal with their cancer.

Hon Anne Swarbrick (Minister of Culture, Tourism and Recreation): Mr Speaker, as you know, I stand to speak not only as a member of this Legislature, but also as one of the 14,570 Ontario women who was referred to in the recently released report by the Institute for Clinical Evaluative Sciences.

I was diagnosed with breast cancer in 1991, the time period under study, and had the surgery that they're concerned with and also, as you know, had the follow-up radiation and chemotherapy as well, which also makes me one of the 150,000 people living with cancer in the province of Ontario and pleased to say, along with that, have now passed the half-way mark to my five-year follow-up from that, which I hope means indications of great success, as I believe many people who are diagnosed with cancer have every right to expect as well.

When I think of a number of the issues we're dealing with here, it reminds me of what I believe is the constant challenge in life, the challenge of finding balance on issues. One of the questions, it seems to me, that faces us is how we can work openly, including as opposition parties, in this province in trying to constantly improve our health care system without turning it into a political football.

I say that because I know very well that when people like myself, who depend very much on the health care system in this province, read the kind of headlines and stories we've been reading recently and hear some of the claims that are being made by opposition party members in this House, it becomes terribly alarming to us and it causes us a tremendous amount of insecurity. One of the issues of balance that we need to apply to some of what we're hearing is the balance of the figures of how well our Ontario health care system is working for so many of us.

The opposition resolution before us today says that "the NDP government has failed to put in place appropriate mechanisms for the increased demand for cancer treatment." I have to respond a little angrily at that, to say let's get real. The problem we're talking about was identified in a report in 1985, and it's my firm belief that all three of the parties that have been in government since 1985 have been led by good, feeling human beings who have all taken the action we all need to take to try to come to terms with what we need to do to try to find a cure for cancer; in the meantime to try to help prevent it as much as we can; in the meantime to make sure there is early detection and treatment available for those of us who require it.

Since that report in 1985, the three governments acted to increase the number of radiation machines that were available to the people of Ontario. Since 1985, there was originally a course of action that all three of us participated in to introduce 18 new radiation machines in the system, taking the number of radiation machines in this province from 34 to 52. Since our government has been in power in 1990, in spite of the terrible plague of the depression that has been wrought upon the province of Ontario since that time, we have added 13 further radiation machines, to bring the total to 65 by 1997-98 in this province.

I had the good fortune last week to be at Women's College Hospital, this time not for treatment, actually, but to participate as a cabinet minister in the Chinese naming of Women's College Hospital. As I walked in for the event I was greeted by the very, very happy chief executive officer of the hospital, who was quickly on his way, apologizing that he'd be right back. He had in hand a framed letter from Ruth Grier, and he said the head of his department who had just received a new CAT scan machine, compliments of this government, had said, "Please give me a framed copy of the letter from Ruth Grier giving us the news that we're getting that new CAT scan." They were so pleased.

When he returned to me, the chief executive officer said, "I've just been talking to the chief executive officer of St Michael's Hospital as well and we're at a loss to understand what the news is, this terrible news, that's making your government look very bad right now." He said: "You are, in fact, delivering to us the capital for the equipment we need to treat these cases. Your government has been doing that."

In fact, the CEO of St Michael's Hospital had told him, putting things in perspective, again finding some balance here, that part of the reason they were at a loss is because the number of people who had been forced to leave Metro Toronto to find radiation services this year had decreased drastically from last year. Last year, 45 people had to leave Metro in order to get radiation services in this province, according to them, and this year he said it was down to eight. Hence, why the great news, why the great uproar, unless this is being treated as a political football, with terrible insensitivity to those of us for whom it causes grave alarm and grave feelings of insecurity.

Every year in this province, including now, there are thousands of people who are being given the treatment we need to deal with our disease, and we should be very proud, all three parties who have formed the government in this province over the past decade, of the kind of health care service and --

Interjection.

Hon Ms Swarbrick: Yes, Sean, you can be proud too of the kind of health care service you've helped to develop in this province, because for most of us it works very, very well, and when it doesn't, all three parties who have formed the government have tried to come to terms as well as we can with it.

In addition to what I've just referred to of our government further acting to increase the number of radiation machines available to make sure that today, tomorrow and in the future there'll be sufficient radiation treatment available for those of us who need it, our government, as you know, through the Minister of Health, has also announced recently the increased operating dollars to hire the radiation therapists required to operate the machines on a longer-hours basis.

I'd like to point out again something we need to deal with in this province. Any operator of a plant or factory in this province will tell you that when you put out the dollars for the incredibly expensive capital equipment in a plant you need to operate it beyond eight hours. In the case of radiation equipment, that's incredibly expensive equipment. Not only does it make sense for our tax dollar purposes that it operate beyond eight hours a day -- and for that reason we're pleased to be providing the dollars to provide the staff to do so -- but I can also tell you from firsthand experience how important that is to working women and working people who have cancer.

We have to change some of the image we have in this province of what people with cancer are like. People with cancer are people like me, also being able to go along through our day-to-day business and work while taking radiation, in many cases.

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When I was receiving radiation treatment I heard the stories from some of the radiation therapists about women who were less fortunate than I, with the understanding boss, our Premier, I had at the time, who allowed me to accommodate my schedule to obtain my treatment. Women who work in many workplaces and have to take that time, the half-hour it takes to wait for the treatment, to end up getting the 20-second zap or what have you, in many cases are being harassed by their employers because of being required to take that half-hour or hour, maybe an hour and a half, depending on travel time, in spite of how they arrange their day to be there first thing in the morning so they can then get to work on time. Clearly, by providing the operating dollars to make sure we're using that equipment over longer hours, it will also mean reduced harassment for the people who are getting that treatment while still maintaining their working lives.

Our government has also announced that we are in the process of trying to recruit radiation oncologists from overseas, as unfortunately not enough of our young interns and young medical students in this province are yet applying to go into what I think is a very important career, being a radiation oncologist in this province, a needed career. We've got interns and medical students and the parents of those who want to be doctors in this province worrying about where they are going to be able to work when they graduate. Radiation oncology is one of those careers that's waiting for many of them, and I can't urge them strongly enough to consider more seriously helping us to overcome the shortage of radiation oncologists in this province so we don't have to resort to what our Minister of Health is now initiating, the search for radiation oncologists from overseas to help us to meet our short-term need today.

The opposition resolution also says, "whereas physicians are performing procedures such as surgery due to concerns that...radiation may not be available on time." This is one of the issues also referred to in the recent media reports and referred to by some of the speakers today that I find terribly disturbing as somebody who's been a patient and as somebody who believes very firmly in patients' rights, including patients' right to choose, including patients' right to informed consent.

I have to point out that I clearly am speaking here on a very personal basis in saying that it disturbs me greatly. To be honest with you, I really can't believe there are doctors in this province who are doing what has been alleged. To do so would be terribly unconscionable. What's being claimed is that doctors are making a decision to exercise radical surgery on people, mastectomies, removal of voice boxes, without telling patients of the choices that belong to them other than going through that radical therapy because, as it's been reported in the newspapers at least, patients would not understand the consequence of delayed treatment.

That's an insult to all cancer patients. It's very easy to understand the consequence of delayed treatment at a certain point, and doctors know through the studies how long it usually takes for the cancer to spread and can therefore forecast how long is safe and how long is not safe to wait for the radiation.

Patients deserve to know their full options available to them, how long it would be for them to get their treatment, what the impact of that might be and, therefore, whether they want to choose to have more extreme surgery or choose to wait for the duration involved or whether they want to choose to travel to another part of our province to obtain treatment.

As the Leader of the Opposition referred to, many people from the north unfortunately in fact do often have to, for population reasons, come to Metro to obtain treatment. If from time to time some of us from Metro have to go through that, it's terribly unfortunate. I would not want to have to do it. It's certainly a reasonable short-term measure while we implement the longer-term measures we have embarked upon through our Minister of Health in order to make sure the full range of options is available.

It's also an option that patients should know is theirs if they want to choose, in the face of those choices, to go to their member of provincial Parliament and raise Cain to make sure they do get the radiation services they need, which I suggest is what would happen if a member of provincial Parliament got up in this House and talked about that kind of situation occurring to any individual person.

I think the reality of what is happening when patients receive more extreme surgery than they might require is clearly referred to in the report I began by referring to, the report that's been made public over the last week. It's the report, as I mentioned, from the Institute for Clinical Evaluative Sciences, and it refers on page 2 to the variation in treatment. Again, I'll be clear that the variation we're talking about is whether a patient receives a mastectomy, in the case of breast cancer, instead of receiving a lumpectomy, a smaller surgery to the breast, combined with radiation.

The report states that "this variation was overwhelmingly associated with the approach to the management of breast cancer adopted at individual Ontario hospitals, indicating the crucial influence of surgeons' practice styles." The report does not say that it's because of surgeons' belief that people were not going to get radiation treatment in time.

In fact, what this reminds me of is another change that we've seen happening. Change always takes time, unfortunately. We're all people; doctors are people. We all need training in our jobs; doctors need training in their jobs. What this reminds me of is, again as a patient at Women's College Hospital and learning a lot about breast cancer, I was told that Women's College Hospital has not done a radical mastectomy for 25 years, radical being different from the modified radical of the full removal of the breast; radical meaning also removing muscle tissue.

Women's College Hospital has not done a radical mastectomy for 25 years, yet I know a woman in the province of Ontario who had a radical mastectomy in the late 1980s. In fact, I believe there are still women in North America, in some places, who are receiving radical mastectomies. It's a matter of training, it's a matter of doctors being up to date in believing in what is the best approach to treatment.

As this study points out, also the approach to management and the approach to different techniques of dealing with cancers are something that can vary from doctor to doctor, from hospital to hospital. It's something we need to work on to try to make sure that we are all being up to date and using the best treatment methods.

As somebody who did have a mastectomy, I'm also afraid that some women who do require mastectomies will think, because of the concern and alarm that's being expressed right now, if they're told they are to have a mastectomy that it is necessarily the extreme and wrong surgical treatment. There are times when it is appropriate, so I would resoundingly support those doctors who have been speaking recently about the need to encourage people to get a second and a third opinion if that is what is being talked about in their case.

I also do not accept the opposition claim that my government has created an environment encouraging more and more physicians to leave this province. We know that the American system allows doctors to be paid more than the Ontario system does, so there's no doubt that some doctors may be attracted, for that and for other reasons, to move to practise in the United States. Yet we also know that the American system costs more. It costs, if I'm remembering the figures correctly, something like an extra 4% of gross domestic product for the American system to operate, and yet there are far fewer people serviced in the United States than are in Ontario, where every one of us has the right to obtain treatment.

Some doctors will leave, for money reasons or for various other reasons, from this province, but I'd like to point out to you that by and large the people of this province believe that, overall, physicians are fairly well paid for their jobs, that physicians overall work and practise for all of the right reasons, and that most of those physicians will continue to choose, as they do, to stay and practise in the province of Ontario for many reasons, including the fact that we in Ontario, thanks to all three parties that have been in government over the past decades in this province, have been developing a tremendously good, quality health care system.

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It's one in which they know that as physicians they can operate without the potential problem that exists in the United States of some days having to tell patients that you can't treat them because the patient doesn't have the money to pay you; you have to turn them away from hospitals, even from emergency services, because they don't have the money to pay for that hospital care.

It must be an awful lot better working in this environment than in one that would force a doctor who cares to help heal people into that kind of situation. Doctors also practise in the province of Ontario in a situation that doesn't force them to become bill collectors, another problem that exists in the United States.

Again, on the issue of balance, I'd like to point out that what we're looking at is the kind of quality health care system that we've chosen to provide for ourselves and to continue to build for ourselves in this province with our tax dollars through the government of the day; and that there is a matter of balance when we look at health care in terms of what it is we can expect from that health care system and what is our personal responsibility, as individual citizens and residents, to do to try and help participate in that prevention, early detection and proper treatment for cancer.

With regard to the obligation of the system we're providing as a government, I'd like to point out that in this province we are spending more than $1 billion per year on services directly related to cancer and trying increasingly to make sure that those dollars are being used as effectively as possible. The more than $1 billion being spent directly on services related to cancer does not include the OHIP cost for doctors' visits; it does not include the costs of drugs required for treatment.

As my colleague who spoke before me has already told the House, this government is committed to measures reducing the incidence of cancer in Ontario. We're committed to many different measures, prevention being, I think personally, the most important one of all. Prevention includes a number of things. It includes corrective action, enforcement action and protective action on environmental issues as well. I believe environmental factors in the incidence of cancer today are one of the things we need to be looking increasingly closely at.

I'm proud to say that it's probably an ironic and interesting coincidence that the same minister who is now the Minister of Health in this province was the Minister of the Environment in this province who worked so hard to develop an Environmental Bill of Rights for Ontarians to be able to exercise, who's worked tremendously hard to develop strict controls on pollution and pollutants in this province, who's worked tremendously hard to try to help reduce waste, which creates landfills, which create toxic problems also in this province.

It's comforting to me to know, in looking at the prevention of cancer in this province, that the Minister of Health today is one who understands that kind of environmental approach to preventing cancer and what needs to be done. I'm also delighted that the present Minister of Environment, Bud Wildman, is also a minister who has tremendous appreciation of the need to protect our environment in order to help prevent illness as well.

In the issue of prevention, our government has also been continuing and trying to expand upon the education work that can be done to assist us all in helping to prevent becoming cancer patients ourselves. There are things that we can do individually as well. I encourage all of us to do them and not just to be exercising your option after being diagnosed -- as of course I need to now -- to watch our diet, to try to follow a healthy lifestyle, to not smoke, to try to follow a low-fat diet, to exercise well. These are all the kinds of things that we can do ourselves to help decrease the incidence of cancer in this province and help to protect not only our lives but the good and wise use of our tax dollars in this province.

Taking advantage of the education in this province, to know what signs we should look for so we can go to the doctor and then be checked, is important. Taking advantage of the screening opportunities that exist in this province to help detect cancers at early stages is very important.

In terms of learning about the issue of breast cancer, which many of us are focusing on, although there are so many types of cancer unfortunately, probably the best book that I would encourage every woman, every person and certainly anyone who has been diagnosed with breast cancer or fears to be so to read is Dr Susan Love's Breast Book or many of the other wonderful books that help to teach people about the realities of breast cancer that are available in the Toronto Women's Book Store as well as some other book stores in this province.

In terms of our government's strong action to come to terms with, to prevent, to help ensure the treatment of cancer is also of course the work we're doing to try to help support finding the cure for cancer through research. So we're pleased, of course, to be continuing very strongly to support research, to identify the cure for cancer including, as my colleague the member for Thunder Bay said earlier, referring to the expansion that our government has recently invested in to expand the cancer treatment centre in Thunder Bay, along with research facilities in the north as well.

I'd like to turn to speaking a bit further about the issues of early detection and treatment because I think they are so crucial, and certainly they do become the most expensive part of what this government invests in within this province.

Our strategy in Ontario includes addressing the improvement of breast and cervical cancer screening. These are two areas where we're able to detect, very quickly and early, cancers if we make sure that we take advantage of the screening opportunities that this government is pleased to provide the funding for in this province.

Our government is continuing its full support for the Ontario breast screening program run by the Ontario Cancer Treatment and Research Foundation. The reasons are very clear for supporting this program. It offers high-quality mammography, it offers physical examination by a nurse examiner, with instruction in breast self-examination. The screening program is now available in 10 centres throughout this province. It's a program that my government is tremendously proud to be funding.

The Ontario health survey of 1991, however, showed that only one third of women between the ages of 50 and 69 are taking advantage of this simple procedure to help identify breast cancer at its earliest stages through our government's program. The breast screening program does reduce the number of serious cancer cases. Evidence has shown that if breast cancer is identified in its early stages, it can be cured in a high number of cases through surgery, through radiation treatment or chemotherapy.

I've also unfortunately, through my own experience, learned of many women who have either gone late for detection or who have chosen not to take advantage of some of the treatment available through Ontario's health care system. I encourage them very much to do so.

One of the many services we're providing through the Ontario system is support groups that exist in certain hospitals. When I was at Women's College Hospital, there was a breast cancer support group for both patients and our partners to attend for free. Through that I learned, for instance, that when breast cancer is able to be detected in its early stages and through surgery, often surgery that does not require very significant alteration of the shape of the breast, and where it's followed up with radiation, those cancer patients have better than a 90% chance of full recovery. That's the importance of early detection: better than a 90% chance of full recovery. That's why it's important that we screen and that we do breast self-examination to identify cancer at its early stages.

Once the cancer is allowed, as mine did, to get into the lymph system, the chances of survival do become reduced, depending on how extensively it travels in the lymph system. But in all cases, with chemotherapy treatment your chances of survival are improved by 30%, which is tremendously substantial. Obviously, I'd rather choose the earlier odds of better than 90%, which is why I strongly encourage the women of this province who are over 50 years of age to take advantage of Ontario's tremendous breast cancer screening programs.

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One woman in nine will develop breast cancer some time in her lifetime. As one friend of mine recently reflected to me, however, again we need to be a little balanced in looking at our statistics. That's a terrifying number. The reality is that relatively few women will contract breast cancer anywhere near my age, having been 39 at the time it happened. In actuality, that rate of one in nine really is if you live to be 85 years of age. In fact, at my age it's more a matter of one in many hundreds. I just say that because I think it helps us put a little perspective, to not let the terror overcome us but rather to let knowledge help us develop a sense of control and a better reality in dealing with this terrible disease.

Breast cancer, however, is the most common type of cancer in Ontario women, with 5,000 new cases being diagnosed annually. Sadly, in 1992, it was responsible for 1,900 deaths in this province; far too many. Just as sadly, the number of deaths from breast cancer has doubled in the past 20 years, from one in 20 some 20 years ago to the one in nine today. Much of this increase, it's important to point out also, is because our health care system and our lifestyles are becoming such that we are able to live to a longer age. So the aging population is partly responsible for that, along with other factors.

There are, however, far too many of us being struck down with cancer when we are far below the average human life expectancy. That's part of why I can't stress enough the importance of the national breast cancer screening study which was released about one year ago. Those results showed that mammography screening did not curb deaths of women aged 40 to 49, which is why it is women over 50 we're especially encouraging to go for regular screening. We are, as a government, continuing our efforts to encourage more and more of those women over 50 to make use of that vital service. Quite plainly speaking, many women over 50 will have their lives saved by it.

The program refers women who are in good health and under 50 to their family doctors, where education is provided to those women and to their care givers about the risks and benefits of mammography for those in that age group and where instruction is given, and this is what I would stress most importantly for women under 50 as well as over, on the importance of breast self-examination. I don't mind sharing the fact that if I had been doing regular breast self-examination, I could have caught the breast cancer at a much earlier stage and been able to avoid chemotherapy and been able to have much better chances of survival statistically than those that face me, but even now those that face me are very good.

Another service our government provides in terms of the issue of early detection which holds tremendous promise is that directed at cervical cancer. This provides for Pap smears, which I can't encourage women strongly enough to take on an annual basis, beginning with when women first become sexually active and continuing until the age of 69. This screening program for cervical cancer helps to detect treatable pre-cancerous lesions. It has contributed to a significant decrease in the incidence of cervical cancer.

Our government supports the Ontario Cancer Treatment and Research Foundation, which operates eight Ontario regional cancer centres. It provides treatment for cancer through radiation therapy, through chemotherapy, through other advanced techniques which account for more than 21% of the Ministry of Health's total spending on cancer each year.

Also supported by this government and by past governments is the Ontario Cancer Institute's coordination of the Ontario health care system, which delivers a broad spectrum of cancer services: academic health science centres; teaching and community hospitals; community agencies; the Canadian Cancer Society; family physicians; other health professionals; patient support groups and volunteer agencies.

These services are widely accessible. We should be proud of them. They're widely accessible to a vast majority of people in Ontario. They're second to none in terms of the quality and the compassionate care they deliver in this province. They account for fully 75% of the ministry's direct expenditures on cancer every year.

For example, the government pays for all operating costs in provincial hospitals as well. These institutions provide cancer patients with services ranging from initial diagnosis and evaluation to surgery, including aftercare, outpatient services, physiotherapy, rehabilitation and a host of other vital services. When we think of those kinds of services and compare what we have to countries around the world, we have tremendous good fortune to live in this province.

In addition to the more than $1 billion that's spent on cancer treatment in this province, our government also pays the province's fee-for-service doctor bills, and many doctors' bills are undoubtedly related to the provision of cancer services. We pay for catastrophic drug coverage, without which many patients could simply not survive.

Unfortunately, from time to time we do end up with backlogs in the system which result in some cancer patients having been made to wait for treatment, and I know how terrifying that is, but this government has been taking immediate action to meet that need as it's confronted us. On the short-term basis, we've developed a centralized referral system to ensure that timely treatment is available, if not in your own city, then by the next closest place. In the long term, we've ensured that waiting lists for radiation therapy caused by the shortage of radiation oncologists are being dealt with by recruiting radiation oncologists from overseas, as well as providing the operating dollars for the staff and the radiation machines needed.

The fact is that the Ministry of Health is dealing responsibly and effectively with Ontario's short-term cancer treatment needs while putting in place a longer-term provincial strategy to provide a continuum of cancer-related services. I don't believe that cancer care in Ontario should be turned into a political football. It's too serious an issue. It's too serious to too many of us.

It's irresponsible to suggest that this government or any other in the province of Ontario in the last decade is ignoring the needs of these people or that we are withholding the vital services on which their lives depend. Ontario provides world-class cancer treatment services. These services are provided free of charge to everyone in the province who needs them. We will continue doing everything within our power to ensure that the quality health care system we deliver in this province is of the finest quality to be found anywhere.

Mr David Ramsay (Timiskaming): First of all, I would like to say that I'm very pleased to be able to speak on behalf of our party on Lyn McLeod's opposition day motion that has been tabled here today. I think it's a very important subject.

I'm going to get back to that, but I'd also like to say that I'm very pleased to be following the member for Scarborough West, who I thought gave a very well-thought-out and reasoned speech, though there is something I would like to bring up that I disagree with that she mentioned.

Before that, I'd like to say that I think we in the House appreciate how candid she is, and sincere and forthright with her own battle with the disease of cancer. I think she knows that we are all out there with her. I think it's good for the people of Ontario to see legislators who have that personal involvement talking about it and talking about the successes we have in this province with cancer.

What I do want to disagree with her about, though, is her accusation that we have been playing politics with this. I would just ask that the member put herself in our place. If she happened today to be in opposition and were to see the situation that there is a shortfall in treatment opportunities for people who have been diagnosed with cancer, I'm sure she would be supporting a very similar type of motion today, and bringing that forward. The nature of this business, which I think everybody understands in this province, is that when we are in opposition it is up to us to choose some areas of priority that we believe the government should be acting upon with greater haste. We act as a catalyst in this Legislature as opposition, and this is an area upon which we feel there should be a higher priority put.

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You'll notice that we don't stand up in our place every day and say to the government that it should be spending more money on every responsibility the government finds itself with, but this is an area that the Liberal caucus has talked quite a bit about in our caucus meetings. We have conferred with our Health critic and also, as I'm going to talk about a little later on, we've decided this is so important that we want to do some more research, so we're going to be doing a task force on cancer care and cancer treatment in Ontario. We feel it's important. As Liberals, it's a very high priority for us and it's our job in opposition to be pushing the government to move on those things we feel are a priority, on those things we feel are for the best for the people of Ontario.

As the statistics will tell people, two in three families in Ontario are directly affected by the disease of cancer. My family has also, in the past, been directly affected by the disease of cancer; my Dad had cancer in the 1970s and passed on. We certainly are all, as the member said, men and women of very strong feeling when it comes to cancer, very concerned.

We can certainly share the plight that many of our constituents are going through right now, have in the past and also will in the future, because we all know, with the demographics of this province and this country and with the greater occurrences of cancer in people over 55, that we are going to have a tremendous increase in the diagnosis of cancer as the years move on. It's going to be important that the Ontario government, which is responsible for health care in this province, makes sure that planning take place so that the equipment is in place, the resources are in place, the human resources are in place so that we will be able to treat cancer, to work on it from a day-to-day basis on a preventive basis but, when it is diagnosed, be able to have the very best treatment available at a reasonable cost so that we can save the lives of Ontarians and provide Ontarians with a good life that they all expect in this great province. It is very important to us, and I believe that no political party would try to play politics with this. We feel it's important and we want to move on it.

I would like to talk about a few things. First of all, I think some of the facts about cancer are quite startling. The more you look into it, the more you realize how big a problem it is and the more we believe in the Liberal caucus that the government has to be doing more. The scope of the disease is immense. In 1993, an estimated 116,200 new cases of cancer will be diagnosed in this country and we will have, by the end of this year, almost 60,000 cancer deaths. By the year 2000, as I've said before, due to a mainly aging population, the Ontario Cancer Registry predicts there will be 30,000 new cases of cancer in men and 28,000 new cases of cancer in women. This compares with 1991, when there were only 21,500 new cases of cancer in men and 20,000 new cases of cancer in women.

We can see that the growth rate, unfortunately, is great in the diagnosis of cases of cancer in this province. More than 80% of both new cases and cancer deaths will occur among those aged 55 and older, so as the tremendous bulge in our population that's right now beginning to be in the middle-aged group moves into age 55 we are going to see a tremendous demand for cancer treatment in Ontario, and now is the time to be doing the work. We feel the government is behind in its resource planning and it's got to be moving on this. It is interesting how the nature of the disease is changing. The parts of the body that are now being attacked by cancer are changing in both men and women, and again this planning has to be implemented by the government so we are certain we have the appropriate treatment.

Back in 1987 I remember, when I was the parliamentary assistant to the Honourable David Peterson when he was the acting Minister of Northern Development and Mines, that people involved in health care delivery in the city of Sudbury in northeastern Ontario specifically were very concerned about cancer treatment in northern Ontario. In northeastern Ontario, we have on an annual basis at least 700 people who need to seek out cancer treatment. This was a growing problem then, and the people in the Sudbury region saw this as a tremendous problem not only for our area but for all of northeastern Ontario where people had to travel to Toronto, primarily at that time to the Princess Margaret Hospital for treatment.

I remember Dr Coringham, who was hired by one of the hospitals in Sudbury, coming to see our government. He worked very closely with me at the time in trying to get the capital funds set up to build a northern cancer treatment in the city of Sudbury and also to make sure that the ongoing financing for staff and resources would be there so that we could produce and provide cancer treatment for citizens of northeastern Ontario.

This has since opened in the summer of 1990. The northern Ontario cancer treatment facility did open in Sudbury. It has been so successful, as we see unfortunately from the headlines today, that we now find ourselves in the situation that patients from southern Ontario are forced to come, ironically enough, to Sudbury now to the tremendous facility that the Liberal government did establish there as we saw that the need was very great in northern Ontario at that time.

Unfortunately, in the last three years of this government, we haven't seen an increase of facilities to handle the increased need we find ourselves with today. This has got to happen. We only have to look at other provinces, in fact poorer provinces than Ontario, that have started to grapple with the problem and have come up with some rather simple but maybe creative solutions that we still haven't been able to discover here or to finance properly here.

In one of the areas of treatment, radiation treatment, we know that we have an underutilized amount of machines in this province for the treatment of cancer. We have radiation treatment machines that stand idle basically about 15 hours in a 24-hour day. Many hospitals only have the staff resources to run those machines during a day shift. Unlike other provinces, such as Nova Scotia, that run those machines till 10 o'clock at night, we don't do that in this province.

It's sort of like the court system and other infrastructure the government has. We have to utilize it well, and we're not utilizing the infrastructure of government very well. The court analogy is very interesting, in that court times are restricted to daytime. We don't have night court, we don't have weekend court; we've got to expand that. It's the same with our cancer treatment: We have the equipment, we have other resources, but we've got to expand the usage of those resources. To do that, we have to allocate the funds to make sure we can bring the trained personnel, the oncologists, into Ontario to run those machines. That's going to be very important.

I know the minister made an additional $1-million allocation and we applaud the minister for doing that, but we say to the minister, that is not enough today to rectify this problem. We feel that the treatment of cancer has to be one of the number one priorities for a Minister of Health of any government, and that's what we're saying to you today.

We feel you're not doing enough in this regard. We are pushing you to do more. We are asking you to allocate more resources in order to treat this disease. We are looking for you to do some more planning so that we can encourage more residents and interns to specialize in oncology and make sure we have the technicians trained in this province and, for now, in the emergency situation we believe we have today, that we go out around the world and seek those trained people and provide the financial incentives to bring those people to Ontario to provide that treatment for Ontarians today.

I've seen some of the quotes from some of the oncologists in Ontario saying, "What would you do today if you were diagnosed with cancer?" One of them was quoted as saying, "I first of all would panic, and then the next day I would go to Buffalo." I don't want anybody to have to say that about my province. I'm very proud about my province. I'm very proud about the health care system in this country and this province, and, as a Liberal, would want to ensure that we preserve the health care system that I think all of us in this House believe in and want to see work. We think that's important, and we are asking the government today to do that.

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There are a lot of unanswered questions as to what needs to be done, and we've decided ourselves, because we don't feel the government is doing an adequate job, to embark upon a task force exercise. We're going to go out, a select few caucus members, and talk to experts in the field, talk to patients in Ontario to find out what the deficiencies are and to come up with some positive recommendations, because we're not here just to criticize. We want to come up with some answers and to help the government provide the proper care that's there.

I want to read just a couple of the objectives, first of all, of our task force. One is to get an accurate measure of the problem as it currently exists and continue to raise the issue of cancer treatment in Ontario and the lack of action and planning by this government. We think that's important. We want to develop a series of recommendations to reduce the waiting lists and ensure proper planning prevents the situation from occurring again.

Some of the issues that need to be discussed and some of the issues that we want to explore in this task force are, first of all, we want to document fully what the current situation is. We have a lot of anecdotal information now coming through. We have one report on cancer treatment in Ontario that needs to be analysed. So the first thing for us to do is to document the present situation.

We really need to document quite fully: What are the waiting periods and what are the causes of these waits? How serious is the breast cancer problem in Ontario and how will its increased incidence affect future planning needs for cancer treatment in this province? What is the role of the province and the Ministry of Health in planning and implementing a cancer care strategy? What is the problem specifically: is it the lack of equipment, lack of personnel or the increased cases of cancer? Is there a provincial strategy related to transportation for cancer patients seeking treatment, and what is that strategy if it does exist? Does the strategy include child care, attendant care? How is palliative care of cancer patients linked to long-term care reform? Is there a strategy to deal with paediatric oncology?

These are the questions that we are going to be raising in our task force. We will be looking to patients, to health care providers, doctors, nurses and technicians in oncology from right across this province as to what their solutions may be for this. Our task force will be going to Toronto, Kingston, Thunder Bay, Windsor, London, Hamilton, Ottawa and Sudbury. We are going to be basically outreaching into the community and asking people to contribute to our study so that we can document what these problems are.

I wish to go back to some of the statistics that surround this awful disease. I wanted to say that over the past decade waiting lists for treatment of cancers of the breast, cervix, larynx, lung and prostate have doubled. In speaking to doctors and in the quotes we've seen from oncologists in the press lately, the longer the waiting period, the more difficult it is to treat the cancer successfully. So it's very important, number one, that we have early diagnosis and, number two, it's obviously very important that we have very early treatment, that in fact we have immediate treatment. That is the problem right now that we seem to be having.

The people of Ontario are really lucky that we do have a good health care system with highly trained general practitioners and specialists who are very good at early diagnosis. We're finding more and more of that with the programs that we have put in place over the years, that the previous government before us, the Liberal government and the NDP government have put in place. Where we're finding the shortfall primarily right now is immediate treatment. If we can get immediate treatment to the patients in Ontario, we will have a much higher percentage of successful treatments for cancer patients in Ontario. So that is where we need to be really moving.

By 1991, three quarters of Ontarians who had cancer of the cervix, larynx or lung had to wait longer than a month for radiation treatment; in 1982, only one quarter of those patients had waited that long. We see a deterioration of the waiting lists, we see the waiting lists are longer, we see the lineups for cancer treatment are longer and because of that we're starting to see less success in the treatment.

As reports have stated in the press the last few days, we're now starting to see more radical types of treatment being utilized much earlier in the course of treatment rather than the most appropriate treatment which might be chemotherapy, radiation or not so radical surgery such as lumpectomy in the case of breast cancer.

This is a very serious subject. This is important to us. It is not something that we or any politician in Ontario would want to play politics with. It is a number one priority for the Liberal government that we get on with cancer treatment, that we provide the resources for cancer treatment throughout Ontario, that we study and start to do the planning and find out why there are the discrepancies in different types of cancer treatment, especially in regard to northern Ontario.

I was quite shocked to see the initial findings of the study released this week that shows that in northern Ontario there may be in some cases some inappropriate early treatments of cancer. I'm not sure why that would be and I'm certainly going to be looking for guidance from the Ministry of Health as they study that report as to why that may be the case. It shouldn't be the case.

I believe all Ontarians should have equal access to first-rate care and I'm sure every member of this House believes that to be the case too. I would certainly want to see the results of studying that particular project that was released this week that showed some of that inappropriate care happening to some patients, especially in some rural parts and northern parts of Ontario. That has to be rectified.

So I stand here in my place today to support this motion that's moved by the Leader of the Opposition, Lyn McLeod. It's a subject that's very important to her. It's a subject that's very important to the Liberal caucus. I am pleased to be part of this debate and will now take my place.

The Acting Speaker (Ms Margaret H. Harrington): Thank you to the member for Timiskaming. Further speakers?

Mrs Marland: This is not an easy resolution to speak on in this House. I don't think it's easy for any of us. It certainly isn't easy for those of us who are part of the statistics.

I notice in here as part of the resolution it says, "Whereas two out of three families will have a family member diagnosed with cancer." In our own family, when our daughter died 33 years ago now, there wasn't a remedy for the type of leukaemia that she died from. I think what really upsets me about discussing this whole subject is that today, 33 years later, there is a remedy for a lot of these different forms of cancer.

I find it very frustrating to sit in the House today and hear some of the statistics read into the record -- and I'm going to be doing some of that as well -- and wonder why the statistics we're giving aren't those that record the successes and the cures and the people who have experienced remission from this dreaded disease for many, many years.

I find it a little unfortunate that the Liberal motion -- obviously, we're going to vote in favour of this motion because overall it's expressing a concern about what's happening in this province today to do with cancer treatment. But I have to tell you there are sections in this motion that I find very difficult to accept, especially the line that says, "Whereas the NDP government has created a climate that is encouraging more and more physicians to leave the province."

Certainly, the NDP government hasn't helped on that subject, but it was the Liberal government who passed Bill 94 in December 1986 that thrust the largest number of physicians in this province into making the decision that they wished to practise elsewhere.

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I was one of the members who stood in this House and spoke from 4:30 till 6:30 in the morning in December 1986, before the Liberal government's passage of Bill 94. There are one or two people in the House at this point who will recall that Bill 94 was the bill that was to prohibit physicians in Ontario from extra-billing, even though only 6% of the 12% of physicians who were opted out from the direct billing through OHIP billed higher than the schedule of fees which OHIP paid anyway.

If we ever saw an example of a red herring that had a devastating effect by the passage of Bill 94 on the physicians and the attitude to the practice of medicine in this province, it was legislation, unfortunately, that the Liberal government brought in. It was also legislation that was supported by the New Democratic Party in opposition.

I think it's unfortunate that the last paragraph of this resolution also refers to, "Therefore the Liberal caucus calls on the NDP government to admit its failure to develop a coherent, effective cancer strategy." If the truth were to be expressed in this House, there isn't any of the three parties in this House whose hands are totally clean on this subject, and I include our own party in that. But we're not standing up saying to this government today that it has failed. What we would like this government to do is to make some decisions in some areas in particular that would demonstrate they truly want to be part of the solution and they're willing to invest in that solution.

I find it a little ironic that this motion is brought forward by the Liberal Party, because I really believe that much of the responsibility for today's crisis in the cancer treatment area rests with the Liberals' inaction when they governed Ontario from 1985 to 1990. Anyone who knows what was going on in the 1980s knows that at the beginning of the 1980s there was a shortage of money. But certainly, in the second half of the 1980s, for the government at that time to look for $1 million, which the current Minister of Health just announced yesterday, was not a difficult thing to do.

I have said that our party isn't blame-free either. There were two reports commissioned by the Ontario Cancer Institute and the Ontario Cancer Treatment and Research Foundation which predicted the current shortage of resources. The first report was in 1973 and the second was in 1985.

The 1985 study warned that, "Resources available to the cancer system represented by the two organizations," which are Princess Margaret Hospital and the cancer institute, "are inadequate in quantity and quality to meet current, let alone future, needs." The Ontario Cancer Registry also predicted that more radiation machines and personnel would be required to meet the demands.

The Liberals governing during those economic boom times when provincial revenues were plentiful could have done more to meet that demand and to plan for that demand. They could have decided earlier to build more radiation therapy machines, which I understand take more than two years to construct because of the radiation containment areas that must accompany them.

The Liberals could have decided to train more radiation therapists, who need two years of post-secondary education, and to train radiation oncologists, who require 10 years of post-secondary education. I believe that for the five years they were the government, with this 1985 report in hand, they also could have taken steps to provide incentives to radiation oncologists who train in Ontario to practise here.

If you look at the numbers about what has happened with the incidence of cancer in this province, we know that between 1981 and 1990, the number of new cases of cancer grew by 47%. At the same time, Ontario's population grew only by 17%. That's why I'm pointing out the critical years, the second half of the 1980s, when the Liberals were the government and there was money available in this province.

One of the ironies about what has happened, especially in the last few years, is really identified in a letter I have here from the Rudd Clinic, in particular over the signature of Dr W.W.H. Rudd. This letter is dated December 15, 1992, and will explain very clearly what I mean when I talk about the fact that not only has government to provide incentives to radiation oncologists who train in Ontario to practise here, but it must; it's part of our prevention, it's part of the prevention that our courageous member for Scarborough West talked about a few minutes ago.

In this letter, which I will read, you will see where one physician, one specialist is actually having to close his office because of the cap that has been placed on his practice. The thing about this cap on physicians' fees is that it is so arbitrary, it doesn't account for the fact that in this case this particular specialist -- I'm not sure exactly how many employees he has but it's somewhere between 15 and 17 and his office is right off the corner of University Avenue, in the area where the hospitals are, which is an ideal place for this office to be located.

The procedure that Dr Rudd does is colonoscopy. For those of you who aren't familiar with a colonoscopy, it is an investigative procedure through the intestine and it goes all the way up into the colon. It's done, in his case, with fibre optics equipment. It is totally painless and it's totally non-intrusive. There's no debate about the effectiveness of this examination because at the time of the examination this fibre optics equipment has at the beginning of this tiny little wire a light, there is a camera which feeds the picture back to a television screen, there are little scissors and there's a little thing like a windshield washer to keep the camera lens clear. During this investigation of the entire intestine all the way up into the colon, if the specialist discovers polyps, he is able to remove them right then. This entire procedure is complete within I think 10 or 12 minutes total. You can appreciate what it means to discover those polyps before they grow and be able to remove them so that the patient doesn't then have the polyps develop into cancer of the colon. As a preventive measure, it's just common sense to make a colonoscopy as available as we possibly can to the largest number of people, particularly men of a certain age in this province.

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By the way, Dr Rudd has to purchase his own equipment, equipment that costs $75,000 or $80,000. There is no money for the purchase of his equipment through OHIP; he invests in the equipment in order to do this procedure. By this practice, he's able to save millions of dollars had these patients been allowed to progress from the condition of having the polyps, let alone anything worse, at the point of discovery, to requiring intensive, intrusive surgery and hospitalization. This is done simply as a walk-in patient and, as I said, you're in and out in between 10 and 15 minutes total.

This letter from the Rudd Clinic reads as follows:

"Dear Patient,

"As promised, this is to remind you that you are due for your follow-up colonoscopy. I'm sure you'll recall that this is the best colon cancer prevention examination available, even more so with our new colonoscopy equipment. This is the good news.

"The bad news is that I am booked up for colonoscopies until August 1993. This is because, after reaching our limit on gross income, OHIP holds back two thirds of our fee. With an overhead of about 60% it actually costs me money to see a patient on OHIP. I am unemployed until April 1, 1993.

"It hurts me deeply that I have to say no to my patients, some of whom I have known for many years, who trust me and don't want to see another doctor. It hurts even more because it stops me from doing cancer prevention, the best thing I have ever done as a doctor."

The point about a cap in his particular case -- and I'm not denying that there are situations in the province where there have been problems with physicians and their billings, but I think we should deal with those as a government, whoever the government is. I just think it's so regressive to say we can't afford the doctors' billings in this province because we can't afford the explosive bill for health care.

The irony is that the percentage of the cost of health care that is attributable to doctors' billings -- maybe the Health minister will be able to tell me what it is today, but I recall when we were discussing this a few years ago that the portion that was attributable to doctors' billings was 19% of the total cost of health care, yet they were being blamed for the fact the health budget was getting out of control.

The thing is, here's a man who is highly skilled and highly trained to prevent much larger costs in the treatment of cancer, because through his procedure he can prevent it, and what we're saying to this man is: "We expect you to work for nothing. We're going to cap the income of your office at $400,000, and if you employ 15, 16 or 17 people to make that office work, we don't care. You're still only going to get $400,000, and that's after you pay 15 or 16 or 17 salaries and your rent and everything else that's part of the overhead." How reasonable is that?

Do you know what this man does? Dr Rudd goes and practises preventive medicine in terms of preventing cancer -- we all agree "cancer" is the most dreaded word any of us ever hear in terms of diagnosis -- in another country. We lose him in Canada. We lose him in Ontario.

We have 10 million people in this province, and we've heard from all the previous speakers this afternoon about the waiting lists for treatment. Isn't it unbelievable that we have someone here who can prevent even the need for treatment and we force him to go and practise in another country? Wonderful for the patients in that other country, but not wonderful for the patients in Ontario who could benefit from Dr Rudd, and I only use him as an example. It's one example of prevention of this dreaded disease of cancer. There are many specialists; there are many, many stories. I just use him as one example.

I think the other part of this discussion that has to be talked about today is where we're going with the remedies. I have a letter here from AECCO, which is Access to Effective Cancer Care in Ontario, and they have flagged a very real concern. Their concern is under the headline of "Wonder Drugs for the Wealthy?" Of course, this also goes hand in hand with the whole debate about the fact that what is happening in Ontario today is that we are not only establishing -- it has already been established -- a two-tier health care system but we are reinforcing it. We are reinforcing it every time a patient decides to mortgage his or her home and spend that money to go and get treatment in another country where it's available in a shorter period of time.

I know as well as everybody else that Queen's Park isn't a money tree. I know these are the toughest times we've had for a number of generations. All I stand here and say to the government today is, let's decide that there are going to be priorities, and the priorities are that if we really believe in a universal health care system, we'd better make sure that there is universal access to that health care system and we'd better make sure that we don't treat our practitioners in that health care system with such disdain and disregard that we're going to say to them: "Okay, you've earned enough. We think all you doctors are too wealthy and too rich anyway, so we're going to cap what you earn."

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They don't look at what it is they earn doing whatever it is they do. As I said a few minutes ago, they can deal with the very few doctors who exploit the system, but they don't have to destroy the health care system in the process. They don't have to treat this way the men and women in this province who chose the practice of medicine for their future commitment in terms of a profession and a career, who chose it because they wanted to help people who are ill. They wanted to be part of a team that prevented people from being ill in the first place, a team like Dr Rudd's, but they also wanted to help those people who fell ill to be cured.

The doctors never wanted to become politicians. We do have two members in this Legislature at the moment who are doctors, but for the most part doctors didn't choose politics; they chose medicine. The men and women who chose medicine as a profession, as far as I'm concerned, are very, very special people because in choosing medicine they knew they wouldn't get to see their families on weekends and often many, many nights.

They knew that they were committing themselves to the antithesis of a Monday-to-Friday, 9-to-5 job and in return for that, those of us who become ill or whose family members become ill have these highly skilled, knowledgeable professionals whom we can go to in their offices or who will see us in an emergency department in a hospital and will be part of the recovery program for whatever it is that has struck us down.

But now, in Ontario we're killing the spirit of these practitioners in medicine. I may go as far as to say we're killing the spirits of the other people who are related, not only the physicians and specialists but the people who are the support teams in the practice of health care in this province. We are killing their spirit because we don't know how to prioritize.

There's a tremendous irony here of course and that revolves around the fact that the majority of people in Ontario are healthy, thank goodness, and it's only when we are ill or our loved ones or our friends or our colleagues at work are ill -- and we know that in this very chamber. We have all experienced it in this chamber. We've experienced the ultimate loss of colleagues to illness in this chamber.

It's only in those circumstances that we have any clue what is going on with the health care system and access to it in this province because if you don't need it, you never have to find out whether it's easy to get it or whether whatever it is in the form of treatment that you need you can get soon enough or, worst of all, whether you can afford it.

This group, this Access to Effective Cancer Care in Ontario, is concerned because there apparently are new drugs that are available that the government has decided not to fund. Just to read briefly from this article in the Ottawa Citizen from Monday, October 18, 1993, it says here:

"Wonder Drugs for the Wealthy?

"Background: Critics fear that cutbacks, user fees and extra billing will eventually kill universal health care in Canada. From a press release by Access to Effective Cancer Care in Ontario, a group of cancer professionals and patient advocates:

"'We're dealing with what is essentially a two-tiered health care system in this province,' says Dr Shailendra Verma, a medical oncologist at the Ottawa Regional Cancer Centre.

"'A trend seems to be emerging that important new cancer drug breakthroughs that have been approved by the federal government's regulatory health protection branch are not being listed on Ontario's drug formulary. This means they are not paid for by the province -- and therefore not available to seniors, those with lower incomes and no private health insurance.

"'We're concerned this is the trend of the future: those wealthy enough will have access to effective treatments, while others will be out of luck.'

"One example of a new drug not paid for by the province, says Dr Verma, is a granulocyte colony-stimulating factor," the acronym is G-CSF, "a protein that stimulates the body's production of infection-fighting white blood cells.

"'We're particularly disappointed in this government's attitude towards G-CSF as this may signal its reluctance to provide equal access to other, newer cancer treatments as they are developed,' says Dr Verma.

"'The ironic thing about G-CSF is that it helps some chemotherapy patients remain healthy enough to stay out of hospital. And that saves the province valuable health care dollars.'"

There has to be an irony, if there is a drug that enables patients under chemotherapy to stay out of hospital, that there wouldn't be some investigation into the balance of what is worthwhile in terms of its being cost-effective. Isn't it ironic too that while some families have insurance through their place of work that may pay for these drugs that are not available through the drug formulary, therefore through OHIP, some of these insurance companies may decide that they eventually will refuse to pay for these medications not covered by the Ontario Drug Benefit Formulary.

We will certainly be in a situation where the people who can afford treatment, either by being able to buy the expensive drugs or travel out of this province for earlier treatment of cancer that has already been detected, will be the people who can buy their way to health. I don't think the dream of any of us is a province where only the wealthy can access the health care system, but the irony is, with this government delisting drugs from the Ontario drug formulary, that has become a reality.

We're also looking at the government's announcement about its $1 million, which we were pleased to hear about in terms of hiring more therapists, especially the graduating radiation therapists in Ontario -- who graduated yesterday as a matter of fact. But you know, it really remains to be seen if these people will want to stay and work here with the social contract conditions in this province.

I think we've got to be very careful when we look at what it is we're saying about health care in this province. As I said at the beginning of my remarks, although we will be supporting this resolution of the Liberal official opposition today, it just seems a little superfluous for them to come in and attack the government for some of the things they list in their preamble, which really were not the current government's fault, but areas that, when the Liberals were themselves the government, could have been part of the solution.

I only hope that we can decide once and for all that we will all work together to solve this crisis and that simply to point fingers at the current government is neither fair nor accurate, frankly, and I dare say it's hypocritical.

I want to be part of a constructive opposition party and to support the government of the day in any decisions it makes to ensure that there is equal access to anyone who needs any kind of treatment in this province, and that we encourage our physicians to stay and practise here without limiting them and treating them like a herd of cattle just because we don't want to look at them as individuals.

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Mr Paul Klopp (Huron): I stand today to really express my deep sadness that this kind of motion was brought here today. I think of two friends of mine: Paul Cyr, who died this past year of lung cancer, and a very good friend of mine, actually his brother-in-law, as fate would have it, who died some six years ago, both of lung cancer, and their bravery and the cards that they were dealt and the strength that no one knows until you've walked in their shoes. To have this kind of motion today in this House only cheapens their death beyond words that I can hardly express.

The member for Timiskaming stood up and said: "Oh, come on, you guys. If you'd been on this side, you would bring this up too." This is purely politics, which I feel is very sad. I'm sure I'm going to hear, "Oh, yes, the NDP, when it was in opposition, did things like this." I can only say to those members out there and to the people who are listening that I was taught that two wrongs don't make a right, and indeed, I think what we're doing here today is that.

If I'd been a member of a caucus at those times, I would have argued very strongly that this is too far. Maybe some members in the opposition have argued about it today, but it wouldn't surprise me if Lyn McLeod came out in a couple of weeks and make a resolution blaming us for the weather in Ontario, because that seems to be what they're talking about in this resolution.

I'll give two quick examples from the member for Eglinton. She said she had a quote from a cancer patient, and we feel very badly for our cancer patients, that said that cancer patient would go anywhere in the province, day or night, to take treatment. Then later on in the same speech, she criticized the government that there's cancer treatment in the north and there's cancer treatment in London. She proceeded to make it sound like the social contract is the problem and imputed that made it first sound like we set the standards for the social contract. We only put on the table some ideas to save some dollars and reintegrate dollars. The member forgot to say that we did not talk about radiation treatment programs or anything like that, but again politics at its finest.

Very quickly, I go back to the member for Timiskaming. He then says that they're going to go and do a study. The studies have already been done. The Premier's Council, this government, this minister have gone through studies. In fact, the ending studies will be up in Sudbury and I understand Shelley Wark-Martyn will be there.

This is all about politics. This is all about fearmongering. This is unfortunate. In conclusion, I feel really bad that this party has to stoop this low about an issue that is so important to so many people. I even commend the Conservative Party for at least being fair.

Hon Ruth Grier (Minister of Health): I'm glad to have a few minutes at the end of this debate to make some comments. Let me say to the opposition that I regret I wasn't able to be here for the entire comments by the Leader of the Opposition. I was bringing some good news to Doctors Hospital here in Metropolitan Toronto.

I think my colleagues have spoken very clearly and very movingly about what this government is doing to deal with what is not a new problem. We knew in 1985, as one study, and there was one even earlier than that, that the rate of increase in the number of people diagnosed with cancer was far beyond the capacity of our existing system to deal with, and existing at a rate that I think gave us some very frightening signals that we had to move from just treating to preventing cancer, and to begin to take some serious steps to look at the entire continuum.

I hope that in this debate it has been made very clear that our government has responded massively, and so did the previous government begin to increase the number of machines, the number of personnel who are involved in cancer treatment; through us, the creation of the Institute for Clinical Evaluative Sciences, which begins to provide the data that enables the patients, the doctors, the hospitals and the cancer treatment centres to know the facts and to ask the hard questions about the system.

For this government, cancer has been a priority, and we have found the funds -- I thank the member for Mississauga South for her acknowledgement of that -- to put the money where we believe it is needed so that the problem of waiting lists, an ongoing problem, can be dealt with.

I'm glad the Leader of the Opposition has formed a task force. I understand that in her remarks today she said the task force would be travelling the province to find out the facts of the situation with respect to cancer. I could be partisan and say that perhaps the appropriate time to have an opposition day debate and to denounce the government for its lack of action might be after the task force had found out the facts, but sometimes that's not the way this place works, and so we're having this debate and then the opposition is going to go out and find the facts.

I think when they go out, they will find a number of things. They will find we have first-class treatment in this province and some of the best research and some of the best specialists to be found anywhere, who are doing a first-class job. They will find that there are hospitals where oncologists do their best and struggle to provide the treatment that's needed, but perhaps are not as closely linked to the cancer treatment centres as they ought to be. I hope the task force will meet not just with the treatment centres, but with the other hospitals and with the specialists and with the people who are working with cancer.

I hope the task force will meet with survivors. We heard a lot from the member for Scarborough West from her point of view. There are survivors and their families and there are particularly parents of children who have cancer, a place where we have made some progress. The number of children dying from cancer, that rate, is decreasing, but there are still far too many.

I hope the task force will ask all of those people: "What do you need in the way of support services? We know about the treatment, but you need support in your communities. What do you need? What can be done to provide that support?" I hope they will meet with community groups that are working to provide long-term care and with the district health councils and their long-term care committees that are planning what is needed in the various regions, my point being that cancer is about more than treatment, doctors and machines. It's about community support services. It's about planning.

I hope they will meet with environmental groups -- and I think this point has been made in the debate -- that have been saying for years that we should ban the incineration of municipal solid waste, something our government has done and the opposition say they would reverse, should they, perish the thought, ever become the government.

I hope they will meet with the environmental groups that are anxious to ban some of the persistent accumulative toxics that are coming out of the industries around this province and flowing into the Great Lakes, because we had just last week the International Joint Commission making the connection between a growing incidence of breast cancer in women who live in communities around the Great Lakes and the toxics that are in the Great Lakes. I hope the task force will ask tough questions about what needs to be done to deal with the environmental, the nutritional and the personal habits that lead to cancer.

The Leader of the Opposition mentioned the need for tobacco legislation. I hope that when that legislation is introduced into this House, as it will be very shortly, I will have the full support of the opposition in moving quickly to second reading and to getting that legislation adopted. I trust that as a result of their concern, as a result of the facts of the situation which they are going to determine and discover as a result of their task force, they will be here in a constructive, realistic and cooperative manner as this government continues to make cancer treatment a priority, but at the same time to put in place the planning structures that make sure we look to the future and that we work to prevent cancer for those not yet born.

Mr Sean G. Conway (Renfrew North): I'm pleased to conclude this debate for my colleagues in the official opposition speaking to the motion introduced and spoken to today by the Leader of the Opposition, the leader of the Ontario Liberal Party.

I want to take a few moments just to summarize the concern of the Liberal opposition, why we're here today and why we will be back early in the new year when the task force will be reporting its recommendations.

I listened to the Minister of Health, who just made a very feisty speech about what she's doing and what we should be acknowledging. I just met the other day with representatives of the lung association in my county. It was over a year ago that this government, as part of its cancer strategy, was going to move expeditiously with a new tobacco control act, and the lung association asked me, and quite rightly, "Where is that priority part of the cancer treatment program?" As of November 2, a full year after it was promised, it's nowhere on the agenda.

It is all well and good for my friend the Minister of Health to come in here and in a feisty way tell us what she's doing, but I just met a few days ago with the lung association, and they want to know where it is that commitment rests today.

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Hon Mrs Grier: Will you support it when we bring it in?

Mr Conway: I certainly will support it, but that's not the issue. The Minister of Health in her sanctimonious and feisty way said over a year ago -- and she stood there a moment ago, a New Democrat in Ontario on November 2, 1993, and she said, "God forbid that the opposition over there should form the government of Ontario." It just goes to show you in what kind of cloud-cuckoo-land Ontario New Democrats find themselves, a party that a week ago was obliterated provincially because they have been seen to have completely lost touch.

A year ago, the cancer strategy was going to be in significant measure built on things like a new tobacco control act. She promised solemnly that this would be introduced as a major piece of the cancer strategy for 1993, and 11 months and one week into this year of 1993 we've yet to see even the bill introduced, so we can imagine what other gaps there are between promise and performance.

I was moved in a way I would not want to describe by the remarkable if brief intervention this afternoon of the honourable member for Huron, but I want to congratulate the member for Scarborough West because I thought with poignancy and with effect she focused much of the human element of this very, very sensitive subject that brings us here today. You're damned right we should be here today talking about cancer, and I'm not about to be lectured by anyone anyplace that we should not come to talk in this place about probably the most sensitive part of the entire health care debate.

I'm one of the lucky ones who's not been personally affected. I listened very carefully to the excellent and timely remarks of the member for Scarborough West and I'm sorry that there weren't more of us here to listen to that testament. I understand why members had to be in other places, but you come to a debate like this today and hear the kind of nitwittery we heard from the member for Huron and you despair about the efficacy of this kind of parliamentary democracy. Then you hear a speech like we heard this afternoon from the member for Scarborough West and my colleague from Eglinton and certainly the Leader of the Opposition and you believe there really is some hope, that we are going to be able to do more about something in which there is an across-the-board concern, to be sure.

There can be no one in this building, there can be no one in this political community who does not share in the objective that brings us here today. We've all been touched. One of my best friends is dying a terrifying death at the present time with this killer disease. My colleagues and the member from Waterloo and the member from Mississauga, to mention others not in my party, today talked about what the demographics are suggesting: more cancers generally and more cancers in certain categories that reflect our aging population. Of course very impressive things have been done, but problems and pressures remain.

I don't wish to engage in some kind of partisan exercise the likes of which the member for Huron disgustingly imagines. Yes, I have sins of omission and commission for which atonement is due, let me say to my friends opposite, but I will say this: I have not in my time in opposition indulged in the kind of politics for which the Lewis and Rae New Democrats were famous. I will never contaminate my hands with that kind of politics, where the families of the sick and dying, and sometimes the sick and dying themselves, were brought to this parliamentary precinct and the most heinous of personalized accusation and assignment of blame were made by those honourable members in that new democracy to members of Liberal and Conservative administrations.

You bet your boots that I'm not going to play that kind of game. But that in no way diminishes the responsibilities that we have as honourable members to look at the current landscape, to report to this precinct what we're hearing.

I represent a large part of rural eastern Ontario, and I've been talking and listening to people who provide the services and the families who receive those services. I want to say that a lot of what I'm hearing is enormously positive, and I expect as our task force travels tomorrow to Kingston and later to Thunder Bay and Hamilton and Windsor and Toronto that we are going to hear a lot of very positive things about care givers and about volunteer organizations, because we all know that to be the case.

But when I hear from families in my part of rural Ontario about the disruption and the dislocation that sometimes, not always and not everywhere, but that sometimes occurs when people in need of that treatment are told they can't go to their centre in Ottawa but rather have to travel to Sudbury or some part of southwestern or south central Ontario, we can all understand, I think --

Interjection.

Mr Conway: And we do send people to Thunder Bay, of course. As the member for Scarborough West said so poignantly and so eloquently here this afternoon, that does raise, in the mind and the heart and the souls of the cancer patients and their families, a very high level of concern, and we know there are very considerable waiting lists on occasion in certain of our centres and our treatment facilities.

We also know there is a real and ongoing problem with not only training but maintaining and properly distributing oncologists and therapists and others in the system. I for one, speaking only for myself, am now prepared to be somewhat, perhaps even considerably more, intrusive in terms of the assignment of those people. I think in our public health care system we do not have to tolerate the kind of laissez-faire maldistribution we have seen over the past number of years. I accept my share of responsibility in allowing that situation to obtain, but that does not, I say to you, answer the concerns that many of my constituents have.

I just want to say to my friends opposite that if the day comes when we cannot come in here and talk about cancer treatment and what's going on and what's not going on -- you know, Dr Thomas Walkom wrote I think a very interesting column not too many weeks ago about some of the politics that attach to this debate. I understand that; I understand it very well. I thought Dr Tom's piece put it rather well. Any of us who've ever been in government understand some of the pressures that can develop for a variety of external and internal reasons within the health care debate. But to be told that the mere putting of this motion is somehow engaging in politics of a low partisan kind I think really does not assist the concern that we all know is out there.

I simply want to say, on behalf of Lyn McLeod and my colleagues in the Liberal Party and I know on behalf of everyone, that there is nothing, I believe, in the health care debate that so galvanizes public concern, so sensitizes individuals and their families, as cancer, the prospect of cancer, the reality of cancer and its treatment.

I've been here almost 20 years and I've listened to this debate and I've watched various governments respond to it, and I can, like the minister before me, report that there has been very considerable progress on a number of fronts. But it is obvious that there are serious ongoing concerns and deficiencies in our delivery system, and we have, in this area of extraordinary sensitivity, it seems to me, an ongoing and first-order requirement as legislators to address that concern. That's why the Liberal Party is here today speaking as we are to this motion. That's why the task force, and that will be part of our ongoing contribution in a positive and constructive way to deal with a matter of urgent, pressing concern and human sensitivity, as so eloquently put by, among others today, my friend, our colleague, the member for Scarborough West.

The Speaker (Hon David Warner): I thank the honourable member for Renfrew North for his contribution to the debate. Mrs McLeod has moved opposition day motion number 3, which stands in her name. Is it the pleasure of the House that the motion carry?

All those in favour will please say "aye."

Those opposed will please say "nay."

In my opinion, the ayes have it.

Call in the members. There is a five-minute bell.

The division bells rang from 1800 to 1805.

The Speaker: Would all members please take their seats. Mrs McLeod moved notice of motion opposition day number 3, a resolution which stands in her name. All those in favour of the resolution will please rise one by one.

Ayes

Arnott, Beer, Bradley, Brown, Callahan, Caplan, Chiarelli, Cleary, Conway, Curling, Daigeler, Eddy, Elston, Eves, Fawcett, Grandmaître, Harnick, Henderson, Johnson (Don Mills), Kwinter, Mahoney, Marland, McClelland, McGuinty, McLeod, Miclash, Morin, Murdoch (Grey-Owen Sound), Murphy, O'Neil (Quinte), O'Neill (Ottawa-Rideau), Offer, Phillips (Scarborough-Agincourt), Poirier, Poole, Ramsay, Runciman, Ruprecht, Sorbara, Stockwell, Sullivan, Tilson, Turnbull, Witmer.

The Speaker: All those opposed to Mrs McLeod's resolution will please rise one by one.

Nays

Abel, Akande, Bisson, Boyd, Buchanan, Carter, Charlton, Christopherson, Churley, Cooke, Coppen, Dadamo, Duignan, Farnan, Fletcher, Frankford, Grier, Haeck, Hampton, Hansen, Harrington, Haslam, Hayes, Hope, Jamison, Klopp, Kormos, Lankin, Laughren, Lessard, Mackenzie, MacKinnon, Malkowski, Mammoliti, Marchese, Martel, Martin, Mathyssen, Mills, Morrow, Murdock (Sudbury), O'Connor, Owens, Perruzza, Philip (Etobicoke-Rexdale), Pilkey, Pouliot, Rizzo, Silipo, Sutherland, Swarbrick, Ward, Wark-Martyn, Waters, Wessenger, White, Wilson (Kingston and The Islands), Wilson (Frontenac-Addington), Winninger, Wiseman, Wood, Ziemba.

The Speaker: The ayes being 44 and the nays 62, I declare the motion lost.

Pursuant to standing order 34, the question that this House do now adjourn is deemed to have been made.

PROTECTION OF PRIVACY

The Speaker (Hon David Warner): The honourable member for Renfrew North had filed dissatisfaction with an answer to a question answered by the Attorney General. The honourable member for Renfrew North has up to five minutes to present his reasons for his dissatisfaction. The Attorney General will have up to five minutes for her reply. The honourable member might wish to allow a few seconds for the chamber to clear.

There are a number of private conversations, and it would be advisable if those conversations could occur outside the chamber and thus allow the honourable member for Renfrew North full opportunity to present his reasons for dissatisfaction.

Mr Sean G. Conway (Renfrew North): Thank you very much, Mr Speaker. I want to say at the outset, I appreciate the minister of justice, who I know is a very busy person, attending this evening on very short notice.

I have in my hand the Instant Hansard of our exchange this afternoon and I want to come back to my absolute fury over this photo-radar issue. I understand again what the honourable minister of justice said today about the concern on our highways. Speeding is clearly adding to the carnage on the highways, and there's no doubt about that and I'm not going to contest that point. The issue for me is: Does that end justify these means?

I say no, non, nyet, and I'm going to fight this damn thing every step of the way, because I have sat here over the years and I've listened to honourable members in the New Democratic Party and in my own party and in the Progressive Conservative Party rightly say we should not have covert monitoring of the workplace, we should not have covert monitoring of our penal institutions. Those have been powerfully put, and I think that's a compelling argument.

There are fundamental issues of civil liberties here, and I just do not accept the notion that because we are all concerned about speeding on the highways that anything goes, anything goes to address that concern. We live in a free and democratic society where there are understandably some sanctions that limit what governments can do.

I say to my honourable friends in this House that as we have agreed over time not to allow monitoring of people in their workplace -- and we got another report yesterday which makes a powerful case against the kind of Orwellian intrusions that we're seeing in the workplace -- surely we understand what's at issue with photo-radar on our roads.

I simply want to make the point, and I say to the listening audience, under the proposal that's contained in Bill 47 that will give you photo-radar, we are going to have a situation across the province, on designated highways and designated periods of time, when there's going to be an electronic bug looking down on you as you drive. There'll be no notice to speak of.

Hon Gilles Pouliot (Minister of Transportation): You're selling fear. That's not fair.

Mr Conway: I want some attention from the minister of highways.

The Speaker: Order. The member for Lake Nipigon is out of order.

Mr Conway: I want to say that the public in this province is going to be very upset when they find out just how intrusive and just how unfair this policy is. You do not have to be driving the car to get the fine. The policy clearly breaches a very important principle of equality before the law because if Mrs Caplan and I are driving down the 401 and we're both breaking the law, the machine picks --

Hon Mr Pouliot: You have a machine system already in place.

The Speaker: The member for Lake Nipigon is out of order.

Mr Conway: -- Mrs Caplan up, picks her licence up, assigns her a fine. I'm driving even more quickly alongside her, I'm not picked up, I'm not fined.

We've got a situation that someone who violates the Highway Traffic Act and is dealt with conventionally by a police officer can and probably will, if there is a serious violation, lose points and will have an impact on his or her insurance as a result. There is no such impact under the photo-radar provision. It is simply going to levy a fine and nothing else.

It's hard not to read this, as my friend from Etobicoke West has said, and the member for St Catharines, and not see it as substantially a revenue grab. My objection continues to be that this is not the way we do business in this province. There is a fundamental question of civil liberties here.

Yes, there is a problem. I accept it. I accept there is a problem, but I say to my friends on all sides, it is unfair and it is unjust to submit the Ontario citizenry to this kind of arbitrary, silent, secret, electronic, covert intelligence. I just think that is obvious.

My friend the minister of justice can chortle, but I've got to tell you that I think there is going to be an eruption of public protest when people understand this policy for what it is. In my view, it is an unfair, unjust, Orwellian intrusion into the daily lives of Ontarians. It clearly has as one of its principal if not its main intention a significant revenue grab. It is going to treat individual citizens who have committed the same offence differently, and that difference alone I think ought to concern people.

Yes, we have a problem. I accept that. I used the examples yesterday. As I travel down the 401 eastbound, everybody passes me at 120. I accept those data and I accept that we have to do something, but I want to tell you, these means of photo-radar are objectionable, obnoxious, they are not the Ontario way, and I respectfully ask that they be withdrawn.

The Speaker: The Attorney General has up to five minutes for her response.

Hon Marion Boyd (Attorney General): The member for Renfrew has again managed to create a cathartic situation for himself here and additional time for the discussion of Bill 47. One of the reasons I was eager to participate is that I feel so strongly that this is a good move on the part of our government that I want to defend very much the move that we've made.

It is very clear that our intention as a government to make Ontario roads the safest in this country will be furthered by the moves that we are suggesting under Bill 47. Photo-radar deals with an acute safety issue by increasing our ability to monitor highways and therefore it provides a deterrent for people from driving at high speeds.

At this point we have agreed that we will pilot photo-radar and we will examine how well it works. We will review any concerns that come up as a result of its use, and we will make further decisions concerning its usage in the province after that review.

The member suggests that taking an action to prevent a criminal act from being completed is Orwellian.

Mr Chris Stockwell (Etobicoke West): Yeah, but you don't get it. You get the criminal with those, you get the licence plate with this. You're not convicting anybody under what he is saying.

The Speaker: Order. The member for Etobicoke West will come to order.

Hon Mrs Boyd: I suggest that taken to its further extent, this member is suggesting that photo-radar is similar to such things as video cameras in banks or convenience stores. Is he suggesting those should be taken down? We know how important they are in terms of creating safety and protection for people working in those institutions and aiding in justice.

What kind of Orwellian reaction is that? This type of surveillance is to keep people from breaking the law. It is not to interfere with the rights of ordinary citizens going about their ordinary business.

Interjection.

The Speaker: Order. Stop the clock, please. I must caution the member for Etobicoke West. His interjections are not acceptable. Minister.

Hon Mrs Boyd: The report from the Information and Privacy Commissioner, Mr Wright, was on workplace privacy, the need for a safety net in the workplace. Mr Wright was talking about such practices as having surveillance cameras in washrooms. He was talking about things like mandatory testing, random testing of all employees for HIV or for drugs, and he was saying that these things are an infringement on people's rights because there was no reason to assume in those kinds of situations where people were in their workplace doing their work that this was an appropriate kind of a thing. He spoke very strongly and we as a party have spoken very strongly about the kind of infringement of civil liberties that comes from that kind of randomized situation.

The beauty of the photo-radar thing is that it will not pick up a car unless that car is going over the speed limit. It will only catch those who are breaking the law, and in fact it would probably be of interest to the member to know exactly how sensitive it is.

Mr Robert Chiarelli (Ottawa West): You are randomizing all provincial offences with this bill. What about plumbers' permits? It's a provincial offence.

The Speaker: Order. The member for Ottawa West is out of order.

Hon Mrs Boyd: In fact it would capture Mrs Caplan and you as you go down the road because this is very quick film and in fact what it would do is that.

The member says this is surveillance that would infringe on individuals. It takes a picture of the licence plate, not of the individual driver. The third party says, "You should be taking pictures of the individual driver," and indeed we're saying no.

What we're concerned about is if a vehicle is being driven at this speed, the owner of that vehicle will be held responsible for that because even if that owner is not the one who is driving, that owner is responsible for the vehicle he or she owns. We are held responsible for the vehicles we own by our insurance companies. Our insurance companies often are the ones that pay the price for this.

In Australia, where this has happened, the deaths, fatalities and accidents have been cut by 50%. We have seen a huge drop in the fatalities in other jurisdictions in North America that have used it and it is extremely important for us to do that.

In conclusion, we have spent this afternoon talking about the problems in our health care system. I ask the member to remember that if we are successful in cutting the carnage on our roads, $9 billion that we now spend in terms of health care for those who are injured in car accidents in this province will be available to use in more positive ways within the health system.

It is extremely important for us as a government to take this preventive measure and we utterly reject the accusations of the member for Renfrew.

The Speaker: There being no further matter to be debated, this House stands adjourned until 1:30 of the clock tomorrow.

The House adjourned at 1822.