Journal des débats 1986-janv-24 | Assemblée législative de l'Ontario

Mr. Shymko: On a point of privilege, Mr. Speaker: I rise with your permission to inform the honourable members that this week Canadians of Ukrainian origin throughout our province and in every municipality in Canada will be commemorating the 68th anniversary of the declaration of the independence of the Ukrainian Republic, an event that occurred on January 22, 1918, in Kiev.

We are the only parliament in Canada that, by way of a resolution unanimously passed by this Legislature, recognizes this event and similar events by way of a proclamation of the Premier on behalf of the people of Ontario. This event represents equally not only the hope and struggle of the Ukrainian people for liberty, justice and peace but also the universal strivings of all mankind.

Although the Ukraine was the first victim and Afghanistan the last victim of a similar foreign aggression, I know my colleagues share the hope and faith that some day the Ukrainians will once again enjoy the same freedoms we enjoy in Canada and regain their right to live as a free, sovereign and democratic state.

ORAL QUESTIONS

ONTARIO DRUG BENEFIT PLAN

Mr. Timbrell: I have a question for the Premier. He will be aware that in recent days the Leader of the Opposition (Mr. Grossman) has on several occasions expressed concerns about the effect of the government's opting-out legislation on senior citizens.

He may also be aware that in committee the Minister of Health (Mr. Elston) has indicated an intention to introduce amendments to the Ontario drug benefit plan that will allow individual pharmacists to opt out of the drug benefit program, the effect of which will be that they will not be allowed to collect from the government or the customer for drugs covered under ODB.

Since everyone over 65 is covered by ODB, and since many pharmacies have as much as 40 per cent to 60 per cent of their sales covered by ODB, can the Premier tell the House how he feels such an amendment will be of benefit to pharmacists, to the senior citizens or to the people in this province who are in receipt of income assistance and are covered by the Ontario drug benefit plan?

Hon. Mr. Peterson: I have a little difficulty understanding the honourable member's question. He says his leader is talking about the effect of opting out on senior citizens, and he feels that opting out is good for them with respect to the doctors?

I am sorry; I missed the thrust of his question. Is he asking me how this will serve the seniors? Is he asking me how the new drug legislation will serve the seniors? What exactly is his question?

Mr. Timbrell: To give the Premier more time to think of an answer, the question is how the intention of the Minister of Health to allow pharmacists to opt out of the Ontario drug benefit plan will in any way, shape or form assist the senior citizens of Ontario, those who are in receipt of income assistance or the pharmacists involved.

Hon. Mr. Peterson: Is the member suggesting we should conscript them all and force them in? We are trying to accomplish the purposes laid forth in this House by the minister on numerous occasions. I am sure the member, as a former Minister of Health, is aware of the problems in the drug industry. I am told many Ministers of Health in the former government came in bright-eyed and bushy-tailed, knowing there was a problem with the drug business, but for some reason never acted on it. This minister has, and he has done so with courage.

It is not the intention to try to conscript people against their will. Hundreds of millions of dollars have been wasted over the years. This has been identified by no less a person than the Provincial Auditor. We are trying to solve that with the help of the pharmacists. The minister's approach is a most sensitive one. If the member has a better one, and if it can accomplish the stated purposes, I invite him and his colleagues to bring that approach to the committee. Everyone is wrestling with it, and I assume the member supports the end we are trying to accomplish.

Mr. Speaker: Final supplementary.

Mr. Timbrell: Mr. Speaker, with respect, this is my first supplementary, inasmuch as the Premier asked for time to think of an answer. The Premier either does not know what the minister has said about his intentions with respect to this legislation or he wants more time to think.

Should his amendment proceed, what will happen in a community such as Sydenham, one with which I am familiar and where there is only one pharmacy, if that pharmacy opts out of the Ontario drug benefit plan as the minister says it will have the right to do? What will happen to the senior citizens in Sydenham and the surrounding rural community, those in receipt of income assistance --

Mr. Speaker: Question, please.

Mr. Timbrell: -- who are entitled to receive prescription drugs under the Ontario drug benefit plan?

Hon. Mr. Peterson: They can buy them somewhere else. That is the intent of the legislation. I believe and the minister believes that competitive forces will keep the thing in balance. We do not see a practical problem in that regard. If the member is asking us to conscript them and not let them opt out, I will take his view to the minister.

Mr. D. S. Cooke: This is one of the amendments the government brought in that I do not understand. On the one hand, we are proceeding with legislation to end opting out or extra billing by doctors. On the other hand, the government has caved in to pressure from the Ontario Pharmacists' Association and has brought in an amendment to allow pharmacists to opt out of the Ontario drug benefit plan, as the Tories encouraged the government to do during second reading.

Will the Premier reconsider the government's position on the amendment it has presented and withdraw the amendment, understanding that in single-pharmacy communities there is a risk that seniors and people covered by the ODB will lose access to pharmacists?

Hon. Mr. Peterson: The assessment of the government, subject to more discussion, is that this risk is either minimal or nonexistent because such a high percentage of the business is dependent on that sector. In our view, it is a theoretical risk more than a practical one. I appreciate the point the member makes, but we do not see the similarity the member may see between the pharmacists' situation and the doctors opting out.

They are independent business people and we want to let them operate in that context to the extent we can. When they are dealing with government and a substantial amount of service is directly paid for by government, we have certain responsibilities to make sure the taxpayers' money is wisely stewarded. That is how we are trying to reconcile these things.

10:10 a.m.

Mr. Timbrell: Whether it be with respect to the relations between the government and the medical community, and now the relations between the government and the pharmacists and the pharmaceutical community, or whether it be with respect to all the other professions, what we have is a minister, who along with so many others is apparently in Windsor today, who in the past six months has thrown Ontario's health care system into chaos.

Will the Premier ensure, whether it be through the allocation of funds or through direction from his office, that we stop the confrontation politics, put the health care system back on the rails where it belongs with the priority it deserves and stop putting in place policies that are quite inconsistent, as the member for Windsor-Riverside (Mr. D. S. Cooke) has outlined, and give the people of Ontario the certainty they deserve?

Hon. Mr. Peterson: With great respect to my honourable colleague, I would ask him to probe his own conscience on this matter. He knows very well that a problem existed with the pharmacists. If he does not think there was a problem, he and his colleagues should stand up in this House and say: "It is no problem. We should not be doing anything about it." However, the member knows and I know how this system works.

Mr. Andrewes: We have not said that at all.

Hon. Mr. Peterson: I am saying the member knows there is a problem, but he and many other ministers failed to deal with it because, frankly, they did not have the guts, or they got the run around in addressing the Premier's office.

I know these things are hard. We are not interested in confrontation, but we have a great respect for taxpayers' dollars. We also have a great respect for the people who provide those services and who want to do so in a way that brings harmony into the system. However, if harmony is just selling out to certain private interests, that is not my view of harmony.

We all have a responsibility: the professionals, the private sector and the government. We are showing leadership, something those guys over there never showed in this matter.

Mr. Timbrell: In six months the government has taken one of the best health care systems in the world and turned it upside down into chaos.

HOSPITAL FUNDING

Mr. Timbrell: My second question is to the Treasurer. Random calls made by our staff to various hospitals in different parts of the province, such as St. Catharines General Hospital, Sudbury General Hospital, St. Thomas Elgin General Hospital, Ottawa Civic Hospital, Oshawa General Hospital and Cambridge Memorial Hospital, just to name a few, show that in recent months the problems of overcrowding in emergency departments and shortages of various types of beds have become more and more acute. It is a province-wide problem and it is another aspect of the disarray that has been allowed to set in in the last six months since the member for Huron-Bruce (Mr. Elston) has taken over responsibility for the ministry.

Will the Treasurer assure us that he is going to give the minister sufficient allocations of funds to address the problems of hospital budgets and to add to the hospital and health care system sufficient numbers of chronic care and nursing home beds to relieve these shortages?

Hon. Mr. Nixon: I am sure the House does not find it credible that any problems in accommodation in the hospital services of the province have arisen simply since the accession of this government. That is not so. As a matter of fact, the transfers of dollars to hospitals through the Ministry of Health were increased by an average of more than eight per cent this year, which is a level of transfer for which we do not offer apologies.

We do wish it could be more, but in the allocation of our reserves the basic transfer was based on the spending estimates we inherited from the previous government. To that we have added additional funds, which you would be aware of, Mr. Speaker, since they have been debated in this House on a number of occasions.

I wish I could say that the resources of the province were sufficient so that the transfers in the upcoming fiscal year would be such that all these problems would disappear. When we look at recent reports indicating the need for the renewal of cancer treatment facilities, which have been allowed to decline from their former excellent levels to where they are a matter of concern for everybody in the House and in the province, we know that some special efforts will have to be undertaken, particularly to upgrade those levels of treatment. This does not mean other insufficiencies can be disregarded in any way.

All I can say in response to the former minister's question is that he would know, having had similar responsibilities in the past, that these problems are not new. The transfers this year were larger than they have been in the past and all of us in this House, certainly the Treasurer and the Minister of Health, recognize the tremendous pressures on us in the coming fiscal years.

Mr. Timbrell: I know that in my time as minister, in every part of the province new hospitals, additions and alterations, including the Willett Hospital in the Treasurer's own riding, as well as the addition of beds, were approved by this former minister.

The Treasurer will no doubt be in Windsor tonight and during the weekend. While he is there will he take the opportunity of his presence in the great city of Windsor to honour the commitment the Minister of Labour (Mr. Wrye) made months ago when he said the soil would be turned in September for the new chronic care facility in that city? Will he announce today or tomorrow the funds to give effect to that commitment?

Hon. Mr. Nixon: In the instance to which the member refers, I understand that a design-build study is being reviewed right now. I am informed by my friend and colleague the member for St. Catharines (Mr. Bradley) that money has already been allocated for the expansion of the St. Catharines General Hospital emergency ward. It should have been allocated previously.

The member has the temerity to refer to the famous Willett Hospital in Paris. He is the person who reversed the decision of his former Premier, the member for Muskoka (Mr. F. S. Miller), who was going to close the hospital.

The continuing problems there are not a problem of funding but a problem that is far removed from that. I have already indicated specifically the St. Catharines situation, the Willett situation and the Windsor situation.

Mr. Timbrell: Is the Treasurer going to announce it this weekend?

Hon. Mr. Nixon: No, we are not.

On a point of order, Mr. Speaker: The honourable member is intruding by interjection the question, "Is the Treasurer going to announce it this weekend?" The government of this province does not try to take political advantage --

Mr. Speaker: Order. That is a point of view.

Mr. D. S. Cooke: I find it passing strange that the member for Don Mills (Mr. Timbrell) would raise the matter of the Windsor chronic care hospital. When he was the minister, along with the member for Muskoka he tried to close Riverview Hospital in Windsor.

My supplementary question deals not only with the Windsor situation but also with the problem right across this province. Earlier this week my leader visited three hospitals where emergency rooms were jammed. The fact is that there is a crisis. Whoever caused it does not matter. Patients still suffer.

When is the government going to put some of these facilities, such as the Windsor chronic care hospital, on stream and, equally important, the home care program for the frail elderly that has been promised for years and would alleviate some of the crowding problems?

Hon. Mr. Nixon: The honourable member will know that the budget had an $11-million additional fund for assistance for elderly citizens of the province. That money has been allocated and is being allocated at the present time for use during this fiscal year and next fiscal year.

However, to return to the situation of hospital facilities, every one of us, from our experiences in our own constituencies, knows this is a matter that has been and still is of continuing concern. We have increased the allocations of funding and I have already referred specifically to some very special matters that will have to be given special consideration by me as Treasurer and by all my colleagues in the government.

Mr. Rowe: During the past year the Royal Victoria Hospital in Barrie has operated well beyond capacity. Records show that four to five patients a day are lying in the emergency ward waiting for hospital beds. Last Wednesday 17 patients lay in emergency and some 200 more were treated for various ailments. How much longer does the Treasurer intend to let this game of health care roulette continue?

Hon. Mr. Nixon: I can assure the honourable member that we are moving towards the solutions more rapidly than honourable members who were Ministers of Health in the previous government undertook such a movement.

I have already referred to the increase in the amount of the transfers of these dollars. We hope we will be able to do something for the specific instance to which the member referred. I personally will refer it to the Minister of Health. I am sure he is already aware of it.

10:20 a.m.

FACULTY OF ARCHITECTURE AND LANDSCAPE ARCHITECTURE

Mr. Rae: My first question is to the Treasurer. It concerns the announcement yesterday by the president of the University of Toronto that the university plans to close its faculty of architecture. The Treasurer will be aware of the outrage that has been expressed in the architectural community by this decision. The University of Toronto is the only university in Ontario that has a graduate faculty of architecture. It is one of three universities today in the province that has a faculty of architecture. Montreal has two.

What steps does the Treasurer, as the person responsible for the funding of our universities, intend to take to ensure that the University of Toronto and the city of Toronto continue to have a world-class architectural faculty right here in this city?

Hon. Mr. Nixon: It would be extremely unfortunate if the school of architecture were allowed to close. When we left here at the end of the session last night, the students were undertaking a demonstration in front of this building and setting up their obelisk. I saw it on the news. This morning when I came in, I had a chance to talk to the students, but so far I have not talked to anyone at the university in this connection. The Minister of Colleges and Universities (Mr. Sorbara) may be able to give more specific information.

I am sure the leader of the third party is aware of the matters referred to in newspaper reports of continuing turmoil, which is the word the newspaper report used, in the administration of the faculty of architecture, the dissatisfaction in the architectural community and of the students themselves, who have refused to participate in certain of the educational initiatives, saying they were not up to the standards they required. This is not a new situation. The president of the university indicated that underfunding for the last decade has contributed to the problem he has now brought to the public.

The closure is a recommendation. As far as I am concerned, I hope the government can do something useful to persuade the administration of the university to maintain this excellent faculty, that has had such an excellent reputation. We are not promising additional dollars, but we do recognize that this is a recommendation from the president and not a fiat.

Mr. Rae: No, the world of fiat is one exclusively occupied by the Treasurer when it comes to education.

With respect to this recommendation by the president, I hope the Treasurer is aware that Dr. Connell pointed specifically to the question of underfunding as being at the very core of the decision. He said very clearly if funding were available, this decision would not have been made. What steps does the minister intend to take as Treasurer of the province to ensure not only the survival but also the flourishing of centres, such as the faculty of architecture, which are crucial to the future of Ontario?

Hon. Mr. Nixon: Every member of the House knows the universities are autonomous. They make their administrative decisions and we provide the funds we can. The honourable member will know from the last question directed to me that pressures to provide facilities for hospitals are equally important, direct and aggressive. These decisions have to be made in a balanced way. Our decision is not to close the school of architecture, but I reiterate that the president has indicated that lack of funding or inadequate funding over a decade has contributed to this problem.

I hope we will be able to provide assistance, at least as good as last year, when an educational excellence fund transferred an additional $60 million to $80 million to the universities above and beyond what was in the spending estimates we inherited. Specifically for the University of Toronto, there was an additional $9 million for administration and improvement of its facilities. The president and his board make the allocations of those dollars. Just as in hospital services, we wish there was more.

Mr. McFadden: The Treasurer intervened directly with regard to the future of the Ontario Institute for Studies in Education. Since his announcement in the budget, he has sent letters and communicated directly about the future of OISE in a very personal way. Will the Treasurer now undertake to this House to intervene in the way he has done with the transfer of OISE to help to maintain the faculty of architecture, or at least to try to resolve the current impasse on financing with the University of Toronto?

Hon. Mr. Nixon: I and any member of the government would be glad to hear from the administration of the university. They have not communicated with the Treasurer on this. The member refers to my letters with regard to OISE. They were answers to communications that had come from the university and a few others.

Mr. Rae: Because of the nature of this decision, does the Treasurer now better understand the concerns of an institution such as OISE, especially about being subjected to the budgetary decisions of the University of Toronto? Can the Treasurer assure OISE its fate within the University of Toronto would be any different than that of the faculty of architecture has been?

Hon. Mr. Nixon: I can repeat the assurances I have made repeatedly in the past that the funding for research in education will not be decreased.

Mr. Rae: The universities will be autonomous; the Treasurer himself said it.

TASK FORCES

Mr. Rae: I have a skill-testing question for the Premier. In which of the following areas has the government of Ontario not established a task force or special inquiry: midwifery, overtime, equal pay in the private sector, the Nursing Homes Act, a French-language school board in Ottawa-Carleton, mandatory retirement, gas prices in northern Ontario, government in Metropolitan Toronto, the insurance industry crisis, single-industry towns in northern Ontario and senior citizens?

Hon. Mr. Peterson: I am not sure I grasped it all. I will not ask the honourable member to repeat the list, but it is a very effective way to go.

Does the member know what we will do? We will just perhaps rip up the accord and not look into these matters any more.

Hon. Mr. Nixon: How is that for a threat?

Mr. Rowe: Better get your slippers on for that one.

Hon. Mr. Bradley: Let us call in a counsellor. I think we need a marriage counsellor.

Mr. Breaugh: They will pay for this.

Mr. Speaker: Order.

Mr. Rae: The Premier will appreciate, in the smugness which has enveloped him, and no doubt will for a few more days, that the people of Ontario have expected action. They have voted for action in a number of areas. What they are getting in a number of them is not action but task forces. It used to be said we had government by polls; now we have government by task forces. Does the Premier not recognize there is an increasing impression that his government is more interested in studying things than in actually doing anything about them?

Hon. Mr. Peterson: We have not established task forces on extra billing, drug prices, acid rain abatement or many of the things we have done. It is interesting that the member accuses me of that. I get accused regularly of doing too much, that we are operating on too many legislative fronts at the present time. It is at such a dizzying pace that it is very difficult for the members of the official opposition to keep up with us.

We have registered our concerns about these things and we are approaching them in the most thoughtful way. The third party may think it has all the answers to all of these problems. That is a prerogative of the socialist mentality perhaps, but we consult. We believe in including everyone in our deliberations.

Interjections.

Hon. Mr. Peterson: Do the members want me to go on? Charged with the responsibility of governing as we are, we include all the people because we speak for all of the people of this province, not just selected interest groups.

10:30 a.m.

Mr. Rae: Since rationalization, consolidation and all those things are very much the name of the game, does the Premier not agree that perhaps a better way to proceed with respect to these task forces would be to establish a royal commission with the following title: Mandatory Retirement, Working Hours, Equal Pay and Insurance Needs of Midwives, Senior Citizens and Nursing Home Residents Involved in French-Language School Boards, the Governance of Metropolitan Toronto and Single-Industry Towns in Northern Ontario and Who Drive to Work in the North Commission?

Hon. Mr. Peterson: That is a most constructive suggestion and I appreciate it. We will establish a task force to figure out whether we should have that royal commission. If the rumours are true that the honourable member is looking for a new job, we will consider him to head that royal commission.

GASOLINE PRICES

Mr. Jackson: I have a question for the Premier. Will he please explain the cause of the apparent confusion in the minds of consumers when they see the price of crude oil fall and the price of gasoline at the pumps rise? Can the Premier tell us why that is happening?

Hon. Mr. Peterson: That is a legitimate question. I understand certain members in Ottawa have been asking those very same questions of the minister responsible and I gather she has not been responding. Knowing how close the member is to the federal minister who is responsible for these matters, I hope he will use his good offices and the high esteem in which he is held by the federal Conservatives to try to get those answers, because no one else has been able to get them.

Mr. Jackson: It is hard to believe the Premier does not have an opinion about price adjustments or pending price adjustments. After suggesting some adjustments may occur, what will his position be on this matter now that he is the Premier? Will he support the position of the royal commission report of 1976 that says the oil industry is competitive and consumers are well served, or will he support his old position, the position held by the member for St. Catharines (Mr. Bradley) who in January 1985 suggested more direct intervention in the marketplace? What is the Premier's position this year and will he speak for the consumers?

Hon. Mr. Peterson: I think we have been speaking for the consumers. From the consumers' point of view, we are delighted to see prices falling as the consumers should be able to take advantage of that. What the member has to do is ask his good friend Pat Carney why this is not being translated to the consumers of this province. That is the question. I also think the member will want to ask the former Ministers of Consumer and Commercial Relations, whose responsibility it was. They will tell him clearly that he is asking his questions in the wrong House.

Mr. Swart: The province does have authority over consumer prices, as the Premier well knows. Even the former government intervened when there was an increase in oil prices to hold down the retail price for a period of time, until the gasoline in stock was used up. Can he not use the power he has over consumer prices to do an investigation and force consumer prices down when the gasoline they have in storage is used up, instead of waiting for the federal government?

Hon. Mr. Peterson: The dilemma I have is that I was assailed by the member's leader a minute ago for having too many task forces. Now he wants a task force to look into the price of energy. One cannot win. I wish those members would get their act together. From the government's point of view, we have done a great deal. He knows the leadership we took in removing and lowering proposed taxes on gasoline to benefit consumers in this province.

RADIOACTIVE LEAK

Mr. Charlton: I have a question for the Premier. He is no doubt aware that one of the spent fuel storage pools at Douglas Point is leaking about 500 gallons of radioactive water a day. Does the Premier understand the significance of this discovery? Can he tell the House what approach the government is going to take to deal with this problem?

Hon. Mr. Peterson: I am aware of what the honourable member is saying. I understand there was a full report from Ontario Hydro on this matter. I may be deficient in some of the details I am telling the member because I am going by memory. I understand they have checked into it. There is no noticeable or radioactive material in the leak and there is no threat to human health or the environment. It has been going on for some time -- I am not sure how long -- and it is under control.

Mr. Charlton: Perhaps the Premier has missed the significance of the discovery.

In the select committee on energy last fall, Hydro took the position these storage pools were virtually impregnable, earthquake-proof and capable of storing that fuel for as long as necessary. Now there is a pool that is only 20 years old that is leaking 500 gallons a day as a result of no extraordinary event at all.

Is the Premier prepared to demand that Hydro do a complete study of all of the storage pools at all its facilities and report to this House on the condition of deterioration of those facilities?

Hon. Mr. Peterson: It is a legitimate point the member is raising in this House today. I can remember many discussions over a very long period about these kinds of things: the question of the storage of spent fuel and the entire question of how we are going to get rid of the nuclear waste. I do not know the answers to those things and I am not sure anyone else does either, but this may be a legitimate area for the select committee on energy to look at.

I think it is one of those things that defies superficial solutions. It is one that probably needs a thorough legislative review. If there can be some discussion at some point in the future, that might be an appropriate agenda item for the committee.

Mr. Jackson: Would the Premier agree to help further the efforts through discussions with the federal government in order to work with Atomic Energy of Canada Ltd. to find a permanent storage facility for these spent fuels?

Hon. Mr. Peterson: Absolutely. Those discussions are ongoing, as the honourable member knows. I do not have anything else to report to him, but as governments, as a generation, as a society, we are all looking for answers to those very tough questions.

YOUNG OFFENDERS

Mr. Speaker: The Minister of Correctional Services has a response to a question previously asked.

Hon. Mr. Keyes: Unfortunately, the member for Algoma (Mr. Wildman) who asked the question is not in the House today, but this is to assure him. In a very detailed review of the statistics surrounding the accusations that were made with regard to a breach of the Young Offenders Act, may I assure this House there was no such breach? The individuals who were kept for varying periods of two, three, four days, etc., were there under court order of a youth court judge under clause 7(3)(b) of the Young Offenders Act.

FACULTY OF ARCHITECTURE AND LANDSCAPE ARCHITECTURE

Mr. McFadden: I have a question for the Minister of Colleges and Universities. I am sure the minister was concerned about the announcement that the faculty of architecture could be slated for closure, as were all members of this House and people in the architectural and university community generally.

Could the minister tell the House what, if any, discussions have taken place to date with officials of the University of Toronto concerning the proposed closure and what, if any, discussions are now proposed to take place in connection with it?

Hon. Mr. Sorbara: I have met with Dr. Connell, the president of the University of Toronto. Two days ago, in the afternoon, Dr. Connell and I met to discuss this issue. He advised me at that time his administration had made a decision to recommend to the governing council that the faculty should be closed.

I was saddened at the news. We discussed the possibility of alternatives, but it was clear President Connell and his administration had set a clear course and it was their intention to make that recommendation.

Mr. Davis: I thought education was a high priority for this government.

Mr. Speaker: Does the member for Scarborough Centre have a supplementary?

10:40 a.m.

Mr. Davis: No.

Mr. McFadden: One area that concerns me is the future of the students now enrolled in that faculty. In the proposal it is suggested there could even be a closure over a four-year period. If the proposed closure goes ahead, is the minister prepared to intervene to ensure that the education of the students now enrolled in the faculty of architecture is in no way impaired by that decision?

Hon. Mr. Sorbara: During my meeting with Dr. Connell, one of my primary concerns, in view of the recommendation he was going to make to his governing council, was the future of the students in the current program. He assured me in no uncertain terms that the proposal he would be bringing to his board of governors would be cast in a framework of ensuring the completion of the education of those students.

Let me point out to the member for Eglinton that this is not a problem. The problems at the faculty of architecture and the University of Toronto are not problems that have arisen overnight. Dr. Connell suggested to me that the difficulties in that faculty have existed for more than three and a half years and that we are experiencing a situation where the administration appears to have no alternative but to make that recommendation to the governing council.

The most important thing to state at this point is that the administration and the governing council will be setting up a full and open hearing process of committees of the governing council to air the issue. No decision has been made. The decision will be made by the governing council and it is appropriate to leave that decision to the council.

Ms. Bryden: Does this not point up very markedly the underfunding of the university system over the past decade and the absolute necessity for reversing that underfunding? Is this a new form of rationalization, as suggested by the Treasurer (Mr. Nixon), resulting from the underfunding? What is the minister doing to increase the funding at both the provincial and federal levels?

Hon. Mr. Sorbara: There is no doubt that underfunding of post-secondary education has a role to play here. Indeed, Dr. Connell said things might have been different if far more resources had been available to the university over the past decade.

That being said, it is important to point out that it is also a programmatic problem. Dr. Connell said to me in no uncertain terms that he was not satisfied, and has not been satisfied for a very long time, with the quality of the program. When we talked about funding and I posed the hypothetical question whether, if additional resources were directed towards the University of Toronto, the university would use those funds to re-establish a faculty of architecture, he could not assure me of that.

Theoretically, I guess the government has the alternative to say that notwithstanding progammatic decisions --

Mr. Speaker: Order.

Mr. Gillies: How about a shorter answer?

Mr. Speaker: Order. I think that is a fairly complete answer.

Mr. Baetz: It is claptrap.

Mr. Speaker: Order.

SPRAY PROGRAM

Mr. Laughren: My question is to the Minister of the Environment concerning the intention of his colleague the Minister of Natural Resources (Mr. Kerrio) to spray our forests in northern Ontario.

I assume the Minister of the Environment knows the budworm egg counts are down dramatically in every district of northern Ontario this year. The booklet being distributed at the open houses states that if valid studies showed it posed a significant threat to the environment, the spraying of any insecticide would be stopped. Finally, since labelling laws in the United States require the following label on fenitrothion, "This product is toxic to fish, birds and other wildlife. Birds and other wildlife in treated areas may be killed. Avoid direct application to lakes, ponds and streams," will the minister require that any spraying that is done in the north be done with Bt, not with chemicals?

Hon. Mr. Bradley: As I have in the past in the House, I can assure the member that the Minister of the Environment will be placing before his colleagues the position of the ministry as it relates to the soundness of any program that might be developed.

The member will be aware that representations have been made to the government from various members of the Legislature about concerns that have arisen in regard to the kill of the forests. The minister has attempted to respond to this, and as Minister of the Environment I will place before members of the government all environmental considerations to ensure that whatever program is selected is environmentally safe and sound.

Mr. Laughren: The open houses were designed to inform and to get feedback from the public. Does the minister think it is fair that the mail-back cards being distributed at the open houses ask the public to vote yes or no to the question, "I support efforts to save our forests from this serious infestation"? That is hardly an intelligent question designed to determine whether people want spraying or what kind of spray should be used. Will the minister put an end to this charade and have a proper environmental assessment of spraying?

Hon. Mr. Bradley: As I indicated in an earlier answer to the member, all environmental considerations will be placed before us. When the member asked this question the other day in the House with a view to making a comment on the specific material that was presented, I indicated to him that I thought there were a lot of people in this province who, using their own initiative, would comment in whatever way they saw fit.

As the Minister of the Environment I invited comments other than a yes-or-no answer, such as letters or petitions to the Minister of Natural Resources and the Minister of the Environment, anything that might have an influence on the ultimate decision that would be made by the government. We welcome that input. We look forward to continuing input on the part of all concerned. I will take into consideration every letter that is received and every personal representation that is made.

Mr. Speaker: Order. That is a fairly complete answer.

Mr. Harris: This is not a new problem. It is the same problem that was gone through last year and the same type of program is being proposed. Last year the solution was to spray with Bt. The results of the program are here in Landmarks, the glossy magazine put out by the Ministry of Natural Resources. It tells of the wonderful success the Bt spraying program had last year.

The minister is not looking at anything new. The ministry is looking at the same information it had last year. I am sorry the Minister of Natural Resources is not here today. He is probably in Windsor. I do not know whether they are spraying there.

Mr. Speaker: Question, please.

Mr. Harris: He has caused so much confusion out there. He said he was going to spray with chemicals and then he said the ministries were looking at it. He said we should do this. Why will the minister not stand up now for the environmentalists? Why will he not stand up for the environment and give us the answer?

Hon. Mr. Bradley: When the member gets up to ask this question I wonder whether he has checked with some colleagues in his caucus who have made representations other than those he is making at present.

The member will recall that the previous government made a decision on this matter that happened to come a few days after the election when that government was attempting to court members of the New Democratic Party. The decision was influenced, at least to a certain extent, by the fact they were attempting to get into a marriage situation with their present partners in the opposition. When they have a complete, united caucus position for a change, they can get up and ask a question of that nature.

10:50 a.m.

SENIOR CITIZENS' UNITS

Mr. Gordon: I have a question for the Chairman of Management Board in the absence of the Minister of Housing (Mr. Curling). Will she assure me that an allocation of funds has been made to construct 220 senior citizens' nonprofit units in Thorncliffe Park in East York, a community in which 16.5 per cent of the population is over 65?

Hon. Ms. Caplan: I am not sure why the honourable member has asked me that question. I would be happy to check it out and get the answer for him.

Mr. Gordon: In view of the pressing need for senior citizens' units in East York, and given the fact that the developer was told by Ministry of Housing staff that approval was pending the 1986 allocation of funds for nonprofit and co-operative housing units, now that this announcement has been made and the Metro Toronto Housing Authority has placed this project on its priority list, will the minister approve the necessary funds immediately? Or is she waiting for a more propitious time, such as the election?

Hon. Ms. Caplan: Now I understand the purpose of and reason for the question. As the member should know, we are currently going through the allocation and estimates process, where the ministries come in and their allocations for the next year are determined before the budget is set for the next fiscal year.

The Ministry of Housing is at this time receiving applications under our assured housing program from many municipalities to let the ministry know what their needs are and how we on this side of the House and in government will be able to respond.

I can assure the member that the Ministry of Housing will be presenting the municipalities with the programs that are available to them and listening intently to all the many needs that were left unmet during the past many years by the members opposite. We will be responding.

SPRAY PROGRAM

Mr. Laughren: I have a question for the Minister of Northern Development and Mines, who knows and cares a great deal about both the forests and the environment of northern Ontario. Would the minister tell us what his position is on spraying? Does he think any chemicals should be sprayed on the forests in northern Ontario?

L'hon. M. Fontaine: Premièrement, la question, je n'ai pas d'affaire à y répondre. Je vais en discuter avec mes collègues. À ce moment-là, je lui donnerai la réponse.

Interjections.

Mr. Speaker: Order.

Mr. Harris: Mr. Speaker, on a point of order: The minister was asked a question. He must either answer the question or refer it. It is his prerogative. We do not agree with it; we think he should have a position. However, he referred it to the Minister of the Environment (Mr. Bradley).

Is the Minister of the Environment going to answer the question on behalf of the Minister of Northern Development and Mines?

Hon. Mr. Bradley: If the question is referred to me, I can indicate once again that all environmental considerations will be given to this decision. The member would know -- he has been in this Legislature longer than I and is more experienced than I in the legislative proceedings of this House -- that this is a decision of the full cabinet. In other words, all the information is brought together, the ministers put forward their ideas and the cabinet ultimately makes a decision on the program that will be followed.

That is precisely what will be done. The opinions of all members of the House will be taken into consideration, including those in the Progressive Conservative caucus who have indicated their support and those who have not indicated their support. We want the widest degree of consultation on this question.

Mr. Speaker: Order. This is becoming somewhat repetitious. Supplementary, the member for Nickel Belt.

Mr. Laughren: The reason I asked the Minister of Northern Development and Mines (Mr. Fontaine) --

Mr. Speaker: Supplementary to the Minister of the Environment.

Mr. Laughren: Mr. Speaker, I really do not want another smart-aleck response.

Mr. Speaker: The purpose of this is question period and I asked for a supplementary.

Mr. Laughren: I would like to put my supplementary to the Minister of Northern Development and Mines rather than to the Minister of the Environment. Is that appropriate?

Mr. McClellan: That is who he asked in the first place.

Mr. Speaker: I appreciate that. The question was referred to the Minister of the Environment and the minister responded. The supplementary is supposed to flow from the response. Therefore, according to the tradition of this House, I suggest the member place his supplementary to the Minister of the Environment.

Mr. Laughren: Mr. Speaker, I will accept your direction.

Why does the Minister of the Environment not have the courage to put before this assembly his position as to why he is going to allow the Minister of Natural Resources (Mr. Kerrio) to spray one litre of chemical spray on the forests of northern Ontario?

Hon. Mr. Bradley: As I indicated to the member previously, that decision has not been made. We are going through a consultation process. The Minister of Natural Resources has set up what he refers to as open houses around Ontario, specifically in the northern and eastern parts of the province where the problem has been most clearly identified. He has put forward a proposal to which I am sure there will be a clear response by those who are in favour of that proposal and by those who are against it.

Ultimately, the decision must be made by the entire cabinet, and the input of all members of the cabinet will be forthcoming then. In the tradition of cabinet solidarity about items discussed in cabinet, it will be a full decision of the government. We will all express our views in caucus and in cabinet and a decision will be announced.

Mr. Gordon: Is the minister aware that people in the north view this approach to the problem as being very negative and against people in the north? The minister will go to any lengths and will spend millions of dollars sucking up a blob of chemicals off the bottom of the St. Clair River, while at the same time he is preparing to dump chemicals on the people who live in the north and on the wildlife. Will the minister give us an answer? Is he going to stand up for the environment?

Hon. Mr. Bradley: I am not quite sure what the question was or how it relates to the other one. The member knows if any program were instituted in the north that had the effect of spraying any product the government finally decided on, that would be a significant expenditure in northern Ontario.

Mr. Gordon: I am not talking about money; I am talking about people's health.

Hon. Mr. Bradley: He was. The member said the government was prepared to spend a considerable amount of money in the St. Clair River but not in northern Ontario. I am suggesting the government will spend in northern Ontario as well.

11 a.m.

I wish the member for Sudbury would consult some of his colleagues in the Progressive Conservative caucus who have expressed a different point of view from the one he is expressing. This government has not made the decision he suggests it has made. When we make the decision, he will find it is environmentally sound. Now if the member was listening, he will have heard the answer.

MASSEY-FERGUSON

Mr. Gillies: My question is for the Treasurer in regard to the Massey-Ferguson company. In his statement of December 17 about the restructuring of this company, the Treasurer mentioned job guarantees as being part of the new agreement. In view of the fact that the company has now announced that most of the workers who were due to be recalled in January or February will not be back to work unt11 June at the earliest, what assurances can the Treasurer give the House that we can have any realistic expectation that these job guarantees will be met?

Hon. Mr. Nixon: There was some concern that the layoff that began before Christmas might even occupy a full 12 months until the reorganization of the company had taken effect. The honourable member is aware that the reorganization is designed to collect the various parts of the Massey combine organization from a number of geographic points, the United States actually, apart from Toronto, and centralize it in Brantford. The guarantee is for a specific number of jobs with the company operating with its combine capacity almost exclusively.

As for the guarantee, the layoff had already occurred, and it was no part of the guarantee that the layoff would end by a specific period of time. As far as we are concerned, the jobs still exist and there is a consideration that the numbers will increase. We hope the people will be called back to employment in the spring, and I am confident that will happen.

Mr. Gillies: I am sure the Treasurer shares my overriding concern that these workers get back to work. What tangible steps is the Ministry of Industry, Trade and Technology taking to assist this company to diversify its product line, to see that the workers get back to work and to ensure public investment in this company?

Hon. Mr. Nixon: The member will know that our predecessor government and the previous government of Canada had invested something like $200 million in Massey-Ferguson. What we want to have happen is a resumption of prosperity in the farm economy, so the farmers with some profit or some prospect of profit will be able to go out and buy some of the excellent machines manufactured in Brantford by Massey-Ferguson.

Unfortunately, the projections for the farm economy remain somewhat less than enthusiastically high, in spite of the excellent programs that have been brought forward by my colleague the Minister of Agriculture and Food (Mr. Riddell). We are disappointed in the prices of the agricultural products on the world market and we are hoping there will be improvements, but --

Interjections.

Hon. Mr. Nixon: The hell with it.

Mr. Stevenson: Compare them with Alberta and Saskatchewan. The farmers of Ontario have fallen further behind in the last six months than in any other six months in the history of Ontario.

Mr. Speaker: Order. New question quickly, the member for Hamilton East.

HAMILTON HARBOUR POLICE

Mr. Mackenzie: With 11 seconds left, it will have to be quick, Mr. Speaker.

I would like to ask the Solicitor General whether he is aware that the employees of the Hamilton Harbour Police have now been informed in their meetings with the Hamilton Police Commission that the best they can expect is part-time civilian employment, which means no benefits, nothing. What are they going to do with the nine to 23 years' seniority and service they have put in and their training at the police college? Is the Solicitor General prepared to intervene in that situation or is he prepared to sit down with the harbour police?

Hon. Mr. Keyes: I am aware of the situation through the media and I have referred it to my staff. We will be discussing it internally and may be meeting with the Hamilton-Wentworth Regional Police later.

SUPPLEMENTARY QUESTION

Mr. Harris: On a point of order, Mr. Speaker: I ask you to reconsider what I thought was a very hard and fast decision on your part with regard to the member for Nickel Belt (Mr. Laughren). He asked a question originally of the Minister of Northern Development and Mines. That question was referred to another minister for an answer, which is entirely in order.

You have stated that your ruling is that the supplementary must flow from the answer. If that is so, the answer could very easily give rise to the question going back to the original minister. I ask you to consider that it may in fact beg that the question go back to the minister of whom it was originally asked.

If the criterion is that it flows from the answer, surely that is not reason enough to say automatically that the supplementary has to go back to the same minister.

Mr. McClellan: Mr. Speaker, I agree completely with my colleague the member for Nipissing. I would ask you to reconsider the ruling.

In fact, there were two answers to the question. The question was directed to the Minister of Northern Development and Mines, who stood in his place and answered. His answer was that he was unwilling to respond and he redirected it to his colleague. It seems to me that my colleague the member for Nickel Belt then had the choice of directing his supplementary to whichever he wished of the two ministers who had answered the question.

On reflection, I believe you should think about the ruling again, because it is most unfair for members who ask questions of ministers to be unable to pursue their line of questioning with the minister they wish to question.

Mr. Speaker: I appreciate the members' comments. I will certainly look at that particular case. However, I still feel very firmly that it has been the tradition of this House, according to the standing orders, that if a question is referred to another minister and if the question must flow out of the response, it can be directed only to the minister who made the response.

Mr. Rae: Mr. Speaker, if I may complete the point in response to what you have just said, the point my House leader made was that there was not simply a referral. In the first instance there was a refusal to answer the question, the minister saying he would prefer not to answer it; then he chose to refer it. The fact that he chose not to answer the question could in itself be the subject of a supplementary question.

Mr. Speaker: I said when I started that I would look at that particular case. I may have been incorrect in that, so I will take a look at it. However, generally the tradition is as I have stated.

SESSIONAL BELLS

Mr. Andrewes: On a point of order, Mr. Speaker: Some months ago a number of members were asked by the assembly to take up residence in the Whitney Block. After that move, Bell Canada installed sessional bells in these members' offices, but since that date those bells have not worked.

On behalf of those of my colleagues who are now resident in the Whitney Block, would you instruct someone to remedy that situation?

Mr. Speaker: I did hear that this situation was happening and I understood that some action was being taken last Wednesday. Some of you may have been in the halls later on Wednesday and heard the bells ring for quite some time. However, I will make certain that the right authority hears of that request.

ORDERS OF THE DAY

ELECTORAL DISTRICTS REDISTRIBUTION

Hon. Mr. Nixon moved, seconded by Hon. Mr. Scott, resolution 17:

That the order of the House of Thursday, June 16, 1983, as amended on Friday, November 30, 1984, and Friday, July 5, 1985, authorizing and prescribing the terms of reference of the Commission to Redistribute the Ontario Electoral Districts be amended by striking out the word "30" in the 10th line of the 10th paragraph thereof and substituting "60" therefor, so that the paragraph will read as follows:

"That, if within the first eight sitting days of the 1985 session of the Legislative Assembly, an objection in writing signed by not less than 10 members of the assembly, in the form of a motion for consideration by the assembly, is filed with the Clerk of the House, specifying the provisions of the report objected to and the reasons for the objection, the assembly shall, within the next 15 sitting days, or such additional number of days as the assembly may order, take up the motion and consider the matter of the objection; and thereafter, the report shall be referred back to the commission by the Speaker, together with a copy of the objection and of the debates of the assembly with respect thereto for consideration by the commission, having regard to the objection; within 60 days after the day the report of the commission is referred back to it, the commission shall consider the matter of the objection and shall dispose of such objection and forthwith upon the disposition thereof a certified copy of the report of the commission, with or without amendment, shall be returned by the commission to the Speaker."

Motion agreed to.

11:10 a.m.

HEALTH CARE ACCESSIBILITY ACT (CONTINUED)

Resuming the adjourned debate on the motion for second reading of Bill 94, An Act regulating the Amounts that Persons may charge for rendering Services that are Insured Services under the Health Insurance Act.

Mrs. Marland: At the adjournment last night I was about to quote from the newspaper an article about an incident in North Bay. That was in answer to the question I had asked rhetorically, had a patient ever died from extra billing? However, from this quotation in the newspaper, a patient has tragically died very recently in this province as a result of a lack of funding in the necessary areas of health care.

The case I am referring to is the case of Denise Meyer of North Bay. Tragically, she died after the introduction of an injection for the purpose of having an X-ray procedure done. This dye was injected into her hand on October 29, 1985. The purpose of the dye is so that for diagnostic purposes a radiological interpretation can be made. The drug that was injected was named Hypaque M-60 and was made by Sterling Drug Ltd. of Aurora. It is known that this drug has a higher incidence of reaction in patients, but it is less expensive than the one made by another drug company.

Two doctors testified at this inquest, including -- I emphasize this -- the vice-president of Sterling Drug Ltd. which manufactures this drug, Hypaque M-60. They said they would not want to be injected with Hypaque if the more expensive drug were available. I met yesterday with the president of a leading pharmaceutical manufacturing company in Canada who was familiar with Hypaque as long ago as 30 years, and even at that time there was this risk.

I can understand measuring the risk of an injection of any material whether it is for diagnostic purposes or for clinical purposes with respect to a cure or remedial relief for a patient. I can understand the risk of whether one does it or whether the alternative is that one avoids the risk by not doing it, and in this case not have the advantage of a diagnosis done through the radiological procedure.

What I find distressing is that in this case, there is another product available. The other drug is iodine-free, which makes it significantly safer. However, the other drug, Omnipaque, is about 15 times as expensive. With the tremendous restrictions on hospital budgets today, it is not possible for every hospital within a budget restraint to afford the more expensive drug. Even within my own municipality of Mississauga, one hospital uses Hypaque M-60 and the other uses Omnipaque.

If we are talking about access to health care in this province, which is the name of the bill before us today, we should be talking about what health care is all about. Surely there is an obligation on all of us to ensure that under the title of health care we can guarantee as far as possible the safety of our patients in this province. If a product is safer and 15 times more expensive, let us be sure we use the safer product. What is really expensive with respect to life? I suggest not one of us in this Legislature would not be willing to buy his life at a price, be it 15 times more expensive or 100 times more expensive.

We heard the other day from a New Democratic Party member, the member for Scarborough-Ellesmere (Mr. Wamer). We heard the sad story about his grandfather. He told us that in the front of the family Bible at home, he keeps a crumpled piece of paper, which is the bill of sale for his grandfather's property that was sold in the late 1930s to pay the health care bills for his grandmother.

I am sympathetic to that forced sale. I also recognize that in the late 1930s there were a great number of forced sales for other reasons, as that was the Depression period. However, I am very sympathetic that the forced sale to which the member referred was because of the horrendous health care bills his grandfather had to pay for his grandmother.

I think it should be well noted that this happened during the period of the Liberal government's reign in Ontario. It was not until the Progressive Conservative government came in that health care insurance programs became available.

I have mentioned the NDP's turn towards the Liberal government. I wonder what it is thinking today about its members in the United Steelworkers union in Timmins who have publicly stated they are sympathetic to their Timmins doctors. Also, a national representative of the Canadian Union of Public Employees has spoken out in support of Timmins.

It may well be that these union members are better informed than the NDP legislators in this parliament and that these bright union people can see the far-reaching effects of legislation that mandates that every physician in Ontario must be paid the same.

One item about Bill 94, the Health Care Accessibility Act, which prohibits extra billing by physicians, dentists and optometrists, really interests me. While the Liberal-NDP accord believes in socialistic state control with all these professionals being paid the same regardless of the individual professional's responsibility, skill, training, expertise and experience, these same elected members of the New Democratic Party and the Liberal government believe politicians should be paid remuneration that varies with responsibility.

11:20 a.m.

For example, the salary of the Premier (Mr. Peterson) is different from a back-bencher's salary, as is that of a cabinet minister, a parliamentary assistant and even a lowly committee chairman. All these people are paid different salaries. I find that to be the greatest demonstration of a double standard. Perhaps the Liberal government and the NDP members can explain to me the differences among individual politicians. We are all elected equally; we have no training for the job. Every election is an equalizer; everyone in this Legislature has to be elected in the riding first. When we come to this Legislature, we all readily recognize there is a difference in the responsibilities of the Premier, the cabinet members and the Speaker (Mr. Edighoffer).

We agree these people with these different responsibilities in this Legislature should be paid more. Incidentally, I would like to reinforce it; I agree with this.

However, where is the difference between members of the Legislature, who are paid by the provincial tax base, and physicians, who are paid by the Ontario health insurance plan? How can these MPPs sit here and say every doctor is equal in responsibility, skill, training and expertise when they acknowledge they themselves are not? They are saying the physicians are a different case. They are saying physicians are the same as each other, whereas members of the Legislature are different from each other.

It is worse than that. The doctors in this province are not asking the public to pay their graduated fee schedule as, I might emphasize, the public pays the graduated salary schedule for members of the Legislature. The doctors are simply saying, "Give us the choice to establish our own worth, as do TV repairmen, plumbers, electricians, lawyers, accountants, builders, bricklayers and architects." I could go on with a longer list.

They are saying, "Give the doctors the choice to establish their own worth and then give the patients the final choice as to whether they are worth that fee." The doctors are being paid out of the Ontario health insurance plan. I emphasize again that 88 per cent of our Ontario physicians are working within that plan. It is interesting that this whole debate revolves not around the majority of the 12 per cent who are opted out but, indeed, the 20 per cent of that 12 per cent who extra bill.

We have heard all along about the doctors' choice to opt out and opt in. I defend that wholly, but I also defend the public's right to free choice.

Mr. Callahan: How is the member voting?

Mrs. Marland: Since I have been asked, I will say I am voting against Bill 94 in this Legislature.

While I defend the doctors' right, I also defend the public's right to free choice. That is the very essence of freedom on which this country was built. It is the freedom I mentioned at the beginning of my speech.

While I mention how this country has been built, I would like to refer to the real and rich mosaic we have here because of all the immigrants to Canada. How great it is to read this report from the Sunday Star, December 22, 1985. It is headlined, "Our Multiculturalism Is Not Perfect but It Works." This report has explored Metro's minority communities for their impressions of the areas with which they are satisfied. It covers areas such as education, the police force, rental accommodation, Toronto Transit Commission service, social services, recreation facilities and child care facilities. I will not list the rest at this time, but it also covers the access they have to quality health care or medical care.

It is singularly significant that the multicultural minorities of Metropolitan Toronto, which I understand has now more than two million people, are 90 per cent satisfied with their access to quality health care. This is not a survey done by the Progressive Conservative Party nor a poll by someone we hired, but an independent minority report by what I hope might in some areas still be an independent newspaper. It seems to me the multicultural minorities of this province may understand this whole issue better than do the Liberal government of today and its New Democratic Party supporters.

What is wrong with our present system? I hear it said that Ontario should have this legislation because it is the last province in Canada with freedom of choice for both patients and doctors. That is not actually true but it is what one hears. Everyone else has legislation, so why not Ontario? I will not go into the details of the legislation in all the other provinces, but I would like us to look at some of it.

We are always told about how well the system works in Quebec. If I lived in Quebec, I would have very grave concerns when 300 to 400 doctors a year are leaving the province. Where will the manpower be to look after the needs of the sick people in Ontario in the future?

Let us look at British Columbia. It has an absolutely marvellous system of billing numbers. A doctor cannot practice in British Columbia without being allocated a billing number through which there is geographic control as to where he might practise. Even worse, in BC there is a system of capping certain types of services. When a doctor has done a certain volume of one type of service -- for example, if he specializes in doing annual physicals or chooses to devote a lot of his practice to that -- he receives only 75 per cent of the fee for service beyond that amount of volume.

What does the physician then say to the patient? "Do you prefer to come in at the beginning of the year for a full and thorough medical while I am still being paid a full fee, or would you rather leave it until the end of the year and have a 75 per cent examination for 75 per cent of the fee?"

11:30 a.m.

I could give further examples, but suffice it to say there must be a reason patients come to Ontario from not only Canada but other parts of the North American continent and other countries around the world. The reason patients travel all across Canada to Ontario cannot be that sick people like to travel. It cannot be that service clubs all across this country like to have special fund-raising programs to pay the travel expenses of patients.

Every week we read of a child being flown to Toronto for medical treatment from some remote part of one of our other provinces. The reason for that, I humbly and respectfully suggest, is the kind of medical care that the physicians of this province offer and provide conscientiously and professionally.

In speaking about freedom and particularly about the freedom of patients, since I think the freedom of doctors has been well described, I want to tell members about a family of patients living in Mississauga. This family's name is Macleod. I have here a letter written to the Minister of Health by Mrs. Macleod. As tragic as her family's experience has been, she has given me permission to use this letter.

Mrs. Macleod is the mother of two children who have severe facial deformities. She is also vice-president of a group calling itself About Face, which I understand is the Craniofacial Society. She says in her letter to the Minister of Health:

"I believe it is important that you realize the effects in human terms" of "your proposal to ban extra billing....

"If the proposed legislation banning extra billing is enacted, my children will lose the services of Ontario's -- indeed, Canada's -- only craniofacial surgeon, Dr. Ian Munro. With his superb surgical care, my children and others like them can be helped to lead normal, productive lives. Without it, they face certain terrible social ostracism and are at risk of becoming a drain on our already overburdened social services. While children such as mine undoubtedly represent many health care dollars, it is hardly cost-effective to deny them surgery; institutional and long-term dependence on society are far more expensive alternatives.

"Dr. Munro has stated publicly his intention to leave medicine and/or the province if the extra billing legislation is passed. As disastrous as his departure would be for my family, I wholly support his stand."

Bear in mind, this is from a mother with two children who are beyond description in this House.

"Dr. Munro is a consummate professional, a physician unwilling to compromise his standards of excellence, yet working within the constraints of a system that demand he do just that. Those same standards have brought my children" -- and here I want to emphasize this is a letter written by this mother, because the next words are difficult to read -- "from facially repulsive to near normal."

She goes on to suggest to the Minister of Health: "The problem lies far deeper than a small percentage of physicians who choose to value their services adequately. Because my children are frequent consumers of health care services, I have witnessed first-hand many of the effects that chronic underfunding has caused in our health care system.

"Although Dr. Munro is technically capable of performing certain procedures, he is prevented from doing so due to the lack of necessary equipment, notably a 3-D scanner for preoperative diagnostic imaging. If private fundraising were undertaken to purchase and maintain equipment such as this, the facility where it was installed would risk losing funds from the Ministry of Health the following year. It becomes a no-win situation, with the patient standing to lose the most.

"Even if Dr. Munro chooses to stay in Canada, I may be forced to seek further care for my children at a better-equipped American craniofacial centre if I want to give them the best possible faces."

This case is about survival. When we are discussing a Health Care Accessibility Act, we had better be sure we fully understand what the accessibility issue is.

Perhaps I should talk about the shortage of intensive-care-unit beds at the Hospital for Sick Children where, just before Christmas, the very same day this bill was announced in the House by the Minister of Health, surgery for three young children was cancelled because there were no intensive care unit beds available. Bear in mind that our Hospital for Sick Children in Toronto is world-renowned as a medical institution for children. Tragically, one of those children was in heart failure and the surgeon had no way of knowing whether that baby would live until there was an intensive-care-unit bed available.

11:40 a.m.

It is time we, as responsible legislators in this province, told the public what accessibility is all about. As I said last night, I do not blame the public for being in favour of a bill to ban extra billing because people know only what they read in the media. The public does not know there is only one doctor in Canada to do that surgery unless one is a person such as Mrs. Macleod, who has not one but two children with incredible facial deformities. People do not know what that family is going through.

I did not know that surgery was being cancelled regularly. I am not talking about elective surgery; I am talking about survival surgery. Surgery is being cancelled daily, not only at the Sick Children's hospital but at all hospitals, because of a lack of beds. Is it not more tragic when it is children who have yet to lead their lives?

In speaking about the freedom of patients to choose, we hear all the time about the problems of the poor and how they do not have access to the same medical service as the people who can afford to pay the extra bills.

In the past three months, I have spent a great deal of time with the physicians who are in the opted-out mode of health care in this province and with my own physicians in Mississauga. I have met with the chief of staff of the Mississauga Hospital and with the anaesthetists, the ophthalmologists, the cardiovascular specialists and so forth. I now know at first hand that although they have opted out, they have never refused a patient access to their treatment. If a patient is not able to pay their fees, they have not pursued their collection. In fact, what is really important is that the fee is not even rendered.

We talk about patients saying they cannot afford it. Those professionals in this province do not subject or demean their patients to a means test to prove they cannot afford it. They accept the patients' word that they cannot afford it and the bill is not rendered.

At the other end of the scale, and this is somewhat interesting, in Mississauga we have a specialist in gynaecology and obstetrics, Dr. James Brayley, who in 1983 lost a total of $10,000 from patients. That aspect had never occurred to me. Perhaps it had to the members, but it had not occurred to me. Here is a man who, through his obstetrical practice, is delivering babies, but cheques from OHIP that went to his patients -- in 1983 to the total of $10,000 -- never came to Dr. Brayley. He did not receive $10,000 worth of fees for delivering babies.

I suppose that is one area where a patient might be able to be more callous about getting away from paying. I am not suggesting that happens a great deal. I hope the public in this province does not do that a great deal. However, is it not amazing that one physician could lose $10,000 when he was opted out because he trusted his patients to receive payment from OHIP and then pay his bill?

What they did instead was to receive the payment from OHIP and keep it. Perhaps that was their last baby. Perhaps they had moved away. For any number of reasons, they were not planning to use Dr. Brayley's services for another birth in their family. Not only did they get the baby, but they also got an additional baby bonus. For those reasons, Dr. Brayley opted in.

Mr. Mackenzie: On a point of order, Mr. Speaker: I do not see a quorum in the House.

The Acting Speaker (Mr. Morin) ordered the bells rung.

11:49 a.m.

Mr. Speaker: There is a quorum present.

Mrs. Marland: Before the call for a quorum, I was talking about the risk there has been in the province for physicians who have chosen to opt out. I was giving the example of Dr. Brayley, an obstetrician in Mississauga, who in 1983 lost $10,000 in fees that were not paid back to him by patients who received cheques from OHIP. Although Dr. Brayley is an opted-in physician, he is very much opposed to Bill 94.

In all the speeches I have heard from the Liberal government members and the New Democratic Party members in this Legislature, there is this tremendous concern for the public and the fact that the public does not have access to opted-out physicians. The members continually say the public is concerned and yet they are very hard put to find examples to prove their point.

However, of all the letters and telephone calls I have received from the public, numbering in excess of 47 at this time, I have had one letter in favour of this bill. Prior to the legislation being introduced, in my eight months as a member I had one letter complaining about doctors opting out.

I have a letter here not from a constituent of mine in Mississauga, but from a resident of Aurora who wrote to the Minister of Health (Mr. Elston). She says she is totally opposed to the elimination of extra billing by Ontario physicians and she gives the reasons underlying her position. I take great interest in this letter because it is not written by a physician; it is written by a member of the public whom all the good members of this House are elected to represent. She says in her letter:

"In my opinion, the role of government and, hence, the aim of OHIP should be to subsidize health care costs to provide some assistance, especially to those unable to meet the costs of their health care. Forcing all physicians to opt into OHIP has the effect of creating a wholly state-financed and controlled health care system.

"The proposal to eliminate extra billing thus restricts my freedom of choice. As a consumer of health care services, I should have the freedom to choose for myself whether to opt completely into OHIP or whether to buy extra services. I resent not only my loss of freedom in this matter, but also the apparent paternalistic bias of politicians and government bureaucrats, who assume I am unable to judge the extra billing and decide for myself whether it is worth it.

"The rights and freedoms of physicians are being infringed upon, their right to compete in the market system and their freedom to choose to do so if they wish. The elimination of extra billing, in effect, removes the medical profession from the private market. Why should this profession be treated any differently from other public-service-orientated professions, such as the legal profession or engineering?

"The elimination of the physician's right to extra bill will inevitably result in a further decline in the quality of our health care system. Physicians who now extra bill would be foolish not to take their services elsewhere and those who stay will surely have lost an important incentive to work beyond the rule.

"Finally, the proposal to remove extra billing is no more than simple scapegoating. It is a blatant attempt to shift the responsibility for inefficiencies evident in our health care system from the administrators of the system to the physicians. If it is reform that you are seeking, why not begin with the more real problems created by your ministry's policies and programs governing financing and support of hospital administration and medical research?"

That is a letter from an ordinary resident of this province saying, "Please let me choose." I am standing here today in the Legislature on behalf of this woman and all the thousands, indeed millions, of other people in this province who are saying the same thing.

As a woman, I may choose to save my money and spend it on having my hair done, and women in all income categories in this province pay to have their hair done. I may spend whatever. If it is a whole treatment for my hair, it may be $25, $30, $40 or $50, but it is my choice to do that for my appearance.

Does it not follow that it should equally be my choice to save my money and spend it to go to an opted-out physician who, because he or she is opted out, is able to spend more time with me and give me an hour-long medical examination, rather than to go to an opted-in physician who, because of the regimentation of the system, is paid $35 for a general physical examination, understanding, of course, that the fee for service is commensurate with the time that is required?

I am not criticizing the amount of time the opted-in physician gives. I am defending the amount of time the opted-out physician may wish to give me as a patient and, in turn, the amount of money I may choose to spend.

I know a physician who specializes in women's medical services. This physician has a particularly lengthy presentation to explain to a woman how to diagnose lumps in her breasts.

This whole process takes a lot of time in that physician's office, and I recognize that under the health insurance plan the opted-in physician simply cannot sit down with me as a female patient and spend an hour explaining this to me.

The unfortunate thing about the health care system is that it ends up being a service to help people who are sick, because there is absolutely no time left to spend on preventive medicine. However, if I choose to spend my money to have the kind of medical service an opted-out physician may offer rather than to spend it to get my hair done, that has to be my choice.

The poorer people, whom we are always concerned about and who are said not to have access to these opted-out physicians, do have access to them. We have record upon record of patients who go to opted-out physicians. I am talking about the general practitioner; I am not talking about the specialist.

12 noon

We have records of anaesthetists who have opted out and who do not render the bills. We have records of all kinds of interns, specialists in surgery, internal medicine and so forth, who have opted out and the patient does not receive the bill. I am talking about the initial appointment with the general practitioner who has opted out.

If that patient is not able to pay, is a poor person and a senior citizen, about whom we are all justifiably concerned -- I am proud to say we should be and we are concerned about those people in this province. In fact, the record of this Progressive Conservative government has been well proved because we brought in the Ontario drug benefit plan for those people. We have given them the security of a health insurance plan in the first place.

We are concerned about those people, and I am happy to know, from the research I have done in the last three months, that the medical profession in this province is equally concerned about those people. Doctors are concerned to the degree that the Ontario Medical Association has, as recently as yesterday I understand, said that if there is a concern about senior citizens' billing, the association will police it to ensure that there is no extra billing at all for the senior citizens of this province.

That in itself is rather interesting. I wish the Premier had granted me the honour of being in the House today to listen to my speech. If he were here, I would be able to ask him, as a lawyer, what he did about senior citizens who came into his office for legal services.

I wonder, had he been practising law, whether he would have billed senior citizens the legal aid fee or whether he would have given them any consideration whatsoever. I do not see written anywhere that senior citizens are given special compensation by any profession other than the medical profession. I am proud of our medical profession because it considers patients regardless of their ability to pay. Because of their professional oath, doctors will see all patients. If a patient is unable to pay, they do not extra bill him. Their primary concern is for the patient.

While I am talking about the kinds of physicians we have in this province, I want to tell members about one physician I know in general practice. She has been opted out for about 12 years. Although I know she has not precisely catalogued the time spent, because that is not her intent, I estimate this physician must have spent thousands of hours not only travelling around this province speaking to other physicians but also writing letters and receiving telephone calls. She not only spoke to other physicians but also spoke to the public, to service clubs and organizations. She has tried to get the message across about what opting out really is, whether extra billing is a figment of the imagination or whether it does exist, and when extra billing takes place, who is extra billed.

This physician has done all this for 12 years at great expense to herself professionally. She could have been spending all those hours in her office earning her opted-out fee or she might have been doing another thing that physicians happen to want to do, and that is spend time with her family.

I know of no profession or occupation in this province that takes people away from home and family more than the practice of medicine. When Dr. Joan Charboneau, the person to whom I am referring, chose to take on her crusade about the right of her patients to choose her as an opted-out physician, she did not go on that crusade in the interest of money. If it had been in the interest of money, she would not have been spending the time travelling around this province; she would have been spending the time in her office.

If her concern about her patients, which was her primary concern, had not overruled what opted-out physicians have been accused of, which is wanting to earn money, Dr. Charboneau would have been in her office. She could have been an opted-in physician and she could have chosen, completely legally, to operate a turnstile office. She could have turned the patients in and out like a factory on the fee-for-service system we have today with OHIP. Because this young woman is as dedicated to health care in this province as she is, she has chosen to devote the amount of time she has.

I think the people of Ontario are dedicated to the kind of woman physician that Dr. Joan Charboneau is. I have seen the hundreds of letters she receives. I know some physicians in the past thought that Dr. Joan Charboneau was a bit of a rebel and a renegade, but they have come to realize through knowing and watching her through all these years that she has been doing exactly what we in this Legislature should be doing. In her responsibility as a professional, she has looked at the long-range impact and future for health care in this province.

When on television and in the media we see and read about the other group of professional physicians in this province, we seem to feel they have a great deal of credibility. I have to admit I did not know anything about the Medical Reform Group of Ontario, so I decided I had an obligation to find out something about it before I commented.

12:10 p.m.

I found out that the spokesperson we hear from all the time on the radio, in the newspapers and on television -- I recognize the reason we hear from him is because the media always, and I respect this, have to go out and find the opposing opinion on any matter. That is the media's obligation and responsibility and I respect it. However, I sometimes think that when they find that other opinion, no matter how deep under the bushes they have to go or how far into -- I will not say what I was going to say; I will refrain from saying how far the media sometimes go to find an opposing opinion.

In this case they went to the Medical Reform Group of Ontario spokesperson, Dr. Michael Rachlis, who was interviewed along with Dr. Lionel Reese of London on CBC radio the other night at 7:50. In discussing Bill 94, Dr. Rachlis said his group admits it is a curtailment of the doctors' rights. I became so interested I decided to phone Dr. Rachlis and he said he "agrees with the Ontario Medical Association that extra billing is not the most important issue in health care in Ontario."

I asked him to tell me where access was a problem. Obviously, his group must have some experience or information I do not. In all good conscience, trying to represent the best interests of the people who elected me, I want to know both sides. I want to know whether there is evidence of lack of accessibility to health care, because there is nothing more important than our health. If there is lack of accessibility to health care in Ontario, that is true for my constituents.

When I asked Dr. Rachlis to give me an example or multiple examples, he said he knew of one case in which a doctor refused to see a patient. I suggested if he knew of one there were probably several, but would it not be like any other profession? How could we possibly decide to control every individual? Are there not good and bad Premiers, cabinet ministers, committee chairmen, members -- God knows, elected members -- of a provincial Legislature? If there are good and bad in this world, does it not follow there would be a case, of which Dr. Rachlis knew, in which a doctor refused to see a patient?

The Medical Reform Group of Ontario is given as the authority on the other side, with the credibility to represent the interests of health care in Ontario. I have learned that Dr. Rachlis himself has been in general practice but never on a fee basis. He does not have experience in charging fees.

He told me he had worked from 1976 to 1984 at the South Riverdale Community Health Centre on Pape Avenue, where he was on salary. He is now a graduate student at McMaster in community health medicine. In the medical reform group, Dr. Rachlis tells me there are 110 graduated physicians and most of those are in private family practice. The other members of the group are 35 medical students. Anyone else who wants to join can do so. If one prints a newspaper or wants to get on its mailing list, one may join the Medical Reform Group of Ontario. One does not have to be a physician to be a member.

It actually has 110 physicians, and is it not great that it has 35 students? I hope that when those 35 students graduate from medical school, they will like the practice of medicine that will exist in this province if Bill 94 is passed.

Interestingly, it should be pointed out that those 35 medical students who are in school today had to be in medical school before Bill 94 was introduced, so they had no idea what a horrendous situation might be ahead of them in the health care system.

I asked Dr. Rachlis another question, because I felt that in the interests of fairness I had an obligation to ask it. I had told him exactly who I was and that I was a member of the Progressive Conservative Party. I asked him whether he was a member of the New Democratic Party. His answer was that he did not think he had his card currently, but yes, he had been a member. What I had heard about his political affiliation was confirmed.

I recognize, as I said at the outset, that nothing is so perfect that it cannot be improved. We should always look at improving legislation. We should always improve policies where they can be of benefit to those people who are affected by them.

If there has been a problem of access to physicians, then we should have proof of it. We should have proof of what the Health Care Accessibility Act is trying to address. I wish so much that this Health Care Accessibility Act did address the problem of accessibility in this province.

Those of us who have experienced illness or lost a family member because of illness know it does not matter how many domed stadiums, how many luxuries or how good a life we have in this province today if we cannot live in good health. When we talk about accessibility we should look at the fact that cancer patients wait months for an appointment for a computerized axial tomography scan. We should acknowledge something that another constituent of mine, Carol Slater, has said in her letter to the Minister of Health:

"It is with increasing concern that I realize that yet another one of my rights as a citizen and that of my personally selected doctors is being usurped by government.

"I have studied at great length the issues against extra billing as put forth by government-type thinking and refuse to accept any of them. Those of us who choose to engage the services of any professional have our own specific reasons for doing so, and I highly resent your interference in both my ability to decide and in my doctors' choice to maintain a certain degree of professionalism and responsibility.

12:20 p.m.

"Mr. Elston, I truly value my freedom of choice, my ability to intelligently decide how to spend the income I earn and the personal satisfaction I achieve from being responsible for my own decisions. I personally find your approach to extra billing very insulting and wish to remind you that no matter how sanctified your goals are, the end never justifies the means. Your means are, without doubt, unjustified."

This resident of Mississauga is saying that if she chooses to go to an opted-out physician, it is the same as her choice, as I said earlier, to buy a car, go on a holiday or get her hair done. Whose money is it? It is her money. As she said in this letter, she has worked for her income. The people in this province who seek the services of the opted-out physician do so because it is their choice.

Other people in this province who require the services of an opted-out physician, but are unable to pay, still have the choice of access because that opted-out physician has not, to any evidence we have ever had, billed the patient who could not afford it. While we acknowledge that nothing is perfect, why do we not work to improve it? Why do we not realize the real issue is accessibility?

Why do we not recognize that the debate in this House is not dealing with the real issue. How can it be? With a health care bill in this province which is in the billions of dollars, in which the physicians' portion of the total bill is only five per cent, how can it be that rather than dealing with the real needs for beds, equipment and facilities, this Liberal government is spending the time and the energy of all of us to bring in this legislation? It is not only insulting to a most regal and proud profession, but also insulting to the people who seek the services of that profession and to those of us who, fortunately, may not need those services, but who pay an insurance premium into a health scheme that gives access to every member in the province.

Opted-out patients are not saying to the Liberal government, "We want to go to the opted-out physician and we want you to pay that fee so we can attend one." The patients' choice is to go; it is also their choice to pay and they are happy to do that. I respectfully suggest and I hope the responsible members of this Legislature who are concerned about health care accessibility will not, by passing Bill 94, take away the civil rights of the patients in this province nor of the professionals whose medical advice they seek. I hope, instead, this bill will be withdrawn.

How interesting that the Premier (Mr. Peterson) and the Minister of Health are already saying perhaps they may phase in the implementation of Bill 94 and they may reduce the $10,000 fine as a penalty. Is that not marvellous? They are saying perhaps they will reduce the penalty, the time. Perhaps the Liberal government could consider reducing the insult to physicians and patients, and the gravest insult of all, the risk to the future of health care in Ontario, and retain the right to the best health care possible for every resident of this province under an existing scheme that has been working very fairly and justly.

Mr. Speaker, I thank you for the opportunity to address this Legislature. I shall look forward to Bill 94 being defeated at the time of the vote.

Mr. Laughren: It is with a certain sense of joy that I rise to take part in this debate. This kind of debate is the reason I got into politics in the first place. My constituents sent me down here to vote on this kind of legislation and to vote the way I intend to vote when it comes to a vote.

Mr. Ashe: Only 24 per cent of the population agree with the member.

Mr. Laughren: As a matter of fact, 78 per cent of the population believe there should be no extra billing in Ontario.

Mr. Ashe: Only 24 per cent voted for the socialists.

Mr. Laughren: If the member wants to reduce that to 24 per cent and jiggle the numbers, I cannot stop him, but 78 per cent are in favour of this legislation, not 24 per cent.

I will start out by putting on the record exactly what it is we are debating. I will read from the explanatory notes to Bill 94, the Health Care Accessibility Act:

"The bill provides that physicians, dentists and optometrists who do not bill OHIP directly may not charge more than the OHIP rate for rendering an insured service to an insured person. A person who contravenes this is guilty of an offence and liable on conviction to a fine of not more than $10,000. A judge who finds a person guilty may also order the person to pay back to the insured person any money received in excess of the OHIP rate. As an alternative, the insured person may sue the person for that excess.

"The bill also provides that the Minister of Health may enter into an agreement with associations representing physicians, dentists and optometrists to provide methods of negotiating and determining the amounts payable under OHIP."

It is important that we start out by being clear as to exactly what we are debating and not some of the issues previous members have tried to imply we are debating.

A small dose of history might be appropriate. I was going through some of my own files to determine when this party decided there should be a renewed resolution at our own convention. Back in 1970 we passed a resolution that said, "The New Democratic Party will establish machinery for the determination of fee schedules for physicians and other professional personnel leading to the elimination of unilateral price determination by professional associations and of extra billing of patients."

Miss Stephenson: Including lawyers?

Mr. Laughren: No, we are talking about the health care system here. We are not talking about legal aid, but the former Minister of Health, the member for York Mills (Miss Stephenson), does raise an interesting point when she refers to lawyers.

12:30 p.m.

Miss Stephenson: Mr. Speaker, on a point of personal privilege: I was never the Minister of Health. I was merely the acting Minister of Health.

The Deputy Speaker: That is not a point of privilege.

Mr. Laughren: And a great actress she was.

Miss Stephenson: Better than the member for Nickel Belt.

Mr. Laughren: I concede that.

A couple of members have talked about other professions. I have difficulty seeing the soundness of the argument that one can compare health care with any other profession. We do not stand up and compare health care with the legal profession -- at least not often.

Miss Stephenson: The member has clearly compared it with additional services.

Mr. Laughren: No. There is clearly a difference between the physical health of a person and any other service delivered to people.

Mr. McClellan: One would think the former president of the Ontario Medical Association would know that.

Mr. Laughren: One would think that the Ontario Medical Association's former president -- I hope I am right -- would more stoutly defend the medical profession. It is not appropriate for her to belittle the profession of which she was such a proud member for so many years.

We are proud of our history in the battle for medicare, not only in Ontario but also all across Canada. I do not expect the members of this chamber to heap plaudits upon us for our role in bringing medicare to Canada, and indeed to North America, but history will show and historians will write about the role of this party, regardless of the percentage of the popular vote the polls indicate we hold at any given time.

Some things are more important than polls, and I think the delivery of a decent health care system to people is one of them.

Miss Stephenson: Absolutely. That is why are taking the position we are.

Mr. Laughren: Perhaps the member should tell the members behind her that this is the case.

We have raised in this chamber examples of hardship when it comes to dealing with opting out and extra billing. We have shown clearly that it does deter low- and middle-income people from decent health care. That is the prime reason we feel so strongly about it. Despite the cases of hardship we have brought before this chamber over the years, when the Progressive Conservative Party was in government, as now when it is not, it was never in favour of a ban on extra billing. I must admit there is consistency there, and I commend it for that, although it is a dumb consistency.

On the other hand, I cannot commend the Ontario Liberal Party for its consistency. As late as 1983, the present Premier was calling extra billing a safety valve in the health care system. All I can say is, "Thank God for the accord," because now we are in this chamber debating the very end of extra billing.

However, I issue a word of caution to the Ontario Tories. I am worried that with their federal party in decline they are going to precipitate yet a further decline if they continue to discredit their federal colleagues on medicare. As the members know, it was the federal Liberals who introduced the legislation that imposed a dollar-for-dollar withdrawal of transfer funds to the provinces for every dollar of extra billing in the province. The federal PCs do not oppose that. They have never opposed it as far as I know. However, here we have the Ontario Tories making a mockery of their federal colleagues. That hardly seems appropriate when they are having such difficulty at the federal level.

Mr. McClellan: It is not fair to them.

Mr. Laughren: There is a lack of fairness in the treatment of their federal colleagues.

The provincial Liberals and New Democrats, along with 78 per cent of the population, support this ban on extra billing. The federal Liberals, Tories and New Democrats also support a ban on extra billing. Those are not political parties that have any truck or trade with the Iron Curtain; yet we have the medical profession talking about this legislation being worse than anything behind the Iron Curtain. Some of the Ontario Tory members have been parroting that phrase, and I find that passing strange. I also think they owe an apology to their federal colleagues for using that kind of language.

Actually, the Ontario Progressive Conservatives are standing alone with the doctors. I would not for a minute suggest that the Ontario Tories should reconsider the company they are keeping, but I would give that advice to the doctors of the province.

I understand the doctors' position, because the withdrawal of extra billing as a right does indeed flirt with wage control, and we know how angry the doctors were when wage controls were imposed on working people across this land a number of years ago and in this province. I understand why the doctors are upset about that.

A couple of years ago the critic in the New Democratic Party federal caucus, Bill Blaikie, had a very nice, spiffy quote about the issue. He said, "Medicare is an ideological compromise between entrepreneurial medicine and truly socialized medicine." I believe he is absolutely correct. We are dealing with an ideological issue here, and that is why the Tories are so strung out on it. It is truly an ideological question that has the Tories just about apoplectic. That is why I take such great joy in standing up and debating this bill, because I cannot think of anything I feel more strongly about than the medicare system in this province.

Let us be sure we understand that we are not talking just about the freedom of doctors or, as the member for Mississauga South (Mrs. Marland) said, about the freedom of patients to pay more. We are talking about the whole question of the funding for hospitals and the fees to the doctors from the federal and provincial governments.

Mr. Leluk: What about quality of health care?

Mr. Laughren: Yes, that is what I am talking about. We are talking about the question of extra billing and the ability of the state to carry the costs of a good medicare system. There is an enormous social dimension to the whole question of extra billing.

Miss Stephenson: No.

Mr. Laughren: Yes, there is an enormous social dimension to it. I want to warn people that if medicare is at risk in this province and in this country, then no social program in Canada will ever be safe. There is no doubt about that.

It is no accident that medicare is under siege these days. It is a question of the distribution of wealth and income in this province and in this country. It is a question of user fees versus universality. The argument that really confounds me is that some of the pro-extra-billing people say it allows for patient participation. Is that not delightful? That means, of course, that one can pay more.

If extra billing were allowed to continue, private insurers would inevitably move in. Perhaps that is the real clue to the knee-jerk support of the doctors by the Tory party of Ontario. Perhaps that is really where it is all at, because they know this will prevent the encroachment on the system by the insurance industry. I really think that is what is behind it all.

12:40 p.m.

While part of me is very pleased about the debate we are having and by what I think will be its outcome, I share a certain amount of sadness with my colleague the member for Hamilton West (Mr. Allen), who made a remarkably good speech in this chamber last night. I commend it to members who were serving on committees last night and were not able to be here, because it really was an excellent presentation.

If I can go back to what the member for Hamilton West said, it was a question of the standing of doctors in the community. There is no question that doctors have had a very high standing in the community since they started practising medicine and there is a lot of sympathy among the public that doctors should be very well compensated. I have never had a constituent or anyone else tell me that doctors should not be well compensated for the work they do, the hours they work, the skills they bring to their job and the importance of those skills to the patients they serve.

There is no question that doctors must be well compensated. There is also no question that doctors are well compensated. If the Tory members are saying doctors are not well enough compensated, then why are they not battling for a new schedule of fees that will adequately compensate the medical profession? Why are the doctors themselves not fighting the battle along those lines? Because it is an ideological battle, not simply an economic one. That is why, and it is why the Tories are fighting the battle along those lines.

Mr. Davis: Why are the unions asking for privatized medical care in Britain?

Mr. Laughren: I am going to come to Britain in a moment.

Mr. Davis: I would like the member to do so.

The Deputy Speaker: Order.

Mr. Laughren: Let me tell members what a former Minister of National Health and Welfare said, and I quote:

"When we compare our system with that of Great Britain, we can see where the breakdown of medicare could well lead us. The United Kingdom has a national health insurance system which coexists with private insurance schemes. Under Prime Minister Thatcher's government, a parallel health system is rapidly developing which favours those with private insurance. Britons who are insured privately may wait only a few days or a week for a routine operation to correct a hernia or varicose veins, for example. Those who have the public national health insurance, however, wait six months or even a year for the same operation.

"In the United States we find doctors charging their patients what the market will bear, just as Canadian doctors did more than 15 years ago. Americans need to buy private commercial insurance to cover themselves against the crushing costs of illness, if they can afford it."

That was the Honourable Monique Bégin talking about medicare a couple of years ago. The point that needs to be made is that once the private system gets in there -- and it will get in there if we continue the practice of extra billing; there is no question about that -- there will be a deterioration in our medicare system in this province. There is no doubt whatsoever about that in my mind. That is one of the things that has happened in Great Britain.

I know of a doctor from London, Ontario, who decided he was going to pack it in; he did not like medicare in Ontario. He decided to move to Texas and practise medicine where he assumed he could triple or quadruple his income. He moved and he did triple or quadruple his income. However, within two years he had been mugged, his malpractice insurance was sky high, he had armed protection, he had to put an incredibly expensive security system around his home and he was back in Ontario crying about the decision he had made.

We cannot have those kinds of differences in incomes without having ruptures in the system. If we think we can have a medicare system that makes some people pay who cannot afford to pay, then we are going to have ruptures in our system as well.

For those reasons, I am always appalled at the argument by the doctors and the Tories that there is a lot of freedom at stake here for the doctors. There is an element of freedom at stake, but we all trade off certain freedoms in our society in order to make it better for everybody else. There is not one of us who does not do that. I heard some complaints about the metal detectors in the chamber going into the public gallery. Yes, it is an annoyance. Yes, it is a tradeoff for security purposes.

I know that when we ban extra billing we are taking away the privilege of the doctors to extra bill. Of course we are; that is the purpose of the bill. However, it is a tradeoff for a lot of people to have complete access to the health care system with the rest of society.

I do not want to continue any longer, other than to say that all of us in this chamber belong to our respective political parties for a diverse number of reasons. For some of us, it is self-serving, for others it is very altruistic and, in some cases, it is ideological.

The importance of the health care system is the basic reason I consider myself to be a democratic socialist. I can think of no higher priority for society than the health of its people. I reject, out of hand, both the tin-cup medicine of the member for Mississauga South and the collection-plate medicine of the member for Scarborough Centre (Mr. Davis). I and my party believe in the freedom of our people to have equal access to our tax-supported health care system.

Mr. Davis: The member has not told me why his unions are asking for privatization of medical care in Britain.

Mr. Laughren: What does the union have to do with it?

Mr. Gregory: Thank you, Mr. Speaker, for allowing me to take part in this debate on Bill 94, An Act regulating the Amounts that Persons may charge for rendering Services that are Insured Services under the Health Insurance Act.

I cannot help but comment on the last remarks of the member for Nickel Belt. I do not think the public wants unionized medicine. He talked about collection-plate medicine.

Mr. Mackenzie: What does the member have against unions?

Mr. Gregory: It is not the unions; it is people.

Mr. Mackenzie: The member for Mississauga East, the member for Scarborough Centre and the member for York West (Mr. Leluk) are always making cracks about unions.

The Deputy Speaker: Order.

Mr. Gregory: I am amazed. All I have to do is stand up and the member for Hamilton East goes into an apoplectic state. I am delighted that he is leaving because I would not want to be responsible for him having to subscribe to one of these overbilling doctors. I wish him an early recovery and look forward to his feeling much better when he is back in the House on Monday.

Mr. Mackenzie: I do not need the cruel and unusual punishment the member is inflicting.

The Deputy Speaker: Order.

Mr. Gregory: The member probably missed the best one of the day. However, I will try to carry on on Monday, so he will be able to hear the best part.

I am very upset about the position taken by the Liberal government of the day and by the minister who is being somewhat rigid, as he was with the previous bill dealing with pharmacists. There was a rigidity there and he did finally back down, just as he was required to back down -- without apology, by the way -- on his position on certain drugs that this party brought to light and questioned him on. He maintained that rigidity until yesterday, when he finally made a statement that he was withdrawing that generic drug as a substitute.

It is amazing how ministers on that side of the House, in this latest government, can take this rigid position and not feel any responsibility for even admitting that they were wrong in the first place. They were wrong.

The same rigidity is in this bill. Statements have been made by the minister and by the Premier that they are ready to negotiate with the medical profession, although they have never been approached by it.

I find it strange that this should surprise them when they said they would negotiate but that extra billing was not negotiable. How does one go into negotiations and say, "We will negotiate, except for this, this and this"? There is not much left. I do not think it is a totally honest statement to say they are ready to negotiate but the Ontario Medical Association has not bothered to approach them.

I am disturbed about this bill. I do not think doctors should be civil servants. I am surprised and disappointed that the Liberal Party has turned its back on free enterprise.

12:50 p.m.

Mr. Davis: All except for one, standing for integrity and principle.

Mr. Gregory: That is right. They do have one over there. Where is he? I give him full credit. He is standing for some principle which seems to be absent there. It is a shame.

I used to hear stories from the Treasurer (Mr. Nixon), whom I admire very much, about the great free-enterprise system under Mitchell Hepburn way back in history. That was the former Liberal government of 42 or 43 years ago. Although I did not totally respect Mr. Hepburn's party, I had some respect for the free-enterprise system he advocated. He was no socialist.

I find it strange in this day and age, in 1986, that the free-enterprise Treasurer from Brant sits there and watches his new Minister of Health, who comes from roughly the same area of the province, advocating a turning of the Liberal back on the free-enterprise system. I find that shocking.

As to the experience of doctors as civil servants, the member for Nickel Belt did touch on the British system. When he was questioned on it he defended it and said how wonderful it was.

Mr. Laughren: The member was not listening. I told him it was falling apart. Why is he distorting my remarks? I did not say it was great.

Mr. Gregory: The member did not say it was falling apart --

Mr. Speaker: Order. The member for Mississauga East and the member for Nickel Belt will not carry on a conversation between themselves.

Mr. Laughren: Has he the right to distort my remarks?

Mr. Davis: Why are the labour unions calling for privatized medical care in Britain?

Mr. Speaker: Order. The member for Scarborough Centre is not part of the debate either. Carry on, the member for Mississauga East.

Mr. Gregory: I note a column in this morning's Sun by Greg Parent who writes extensively on medicine. He makes a couple of comments that I find rather interesting. He says: "It's going to take more than heated blasts of indignation to shake the loggerhead thinking of David Peterson and Murray Elston, who are determined to jam state medicine down the public's throat." How do members like that? "They are determined to jam state medicine down the public's throat."

Mr. Laughren: What paper is the member reading?

Mr. Gregory: The Toronto Sun.

Mr. Davis: The Toronto Star.

Mr. Gregory: No, from the Sun, a very legitimate paper. If I want to quote Liberal philosophy, I will get the Star. If I want to quote New Democratic Party literature, I do not know quite where one gets that.

Mr. Laughren: The member admits he is quoting Tory literature.

Mr. Gregory: No, I am not, as a matter of fact. Has the member read Claire Hoy lately? Hardly a bastion of conservatism.

Dr. Garry Willard says: "Peterson wants to go down in history as the man who brought in state medicine." We have heard the rhetoric comparing it and saying the British system is great.

The columnist quotes a story by Dr. Willard:

"Willard tells the story of the British boy who, after months of waiting, was finally admitted to hospital to correct an undescended testicle. He was taken into the operating room and his tonsils were removed. When the mistake was discovered, the hospital approached the mother, apologized profusely and promised to correct the real problem immediately. But instead of an angry parent threatening a lawsuit, they were greeted by a smile and sigh of relief when they broke the news. `Thank God,' said the mother. `He's been on the tonsil list for six years.'"

That is the British system, and what we are doing is advocating getting closer to that system.

Hon. Mr. Nixon: British doctors do not take out as many tonsils as ours do.

Mr. Gregory: They have a six-year waiting list. At any rate, it is a good story.

Hon. Mr. Nixon: Yes, it is. I was wondering what the punch line would be.

Mr. Gregory: I bet the member was. I imagine he was spending a lot of time imagining what he thought it might be. Even I would not do that in the House.

When medicare was established 18 years ago, the doctors agreed to it. They went along with it. They asked for and got the right to opt out of the plan. To this point in history, this has been honoured, causing no great hardship to people. Notwithstanding what has been said earlier by members on my left, it had not proved to be a very serious problem. In March 1979, 18 per cent of the doctors had opted out. In December 1984, the figure was 13.1. It was on a decline.

Mr. Laughren: Talk about specialists. Talk about the number of specialists opting out.

Mr. Gregory: My friend on the left said I should talk about specialists. His party wants to treat everyone the same, but now he wants me to differentiate and talk about specialists. They want every doctor to be exactly the same, apparently. I think it is obvious they are not. Less than five per cent of the total claims processed by OHIP cover services performed on an opted-out basis.

We are destroying reputations and blackening the names of medical practitioners because five per cent of the total claims processed by OHIP cover services performed on an opted-out basis.

Mr. Davis: The same thing was done to the lawyers.

Hon. Mr. Nixon: The preachers will be next.

Mr. Davis: We might get more money that way.

Hon. Mr. Nixon: You can extra bill for guaranteed salvation.

Mr. Davis: Can we extra bill for exorcising the devils over there?

The Deputy Speaker: Order. The member for Mississauga East has the floor.

Mr. Gregory: It is always nice to have my religious adviser on my side in these debates. He tends to keep me on the straight and narrow and make sure I do not stray too far from it, which is what I am doing. When I was so kindly interrupted by my spiritual adviser, I had started to say that, because of the matter of five per cent, we are ready to turn the whole medical profession on its ear. We have totally upset them and we have upset great numbers of their patients.

More will be heard about that as we go along, and I think the government is beginning to realize it. The Premier is softening his stance somewhat. I suspect he will soften it more as opposition to what the government is trying to do starts to rear its head, or, better still, when the Liberals start to believe it.

I find this disgusting. Because of a piece of paper with some conditions on it, signed to satisfy two parties that were dying to become the government -- and now are dying as the government -- they are ready to sign away their belief in the free-enterprise system to satisfy the bunch over there in the little red rump. They have sold out. I guess the Premier is starting to get the message in question period. I found it rather --

Interjection.

The Deputy Speaker: The member for Nickel Belt is not in his seat. He should either continue on his way out of the chamber or return to his seat, but he should not interrupt.

Mr. Gregory: Have a nice weekend. It was so nice to have had his attention for a short time, his very intelligent listening to a speech that contained more meat in the short 15 minutes I have had than his did in three quarters of an hour.

Of the approximately 13 per cent of doctors who are opted out at present, most do not extra bill. They are doing it on a matter of principle. It might seem rather hollow to many in the House that someone has principles, since we as politicians are accused of not having any. It comes as a surprise to some people that doctors have principles and are doing this on the basis of a principle.

Whether or not they are ready to charge this extra amount, they want the right to do so. We are seeing the repercussions when we start to say they cannot have this right. Now everyone wants it. What did we expect? That should not come as a surprise. When we start taking away the rights of people, they want them, even though they do not exercise them.

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

NOTICE OF DISSATISFACTION

The Deputy Speaker: Pursuant to standing order 28, the member for Nickel Belt (Mr. Laughren) has given notice of his dissatisfaction with the answer to his question given by the Minister of Northern Development and Mines (Mr. Fontaine) concerning spraying of forests. This matter will be debated next Tuesday at 10:30 p.m.

The House adjourned at I p.m.

24 janvier 1986