Journal des débats 1982-avril-26 | Assemblée législative de l'Ontario

Hon. G. W. Taylor: Mr. Speaker, today I am tabling a report on the recent assessment done by the Ministry of the Solicitor General on the operations of the Ontario Humane Society, which was commenced during the time the member for Eglinton (Mr. McMurtry) was the Solicitor General.

This assessment was instituted following a number of complaints and allegations about the society. Most of the complaints were made through the news media, others were received through letters to the ministry or through contact with members of this Legislature.

I wish to state categorically that the assessment found no evidence of misappropriation of funds. The staff of the ministry feels an independent audit done by the society is reliable and gives no cause for concern. What the assessment does show, however, is that a number of organizational, managerial and financial problems currently exists in the operation of the Ontario Humane Society.

The report makes four basic recommendations:

1. That the Ontario Society for the Prevention of Cruelty to Animals Act be reviewed. The aim is to clarify the enforcement authority and the responsibility of appointment for inspectors and agents.

2. That the Ontario Police Commission, in consultation with the Ontario Humane Society, develop a training program sufficient to ensure proper qualifications of all appointees.

3. That a management consultant firm be engaged to advise on the appropriate action and bylaw amendments. The firm would study organizational, financial and management issues raised by the report. It would also look at the issue of the composition of the board of directors and the classes of membership.

4. That consideration be given to reviewing the purpose, level and conditions of funding from the Ministry of the Solicitor General to the Ontario Humane Society.

We undertook this assessment because the ministry is responsible for the administration of the Ontario Society for Prevention of Cruelty to Animals Act. That statute creates the Ontario Humane Society and authorizes it to perform law enforcement functions in relation to cruelty to animals. The ministry has an obvious interest in seeing that these functions are properly carried out.

I want to emphasize, however, that the society is not an arm of the Ontario government. It is an autonomous and charitably funded organization. We will proceed with any action in the spirit of mutual co-operation with the society that will ease the present problems.

I can assure honourable members that the recommendations in this report are being carefully studied. The Ministry of the Solicitor General and the society have agreed to review the bylaws, organization and management of the society. We are currently in the process of engaging a management consultant to examine and make detailed recommendations for the improvement of the organizational, managerial and financial aspects of the society's operation.

Necessary changes, including any legislative ones, will be considered following that study.

REORGANIZATION OF THE MINISTRY OF GOVERNMENT SERVICES

Hon. Mr. Wiseman: Mr. Speaker, it is a pleasure for me to inform the House today of changes in my ministry which I believe will ensure even greater service to members of the public, our boards and commissions, agencies, ministries and the entire government. Reorganization of the Ministry of Government Services begins today and will be completed in about two months.

We, at the Ministry of Government Services, are convinced these advancements will greatly enhance our complete service role and mandate for the 1980s. I am sure the House will be pleased to know we have been able to accomplish this reorganization within our present budget and staff resources.

Information regarding our restructuring is being distributed to all members of the House at this time. They will find the notices in their mailboxes this afternoon.

CHILDREN'S MENTAL HEALTH SERVICES

Ms. Copps: On a point of privilege, Mr. Speaker: Last Friday in this House the Minister of Community and Social Services (Mr. Drea) accused the director of Maryvale children's centre of monumentally misleading me and my committee on the issue of children's services, or the lack of them, in the Windsor area. The minister denied there was a problem with children being refused entry to Maryvale, or their going absent without leave because the facility could not handle them.

I spoke today to a parent of a Maryvale child, whose name the minister knows because the parent also has been in touch with his office. This parent advised me that his 15-year-old daughter had run away from Maryvale 10 times in the period between November 1981 and February 1982. He said that his daughter was usually accompanied by three or four other girls when she ran away, which would indicate a very serious problem. The gentleman also advised me that although she had not committed a crime, his daughter was finally placed in a detention centre before she was transferred to another, more suitable, facility.

If the minister still denies there is a problem, I would advise him to refer to a report prepared and approved last July 22, by the children's services committee in Windsor. That report, two years in preparation, recommended a prioritized list of outstanding needs which included 27 items. The number one item facing the children in the Windsor area was services for the emotionally disturbed.

The report stated that eight local organizations had waiting lists and that Maryvale listed individuals needing attention it could not provide. This list included, in the category of young females 12 to 16, depression, anxiety, thought disorders and bizarre behaviour in young female day students; and in residential young females of the same age group, aggression and disruptive behaviour.

In fact it is not Mr. Vossen who has been monumentally misleading it is the minister, who refuses to recognize the problem despite the buildup of evidence across the community as documented in this report.

Mr. Wrye: Mr. Speaker, if I may speak briefly to the point of privilege, as one of the members of the health task force and as member for the riding where Maryvale is located: My colleague for the member Hamilton Centre has already pointed out to the House some of the facts that make it clear that the executive director of Maryvale did not mislead the task force when he told us that seriously disturbed girls in Windsor are not getting the help they need. I would hope the minister would Look at the children's services committee study which, after all, took two years to finalize.

I also want to say I received a call this weekend from Jim Cummings, who sat on the advisory board at Maryvale for six years. He considers Mr. Vossen's remarks sound, reasonably correct and a reflection of what is going on.

I think the minister, who attempted to sully the reputation of a fine man, should stand in this House when he arrives today and publicly apologize to Mr. Vossen for his intemperate remarks. On Friday, he suggested he would lend his credit card to my colleague so that she might call Mr. Vossen. Today, I offer my credit card so that the minister may call Mr. Vossen and apologize.

Mr. Speaker: Oral questions.

PHYSICIANS' SERVICES

Mr. McClellan: Surely, Mr. Speaker, the Minister of Health (Mr. Grossman) intends to come before the assembly today and make a statement, after his posturing on Thursday.

2:10 p.m.

Hon. Mr. Wells: Mr. Speaker, after these other points of order were completed, I was going to inform the members that the Minister of Health (Mr. Grossman) will be here to make a statement. It is not ready at the minute. With the consent of the House, perhaps the House will be agreeable that he could make that statement when he arrives.

Mr. Peterson: On that point, Mr. Speaker, it seems the minister is developing a habit of making last minute and dramatic announcements in this House, which is fine, on the condition that we can stand down our questions until the minister arrives.

Mr. Speaker: Yes, that is acceptable if it is agreeable with the House.

Mr. Foulds: Mr. Speaker, it is getting to be a deplorable habit of ministers of the crown not to be ready to make ministerial statements at the time that ministerial statements are to be made. There is a set time during the day for them.

In making late entrances, the Minister of Health seems to have developed a particularly theatrical approach to his ministry. How long are we, in this House, to be expected to suffer this whim of the Minister of Health? We have known since yesterday about the breakdown in negotiations. Can the House leader tell us why he is not ready now?

Hon. Mr. Wells: Mr. Speaker, first of all it is not a common occurrence. It has only occurred when there has been a particular situation that has been fairly disturbing and demanding of a minister's attention, and when the situation has been changing from time to time.

I can well recall when I was Minister of Education, and we were in the midst of some of the teacher-school board problems, coming in here and asking for the same kind of indulgence that the Minister of Health is asking now. We were asking to make statements at some time during question period mainly because the situation was changing by the minute. Quite frankly, I think that is what the minister is doing.

I have not talked to him for the last couple of hours, but he is preparing the most up-to-date statement possible for this House. I think we should give him the courtesy of hearing that when he is able to get here.

Mr. Speaker: Does the Leader of the Opposition (Mr. Peterson) wish to carry on with oral questions?

Mr. Peterson: I have asked that we have our questions stood down until the minister arrives.

CHILDREN'S MENTAL HEALTH SERVICES

Ms. Copps: I have a point of privilege, Mr. Speaker. Since we now have the appearance of the esteemed Minister of Community and Social Services, and I am sure he monitored every word very carefully out in the anteroom, I wonder if he might advise this House whether he does plan to tender an apology for the besmirchment of the reputation of Mr. Art Vossen of the Maryvale children's centre?

Hon. Mr. Drea: Mr. Speaker, I was not in the anteroom, and I did not hear what the member had to say. However, I understand Mr. Vossen talked to her.

Let us put some things on the record, Mr. Speaker. Mr. Vossen originally told the member that there had been 20 very emotionally disturbed young females who were not admitted to his centre. The fact of the matter is that at best there were five. He found that the setting was not appropriate and they were either recommended or sent to much more secure places.

Second, Mr. Vossen told the member that 20 young females had escaped, run away, or were absent without leave. As I said on Friday, there were eight. The problem with almost all of them was that open setting. Mr. Vossen does not want a closed setting even if the member is Miss Razor Ribbon. With an open setting the placements were not appropriate. The young females were all referred to, or are in, either the London Psychiatric Hospital or secure care.

I would think that Mr. Vossen should apologize to the member and not vice-versa.

Ms. Copps: On the same point of privilege, Mr. Speaker, it is unfortunate that the minister was not here to listen to the documented evidence of one parent; perhaps he might confirm this since the parent was in contact with his office also.

One parent advised the opposition that his daughter fled, went AWOL, escaped the Maryvale facility 10 times in the period between November 1981 and February 1982 -- one individual, 10 escapes. That individual was finally placed in a detention centre before she was sent to a more suitable, more secure facility; that is one individual among the minister's eight. Does he feel that one individual going AWOL 10 times in three months is an acceptable situation?

Hon. Mr. Drea: Mr. Speaker, I know about that case. The gentleman did not tell the member about his son either, did he? He has had more than a little bit of difficulty. That particular female did not escape 10 times. She went away from that open setting where she was given every single chance, nine times. She will not respond to an open setting. Part of the problem has been her parent's demand from the very beginning that she be put in a secure setting. She was placed in a secure setting and now she is in the London Psychiatric Hospital.

Ms. Copps: Mr. Speaker, on the same point of privilege --

Mr. Speaker: The member has made her point of order. This is deteriorating into a debate.

Ms. Copps: There was a second part to the point of privilege I raised, and if possible, I would like a response.

Mr. Speaker: No, it would be more properly dealt with in question period, because that is what you are doing.

Ms. Copps: I just want a response to the children's services report, which does not deal with individual cases, and if I may, that is the main problem.

Mr. Speaker: The member may ask the minister during question period.

Mr. Peterson: Mr. Speaker, since the Premier has arrived, with your permission I should like to stand down at least one question for the Minister of Health and perhaps ask the Premier a question.

Mr. Speaker: May I try that on for size, please? The Leader of the Opposition has requested to use one of his mandatory questions and to stand down the second one, awaiting the arrival of the Minister of Health.

Mr. Foulds: Mr. Speaker, I respectfully request, so that the opposition is not continually held to ransom by the ministers being inappropriately briefed and using this place the way their whims take them, that you recess this House for a full question period until the minister is ready.

Mr. Speaker: That really is beyond my authority. It would have to be the wish of the members of the House.

An hon. member: It is up to the Speaker to make his order.

Mr. Speaker: It is not. The Leader of the Opposition has indicated he is ready to go ahead with his first question.

ORAL QUESTIONS

ALSANDS PROJECT

Mr. Peterson: Mr. Speaker, this question is to the Premier. I gather he was meeting this morning with the Premier of Alberta, and I gather the topic of conversation was the Alsands project. Would the Premier be prepared to inform this House what views were exchanged, whether Ontario has a role in the resurrection of that project, and whether the Premier is prepared to invest taxpayers' funds in that Alsands project?

Hon. Mr. Davis: Mr. Speaker, I was pleased to receive a visit from the Premier of Alberta. The Leader of the Opposition is quite right, he was here to talk to me about Alsands. I had a very lengthy and informative discussion with the Premier of Alberta.

Without betraying any confidences of that meeting, I think the Premier of Alberta made it clear, when coming into my office and upon leaving my office, if I heard him correctly and I think I did, that the purpose of his visit was not to seek any form of monetary participation from this province. That, as I understand it, is really not an issue, or even thought about at this particular moment.

I can tell the Leader of the Opposition no more than that at this moment. There are other discussions going on, as I understand it, between the government of Alberta and the government of Canada, and I am not in a position to disclose what was conveyed to me at our discussions this morning.

Mr. Peterson: Given the fact that, according to some reports, that project, if it started, could bring $6.5 billion to the Ontario economy during the construction period and would probably provide 14,000 temporary jobs and 2,400 permanent jobs to this province, does the Premier not consider he should get involved and that it would be a far wiser investment than the one in Suncor which brings not one job nor one drop of oil to Ontario?

2:20 p.m.

Hon. Mr. Davis: I thought the Leader of the Opposition heard my answer to the first part of the question. He has now taken to reading my speeches which I find encouraging. That advice probably comes from the new executive director of his office who used to be with the Canadian Unity Information Office. That is in spite of the government of Canada and the Prime Minister being a millstone around his neck. This has become millstone city as far as the Leader of the Opposition is concerned. Did he read what his colleague said about the Prime Minister Thursday night? He was extolling his virtues.

In a speech I made to one organization about four or five weeks ago, I pointed out exactly what the member said just a few moments ago. While the estimated investment in the project is somewhere around $12 billion, our rough estimate is this could mean -- and I emphasize "could" -- that in terms of economic spinoff, somewhere between 40 or 50 per cent, perhaps a shade higher, would accrue to Ontario.

I made this view known some weeks ago. The government of Canada is aware of our support of Alsands and certainly the Premier of Alberta is. He mentioned and appreciated that we had made this position public on a number of occasions, so Ontario has already expressed to both governments its strong support of the project.

I point out, because the Leader of the Opposition is or pretends to be the financial expert, that we have not been asked by either government to invest any money. That is not the issue at this moment.

Mr. Peterson: I understand the Premier's position to some extent but does he not feel, given the stakes involved here and that it could have a tremendous spinoff for the province, that he should be more active in this matter and volunteer his assistance in some form or other to try to get a consortium going to build that project? By his own admission it would have tremendous economic spinoffs for Ontario. Maybe the Premier should take an active role. Why does he not go to them and volunteer to sell the interest in Suncor which does nothing for Ontario, and do something that does do something for Ontario?

Hon. Mr. Davis: I will try for the third time to explain this to the Leader of the Opposition.

The present situation with respect to Alsands does not relate to the need for more government investment. That is not the particular problem. I am trying to convey to the Leader of the Opposition that the issues as I understand them are separate and distinct from that. There are meetings taking place between the two governments and, I assume, between the governments and those who remain in the consortium. Participation of a financial nature from this province is not only not required but is not being sought. I hope that registers because that happens to be the case.

I assure the Leader of the Opposition, and I will get him a copy of the speech, that both governments are fully aware of this government's support for moving ahead with Alsands. We have been in support for a considerable period of time. We have made it public on a number of occasions. Both governments as well as the private sector are fully aware of that. I can assure the member we are continuing this position.

SCHOOL TEXTS

Mr. Foulds: Mr. Speaker, I will also take one question and stand one down, if I may.

I would like to ask a question of the Minister of Education. Is the minister aware that the school children of Ontario, in one of their widely-used grade 7 and 8 history texts, called Fair Domain, encounter the following passage?

Referring to the Huron Indians: "The tribesmen were so accustomed to gambling, drinking, quarrelling, torturing and even eating the flesh of their enemies, that they found it hard to change their manner of living. The warriors could not understand why they should not hunt on Sundays and why they should not have three or four wives."

Is the minister also aware that, in a widely-used high school text, the children act out a rather objectionable little sexist drama, which is illustrated rather graphically with a character called Brigitte LaBombe? I will send a copy across to the minister.

Since these books are in use in Ontario because the school boards of this province claim they cannot afford to replace them, will the minister outline what plans she has to make funding available to get textbooks with racial and sexual bias and outdated books out of the classroom and what steps she will take to encourage the development of new learning materials in Ontario?

Hon. Miss Stephenson: Mr. Speaker, no government and no Ministry of Education has been more active in the area of vetting and developing new textbooks to eliminate bias based on ethnicity or sex than this government and this ministry. As a matter of fact, no government or ministry has spent more money in doing it than this government or this ministry.

In addition, as the honourable member obviously knows, there is a Circular 14 list, which is submitted to all boards. This year we have been much more active in our pursuit of the statement which now appears in the front of Circular 14, that those books which do not appear on the list are to be removed from the classroom. That is the board's responsibility.

About a decade and a half ago it was decided that boards of education in Ontario were groups of responsible adults capable of making rational decisions related to the funding of education within their own jurisdiction, and directed funding was removed from any kind of grant mechanism developed within the Ministry of Education for educational purposes.

I do not believe the situation has changed in terms of the responsibility of those adults who have jurisdiction for the delivery of educational programs at the local level. I do believe the situation has changed in terms of the cost of education and the concerns which boards express that, given the demands of about 85 per cent of their total budget for the purposes of salaries and wages, they have little leeway or flexibility to meet some of the concerns being expressed by the book publishing industry and by the Ontario Teachers' Federation in a news conference they held about 10 days ago.

I believe the two books mentioned by the member are not included in Circular 14. I will be absolutely astonished if they are. I do believe it is the board's responsibility to develop a greater degree of capacity to ensure that the texts they are using meet the standards that are set by the Ministry of Education.

Mr. Foulds: May I ask the minister on what she is basing her information with regard to these books not being on Circular 14? Our information at noon was that these books are still on Circular 14 and that they are still two of the most widely used textbooks in Ontario schools. The book out of which the little drama comes was published in 1978. The history textbook was published in 1960.

Does the minister not realize that Ontario currently spends approximately $11 per student on textbooks and that other provinces, such as Alberta, spend $23 per student on textbooks? Will she now admit that without some directed funding to textbook buying at school board levels, she will not be able to modernize the textbook industry of this country, a large part of which is located in Ontario; she will not be able to develop supplementary materials for the classrooms of the province; and she will not be able to get into the schools the kinds of modern textbooks that are so desperately needed to eliminate some of the stereotypes and biases?

Hon. Miss Stephenson: The Ministry of Education provides millions of dollars every year for the learning materials development fund. It provides a considerable amount of funding to TVOntario for the provision of educational programming. It provides the program that purchases a copy of each new approved text for each relevant school in the province. And, on average, it spends about $21 per year per student in support of learning materials -- not all are textbooks -- for students within Ontario.

2:30 p.m.

In addition, I would remind the member that the vast majority of the publishers are here in Ontario. Indeed, if he asks them, they will say no province has given them greater support in the development of Canadian educational materials than Ontario has.

Mr. Nixon: Mr. Speaker, is the minister not aware that a world-class centre for research into Indian history and goals exists in the old Mohawk Institute in Brantford, Ontario, which is well- financed, mostly federally and a little bit provincially?

Why would she not undertake to have those people, who are working full-time on this matter, vet the textbooks that have been brought to our attention by the minister -- sorry, member, soon to be Liberal minister -- and also undertake to prepare the sorts of things we are going to have to put into our schools, particularly if we are going to meet the requirements placed on us by the new Constitution in the immediate future?

Hon. Miss Stephenson: Mr. Speaker, I would ask the member if he has had an opportunity to read the new course guidelines that have been developed for native studies which were --

Mr. Nixon: They were introduced by your predecessor.

Hon. Miss Stephenson: No, they were not.

Mr. Speaker: Order.

Mr. Nixon: Have you abandoned your predecessor's initiative in this already?

Hon. Miss Stephenson: We have an entirely new initiative in this area, which I will be delighted to transmit to the honourable member so that he can see just how valuable the input of our native peoples has been into the establishment of good learning materials for all students, but particularly for native students, in this province.

Mr. Grande: Mr. Speaker, do I gather from the minister's comments that she accepts those passages in those books as being totally acceptable to her? Is the minister not aware that in the Ryan report it states that 41 per cent of the textbooks used in our classrooms were published prior to 1974, 20 per cent of those being published 12 or more years ago and 19 per cent from 11 to eight years ago?

If she is aware of the report -- and I am sure she is -- is the minister not aware of the comments of some teachers in that report? They say, "I have the only textbook in the classroom. We do not have any textbooks. Before it was a lack of good texts, now it is a lack of funds. We run all our materials off, and are getting tired of writing dittos and running them off."

When is the minister going to stop pretending there is no problem and begin to address the quality of education? Clearly, with these kinds of textbooks in our classroom, the quality of education is deteriorating rather rapidly.

Hon. Miss Stephenson: Mr. Speaker, the answer to the member's first question is a resounding no. If he would open his ears he would hear what I had to say.

Second, I am fully aware of the responsibilities of boards of education. The Ministry of Education has assumed its responsibility and has discharged it admirably. We are now trying to assist boards of education through various means to make the right decisions related to the supportable, and support of, texts for children in the learning experience.

EMPLOYEE HEALTH AND SAFETY

Hon. Mr. Ramsay: Mr. Speaker, earlier this month questions were asked of me by the member for Sudbury East (Mr. Martel) regarding health and safety conditions at the Rothsay Concentrates Co. in Moorefield.

There has been a further involvement by the ministry since I last spoke to this matter, and I now wish to inform the honourable member of the subsequent developments. As he will undoubtedly recall, 72 orders were issued against this company in January. There is agreement by all parties of the occupational health and safety committee that these orders have been complied with.

On April 15, an industrial health and safety officer conducted a further inspection of the plant in the presence of company and union members of the joint health and safety committee. Seventeen new orders were issued directing the company to rectify certain physical hazards in the plant, to ensure the availability and use of safety equipment and, in future, to abide by the accident reporting requirements. The ministry will, of course, be monitoring this plant closely for compliance.

In his report, the inspector listed approximately 30 items of concern identified by the union. Some of these concerns were the subject of the orders to which I have just referred. Others, while mainly of a housekeeping nature and not representing contraventions of the act, will be addressed by the joint health and safety committee.

I should also mention that on April 15 and 16 another official from the occupational health and safety division met with the members of the joint committee to review its effectiveness. There do appear to be shortcomings in the committee's past performance, which I believe were caused in part by other industrial relations problems.

Therefore, I have made available the mediation services of my ministry to assist in these industrial relations matters. This mediation effort is over and above the assistance which will be provided to the joint committee until such time as it is operating effectively.

Mr. Speaker, I also have one other very short answer to a previous question from the same member, with your permission.

This is in respect to Irwin Toy Ltd. I also want to take this opportunity to provide an update on the ministry's investigation into the use of the substance methyl ethyl ketone at the Hanna Avenue plant of Irwin Toy Ltd.

The so-called MEK is a solvent used as an agent for the purpose of thinning glue. On April 13 and 14, the plant was visited by an occupational hygienist and an industrial health and safety inspector. Air samples taken by the hygienist in the areas where the substance MEK is used showed concentrations well below the hazardous level.

The hygienist, however, did find that some employees were not being adequately protected from direct skin contact with the substance and ordered the use of rubber gloves. The inspector also issued an order relating to protective equipment and 21 other orders on such matters as the elimination of physical hazards from the shop floor and the proper storage of MEK.

A further inspection will be conducted to check for compliance with these orders.

Mr. Martel: Mr. Speaker, when we have an inspection like this and the minister finds 21 contraventions, how many times are we going to go through this little game until his ministry says to those corporations, which continue to violate the act, that we have had enough and charges are going to be laid?

Hon. Mr. Ramsay: Mr. Speaker, the inspection files in question in both cases have been forwarded to the ministry's legal services branch for its opinion. There is a good possibility of further charges.

RENT CONTROL

Mr. Ruston: Mr. Speaker, I have a question for the Minister of Consumer and Commercial Relations with regard to Webbwood Estates Mobile Home Park's rent increases.

The average rent increase over the past five years to a typical tenant has been 21.4 per cent, including a 1982 increase of 19.1 per cent, which is now under appeal. These increases are largely based on huge administrative costs and enormous salaries paid to the principal owners, who manage the park.

The tenants obtained an estimate from an independent management company which indicated it could provide the same service for half of the costs now being incurred by the tenants, with the commission's approval. Is the minister aware of these facts, and what steps is he willing to take to rectify this situation?

Hon. Mr. Elgie: Mr. Speaker, as the member has quite properly pointed out, the matter is under appeal. It would be most inappropriate for the minister to comment on matters of substance that are going to be heard by an appeal board.

Let us clearly understand, for the member's benefit, that his party, along with all other parties, agreed to the cost pass-through principle. That is the principle that the rent review commission utilizes in evaluating requests by landlords for increase awards.

Mr. Ruston: Would the minister explain how the Residential Tenancy Commission can allow larger increases in administrative costs and equipment while at the same time stating in the text of its decision, "There has been no significant improvement or deterioration in the standard of maintenance and repair of the building"?

Could the minister also explain the legitimacy of a landlord charging a tenant $1,200 to store equipment on his own property?

Finally, does the minister consider it reasonable for a landlord-manager and his wife to receive a joint salary of approximately $76,000 when the property is operating at a deficit? Are the tenants alone supposed to bear the financial burden of mismanagement?

2:40 p.m.

Hon. Mr. Elgie: I am certain I understand the reason the member asked this particular question. I can only repeat what I said before. I am sure he does not expect the minister who is responsible for and reporting on behalf of the rent review commission to make public statements about a quasi-judicial tribunal which is making decisions on principles established by law, and about a matter which is now under appeal to the appeal commission of that tribunal.

Mr. Philip: Mr. Speaker, I admit it is inappropriate to discuss a particular case when it is before a tribunal, but is the minister, in his new capacity, not prepared to admit there is gross inefficiency and incompetence in the way in which the guidelines are set up, in that the Residential Tenancy Commission may not act on its own initiative to investigate how moneys are being spent after large projections have been made by landlords to justify large rent increases?

What will the minister be doing to overhaul the guidelines and rules by which the commission now, and not very efficiently, operates?

Hon. Mr. Elgie: Mr. Speaker, first, I do not agree with the comment about the effectiveness and efficiency of the commission. The member knows there have been recent additions to the number of commissioners available, and we hope that will help with the backlog. We are also reviewing guidelines from time to time and some of the matters he has raised will be issues for discussion as we go through that process.

Hon. Mr. Wells: Mr. Speaker, may I ask for the consent of the House to revert to statements so that the Minister of Health (Mr. Grossman) can make what is a fairly lengthy statement -- it will probably take about 15 minutes -- to outline the situation which has occurred and where we now stand in this dispute?

I was talking to the minister just a minute ago and he confirmed that he has had telephone conversations with Dr. Reese and others which necessitated changes in his statement right up until the last few minutes and that it was for legitimate reasons that the statement was not ready at two o'clock.

Mr. Speaker: Do we have the consent of the House to revert to statements?

Mr. Foulds: Mr. Speaker, are copies of the statement available? We should not proceed until we have printed copies.

Mr. Speaker: They are on their way.

Hon. Mr. Grossman: Mr. Speaker, while the statements are being distributed, may I apologize to the House once again for my tardiness in arriving.

Mr. Speaker: Just before the minister starts, do we have the consent of the House to revert? Agreed. Please proceed.

Mr. Foulds: On this point, Mr. Speaker, I resent the fact that the press has the statement but members of the House do not. I do not have a copy of the minister's statement.

Mr. Speaker: I do not have any control over that.

STATEMENT BY THE MINISTRY

PHYSICIANS' SERVICES

Hon. Mr. Grossman: Mr. Speaker, first, I confirm what my colleague the House leader has said. Our statement, which is fairly lengthy and attempts to inform the House as much as possible with regard to the negotiations right up until this morning, took some time to prepare. Further, as a result of an exchange of phone calls today the statement had to be revised substantially.

As suggested by the Leader of the Opposition (Mr. Peterson), when things did not go as we thought over the weekend, I took the liberty of calling him at home in order that he be kept informed as to events. In my desire to keep the House fully informed as well, I wanted to make sure that the statement was accurate and reflected the state of affairs as they existed precisely at this time.

As we have said many times, the situation alters from hour to hour and I am sensitive of my responsibility to report to the House. I apologize for the fact that I am late but it is necessary to be very careful in these matters.

I would like to report to all members of the House on developments today in our negotiations with the Ontario Medical Association and share with the House our view of impending developments. Yesterday, when the OMA council rejected an offer for settlement, I extended an invitation through the negotiating committee for a meeting with Dr. Reese, the president of the OMA. This morning, but not yesterday, Dr. Reese took up my invitation and I spoke to him twice by telephone.

On the basis of those calls, some misunderstanding still appears to remain so I suggested to Dr. Reese that I am prepared to meet with him on Tuesday and to meet with his OMA board on Wednesday. As a request, the only request I made, I asked Dr. Reese as president of the OMA to ask his members to postpone the job action they plan for tomorrow and Wednesday in order to create the most favorable climate for discussions. I am able to provide the assembly with his entire response as I told him I was writing it down to relay it to the Legislature this afternoon.

He said: "I am certainly prepared to meet you on Tuesday and I am prepared to invite you to meet the board on Wednesday to allow you to deal directly with the board to explain your position, because there would appear to be problems of communication between the government and the board. However, simply on the basis of my willingness to talk at this time, I cannot call off the walkout for this week."

To be fair, Dr. Reese did indicate that if we would accept the OMA's last demand with regard to years four and five and if we agreed to enrich our three per cent special adjustment figures he would then call off these walkouts. I would, of course, give no such undertaking at this time but I thought, and think now, that he should at least postpone the walkouts in view of these continuing discussions and the admitted misunderstanding.

I will meet Dr. Reese tomorrow at 4 p.m. and with the board of the OMA on Wednesday at noon. In these circumstances, I hope all physicians will think seriously about the position of the government and the OMA before taking action which would affect their patients.

I intend to review the entire negotiations process with this House and want to affirm the position of the government in dealing with any disruption of the health care system. The government remains unequivocally committed to the defence of medicare and the protection of patients and others using our health care system.

We believe we can achieve that objective through the use of appropriate sections of the Public Hospitals Act and the medical part of the Health Disciplines Act. If we or the hospitals or the College of Physicians and Surgeons find that these acts are not adequate, I will come to this House immediately with the legislation necessary to strengthen them.

Because of our belief that the physicians will not violate these acts or their responsibilities, we do not at this time plan any legislated settlement or any new legislation such as that suggested to "order the doctors back to work" or otherwise change the historic patterns for the control of professional disciplines in this province. None the less, I want the physicians of Ontario to know that we in the government recognize the level of frustration they feel and assure them of our determination to deal with the cause of this frustration in the months ahead.

Before reviewing the details of the negotiations which have brought us to the present, I would like to outline briefly some critical features of the unique process by which the government negotiates with the independently employed physicians of Ontario through the Ontario Medical Association.

Although the negotiators are concerned only with the total amount of money which we add to the appropriation for medicare, this is applied to thousands of individual acts which doctors perform and this in turn determines how much they earn.

2:50 p.m.

Because of the complexity of the financial data and statistics involved, both the government and the Ontario Medical Association agreed several years ago to a fact-finder process.

Last year, Professor Paul Weiler of Harvard was chosen as fact-finder. He recommended, and the OMA and the government both accepted, an increase of 14.75 per cent.

It is useful to remember that this settlement was made up of an economic increase of 11.75 per cent and a catch-up component of three per cent. Professor Weiler also adopted a methodology which he believed would identify the average full-time physician in Ontario and his income and expenses.

The OMA asked that the same Professor Weiler be reappointed for the 1982 negotiations. In doing so, we presumed the OMA fully understood his methodology; it was set out fully in his 1981 report. He used that same methodology again as the basis for his 1982 report, and it has been used in all calculations we have presented.

I stress this, because some physicians and others believe the calculations are designed by the government to misrepresent income. This is incorrect. They are all based on a system developed by an independent fact-finder recommended to us by the OMA.

At this point, I think it would be useful to review briefly the entire negotiations so that members can see how they unfolded.

The government's original offer in January was for a 10 per cent increase in the schedule of benefits for 1982-83. The OMA asked for either a one-year or two-year agreement, with an effective increase of 27 per cent per year; that is, 27 per cent for one year or 61.5 per cent compounded for two.

Because of this very significant gap, we asked the committee chairman, Professor Weiler, to assume a fact-finder role, as he did the previous year, and to suggest a fair solution -- all as provided for in the agreement with the OMA.

Last year, as I have indicated, he recommended an increase of 14.75 per cent, which was accepted by both sides. As I said, the OMA urged his reappointment for the 1982-83 negotiations and, using the same approach and the same methodology he developed a year ago, Professor Weiler recommended a two-stage increase of seven per cent on April 1, 1982, and 7.25 per cent on January 1, 1983. For the second year, he included three per cent for catch-up.

He said in his report, which has been made public, that he believed this would reconcile the principal concerns of the government and the physicians of Ontario. This package was immediately rejected by the council of the OMA, and their negotiators asked us to consider a longer- term agreement.

As I reported to the House two weeks ago. We found the longer-term attractive; but, unfortunately, the OMA asked for a complex variation of their original monetary demands.

Using the method adopted by Professor Weiler and the figures provided by the OMA, this approach would increase the cost to the Ontario health insurance plan from $1.29 billion currently to $2.43 billion over three years and almost double the income of participating physicians in less than three years. In other words, a 72 per cent compounded increase in the schedule of benefits over three years would increase incomes by 98 per cent.

In response, we discussed a series of options within the framework proposed by Professor Weiler to provide staged increases for a one-year, two-year or three-year agreement.

Anyone familiar with collective bargaining will recognize the scope this provides for negotiation. Unfortunately, the OMA team took only one variation of the three-year option to its council, which rejected it.

As members will recall, this proposal provided for six increases based on the 1981-82 agreement. These are: 11 per cent on April 1, 1982; three per cent on January 1, 1983; eight per cent on April 1, 1983; three per cent on January 1, 1984; six per cent on April 1, 1984; and a final three per cent January 1, 1985.

This would add an additional $656 million to OHIP payments over three years and, using the methods adopted by Professor Weiler, raise the after-expense income of an average full-time physician from the present $80,300 to $114,100 when it expires on April 1, 1985.

For reasons of fairness which I explained on April 1, we added 11 per cent to the OHIP schedule of benefits and proceeded with the subsequent increases in the absence of a negotiated agreement.

That brings me to the meeting of the joint committee a week ago Thursday. Because there seemed to be some feeling among some officers of the association that three years was too long and that the 25 per cent proposed for two years was too little, we offered to compound 11 per cent on April 1, 1982; three per cent the following January; eight per cent on April 1, 1983; and three per cent on January 1, 1984.

To understand the implications of this, this would increase our two-year offer from 25 per cent to an effective 27.2 per cent and raise the income of the average participating physician from the present $80,300 to $106,500, rather than $104,400, over 24 months.

In other words, simple compounding added $2,000 per year to physicians' incomes in two years. These, I want to emphasize, are incomes which remain after deducting the cost of practice according to the process used by Professor Weiler in his last two reports.

This $22-million increase was dismissed and we were then asked by the OMA to come forward with a four-year or five-year proposal that would make specific provision for catch-up as well as adjustments for inflation.

Last week, we proposed yet another variation which had two specific components: three per cent on January 1 of each of the four or five years specifically for catch-up and an economic adjustment on April 1 of each of four or five years. These were 11 per cent on April 1, 1982; eight per cent on April 1, 1983; six per cent on April 1, 1984; and economic adjustments on April 1, 1985 and 1986. We were prepared to negotiate these amounts now or provide a procedure to determine those 1985 and 1986 amounts in the future.

Again, without going into all the calculations involved, this would guarantee the average full-time participating physician a minimum increase of 84 per cent over five years and raise the after-expense income from $80,300 to at least $148,000 inside 60 months. This was rejected as well.

As I hope members can see, we have offered every conceivable option. We could change the cash flow to put more money in earlier; we suggested compounding the amounts to increase the base; we were then ready to accept a long-term agreement and we were then prepared to consider a short-term agreement.

As a final gesture, last Wednesday Mr. Butler, with my concurrence, asked the OMA whether a one-year offer to implement the total Weiler package of 14.25 per cent immediately, rather than in stages, could be a basis for settlement. That too was rejected by the negotiating committee, even though it would have brought us to within a few hundred dollars of the $97,000 average income which we understand the OMA is seeking for 1982-83.

Although these negotiations appeared stalled, they contained a seed which brought us to this past weekend's discussion.

3 p.m.

The government negotiators had been asked whether we would seriously consider a four- or five-year term which would include a specific guaranteed component to attempt to make up some of the income physicians believe they lost in the early 1970s. Professor Weiler did, in fact, argue and agree that they had lost some income in the 1971-75 time frame.

Using Professor Weiler's approach, our negotiators put forward a five-year proposal. Taking the April 1 and January 1 dates respectively, those figures work out to be 11 per cent and three per cent, eight per cent and three per cent, six per cent and three per cent, a figure to be negotiated plus three per cent, and another figure to be negotiated in 1986 plus three per cent.

These amounts were to be fully compounded, unlike the three-year package we initiated on April 1 this year. This would increase the dollar value of the offer very substantially, quite obviously. As well, we were prepared to guarantee, come what may, that the three per cent adjustments in those years would not be touched, nor would they even be taken into account as a factor in reaching the economic adjustments due on April 1 in the final two years.

These amounts, we agreed, would be arrived at by a mutually acceptable process which would take full account of economic trends using all the economic indicators traditionally used in determining levels of remuneration.

These final negotiations and our enriched offer commenced last Wednesday, when our chief negotiator, Robert Butler, received a call from a member of the OMA negotiating committee who said that in his judgement our last offer should be discussed by their board of directors once their president, who was in the United States, had given it some consideration.

As a result of informal telephone discussions between Mr. Butler and members of the OMA negotiating committee, I met in my office with him and Dr. Hugh Scully, acting for their chief negotiator, Dr. Vail, who was in surgery at noon last Thursday.

Dr. Scully told Mr. Butler and I that he, Dr. Vail, Dr. Reese, Dr. Moran, their general secretary, and Ben Trevino of the negotiating committee, believed the offer would be acceptable and that they were going to call a special meeting of the board on Saturday and recommend it to them. Dr. Vail confirmed his agreement to Mr. Butler later that day. It was on the basis of all of this that I made my brief statement to the Legislature last Thursday.

I want to emphasize that in spite of what subsequently occurred over the weekend, I believe Dr. Scully, the other members of the OMA negotiating committee who spoke to Mr. Butler, and the senior officers of the association, were motivated by the desire for a fair and negotiated settlement.

On Sunday, however, this offer was rejected by the council, apparently on the grounds that the catch-up was not adequate and that the basis for determining the fourth and fifth economic adjustments was too vague.

While our negotiators were waiting at the hotel to continue negotiations on Sunday afternoon, Mr. Butler received a call at 12:55 from Dr. Vail, who said the board had simply rejected their proposal and was announcing its decision at 1 p.m., five minutes later. Mr. Butler offered to discuss their problem and offered to arrange a meeting between Dr. Reese and myself. This offer was turned down. Instead, the board adjourned, issued a news release and the members went home.

When Dr. Reese called me this morning, I reviewed all these details with him. We have, as I said, agreed to meet. I think it is needless and pointless for the OMA to continue their job action Tuesday and Wednesday. They could and should postpone it until after my meeting with Dr. Reese and his board. None the less, we will continue in good faith to seek an acceptable arrangement with the OMA, and we will do all that is necessary to protect the health care system of Ontario.

We will continue to seek an agreement and protect our citizens, who are, after all, both taxpayers and patients.

ORAL QUESTIONS (CONCLUDED)

PHYSICIANS' SERVICES

Mr. Peterson: Mr. Speaker, I have a question of the Minister of Health, who reasserts his commitment to protect health care in Ontario. I want to ask him what provisions he is putting in place to make sure that commitment is not threatened over the next couple of days, as I gather the walkouts will proceed.

When I asked him before about the monitoring arrangements through the OHA, he said he was not getting the feedback through the OHA but went directly to the hospitals to ask them what the current state of backup in the hospitals was as a result of the previous rotating walkouts they were scheduling.

Does the minister now have the facts on how many elective surgeries were cancelled, how many of those surgeries affect children, how they relate to the possible investigation of cancers and what other kinds of surgeries were cancelled? How good is his monitoring system? Does he know what is going on in the hospitals?

Hon. Mr. Grossman: It is good, and we do know, Mr. Speaker.

Mr. Peterson: Is the minister prepared to table that information in the House so that all members of this House, as well as the people of this province, will know the real effects of the walkouts that have occurred up to this time and what will transpire in the next two days as a result of this wholesale walkout?

Hon. Mr. Grossman: When we get a chance to review this information -- and for quite obvious reasons I personally have not had a chance to do so --

Mr. Peterson: Then you don't know what is going on.

Hon. Mr. Grossman: My ministry does. I have had a brief update on the situation. My senior staff, whom I trust completely, are satisfied that most hospitals are taking appropriate procedures to make sure they meet all their obligations under the legislation.

As a result of the telex I sent out last week, those hospitals that are having difficulties, that have reported shortfalls, that have reported any perceived problems or, indeed, whose reports back to us were not satisfactory, have been contacted by us and told that certain steps must be taken. At present, we have a large staff hard at work on that with all of the hospitals.

So the Leader of the Opposition will understand, on the basis of reliable information supplied by most of the hospitals throughout this province, it appears at present that there will be no urgent or immediate threat tomorrow or the next day. That is on the basis of the information that the hospitals have and on the basis of the information that we and the hospitals have from the OMA and the participating physicians with regard to the plans they intend to put in place for next week.

In simple terms, we have ensured that hospitals will take all steps necessary to meet their obligations under the act; and it appears all those obligations will be met.

Of course, there is nothing one can do to ensure that a particular doctor somewhere in the system does not take a certain action which ultimately will have gone too far. There is nothing one can ever do about that, except to use the disciplinary powers and the full force of those disciplinary powers.

With regard to the statistics available, when we review them we will see what information can be relayed, obviously without names and without too much detail because that would be breaking a serious confidentiality, and we will try to satisfy the House that this information is available to the members so they can make their own value judgements. We will see what we can do to compile that for them.

Mr. Foulds: Mr. Speaker, now that it is clear negotiations have broken down -- for example, the minister says in his statement: "As members can see, we have offered every conceivable option" -- and the minister is going to allow the walkout tomorrow and Wednesday, can he clearly indicate to the House what he will perceive as a threat to the health care system? I choose my words carefully. Will it require a death? Does it mean somebody is going to have to die? If not, can the minister tell us what steps he has taken to prevent the potential threat to the health care system? Is he only going to act after the fact? Will he now at least request the College of Physicians and Surgeons of Ontario to implement concerted action by members of the Ontario Medical Association as a cause for medical misconduct?

3:10 p.m.

Hon. Mr. Grossman: Mr. Speaker, let us be quite fair about this. I take some exception to the tone of the question asked by the deputy leader of the third party, because if there is any indication in that question that this government does not perceive these actions as ones which warrant consistent and careful monitoring, that would be unfair and inaccurate. If there is any implication in that question that this government will sit back and wait until there is a tragedy, that is unfair, wrong, totally inaccurate and unacceptable for the honourable member even to suggest by implication.

Each and every day in this province, the member, the members of his caucus and every citizen have one basic thing to rely upon, and that is the physicians' dedication to their patients' health. We can sit here and pass every piece of legislation that he and I can dream up, but I believe the physicians of this province will not allow under any circumstances --

Mr. Foulds: Louder, Larry.

Hon. Mr. Grossman: The member does not want an answer. He wants to make an accusation involving a possible tragedy, and he gets excited when I take objection to that.

Mr. Wildman: He didn't make an accusation.

Mr. R. F. Johnston: He is indicating your posturing.

Mr. Foulds: Stop pointing your finger and answer the question.

Hon. Mr. Grossman: Let me make it very clear to the member that, perhaps unlike him, while I have clear responsibilities, I recognize the ultimate responsibility for protecting the patients of this province will happen in the hospitals, in the offices and in the homes of this province. It will be the physicians providing that care who will ensure there is no tragedy.

If the member believes that any law he wants to write or pass will make a physician suddenly decide he will not do something that will threaten the health of a citizen of this province, then I believe he is deluding himself. If he has taken the time to read the Health Disciplines Act and the regulations thereto, he will know the physicians of this province have extreme and severe responsibilities to their patients. They are spelled out quite explicitly, and this government through the CPSO has vested responsibility.

Let me step back a moment. This Legislature, through the College of Physicians and Surgeons of Ontario, has vested a lot of authority in that college to take every step necessary to make sure that an extremely high obligation is imposed upon and carried out by every physician. As one looks at the sequence of events over the past three weeks, and at the numbers and types of incidents reported, it appears to date that almost without exception, although not totally, the physicians are meeting their obligations.

That is not to say I am satisfied with the job action. I do not think it should be undertaken. That is not to say I think actions such as those related to the Hospital for Sick Children are allowable or acceptable under any circumstances. But the fact of the matter is that the bottom line in terms of protection -- I want to use the words the member used: the threat to the health care system -- lies in the hands of the physicians of this province.

I have to say to the member that, as unhappy as they may be or appear to be, I have seen little indication that there are very many physicians, if any, in this province who are prepared to risk the health of their patients to get more money. Let me make that clear.

Let me also make it clear that this government is not responding to the kind of job action by simply saying, "We'll pay any price to stop the job action." Nor are we understating the implications of the job action. But, with respect, to suggest that this government is not monitoring or understanding the job action, and for him to hold out a perception that the OMA is suggesting to its members that they do more than it is telling them to do, is raising a threat and a perceived threat to the citizens of this province which is quite unfair.

Ms. Copps: Mr. Speaker, I remind the minister that there are sick children in hospitals all across this province --

Mr. Speaker: Supplementary, please.

Ms. Copps: -- and I want to ask a supplementary question. In his main statement, the minister stated the ultimate responsibility would lie with the doctors and the hospitals. Will he tell this House what action he has taken in response to a letter sent to him regarding an action by the board of directors of the Ottawa General Hospital some six days ago?

I will read the letter into the record. The letter came from Mr. Pierre Richard, the chairman of the board. It was sent to the minister, as well as to the head of the OMA:

"At a meeting of the board of trustees of the Ottawa General Hospital held on April 20, the matter of the withdrawal of certain professional services by doctors holding privileges within the hospital was discussed. The board of trustees is appalled by the possibility of a one-day disruption this week, to be followed by a possible two-day disruption next week, if matters are not settled between the Minister of Health and the Ontario Medical Association.

"The Ottawa General Hospital recognizes its obligations under the Public Hospitals Act and the obligations of the doctors to exercise their privileges within the hospital. However, under present legislation, it is the understanding of our board of trustees that we are powerless to act and certainly powerless to resolve this matter expeditiously. On behalf of our hospital and our community, we pray that the Minister of Health and the Ontario Medical Association act immediately and settle this matter, to avoid disruption, unnecessary expense and hardship to our patient population."

In the light of the hospital's reply that it is "powerless to act" in the face of two-day disruption, what will the minister do to prevent this strike and protect the health of patients?

Hon. Mr. Grossman: Mr. Speaker, I suggest that the board is not powerless; it has authority under the Public Hospitals Act and the Health Disciplines Act to take appropriate action. I appreciate the honourable member's comment that she supports the suggestion that we should act immediately to settle the dispute. I know she says that in the context of her suggestion that our 10 per cent offer originally was generous enough. I am sure that would go a long way to settling this dispute.

For the guidance of the member, other members of the House and those members of hospital boards who are being kept informed on this by our ministry, under the Health Disciplines Act the definition of professional misconduct includes, among a long list of things, "failure to carry out the terms of an agreement with a patient; contravening while engaged in the practice of medicine any federal, provincial or municipal law, regulation or rule or a bylaw of a hospital designated to protect the public health."

So "professional misconduct" under the Health Disciplines Act includes by definition, in the regulations passed by the government of Ontario with the concurrence of the College of Physicians and Surgeons, "contravening. . .any bylaw of a hospital" in this province. Therefore --

Ms. Copps: So you are not prepared to do anything. Six days ago you received this letter. Will you reply to it?

Mr. Speaker: Order.

Hon. Mr. Grossman: Before the member has to stand on a point of personal privilege, let me finish. I may give her some more information.

"Failing to carry out the terms of an agreement or contract with a hospital" is also defined as professional misconduct. These are some of the reasons I believe that appropriate legislative steps, measures and protections are in place for the hospital boards to take appropriate action against those physicians who appear to be undertaking job action that may amount to professional misconduct under the definition of the act.

That information either has been relayed already to the board of that hospital or will be relayed shortly to the board of that hospital, or perhaps the member may want to go out in the hall before she goes out to see the cameras and relay that information to the hospital herself.

Mr. Foulds: Mr. Speaker, I have a new question for the Minister of Health on the same subject. Now that it is clear, with his statement today, that the minister is negotiating in public with the Ontario Medical Association, can he help the public of Ontario and the members of this Legislature reconcile the totally different steps and statements made about the process by himself yesterday and by the OMA? Can he tell this House why we should continue to have faith in his negotiating ability when it is clear that the OMA, the spokesman for the medical profession in the province, has lost faith in the minister?

3:20 p.m.

Hon. Mr. Grossman: Mr. Speaker, might I say that the tenor, general direction and tone of the OMA's press release yesterday really does speak for itself. It does not warrant any response. It does not call for any response from me. I will not even purport to answer it, because it is so outrageous. Let me make it clear that I have nothing further to say about the tone or some of the words used in that press release. They were inappropriate.

If the acting leader of the third party wants to take the position that because of a press release issued by the OMA I am no longer a good negotiator on behalf of the government, he should go back and read some of the things that were said about me by the Chrysler negotiators or by the Secretary of the Treasury in the United States when he called the Premier (Mr. Davis) and complained about our negotiator. Ultimately, I ended up with a deal that even the member's party supported.

Mr. Foulds: What about the contradiction in the series of events.

Hon. Mr. Grossman: I will get to that in a minute. I think the members should put the expletives used in that press release yesterday in the context of the audience, perhaps, for which it was written and the purposes for which it was written.

In terms of the events leading up to last Sunday, yesterday I put out a statement, of which I am sure the member has a copy. Having agreed to recognize the OMA as the bargaining agent-representative for the physicians of Ontario, I think the government is bound and obliged to deal with and listen to their negotiating committee and the members of their negotiating committee.

When Dr. Scully contacted Mr. Butler last Thursday morning and offered to meet with him, just to be sure that this one-on-one discussion was one that involved authority, Mr. Butler said to Dr. Scully, "Do you have authority to conduct these discussions?" Dr. Scully went back to ascertain his authority. It took him an hour. He called back and assured Mr. Butler that he had authority to conduct these discussions.

I think we would be subject to a great deal of criticism with regard to our negotiating ability if we said, "We know you have authority but we will not discuss it with you." Then we would be criticized for allowing a job action to continue while refusing to listen to proposals put to us by an authorized spokesman for the OMA.

The authorized spokesman for the OMA met with Mr. Butler. They reached an understanding with regard to a certain framework of figures which Dr. Scully said he and others felt would likely be accepted by a board meeting that they were prepared to call for Saturday and that he, Mr. Trevino, Dr. Reese, Dr. Vail and Dr. Moran would advocate its acceptance on Saturday.

Dr. Scully said, "I want some proof from you, Mr. Butler, that your principals will accept this arrangement." Therefore, accounting for my late arrival last Thursday, I met in my office with Dr. Scully and Mr. Butler. In the presence of Mr. Butler, Dr. Scully essentially repeated what I have just said. I indicated that on behalf of the government I was authorized to support that proposal as the basis for settlement.

Dr. Vail subsequently was contacted by Mr. Butler, Dr. Vail being the chief negotiator for the OMA, and he confirmed all of the above to Mr. Butler. That is the basis on which the weekend board meeting was convened. I was extremely surprised and disappointed to understand that, rather than follow the advice which I am sure was given, as we were told, by those four or five people, this board meeting asked that negotiations resume and that the negotiating teams meet for many hours.

I had every expectation that those four or five very influential, authorized spokespersons for the OMA, in advocating the arrangement we had agreed on, which they said they would support, would be able to persuade the board that they as the chief spokesmen should be trusted.

Apparently something happened at that board meeting. I certainly cannot answer for what happened at that board meeting except to say that what has become apparent is that the board rejected it. Even after the board rejected it as a result of further negotiations, we altered our offer to try to meet the demands and requests of the board; the board still rejected the offer.

I cannot explain what happened inside that board meeting. I particularly do not understand how they could have unanimously voted to turn down an offer that was better than the offer that four or five of their leaders had offered to take and support for settlement. So those are the events of last weekend.

My final disappointment was on Sunday afternoon, when it became apparent that the rejection was perhaps due to a misunderstanding, a failure to understand all the implications of the government's arrangement and proposal. I offered to meet with Dr. Reese, but instead, as I indicated in my statement, the OMA board, Dr. Reese, whoever -- I do not know -- said no. They went to their press conference; Dr. Reese went back to London, and the board dissolved.

Happily, Dr. Reese at least called this morning to say that he wished now to take me up on that invitation and to try to sort out some of these understandings or misunderstandings and seek some clarification. He clearly wants an enrichment of the government offer, make no mistake about that, but clearly he wants and has agreed to undertake further discussions, and we have agreed as well.

Mr. Foulds: Let me get this straight if I can, because the minister's answer tends to confuse more than enlighten. Is the minister admitting, first of all, that he is powerless to take any action at present with regard to a doctors' walkout? What is he going to talk about tomorrow with Dr. Reese? Is money the only tool he has? Is he going to try to buy his way to an agreement?

Hon. Mr. Grossman: Quite obviously, if I were prepared to buy my way to an agreement we would have solved this several weeks ago and I would not be receiving complaints from very many members of the opposition that, in their words, we are allowing a situation to continue too long and allowing job action to occur.

This government is not prepared to pay amounts of money that it feels are not warranted simply as a result of pressure because, of course, pressure brought by certain key groups in society, physicians being one of them, can be so great and so overpowering that there is no price that some people would say is too much to ensure adequate health care.

The honourable member is no different from me. If we did not have adequate medicare in this province, I would pay anything for health care; particularly if it involved my children, money would be no object. If we did not have medicare, it would be a totally different scheme. But the taxpayers and the physicians in this province are all participants in a medicare scheme, and we as taxpayers are paying for the health care delivery system in this province.

Conceivably, we could buy our way out of this; but then what is the ceiling? There is no ceiling if we buy our way out of it. That is why, although it is easy for some members of the opposition -- and I look at some over on the Liberal benches -- to say, "Give them more money," while others say, "You are giving too much already," and some say, "We do not know how much you should give, but settle it" -- that was the Leader of Opposition.

3:30 p.m.

I understand all of that but ultimately we have to strike an arrangement which is not easily struck and which is fair to both the taxpayers and to the physicians.

I do not consider either alternative: that is of being unfair on the side of the taxpayers and saying we will not increase it on April 1, that it will be zero, much like they did in the province of Quebec; nor do I conceive it as a viable alternative to say health care is so important the sky is the limit and they can just name their price and we will pay it.

That is why this is very delicate and difficult to deal with. It is, of course, compounded by the emotional distress that every citizen of this province and I face through this period of time, compounded by some extreme statements that have been made from time to time, not from this side of the House and not from these negotiators on the government side.

It is very difficult to reach what will be seen to be a fair arrangement. It is finally made even more complex by the fact that a group of board members at the OMA are charged with the difficult responsibility of making some decisions on behalf of 14,000 physicians. Very many of these physicians are having the same difficulty grappling with compounding, additive, a five-year arrangement, catch-up concepts, the Weiler report, methodology, 30th percentile and so on. So it is very difficult to handle it.

I can only say to the honourable member, as one who was up until 4 a.m. on Saturday night trying to solve that, it is very difficult to work through this. None the less, I am determined to stick with it, including on Tuesday and Wednesday with the board, to make sure that everyone is equitably treated.

Mr. Peterson: From our vantage point, I have watched these negotiations and as well I have had a number of discussions with some of the officials involved from the OMA. It has become obvious to me, not only from watching the public escalation of rhetoric against the minister, that bad feelings have developed in these negotiations. The last offer was called a deception and an insult.

I believe there has been a deterioration for a variety of reasons, one because of the minister personally. Why does he not consider bringing in the Premier at the 11th hour to try to get a resolution to this question tonight?

Hon. Mr. Grossman: May I say that Dr. Reese has accepted my invitation to come to see me and that is an appropriate thing for him to do. I think it is an indication, notwithstanding the press release that the OMA felt obliged to put out yesterday, that Dr. Reese, who has had conversations with me earlier, has a somewhat different opinion of me. I believe, if the member does not mind me saying, there are still a great number of physicians in this province who have a different opinion of me than he is trying to project.

I can only report that I have spoken with my Premier from day to day. I enjoy, something that may be unique in the member's party, the full and complete support and authorization of my leader. Dr. Reese knows that and I believe a great number of physicians know that my job is not to beat them down or beat them up or to doctor-bash, as some people on the side of the leader of the Liberal Party, in fairness, have done. They know that I have been most temperate, even when tempted, as recently as yesterday, by that outlandish press release, and will not get involved in any mud slinging at all with the doctors.

I say to the leader of the Liberal Party that I do not intend to do that and perhaps that is why I enjoy the full and complete confidence of my leader, while the member for Renfrew North (Mr. Conway) is looking carefully over the Leader of the Opposition's shoulder.

Mr. McClellan: I would like to ask the minister, since I am confused by the increasingly comic-opera nature of the negotiations, if he could explain to me how it is that he is able to stand up and say that his last offer to the OMA, which is detailed on page 11 of his statement today -- compounded increases, the three per cent adjustment bracketed and mutually agreeable process on top of the figure set out on page 10 -- how he can say that last offer was relayed to Dr. Scully, Mr. Butler, Dr. Reese and Dr. Moran and that they were "going to call a special meeting of the board and recommend it to them," when the OMA spokespersons categorically deny they ever said that they would recommend a specific proposal to their board of directors on Saturday?

Hon. Mr. Grossman: I can only state clearly, as I have done both in and outside this House, what the sequence of events was. I do not want any confusion to come out of the honourable member's statement. Robert Butler, the government's chief negotiator, is former Deputy Chairman of Management Board of Cabinet in this government and a very respected member of the business community of Ontario. Both Mr. Butler and I were present last Thursday in my office when Dr. Scully relayed that information. It was subsequently confirmed by Dr. Vail to Mr. Butler in a telephone conversation.

I have, in Mr. Butler's handwriting, the offer that was being talked about at that time. I made notes in Dr. Scully's presence, so that the words I used in this assembly last Thursday would reflect, accurately, the state of the negotiations at that time. I have stated what I know to be the facts. The members of this House may choose to believe Dr. Reese's version of the facts as relayed on Metro Morning today but Dr. Reese was not in my office last Thursday. I leave the members of this House to judge who might be a better witness to the events that occurred in my office last Thursday. Dr. Reese was in Chicago. I was in my office with Dr. Scully.

HYDRO EXPORTS

Mr. Chariton: Mr. Speaker, I have a question for the Minister of the Environment. I presume that the minister has seen the letter of last Thursday from Mr. Rubin, of Energy Probe, regarding the sale of power to General Public Utilities, on page three of which Mr. Rubin refers to the responsibility of the cabinet of this government in the approval of any contract Ontario Hydro should sign with the US on that sale.

The minister has stated on a number of occasions that under federal legislation the Environmental Assessment Act would have no legal force. But, surely, since the cabinet sets the policies for Ontario Hydro and will have to approve any contracts between Ontario Hydro and any US authority, he has the ability to intervene in cabinet and ask them not to approve any contractual arrangement on this GPU sale until such time as an environmental assessment has been conducted and shows, clearly, that that sale is both necessary and advisable in environmental terms.

Hon. Mr. Norton: Mr. Speaker, I am not sure there was a question. I heard a rather lengthy statement but I do not think there was a question; unless it was, have I seen Mr. Rubin's letter. Yes. It was delivered to me by hand in the House some time Thursday afternoon and is at present on my desk. It is a rather lengthy letter and although I have taken a quick look at it, I have not had a chance to read it in detail. That is the only question that was asked.

Mr. Chariton: Is the minister prepared to intervene with the cabinet to get assurances that there will be no signing of contracts until an environmental assessment, whether it is legally binding on the federal government or not, clearly establishes that any proposed contract by Ontario Hydro is environmentally safe and sound?

3:40 p.m.

Hon. Mr. Norton: Mr. Speaker, the issue is not whether an environmental assessment is legally binding upon the federal or the provincial government. The question is whether the environmental assessment legislation of this province has any role in this situation based upon matters relating to constitutional law. There are three legal opinions of which I am aware which make it clear that is not the case.

If the member is trying to determine what my specific recommendations may be to cabinet when the matter comes before it, I have no intention of breaching my oath of office and divulging what my specific recommendations will be until such time as I have made those recommendations to cabinet.

Mr. Elston: Mr. Speaker, I wonder if the Minister of the Environment would tell the people of Ontario that he would be willing, under his own auspices, to carry on an environmental assessment hearing so he could get full disclosure of all the information he would need to ensure that the cabinet would have the information needed to make the final determination as to whether Ontario Hydro will go along with this sale.

Hon. Mr. Norton: Mr. Speaker, as I have indicated before, and it has already in fact begun, I shall make sure I have all the information at my disposal that is necessary in order to fully advise cabinet.

PETITION

MANITOUWADGE AND SCHREIBER BOARDS OF EDUCATION

Mr. Stokes: Mr. Speaker, I have a petition I would like to present to the Minister of Education. This is the justification of the reason I am presenting the petition:

"It is essential for you to note that these signatures were gathered over a 24-hour period which was characterized by very inclement weather. Further, it is important for you and the ministry to understand that the Schreiber situation was only a small part of the myriad of problems and dissatisfactions that led the people of Manitouwadge to become incensed enough to sign this document. Rather, this board's insensitivity to Schreiber was merely the straw that broke the camel's back. Further, it is interesting to note that the majority of Manitouwadge's complaints and growing refusal to accept this board as acting in the true interests of the people stem from the board's own documents and presentations.

"We would respectfully ask that you forward this petition to the Minister of Education, along with your supporting comments, as soon as possible (yesterday would be fine). Also, we would ask you to make the presence of this document in the hands of the Ministry of Education publicly known to the Legislature."

The petition reads as follows:

"We, the undersigned residents of Schreiber and Manitouwadge hereby make the following petition:

"1. To re-establish the Manitouwadge and Schreiber boards of education.

"2. To return to the Manitouwadge and Schreiber boards of education any and all assets, real property, houses, apartment buildings, etc., found within the townships of Manitouwadge and Schreiber and currently under the control of the Lake Superior Board of Education.

"3. That the implementation of any approved but not yet enacted decisions and/or actions of the Lake Superior Board of Education be delayed.

"4. That the newly constituted boards be given the power to review such decisions of the Lake Superior Board of Education pertaining to Manitouwadge and Schreiber over the past 12 months with a view to determining whether or not these are truly in the towns' best interests."

It is signed by 1,443 residents of the township of Manitouwadge and 732 residents of the township of Schreiber.

CHILDREN'S MENTAL HEALTH SERVICES

Mr. Boudria: Mr. Speaker, on a point of privilege: Now that the time for the tabling of reports has just expired, I would like to draw to your attention that on last Monday, April 19, the Minister of Community and Social Services (Mr. Drea), as reported in Hansard on page 909, stated to myself and the member for Scarborough West (Mr. R. F. Johnston) that he would table a report by Dr. Naomi Rae-Grant of the Children's Listening Centre of North York.

That was seven days ago, Mr. Speaker, and I am informed by the Clerk that we have not yet had the tabling of this report.

Mr. Speaker: I am sure the minister will take note.

MOTIONS

ESTIMATES

Hon. Mr. Wells moved that the estimates of expenditure for the fiscal year ending March 31, 1983, of the Ministry of Tourism and Recreation, be referred to the standing committee on resources development; to be taken following the estimates of the Ministry of Energy.

Motion agreed to.

PRIVATE BILLS

Hon. Mr. Wells moved that Bill Pr6, An Act respecting the City of Windsor; Bill Pr10, An Act respecting the City of North York; and Bill Pr13, An Act respecting the City of Toronto, now referred to the standing committee on general government, be transferred to the standing committee on administration of justice.

Motion agreed to.

MOTION TO SUSPEND NORMAL BUSINESS

Mr. Peterson: Mr. Speaker, as you are aware, last Thursday we gave notice that we wanted to move an emergency debate with respect to the withdrawal of doctors' services across Ontario. That was put over to today, and refiled today.

Mr. Peterson moved, seconded by Mr. Nixon, pursuant to standing order 34(a), that the business of the House be set aside to debate a matter of urgent public importance, namely the threat of the withdrawal of all but emergency services by the doctors of Ontario.

Mr. Speaker: Before the member proceeds, I would advise all honourable members that the notice of motion has indeed been received in time and does comply with standing order 34(a). I will be pleased to listen to the honourable member for up to five minutes on why he thinks the ordinary business of this House should be set aside.

Mr. Peterson: As I said earlier, we thought this debate should have been held last Thursday but we put it over until today. I can tell you, sir, it is even more critical today than it was last Thursday. We, in the opposition, have sat and watched what we consider to be a major deterioration in the negotiations between the Ontario Medical Association, the doctors and the government of this province since the unilateral imposition of the government's position -- the final solution, I should call it -- on March 31 of this year.

It has always been our wish that there should be a negotiated settlement; that this dispute would be solved amicably. I do not believe that we on this side of the House have in any way complicated the negotiations. I think I speak for my friends in the New Democratic Party as well when I say all of us have wanted a peaceful resolution. We have gone through several days of rotating strikes across the province and we now face the threatened withdrawal of medical services, this Friday, on a provincewide basis.

This is a most serious situation, Mr. Speaker. Our already beleaguered and overburdened health care system is now faced with cases that are having to wait two, three and four months for elective surgery. Every single day is important in the operating rooms of the hospitals of this province. It is critical that we get on with the job.

We find evidence everywhere. My colleague, the health critic, has been collecting evidence of the critical nature of the health care system in this province. We are already seeing examples of the effects of underfunding and mismanagement which will compound those difficulties which already are so much more serious than they have been in the past.

We deem this to be an emergency. In the 10 minutes allotted to me in the debate -- should that be granted by you, sir, in your wisdom -- I am going to give you our view of how it should be solved.

The evidence received by all my caucus colleagues, both directly and from their constituency offices, indicates the threat which exists not only to the quality of the health care system as a whole but also to individuals, in case after case, such as the senior citizen who has to take a taxi ride to get his prescription refilled. That $5 may not matter very much to you, Mr. Speaker, but, believe me, that taxi ride matters very much to the person on a fixed income who has to pay it out of his wallet; it substantially alters his budget for that month. And the list goes on and on.

3:50 p.m.

We have had selective intervention by the minister. He believes it was a gross travesty for doctors to walk out of the Hospital for Sick Children, but how does he relate that to the postponement of surgery for a senior citizen or a woman who needs exploratory surgery for suspected cancer? I do not know how he differentiates the trauma involved in these various cases. Yes, I understand and sympathize with the plight of young people, but those problems are going on all across this province.

We believe we need an emergency debate this afternoon to put our position forward, as we have as best we could in question period for the last two or three weeks. We think we need a thorough airing of this question so we can all have an opportunity to point out to the government the gravity of the situation it has allowed to develop over the last three weeks or so.

I say with regret that in the absence of a negotiated solution, which would have been preferred, which we tried to co-operate with and which we encouraged from every point of view, we are going to have to use the power of government to prevent those walkouts from taking place. I will talk about that a little later.

Mr. Speaker, I want to impress on you the urgency and gravity of the situation, and I would ask you in your wisdom to grant this House the emergency debate so we can have a full discussion.

Mr. McClellan: Mr. Speaker, I am pleased to rise and indicate that the New Democratic Party will support the motion for an emergency debate this afternoon on the very urgent question before us and urge you to grant that debate. The issue, very simply put, is the question that the member for Port Arthur (Mr. Foulds) asked in question period: Is there a threat to patient care in Ontario because of the scheduled rotating walkouts next week and the three days of general walkouts the following week?

The Minister of Health (Mr. Grossman) has been asked over and over again whether these walkouts are a threat to medical service and the quality of medical care in Ontario under the terms of the Health Disciplines Act, which oblige him to protect and maintain the standards of medical care.

When the minister was asked that last Tuesday, April 20, he said in effect that he did not know: "Whether there are sufficient doctors in those hospitals to ensure that patient care is not threatened in this province is precisely the reason I am sending a telex to every hospital." In other words, he did not know. He confirmed in a supplementary answer to my question, "We cannot make those assessments." This was on Tuesday, April 20; he still could not make the assessments on Friday.

He was asked again today to assess the risk to patients in Ontario. What did he say? He did not tell us how many hospitals had responded to his telex; he did not tell us how many hospitals were prepared for a strike tomorrow. He said, "Most hospitals." How many is that? How many hospitals are prepared and how many are not prepared? It is obvious that on the eve of the general walkout the Minister of Health is as unable to tell us whether there is a threat to the health care system in Ontario as he was a week ago.

It was stated in this morning's paper he said that if there were a threat to health care he would bring in legislation to end the strike. But he does not know whether there is a threat to health care; he does not have the facts of the situation. He is playing Russian roulette, and that is not a game we are prepared to play. It is as simple as that.

We put forward our solution on April 15. It represents a threefold process of settlement.

First, we want the kind of concerted walkouts that are taking place tomorrow to be characterized as professional misconduct under the Health Disciplines Act. Second, we want a new dispute settlement procedure to be introduced in Ontario, based on the recommendations of the Hall report, that would bring in third party binding arbitration. Third, and equally important, we want an end to extra billing so that there will not be massive retaliation by the Ontario Medical Association against the universal insurance program and against any settlement the government of Ontario brings forward.

I take it from the minister's statement today, on page three -- I can pursue that in the debate, but I assume the minister is looking at amendments to the Health Disciplines Act, as we have suggested.

I do not know what the leader of the Liberal Party is proposing, because up until the start of this debate, we have had nothing concrete. We look forward with interest and suspense, not to say apprehension, to hearing what he is going to propose by way of what he is calling back-to-work legislation. What we think is appropriate is an amendment to the Health Disciplines Act. I hope we are both talking about the same thing.

At any rate that will be another important feature of the debate, for each of the parties to do as we have already done two weeks ago, that is to say set out their proposals for a settlement of the dispute.

Hon. Mr. Wells: Mr. Speaker, in commenting on the suggestion today, the motion put forward to you that the business be suspended so that we may debate the withdrawal of all but emergency services by the doctors of Ontario, I would like to say, first, I think many times I have stood up here and argued, I think effectively, but perhaps not persuasively enough to persuade you, sir, that what was being proposed was not a subject for a real emergency debate in this chamber.

I think many of the debates we have had in that area have been -- how could I phrase it? -- perhaps just an excuse to talk about something that may not have been as much of an emergency as some of us may have thought. But we have always bowed, sir, to your judgement, and we have many times ourselves agreed after you have given your judgement that a debate should proceed rather than blocking such debate, as we could.

I think there is no question that the matter before us today is truly an emergency matter, one that fits right in with rule 34 of the standing orders of this House. It is something that all members of this House would like to express some opinions on. I find myself in a unique position in even talking about it here and I am not going to take part in the rest of the debate, but it was my privilege to be Minister of Health in this province on the day medicare as we know it now began in this province.

There were people then who said that in the way it was being run in this province it would not work. I want to say that it has worked, and it has worked because of the dedication of the health professionals of this province. It is well to remember that there would be no health system in this province without the health professions, and there would be no health system in this province without the doctors of this province. I think it is well to remember that as we take part in the debate --

Mr. Nixon: Usual slam on the chiropractors.

Hon. Mr. Wells: I think the chiropractors do a fine job too. I have always been a supporter of the chiropractors, as my friend knows.

I think it is well we remember that, though, as we participate in this debate. All I would like to say is, from our side, we view this as a true motion that expresses the emergency situation and we are happy to support an emergency debate this afternoon.

4 p.m.

Mr. Speaker: Thank you. I have listened carefully and with great interest to the comments of the various members. Quite obviously, there seems to be an agreement that the debate should go ahead.

I would like to point out one thing by referring to the standing orders. The standing orders do not say anything about it being an emergency. The debate itself is an emergency debate, but the standing order says quite clearly, "The Speaker shall then rule on whether or not the motion is in order and of urgent public importance."

I think that is the key. I do find that the motion is in order, and I do find that it is of urgent public importance. I rule, therefore, in favour of the motion.

The question before the House is shall the debate proceed?

Motion agreed to.

Mr. Speaker: Just before the Leader of the Opposition starts, I would like to remind all members that they are limited to 10 minutes.

PHYSICIANS' SERVICES

Mr. Peterson: I thank you, Mr. Speaker, and I compliment you on your wisdom in allowing this debate to proceed today. I am only sorry that the Minister of Health (Mr. Grossman) is not in the House to participate in this debate. Presumably, he will be briefed on the whole matter by his long list of aides who have been assisting him in the long series of complicated negotiations.

I want to make several points today. It is my belief, and I alluded to this in a question I asked earlier, that the medical profession has, to some extent at least, lost confidence in the minister. I believe there is a personal feeling growing among a number of them. I have talked to some of the leadership. I have talked to a number of doctors across this province who have phoned me to express their points of view on a variety of issues.

They believe the Minister of Health is trying to make his own political career on their backs and this has resulted, in his case, in a number of miscalculations and actions that have not served the negotiating process well.

I said at the beginning, and I will repeat it again, that we have always favoured a negotiated settlement. It is funny that in this House the Minister of Health has stood up and tried to deflect a question by quoting some ancient newspaper report of what the former critic for Health said as compared to what I have said. He tries to play the same game with the New Democratic Party, quoting the former leader as opposed to the new leader, and he says to himself, "Am I not a wonderful fellow because I am so consistent?" and weasels out of the responsibility by saying that we have different points of view.

I am speaking for my party when I say we have been completely consistent on this matter. I have been asked by a number of people as to what my point of view is and how much money I would give to the doctors. I say to the government now, as I said then, it is impossible to ask someone who is not sitting at the negotiating table to come up with a realistic figure.

I am not party to the macroeconomic projections of this province for the next three years. I do not know what revenues will be. I have no idea of the plans of the Treasurer (Mr. F. S. Miller). I have no idea what inflation will be. They are the ones with the computer models. They are the ones with all the information as to how much can be allocated to the health care field two or three years from now.

It would be superficial or only politically expedient for me or anyone else to jump and say that is enough, that is too much, or that is the right amount. I do not like to make judgements when I am not sure of the accuracy of those judgements, unless I at least, have reasonable information on which to make them.

Obviously, it was a source of great delight to the Minister of Health to say that I would not get involved in a debate to the extent that I would say the appropriate figure is 11 plus three per cent; 10 plus three per cent; eight plus three per cent, or whatever the figure happened to be. I believe that we in the opposition are not in the position, as is no one -- even perhaps you, Mr. Speaker -- who is not part of those negotiations, to say what the real answer is.

The real answer is what both sides will take peacefully and what both sides can live with. That is the real answer. That is a negotiated answer. I am just sad that the process of negotiation has broken down. If the minister treats the Ontario Medical Association -- and I suspect he does -- like he treats the opposition members in this House, it is no wonder the negotiations have broken down to some extent.

As I said earlier, in spite of his attempts to play statesman on this matter with a low-key rational approach, there has been a major series of miscalculations on his part which are seriously affecting the negotiations. I want to deal with those in my limited time.

The minister is the one who made the final three-year offer on March 31 of this year. It got the doctors' backs up and they said, "We don't want to deal with that kind of person. That was the first thing that made them mad. There were other things before. There was a 10 per cent offer back in January. There was a long delay of some six weeks between his taking over the ministry and his first offer. Then he gave his final solution and walked away from negotiating for a period of a week or so.

Then the doctors, the Ontario Medical Association and the ministry got involved in a game of "It's your move, Alphonse," as to who would negotiate with whom. Everybody was playing Mexican standoff. We saw these final solutions, this get-tough bargaining, and it invited people to call the other side's bluff. All the while the OMA was developing a defensive strategy.

In human terms, I have tremendous sympathy for the frustrations the OMA and the doctors are feeling across this province.

In that statement, the minister's whole strategy was to set brother against brother. As I mentioned in the House that day, he said: "The doctors will not follow the leadership of the OMA. I have faith that they will not walk out." In saying that, he invited them to walk out.

I am sure the degree of militancy and the degree of discipline in the OMA has caused the minister some alarm and has caused him to rethink his original strategy of trying to break that group apart, or at least to ask doctors to break ranks with their leadership.

Then he intervened politically, saying, "Well, you can walk out in certain hospitals, but don't walk out in Sick Children's Hospital." Then he tried to call in a favour from Doctors' Hospital, for which he gives himself credit for saving four or five years ago in a previous incarnation. But when we invoke that kind of politics --

Hon. Mr. Grossman: Mr. Speaker, on a point of personal privilege: I shall deal with all his other crazy accusations later, but the Leader of the Opposition was in the House last week when I rose on a point of personal privilege and pointed out I did not ask for any favours or call in any favours from Doctors' Hospital.

He need not believe me. I just want the record to show that I corrected it last week and I reaffirm unequivocally this week that I did not have any contact whatsoever with the Doctors' Hospital or request anything, and the Leader of the Opposition really should not --

Mr. Peterson: Mr. Speaker, in fairness, the minister did say that. I did not see the letter of retraction in the Toronto Star that he presumably sent and I apologize for that. But as I said, it was a political intervention exploiting the emotive appeal of a children's hospital; first, the Hospital for Sick Children, then another sick children's hospital in eastern Ontario and then all paediatric wards across the province.

I said in my earlier remarks that, as much as I sympathize with that point of view, having small children myself, I find it a less than honest way of facing up to some of these problems facing us in the area.

I know I am under time pressure, but I have mentioned in this House before the terrible burden the minister has put on the College of Physicians and Surgeons of Ontario, asking it to become labour arbitrators or mediators in this labour dispute, asking members of the college who themselves have participated in walkouts to sit in judgement on their peers.

That system of discipline in this dispute is breaking down. It does not work and we have had a number of comments from various members of the college as to why it is unfair to put this burden on the college and ask them to do the minister's work.

Then we go on to the Ontario Medical Association, which felt badly about the onus he put on it. He accused the OMA in public of not faithfully conveying his message to the doctors, saying that if he had the opportunity of explaining his proposition to the doctors directly they would have agreed with him. He was accusing the OMA in some way or other of not being fully forthcoming in taking his message to its own membership.

Then he put an unbearable burden on the Ontario Hospital Association saying, "I want to ask you to monitor the activities of the hospitals," as to which doctors were not sitting on committees, were not signing charts, were involved in postponing or cancelling surgery and a variety of other things.

He found about a week and a half after that he was not getting reports back from the OHA. In fact, they had never been officially notified that they were to report. Then he went directly to the hospitals, and we asked him specifically today in the House to give us the facts. What are the facts? How many people are being upset by these cancellations or postponements of surgery? He did not know.

He says he is gathering that information, but from what we know from my colleagues' task force going across this province there is tremendous hardship. We are all hearing about this daily. The series of miscalculations he has made not only in the negotiating, bargaining process but in enforcement has further eroded his position in these negotiations.

4:10 p.m.

I do not have very much time left, but I want to say the minister should have brought in legislation at two or three o'clock today after question period for first, second and third readings of back-to-work legislation in this province. We would have supported it; we would have helped to expedite it.

It should be introduced tomorrow. It should have been there to prevent this walkout. There is ample precedent for it; he could look at the legislation in Quebec and a variety of other jurisdictions. We should not allow that walkout. In spite of the fact that we want to negotiate a settlement, our paramount concern on this side of the House has always been the welfare of the patient and the integrity of the health care system in Ontario, and it is being severely threatened by this walkout.

I regretfully say that we must use the power of this Legislature to prevent that tonight. We should have an emergency sitting tonight to get that legislation through so it will prevent the walkout tomorrow, and so we can go back and solve it this time by binding arbitration.

Perhaps we have to look at more intelligent mechanisms to solve these kinds of disputes in the future if the process has broken down, but we have an obligation to solve this problem here and now in Ontario, and time is of the essence.

I am asking the minister to use his power. We will support him; I am sure my colleagues in the New Democratic Party will support him to get it through the House.

The Deputy Speaker: Time.

Mr. Peterson: If you would allow a minute because of the point of privilege I would be grateful.

The Deputy Speaker: No. I have allowed that already. I am sorry, I should have indicated that.

Mr. Peterson: I just want to say to the minister as forcefully as I can that he is asking for trouble. He has made the mistakes. Let us now work together to try to get a solution to this problem before there is a major tragedy that will make us all very sad and that will hurt the integrity of the health care system in this province.

Let us do it now. He has the power; we will help.

The Deputy Speaker: I would just like to point out to the Leader of the Opposition that I did not want to interrupt his speech; I did make allowance for the Minister of Health's point of privilege.

Mr. McClellan: Mr. Speaker, I had expected the Leader of the Opposition (Mr. Peterson) to set out in detail his proposals for back-to-work legislation, as he calls it, but I am afraid his proposals were characteristically vague and insubstantial. I still do not know what he is talking about, except that he is talking about "back-to-work legislation."

I hope that during the course of the debate his colleagues will specify exactly what he is proposing, because what kind of legislation is brought before us to deal with this dispute is significant. It is not simply a question of asking for back-to-work legislation as though this were not a unique situation.

My colleagues and I have argued as strenuously as we could that the appropriate route for the government to take is to amend the Health Disciplines Act so that the concerted withdrawal of medical services by doctors would constitute professional misconduct. I understood from the minister's statement today that, in the event he should come to the conclusion that there is a threat to health care and he feels himself required to bring in legislation, he is looking at the same thing. At least, I hope that is what he is doing.

I would insist, however, that the two other concerns we have identified be dealt with as well in any kind of legislated settlement of this dispute. It is not sufficient simply to talk about the legislation that would make the withdrawal of services professional misconduct; it is also necessary to bring in a new dispute settlement procedure along the lines of Mr. Justice Hall's.

It is as clear as it possibly can be that the current process of resolving disputes between the government and the Ontario Medical Association has disintegrated into some kind of low farce. It is opéra bouffe of the worst kind. The minister says one thing and the Ontario Medical Association has a diametrically opposed version of the events of the last couple of days.

Hon. Mr. Grossman: Who would you believe? What do you think?

Mr. McClellan: Fortunately, I do not have to sort that one out. All I point to is the fact that the negotiation process is in a state of shambles. There is nothing to fill the void after the fact-finder has completed his report.

It seems to me the logical next step to bring into place a rational, objective, nonemotional, noninflammatory dispute settlement procedure is to accept the recommendations of Mr. Justice Hall so that there is an additional procedure that can be triggered when an impasse occurs.

A three-panel board of arbitration with an independent chairman chosen by the Chief Justice of Ontario can be brought to bear on the situation, to examine the situation fairly, objectively and independently without the brush of either government bias or professional bias, and its decision, based on that independent objective inquiry, would be binding on both parties.

Third, and equally important in any legislative dispute, there must be an end to extra billing. Otherwise, as one who rarely makes predictions or prognostications, I suspect very strongly that when the minister is forced into a legislated settlement because of the clownishness of the negotiating process, if there is a legislated settlement and there is not an end to extra billing, there will be a new campaign to encourage doctors to opt out of OHIP and extra-bill their patients that will make the 1978 campaign look like a kindergarten party.

If the minister wants to legislate an end to this settlement he is going to have to bring in all three measures. What has the minister's position been to date? It has not been very impressive. Quoting from Hansard on page 606, he started out by saying on April 6, "At present the situation is largely composed of threats." Those would be the so-called threats by the doctors to have five days of rotating strikes in North Peel and four days of rotating strikes in St. Thomas. The minister said those were threats and they were not going to happen.

Right through this whole sorry episode the minister has taken the threats of the Ontario Medical Association and dismissed them. Starting with its threats of administrative disruption, he dismissed those until they were implemented and then he dismissed the threats of rotating strikes until the strikes took place.

Then he dismissed the threats of escalated strikes until the escalated strikes are upon us. Does he now dismiss the threat of a general walkout? So far the OMA has at least been as good as its word. It has carried out every single threat it has made. The minister has been singularly foolish in dismissing every threat it has made.

The minister has pretended there is no risk to patients, even though again today he was unable to answer questions in this House with respect to the state of readiness of our hospitals. Even though we are on the eve of a general walkout tomorrow, he still cannot tell us how many hospitals have responded to his telex. He cannot tell us how many hospitals are in a state of preparation for a strike.

He says most hospitals are prepared. I assume "most" means less than all. How many are not in a state of readiness? In which communities are the hospitals located that are not ready for the walkout tomorrow? Of course, the minister cannot answer those questions because he does not know. As we stand on the eve of a strike, he does not have the means of assessing the degree of risk. He admitted that last week and he was unable to refute it today. The minister does not like it, but the issue boils down to the degree of risk this government is prepared to take.

As we stand here, we are engaged in the psychology of a death watch. The media are waiting for the first tragedy. I think the community has an enormous sense of apprehension about what is happening in our medical system in this province.

4:20 p.m.

The minister is not able to assure us there is no risk. He is not able to present us with facts to reassure the people of this province that there is no risk. So he is gambling that there is no risk. He says, "Unless there is a threat to the health care system, I am not prepared to bring in a legislated settlement."

What that means -- I do not know how else to interpret it and neither does anybody else -- is that unless and until there is some kind of a tragedy this government is not prepared to act. I think that is an intolerable gamble. It is as simple as that.

I do not think the minister should do that. I think the minister has the responsibility clearly set out in the Health Disciplines Act to protect the quality of medical services in Ontario and ensure that each and every individual has access to those services. That is his duty and it is described in the act as his duty. It is not his duty to sit there and wait until some tragedy forces him to act.

The Deputy Speaker: One minute.

Mr. McClellan: He should assume his duty and responsibility under the act. We have indicated to him what we are prepared to support.

We are prepared to look at anything else he brings forward as a legislated settlement, as men and women of goodwill, but we ask him to assume his responsibilities, not to take the chance of something happening, and ideally to bring in a legislated settlement based on amendments to the Health Disciplines Act that would preserve the responsibility of the College of Physicians and Surgeons for disciplining its membership, but make it explicit that the withholding of medical services for collective bargaining purposes does, in fact, constitute professional misconduct.

Mr. Gordon: Mr. Speaker and colleagues, I am certainly rather taken aback by the approach of the Leader of the Opposition (Mr. Peterson). He seems to be living in a sort of Alice in Wonderland world when he tells us he cannot really comment on negotiations in any meaningful way because he does not understand the figures.

He does not understand where Ontario is going in the next three years, because he does not understand the blue book, the budget and so forth. He does not understand the joint committee on physicians' compensation for professional services headed by Chairman Paul C. Weiler.

I really have to wonder when someone demands an emergency debate on something we agree is an emergency and he says he really cannot get into it because he does not understand. I want to tell him the people of this province are not going to be enthused over the next three years unless he begins to get some facts, unless he begins to say something meaningful, unless he comes in here with some constructive points.

Let me make a second point. The member says it is a terrible burden on the College of Physicians and Surgeons, but he has no suggestions. He does not suggest anything. He does not say, "They have this problem so I think we should be doing this, this and this." That is not going to wash for long in this Legislature. I think he should think about it.

Mr. Peterson: You don't think I will last as long as you, Jim?

Ms. Copps: The only one who is washing his hands is Pontius Pilate over there.

Mr. Gordon: We will come around to you, don't worry.

Ontario's network of 230 public hospitals is the institutional core of the health care system of this province. Since hospital patients by definition are ill and in need of care, the impact of threatened OMA job actions on hospital service is a subject of particular concern.

Let me reaffirm in the strongest possible terms that this government will not tolerate harm to the health of any patient of any hospital in Ontario as a result of the withholding of services by a physician. We hope and believe the physicians of the province will place their responsibility to patient care above their desire for greater financial reward. Indeed, the OMA itself in its newspaper advertisement has declared, "No one will suffer more than inconvenience."

In carrying out its mandate, the Ministry of Health has been watching developments in the hospital sector very carefully. The government, and I am sure the public, appreciate the cooperation of Ontario hospitals in monitoring events in their institutions. In addition, the Ontario Hospital Association agreed to carry out basic monitoring of member hospitals.

Following a review of the procedure with the OHA, the association agreed that some specific monitoring processes should be carried out directly by the ministry, which is considered equipped to carry it out more effectively.

Accordingly, the Minister of Health (Mr. Grossman) has requested hospitals to inform the ministry immediately of any major problems concerning the quality of care and treatment of patients. Hospitals have also been asked to provide weekly written reports on patient care for the duration of the job action.

Furthermore, as members will have heard, hospitals must be prepared to deal with the evolving situation. Consequently, the minister has requested hospital board chairmen to convene special meetings of hospital trustees. The obligation of trustees is clear, both legally and ethically: to protect and safeguard the health of the patients entrusted to the hospital's care.

The hospitals have been asked to respond to the ministry on three specific points. All hospitals are to report on the recommendations of their medical advisory committees for maintaining the quality of care during any withdrawal of services. As well, they are to report on the steps being taken by the committees to provide supervision over the practice of medicine in the hospital.

Hospitals are also requested to submit their plans for assuring that essential services are in place. Finally, hospitals have been urged to notify the ministry if they foresee problems in maintaining an adequate standard of care.

I might answer one of the points brought up, I believe, by the member for Bellwoods (Mr. McClellan) when he was talking about the present preparedness of hospitals. This was sent April 20, via CNCP Telecommunications:

"I request that you advise the ministry of the following:

"(1) Your medical advisory committee's recommendation as to how the quality of medical care will be maintained in the hospital during any withdrawal of services, as well as the steps the medical advisory committee is taking to provide the supervision over the practice of medicine in the hospital.

"(2). Your plans to assure that essential services are in place to maintain the quality of care and treatment of patients in your hospital at an acceptable level.

"(3). Your undertaking to notify the ministry should your plans indicate that your hospital may not be able to maintain an adequate level of patient care and treatment and may fall short of meeting your obligations as outlined above.

"I would appreciate it if your report could be made available to the area team by telephone, followed by written confirmation before the date of the threatened withdrawal of services."

This information will give the ministry an accurate picture of the impact of physicians' action. The government is fully confident that the hospitals will successfully meet the challenge posed by any job action. In fact, there is reason to believe that the withdrawal of service will not be as drastic as some OMA pronouncements would suggest.

For example, in a number of hospitals last week physicians made their regular rounds despite the job action. The president of the OMA has stated that during the walkout some doctors will make hospital rounds, emergency surgery will be done, babies delivered, broken bones fixed, bleeding patients looked after and people with high fevers and infections will receive care.

Nevertheless, I believe physicians should understand that one of the options hospitals possess is their control over hospital medical privileges. Those privileges include the right to admit patients and use hospital facilities. Hospitals then, do have the means to deal with any incident of physician failure to look after patients adequately. Other sanctions exist through the disciplinary powers of the College of Physicians and Surgeons.

Opposition members want back-to-work legislation. It should be clear that the most effective adjudicator in this situation is not the arm of the law but the conscience of the individual physicians of this province.

Mr. Foulds: Like the hospital workers.

Mr. Gordon: I am glad the honourable member has brought that up. It is interesting that the New Democratic Party in Saskatchewan legislated 4,000 hospital workers back to work and then passed legislation that would not allow any other group to strike during the election campaign. That really is the kind of thing all New Democrats can subscribe to over the next three years and maybe even a fourth year.

4:30 p.m.

Each of us in this House has the utmost respect for the physicians he knows personally and is confident that professional ethics will prevail. While the government is dismayed by the tactics of the Ontario Medical Association and despite the fact that negotiations have broken off again, we are committed to continuing to negotiate in good faith. We are equally committed to doing everything in our power to ensure that patient care in our hospitals is not jeopardized in any manner whatsoever.

Ms. Copps: Mr. Speaker, it is obvious that the member for Sudbury (Mr. Gordon) is not privy to the facts. If he were, he would have been able to inform this House about the response to the telex, which is something we have been seeking from the minister for the last number of days.

Earlier today I tabled a letter, dated April 21, that was sent by a hospital board of trustees to the Minister of Health (Mr. Grossman) and to Dr. Lionel Reese, in direct response to the telex from the ministry, in which it is stated: "The Ottawa General Hospital recognizes its obligations under the Public Hospitals Act and the obligations of the doctors to exercise their privileges within the hospital. However, under present legislation it is the understanding of our board of trustees that we are powerless to act and certainly powerless to resolve this matter expeditiously."

They have turned over the responsibility to the minister. Yet the minister stood in the House today and said the ultimate responsibility lies with the hospitals and the doctors. This is a classic case of the minister, like Pontius Pilate, washing his hands of the health care problems facing the people of Ontario.

If the minister chooses not to believe the words of the official opposition or of the third party, perhaps he will heed the words of the Ottawa Citizen, which clearly points out in an editorial that this government's policy is ruled by panic.

The editorial, under the heading "Rule by Panic Hurts Health Care," reads:

"Sheila Copps and her Liberal fact-finding committee couldn't be touring the province at a more opportune time. The state of health care and health education, particularly in Ottawa-Carleton, is, to put it mildly, depressing.

"Not so long ago, Dennis Timbrell, then Ontario's Health minister, bemoaned the cost to the government of hospitals and hospital beds. Out went the beds and naturally now we have a shortage. . .'Improperly placed patients have made the situation much worse,' Civic Hospital director Peter Crothers told the Copps committee."

I am sure the minister is quite aware of the findings of the committee, since he has had an official monitoring just about every one of our presentations. Where no monitoring has been done, he has told members of the district health council that he would be interested in having the information passed along to the ministry.

The closing sentences of the Ottawa Citizen editorial, referring to the underfunding facing colleges and hospitals, is very telling in this situation and with respect to the whole health care system in the province. They read: "But college officials don't hold out any hope that Davis and the boys" -- with all due respect, I say to the Minister of Education (Miss Stephenson) -- "will change their tune. They know, as we do, that hucksterism is the name of the game, not good solid planning."

I can say in good conscience that all of us were hoping the situation would be resolved this weekend. Whereas it is important for the opposition to provide critical opposition in the area of health care and in other areas, we also realize that there is something much greater at stake.

When the minister said in his statement that he did not wish to invoke back-to-work legislation -- a model, I might point out to the New Democratic Party's Health critic, who seems to be unaware of past historical models, that was legislated by Quebec in 1970 -- that he did not want to change the historic patterns for the control of professional disciplines in the province, I submit to the minister that the historic relationship of doctors to patients in this province has been changed drastically.

The fact that doctors and the Ontario Medical Association have taken it upon themselves to walk out, to withdraw services, to go on strike, however the minister would like to define the strike, is certainly a departure from the historic relationships that we in Ontario have enjoyed with our doctors to date. That being an historic change, I suggest the minister might take a historic step and follow the Liberal Party's suggestion to invoke back-to-work legislation.

Mr. Foulds: Can you spell that out for us?

Ms. Copps: If the honourable member is seriously interested, I will send him a copy of the Quebec legislation, which was invoked almost 12 years ago and which certainly would provide a model for this situation here in Ontario.

I also wish to point out that the health problems facing the people of this province certainly will not be ended by the resolution of this problem.

Hon. Miss Stephenson: You must be joking. Holy cat! She wants a War Measures Act against the doctors. Once a Liberal, always a Liberal.

Ms. Copps: It is very interesting that the former president of the OMA, the Minister of Education (Miss Stephenson), has had nothing to say on this issue. If she has comments to make on this situation, I invite her to rise and state them in the House.

As a matter of fact, the minister has been untowardly silent in this situation, preferring instead to consult her notes and bury her head in her papers when any situation regarding the doctors is raised in this House.

Hon. Miss Stephenson: Do you have any knowledge of the parliamentary system of government? Obviously you don't.

Ms. Copps: I again invite the minister, who seems to have very candid opinions on other subjects, to stand and be counted in the House. Frankly, I do not think she has the guts.

The Deputy Speaker: Back to the debate.

Interjections.

The Deputy Speaker: Order. We are not having a dialogue across the floor of the House.

Ms. Copps: We have here a situation where the Minister of Health has refused on repeated occasions to accept responsibility for administration of the Public Hospitals Act. We have here a situation where the minister prefers, rather, to deflect the very serious responsibility that he monitors in his position as Minister of Health. He deflects that to the College of Physicians and Surgeons and to the hospitals.

The minister told us in the House here today that he personally was not aware of each individual situation being faced by the College of Physicians and Surgeons. Very frankly, I wonder whether he is putting the onus on his senior government officials to carry the bag for him. If one goes back into the comments made in Hansard, the minister very clearly said he was putting his trust in his senior officials and that he was not personally aware of every situation.

With respect to the letter from the Ottawa General Hospital that was sent to the minister on April 21 as a result of his telex, where in his very concerned way he supposedly got in touch with hospitals across the province, he said outside the House that he did not know whether a reply had yet been tabled to the hospital boards and that he did not know whether the matter had been raised with the College of Physicians and Surgeons.

I submit that a situation where a hospital board or a group of trustees indicates in writing that it no longer can be responsible for carrying out the activities of monitoring the Public Hospitals Act in its own hospital is a very serious situation. Frankly, I am shocked not only that the minister has not developed a mechanism whereby we can control this situation across Ontario but also that he does not even know whether a response to this letter has yet been sent to the hospital board in question.

I submit that in our limited travels across the province -- and believe me, they have been limited, because we are operating on an opposition budget; it is a very difficult situation to get information -- if this letter has been drawn to our attention in just one visit from one hospital last week, I ask the minister how many other hospitals have got in touch with him; how many other hospitals have expressed concern about their ability to carry out their responsibilities as trustees. And if in fact those trustees have contacted the minister, why has he not tabled in this House some specific programs, some specific modus operandi to respond to the serious continuing walkouts we are going to be experiencing this week?

4:40 p.m.

It is fine to say the hospitals should be responsible. It is fine to say the doctors will monitor their activities. It is fine to turn it over to the College of Physicians and Surgeons. But ultimately the people of this province are looking to the minister for leadership and for answers to a walkout by doctors that is certainly going to jeopardize not only the health but possibly also the lives of people across this province.

If the minister does have such a modus operandi and such actions in his ministry, will he please bring those to the attention of the House so that we, as well as the people of Ontario, can judge whether the government's reaction to the continuing hospital walkouts and the continuing doctors' walkouts will be sufficient to meet the critical need we are going to be faced with in the next few weeks?

Mr. Renwick: Mr. Speaker, the House will be pleased to know that in the riding of Riverdale we have the South Riverdale Community Health Centre. Outside that building, to inform the community, is a clear and simple statement that all services are maintained as usual. That is a matter of great solace to the people in the area I represent.

Mr. MacDonald: It is the same in York South.

Mr. Renwick: I am sure that is so, and I am sure it would be true in any area where there is a community health clinic operated on a nonprofit basis.

There are many concerns one could address in the debate today, but I want to direct my attention solely to the minister and his obligations, not as they may be written in law at some future time but as they exist today. If the minister has not already breached the responsibilities placed by our legislation upon him, he is perilously close to it, and I would say that by this time tomorrow he will be in breach of his obligations. I want him to understand that.

Our law is not confused. Our law is clear. Our law was the result of a great deal of work which finally received the approval of the Legislature when we enacted the Health Disciplines Act. My colleague the deputy leader of this party put the key clearly to the House this afternoon. The public situation in Ontario -- not the situation in the world in which the minister is living in his negotiations and telephone calls, but the position which the deputy leader of this party put -- is what the public apprehends. That is that negotiations have broken down and that tomorrow there will be a walkout, using the term of the Ontario Medical Association, or, what I think is probably a more accurate statement, an interruption in the provision of medical services to people in this province.

Because the minister is engaged in negotiations under the Health Insurance Act, we are being asked to ignore the obligations of the minister under the Health Disciplines Act and pretend that they do not exist. I want the minister to understand this clearly because, as my colleague the member for Bellwoods (Mr. McClellan) has indicated, it may be that legislation is necessary but, if the route to be followed is the proper route, it should be through the Health Disciplines Act.

I want to say to the minister that with the exception of one word -- and I suggest that word is only in there because of the euphemism of the relationships between a government and a self- governing profession -- which might be changed if necessary, and I do not believe it is necessary, the minister has responsibilities which he must exercise in the next few hours.

I do not think for one moment the minister can dismiss, for whatever reasons he may wish to dismiss it and leaving aside everything that is intemperate or may offend the minister, the actual language of the statement made just yesterday by the president of the Ontario Medical Association which the minister has done nothing to disabuse:

"All local organizations of the OMA will be informed immediately of the board's decision so the province-wide walkout scheduled for Tuesday and Wednesday will be carried out as planned. The medical profession of Ontario will continue to meet its responsibilities for the health care needs of the people of the province to the best of its abilities. On the other hand, the government of Ontario is acting in an irresponsible and arrogant manner. Any jeopardy to health care therefore must rest fully on the government's shoulders."

It is our position, and I want to put it very clearly, that we are not going to be caught in the game of whose responsibility it may be when the time comes that something serious happens. My colleague the deputy leader put it in somewhat dramatic terms, perhaps overly dramatic, because he felt it was a proper way to put it, and the minister responded by accusing us of making an accusation against him.

There is nothing in the laws of this province that allows the minister to pick and choose who does or does not receive medical care in Ontario. We cannot say that by and large people will receive care or that they will receive some part of the care to the extent and degree that will satisfy the words of the law of Ontario.

I want to touch briefly on the law. The minister will excuse me, but I belong to that profession; I believe in the tradition of self-governing professions and I do not want what is happening here to destroy one of the major professions in this province.

My references are very simple. If anyone wants to look at them, they are sections 2, 3, 46 and 49 of the Health Disciplines Act. I will not go into them all in great detail; I just want to highlight them. I assure the House that, to the best of my ability, these are accurate statements.

It is the minister's duty to ensure that the practice of medicine is effectively regulated in the public interest. It is his obligation and duty to ensure that the standards of practice are maintained. It is his obligation to ensure that the rights of individuals to the services provided by the practice of medicine are maintained.

The College of Physicians and Surgeons of Ontario has this obligation. I am no longer talking about the OMA; I am talking about the minister in relation to the council of the College of Physicians and Surgeons. The College of Physicians and Surgeons, in order that the public interest may be served and protected, is obligated to regulate the practice of medicine and to govern its members.

In addition, under this statue, the minister has this power: to request the council to undertake activities that in the opinion of the minister are necessary and advisable to carry out the intent of the statute. The minister has other powers; they are in the sections to which I have referred. But under that specific power, it is the minister's obligation to request the council to undertake activities that in the opinion of the minister are necessary and advisable to carry out the intent of the act. The intent of the act as passed by this Legislature was to protect the people of Ontario in the provision of health care services. The minister has that responsibility, and he must exercise it.

Some people may say that the council of the College of Physicians and Surgeons could object to a request by the minister and not carry it out. That may be a euphemism, as I said earlier. The Minister of Health (Mr. Grossman) on this day could request the College of Physicians and Surgeons to assert to the membership of that college, which is every physician in Ontario, that one of the activities it will not condone is a general concerted walkout by the members regardless of how many members participate in it or the extent and degree of participation by any particular person.

4:50 p.m.

I say very carefully that it is not sufficient, as the member for Sudbury (Mr. Gordon) tried to say, that we will leave it to the conscience of each individual physician. If we were going to do that, we would have not passed the statute of the province of Ontario. Of course we expect them to live by that obligation, but the minister is responsible.

The minister, as I said at the commencement, is perilously close to being in default under that act. If he does not act through the council of the College of Physicians and Surgeons to call off the walkout within the next several hours, then in my judgement, for whatever it may be worth to him, he will be in default under that act.

I could go on and cover a number of other points. I could refer to the very simple statement I made about a year ago now when we had a brief lull of some kind of time on our hands, but I want to make this brief one statement about opting out and the question of extra billing. I quote from what I said on June 18, 1981:

"To the extent the problem of opting out and extra billing is allowed to continue as a hidden lever in the negotiating process between the provincial government and the medical profession in the settlement of the costs of those services, we are putting the whole of the medicare system in jeopardy in the very broadest sense of that term."

Ms. Fish: Mr. Speaker, I would like to return to some of the themes that have been touched upon by members opposite through different speakers and at different times.

While acknowledging, as some have suggested, the authority and responsibility of the Minister of Health (Mr. Grossman), I would like none the less to explore a little further some of the authority and responsibility of both the hospitals and the College of Physicians and Surgeons of Ontario, which have been touched upon in part.

The member for Hamilton Centre (Ms. Copps) suggested, as did the Leader of the Opposition (Mr. Peterson), that perhaps an unfair burden was being placed upon the College of Physicians and Surgeons to determine whether there is professional misconduct, to sit in judgement of complaints respecting activities of those members of the medical association who have been engaged in what can only be termed as a wholesale withdrawal of a major portion of health services to the patients and public of Ontario in the course of engaging in what can only be described as a series of rotating strikes.

It is interesting to suggest that the council of the very body that has the responsibility of establishing and maintaining standards of conduct for the professional conduct of medical practitioners in this province -- a body established to give life to the phrase the member for Riverdale (Mr. Renwick) suggested, "the self-governing profession," which those members of the medical association suggest they are -- equally has the responsibility of discipline and determining that corrective action is taken when members of the association, that purportedly self-governing profession, withdraw their services and potentially place the public of Ontario at risk.

Neither the council nor any member of the medical association can have it both ways. You are either a member of a self-governing profession, operating through the College of Physicians and Surgeons with a council establishing and maintaining your standards of service, or you are a member of an association that perhaps merits reconsideration for certification under the Ontario Labour Relations Board.

The responsibilities of the council are clear. I note that they are meeting over the next few days. I am extremely concerned that there are members of that very council who have engaged in and support the withdrawal of health services to the people of Ontario. I am appalled that members of the council have not to date debated the very real question as to whether withdrawal of services in this fashion maintains or is appropriate professional conduct.

I would share with the members of the assembly today one of the key criteria for determining professional misconduct; it is the failure to maintain the standard of practice of the profession. I would note as well that the final indication for misconduct is "conduct or an act relevant to the practice of medicine that, having regard to all circumstances, would reasonably be regarded by members as disgraceful, dishonourable and unprofessional."

Does the council of the College of Physicians and Surgeons consider that the wholesale withdrawal of health services to the patients of Ontario is, excuse me, graceful? It is honourable? Is it professional? How will the council and the members on disciplinary hearings feel about the complaints that may come forward? If they are to be self-governing, they must exercise their responsibility and let us know where they stand on a very critical question. It may be we will have to review the self-governing aspect. It may be we will have to re-examine the authority and jurisdiction given to the council.

It is perfectly clear that, at the time it was established, rotating strikes of this sort and the withdrawal of services were completely unprecedented and unheard of. They were not contemplated by practising physicians in this province. Yet today we see it happening again, threatened for a further period of time, with the strutting of the president of the Ontario Medical Association, crowing in his news releases about the fact that he projects 70, 80 or 90 per cent of his members withdrawing their services. Perhaps the time indeed has come to reconsider that relationship.

I move briefly, in consideration of time, to the thought that some reference might be appropriate to the role of the Ontario Hospital Association. There has been read into the record already a couple of times the telex from the Minister of Health to hospitals seeking advice from them in dealing with withdrawals. Something I have not yet heard read into the record, and therefore would like to share with the members, is a suggested form of reply the OHA sent around to its participating members. I quote:

"The OHA has not been notified by all hospitals of the extent of medical staff actions to boycott committees. It is apparent, however, that in a number of hospitals the medical advisory committee is not functioning in the customary manner at this time," that being April 21. "In such circumstances, the OHA believes it is a good and sufficient response to the minister's first request" -- that is to say, the request of the advice of the MAC in dealing with the withdrawal of service -- "to state that your board has been assured by responsible officers of your medical staff that the quality of medical care within the hospitals will be maintained and carefully watched."

I suggest to the members that if the OHA, which purports to speak for the hospitals of this province, is going to be suggesting the form of reply to hospital administrators and to hospital boards, apparently or conceivably without an examination of the specific responsibilities of those administrators or of the boards, then it might do well to reread the Public Hospitals Act and regulation 865 under that act to understand the responsibility of the boards, the administrators and the medical advisory committees. It seems to me that would be appropriate if it is purporting to speak for the hospitals and, indeed, purporting to advise the hospitals about some sort of fill-in-the-blank form letter reply hospitals perhaps can give.

Let me be specific on regulation 865 under the Public Hospitals Act. It is very clear. Clause 3 states, "The board of a hospital is responsible for the enforcement of the act, the regulations and the bylaws of the hospital." It is, in other words, responsible for ensuring the continued delivery of health care through the hospitals of this province. It is interesting to note that one of the requirements is the establishment of the medical advisory committee, composed of members of the medical profession who, among other things, under the regulation "provide supervision over the practice of medicine in the hospital."

I ask you, Mr. Speaker, if the members of the medical advisory committee are not serving on the medical advisory committee, how, then, do they supervise the practice of medicine in that hospital? I put that question to the individual doctors concerned; I put that question to the boards and the administrators of the hospital and, most particularly, I put that question to the council of the College of Physicians and Surgeons of Ontario. Where does the council stand?

5 p.m.

Finally, I would put a further question to hospital administrators. There is an interesting clause further on in regulation 865, and it reads as follows: "If the administrator believes that a member of the medical staff is unable to perform his duties in the hospital, the administrator shall notify the president or secretary of the medical staff, and thereupon the president or secretary, as the case may be, shall arrange for another member of the medical staff to perform the duties." It could not be clearer.

The Acting Speaker (Mr. Robinson): The member has one minute remaining.

Ms. Fish: I say in closing that if the climate, the expectations, the standard of ethical conduct have so drastically altered from the days when the College of Physicians and Surgeons was established and from the days of the movement to boards operating the public hospitals of this province, then indeed it may be time to drastically revise, reconsider and review the relationship between government and those who are practising medicine in this province.

Mr. Wrye: Mr. Speaker, I rise to speak in this debate with a sense of disappointment that we are not speaking in debate to put an end to this walkout, and I find myself completely at a loss to understand why the minister and this government continue to allow themselves to be pushed around in the face of a situation in which the quality of health care is really being put at risk, as it will be, in my opinion, tomorrow and Wednesday and, should this situation drag into next week, for three days in the week of May 1.

I found it absolutely incredible to watch a minister, in a sense, grovel in his place today -- and that is what he was doing -- when he said: "I went to the president of the Ontario Medical Association and said: 'I will meet with you; I will meet with the council of the OMA; I will plead with you. Now will you call off your strikes, which are scheduled to go province-wide tomorrow and Wednesday?'" Dr. Reese said, "No, I won't, Mr. Minister." And the minister said, "Oh well, I tried."

These strikes have become no laughing matter. A constituent, who called my office late Thursday, told me a story of how she had been off work since the end of January. She required additional surgery, which was to be performed tomorrow, but because we are going to have strikes all over the province tomorrow, including the city of Windsor, that surgery had been cancelled.

For two months this lady has been losing an average of $90 a week in pay because she was off sick, and she was looking forward to having the surgery completed -- elective surgery though it was -- having a sufficient time to recover and then returning to her place of employment and also to some measure of the kind of financial independence she and her family had enjoyed. When that surgery was cancelled last week it delayed her return to work by some two months, because it has been rescheduled for June 24, almost two months to the day from this date.

I might add that I spoke with her physician this afternoon and apprised him of the situation so he would understand that there is a very real financial hardship to this lady and her family as a result of his decision to cancel the elective surgery. He has given me a promise that he will look at the matter again, and I understand that he has informed the lady in question that he is attempting to get her a bed in the hospital, even at this late date, so the surgery can be performed.

But if there is this one example in my constituency, there are thousands like it across the province. One would have thought by this time, whether the situation was life or death or not -- and I know the deputy leader of the New Democratic Party suggested to the minister today that he is indeed playing it a little fast and loose with the life and death situation some people might face. The minister found that to be rather extreme. I do not know whether it is or not, but surely we have reached the point where the people of this province deserve a little better than the kind of nongovernment they have been getting for the last several weeks.

I think the major responsibility rests -- though I certainly appreciate the comments made by the member for St. George (Ms. Fish) and I fully endorse her call for a little more independence on behalf of the council; it is trying to have it both ways in being the council of the College of Physicians and Surgeons and, in the next breath, endorsing and taking part in these rotating walkouts. But we could have avoided all this if we had had a little more flexibility on the part of the government at the outset. I refer specifically to the original 10 per cent offer by this government, and then its refusal to negotiate and moving very quickly to a fact-finder.

If we had had a little more flexibility throughout, we might have resolved the situation far quicker. It is just fine for the minister to stand in his place and blame my colleagues the member for Hamilton Centre (Ms. Copps) or the member for London North (Mr. Van Horne) or somebody else. The member for Sudbury (Mr. Gordon) thinks that is great, that somehow the opposition ought to govern. Give us three more years, I say to my friend from Sudbury, and we will be governing. We will be governing because the government has proven itself utterly and absolutely incapable of governing, not only in this dispute but in so many others.

The minister stood up and said the leader of the Opposition does not understand all the details. That is only to say that he is not now preparing a budget. He will be in 1985. He will be.

Interjections.

Mr. Wrye: They have an answer for everything. Absolutely everything.

Interjections.

The Acting Speaker: Order.

Mr. Wrye: They follow Saskatchewan, that is true.

We had the minister standing in his place on April Fool's Day and informing us he had invoked the final offer. I have reread his statement several times and I thought that was it, and so did everyone in this Legislature. Yet, nine days later he came on bended knee and said:

"Let us have urgent talks. Let us reopen the whole thing." If the minister wanted to talk about having a little more flexibility going in, why was his offer not compounded immediately? In most multi-year disputes I have ever seen, we do not have simple offers, we have compounded offers. But we wanted to make the OMA a little more bitter along the way.

Finally, the minister came here on Thursday and implied that he had a memorandum of agreement, when all he had in years four and five was some kind of economic adjustment. No wonder there is misunderstanding.

This is not to say the OMA have been right every step along the way. It certainly is not right in what it proposes to do tomorrow and Wednesday. It should in good faith get back to work tomorrow and Wednesday while the minister attempts to work out a solution. Failing an agreement on the OMA's part to act in good faith, the minister should have put an end to this. He should have put an end to this by introducing back-to-work legislation today.

Frankly, I am sure he has it prepared and he could have introduced it in this place. We could have been done with it by the time we adjourned at 10:30 tonight. The minister has another 50 minutes, and he has not made his remarks. Quite frankly, since the OMA has not shown the flexibility to end these walkouts, I am sure we, on this side of the House, are prepared to sit this evening and move ahead with this matter before we put health care in this province at a critical risk.

5:10 p.m.

Throughout this whole matter the minister has suggested that, first, the College of Physicians and Surgeons of Ontario, then the Ontario Hospital Association and now the individual hospitals under the Public Hospitals Act all have the responsibility to end these matters and bring about proper health care in Ontario. To use one example, it seems to me that to suggest to the Ontario Hospital Association that privileges should be removed from individual doctors simply is not practical. Who is going to practice medicine in the various hospitals if all the privileges are removed? Are we to add insult to injury? Are we to continue to have the dispute escalate?

Rather than moving from one position to another and attempting to pass the buck to others, what should have happened is the minister should have accepted his own ministerial responsibilities a long time ago when the negotiations began. He should have taken them in hand rather than trying to play a game of quiet bluff with the OMA. I suggest the results of that game will be seen tomorrow and Wednesday throughout Ontario as thousands of doctors remove their services and put at some degree of risk the whole matter of quality health care in this province.

Mr. Wildman: Mr. Speaker, I rise to speak in this debate because I agree we face an emergency. I had hoped we would hear two specific things in this debate. First, I hope the minister in his response will tell us exactly what he means when he says that if the system is endangered, if health care is endangered, he will take action. I want to know specifically, and I hope the minister will tell us, what he means when he says danger, and I want to know what kind of action he contemplates.

The other thing I had hoped to learn in this debate was the exact Liberal position.

Mr. Breithaupt: Another disappointment.

Mr. Wildman: It is indeed another disappointment. I do not think the emergency we face is a time for us to get up in this House and make a lot of political statements. In asking for the debate, the Leader of the Opposition (Mr. Peterson) said he wanted an opportunity to put forward the Liberal position and for the minister to put forward his position. The minister still has that opportunity. So far I have not heard what the Liberal position is; except that they do not like the situation. None of us likes the situation.

Our position is clear. My colleagues have stated it and I will repeat it. It is one the minister does not agree with. I wish he did. To some extent, I agree with the comments made by the member for St. George (Ms. Fish) when she talked about the medical profession attempting to have it both ways in this situation. I do not think we can continue to allow that to occur.

I submit the reason they have been able to "have it both ways" is because the minister has attempted to have it both ways. All along, he has stated that he is attempting to negotiate, that he wants to negotiate an acceptable fee schedule, one that is fair to the medical profession and one that the taxpayers can afford. He has said that but, at the same time, he has indicated that he cannot go above certain levels, or he does not wish to go above certain levels.

That is a legitimate position for him to take. But instead of then saying, "All right, this is what we are going to offer," he said, "We have some other possibilities of negotiation," and it goes on and on and on. While the Ontario Medical Association decides that they will continue their job action, in our view we do have a dangerous situation, and health care in this province is in danger.

The minister has laid out all of the proposals in terms of the responsibilities of the hospital administrations and the responsibility of the College of Physicians and Surgeons of Ontario, but he has not said that he recognizes his own responsibility and what he is going to do. He has not made it clear to us how he is going to resolve this dispute and avoid the rotating walkouts.

As a matter of fact, he seems to be prepared to accept the rotating walkouts. He seems to be prepared to say, "All right, this kind of approach is acceptable as long as the health care is not endangered and as long as the individual patient's health is not endangered." Yet he does not in any way define what he means when he says those things. Frankly, the public of this province is left confused by the minister's position, and I believe the medical association is also confused by it.

We have made quite clear what we believe should be done. We believe that the minister should accept the Hall recommendation for binding arbitration in disputes that cannot result in an amicably settled negotiation. We also believe that the minister should take his responsibility under the Health Disciplines Act and move to amend the regulations so the current kind of job actions will be defined as unprofessional conduct.

Over and above that, we have made it clear many times that the practice of extra billing must be ended in this province. One considers the situation of the doctors, as the member for St. George said, trying to have it both ways. The government is too. They want to negotiate a settlement, they want to negotiate a fee schedule that should be binding on the government and on the OMA, on everyone; but at the same time they want to allow the individual doctors, if they do not like the fee schedule, to be able to say to their patients, "I will bill OHIP for the portion of the bill that I am going to charge you up to the fee schedule under OHIP, and then I am going to bill you, over and above that, an extra amount that you will have to pay yourself, through a private insurance system, or whatever." That is just not acceptable.

The member for Oxford (Mr. Treleaven) said a little earlier he wanted us to make our position clear. That is our position. It is clear. It is one that is supportable. It is the kind of action that has been taken by other provinces in this country.

We are not in a situation that is isolated to Ontario. We have difficulties in terms of resolving the fee schedules for doctors right across the country. I believe we are in a situation where certain individuals, both within and without the medical profession, are attacking the medicare system as we know it. I believe there is a concerted effort on the part of not just some doctors but on the part of some politicians in this country to destroy the medicare system. I believe it is imperative that this minister takes action, quickly and immediately, to protect universal access to medicare in this province.

It is not enough for the minister to get up repeatedly in his place, play to the cameras and say, "I am a very reasonable man." Obviously, he has to be reasonable and he has to negotiate in good faith, but he also has a responsibility to protect the health of patients in this province and to protect the accessibility of all Ontario residents to good and adequate medical care.

5:20 p.m.

In this House, we are all used to the Liberals trying to have it both ways. Frankly, it is time for the government to take a position and say clearly what its position is and what it is going to do. What does "endangering health care" mean? What does "endangering the health of a patient" mean? What does the minister mean when he says that? If we reach that situation, what is he prepared to do to avoid a serious situation all of us in this House want to avoid?

If the doctors follow the procedures they are contemplating, the Liberals have said they want back-to-work legislation. They have not said exactly what kind of legislation that would be and they have not said how it would be brought about. They say: "We are an opposition party. We do not have to spell out exactly what our position is going to be. It is up to the government to govern."

In that much, I agree. It is up to the government to take the action that will protect the medicare system and defeat its further erosion.

We have made our position clear. We have made clear to the minister what we think he should be doing. I think he has made it almost as clear that he does not want to do what we have been proposing. If that is the case, what does he want to do? Is he going to continue to come into this House every second day and say, "I have another meeting arranged and we are looking for a settlement; it looks like we are going to have a settlement," then come back to the House two days later and say, "Well, it did not work"? The minister has the opportunity to tell us exactly what he means. I hope he takes it.

Mr. Cousens: Mr. Speaker, as part of the context of the deliberations today, we are looking at a larger picture. That has to do with a number of the key elements that go into a negotiating process.

The first thing I would like to comment on is the intentions of the government and the intentions of the minister which have been brought into some question by some of the comments made by the member for Riverdale (Mr. Renwick) and the member for Bellwoods (Mr. McClellan), comments which would somehow question the integrity of the negotiating process from the government side.

Having talked to the minister himself on numerous occasions, having listened to him in the House today, I do not think there should be any doubt in the mind of any member in this House or within the populace at large in Ontario that the Minister of Health (Mr. Grossman) cares as much as anybody about having a good health system in this province.

He is not going to give up on that. He wants the thing resolved and he wants to serve the people of this province. He is not only doing it for the short term to obtain a solution, but has in mind the long term so we can continue to build on a strong health care system for this province.

I think we should also realize we are living with a crisis in the economy in this province. There are many people without jobs. We are talking about people in the automotive industry, the construction industry and various areas where they are having tough times. At the same time, the government is not drawing in the funds it was when times were more prosperous. The government has to be fiscally responsible in presenting its case and in being able to say, "Here is an honourable agreement and honourable terms."

As part of that great, broader picture, no one in Canada has been bankrupted because of health care. In the United States, many individuals have suffered great personal financial loss because they could not afford it. What some would ask today is that the government bankrupt itself by going more and more deeply into the pot to pay for health care.

The process of negotiation is something we have to take seriously. Our government is indeed taking it seriously and is anxious to resolve this. May I say there is not a lot gained by trying to negotiate in public, and certainly the Minister of Health has manifested a good presentation in trying to carry out negotiations between the Ontario Medical Association and this province.

I find it difficult to understand the contention of the OMA that its disruptive actions are directed against the government. Doctors treat people, and it is the people who are being penalized by the withdrawal of services. It is very clear that the measures undertaken at the behest of the OMA have only one goal in mind: getting more money from people. As we all should realize, there is only one source of money for government, and that is the taxpayer.

The OMA is taking its case before the court of public opinion with all the risk that entails. In full-page newspaper ads the OMA maintains that all it wants is for the Ontario health insurance plan to pay a fair fee. What is fair? According to Statistics Canada, doctors are already the highest-paid group in the country, and Ontario doctors are the highest earners in Canada, with the sole exception of those in Newfoundland.

We contend that the OHIP schedule presented by the Minister of Health on April 1 is fair and adequate compensation. It provides for a 34 per cent increase over the next three years, to bring the after-expense income of the average doctor to $114,000 for 1985.

We must remember that the OMA itself chose the fact-finder, Mr. Paul Weiler, a Harvard law professor, who eventually recommended the two-stage, 14.25 per cent increase for doctors this year. The OHIP schedule implemented was in line with his recommendations, though more generous, but the OMA rejected it out of hand.

The OMA had accepted his recommendations the previous year. The OMA had demanded a 72 per cent increase. That would have brought the average doctor's wages to $158,300 by 1985, or almost double the income of full-time participating physicians; and that was from OHIP alone.

Today, we are talking about an age when there are economic problems all over the place. The increase the government put into effect will increase OHIP's budget by $656 million between now and April 1, 1985. There is more going out of and less coming into the Treasury; receipts from corporate income, mining taxes and the sales tax will decline by some $300 million this year. At the same time, it is estimated that the federal transfer payments to Ontario this year alone will decline by $290 million, a major portion of which would have gone to health. Also, 90,000 more taxpayers are out of work in the province this year than last.

Everyone, including the MPs in Ottawa, who automatically index their salaries, tries to catch up with inflation to overcome the erosion of their buying power; doctors, despite their income, feel they are no exception. The Minister of Health has stated that if the OMA had given its members all the facts about the negotiations, physicians might not be taking part in the rotating walkout, at least not at this time, when the current rate of reimbursement matches the last request by the OMA. We in government feel that the present disagreement could have been resolved without the OMA resorting to extreme measures. The door is open, but the overriding reality is that we cannot afford to accede to excessive demands if we are to preserve our health-care system.

Many doctors feel that the events of the past week are unfortunate, that such events should not come to pass. The government shares this view. We have to protect the standards we have reached. The goal of the government is to provide to all the citizens of Ontario the optimum quality of health care.

Mr. Bradley: Mr. Speaker, I rise to participate in the debate that, last Thursday, all of us hoped would not be necessary, most particularly on the basis of the words of the Minister of Health (Mr. Grossman) or, at least, the message the Minister of Health conveyed to the House that there was an opportunity for a negotiated settlement in this dispute. Without a doubt, all members of this House would be hopeful that is the way this matter could have been resolved.

While I suppose no matter what issues arise there are political considerations by members of all parties, I think when we deal with the health of people in this province most of us tend to push those political considerations into the background and hope that somehow we can find an amicable solution, one which is acceptable to most, particularly to the two parties involved in the negotiating process.

5:30 p.m.

It seems to me, as is the case most of the time when negotiations take place, the blame should be shared by both sides in the negotiating process. The Minister of Health makes a case for the position of his ministry and of his negotiators and I am sure he believes that is the appropriate case and a very accurate case. On the other hand, the members of the Ontario Medical Association, particularly their executive and the negotiators, make another case.

One thing that does come through in talking to individual doctors, aside from the negotiators from the OMA, is that they seek a negotiated settlement and would be hopeful of avoiding the kind of confrontation that we see now. The second thing is that whether it is because of the information they have received from their executive or otherwise, they have a distrust of the position put forth by the Minister of Health at the present time and they would be very concerned about the kind of recommendations that we in the opposition have made for terminating any of the actions which they are contemplating next week.

I look also at the fact that special circumstances confront the doctors when they make their case. I had an opportunity to interview on cable television the head of a medical association who subsequently asked that the interview be cancelled.

He expressed some very strong points of view but, as we know, many members of the medical profession, although they may be at odds with this particular minister at this particular time, have a political affiliation which is strongly identified with that party opposite. Even within the medical profession, those who wish to express very strong views about that government are reluctant to do so because of the awesome power that government ultimately has in dealing with medical care.

We recognize that doctors work long hours. They have an awesome responsibility over life and death. They must assume costs for benefits and pensions and what we would consider to be fringe benefits in normal employment. They have the overhead of the office and staff and the cost of education and training.

These are all tremendous costs. On the other hand, we have a situation where the people of Ontario cannot simply deal with the medical profession with a blank cheque.

I think members on all sides recognize that. I think the minister said that himself this afternoon. He said it was not simply a case of writing into that cheque exactly what the doctors wanted. Indeed we could probably settle the dispute that way very quickly, but it would not be the responsible thing to do. I think members of the House would concede that is certainly the case.

I also found in discussing with doctors that the problem seems to go beyond the fee schedule. I do not know if in his negotiations the minister got into these kind of conversations. I presume they were confined almost entirely to the fee schedule itself, but many doctors are also concerned about the facilities with which they have to work, such as the equipment they have in the hospitals and the number of beds that are permitted in a hospital.

They are concerned about their working conditions. This is nonmonetary as far as they are concerned but costly as far as the government would be concerned in terms of the grants to the hospital system. They believe that if some of those problems could be overcome it would make their job a little easier, a little more efficient and perhaps allow them to realize many more of the medical miracles for which they have been responsible in the past. That would go a long way to improving the atmosphere in the negotiations between government and the medical profession.

They also look at the efficiency of the payments from OHIP. Recognizing that they are dealing with a lot of claims within a year, it is not an easy process. I am the first to concede that. Many of them complain they are not entirely happy with the efficiency of that process and if that was improved it would have a marked effect on their attitude towards the government.

An example the minister may be aware of -- certainly the previous Minister of Labour, the member from York East (Mr. Elgie), would be -- is the aggravation caused doctors by payments coming from the Workmen's Compensation Board. If there were an indication from the minister that he was prepared to address some of those peripheral problems in the negotiating process, the doctors might take a rather more positive attitude towards the government.

We recognize there are problems arising even with present sanctions by doctors. I note from newspaper clippings that 85 per cent of Cambridge doctors participating in the Wednesday, April 15, walkout were refusing to renew prescriptions over the phone and to prescribe inexpensive generic drugs for people on government drug plans.

Although many doctors are continuing to authorize telephoned prescriptions, those who are refusing to do so are making it very inconvenient for the ill or elderly by requiring them to visit the office whenever they need to have a prescription renewed; particularly when that office is going to be closed for a couple of days this week and perhaps three days next week.

Those are the kinds of problems which have to be confronted by the minister. One of the reasons we are calling for legislation is to bring about binding arbitration and prevent these things from happening.

Newspaper clippings also show that in Kitchener-Waterloo the walkout on Friday, April 16, closed doctors' offices and forced cancellation of nonemergency surgery at both hospitals. The emergency ward at St. Mary's General Hospital treated double the number of people for a normal Friday. At Kitchener-Waterloo Hospital only three cases went into the operating room that day and all other surgery was cancelled.

The list of similar situations goes on. I could cite many more cases. The problem is going to increase drastically when the doctors carry out their threat on Tuesday and Wednesday of this week. Each of us, regardless of our political party, will be answering his telephone and trying to explain why people are unable to get the kind of medical care to which they feel entitled and to which they had become accustomed prior to this dispute.

We are happy that we had this kind of co-operation from the medical profession in the past. If the only way we can prevent the situation from deteriorating is to bring in the appropriate legislation, then that is what we are calling for at the present time. There is no other way --

Mr. Philip: What legislation?

Mr. Bradley: The government says it has its legislation. We have cited examples; for instance, the modified legislation brought in by Quebec. But I am not going to bother with those people to my left, who have the answers to everything and forget that the enemy is over there. That is why they are in third place.

Interjections.

The Acting Speaker: The speaker has one minute remaining.

Mr. Bradley: With regard to advice, I note that the Deputy Minister of Health is at present receiving some rather good advice, no doubt, from the former president of the medical association, the Minister of Education (Miss Stephenson). I hope she will be able to counsel him on ways to avoid this particular problem.

We are calling for the minister to take decisive action to ensure that the medical profession complies with what we expect of it so that the health situation in this province is not allowed to deteriorate by means of a doctors' strike; and that for this particular instance, at least until we can find a better mechanism, he will place this dispute before a tribunal of some sort for binding arbitration, so that this matter be solved in this way and that the present impasse be overcome.

Mr. Foulds: Mr. Speaker, I want to leave time for the minister to reply. However, there are a number of points I would like to make.

First of all, what we have here in Ontario is a genuine emergency. We have a very real potential and apprehended threat to our health care system. What we have here is an enormous discontent on the part of the doctors of this province, and not just the OMA.

What we have here is a government without a clear policy on medicare in this province. What we have is a province that since the late 1960s has never been fully committed to the medicare system of Canada. John Robarts called it a Machiavellian scheme and said medicare had been foisted on this province. That lack of commitment, that lack of dedication to the medicare system of this province is now coming home to roost on the shoulders of the government.

5:40 p.m.

What we have in Ontario today is a health care system that is under attack and the government does not know how to respond. Why are the health and safety of Ontario's patients threatened in 1982? Let us make no bones about it, that is what will happen when we have a province-wide walkout tomorrow and the next day. Why do we have doctors and OMA spokesmen using the language of trade unionists but refusing to accept the responsibility of trade unionists and collective bargaining?

What we have today is a minister who is forced to negotiate with the OMA in public because he cannot negotiate in private. What we have is a minister who is trying to drive a wedge between the OMA and the College of Physicians and Surgeons of Ontario and between the spokesmen for the OMA and the ordinary medical practitioners of this province.

What we have is a minister who has no position, whose position changes from day to day, who comes into the House late and often without a statement when statements should be made on behalf of the ministry.

What do we have coming from the official opposition, the Liberal Party? We have changes in policy from day to day with regard to the amount of funding and changes from hour to hour with regard to what the so-called back-to-work legislation should be.

I want to associate myself entirely with the three-point program outlined by my colleague the member for Bellwoods (Mr. McClellan), which is clear and unequivocal about the way we would see this current problem solved, and I want to associate myself entirely with the comments of my colleague the member for Riverdale (Mr. Renwick), who outlined clearly and precisely the minister's responsibility.

It is very simple for the member for St. George (Ms. Fish) to rhetorically attack the OMA, the Ontario Hospital Association and the College of Physicians and Surgeons, but that does not help the patients of this province and it does not get to the crux of the matter, which is what the minister should do to prevent a potential tragedy in this province.

What we have here is a breakdown in trust, for in his statement to the Legislature today the minister is clearly saying he can no longer trust the negotiators for the OMA, and in the statements issued yesterday by the OMA it is saying clearly and unequivocally that it can no longer trust the minister.

There is a very simple message that we in the New Democratic Party would like to give on health care: we want fairness in the system for the patients, for all health care employees, for taxpayers and for doctors.

A year or so ago we faced job action by another group of workers in the health care system, the hospital workers. They earned, on average, $13,300 a year. Their job action was made illegal by the Conservative government and as a result of their work stoppage the following punishment was exacted: 3,440 workers were suspended, 5,582 received disciplinary letters in their files, 36 were fired, 22 were charged with various offences by the Attorney General (Mr. McMurtry) and the three leaders got jail terms.

By June 1982, the same hospital workers will be earning, on average, $16,000 a year.

I want to say directly to the minister again, as I said this afternoon, do we have to wait for someone to die? Do we have to wait for a tragedy in this province before he feels he can take preventive action on behalf of the patients of Ontario? Because we say, if he says that, it is simply not good enough. It is an evasion of his ministerial responsibility, a sloughing off of his ministerial responsibility to other bodies. When the buck stops, I say to the minister, it stops with him.

I ask the minister directly and sincerely, will he not consider the suggestions made time and time again in the House by my colleague the member for Bellwoods? Will he not consider the arbitration panel as devised and suggested by Mr. Justice Emmett Hall? Will he not put on the bargaining table, to give himself a lever, an end to extra billing? Will he not ensure that the necessary changes to the Health Disciplines Act will make it clear that a concerted withdrawal of services is professional misconduct and subject to disciplinary action?

Hon. Mr. Grossman: Mr. Speaker, I have listened with interest to the debate this afternoon, because of the importance of the subject matter. I have genuinely listened to the points raised across the floor, and there were some valid points made on all sides of the House this afternoon. They reflect the difficult position one finds oneself in when one is trying to arrive at what everyone in this House has acknowledged they want; that is, a negotiated settlement between the parties. That is not easily arrived at, and it is not easily arrived at because of many pressures. Members have seen here this afternoon that, had I adopted some of the strategies advocated by one party opposite, then the other party opposite would have been accusing me of doing something they had suggested I not do. One really is in a very difficult position here.

I must say right off the top that I reject any argument that we are trying to drive a wedge between anyone. What we are doing is enforcing all the legislation this Legislature has equipped us to use and to have; the College of Physicians and Surgeons of Ontario has undertaken to act as called upon and is acting as it has been called upon to do; the hospital association has confirmed in their newsletter today that they are living up to their responsibilities and have made them quite clear to their member hospitals; the physicians, even the OMA, which has been very careful to take appropriate standby actions when it has withdrawn services.

I do not condone the withdrawal of those services, but when one looks at the responsibilities we have under our legislation, at those of the hospitals have under their legislation, and at those of the College of Physicians and Surgeons under its legislation, I say very carefully and advisedly that to date they have lived up to their obligations.

I want to say to the Leader of the Opposition (Mr. Peterson) that I was rather disappointed and surprised to hear him suggest it was not up to him or his party to give an answer as to what would be an appropriate price. To use his own words, "It would be superficial or only politically expedient for me or anyone else to jump and say that is enough, that is too much, or that is the right amount." I can only conclude from that he is saying at least three members of his party have been politically expedient and superficial, because that is precisely what they have done.

I must say too I am surprised that the Leader of the Opposition --

Mr. Peterson: You give us your job and we'll solve it. You know it's the same cheap tricks. It's no wonder the doctors don't like you, because you use the same sleazy techniques.

Hon. Mr. Grossman: The Leader of the Opposition spent a great deal of his time making quite personal accusations about me as Minister of Health, and he has to be prepared to sit in this House and take it just as well as he tries to give it.

Mr. Peterson: There's no question about your incompetence in this negotiation. It's at issue.

Hon. Mr. Grossman: The Leader of the Opposition talks about the way I treat the opposition. He knows very well that I informed him before I came into this House last Thursday and that I called him over the weekend so he would be fully apprised of the situation at all times. That is the kind of openness through which I deal with all parties when I am involved in negotiations, and the honesty and reliability I have placed upon people I deal with.

5:50 p.m.

I was particularly interested to hear the Leader of the Opposition say that he could not possibly say what the right number is. He said: "I am not party to the macroeconomic projections of this province for the next three years. I do not know what revenues will be."

He was Treasury critic for three or four years. He succeeded Marvin Shore in that job. I am sure he has had the opportunity to read some of the budget papers that both the federal and provincial governments have been bringing out. I think it is quite a personal indictment of the Leader of the Opposition for him to admit he has no idea of the degree of government affordability in this area. He has no idea whatsoever by his own admission.

With regard to the Health critic for the Liberal Party, not to use the time that I want to use this afternoon on this matter, I invite her to raise this question in question period tomorrow because, if she does, she will be rising on very many points of personal privilege. It will suffice to say that with regard to the Ottawa General Hospital, the letter she referred to was written the day before my telex went out. It was not in response to my telex. It was handed to her the day after they wrote it, obviously before I received it, and there is a meeting tonight of the hospital to find ways in which to answer my telex. They have undertaken to respond fully to their obligations under the Public Hospitals Act and the telex I sent them. So that situation is totally and completely handled. The response is absolutely there.

Ms. Copps: It is six days old and you don't even know whether --

Hon. Mr. Grossman: They wrote the letter before I sent the telex. The member for Hamilton Centre (Ms. Copps), should try and listen.

The debate this afternoon has been quite useful to me as I try to guide this process through the next few days. There is no question but that the responsibilities that lie on every part of the health care delivery system are going to be intensified. The college is going to have to increase its level of activity. There is no question about that. Each individual hospital board is going to have to respond to my telex and concentrate on its responsibilities under the legislation. Indeed, each physician is going to have to --

Mr. McClellan: Do you mean they haven't responded?

Mr. Foulds: You expected to have the information last Friday.

Hon. Mr. Grossman: I listened quietly to the members' speeches.

Each physician is going to have to listen and watch carefully with regard to his responsibility as to what is or what is not professional misconduct under the Health Disciplines Act and the regulations thereto.

I must say the proposition that surrounds this House, and the problem that has been talked about here vaguely in passing, is the problem of back-to-work legislation. We all know that is a very difficult piece of legislation to draft, though probably not impossible. They are independent professionals, and one has to wonder exactly what effect it will have when one brings in legislation forcing professionals to see people whom apparently, as the proposition would have it, they are unwilling to see or treat.

I would find that to be a very serious situation if we found physicians who were unwilling to treat patients who needed to be treated. As I read the OMA's assurances to date, and the assurances I have heard from various physicians throughout this province, they are going to treat those patients who need to be treated.

Neither do I underestimate, however, the longer-term problem if this goes on, because there are cases, and some have been raised in this House, which present hardship upon people and cases in which that hardship, in my opinion, will warrant consideration by the College of Physicians and Surgeons. I intend for those cases to be drawn to the attention of the college and dealt with by the college. If that procedure is not working, then ultimately we will have to look at various other mechanisms that are in place in this province.

When we do that, and as I pointed out it is my obligation to enforce and to oversee in this province, then members opposite, such as the acting leader of the third party, will accuse me of setting brother against brother or doctor against doctor. But, of course, I am not doing that. What I am doing is relying upon the legislative procedures put in place whereby doctors have undertaken a certain responsibility in order to maintain the principle of self- discipline. I believe they will live up to their responsibilities.

As we look over the events of the next few days, we will be monitoring the situation very intensely. It is obviously a temptation to a Minister of Health to bring in back-to-work legislation, however it might be drafted. It is obviously a temptation for me to serve notice on the college with regard to various regulations they might bring in. It is obviously a temptation to me to communicate directly with the members of the OMA, which is what people in this House have accused me of doing, even though I have been very careful not to do that.

The point I am making is that in each and every case there is a great temptation to use a number of mechanisms available to me. Ultimately, however, I read this House as wanting me to achieve a negotiated agreement. There has not been a speaker today who has disagreed with that goal. There have been a lot of people saying, "Oh well, just go and do it," and, "You've let us down because you have not been able to do it."

The point is that to achieve a negotiated agreement requires a great deal of careful consideration, a resistance to use some levers that might be available at one stage, but which one might have to use at another stage. To use any of those prematurely would make it impossible to reach a negotiated settlement. Yet to use them at a point which would be too late would equally be a tragedy.

That is an onerous responsibility which I accepted when I took the oath of office as Minister of Health. I have to discharge that to the best of my ability.

I have responsibilities vested in me which obviously are dependent in large measure on those who work in the health care system, in the hospitals, in the college and in each and every medical office throughout this province. None the less, we are monitoring the situation and we are exercising our responsibilities carefully and with as much consideration as we can.

In closing, it is easy to suggest all sorts of comfortable solutions. Ultimately, I know all members of this House share with me the desire that (a) we can get a negotiated agreement, and (b) that serious wounds not be opened up as a result of this that will hamper the health care system over the years to come. That is what I am trying to accomplish.

Finally, I must say to the House that if we are unable to do this in the next short period, there is no question that we shall have to face up to the reality that wounds have been opened which must be stopped, and certain activities will then have to be considered by us which we have been reluctant to consider because we have been hopeful we can get a negotiated settlement.

That is what this House wants, that is what this government wants and that is what this minister is trying to achieve.

BUSINESS OF THE HOUSE

Hon. Mr. Wells: Mr. Speaker, perhaps I could indicate to the House the order of business for tomorrow.

Since we did not deal with legislation that was on the paper today because of this debate, we shall begin with Bill 38, An Act to establish the Ministry of Industry and Trade, followed by Bill 41 and then, if time permits, committee of the whole House on Bill 6. Then there is the list we announced previously: Bills 9, 12, 13, 15, 28, 14 and 11.

The House adjourned at 5:59 p.m.

26 avril 1982