Journal des débats 1986-juin-03 | Assemblée législative de l'Ontario

Mr. Speaker: I ask all members of the Legislative Assembly to join me in recognizing in the Speaker's gallery this afternoon the Honourable Elwood N. Veitch, Minister of Consumer and Corporate Affairs for British Columbia. Welcome, sir.

MEMBERS' STATEMENTS

SENIOR CITIZENS' SERVICES

Mr. Dean: In response to my recent question regarding the lengthy delay in the release of his white paper, the Minister without Portfolio responsible for senior citizens' affairs (Mr. Van Horne) assured me that when I read his paper I would "agree this time was well spent." I have read his paper and I do not agree the time was well spent.

I was particularly disappointed to note that the paper did not include a plan for the integration of programs. While the paper mentions the need for integration, the fact that it took statements from four ministers to announce the release of the paper clearly indicates that such integration is still a long way off. By failing to provide concrete proposals for the integration of seniors' programs under one roof, the minister has avoided the toughest decision facing him in his portfolio.

The minister has also avoided dealing with the critical shortage of nursing home beds. While home care is clearly preferable to institutional care, the fact that institutional care is often unavoidable cannot be ignored.

Also, while the report does advocate more community care, the funding provided is insufficient to alleviate the current demand for beds in seniors' institutions. At the same time, the report makes no mention of increasing support for these facilities. In the year since this government took office, not one new nursing home bed has been allocated.

These are but two of the issues the minister has delayed dealing with, claiming he needs more time to study and consult.

VOLUNTEER SERVICE AWARDS

Mr. Mackenzie: This past Sunday I had the privilege of attending a series of Volunteer Service Awards at the Royal Botanical Gardens in Hamilton at which the Minister of Citizenship and Culture (Ms. Munro) handed out more than 100 individual awards to residents of Hamilton area ridings. About 30 or 35 of the recipients were from my riding.

I was there with four other members, Liberal and Conservative, as well as one of my own colleagues. We had a very brief acknowledgement that we were in the audience. We then proceeded to sit there like a bump on a log for the next hour while the minister handed out all the awards, including those to people from my own riding.

I understand there was a little classier performance in Windsor and northwestern Ontario where the ministers at least had the class, the courtesy and civility to include the members who were involved where the awards were being presented to people from their ridings. I am wondering whether we have gone so far as to make this a partisan Liberal approach rather than a province of Ontario award. Perhaps the Liberal Party should pay for it.

SOYBEAN EXPORTS

Mr. McGuigan: I rise to air a complaint that affects soybean producers in southwestern Ontario. The total Canadian oil seed industry is suffering severe economic depression. In western Canada, the canola or rapeseed crushing industry receives federal and provincial operating subsidies, while the eastern crushers of soybeans receive no such assistance.

Canada has a vast overproduction capacity for crushing oil seeds. The western canola crushers use the government subsidies as a means of lowering the domestic selling price of their products. Currently, the three eastern crushers, Maple Leaf Monarch Co. of Windsor, Canadian Vegetable Oil Processing of Hamilton and Victory Soya Mills Ltd. of Toronto, are operating at 70 per cent of capacity, and they expect declining production in the face of western Canada subsidies. Employment in these unionized plants is also adversely affected.

Subsidies to western producers should be withdrawn and the funds applied to all the crushers, eastern and western. The funds should be redirected to be used to assist our crushers in meeting export subsidies prevalent in the world market. It makes no sense to apply offsetting subsidies to eastern crushers as this money would be wasted. We think the government money should be used to develop export markets, and we call on all members to deliver this message to their federal members.

REGIMENTAL REUNION

Mr. Brandt: In February, I was approached by Jack Hayes, president of the 26th Battery Association. The 26th Battery was to be this year's host for the regimental reunion, an event that takes place every two years. This year, the reunion was planned for May 16 in the great community of Sarnia and was to involve up to 150 veterans.

Mr. Hayes inquired with me about some financial assistance from the provincial government to host the event. I advised him to write to the Premier (Mr. Peterson), care of the office of protocol services, and apply for a hospitality grant. I also wrote the Premier in support of the 26th Battery's request. In April, the Premier replied that the 26th Battery's application was being taken under consideration by the hospitality committee. That was the last they heard about the matter from either the Premier or the hospitality committee.

I have a letter from Mr. Hayes expressing the 26th Battery's disappointment over the lack of response from the government. He finishes his letter by saying they carried on regardless. That is the attitude that served our veterans so well in both world wars. They carried on regardless, often despite overwhelming odds, and in this case despite being ignored by the current government.

On behalf of the 26th Battery and on a personal note, I express my disappointment to the Premier on how this issue was handled. I will send the related correspondence over to him.

COMMONWEALTH PARLIAMENTARY ASSOCIATION

Mr. Breaugh: Mr. Speaker, today I have something for you to consider. This year will be the 75th anniversary of the Commonwealth Parliamentary Association. We have not been particularly active, even though we have an Ontario branch of the parliamentary association. I suggest that you and all members present become more active in the parliamentary association. I believe very strongly in the parliamentary tradition. I would like to see the House recognize this auspicious occasion in some appropriate manner.

I would also like the House to consider what we have seen in other jurisdictions. For example, several American state legislatures entertain student parliaments, senior citizens' parliaments and things of that nature. We do not do much in this jurisdiction to recognize long service by members. That is also a matter I would like considered by our branch of the parliamentary association .

Hon. Mr. Nixon: By reducing pension payments.

Mr. Breaugh: We may do something like that.

The main thrust of my concern is that the parliamentary procedure is an important one that has served democracy well. It deserves some recognition by our branch of the Commonwealth Parliamentary Association. I am aware that in many parts of the world, people are trying very hard to get democracy to work through a parliamentary system. I believe parliaments have served us well, and we need to recognize that fact.

CANADIAN AMBASSADOR TO THE UNITED NATIONS

Mr. Sargent: Yesterday in the New York Times there was a picture of Stephen Lewis, with the headline "Canada's Chief Delegate to the United Nations." The article praised him for his tenacity of purpose in his fight on the crisis in African countries. After a week of hectic negotiations, Stephen Lewis made all Canadians proud. For the first time in 40 years, the assembly finalized a plan to review Africa's devastated economies. A lot of us served as members with Stephen Lewis, and I want him to know we here in Ontario are proud of him.

HOCKEY CHAMPIONSHIP

Mr. Pierce: It gives me great pleasure today to share with the members the accomplishments of the Fort Frances High School Muskie hockey team. Despite having a relatively small school population from which to draw the players, the Muskie team has had overwhelming success since its formation in the mid-1960s.

Since 1967, they have earned the right to compete 13 times in the All-Ontario High School Hockey Championship and have had the privilege of hosting the All-Ontario twice during that period. During their previous 12 visits, the Muskie team collected one bronze and four silver medals. However, during the most recent All-Ontario tournament in Oakville this spring, the Fort Frances Muskie team won its first gold medal. Emblematic of high school hockey supremacy in Ontario, their victory is made sweeter by the thought that this season --

Mr. Speaker: The member's time has expired.

2:12 p.m.

STATEMENTS BY THE MINISTRY AND RESPONSES

FOREST FIRES

Hon. Mr. Kerrio: I would like to tell the members of the House about what could be called miracles that have been performed by hundreds of people across northern Ontario over the past week or so.

The term "miracles" might seem a bit sensational, but it captures the flavour of what I saw last week when I flew by helicopter over a major fire northwest of Red Lake. That fire, which is still not under control, has destroyed 475 square kilometres, or more than 100,000 acres, of forest, including valuable timber and wildlife habitat.

Red Lake 7 is only one of the 28 fires burning in Ontario right now. It has been slowed to a crawl by four days of cool, damp weather, but it is still potentially dangerous, as is the situation across the north.

As a result, the restricted fire zone has been extended to Friday in the northwest, but it has been lifted in the north-central, northern and northeastern regions of the Ministry of Natural Resources.

We are taking advantage of this slight break, which included some rain in the Red Lake area last night. Right now, fire officials are scrambling to gain as much ground as they can on fires and to get as many crews and as much equipment into place as they can.

This is just the start of the fire season. We have the rest of the spring and the whole of the summer ahead of us, and it could be a long, hot one.

Given the danger we face, I would like to underline the province's forest firefighting priorities.

Our first priority is people; public safety is always our first priority. The second priority is private property, and the third is the protection of other resource values. That is our value system in a nutshell.

We can be thankful this province has developed a heck of a system to meet these priorities. On my recent trip north I saw a smooth-functioning, skilled, dedicated organization, staffed by competent MNR people. I saw it in place, and I saw it working.

The other thing is that the residents of northern Ontario should be commended for their tremendous response to our restricted fire zone. The number of man-caused fires is reduced substantially as a result of the people of northern Ontario taking the restrictions to heart and being very careful.

Let me sum up briefly the forest fire situation in Ontario.

We have 28 fires burning on a total of roughly 1,200 square kilometres; some of them are so far north they are simply being observed.

Red Lake 7 now covers 473 square kilometres and is 15 kilometres north of Red Lake. Ground forces are establishing a 90-kilometre-long hose and bulldozer line along the eastern and southern boundaries.

Counting support staff, 500 firefighters are working on Red Lake 7, including 16 new crews which moved in Monday. They are being supported by nine bulldozers on loan from Great Lakes Forest Products Ltd.

The damage caused by Red Lake 7 has been extensive. Half the fire is in Woodland Caribou Provincial Park; the rest is in a valuable forest management unit through which a $9.1-million access road was recently built.

The fire has also destroyed years of detailed forest management planning for that area; plans that had just been completed. So far only one tourist lodge has been lost to the fire, which also had the potential to envelop several others which were protected by ministry crews.

Across the province, almost 900 firefighters and 300 support staff are involved in operations, backed up by 14 heavy water bombers and 41 helicopters.

We have had some unexpected relief from the weatherman. That is good, but the benefits could be wiped out with just a few days of warm, windy weather.

Mr. Pierce: In response to the Minister of Natural Resources, this party wants to thank him for bringing us up to date on the forest fires as they are in the province today. I want to caution the minister that in formulating the final plans for any parks in northwestern Ontario, he should take into consideration the amount of land that is currently used by tourist operators, paper companies and lumber mills and make sure allocations are made to provide for the losses that have resulted from the fires in northwestern Ontario.

As the minister has said in his statement, the people of northwestern Ontario have co-operated to the fullest. The companies in the area have put machinery and men in the bush under very extreme conditions to help bring the fires under control. The minister can show his response by taking into consideration what happens after the fire as well.

I also want to thank the minister for recognizing what he calls "one heck of a good system to meet these priorities."

Mr. Bernier: I rise to join my colleague the member for Rainy River (Mr. Pierce) in thanking the Minister of Natural Resources for bringing this House up to date on the forest fire situation in northern Ontario, particularly in northwestern Ontario.

I had the opportunity of visiting the area last Thursday with His Honour the Lieutenant Governor. We were in the Round Lake area. We flew over the fire at the north end near North Spirit Lake and saw the devastation of that fire. We landed at Deer Lake and were greeted by a large number of native people who are anxious to help the minister and his ministry fight that fire.

Mr. Speaker: The member's time has expired.

Mr. Bernier: I just want to compliment the minister for using the natives of this province for firefighting. They do an excellent job.

Mr. Pouliot: We too would like to join in the accolades the Ministry of Natural Resources is receiving regarding the very dangerous forest fires. It was clearly a collective effort, and they were first and foremost in the line of action. What has been done is right, and I say to the minister with all sincerity, on behalf of the people not only of Lake Nipigon but also of northwestern Ontario, that he has done a job of which he must feel justifiably proud.

DRINKING AND DRIVING

Hon. Mr. Scott: My colleagues in this House are aware of and, I am confident, support the government's continuing commitment to the battle against drinking drivers. The battle is being joined by increasing numbers of citizens who are bringing home the message that drinking and driving is not acceptable social behaviour.

Today I would like to share some heartening news with my colleagues in the House, further proof that all of our citizens working together can successfully combat this social problem.

Recently my ministry commissioned a study by the Traffic Injury Research Foundation of Canada. We wanted an update on the drinking-driving countermeasures programs during December. All of us know of the intense efforts of police, citizens' groups and government to focus on the problem at that time of year.

The TIRF study found that during December 1985 the number of drinking-driver fatalities and the number of impaired-driver fatalities dropped to historic lows. Furthermore, during last December the percentage of driver fatalities tested for blood-alcohol content who had BACs over the legal limit also decreased to the lowest levels on record for any month of any year in Ontario.

By way of illustrating this dramatic decrease, I should point out that in the month of December, during the 10-year period 1973 through 1982, an average of 41.9 per cent of drivers who died were legally impaired. In December 1985, the comparable figure plummeted to 7.4 per cent.

The TIRF study shows that over the past three Decembers Ontario has experienced a drop in alcohol-related fatal accidents unparalleled anywhere in Canada. To quote from the report, "The decreased numbers and percentages of drinking-driving fatalities most likely reflect direct and specific effects of the many actions taken to prevent impaired driving during December."

The report concludes that the Ontario experience demonstrates the general effectiveness of broadly aimed, nontargeted countermeasures such as those implemented during recent December periods.

All of us in this Legislature realize, however, that the cost inflicted on Ontario's citizens by drinking drivers is still far too high. In 1984, more than 550 persons were killed and 27,000 persons were injured in Ontario accidents where alcohol was a factor. These accidents also cost the people of this province more than $200 million.

These statistics graphically demonstrate that we cannot relent in our war against drinking and driving. My ministry will continue to develop new programs and initiatives to combat this problem, and I look forward to the continued support of my colleagues on all sides of the House as we try to rid our roads of the drinking driver.

Mr. Runciman: I rise to express our party's pleasure at the statistics the Attorney General announced today. It is incumbent upon us as well on this side of the House to indicate that we cannot help but be struck by the sheer hypocrisy of the government on the one hand talking about impaired drivers and on the other hand promoting the increased sale of alcoholic beverages through beer and wine sales in grocery stores.

I want to provide him with some other statistics. Last year, Brewers' Retail refused service to more than 384,000 potential customers. We do not see that kind of scrutiny occurring in grocery stores.

The local option provision that has been speculated about in the media probably will encourage increased driving to acquire alcoholic beverages, commuting from dry to wet communities.

The increased number of outlets of alcoholic beverages -- it is speculated there will be between 7,000 and 11,000 new outlets on the market -- and increased operating hours will result in increased incidents of impaired driving. Virtually all experts agree on this.

This government is ignoring the facts to keep, as the Toronto Star said today, an off-the-cuff campaign promise. This is a promise that, if followed through, will result in a rapid reversal of the very positive trends the minister announced today.

Mr. Rae: I want to comment on the statement made by the Attorney General. First, the figures he has published today demonstrate that when we are serious about dealing with the problem of drinking and driving, we can do a great deal to reduce it and we can do a great deal to save lives.

It is now incumbent upon government to look seriously at the reduce impaired driving everywhere program. It is an expensive program in terms of the number of policemen who are put on duty to deal with drinking and driving, but in Metro Toronto it has been an effective program. If it works, we ought to look at ways of continuing to fund that program for a longer period of time than just during the Christmas period. One thing the statistics show, as well as a dramatic reduction in the month of December, is that those numbers change dramatically when the program ends. We all realize that with the increased possibility of people being caught the incidence decreases dramatically. We understand that feature of human behaviour.

I cannot help commenting at this time with respect to the Attorney General's statement that one of the major reasons he was advocating the sale of beer and wine in corner stores was that it would reduce the distance that people had to drive to pick up a case of beer or a bottle of wine. He was putting this forward as a serious argument in defence of what I think is increasingly being seen across the province as an indefensible and very dumb idea, that is, the sale of beer in corner stores.

If anything, the government has managed to make a dumb idea even dumber by proposing the notion of local options. That means there will now be an actual incentive for people to drive from dry areas to wet areas to purchase alcohol at times of the day when they cannot purchase it where they live. All he is really doing by this amendment is encouraging people to drive longer distances to get access to alcohol. It undermines entirely the argument the Attorney General was initially making in defence of the indefensible.

In the light of what is clearly a common commitment in this Legislature to reduce the incidence of accidents on the road, to save lives, to save the future of those people who are driving and who are often hit by impaired drivers and to save the lives of those who are impaired themselves, this government has a responsibility not to introduce any measure that could increase the number of accidents on the road.

For that reason alone, the idea of the sale of beer and wine in corner stores, with the addition of the local option, is an idea I hope will not come in Ontario.

SENIOR CITIZENS MONTH

Hon. Mr. Van Horne: It is a pleasure for me to announce that June is Senior Citizens Month in Ontario. This is the 16th anniversary of the province's tribute to its seniors, and I am particularly honoured, as Ontario's first minister for senior citizens' affairs, to be making this announcement to the House today.

The theme for this month's celebrations is "We're Getting On With Life," and I want to tell the members that no truer statement could be made of Ontario's senior citizens. In the past year, I have had the opportunity to visit communities throughout Ontario while I conducted a review of the services offered by the province. I have learned at first hand the contributions and achievements of our seniors, and it is a privilege to rise in this House and salute this growing segment of our population.

The focus of the province's tribute to seniors will be the presentation of the Senior Achievement Awards at 6:30 this evening in the main foyer of the Legislative Building. Seniors' clubs and community organizations, as well as the general public, were asked to nominate seniors in their areas who have contributed to the quality of life in Ontario.

We received more than 500 nominations, but with the help of the head of the Ontario Advisory Council on Senior Citizens, Ivy St. Lawrence, Doug Rapelje from Niagara, the member for Wentworth (Mr. Dean) and the member for Scarborough-Ellesmere (Mr. Warner) -- and I note in parentheses to the member for Hamilton East (Mr. Mackenzie) this is an indication that this is a totally nonpartisan operation -- we were able to choose 22 recipients of the Senior Achievement Awards. They are:

Raoul Bernard, Hearst; Sister Constance, Willowdale; James Noble Davidson, Kenora; Dr. James Duncan Galloway, Burlington; Verdun J. A. Gauthier, Longlac; Miss Hope Holmested, Richmond Hill; Mrs. Joyce King, Tottenham; Max Mandel, Toronto; Mrs. Marjorie Margaret Mann, Nepean; John Maracle, Ohsweken; John Martin, Windsor; Mrs. Frances McHale, London; Mrs. Olive Mitchell, Toronto; Antonin Pigeon, Plantagenet; Titus Porter, Ohsweken; Miss Laura Sabourin, Cornwall; Raghbir Singh Sandhu, Mississauga; Dr. Helene L. Shingles, Sarnia; Mrs. Florence Smith, Prince Albert; Mrs. Joy Stuart, Kingston; Peter Wai-Tsoi Wong, Etobicoke; and Mrs. Mary Wood, Woodbridge.

To help promote local events which focus attention on seniors, the government of Ontario has produced a poster emphasizing the meaning of this year's theme, "We're Getting On With Life." The message is clear: Senior citizens have the drive and determination to take charge of their lives and remain self-sufficient in their own communities.

For many, 65 has become the "age of opportunity." Seniors explore new ventures and participate in more activities than ever before. In Ontario, we have thousands of seniors who volunteer their time and skills to help others; some start a new career or return to school; others pursue new interests.

I hope members will join me in this tribute to Ontario's seniors by celebrating this very special month at local events in their own communities.

Mr. Dean: I join the Minister without Portfolio responsible for senior citizens' affairs in noting the commencement of Senior Citizens Month in Ontario. In the statement he read, he exhibited enough grace to recognize the initiative of previous governments of Ontario in first setting aside a week and later a month, June, to pay tribute to seniors.

I join with him also in recognizing the particular contributions of certain outstanding seniors in Ontario who are going to be recognized for the second year in this province for their notable contributions to our communities in various places. I will be pleased to be present later today.

In his statement, the minister has indicated that in the past year he has had many opportunities to visit communities and meet certain of the seniors. I would have thought that in all that consultation he would have been able to glean enough information for other seniors' initiatives which are still somewhere in the limbo of his ministry and he would not need to delay still further doing the things we all, agree are necessary for seniors.

Mr. Rae: I would like to begin by congratulating the winners of the Senior Achievement Awards. They have the best wishes of our party.

This month my grandmother will be celebrating her 100th birthday, and I am especially conscious --

Hon. Mr. Peterson: We will give her a QC.

Mr. Rae: She still votes New Democrat, Mr. Speaker. I want to assure you of that. She always has.

I want to congratulate the winners, to say how very proud we are to be participating in these awards and to thank the minister for his announcement today.

VISITOR

Mr. Rae: While I am on my feet, I wonder whether I may take the opportunity to introduce in our gallery the leader of the New Democratic Party in the Yukon and indeed the leader of the government in the Yukon, Tony Penikett.

2:34 p.m.

ORAL QUESTIONS

EXTRA BILLING

Mr. Grossman: I have a question for the Premier. Can he tell us whether during the secret discussions with the Ontario Medical Association, the Premier, the Minister of Health (Mr. Elston) or the Attorney General (Mr. Scott) made an offer to the OMA to allow doctors to extra bill under certain circumstances?

Hon. Mr. Peterson: I was not at all the meetings. I will happily refer this to the Minister of Health, who was there and who would be very happy to discuss the issues with the Leader of the Opposition.

Mr. Speaker: Does the Premier wish to refer this to the Minister of Health?

Hon. Mr. Peterson: I would be very happy to do so.

Hon. Mr. Elston: We put a set of proposals on the table before the OMA, which have become known as the 10-point proposal. In that, we said we would discuss any way or any mechanism that would provide the OMA with some flexibility, some degree of independence or arm's-length-type relationship with the government to resolve issues or disputes. We discussed a lot of items about which we told this House last week.

Mr. Grossman: This is the fourth or fifth opportunity the minister has had to duck answering the question. This morning he will have received a letter from Hugh Scully, chairman of the board of directors of the OMA, dated June 2 and addressed to the minister, which reads as follows:

"There appears to be some confusion about two items discussed during our `secret' negotiations. Perhaps I can clarify it.

"1. Over the course of several meetings, you and Mr. Scott repeatedly and forcefully offered to allow all physicians to opt out and extra bill at will in the event that fee negotiations failed to produce an agreement."

Given that the minister apparently made the offer to the OMA to allow extra billing, how could he have done that, knowing this would be in clear contravention of the Canada Health Act and would eliminate his opportunity to claim back the $53 million?

Hon. Mr. Elston: The honourable gentleman did not read the entire letter. I did not receive this until this morning, just as he did; perhaps he assisted in delivering it, I do not know.

The situation is quite clear. In those negotiations, we discussed a whole range of opportunities to provide flexibility and innovation. During the discussions, we were searching for ways to come to grips with a concern that was expressed by the membership of the OMA, which was that it wanted to have something wherein it could see there was a certain independence or lever it could exercise. We discussed all kinds of options in those meetings. We were unable to come to any type of an agreement.

Mr. Grossman: That was not the question.

Hon. Mr. Elston: The question was, what did we discuss. We discussed all kinds of things that would provide an opportunity for providing them with independence from the government. They did not want to be seen to be giving the government unilateral authority over the OMA. We discussed a series of options. We were pleased to discuss and explore those.

Mr. Grossman: So that the minister cannot accuse me of leaving out important parts of this letter, I will read the next part.

"We maintain that the decision to opt out is a matter of individual freedom and should not be viewed as part of any collective action.

"2. At no time during our discussions did you or Mr. Scott offer the OMA binding arbitration as a means of resolving disputes arising out of fee bargaining."

That is the entire content of the letter. I would point out that item 2 directly contradicts what the minister said in the House last week.

In any event, in my final supplementary I want to ask the minister this question, because he refused to answer it a moment ago: Why would he have made that offer? We know it was not accepted. Why would he have made that offer in view of the fact that it contravenes section 18 of the Canada Health Act and would eliminate his opportunity to claim the $53 million?

Hon. Mr. Elston: I think the honourable gentleman would like to know that we discussed all kinds of options. We also discussed very thoroughly the option put to us by the OMA, which also would have contravened section 18 of the Canada Health Act. He and I both know we were working inside that negotiating process to examine all kinds of options and opportunities that might be available to us.

Our concern was that no patient in the province should ever pay extra. We were concerned that we had an opportunity inside this mechanism to discuss a whole broad range of opportunities for us to come to a compromise position. At one time, we felt we were close to coming to some kind of a negotiated settlement. We talked about probably every kind of option available. That was our opportunity, and we decided we must examine where we could go. Those were thrown out and rejected. I cannot help that, but we were willing to discuss opportunities.

Mr. Speaker: New question.

2:40 p.m.

Mr. Grossman: The minister will not answer the question with regard to the Canada Health Act.

Hon. Ms. Caplan: He gave a good answer.

Mr. Grossman: Of course he did not. I have another question for the minister as he continues to run and hide.

On May 27, in a speech to the Ontario Association of Registered Nursing Assistants in Saint Ste. Marie, he said as follows:

"The government accepted that there might be circumstances in which it was appropriate to provide payments to certain physicians over and above those currently made by the plan. Examples included physicians charging more than plan rates in recognition of excellence, experience," and a number of other matters.

Would the minister not agree that this directly contravenes as well section 18 of the Canada Health Act?

Hon. Mr. Elston: No, I would not agree that this would contravene section 18. Our position has been that nobody should pay more for insured services, and we can assure people in this province that they will not pay more for insured services.

Mr. Grossman: Section 18 of the Canada Health Act reads, "In order that a province may qualify for a full cash contribution, no payments may be permitted by the province for that fiscal year under the health care insurance plan of the province in respect of insured health services that have been subject to extra billing by medical practitioners or dentists." Can the minister explain to us how he can reconcile his statement with section 18 of the Canada Health Act?

Hon. Mr. Elston: It has come as no surprise to the honourable gentleman that we have for some time indicated our willingness to examine payments in recognition of merit and of other things that put pressures on practitioners with respect to their belief that the fee schedule is inadequate. We indicated as well in our 10-point proposal that we were quite willing to work with the Ontario Medical Association to deal with concerns that have been raised by the general practitioners, who feel they have fallen behind specialists in relation to rewards.

In that sense, we were willing to work along with the OMA to provide special funds that would provide some flexibility in meeting the needs of the physicians in the province so that we could meet some of the concerns that have been set out for us in some of the forums we attended and, quite frankly, during the discussions we have had with both individuals and groups of practitioners.

Mr. Grossman: This will be the sixth question this afternoon in which the minister will be invited to deal with the Canada Health Act. I predict that for the sixth time he will refuse to deal with whether his offers comply with the Canada Health Act. The reason the minister ought to deal with it is that he has clearly dishonestly been telling the public that he will be getting $53 million back when he has offered it away.

My final supplementary --

Mr. Speaker: Order. The member accused the minister of being dishonest. Would the member withdraw?

Mr. Grossman: I will withdraw that. I was making a point.

Would the minister not agree that, with the amendments he has tabled to Bill 94, extra billing can occur and can be stopped only by patients taking action to get the money back? Would he not agree that some patients obviously, having received a bill, could pay it and not complain? If that is the case, once again section 18 of the Canada Health Act will not have been complied with and the minister will not get the $53 million.

Hon. Mr. Elston: The honourable gentleman will understand that the intent of the legislation is to eliminate extra billing. It does that, in my opinion, with respect to extra charges. It makes them illegal. We have mechanisms we think will catch those situations and we are prepared to use those mechanisms when they are passed into law.

That is the intent of the legislation. It is clear to me that this legislation complies with both the spirit and the intent of the Canada Health Act. I have been asked whether it does; I believe it does. We have had communications at staff level with people in Ottawa, and they believe it does; so we feel relatively certain.

I have again had to prove the honourable gentleman wrong. I addressed his question on the Canada Health Act very fully and completely.

PENSION FUNDS

Mr. Rae: I have a question for the Minister of Consumer and Commercial Relations about the arguments that counsel for the Pension Commission of Ontario have been making in court concerning the Dominion Stores case, presumably on behalf of the government of Ontario represented by the Ministry of the Attorney General.

Can the minister explain why his counsel would have argued, and I quote from their factum, "The beneficiaries are not permitted to participate in any of these decisions," meaning the decisions with respect to the withdrawal of the surplus? Why would they make that argument when in their own factum they admit that between 1944 and 1984 the plan was a contributory plan and the employees themselves put money into the plan?

Hon. Mr. Kwinter: The leader of the third party will know the reason the statement was made was that under the contractual agreement there is no provision for that. That matter is before the courts. The case has concluded, but the judges have reserved judgement, and we will have to wait to see what they rule.

Mr. Rae: I am not asking what the courts are going to do. I am asking why the minister's lawyers are going into court and saying the employees have no right to be consulted, that they have no right to be told what is going on and that the union has no interest in the case, when the employees have contributed literally hundreds of thousands of dollars to that fund over the past 40 years. Why are his lawyers saying the workers of this province do not have the right to be consulted when they ought to be consulted?

Hon. Mr. Kwinter: The leader of the third party will know that under our proposed Pension Benefits Act, and in effect even before the act is introduced, we have made provisions that no withdrawal can be made unless all the parties who will be affected are given at least 30 days' notice. Having said that, in the case of Dominion Stores that was not a provision. There was no provision for that, and this is what the lawyers are saying.

Mr. Rae: The minister is not prepared to answer my earlier question, which is a basic question about the rights of employees today, not about some fictitious legislation that is going to come in. We may not even see it until the fall, if then. Why did the pension commission agree to allow the withdrawal of those tens of millions of dollars from the fund when there was no specific mention in the plan with respect to the withdrawal of surplus? In fact, it was not until a month later that the minutes were amended, the plan was amended retroactively to so-called permit the withdrawal. Why did the pension commission allow that on December 17 when there was nothing in the plan to deal with the question of withdrawal of surplus?

Hon. Mr. Kwinter: The pension commission is an arm's-length commission. In their opinion, based on their practices, they allowed it. Obviously, somebody disagreed and has challenged it in the courts. That determination will be made by the courts.

Mr. Rae: After the money is gone, the workers have to go to court and spend tens of thousands of dollars to get their own money back. That is the position the minister's pension commission is leaving the workers of this province in.

Mr. Speaker: New question.

Mr. Rae: It is a disgrace. The minister ought to be ashamed of himself for that kind of action.

FREE TRADE

Mr. Rae: I have a question for the Premier. I am surprised he did not come to the House today with a statement with respect to what happened at the free trade negotiations in Ottawa yesterday. I would have thought he would have made a statement. Perhaps he is too embarrassed by having been bamboozled by one of the great BS artists of the century and by having sold out the interests of Ontario when it comes to this trade discussion. The Premier now has admitted that he has no ability to say whether the question of the auto pact will be on or off the table. What is he going to do since it is clear the auto pact is on the table? What does he intend to do about it?

Hon. Mr. Peterson: I knew I did not have to make a statement because I knew the honourable member would ask me about it. I will pass on his compliments to the Prime Minister. With respect to the question about the auto pact that the member has raised, there was considerable discussion about it last night. It was raised by us. I believe the other Premiers recognize the importance of that document. There was a very firm assurance from the Prime Minister last night that he would not raise the auto pact. I do not know where the member is getting the information he is presenting to us.

2:50 p.m.

Mr. Rae: It is almost sad to hear the Premier say that as if it were some kind of defence of the auto pact. It is not Canada that is going to put the auto pact on the table; it is the Americans who are going to put it on the table unless it is specifically excluded from the negotiations.

Why was that not made a condition before the Premier agreed to get on the free trade train, which he so clearly agreed to do last night?

Hon. Mr. Peterson: With great respect, the member's interpretation of what has gone on is dramatically oversimplified. If he checks with his friend Howard Pawley, he will recognize there are subtleties to this situation that may not always be apparent to the naked eye.

We agreed to the following yesterday: The first ministers will be meeting every three months to monitor the procedures and check the mandate over which they will have responsibility. The Prime Minister recognized last night that, at the same time, the provinces will have a formal role in any ratification, should that come about.

We are monitoring that on a three-month basis. If that proves inadequate, then we can change the procedure. That is what was agreed to last night. Some would argue that was a constructive exercise in nation-building, while others, perhaps like the member, would say we should walk away, let the thing go on and have to accept what is handed to us.

I do not have to apologize to my friend opposite about the strong position we have taken on the auto pact. The Prime Minister and everyone else realize that. The member is interpreting things that have been said in the United States. There have been a great many miscellaneous comments on the trade issue, about what is on and off the table. I have heard them and the member has heard them. He has heard them in conflict. He has heard the negotiator say one thing and the ambassador say other things about social programs and a variety of other things.

At this moment, we should not react to every person who has something to contribute on this as saying definitively it will or will not be on the table. It is my very strong view that the automotive pact should not be on the table. We will use our very best efforts and our authority in this matter to prevent alterations that are detrimental to Ontario.

Mr. Rae: The Premier has now made the auto pact about as safe as a BC shingle. That is the state of play with respect to the auto pact.

A veto is only good if one uses it. Since the Premier has boasted almost from the beginning that he has a veto and that Ontario has a veto, given what has happened over the past two weeks with respect to the number of statements about what the Americans think is now on the table, both with respect to cultural industries and the auto pact, and given the imposition of this very unfair tax on our cedar shingles and shakes and the tax on our steel exports, why does he not exercise his veto now when it might have some impact and change the very nature of these discussions, so that instead of having a broad free trade negotiation, we have discussions that are restricted to those issues which are in the interest of Canada and not in the interest of the United States to raise in the negotiations?

Hon. Mr. Peterson: I wish life were that simple. As the member knows, there are no similarities to the auto pact, which is not a free trade agreement. The member will agree it is a managed trade agreement. It has a one-year termination clause, i.e., either side could give notice of termination a year from now. That is unlike the shingles and shakes issue to which he tried to equate it, where there was presidential action.

I am of the view that Ontario, de facto and de jure, has a responsibility in the ultimate ratification of this agreement or refusal to accept it. The member would argue, I gather, that if we stood up today, picked up our baseball bat and ran away, all these other problems would solve themselves. That is the view he just articulated in this House. I do not think anybody in this country who is close to the issue shares that view, including other people of the member's persuasion and those who share his point of view.

We are facing a worrisome situation at the moment. I am starkly aware of the irony of trying to discuss a trade agreement, on the one hand, and fighting a trade war on the other hand. However, those things are going on at the moment.

Some would argue for a so-called stand-still agreement. However, do we have the power to impose that? What would be the effect if we walked away from the table? Those situations are currently a matter of speculation.

EQUAL PAY FOR WORK OF EQUAL VALUE

Mr. Gillies: My question is of the Minister of Labour. He may be aware that yesterday the minister responsible for women's issues, the Attorney General (Mr. Scott), was not in the mood to talk about women's issues, as is often the case; so I will ask the Minister of Labour the same question.

Is his commitment to pay equity just public relations and verbiage or is it real? Will the minister be bringing Bill 105, the public sector pay equity bill, into this House by the end of the month for second reading debate so that it can go to committee for consideration this summer?

Hon. Mr. Wrye: The exact timing of the business of the House is normally determined by the government in consultation with the various House leaders. I am sure that will continue to be the case. As the honourable member knows, this party remains firmly committed to bringing forward Bill 105 at the appropriate time and to moving forward with pay equity, something the previous government refused to do.

Mr. Gillies: With the confusion over there, I say, "Point made." We have a concern and women have a concern about the quote by the Attorney General last week. He knows this party will be moving amendments to that bill. Very likely the third party will be doing so. The Attorney General said, "This is a plot to shipwreck and delay the public sector bill." Will the minister dissociate himself from that outrageous observation, fulfil his commitment to bring this bill forward and not try to hang any delay on the opposition members?

Hon. Mr. Wrye: What is most outrageous of all is to hear that party, which had years and years to bring pay equity forward, now pontificating as if it were concerned about it. That is absolutely silly. I thought the honourable member opposite would understand that an attempt to bring forward an amendment to Bill 105 to include the wider public sector within the present parameters of the bill would effectively force a complete and substantive rewrite of Bill 105. As my colleague the Attorney General has said, that would have the effect of shipwrecking the legislation.

Mr. Gillies: That is absolute nonsense. The opposition can move to amend any bill and the minister knows it.

Hon. Mr. Wrye: My friend is correct. Theoretically, the opposition can bring forward substantive amendments. If the opposition is prepared to bring forward amendments, I hope they will be such that the overall intent of the legislation will not be shipwrecked and that we will not delay this very important initiative for women in the public sector.

Ms. Gigantes: My question is for the minister responsible for women's issues. I would like to ask him precisely the same question. How dare he say the opposition is holding back this legislation and trying to shipwreck the legislation when he will not bring it forward? How dare he?

Hon. Mr. Scott: I never actually thought about it in that way before. I think we are proceeding properly. I do not think the government has anything to apologize for. We are waiting until the consultation process is completed.

3 p.m.

Ms. Gigantes: The minister has had positive indications from both opposition parties in this minority House that they wish to deal with this bill as quickly as possible and that they have positive amendments to make to it. Will the minister explain to us why the government is delaying bringing it forward?

Hon. Mr. Scott: As I have indicated on several occasions, apart from the consultants, there are a business advisory group and a trade union advisory group.

Mr. Rae: They want the bill brought forward.

Hon. Mr. Scott: If the member wants an answer to the question, let him just listen.

Both groups have made application for support from the government to enable the trade union group to do studies over the summer about pay equity. We have indicated to the trade unions that we will support that plan of theirs. The trade union members came to us yesterday and made a proposal in which they sought government support for studies to be done this summer.

Mr. Rae: We know the minister's respect for unions.

Hon. Mr. Scott: Do not panic because I mentioned trade unions.

Mr. Speaker: Order. I have stated on many occasions, please disregard the interjections. They are out of order.

Hon. Mr. Scott: When that proposal was made by the trade unions, it paralleled a proposal that had been made by the business advisory group. Both contemplated that their studies would be completed by mid-August, and the government acceded in principle. We have not worked out the precise details of the projects in which they are going to be engaged.

We think a significant contribution is being made by business groups and by the trade union movement to the principle of pay equity in the private sector, and we want to support their efforts by supporting that kind of consultation. I am not ashamed of that process.

Mr. Speaker: New question; the member for St. George.

Ms. Fish: I want to ask my question of the minister responsible for women's issues. The minister will be aware that day care workers in this province are approximately 99 per cent women. They are dealing with what I think can clearly be described as our province's most precious resource, our children. Their average wage is 66 per cent of the average industrial wage in this province. What steps will the minister take to bring forward legislation to ensure pay equity for those women?

Hon. Mr. Scott: The question of day care, or child care as it is now called, is being considered by the Minister of Community and Social Services (Mr. Sweeney). We are also considering, in the private sector and in the broader public sector, the extent to which the problems of child care workers can be responded to in a pay equity package. When we make the decisions and introduce the bill, the answer will be plain.

Ms. Fish: There are wide differentials even within those statistics of the pay that is accorded to those women dealing with children. Those in commercial centres earn approximately 30 per cent of those in nonprofit centres and approximately 50 per cent of those in municipal centres. If the Minister of Labour (Mr. Wrye) has indicated his clear refusal to extend the existing Bill 105 even to the broad public sector and the municipal workers, how and when will the minister reach pay equity for those at the bottom end in the commercial centres?

Hon. Mr. Scott: The government scheme is to introduce a bill that will cover the private sector and the broader public sector. It will include all the child care workers who are in the broader public sector and the private sector. There are certain problems about dealing with child care workers because, depending on the definition of "establishment" that is selected under the legislation, they may not have a comparison to make, as pay equity requires. I am very conscious of the problem to which the honourable member directs my attention. The bill will show the way the government intends to respond to it.

FREE TRADE

Mr. Mackenzie: I have a question of the Premier. With the latest announcement by the United States International Trade Commission imposing stiff tariff penalties on our steel, well-drilling and tubing products on the heels of the slap in the face we got in the cedar shake industry, should we not end the dishonest Mulroney charade and turn instead to negotiating a mechanism to deal with individual sectoral problems?

Hon. Mr. Peterson: Some people have argued that these discussions should have taken a sectoral approach, industry by industry, but I understand there was no interest on either side in taking that approach. The member would argue, for example, that the steel industry problem should be attacked industry by industry. The steel industry has been subject almost to a managed agreement back and forth between the various industries and the steel caucus. It is not subject to a legal agreement, but it has been working itself out over a long and difficult period of time.

As I understand the mood of the federal government and the US government, that approach was no longer acceptable. It may be the member's idea, but I think they did not want to take that particular approach, and that is why it has been dismissed at this point. Even though the member may think it is a good idea, I do not think anyone else who is negotiating does.

Mr. Wildman: In view of the Premier's answer, in view of the fact that Algoma Steel Corp. is in a very serious economic squeeze and has already announced major down-sizing and in view of the fact that the recently announced tariff deals specifically with pipe, the major export of Algoma Steel, a section of the company that has been expanded recently, can the Premier explain what mechanism he is proposing to protect the market share of companies such as Algoma Steel in the US and to ensure that these kinds of tariffs are withdrawn?

Hon. Mr. Peterson: As I understand it, the Canadian industry now has about 2.4 per cent of the US steel business. It has been subject to a great deal of pressure, and the sense is that if it got up to 2.8 per cent, it would be subject to countervail or a lot of other responses from the US.

I have asked myself the very same question. What are our legal options? I can tell the member that, as a province, unfortunately we do not have any legal options, to the best of my knowledge, although that canvassing of the options is not completely over at present.

Then the member would ask, "What are our political options?" Obviously, these things were discussed last night, the responsibility in bilateral discussions of the federal government. We put forward our concerns on this matter, as has Saskatchewan, the home of International Steel and Pipe Corp.

One of the realities of the situation right now is that it is not going to have an immediate short-term effect on Algoma or Ipsco, because nothing is happening there anyway; they are not selling anything in the US. However, it could have an effect in the long term, depending on an upturn of the market. Algoma got hit far less than Ipsco, as the member knows. Ipsco got hit for 41 per cent; Algoma was seen to be dumping and got hit for something like 14 per cent.

The point is that it is still serious. What would be the appropriate response? Some might argue -- I guess the leader of the third party would argue -- that I should pick up my briefcase, come back to Toronto and just yell at people.

Mr. Foulds: Oh, come on.

Hon. Mr. Peterson: That is what the member is arguing. Others would argue that the federal government has to use its credibility, whatever is there, between the Prime Minister and the President to try to get to a standstill and not allow any more of this to go on while a bilateral trade dispute-solving mechanism is organizing.

Mr. Warner: The Premier is trying to sit on the sidelines.

Hon. Mr. Peterson: If I may finish, I do not mean to be too long with respect to the question asked by the member for Hamilton East (Mr. Mackenzie).

One of the things that will be discussed is a dispute-solving mechanism rather than going through this plethora of options: countervail, the International Trade Commission or a variety of different agencies and groups that have rulings. If some regularized mechanism could be found to solve these disputes on a bilateral basis, probably we would all be winners; I am sure that is something even the member opposite would like to see. That is one of the thrusts. It is going to be long and difficult, and I cannot tell the member what the outcome will be.

RELEASE OF PROSTITUTE

Mr. Speaker: The Solicitor General has the response to a question previously asked by whom?

Hon. Mr. Keyes: It was asked by the member for Carleton-Grenville (Mr. Sterling). I am sorry the member is not here today, but I can give the response to the House.

On Monday, May 26, the member for Carleton-Grenville asked why the Ottawa police force had released a woman they had arrested for prostitution, who was apparently carrying acquired immune deficiency syndrome antibodies.

I have subsequently been advised that this young woman was arrested on Friday, May 9, 1986. The Ottawa crown attorney was consulted, and she was held for the weekend pending a show-cause hearing on Monday morning. The medical officer of health was also advised.

On May 12, the accused appeared before a justice of the peace and was released subject to nine conditions. These included her attendance at the Royal Ottawa Hospital and that she enter into a drug rehabilitation program. She was prohibited from visiting the Byward Market area and was to follow an order under section 22 of the Health Protection and Promotion Act that she "not put another individual at risk."

The Ottawa police also advised that the accused did not live up to these conditions and failed to report as required to that force. A warrant was issued for her arrest, and she was apprehended on the same day on which the question was asked in the House. She appeared before another justice of the peace for a show-cause hearing and will be released on appearance on July 14. Police were not responsible for her release, but rather the courts.

3:10 p.m.

Mr. Harris: On a point of order, Mr. Speaker: When ministers are responding to a member's question, would it not be appropriate to have the member who asked the question in the House?

Mr. Gillies: It is a courtesy that was always extended. We always did it that way.

Mr. Speaker: Order. There have been many occasions when people answering questions have risen and stated they had an answer for someone who is not here. Any other member has the opportunity, particularly the House leader of the party; I do not think it is up to the Speaker.

Does that complete the response?

Hon. Mr. Keyes: There is only one other sentence to it. I have given the essence of it, and I am quite happy to leave it as it is.

EASTWAY FORD

Mr. Runciman: I have a question for the Minister of Consumer and Commercial Relations. Why is his ministry threatening to terminate 70 jobs in St. Thomas by revoking the licence of Eastway Ford?

Hon. Mr. Kwinter: I am not aware of that situation. I will be happy to look into it and get back to the member.

Mr. Runciman: I appreciate that commitment by the minister. According to officials in the ministry, this action came as a result of a call made by some of Eastway's rivals in London to their local member, the Premier (Mr. Peterson). I ask the minister to look into the possibility that his ministry's motives are purely political and stem from an abuse of power by the Premier rather than from a concern for justice.

Hon. Mr. Kwinter: As I said, I will look into the matter and get back to the member.

FREE TRADE

Mr. Foulds: I have another question on free trade for the Premier. With reference to the large number of things the Americans wanted on the table for free trade talks, he said last week, "That table could become more crowded than Thanksgiving at grandma's." What assurances does he have that northern Ontario softwood lumber will not be the next item on the United States hit list to crowd Grandma Reisman's table with Ontario jobs?

Hon. Mr. Peterson: At the outset, I want to thank the honourable member for reading my speeches. I appreciate that very much. My speeches do not bring as much joy in other quarters as they do to the member. I want him to know that.

Mr. Rae: It is a tough job, but someone has to do it.

Hon. Mr. Peterson: If the member has trouble, I will have someone read them to him. The big concern in this country right now is a potential move on the softwood lumber question. It is of grave importance to British Columbia particularly but also to other areas. One of the great surprises is that this shingles and shakes thing came right out of the blue. Apparently the federal government had no knowledge of it; so it says. On the other hand, it was warned by Premier Bennett.

I cannot stand in this House and give members my absolute assurances on these situations. I do know that the Prime Minister is going to put forward in the strongest terms to the President of the US that there should be no action whatsoever on the softwood lumber industry, but it has been under assault for a long time.

Believe me, I do not like to be in the position of defending the Prime Minister. I am just explaining; I am not defending, and the member understands that. I wish I could tell him with certainty that nothing will happen. I wish I could control it legislatively; we would do something about it. I cannot, in absolute candour, give 100 per cent guarantees. It has been the subject of a great deal of discussion, and I hope nothing will happen.

Mr. Wildman: The Premier is holding out hope, but is he aware that 94.5 per cent of Ontario's forest products exports go to the US and that the total exports of Ontario in 1983 amounted to $6.1 million and accounted for $618 million in payroll to northern Ontario? If he is, can he tell us how his hope is going to protect the exports, the share of the market and the jobs in northern Ontario? It did not protect the people in British Columbia. Also, this is not coming out of the blue; we have been under pressure for a long time.

Hon. Mr. Peterson: I say to my honourable friend, I am aware of the problem. I am sure the statistics he quotes in this House are accurate. I know the importance of trade to this province. As he knows, we have roughly a $20-billion trade surplus with the US; that has come under some siege lately. We have seen some initiatives, some attacks, counterattacks and retaliation. Protecting our markets is of great importance to this province, as it is to this country.

I put forward those views, as have others. We will continue to fight on.

Mr. Mackenzie: And do you think a private apology from Reagan to Mulroney is enough reason to continue?

Hon. Mr. Peterson: I guess the member's colleague's view is that I should walk away and hope it does not happen to us.

Mr. Wildman: No.

Hon. Mr. Peterson: That is the view he puts forward. It is not our view at the moment. It is an option we will always have at some time or other in the future. However, those concerns have been put in the US by me personally and by a wide variety of other Premiers and federal people, including all parties across this country, I think, as to how important the relationship is. We are doing the best we can on a political level. We are involved in a tough fight at the moment.

BEACH POLLUTION

Ms. Fish: I have a question of the Minister of the Environment. The minister will know Toronto's beaches have been closed in the past few years because of the high counts of faecal coliform in the water from human and animal wastes. He will also be aware of serious allegations about the flagrant and regular dumping of human waste in the harbour in the port of Toronto. What specific steps is the minister taking to ensure that such dumping of human waste in the Toronto harbour does not occur?

Hon. Mr. Bradley: As the member will be aware, a number of factors contribute to the closing of beaches here in Metropolitan Toronto and across Ontario, one of which she has indicated.

I have asked for a report from people in my ministry regarding this practice. It seems the allegation was made off the record, according to the article the member and I saw in the paper, indicating that people were dumping illegally. Our investigations branch as well as people in the abatement branch are investigating this matter to determine how we can best deal with it.

First, it seems to me that those who are dumping legally should have a form. Some people will say, "Of course, that can be tampered with in some way," but that is subject to law as well. It should be a form that would clearly indicate they have gone through the appropriate procedure to avoid the circumstances we would be concerned about.

My ministry is investigating that, and I will be happy to report back to the member at the earliest opportunity.

Ms. Fish: The minister will be aware that his staff has indicated their principal difficulty is budgetary restraint. The minister has devoted $9 million to water quality cleanup in the Toronto-area beaches. His own leader is on record as saying that is too little, too late and it should have been doubled to $20 million. Will the minister undertake to live up to the promise of his leader and double the amount of money that is committed to the cleanup of the water at Toronto's beaches?

Hon. Mr. Bradley: I do not know whether that is a supplementary question, but I am not the Speaker, so I do not determine that for the member.

Mr. Harris: That is right; so answer the question.

Hon. Mr. Bradley: The member for Nipissing (Mr. Harris) should not be so sore about it.

In answer to the member's specific question, the problem she is talking about, which emerged from the newspaper report, is a matter of enforcement. Even if we had an army of people along there, I suggest it might be hard to identify the specific people who are in contravention of that. We think a proper mechanism of reporting would be more important. That is only one aspect of it.

With regard to the other question, the member will know that at the last meeting of the Canadian Council of Resource and Environment Ministers, held here in Toronto in the fall, I encouraged the federal government to become joint partners in dealing with international waterways. She will also be aware that the previous federal government was involved in providing funds to assist in a cleanup of beaches. I have indicated very clearly that we are attempting to get the federal government on side in this. We are prepared to participate, along with the municipalities. I know the member will want to be of assistance by speaking to some of her federal friends to secure the federal funding that I think could make this go.

3:20 p.m.

HAZARDOUS SPILL

Mrs. Grier: I have a question for the Minister of the Environment. On May 12, Dow Chemical in Sarnia accidentally released four tons of carcinogenic vinyl chloride gas that blew over Port Huron, Michigan. Why did his ministry fail to notify authorities in Port Huron of this very serious occurrence despite agreements between the Department of Natural Resources in Michigan and the Ministry of the Environment in Ontario that require reporting of such incidents?

Hon. Mr. Bradley: I must say to the member -

Mr. Rae: Just give him his answer.

Hon. Mr. Bradley: What did the leader of the third party say?

Mr. Rae: Just read the answer.

Hon. Mr. Bradley: I am not supposed to do that; I am not supposed to reply to interjections. I asked exactly the same question of the officials this morning. We have given that undertaking not only as a result of courtesy between the two sides -- Michigan and Ontario -- but also as a result of a formal agreement we have with Michigan. From time to time, communications have not been as they might be. I have indicated clearly my desire to see any and all incidents of this kind reported. The member has a valid contention. I intend to see that this happens.

Mrs. Grier: It is pretty serious when we blow vinyl chloride gas on Port Huron and when Detroit appears to be building the world's largest incinerator, which it acknowledges will blow dioxin on the residents of Windsor. Of what use is it to have agreements signed by the Premier and the Governor of Michigan, with much fanfare and photo opportunities, when it is only through the intervention of a federal agency in the United States that the incinerator is put on hold and when the Governor of Michigan refuses to back down and acknowledge that the incinerator will pose a threat to people in Ontario?

Hon. Mr. Bradley: I wish I could read the member the note that was sent to me.

I am told that we did inform the Port Huron officials. I asked that question of ministry officials this morning, and the information given to me is that we informed Port Huron officials. I cannot read the second part of the note.

I heard the member talking about the general agreement between Michigan and Ontario. On most occasions, it has worked exceedingly well. The member will be aware through her extensive investigations that Ontario has intervened with the Governor's office in this case and has been involved in discussions with the Environmental Protection Agency in the US. I know David Balsillie of our ministry was at a meeting in Chicago some time ago to outline Ontario's concerns. We have been involved in ongoing meetings, through the accord we have with Michigan and through the provisions that are permitted by the Environmental Protection Agency, to ensure that Ontario's position is put very clearly. I think we are being effective in this regard.

HOUSING POLICY

Mr. Gordon: I want to thank our guest speaker. However, that is not the question.

Mr. Speaker: I was wondering whether you had one.

Mr. Gordon: I have a question for the Minister of Housing. In today's Globe and Mail, the Fair Rental Policy Organization of Ontario came out with a full-page ad indicating it believes the government's housing solutions have failed. They do not see the private sector building any housing. Is the minister going to do away with Bill 78, or is he going to reintroduce it?

Hon. Mr. Curling: It is surprising what the members on that side read and what interpretations they get. I read the ad myself, and it did not say that. The Fair Rental Policy Organization of Ontario is saying it recognizes that in the past the previous government neglected to bring in a comprehensive housing policy to tackle the lack of bringing affordable rental housing to the market.

The honourable member may not have had the opportunity to read the assured housing policy that was brought forward in December and addresses many of those solutions. I encourage him to go back and read the assured housing policy.

Mr. Gordon: The minister did not answer the questions of whether and when he is going to bring in Bill 78. He has been Minister of Housing for 46 weeks, and all we have had is a lot of hype, announcements and reannouncements about his assured housing policy and about Bill 78.

I am going to ask the minister a very simple question. As minister, he should not have any trouble answering it. Can he tell the people of Ontario exactly how many units of affordable rental housing have been built in this province in the 46 weeks he has been minister and in which municipalities?

Hon. Mr. Curling: The member says we have been dealing with the introduction of this bill for 46 weeks. He should take one week for every year the previous government was in power and see what it did about bringing about affordable rental units. Under the assured housing policy we have introduced, 6,700 units have been approved.

He can also check the 5,000 units that have been addressed under the Renterprise program. If we look at the 6,000 under the convert-to-rent program that we also introduced, much more has been done than the previous government ever did towards bringing affordable rental units into this place.

RENT REVIEW

Mr. Reville: I have a question of the Minister of Housing relating to the same document. The minister has boasted about the new, improved relationship between the government and landlords. We hear the landlords boasting they have a solution, but it is not an improved solution or a new solution; it is a solution that would be devastating to tenants.

Mr. Speaker: I am sure you have a question.

Mr. Reville: Will the minister tell the House whether his landlord friends have hung him out to dry? Has he extended the hand of friendship to landlords only to have it bitten?

Hon. Mr. Curling: I can appreciate the honourable member's question and his hesitancy in believing what is happening. Let me assure him that the rent review advisory group I have put together with landlords and tenants has come together and brought some very good recommendations to us.

As I have said before, it is not surprising the member has some doubts about whether we are dealing with the matter that way. Never in history have landlords and tenants sat down to resolve the problem. I do not think the previous government knew what a tenant looked like or what all landlords looked like. No, my hand has not been bitten. They have got together and they will continue to recommend any improvement on our landlord and housing positions.

Mr. Reville: The minister did manage to get the landlords to sit down, but they got up from the table saying something quite different. They are saying: "End rent controls. Bring in shelter allowances." Will the minister tell us which message we are to listen to: kill rent review or strengthen it?

3:30 p.m.

Hon. Mr. Curling: Rent review is a permanent structure for housing policy. It is here to stay, and it will continue to stay as long as this government is in power, which will be a long time.

Mr. Gillies: The minister's urban renewal policy is like Nero's.

Mr. Speaker: Order. Do not be hard on the member for Lincoln (Mr. Andrewes).

CALIFORNIA WINES

Mr. Andrewes: My question is for the minister responsible for wine policy. Since the Minister of the Environment (Mr. Bradley) told us yesterday he has that responsibility at the Liberal cabinet table, and since his Premier has been very supportive of protecting the agricultural base in the province of Ontario, particularly at a time when Canada is involved in discussions on trade with the United States, will the minister now demand that wines from California be removed from the menu at the Trillium restaurant at Expo?

Mr. Speaker: I have read Hansard from yesterday; I was not here. I understand the Minister of the Environment said something to the effect that he was responsible. I looked at the content of the question and, in my view, it should be directed to the Minister of Transportation and Communications (Mr. Fulton).

Interjections.

Mr. Speaker: Order. I wish members would give me an opportunity. I said, in my view, it pertained to a matter dealing with a product sold in the Ontario Pavilion and it appeared to me it should be directed to the Minister of Transportation and Communications, who is responsible for its operation. I will have to ask the Minister of the Environment whether he is in charge of the wine policy for the government.

Interjections.

Mr. Speaker: Order. I am just asking him whether he is.

Mr. Harris: On a point of order, Mr. Speaker: You are imputing something. The Minister of the Environment stood in his place yesterday and told us he was the member responsible. He told the whole House, including the Speaker.

Mr. Gillies: The chair upheld him.

Mr. Harris: How can we take all this time --

Interjections.

Mr. Speaker: Order.

Hon. Mr. Peterson: If I can be helpful, I just appointed him when I came back today.

Mr. Harris: On the point of order, he lied yesterday. I ask him to stand in his place and withdraw it.

Hon. Mr. Peterson: Obviously, my friends opposite do not have a sense of humour. I misjudged them. That minister has taken special responsibility for wine policy for a good number of months now and organized the historic Niagara accord. He is quite entitled to speak on these matters for this party.

Hon. Mr. Bradley: Since the members of the opposition party are so concerned about this matter relating directly to the Expo pavilion, I will allow the Minister of Transportation and Communications to answer.

Interjections.

Mr. Speaker: Order. The time for oral questions has expired.

INTRODUCTION OF BILLS

WINDSOR YOUTH MARCHING AND CONCERT BAND ACT

Mr. Newman moved first reading of Bill Pr4, An Act respecting the Windsor Youth Marching and Concert Band.

Motion agreed to.

LANDLORD AND TENANT AMENDMENT ACT

Mr. Shymko moved first reading of Bill 49, An Act to amend the Landlord and Tenant Act.

Motion agreed to.

Mr. Shymko: The purpose of the bill is to allow landlords the freedom of choice to waive certain rights in favour of tenants. This is related to addressing the whole issue of affordable housing for the citizens of our province.

RESIDENTIAL TENANCIES AMENDMENT ACT

Mr. Shymko moved first reading of Bill 50, An Act to amend the Residential Tenancies Act.

Motion agreed to.

Mr. Shymko: I want to add to my original comments on the first bill I presented for first reading. The purpose of this bill is also to allow the freedom of choice of certain landlords to waive their rights in favour of tenants. This again addresses the issue of affordable housing.

ONTARIO BIBLE COLLEGE AND ONTARIO THEOLOGICAL SEMINARY ACT

Miss Stephenson moved first reading of Bill Pr18, An Act respecting the Ontario Bible College and Ontario Theological Seminary.

Motion agreed to.

3:40 p.m.

ORDERS OF THE DAY

House in committee of the whole.

HEALTH CARE ACCESSIBILITY ACT (CONTINUED)

Consideration of Bill 94, An Act regulating the Amounts that Persons may Charge for rendering Services that are Insured Services under the Health Insurance Act.

On section 2:

Mr. Chairman: When we broke yesterday, the member for York Mills (Miss Stephenson) had made comments to the member for Humber (Mr. Henderson) on his amendment. Perhaps the member for Humber would like to reply to those comments.

Miss Stephenson: I thought we could --

Mr. Chairman: No. This is committee of the whole House and not debate. He can discuss things with the member and she can then come back again to discuss them.

Mr. Henderson: I did appreciate the remarks of the member for York Mills. She conveyed her observations and comments in her usual feisty but very good-natured way. I felt that in this instance she was also very sage, very wise and very prudent in what she had to say. If I may say so, she was also very politic because it is wise public administration to devise and perfect a system that preserves goodwill and is, therefore, likely to work.

I especially want to convey my concurrence with or echo her observation that the issue in this matter is freedom. The first issue is freedom of physicians. One often asks why physicians place such particular importance on professional freedom and seem to value it so very highly. I can only say in response to that kind of implicit question that one must think of the incredible advances in technology and medical science in a whole array of disciplines and fields in which a physician must remain abreast; of the ongoing, thorough understanding of fundamental clinical disciplines that he must preserve and have at his fingertips at all times; of the incredible pace and work load of the modern clinical practice of physicians who work day and night on behalf of their patients; of the necessity also to maintain collegial relations with colleagues, work on shared-duty systems and participate in hospital committees; and of the obligation increasingly placed on modern physicians to justify and interpret all that to a sometimes sceptical public at the same time as maintaining empathy and sensitivity towards patients.

If one is going to ask a professional person to maintain that kind of balancing act, then the government had better not start off by placing him in a straitjacket. I believe, as many of my colleagues do, that this matter of professional freedom is no self-serving interest but is indeed a professional freedom that must be preserved on behalf of excellence in patient care.

Second, there is an issue of freedom of patients which has been raised by my amendments. To seek out the physician of one's choice and to seek a physician with whom one can arrange the contractual arrangements of one's choice is a very important and very precious kind of freedom and one that deserves to be preserved in a democratically governed society.

There is also an issue of the freedom of minorities. In government and in this Legislature, we speak a lot about visible minorities. I believe there is also an issue of the rights of nonvisible minorities, by which I refer to that group of patients that wishes to be free to make contractual arrangements of its choice with its physician and that nonvisible minority of physicians who wish to exercise the right to practise their art and science at arm's length from the state.

There also is an issue of freedom of elected members. I mention this in the absence of the member for Windsor-Riverside (Mr. D. S. Cooke), who suggested yesterday that I ought to resign and sit as an independent member. A democratic government and our democratic way of life surely rest on and are enhanced by the freedom of elected members of Legislatures and other assemblies to speak, to express a point of view, on behalf of conscience and principle.

Liberalism allows for that. I suspect that many would argue that conservatism and democratic socialism allow for that. That is yet another sense in which freedom is important to keep very much in the forefront of one's vision in the consideration of this kind of legislation and of the amendments I put forward. In that sense, the precedent is perhaps an important one.

I want to comment very briefly on the observations yesterday of the member for Windsor-Riverside, who proposed that I ought to resign from my party, sit as an independent member and look more carefully at who my allies are. Last fall a number of members of his party were suggesting to me, in good-natured camaraderie, I suspect, that I ought to join them. That was after a particular committee I was sitting on had discussed some matters and I had made some observations that seemed to be to the pleasure of his colleagues. I noticed that those kinds of invitations stopped in January. I was not very sure why, but I find it curious that the member for Windsor-Riverside should make such a proposition to me now. It is not warranted at all.

As to his proposal that I should look at who my allies are, I have given that some thought as well . I would much prefer to see these amendments gathering some support from within my own party. It does not entirely come as a surprise to me that this has not quite occurred. I can, none the less, wish it were so.

Any politician who does not get support where he wants it looks elsewhere. I have done that too and I do not find very much to be disappointed in. While they might or might not wish to be called my allies, members of a party that won rather a large number of seats in this Legislature a year or so ago and has had some experience in government and knows something of the compromises and flexibility that are required, I am happy to see, have given some support to the amendments I put forward. I am not at all upset in having had an opportunity to think a little further on this question of identifying the nature and quality of my so-called allies in the matter of these amendments I have put forward.

The member for Windsor-Riverside, who proposed that I am speaking for the Ontario Medical Association, is quite factually wrong and must stand corrected. I detailed that yesterday. I can only conclude that the honourable member has not himself talked to the OMA and is not at all familiar with the position it has put forward. He ought to become more familiar with it. Physicians have some experience and expertise and something to say in these matters; they even have a little bit of wisdom. It would behoove the honourable member to be a little more familiar with their point of view.

To wrap up my comments, it seems to me that it is one thing to use the power of the state to guarantee services to needy citizens who may otherwise be deprived or disadvantaged in obtaining those services. It is rather another matter, it seems to me, to say that the needy and the disadvantaged ought to dictate the pattern of delivery of services to everyone else in the province and then ask government to use the power of the state to make that stick.

Physicians are mobilizing as never before, I suspect -- certainly as I have never seen them or known them to do before. Physicians in Ontario are carrying placards, distributing leaflets and pumping hands at subway stations, bus stops, malls and elsewhere. That would have been unthinkable only a decade or less ago.

The politicization of physicians is barely off the ground. Doctors do not like that. They do not wish to be caught up in a political process. They wish to be free to serve their patients and to practise their art. Patients do not like that. They do not want their physicians to be political creatures, I do not believe. Of course, patients are the same citizens and constituents who vote, and this sentiment that I attribute to patients and to physicians is one that wise members would keep in the forefront of their awareness.

3:50 p.m.

It will be a very painful process to pass this bill if it is passed in something resembling its present form. If that pain can be tolerated and if the bill should go forward in something resembling its present form, if all that is successful, the problems will then just begin.

Mr. Chairman: May I just bring the member back to his own amendment and ask that he stay a little closer to it rather than speak on the bill per se?

Mr. Henderson: I will be happy to do that. I was about to conclude. I put forward this amendment to section 2 in the belief that it would solve the problems of extra billing, which is my aim, and that it would preserve reasonable goodwill and harmony or allow for an opportunity to do that with my professional colleagues, upon whom we rely so much to make the system work. I therefore recommend this amendment to section 2 to the consideration of my colleagues in this House.

Mr. Andrewes: May I ask the member for Humber a question about his clause 2(2)(c)?

Mr. Chairman: Is that subsection 2 or subsection 1?

Mr. Andrewes: It is clause 2(2)(c), which reads, "the practitioner has been granted dispensation from the application of the subsection by the Minister of Health." What instances does the member see in which that exemption might be granted?

Mr. Henderson: First, by way of preamble, a few people have misunderstood clauses 2(2)(a), (b) and (c). My intent is that, except as prohibited in subsection 2(1), physicians and some others may charge up to their professional association rate provided that clause 2(2)(a) or (b) or (c) applies.

In clause 2(2)(c), I had in mind the very special situation of a physician who simply does not fit in very well to ordinary categories that might be considered for a group dispensation or group situation. I was thinking, for example, of my colleague, Dr. Ian Munro, who was doing such very specialized and pioneering work. In the event that he were to approach the minister and say, "I think my needs and my circumstances are special," the minister might want to have legislation that would allow him to give special consideration to that kind of situation.

Each of Dr. Munro's operations combines an incredible amount of teamwork from disciplines as diversified as social workers, psychologists, dentists, artists, sculptors, radiologists, surgeons and paediatricians. That kind of representation is included in the team of people who work with Dr. Munro in preparing for what comes together in the form of an operation that might last only a few hours.

I do not know how one can set an across-the-board government tariff which would make any sense that would apply reasonably to somebody whose work is so unique. It simply does not make any sense to propose that an across-the-board tariff could be set up when each operation is in itself a brand-new work of art, and I am not exaggerating in using that kind of language.

I am sure that throughout the province there are other instances of physicians, surgeons and other practitioners who have involved themselves in practices that are highly specialized, highly unique, highly individualized and very difficult to categorize, who ought to have special consideration. I am only proposing by this clause 2(2)(c) that there be a mechanism whereby the minister may give special consideration to highly unusual circumstances that do not fit in anywhere else, circumstances that are very important to the health care system by virtue of the degree of specialization; by the opportunity, in effect, to remake a wrecked life by the potential for this kind of surgery, and by the fact that there may be only a few people in the world who are able and have had the training and experience to offer this kind of service.

We do not want to lose these people. We want to have the flexibility in our legislation to allow very exceptional practitioners to receive special consideration.

Mr. Andrewes: I thank the member for Humber for that explanation. He has put this responsibility on to the minister. What criteria did the member have in mind for making that kind of dispensation? Does he have in mind a panel or advisory group to the minister? How would the minister undertake to provide this dispensation? What guidelines does the member offer?

Mr. Henderson: I must confess to the member for Lincoln that I have not thought through the details of that as well as I might have. If he has any ideas, I welcome them.

It had occurred to me that the district health council might be a body that could be brought into some mechanism to ensure that these kinds of requests would receive fair consideration. The district health council would presumably have a wish to try to attract and retain exceptional practitioners in the district or region they represent. I am sure there are disadvantages to that suggestion as well.

I presume that if through some convergence of events that I cannot readily foresee at the moment this clause ever became law, the minister would put his mind to it in a very thorough way and it would be possible to devise some mechanism, perhaps some committee to advise the minister on it. It would be important that there be some expert input into that committee, perhaps from the Ontario Medical Association. There are some evaluations that must have expert input. Physicians can perhaps evaluate the exceptionality of a practitioner's situation in ways that others cannot.

I must acknowledge that I do not have a very full answer to the member on that point. It is something that merits further thought and he might well have some excellent ideas he will want to put forward.

Mr. Andrewes: I want to go back to the member for Humber for a moment. One of the proposals the minister put on the table for the OMA was what is loosely termed an "excellence fund," which we assume would provide some additional incentive for those who in some way feel their services warrant a fee over and above the Ontario health insurance plan fee. The minister is not nodding; perhaps he is not listening. I assume that was his purpose in putting the incentive fund on the table. Am I correct?

Hon. Mr. Elston: I am sorry.

Mr. Andrewes: I was asking the member for Humber, in the light of his amendment, a series of questions to try to clarify how his proposed dispensation from the effects of the amendments he has made might be carried out and how the minister, to whom he gives the responsibility to provide this dispensation, might arrive at some criteria for granting the dispensation.

I am looking for some advice on the whole question of the excellence fund that was proposed, whether the excellence fund was directed at those physicians who feel their qualifications and unique skills are such as to warrant payment over and above the Ontario health insurance plan fee. Was that the concept embodied in the excellence fund?

4 p.m.

Hon. Mr. Elston: That has nothing to do with this amendment whatsoever; it is not part of this amendment. I can tell the member we were hoping the excellence fund would be worked on between the government and the Ontario Medical Association, but it has nothing to do with this amendment whatsoever. There is nothing in this amendment to contemplate those other portions of the reasonable program we put forward for discussion.

Mr. Andrewes: I take exception to these comments. The amendment put by the member for Humber says:

"(2) Except as prohibited in subsection (1), a physician or an optometrist who does not submit accounts directly to the plan...or a dentist may charge an amount not to exceed the amount provided for in his or her professional association's schedule of fees provided that...(c) the practitioner has been granted dispensation from the application...."

The member for Humber chose the model of Dr. Ian Munro, who, by his definition and description, indicated that each time physicians of that skill went to work, they performed something unique; their procedure was somewhat specific to the individual and the circumstances that confronted them.

I am asking only whether that is in the same context as the question of the excellence fund. Is it the Ian Munros of this world to whom the minister is directing the concept of the excellence fund?

Hon. Mr. Elston: That has nothing to do with this amendment. The excellence fund is not included in this. He knows that, and I know that, and there is no merit in proceeding in discussion of that fund or that concept at this point. This thing does not talk about that. We are getting far removed from designations that are thought of in the context of another person's amendments. His amendments are not my amendments. I am not supporting those amendments, and I am not able to provide the member with any background with respect to what his amendments are about.

Mr. Andrewes: I am a little puzzled by the fact that we are in committee, where we are supposed to provide each other with some clarification of issues and have a reasonable discussion. Nevertheless, I will try to pursue this issue with the member for Humber and ask him whether the concept of the excellence fund, as he understands it, is in keeping with the thrust of his amendment.

Mr. Henderson: If the member is asking me whether the excellence fund is the same kind of concept as I have proposed in clause 2(2)(c), I suppose there is a commonality -- and I do not speak with any authority on this -- in the sense that one of the functions the excellence fund was intended to serve was to find some mechanism for acknowledging the exceptionality of certain individuals. That is what I had in mind in clause 2(2)(c).

I suppose the differences between the excellence fund concept, as I understand it -- and my understanding of it may be very imperfect -- and clause 2(2)(c) would have more to do with the implementation and perhaps with the social psychology and group dynamics of how it would all work out and with anything that is very easy to discuss in the context of framing things legislatively.

Once something as broad as an excellence fund is set up, it brings into play a lot of factors of group dynamics, group rivalry, group envy and other tricky bits of human vocational psychology that carry their own force and have their own consequences, the nature of which is hard to foresee. The very fact of not foreseeing something in clinical practice is very important. People live and die by the rightness or wrongness of the clinical acts and sometimes the organizational, administrative and legislative acts that underlie those clinical acts.

I thought of clause (c) because it seemed to me a simpler way of acknowledging the exceptionality of certain practitioners, a much less complicated way that need not impinge on bureaucracy and need not call into play a proliferation of institutions or parts of institutions. I like clause (c) because of its simplicity and because it gives the minister a mechanism for devising something that might work relatively well and relatively simply.

Miss Stephenson: I want to ask the member for Humber whether the mechanism might be similar to that in place now for the establishment of the fee for procedures that are listed as benefits under OHIP but have no fee attached to them. A significant number are in the OHIP booklet which is distributed to physicians in this province. They are primarily in the area of cosmetic surgery, but much of that is related to reconstructive surgery. When the reconstruction has a physiological and psychological basis, the procedures are benefits under the plan. The determination is made by the physician-bureaucrats, so to speak, of the insurance program, who determine whether they will be insured benefits.

The difficulty in that circumstance, and it is a circumstance that has to be met with some regularity these days, is that there is not a standard OHIP fee against which can be measured, for example, the kind of criterion the member has placed in clause (b), where he has suggested that if 50 per cent of the billings of an individual have been at the level of the OHIP benefit within the previous three months, that exception could be in place. In some circumstances, and they may be a narrow range of circumstances, it might not be possible to do that measurement.

I am concerned that situation should be addressed somewhere as well, but I am not sure it needs to be in the legislation. I wonder whether the member had that in mind when he was looking at the specific dispensation provided by the minister on a basis that I would suggest would be a consultative basis involving not only the district health council -- which is a good idea because it represents the community, the providers and the recipients of health care -- but also the College of Physicians and Surgeons of Ontario or the College of Optometrists of Ontario and the professional association in addition. In both of those circumstances, the college is the body that determines whether an individual has a specialty worth noting in terms of the seniority of the profession.

4:10 p.m.

Mr. Henderson: I want to thank the member for York Mills for those comments and for raising the helpful point of comparison with the determination of the fee in an instance of services where it is not spelled out.

If, by some arrangement of circumstances, clause (c) were ever to come into effect, I would like to imagine there would be something allowing for some sort of community input so the decision would not simply be made by physician-bureaucrats, as the member says, but there would be some way for a community to say to the minister, "We want this kind of practitioner" or "We want this practitioner." The district health council might be one such mechanism.

There might be other mechanisms. The member for York Mills might have some ideas about that. There ought to be something that would give the community a little more say in it than simply speaking to the physician-bureaucrat -- I realize that would not be the nomenclature -- or to the person in the Ministry of Health. I would like to see something a little more democratic by way of a decision-making structure.

If I understand the member's final point, clause (c) need not be invoked if the exceptionality of a particular practitioner could be accommodated under clause (a) or clause (b).

Let us stay with the example of Dr. Ian Munro. If he were working in a hospital or clinic where most of the people were already opted in, there would not be a problem. If that were not the case and he chose to do better than half his work on an opted-in basis for three months, it would not be a problem. However, I would like to see some kind of mechanism whereby if neither clause (a) nor clause (b) applied, there would still be at least a mechanism whereby the minister could make a dispensation upon suitable input from the community. That is what I had in mind in clause (c).

Miss Stephenson: The implication of such an act on behalf of the minister would be a useful one right now. I am fairly sure the member for Humber is aware that the in vitro fertilization clinic established through the University of Toronto department of obstetrics and gynaecology is one of the most successful in the world in terms of its positive rate of success, which is something of the order of 36 per cent. No other clinic, even the original one in Britain, has achieved that.

This is a procedure that is not listed anywhere in any of the procedural information provisions, and it is a matter of some concern to those who have been involved. As a result of that involvement, a number of very bright young graduates have proceeded to very intensive post-graduate training in order to seriously consider returning to Canada. It is my understanding that because of the provisions of Bill 94 as it is currently written, three of them have made the determination not to return to Canada. They were to be the next generation who would carry on this very important work which provides an obstetrical success rate in many instances where all other procedural activities fail. We will be bereft.

If the member's mechanism were in place, the unique service to be provided by these young specialists would be recognized through some procedure that would require the minister's final stamp of approval and would permit that procedure to be carried out with reasonable recompense since it is so rare, so unique and so highly specialized.

It is not simply in the reconstructive surgery area, the cosmetic surgery area or the artistic provisions in which some surgeons must become very deeply involved; it is in other vital circumstances as well that this provision would be useful.

The suggestions the member has made in terms of the requirements even to be considered for an exemption from the rule of billing at the level of the OHIP benefit are well balanced. They are pretty stringent in some circumstances. There are instances in which a very experienced family physician who happened to be the only physician in a community, by the member's requirements, would never be permitted to bill beyond the level of OHIP benefits because within that community he or she was the only physician available. That would provide a pretty stringent requirement.

None the less, this is a reasonable direction to pursue to attempt to find a way to ensure that the primary concern of the professions is addressed appropriately. That primary concern is the traditional freedom to function as agents and on behalf of patients rather than as those employed by the government for the purposes of delivering services in health care. I cannot stress too vigorously my great and increasing understanding of that concern as the only item at issue in this debate as far as the professionals are concerned.

Yesterday, the member for Windsor-Riverside suggested very strongly that I was totally out of touch and knew nothing about what was going on in the delivery of health care. I tried to inform him that I have some mechanisms for keeping in touch. I also wish to inform him that after last night's meeting of district 11 of the Ontario Medical Association, I learned I am not only in touch but also may be a little too conciliatory

Mr. Breaugh: Who made that wild accusation?

Miss Stephenson: -- in the directions I would pursue to try to resolve this issue compared to those actively practising, the highly specialized and family-physician members of district 11 who met last night to provide guidance to the executive of the OMA. Since they represent almost one third of all physicians in Ontario, it might be wise to be a little hesitant about pursuing a goal that appears to be the total subjugation of the profession.

As I said yesterday, I firmly believe the amendments suggested by the member for Humber go a very long way to solving that problem, to removing us from the toils of the impasse in which the ministry and the profession now are embroiled. As well, I firmly believe my request yesterday for a 24-hour period of serious consideration of these amendments was not only valid but also very reasonable. I hope 24 hours has provided some food for thought.

I do not expect the minister will have paid any attention to the amendments, but other colleagues of the member for Humber on that side of the House might have paid some attention to them and might have seriously considered their implications for the future quality of the health care delivery system in this province, because Bill 94, as currently written, ensures that this quality will decline.

The member for Humber has done a great service to his party by developing amendments that would go a long way in continuing to ensure that the high quality of service in Ontario is maintained rather than destroyed. I am pleased that clarification has been provided us regarding the mechanisms the member is suggesting in clause 2(2)(b) and clause 2(2)(c) of his amendment.

4:20 p.m.

The Deputy Chairman: Does the member for Humber have any comments?

Mr. Henderson: I have about one sentence. Notwithstanding the guffaw from out Oshawa way, I believe the member for York Mills is correct in identifying a stringency. I did think through all or almost all aspects of this dilemma as thoroughly as I was able, and I did try to put together something that would be rather stringent and would leave a lot of aces in the hands of the minister. It is stringent enough to have got me a little unhappy feedback from some of my colleagues; so it is seen by them as stringent. It does yet preserve professional freedom, and it does yet address the problem issues raised by extra billing.

I recommend that notion of stringency to my honourable friend the member for Windsor-Riverside, who feels I am echoing the views of the OMA. That is not the case, and it is not at all seen by them or by me as the case. These are stringent guidelines that none the less would work.

Mr. Breaugh: I want to interject briefly. I have some concerns. We are into the second day of debate on this bill. As the member for York Mills spoke yesterday, it became clear to me that she intended to talk out the afternoon. She did, and that is fair game. She sought 24 hours to cool out, and she got that.

We are here this afternoon to process a piece of legislation. In virtually two days of legislative debate, we have not had the opportunity for one vote on one amendment. I appreciate that the member for Humber has successfully hijacked the minister's position in taking the bill through the Legislature. It is his right to do that, and he has exercised that right. It is rather unfortunate that we have had two days of debate without getting to the proposals from the minister.

The chair is in an awkward position. We are in committee, and traditionally, during committee work, we have allowed questions back and forth and there has been some laxity. I want to put it to you, sir, that people around the province have watched us dither and dather for two days about this important piece of legislation. I ask the chair to make people abide by the rules, which I remind all members are that we are here to speak to the amendments, not to voice our opinions about meetings we went to last night, or what we would like to do or the wonderfulness of the world.

We are here to process a piece of legislation. People around Ontario are watching us on television and expecting us to do exactly that. I would like us to get around to that business. However much we might want to say on the bill, there are an important bill and now amendments before us, and I am anxious that we get to work and do our job.

Miss Stephenson: These amendments are very important.

5:15 p.m.

The committee divided on Mr. Henderson's amendment to section 2, which was negatived on the following vote:

Ayes 38; nays 63.

Mr. Chairman: Mr. D. S. Cooke moves that section 2 of the bill be amended by adding thereto the following subsection:

"(2) A practitioner referred to in subsection 1 shall not accept payment in respect of an insured service rendered to an insured person until after the practitioner receives notice that the patient has been reimbursed by the plan unless the insured person consents to make the payment on an earlier date."

Order. Will those leaving the chamber please do so now and quietly. Otherwise, please be seated.

Mr. D. S. Cooke: I have a subsection 2(3) I would like to read also. There are two amendments.

Mr. Chairman: I understand you perhaps want to have these considered together as a unit. Is there some reason that they must be? It is more confusing for the members.

Mr. D. S. Cooke: It does not matter. I can move them separately.

Mr. Chairman: Unless they have to go together, that would be simpler for the members.

Mr. D. S. Cooke: Very briefly, this matter was debated at length in the standing committee on social development. One of the concerns that was expressed by consumer groups and those people supporting Bill 94 was that doctors who can opt out under Bill 94 will be able to ask for that money, the payment for the insured service, right after the service has been provided, unless my amendment is carried. In effect, even the OMA has agreed that if this amendment does not carry, we could have a bill that will result in decreased accessibility rather than the increase in accessibility which is the purpose of the bill.

The purpose of this amendment is simply to ensure that a person will not have to pay for the service until he or she has received his or her payment from OHIP. Under this amendment, the physician will be notified that payment has been received by the patient. This will guarantee that accessibility will be increased and the principle and idea behind Bill 94 will be implemented. I hope we can count on the support of the government on this important amendment.

Hon. Mr. Elston: I have a couple of points to make. First, we have not yet dealt in clause by clause with subsection 2(1) and we are amending the section to deal with a subsection 2 that refers to subsection 1. It is a matter of making sure we are progressing at the right stages.

5:20 p.m.

Mr. Chairman: Does the minister mean that section 2 becomes subsection 2(1)?

Hon. Mr. Elston: Yes. This amendment refers to subsection 2 and we cannot deal with that. There is a clause in there that is not being amended, as I understand it.

Mr. Chairman: That is correct.

Hon. Mr. Elston: It appears in the bill, and I think we should probably deal with it first.

Mr. Chairman: However, we have several amendments. We have one from the member for Windsor-Riverside and we also have one from the member for Lincoln (Mr. Andrewes). If we take the member for Lincoln first, that is an amendment which says, "delete the entire section 2," then sets out his set of amendments. Therefore, is it not in order for us to take the amendment of the member for Windsor-Riverside first. He is amending only and not deleting the entire section. Is that not correct?

Hon. Mr. Elston: I do not think so.

Hon. Mr. Sweeney: The member for Windsor-Riverside is adding on.

Hon. Mr. Elston: If the member for Windsor-Riverside would like to add on to the entire section and deal with the entire section at one time, I have no problem with that. He then has subsections 2 and 3 to add, as I understand his notice of amendment. I am not sure about any others that may serve as a part of it.

Mr. Chairman, if you want to deal with the entire section, I would have no problem in doing that, but I want to understand what we are considering as these items are brought forward.

Mr. Chairman: We have not carried section 2 and we cannot carry section 2 at this point.

Hon. Mr. Elston: In that case, if we are going to deal with the amendment that has been moved, I would like to rise at this time and indicate we will support this amendment as brought forward and look forward to having a vote on this important item.

Mr. Andrewes: At present, I have misplaced my copy of this amendment. Can the member for Windsor-Riverside give me another copy?

Mr. D. S. Cooke: I have only my one copy.

Mr. Chairman: Ah, the ever-present government whip.

Mr. Gillies: They call her "helpful Joan."

Mr. Andrewes: She has the handiest photocopier in the building.

It probably will not come as any surprise to the minister or the member for Windsor-Riverside that we will not support this amendment. The amendment binds the patient and physician to a contract on payment, which destroys the relationship between the patient and the doctor.

I also find somewhat offensive the other aspect of this amendment, which is that it assumes physicians are not reasonable, compassionate and understanding people. It assumes they will not develop a relationship with their patients as far as payment is concerned if payment is a problem. Therefore, we find the amendment offensive because it violates an oath sworn by physicians as members of a profession. It violates professional ethics in a doctor-patient relationship that we should be able to understand. We should not need to pass this kind of offensive legislation.

Miss Stephenson: I do not believe that I could express sufficiently strongly in words the total disgust with which I regard this kind of amendment suggested by the New Democratic Party and supported by the minister.

The minister, as the Minister of Health, has been dealing with the medical profession now for almost one year. He has learned, I believe, that the code of ethics of the medical profession is the most stringent, the most demanding and the most closely followed by any group in total percentage of ethical members.

I am absolutely astonished that the minister would stoop to suggest that he should legislate totally the doctor-patient relationship. It is not enough, apparently, that he is intruding and invading a territory in which he has no business. He now is about to say that, as a result of this legislation, he is the only one who can decide when and if an account should be sent to a patient by an opted-out physician.

I reiterate that the member for Windsor-Riverside has no idea what he is talking about when he talks about the delivery of health care by physicians. He has no understanding of the relationship that occurs between a practising physician and his or her patients. He has absolutely no insight into the very reasonable plane that is established in 99 per cent of those relationships.

I believe very strongly that it is an absolute insult to the total medical profession to suggest that this kind of legislated act is necessary. The member for Windsor-Riverside suggested that there had been debate about this in committee. There was no debate. In committee we were never given an opportunity to debate anything because we spent all the time hearing delegations. I do not believe that is construed as debate within committee.

There was a statement made by representatives of the practising physicians that they understood there might be a hardship for some patients and that obviously they would not demand payment until the patient had been reimbursed, but that is an understanding which is part of their ethical background and procedure.

It is unfortunate this Legislature has sunk to the level of suggesting that no professional in this province should ever submit a bill of any kind until an insuring program has provided the client with some kind of reimbursement. As far as I know, we do not attempt to control any other group in society in that way. I find this absolutely unintelligible as far as human activity in a so-called democratic society is concerned.

Mr. D. S. Cooke: I would like to take two minutes to respond to the member for York Mills, the first doctor in Ontario to opt out of the Ontario health insurance plan. During the hearings, this was identified as a problem. In fact, doctors came before the committee and gave the impression to the committee that they would exploit the fact that they could opt out and charge immediately after the service had been rendered as a method of protesting this bill.

The member should not tell me that this ethical myth that is so terrific and provides everybody in Ontario with equal accessibility will work. We know it has not worked. That is why we have Bill 94. We have to put in this protection because we have seen some of the tactics that have been used by some physicians in this province, such as the physicians in Timmins. We know we have to put this in. It does not make me feel good to say that we have to regulate further, but the reality of the situation is that there are some irresponsible people who are not in touch with the needs of middle- and low-income people in this province. To protect the latter, we have to put this in and I am pleased that it is going to pass.

Mr. Andrewes: I am pleased to learn that the minister has decided to join the debate in spite of his hesitancy to do so earlier on. What leads the minister to believe there is a problem?

Hon. Mr. Elston: I am a member of the committee. If the member for Lincoln has concern about an amendment that has been moved, he should address it to the person who moved it. The situation was outlined by the member for Windsor-Riverside. I have nothing further in explanation of his amendment.

Mr. Chairman: The member can ask the mover of the amendment or can ask the minister's position on the bill. The minister is carrying the bill.

5:30 p.m.

Mr. Andrewes: That is what I assumed, Mr. Chairman. The minister is carrying the bill. The minister wanted this bill brought out of committee so we could have this discussion. We are trying to have a reasonable discussion; yet the minister sits there and will not respond to my questions. Are we going to protract this debate simply on that ground alone?

Mr. Chairman: In fairness to the minister, the question was not as clear as it might have been. Could you rephrase the question?

Mr. Andrewes: The minister has indicated that the government would support this amendment. What leads the minister to believe the amendment is necessary?

Hon. Mr. Elston: It has come to our attention, in questions in the House and in other places, that problems have existed, that there are difficulties. I have dealt with some as a constituency representative in other times as well. It seems to me that the amendment is placed, in a sense, to make sure the bill is much more workable and does provide protection for patients. That is the essence of the need for the legislation. I have nothing further to say, unless the member would like individual circumstances where there have been problems. Those could be set out, if the member wishes.

Mr. Andrewes: Please understand that I am not trying to be unreasonable, but what the minister is endorsing here is legislation that draws into question the efficacy of a medical practitioner. He and the member for Windsor-Riverside are proposing an amendment that would legislate professional conduct. I ask the minister to give us some compelling and convincing reasons other than some constituency visits he has had. I do not know how many members have had those kinds of constituency visits. I have not had any. Perhaps my evidence might stack up against the minister's, but I would like to see his evidence.

Hon. Mr. Elston: Problems were outlined during the committee deliberations, and there was a series of extensive presentations. There were suggestions that people did feel real hardships in having to make payments. Sometimes the arrangements were not as easily made as at other times.

The situation was one where a person, having visited a specialist here in this city, having been referred down here by his general practitioner, not only came face to face with the fact that, being on welfare, he was unable to afford the extra charge, but was also requested to pay the charge up front, before the service was delivered. I have brought that anecdote out several times and have been told not to go back into those anecdotes, but those are the types of situations we are discussing. What we are doing with this amendment is creating a situation where the patient will know that there will not have to be an upfront payment, that he will have the time to pay when he is reimbursed.

I do not see a particular way around the difficulty the member has had where people have not gone to him. I do not know why they have not gone to him, but they have come to me on more than one occasion and I cannot do anything more than provide the member with those details. I do not know how else to do it. I cannot do it blow by blow, I cannot ask all the members of the Legislature to do it and I cannot ask people to go through the entire Hansard of all the deliberations; I do not think the member wants me to do that. But that is one of the reasons for us to support this.

Mr. Andrewes: I am not asking the minister to do that at all. All I am saying is that, ideally, if I went home on the weekend and a constituent or two or three or four come in with a similar problem, I would love to be able to say, "Yes, we will pass some legislation and solve your problem." The minister is assuming there is a problem because he heard some evidence adduced to him in the committee. He heard some evidence there. He heard some evidence from members, I assume. He has heard some evidence offered to him individually as a constituency member of this Legislature, and he is now prepared to support, and enshrine in legislation now for all time, a rule on the basis of a very narrow bit of evidence, as far as I can understand. I am not convinced this is the right way for this Legislature to operate and I want to be convinced.

Mr. D. S. Cooke: I might draw to the member's attention a parallel situation a few years ago when the member for St. Andrew-St. Patrick (Mr. Grossman) was Minister of Health. He asked for an amendment to the Health Disciplines Act to force doctors to give advance notice if they were going to extra bill. This great profession that is so responsible had to be regulated by its government as well into being professional and responsible. It had to be forced to do that.

Miss Stephenson: In the instance that was outlined by the minister as the one he could recall, the question I would ask is whether --

Hon. Mr. Elston: Come on. I indicated it was one I have used on several occasions. It is not the only one I can recall, and the honourable member knows that is what I said.

Miss Stephenson: No, I did not. I am sorry, I did not know that is what the minister said because that is not what I heard him say. He did say he had used it on several occasions.

I point out to the minister that if the individual physician made the request for payment before the delivery of service, it should have been reported immediately to the College of Physicians and Surgeons of Ontario, because that is an unethical act on behalf of the physician and that is where it should be dealt with.

The code of ethics, which has been developed within this country and provides a very reasonable guideline -- not reasonable for physicians, but a reasonable guideline for the protection of the public -- ensures that this should not happen. If it does happen, we do not have to pass legislation. We simply refer it to the college of physicians and surgeons, where that individual will be dealt with. When this kind of activity is outlined already in the code, surely we do not need legislation.

The instance mentioned by the member for Windsor-Riverside is nothing that was ever outlined in the code. It was specifically related to a desire to ensure that all patients were informed that the amount that was going to be billed was greater than the level of the OHIP benefit in order that they would be prepared. That kind of discussion is necessary, we believe, if that is going to be done.

The regulation that was added to the act was to ensure that this sort of activity would be done, but that is not within the code of ethics. The activity mentioned as an example by the minister is within the code of ethics and can be dealt with most effectively that way. I really have some concern that, on the basis of this kind of example, the minister would suggest this kind of legislation is necessary.

Mr. Chairman: Are there any other honourable members who wish to speak to this amendment? There is no response.

Miss Stephenson: I have one more comment. I expected that perhaps the minister might respond, but since he is not going to do so, I would simply like the minister to understand that what was perceived by the profession generally as a very significant insult in the totality of Bill 94 has now been effectively expanded very dramatically. The minister has just added yet another severe insult. If he really wants to have a totally demoralized, absolutely antagonistic medical profession delivering health care on behalf of the Minister of Health of Ontario as his employees, that is exactly what the minister is going to get if he adds this kind of insult to the legislation he is already perpetrating.

Mr. Chairman: Is there any further response or comment before I put the question?

Miss Stephenson: What are we going to do with the legal profession? That is what I want to know.

6:19 p.m.

The committee divided on Mr. D. S. Cooke's amendment to section 2, which was agreed to on the following vote:

Ayes 58; nays 37.

Mr. Chairman: Mr. D. S. Cooke moves that section 2 of the bill be further amended by adding thereto the following subsection:

"(3) A physician, optometrist or dentist referred to in subsection 1 who makes a charge for an insured service shall supply the insured person with a written statement of the charge in particulars sufficient to identify the nature of each service and the charge therefore."

Order. Will the people leaving the chamber please do so quietly or take their seats.

Mr. D. S. Cooke: This amendment will require that any physician, optometrist or dentist who has opted out under Bill 94 will have to file a statement with the patient. This will identify for the patient whether he is being extra billed. This will help the enforcement mechanism that is suggested by the minister. It will allow for proper enforcement of the legislation and for consumer education.

Hon. Mr. Elston: This amendment is slightly changed from the one we saw earlier. This includes only those people under the original section 2, who are opted-out physicians, optometrists or dentists. We have some concerns with respect to the administrative effectiveness of this amendment. In fact, it could cause some difficulties in providing us with some administrative means of ensuring that the information provided complied with detail sufficient to meet the guideline or intent of the section. Under the circumstances, therefore, we cannot support the amendment in its current form.

I should advise the members of the House that under the Health Insurance Act there is a requirement at this stage that a card be made available and filled in with the designation of the service provided and the charges for it. In some ways, this section, as suggested, would be in addition to something that is already available under the OHIP legislation.

Mr. Andrewes: With the confusion in the House, I have a little trouble hearing what is going on, but I sense that what the member for Windsor-Riverside is doing is to ask a practitioner to supply a patient, upon leaving the office, with an itemized account so that the patient actually knows whether the charges levied are in line with the OHIP fee schedule. Is that the gist of it?

Mr. D. S. Cooke: That is right.

Mr. Andrewes: In all likelihood, we will not be supporting this amendment. I want to say to the minister that he may want to consider a broader amendment. He has indicated that this amendment is very specific. He may want to look at a broader issue.

Miss Stephenson: I have not seen this amendment.

Mr. Andrewes: I am sorry. Would the member like a copy?

Mr. Chairman: Carry on, please.

Mr. Andrewes: There is a fair bit of sympathy for an annual statement that would come to a patient.

Mr. Breaugh: Now we know who hit the member in the eye.

Mr. Andrewes: That is only speculation.

There is a fair bit of sympathy for an annual statement that would come to a patient from OHIP to each subscriber to that health insurance plan, a broader statement that would include services rendered by a physician, services rendered by a dentist that are insurable under the plan and services rendered by anyone else whose services are covered as insurable, including optometrists, chiropractors, physiotherapists and other people who are covered under the health insurance plan.

I want the minister to know as well that we would encourage him to look at an amendment that would provide patients on an annual basis with some kind of reconciliation for services they receive in a hospital. It is important that the concerns of the member for Windsor-Riverside and his caucus be addressed. At the same time, it is important that the concerns of the population as a whole be addressed, that they know the services they have received have been thoughtfully accounted for and also that they have some sense of the health care system and of the cost that has been incurred to that system by the individuals who have received these services.

There is sympathy for this amendment in the Progressive Conservative caucus; the specific amendment itself we will not support.

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

The Acting Speaker (Mr. Morin): As the Ontario Senior Achievement Awards will be held in the front lobby at 6:30 p. m., may I ask that all members refrain from using the great staircase at the adjournment of the House today.

The House adjourned at 6:30 p.m.

3 juin 1986