Journal des débats 1986-juin-04 | Assemblée législative de l'Ontario

Mr. Hennessy: I want to make a statement about the government's management of the Urban Transportation Development Corp. sale and the impact it is having on Thunder Bay and the Can-Car Rail plant.

At the beginning of March, we were told by the Premier's wonder boy, John Kruger, that the sale of UTDC to Lavalin was all wrapped up. The weeks have turned into months and there is still no sale. This dithering has had a bad effect on Can-Car Rail, and the employees are fed up. They have seen the manager of the plant let go, they have seen the superintendent of the plant let go and they have seen 126 employees let go the other day with the possibility of many more to come.

During the winter, the Premier (Mr. Peterson) was in Thunder Bay promising no jobs would be lost at Can-Car Rail. What good are his words now? The people at Thunder Bay feel betrayed by the bungling of this government. The workers at Can-Car Rail, one of the finest rail assembly plants in the world, feel they have been led down the garden path.

When will this government realize it cannot play with people's lives this way. Why can John Kruger and the Premier, who boasts of his business expertise, not get this deal closed? Why can the workers at Can-Car Rail not get back to work instead of living in fear and frustration? Why can the Premier and Kruger not get their act together over there? In a polite way, I ask the Premier to quit sitting on his laurels.

PROVINCIAL PARKS

Mr. Laughren: I am very concerned about the parks policy of Ontario in 1986. I picked up a copy of Ontario Provincial Parks Guide for 1986. The booklet is supposed to tell people what is available and what activities go on in the various provincial parks, but it is either deliberately misleading or it overlooks some facilities that are available.

While the booklet lists such things as swimming, comfort stations and boat rentals, it overlooks the possibility of mining, logging, hydro dams and hunting, which are also allowed in our provincial parks. Did the Minister of Natural Resources (Mr. Kerrio) deliberately leave out the other activities that are available, or was it just an oversight? Would he care to make a statement on that?

What is particularly galling is at the same time the things that actually can go on in our parks are overlooked, the amount of the charge being levied against senior citizens has been significantly increased and the cost to these non-profit organizations has also been increased. It is time the minister brought some order into parks policy in the province.

STUDENT BAND

Mr. McKessock: A few weeks ago, I mentioned to the members that the John Diefenbaker Secondary School band from Hanover would be participating at Expo 86. Not only did the school's 49-member concert band bring home a silver medal from an eight-day trip to Expo, but it also brought raves from Vancouver's fair.

Brenda Porteous, a 17-year-old girl from the Hanover school, said the band gave a total of three concerts, one at the school where the musicians were billeted, one at the Washington pavilion bandstand at Expo and the other at Douglas College. She said she was most impressed by the Ontario Pavilion. "It gave the world a good image of Ontario and made me feel very patriotic," she said.

Band leader John Smith called the trip fantastic. He said, "I really felt it was an excellent experience for all of us." He was pleased to learn how the Hanover band compared with others across Canada. He felt the accomplishment was something of which the band and community could be proud. He said the students knew before the trip that they were representing the community and they handled the whole experience with a mature, co-operative and happy attitude.

The members might be interested to know that John Smith, the leader of the band, is the son of Gordon Smith, former MPP from Simcoe East.

GRIFFITH MINE

Mr. Bernier: As all members of this House know, the closure of the Griffith iron ore mine in Ear Falls created an economic dilemma to that community and to that general area.

As a result, a grant was provided to establish the Ear Falls-Red Lake Economic Assessment and Planning Committee, chaired by a former Speaker of this House, Jack Stokes. This committee was set up to recommend a plan of action to compensate for the closure of the mine and the loss of 300 jobs.

In spite of its efforts to enlist the aid of several ministries at the federal and provincial levels, absolutely nothing was done to assist in its endeavours and, in fact, no response was received from this government.

As a result of the lack of interest and concern, the committee has indicated that it sees no justification for the continuance and perpetuation of this frustrating and wasteful exercise. It sees no alternative but to discontinue its studies and has so advised the government as of June 3, 1986.

This government has now received the report from the Royal Commission on the Northern Environment, which produced 129 recommendations, and the final report of the Advisory Committee on Resource Dependent Communities in Northern Ontario, which produced 80 recommendations. In addition, the government has now received the final report of the Ear Falls-Red Lake Economic Assessment and Planning Committee, which has nine recommendations in it, and Jack Stokes's report on the Dash-8.

The four major reports all deal with northern Ontario's concerns, and to date no action has been taken on any one of them.

PUBLIC HEALTH NURSES

Mr. D. S. Cooke: All across Ontario, public health nurses are fighting for justice in this province. In the last year, there have been strikes or lockouts in Kingston, Windsor-Essex, Kent and the latest example in the Muskoka-Parry Sound area.

All the public health nurses in these areas are asking for is parity with hospital nurses. In the Muskoka case, they do not even have parity with nurses in nursing homes in the same area. The nurses in this area are the second-lowest paid in all of Ontario.

Public health across this province has not been a priority with either this government or the previous government. In fact, the whole area of prevention has been downplayed by both the current government and the previous government. Public health has not been the focus of health policy in Ontario. Neglecting this aspect of health care has become a tradition. Tories have always done this and now the Liberals are doing it.

The government of this province has to look at the cost-sharing arrangements with the municipal governments, take public health out of the municipal property tax deal and make sure it is all funded by progressive taxes through the provincial government.

Second, the attitude towards other health care professionals in this province has to change. The fact that this government gave an increase a few weeks ago to the doctors that cost the taxpayers of this province $65 million, while at the same time it will not even pay parity to public health nurses, shows the double standard of the Liberal government in Ontario.

LIQUOR STORE

Mr. D. W. Smith: I am pleased to announce today that we are going to hold the official opening of the new Liquor Control Board of Ontario store in the village of Courtright. I want to thank the Minister of Consumer and Commercial Relations (Mr. Kwinter) for his help in getting this store there. The people of that community worked hard to maintain one store in the community. As everyone knows, in the small municipalities in all our rural communities, if one store is taken away, it is one less reason for people to come to that town or village. I thank the minister and his staff for all the help they have given to me and that community.

RECYCLING

Mr. Andrewes: Some time ago, on about May 1, Mr. Speaker, I raised with you the issue of the change in format in the east and west lobbies in that disposable cups are now available for members rather than recyclable china cups. You responded to me quite promptly, and I thank you. You said you had made this change because of your concern about rising costs.

The issue I raised with you was not based on the fact that I was concerned about the aesthetics of china versus plastic or styrofoam. It was a broader issue that evolved around a concern about our wasteful society, our throw-away attitude and our lack of concern about reusing materials.

How can the government, through the Ministry of the Environment, impress upon us as citizens of this province the need to recycle and reuse materials and to reduce the amount of domestic waste when we are not setting that example here in our own institution?

2:12 p.m.

STATEMENTS BY THE MINISTRY AND RESPONSES

AQUACULTURE

Hon. Mr. Riddell: I am pleased to inform the House of an exciting and very positive initiative that is being taken by my government in the area of aquaculture.

Ontario will establish a major new centre for aquaculture research, the first of its kind in Canada. The new Alma research station, located near Elora, northwest of Guelph, will allow us to expand greatly our aquaculture research programs .

Aquaculture research in Ontario is a co-operative effort between the Ministry of Natural Resources and my ministry. I look forward to working with the Minister of Natural Resources (Mr. Kerrio) and his staff and other agencies of the Ontario government in finding additional ways to encourage and enhance this industry.

The new centre will let our scientists carry out work that was not possible with the current limited facilities at the University of Guelph. Our existing research work has been conducted on a laboratory scale. Up to now, we have had no facilities to expand this to farm-scale demonstrations.

Realistically, the information from these laboratory-sized experiments must be tested under practical farm conditions. We have to be able to do this before we recommend procedures for commercial applications. That is the kind of thing our new station at Alma will do.

We will also use this new facility to expand our breeding, nutrition and pathology studies. We want to emphasize the experiments to breed trout better suited to Ontario conditions. We will now be able to do more with the early rearing and grow-out to market of fish, as well as research related to brood stocks and breeding techniques.

This research station means the start of a new era for aquaculture research in Ontario. I am confident it will mark the beginning of a bright new era for the industry. Aquaculture has the potential to increase fivefold over the next decade. The timing for the expansion of the industry is right. Consumer tastes have changed-away from traditional foods and towards ones people see as being lighter, more nutritious and more digestible.

The fish farming business has already been booming in Ontario. Over the past decade, the output of the province's fish farms has increased by at least 10 times. The new aquaculture research station will allow us to carry out the research and development needed to help aquaculture meet its economic potential in Ontario.

Mr. Stevenson: I am pleased to say that while we are used to hearing the Minister of Agriculture and Food come up with fishy stories, not only in the Legislature but also all over the province, we are actually happy to hear his fish story today. It is safe to say the fish farm organization in Ontario has been working very hard over the past several years to get a greater percentage of the market for fish consumed in this province. They have organized themselves quite well.

As a matter of fact, John Holder, who used to be the manager of the Franklin fish farm in Mount Albert, was one of the pioneering people in this organization and worked very hard for it until about a year ago when he took a position in eastern Canada. I know the group will be happy to see the assistance from the province and I trust it will continue to develop in the way it has in the past and will continue to come up with imaginative ideas for producing fish at fish farms in the province.

LIQUOR REGULATIONS

Hon. Mr. Kwinter: I wish to announce today further initiatives to be taken by the government as part of our comprehensive and systematic review of Ontario liquor laws.

Over the past several months, a number of changes in liquor regulations have already taken place. The government has approved the licensing of brew pubs, allowed the operation of microbreweries and acted on such items as duty-free stores, kosher wine sales centres and greater in-house promotion at Liquor Control Board of Ontario outlets.

As well, extended hours of operation have taken place at Brewers' Retail and LCBO stores and, of course, we are proceeding with our policy on the sale of beer and wine in independent food stores.

Nonetheless, I believe members are well aware that many aspects of liquor regulation in Ontario still require updating. Some regulations under the Liquor Licence Act, such as the rule prohibiting the use of disposable cutlery, are often nonsensical, and restrictions, such as those on patio umbrella advertising, are simply archaic.

Therefore, as a further step, I am today announcing the establishment of an Ontario Advisory Committee on Liquor Regulation. This committee will be chaired by my parliamentary assistant the member for Mississauga North (Mr. Offer). Other members of the advisory committee will come from the Liquor Licence Board of Ontario and the Liquor Control Board of Ontario. The purpose of the advisory committee is to obtain public and industry input on current issues so that we may continue this government's responsible change in our liquor laws.

The committee will be assisted by staff from the ministry, the LLBO and the LCBO. The advisory committee will receive written submissions from the industry and public until July 31, 1986. Subsequently, the advisory committee will participate in a process of regional or local consultation, travelling throughout the province to approximately 20 centres and receiving reports and recommendations from these communities.

The advisory committee, upon completion of the public consultation stage of the review, will write and submit a report of its findings and recommendations to the Minister of Consumer and Commercial Relations. I am tabling in the House today the full terms of reference of the advisory committee.

In setting this review in motion, I see it leading to both short-term corrective action and long-term achievement. In the area of administrative or housekeeping procedures, we will act expeditiously on such areas as safety standards regarding capacity; signage referring to the availability of liquor and whether an establishment can be called a saloon or a bar; design factors currently required in licensed establishments; containers in which spirits can be sold; and various technical regulations. These are the items, among others, that require immediate attention, but which, at the same time, can be handled through administrative action.

In addition, there are substantial areas of liquor regulation that could be regarded as broader and more contentious in nature. These include such items as liquor advertising; special occasion permits; the type and nature of licences and permits issued under the Liquor Licence Act; classes of premises to be licensed; the food and liquor ratio; the criteria employed in reviewing licence applications, the days and hours of operation of licensed premises; and others.

It is in these areas we believe both the public and industry should be involved and consulted before legislative or regulatory improvement is implemented. This is where the Ontario Advisory Committee on Liquor Regulation will serve as the vehicle to ensure change is responsible and reflects current public attitudes and expectations.

The advisory committee will report its recommendations to the Minister of Consumer and Commercial Relations, to be followed by required legislative and/or regulatory action. In adopting this approach, we will be able to accomplish the following objectives: through administrative action, clear away rather quickly some of the current irritants and redundant regulations in the Liquor Licence Act; and through public and industry consultation, address in a timely, responsible and thoughtful fashion many areas that need early change and updating to make liquor laws more in tune with the Ontario of the 1980s and take us constructively into the next decade.

Mr. Runciman: I have a couple of comments on the statement by the Minister of Consumer and Commercial Relations. My colleague from Ottawa described it as a Coney Island beer, all foam and no body. That is pretty accurate. It strikes us as being more jobs for more Liberals. I do not know whether the Attorney General (Mr. Scott) is going to have any involvement; we might see booze legalized for the lawns at Queen's Park.

I would like to make a few points. The former chairman of the Liquor Licence Board of Ontario, Willis Blair, tried for many months to meet with this minister to discuss regulatory change. Instead of listening, the minister turfed Mr. Blair out.

The brew pub initiative mentioned in his statement was undertaken by this member and approved by the previous government. The reference to regulatory changes that have already taken place is worthy of note, especially the very controversial change involving celebrity advertising of beer, a change that was brought in through the back door, minus the consultation the minister is suddenly embracing. He is talking about archaic laws and regulations that are currently in effect, such as disposable cutlery and so on, but he is not making those changes immediately. Instead, he is going through the back door on some very controversial areas such as celebrity advertising.

We also note his reference to beer and wine in independent grocery stores. This is the first formal indication we have received that chain stores will be prohibited from selling beer and wine under this proposed legislation. I am sure Steinberg's and other chains will be interested in hearing that.

In summary, we look forward to the committee's recommendations and we hope the minister's new-found interest in consultation re liquor laws will extend to the municipalities of this province, which he wishes to saddle with his beer and wine headache.

Mr. Reville: I want to make one brief comment in connection with the statement by the Minister of Consumer and Commercial Relations. It is in respect of Chinese herbal remedies, a matter I have drawn to his attention in the past. It is very important that our Liquor Licence Act reflect cultural decision-making. Chinese herbal remedies, which do contain alcohol, have been used by that community for many centuries and we should not now be interfering with something that is safe and acceptable to that community. I hope the minister will move quickly on that part of the Liquor Licence Act.

Mr. Swart: I too want to refer to the statement by the Minister of Consumer and Commercial Relations on the Ontario Advisory Committee on Liquor Regulation. I want to say immediately that an examination of the policies in the terms of reference is desirable. Such things as the suitability of forms of advertising as well as advertising content, the suitability of maintaining the legal drinking age of 19 years, the days and hours of operation of licensed premises throughout the provinces and the policies on licensing and who will be licensed are very important matters and need to be examined in some depth.

However, the minister's proposal for the advisory committee with respect to the persons who are going to be dealing with these matters is little short of preposterous. Why would he not want an independent committee to be dealing with these matters? He already knows that the chairman, a member of his own caucus, is obviously biased towards greater accessibility to alcoholic beverages, simply as a member of his caucus, as the minister is. The only other people to be on this committee are to be members of the Liquor Licence Board of Ontario and the Liquor Control Board of Ontario. How does he expect to get an independent report from that group?

Seriously, why does the minister not give consideration to having representatives from consumer groups, law enforcement officers and the social work groups in this province on that advisory committee? In fact, perhaps it should be a parliamentary committee that looks into matters of this magnitude. In the report, the minister indicates he is going to proceed with the sale of beer and wine in grocery stores. Is that not a matter of the same magnitude as these other things, or does he not want to hear from the public on this?

The polls show the public is reversing its support of the proposal; perhaps the minister does not want to hear that. He knows very well that the public considers it a very silly move to give that local option to the municipalities to try to bail himself out of the responsibility. In this proposal, he is treating a matter of major concern to society in a frivolous and biased manner. It is a disgraceful way of dealing with it.

Interjections.

Mr. Speaker: Order. That completes the time for responses.

SPECIAL WARRANTS

Mr. Harris: Mr. Speaker, I would like to bring to your attention a direct violation of standing order 56; it is the old standing order 51. On April 24, 1986, the Chairman of Management Board (Ms. Caplan) rose in her place and said, "In accordance with section 51"-new section 56-"of the standing orders of the assembly, I am tabling the special warrants that were issued when the Legislature was not in session. Copies of these special warrants have been placed in the postal boxes of the members."

I would not accuse the minister of deliberately misleading the House simply because those copies have not been placed in the postal boxes of the members. However, as it states in standing order 56, "Management Board orders...and a summary of special warrants shall be tabled on the first sitting day following the issue of the warrants."

As a result of a telephone call to the Clerk's office this morning, we discovered these warrants have not yet been delivered to the Clerk's table, the Clerk's office or the members' boxes.

This is not only a violation of the standing orders but also another example of ministers making statements in this House on which they clearly do not follow through. It is an example of good public relations but lousy management ability. I would not suggest it is dishonesty, but it is bad management.

Mr. Speaker, I ask you to instruct the minister to comply with standing order 56 and, more important, to rise in her place and apologize to this House for not fulfilling her commitment.

Mr. Speaker: Does the minister have any comment?

Hon. Ms. Caplan: No.

Mr. Gillies: No comment? Is that open government for you?

Mr. Speaker: Order. The matter has been drawn to the attention of the minister.

2:30 p.m.

TABLING OF INFORMATION

Mr. Sterling: On a point of order, Mr. Speaker: Yesterday the Solicitor General (Mr. Keyes) rose in his place to deliver a response to my question of May 26. Our House leader rose at that time to make the point that it was appropriate that the member who asked the question should be in the House when his question was being answered. You suggested there have been many occasions when ministers have had answers for someone who is not here.

I have reviewed the Clerk's precedents book and can find no such precedent. I have asked several of my colleagues, and they can recall no precedent. I note in the precedents book that a member may not be recognized if he is not in his place. I also note that a question may not be put to a minister if he is not in his place. I also note in the precedents book that if a member rises to ask a question and the minister is not in his place, the questioner's party does not lose its place in the rotation. All these precedents are in the spirit of the question period.

However, the precedents you referred to yesterday are not in that precedent book nor, with respect, sir, does your interpretation concur with the spirit of question period.

I respectfully suggest that allowing a minister to give a response to a member who is not in his place is not a precedent we should be setting in this House. I suggest that a minister should be able to rise in his place and respond to a member's question only when that member is present. To allow a response, as you did yesterday, denies the member the opportunity to ask a supplementary question to his answer. Failing that, the minister should at least be required to obtain the unanimous consent of the House before responding to a member who is not present.

I ask you to give serious consideration to the rights and privileges of the opposition in placing questions and the dangerous precedent you may be setting in this regard. I ask you in the future at least to obtain the unanimous consent of the House before allowing a minister to respond to a member who is not present.

Mr. McClellan: Speaking to the point of order, I agree with the sentiments expressed by my friend the member for Carleton-Grenville. I am sure it would be possible to find precedents from the previous government in which ministers answered questions on the day following the day the question was asked in the absence of the questioner. I believe that at least violated the traditions of decency and courtesy within this House. While I think that is true, I believe most ministers in the past have tried to show the courtesy to members of the opposition, when they have to respond on a subsequent day, of waiting until the questioner is present in the House.

Even if we are not able to nail this down as firmly as my friend the member for Carleton-Grenville would like by way of precedent, I hope we can at least establish a new precedent based on courtesy and respect for members of the opposition that ministers will wait until the questioner is present before they rise to answer a previously asked question.

Hon. Mr. Peterson: In the absence of the government House leader, perhaps I can respond. I think the member for Bellwoods (Mr. McClellan) makes a very good point. It is not worthy of the House at this time to get into a procedural wrangle on this issue. I can assure the honourable members opposite that there have been many precedents from the previous government when answers were given on days when members were not there, but that is immaterial.

Mr. Hennessy: You are the government now.

Hon. Mr. Peterson: Those can be produced if members want to turn it into a legalistic kind of thing.

I can tell my friend the member for Bellwoods I think his approach is the right one. I will ask my colleagues to try to respond on the days the members opposite are here. One of our responsibilities obviously is to try to develop answers as quickly as possible. Sometimes people are away, and sometimes we never know who is here even by observing the benches opposite. However, we will attempt to do that to accommodate them.

The other solution is that if those who are gainfully employed in other places would come here every day, we would never have this kind of problem.

Mr. O'Connor: The Liberal members were disguised as empty chairs last Friday.

Mr. Speaker: Order. The member for Carleton-Grenville came forth with a point. The member for Bellwoods and the Premier made their comments on the same point.

Having reviewed the standing orders, I believe there is nothing in them that says the Speaker is responsible for responses other than when they are too long, and the orders say they then must be done during ministerial statements. However, because of the long and detailed comments of the member for Carleton-Grenville, I will certainly take a very close look at the matter.

Mr. Grossman: I remind the Premier that almost all our members were here last Friday to pay our respects to Bishop Tutu while his members were not. So much for attendance. For that matter, I was at the Tutu dinner while the Premier was at the Shaw Festival.

Mr. Ferraro: That is only because the member got free tickets.

Mr. Speaker: Order. Does the Leader of the Opposition have a question?

2:36 p.m.

ORAL QUESTIONS

URBAN TRANSPORTATION DEVELOPMENT CORP.

Mr. Grossman: I have a question of the Minister of Transportation and Communications. We have now received a copy of the statement of the Urban Transportation Development Corp. for the first quarter of 1986. It indicates an anticipated profit has now been turned into a loss for the first three months. I read from page 2 of the covering note to the financial statement, "In particular on the Vancouver project, BC Transit has indicated an unwillingness to pay any further invoices until the ownership of UTDC has been firmly decided."

Given this inability to collect that money from Vancouver because of the uncertainty of the ownership of the company, is the minister prepared to acknowledge that the uncertainty and the mismanagement of this deal over the past three months has cost the Ontario taxpayers a great deal of money?

Hon. Mr. Fulton: That is one editorial comment raised in that particular statement. As the honourable member is aware, negotiations were going on as recently as today. We are very optimistic that we will be able to make an announcement in the near future. As a former Treasurer, the member knows that budgets and actuals do not always correspond in the reality and in the light of day of a quarterly statement.

The real losses attributed to UTDC are losses of expected revenues from certain sales by the company that have not come through within that time frame. I can refer specifically to Boston, Santa Clara and Detroit.

Mr. Grossman: My question to the minister was not in regard to why the $3-million loss had occurred, but rather in regard to the uncertainty created by the inability to conclude the sale of UTDC after almost one full year.

I am informed that the reason BC Transit will not make any further payments is that it does not know who might be owning the company to back up the warranties. Therefore, to protect themselves, they are holding back money. Does the minister not agree this is a critical situation that is obviously costing UTDC money and harming its reputation?

2:40 p.m.

Hon. Mr. Fulton: I do not agree with the Leader of the Opposition that the reputation of UTDC is being harmed. In our discussions with Premier Bennett, we learned BC Transit was looking to expand the SkyTrain system and not to go the route the leader is suggesting.

Mr. Grossman: The evidence is right here. I am not fabricating it. This is not from a phone call from mysterious sources. It is in the UTDC's own financial statements that Vancouver is unwilling to make the payments because it is concerned about the future ownership of the company. That is an incontrovertible fact. It is reported by British Columbia, and it is confirmed and reported by UTDC. Therefore, I have to place my question to the minister again. Is he prepared to acknowledge today that uncertainty over ownership is costing UTDC money?

Hon. Mr. Fulton: There is an overall loss of interest payments that cannot be attributed specifically to any one given sale in the statement to which the member refers. It is a very minuscule amount of money in the overall statement of the operating company. Given the potential and the prospects that we are aware of and that are ongoing, I do not share the leader's view one bit.

Mr. Grossman: I have another question for the Minister of Transportation and Communications. Perhaps he can clarify for us how many of the bids that UTDC was considering making on international markets have had to be withdrawn or cannot be made because of the uncertainty over ownership?

Hon. Mr. Fulton: I am aware of only one, and it was not in any way considered to be a hard sale or a bid. I believe it involved the city of Dallas, which was on a fishing expedition for a transit system.

Mr. Grossman: The minister will recall this party pointed out in the House several months ago that the Dallas deal was being threatened by the way the government was handling the UTDC ownership issue.

Mr. Ferraro: Oh yeah, public accounts-

Mr. Grossman: He has acknowledged we were right. He has just acknowledged the government's bungling has cost the taxpayers-

Interjections.

Mr. Speaker: Order. Will the member for Wellington South (Mr. Ferraro) contain himself?

Mr. Grossman: Will the minister share with the House the number of jobs that might have been produced in Kingston and Thunder Bay had the Dallas bid gone in and been successful?

Hon. Mr. Fulton: I did not imply for a second that the Dallas situation had much to do with our actions; in fact, it was the Reagan administration's policy of not financially supporting out-of-country purchases of transit. I am sure the Leader of the Opposition knows that.

Mr. Grossman: We not only do not know that, we also categorically deny the accuracy of what the minister just said. We are informed that the Dallas deal is a non-starter for UTDC because of the continued uncertainty about ownership.

My final supplementary is this. In February, the minister reported to this House, I am sure in good faith, that he expected the deal to be concluded in four weeks. It is now 12 weeks since he made that report to the House. Can the minister report to us today on the status of the negotiations and whether the negotiations have turned to a discussion of transfer of shares and paper instead of the $30 million or $40 million in cash that was originally talked about?

Hon. Mr. Fulton: The Leader of the Opposition is referring to the fact we announced that we had received and narrowed down the bidders and that the final selection of the winning bidder would be made in about four weeks. On March 7, we said we would get into the serious, detailed negotiations with that successful bidder, which we are doing and which was ongoing as recently as this week. As I said in my first answer, we anticipate a resolution to this matter in the near future.

FREE TRADE

Mr. Rae: I have a question for the Premier. Can the Premier can tell us whether he was consulted by Mr. Wilson or somebody else in the federal government about the decision to impose retaliatory tariffs on the publishing industry, among others?

Hon. Mr. Peterson: No, I was not.

Mr. Rae: In the light of that admission by the Premier, which I think is an admission that Ontario is being entirely ignored in these matters and not being taken seriously, I wonder whether the Premier can explain to the House exactly what his strategy is. Is he in favour of reduced tariffs and non-tariff barriers with the United States? If that is the position of the government of Ontario, why was the government not consulted and what is the position of the government with respect to the imposition of these tariffs?

Hon. Mr. Peterson: As the honourable member will be aware, we are not charged with the responsibility of creating tariffs or of responding in this particular little skirmish that has developed over the border.

The Canadian government was not aware the Americans were going to move on shakes and shingles. Then Mr. Wilson, in his wisdom and presumably with the support of the federal cabinet, picked an area in which he wanted to respond to make a point. Many people have questioned the wisdom of that; perhaps the member is one of them. That is fair enough, but it is not our responsibility. They do not ask us when they make these moves. I do not think they asked any other Premiers; if they did, I am not aware of it. They had to pick their options in making their points in a discussion with the US.

If the member is suggesting that Mr. Wilson or the Prime Minister should phone us before doing one of these things, that would be a major departure from the traditional way of conducting the relationship with the US.

Mr. Rae: Does the Premier not understand this kind of action by the federal government is going to cost jobs in Ontario? It is going to put lots of people out of work; I hope he understands that. Does he not understand the decision by the federal government to move on its own can only be seen as a precedent for the kind of action that it is going to take in all the free trade discussions?

Does the Premier not realize that he wrote himself out on Monday night, that he was written out when they announced the decision with respect to new tariffs and that he is becoming increasingly irrelevant to what is surely one of the most important questions about the Canadian economy and about Canada itself; that is, the question of free trade? He is writing himself out of the history books and he is writing himself out of the question. He should be ashamed.

Hon. Mr. Peterson: I do not agree. If anyone has written himself out of the play, it is my friend opposite. I will respond because it is a serious question on which I fundamentally disagree with the member's interpretation. Presumably he would say that if there were a federal budget, we should be consulted ahead of time. There are lots of things the federal government does that have a profound impact on Ontario. After all, we are 40 per cent of the economy of this country. The member could make the same argument.

He is asking for a new method of federal-provincial co-operation in which we participate in the creation of tariff policy and other things. It would be nice if we were aware of it, and it would be nice if they considered our views now and in the future, not to mention the past. However, that is not the way the country works. Each level of government takes its responsibility.

I do not for a moment take from that, as my friend opposite does, that this implies anything in the so-called discussions. It was a tactical move. He can agree or disagree with it. It has some impact here, depending on how one analyses it, but probably not of significant consequence. It will drive up prices a bit in some areas. Whether it will work in cooling out this trade skirmish, I do not know. I hope it does, but it may not, and then we are on to the discussions.

However, if my friend opposite thinks we have written ourselves out of the discussions, I can assure him he is completely wrong, and I do not think anybody across the country would agree with him.

Mr. Rae: Surely the Premier is admitting he does not know and saying he has not been consulted. The auto pact is a federal agreement; it is an agreement between the government of Canada and the government of the US. By analogy, is the Premier saying there is no way in which he can affect the future of the auto pact in the discussions that will take place with the US? Is that what he is saying in effect when it comes to tens of thousands of jobs in this province?

2:50 p.m.

Hon. Mr. Peterson: There is a very serious misunderstanding. Of course I am not saying that. I am saying that when the Canadian government moves unilaterally on the imposition of tariffs, that is its responsibility. When it moves on a bilateral agreement as per the auto pact or any comprehensive trade negotiation, we not only have a legal role but also a political role in the implementation of that; we have all agreed the provinces will have a formal role. The analogy does not make any sense.

Mr. Rae: Is the Premier seriously arguing that the skirmish with respect to tariffs between Canada and the US has nothing to with the negotiations that are under way between Canada and the US?

Hon. Mr. Peterson: I would seriously argue that it was a tactical decision made by the federal government, and I do not believe it was made in consultation with any other Premier. The federal government has the responsibility to do that, and in a sense it does not bear directly or legally on the discussions that are taking place-

Mr. Wildman: Legally?

Hon. Mr. Peterson: It does politically, but in any legal way, it does not. I do not know how one could draw the conclusion that it does.

Mr. Rae: If the Premier's views were not regarded as important enough to warrant even a phone call from his good friend the Prime Minister of Canada, from the Minister of Finance or from anybody else in Ottawa, including Simon Reisman, why does the Premier believe he will be taken seriously with regard to the secret report, which we understand was sent by the Treasury to the government of Canada? Why should those views be taken any more seriously since he has not been taken seriously this week?

Hon. Mr. Peterson: We are taken very seriously, and it is important that we are all taken seriously, particularly in the areas where we have authority and jurisdiction. The federal government understands we do, and it has made some moves to take that into account. If the honourable member is saying the federal government has to phone us every single time it takes an initiative with a foreign country, I have to tell him that is not the way the country works. I am sure he learned that when he studied political science.

Interjections.

Mr. Speaker: Order.

Mr. Grossman: My question is to the Premier. Apart from one meeting held by two of his ministers two and a half weeks ago, can the Premier tell us specifically what he has done to protect our industry from softwood lumber tariffs?

Hon. Mr. Peterson: As the honourable member knows, there have been a number of ongoing meetings between the federal officials and our group. They are aware of our opinion on the matter, and we hope there are absolutely no moves. We have put our support behind the federal government and behind the ambassador who is making ministrations in Washington today. If the member is asking whether I have the power to prevent that from happening, the answer is that I do not, but the government has our support in fighting those moves.

Mr. Grossman: Consistent with the question from the leader of the third party, my question revolves around the degree to which the Premier is able or willing to stand up for the interest of Ontarians. Specifically, has he done any of the following: (1) Has he written the Prime Minister of Canada with regard to our softwood industry; (2) Did he raise it on Monday night with the Prime Minister; (3) Has he made any representations directly or indirectly to Washington? Has he done any of those three things?

Hon. Mr. Peterson: The answer to the three-choice question is that we have done B.

HAZARDOUS SPILL

Mrs. Grier: I have a question of the Minister of the Environment. In addressing an audience in Guelph on Sunday, the Minister of the Environment said: "Unlike the previous government ...we place a premium on promptly and fully informing the public of all our environmental findings and problems. Our priority is timely, reliable public disclosure-whether the news is good or bad."

Yesterday, in response to a question from me, the minister assured the House that officials in Port Huron, Michigan, had been informed of a very major emission from Dow Chemical. Given that it took two days after the spill for the officials in Michigan to be informed, is that the minister's definition of prompt and reliable public disclosure?

Hon. Mr. Bradley: No, that is not my definition of prompt and reliable disclosure. As I have indicated in the House to the member, while the officials in Port Huron were notified, there was not timely notification. It seems to me that in the case of both water and air emissions, it is important that the Ministry of the Environment report at the very earliest opportunity and almost regardless of the so-called seriousness of the spill. I have given that indication to my ministry.

Mrs. Grier: The minister has given that indication to this House on innumerable occasions. He gave us that indication after the Chipman emissions in Hamilton. We are now talking about a very serious spill of four tons of vinyl chloride gas at a level of nine parts per million, barely below safe occupational hazards, and nobody was told for two days.

Can the minister give us any assurance that his sincerity and good intentions are being translated to the lower levels of his ministry and that there is a change from what we experienced a year ago?

Hon. Mr. Bradley: Yes, I can give the member that assurance. As I indicated to her yesterday, the information was provided, and it was not timely from my point of view. Those who are responsible at the front-line level know the Minister of the Environment wishes to have this information provided not only to our local people or for inter-ministerial communication but also to those in adjacent jurisdictions. I have certainly given that indication.

I think the member knows as well that I am not here to defend what I consider to be a less than adequate response. In this case, based upon the investigation I have done, it is my view that there was not an adequate response, that their interpretation of the seriousness of the spill was different upon reflection and study from what it would have been at that time. I assure the member I have given orders that it should not happen again.

WATER QUALITY

Ms. Fish: My question is to the Minister of the Environment. In commenting upon the problems of chemical contaminants in drinking water, a representative of his ministry was quoted this morning as saying: "The more they talk"-that is, the environmental groups-"the more you realize they don't know what they're talking about. What we have is a non-problem." Does the minister stand behind his official's comments?

Hon. Mr. Bradley: I recall being at a combined Rotary Club-chamber of commerce meeting in the city of St. Catharines.

Mr. Brandt: Here it comes.

Hon. Mr. Bradley: I am going to be kind. I am not unfair; the member knows that. He is a friend of mine, and I want him to remain so.

I remember that the member for Sarnia (Mr. Brandt), who at that time was the Minister of the Environment, indicated very clearly that our water was second to none in the world. Many people in Ontario are proud of our record in dealing with environmental problems when compared to those of other jurisdictions, and the member drinks the water to indicate that.

In response to the member's specific question as to whether I as the Minister of the Environment believe environmental groups do not make a significant contribution to the debate over the quality of drinking water in any jurisdiction, the answer is no. If the member looks at the record, she will find that I value the input and contentions of environmental groups.

This was a long interview. I was not at the interview, so I cannot attest to what was or was not stated. However, if the member is asking my opinion, I think environmental groups have a significant role to play, and we should always be working towards better drinking water regardless of how it might compare with water in other parts of the world.

Ms. Fish: I take from the minister's answer to my question as to whether he stands behind his official's comment, that he does not. I trust we can look forward to an official apology to the environmental groups.

His official said a most disturbing thing, a most odd thing, namely, that there is a non-problem with drinking water. In January, when for the first time the minister found dioxin in treated drinking water in this province, he indicated it was frightening, and he called for a wholesale improvement in the treatment of water in the Great Lakes. I agree it is frightening and there should be an improvement. Can the minister tell us what specific steps he has taken to improve the drinking water along the Great Lakes?

Hon. Mr. Bradley: I am glad to see that, now the member is on that side of the House, she finally considers it to be a frightening problem, because for a number of years she obviously did not.

Mr. Gillies: It is the official who said it was not a problem.

Interjections.

Hon. Mr. Bradley: As the member's leader once said, "You are a great pitcher and a poor catcher."

Mr. Speaker: Order. Once again, interjections are out of order. Please disregard them.

Hon. Mr. Bradley: To continue with my response to the member for St. George (Ms. Fish), I want to indicate as well that while there are occasions when I may not entirely agree with what my officials say, I am not here to muzzle my scientists in what they can or cannot say. But I will indicate from time to time, as I do in this House, when I am not in agreement with a specific statement.

3 p.m.

As to the work that is being done on the improvement in water quality, I know the member will support the position I have taken in our negotiations with the Americans over the situation that exists in the Niagara River. There must be a specific abatement program with a schedule for the reduction of contaminants; there must be a serious effort at excavation rather than a simple minor reference to it; and there must be very extensive monitoring.

INSURANCE RATES

Mr. Swart: I will put a question to the Minister of Consumer and Commercial Relations and bring to his attention the case of Delbert and Marion Seabrook of Del Mar drive-in and campground in Iron Bridge, Ontario. They have been unable since the season started on May 1 to open their dirt go-kart track because they cannot get liability insurance for their customers, even though they have been directly and indirectly in touch with Grant Swanson of the ministry on several occasions during the last month.

How does this square with the minister's statement to this House three months ago in which he said: "There is insurance available for every risk. We are finding insurance for anyone who requires it."

Hon. Mr. Kwinter: I thank the member for the question and I stand by that statement. To date, that is the first one. I would be delighted to have the member send me the details. There are dirt tracks around Ontario and they are getting insurance. Our market assist program is working. If the member will send that information to me, I will be delighted to follow up on it.

Mr. Swart: The asphalt tracks are getting insurance; the dirt tracks are not, and there are a number of them.

Does the minister not think it is a bit bizarre that this track was built totally with public funds loaned under the Northern Ontario Development Corp. just a year and a half ago and now, through the inadequacy of his ministry's policies, it cannot get any revenue to pay off the loan? Does the minister propose that the loan be written off or that it operate without insurance? Or maybe they should move to Manitoba, where such insurance is available under the public insurance corporation.

Hon. Mr. Kwinter: I stand by my previous answer. If the member will send me the details, I will make sure my people look at it. I cannot guarantee the price, but we can get them insurance.

WASTE DISPOSAL

Mr. Stevenson: I am sending the Minister of the Environment a bag of industrial waste. I would like to know why he is making it so difficult to dispose of waste onions in Ontario.

Hon. Mr. Bradley: I was not aware I was making it so difficult to dispose of waste onions in Ontario. I will probably find out more when the member comes up with his supplementary. Perhaps he can tell me how.

Mr. Stevenson: I will not take the valuable time of question period to explain it to the minister. I ask him whether it is his intention to force the waste onions from the packing plants back to the farmers who grow them, so that they will have to resort to greatly increased chemical usage to control insects on their vegetable farms.

Hon. Mr. Bradley: This is the first time this problem has been directly brought to my attention. As the member knows, I always try to assist him in finding solutions. I will be happy to try to assist him in finding a solution to this. Do I get to keep this?

Mr. Stevenson: Yes.

Hon. Mr. Bradley: Thank you.

OCCUPATIONAL HEALTH AND SAFETY

Mr. Martel: I have a question for the minister responsible for the swamp, the Minister of Labour. On April 1, 1986, an employee of Johnson Matthey Ltd. of Brampton and a member of the steelworkers union was seriously injured when material he was preparing for melting exploded in his hand. Among the injuries were the severing of his left thumb, multiple injuries to his right hand and his eyes and severe burning to his face and his upper body. These workers had not been advised they were working with a substance called gold fulminate, which is explosive when dry. They had been told they were working with gold cyanide.

Since the company was advised it violated the Occupational Health and Safety Act under section 145 and clause 14(2)(a), can the minister tell me why charges have not been laid to this time, or whether he ever intends to lay charges?

Hon. Mr. Wrye: I did not catch the name of the company, but I gather from what the honourable member said, if I have the date right, the incident occurred on April 1, 1986, about nine weeks ago. I am sure it took a period of time for the investigation to be completed. Since the completion of the investigation and a report from the inspector involved, including any recommendations he may have with respect to prosecution, those matters are being reviewed.

The members knows the prosecution policy. There are a number of steps in the review of prosecutions. The member will learn if an information is laid, as will the union involved in the normal way, but I do not view a little over two months to be an extraordinarily long period of time. There is a small backlog because of the quite substantial number of prosecution requests that are now coming forward from the various branches of the ministry.

Mr. Martel: There is a double standard in that workers are charged on the spot for not wearing a helmet and for not wearing safety glasses or safety boots. Can the minister tell me why this double standard applies? In this case, will he also tell me why the inspector wrote only a little bit of advice saying the act had been violated?

If we were to violate the Highway Traffic Act in this province with the impunity with which this act is violated, we would have no control on the highways. That is what is going on in the work places in Ontario; there is absolutely no control.

Hon. Mr. Wrye: Obviously, I am going to take a look at the individual circumstance. I know my friend will be interested to know, taking all three branches of the ministry, for example, in 1984-85 from May 1 until April 30, there were 268 recommendations for prosecution. One year later, the numbers increased to 417. Most significant, in the first five months as we began to gear up under the new policies of this government, the number of orders, on a year-to-year comparison, went from 86 under the former government and its policies to 208 recommendations for prosecution. There were 71 in the month of April alone.

DRUG BENEFIT FORMULARY

Mr. Leluk: My question is to the Minister of Health, whose ministry has not issued a new Drug Benefit Formulary since January 1985. The minister should be aware of the case of a consumer in Chatham, a cystic fibrosis sufferer, who has had great difficulty in getting a prescription filled for sodium chloride ampoules. That is because the pharmacy would be forced to dispense the prescription for a one-month supply at a loss of $250, which is $3,000 annually.

Does the minister intend to issue today a new formulary to update these drug prices, so this Chatham cystic fibrosis sufferer and others like him will be able to obtain their necessary medication and the local pharmacist will not have to suffer an annual loss of $3,000?

Hon. Mr. Elston: I will be pleased to look into the situation. I would have preferred that the member brought this to my attention directly so we could have looked at it earlier. I have indicated to the member on an earlier occasion that we are looking into printing the new formulary. The member knows that is the case. I have asked that the information be gathered to print the new formulary.

3:10 p.m.

Mr. Leluk: The Premier (Mr. Peterson) was sent a letter on March 12, 1986, citing this very specific case. It was sent to him by a pharmacist in the London, Ontario, area where he resides. I am surprised he has not discussed this matter with the minister, given its importance. It just shows how much the government cares about the health of the people of this province.

Mr. Speaker: Supplementary.

Mr. Leluk: Will the minister confirm that his officials are requesting new prices from manufacturers for a July 1 formulary and that the Ontario Pharmacists' Association has offered him assistance with both the verification and marketing data to aid him in the publication of the formulary while the legislation and regulations are pending?

Hon. Mr. Elston: One of the people who acts as a lobbyist for the OPA has on occasion advised me that he is prepared to provide as much information as the OPA has. He says it does not have exhaustive information in this regard but has advised that it will be able to provide us with whatever information it has. I have thanked him for that assistance. We will take advantage of it.

Also, I have been phoned directly by pharmacists and I have accepted their advice with respect to certain products. They have advised me as well that there are still a number of products in which there is a spread in high-volume purchase areas. I can understand the difficulty with respect to what may be a single-source product, the low-volume drug the member brought to my attention.

The member is wrong when he says we are disregarding the health of the people of the province. When these people's problems are brought to my attention I act as quickly as I can. I will act on this one as quickly as I can as well.

With respect to the particular formulary question on which we are working, we are seeking and receiving the advice not only of the OPA but also of individual pharmacists who have brought their concerns to my attention.

RENT REVIEW

Mr. Reville: My question is for the Minister of Housing. This morning's Toronto Star says, "The Ontario government will introduce legislation tomorrow that drastically changes its rent review program, including allowing annual rent increases of about six per cent instead of the present four per cent."

I suggest that in some cases for older buildings those guideline increases may be as high as 7.2 per cent and for newer ones as high as 10.2 per cent. Will the minister explain to the House how a rent increase guideline of 10.2 per cent is in the interest of tenants?

Hon. Mr. Curling: I will be reporting to the House tomorrow the rent review reform that was brought to me by the Rent Review Advisory Committee. I urge the member to wait until I present that, and he can make those observations.

Mr. Reville: While we are waiting for the legislation, perhaps the minister can design an answer to this question. Why is it in the interest of tenants that $250 million will be taken out of their pockets and put into the pockets of the landlords of this province?

Hon. Mr. Curling: I am not aware of $250 million being taken out of one pocket and put into another. When the report comes in tomorrow, the member can make his observations.

NATIVE JOBS

Mr. Shymko: What steps has the Minister of Energy taken or is he taking now, along with the absent minister responsible for native affairs, the Attorney General (Mr, Scott), to ensure that the Indian and Metis residents of Armstrong, Ontario, will get their fair jobs at the proposed $411-million Ontario Hydro project at Little Jackfish River? In particular, my concern is for the unemployed native youth. What has he done so far?

Hon. Mr. Kerrio: When we consider that kind of undertaking, we can make those kinds of comments to Ontario Hydro, which has assured us it will hire all the native help it can.

Very recently, when the native peoples came down from Armstrong, this minister made it possible for them to work with the lumber companies in that area and have jobs provided for them through the help of the ministry. We are doing everything we can on behalf of the natives, whether it be to help harvest our timber, to build hydro projects or to fight fires. We are doing whatever we can to help the natives in northern Ontario and much more than was done by the previous government.

Mr. Shymko: Talk about a cop-out answer. Two weeks ago, the native representatives walked out of a meeting in Armstrong. Is the minister going to follow Manitoba Hydro's example of the Limestone project, which hired many natives, or will he do the same as the Hydro-Québec project in Baie James, where not one native was hired? There are 2,300 person-years of employment created by this project.

Hon. Mr. Kerrio: It is obvious that a government that settled the English-Wabigoon system question, which had hung fire for all these many years, shows our interest in the native people of Ontario. We are moving forward on settling many of the old differences that existed before. We are doing everything we can to provide jobs for the native people in Ontario and will continue to do so.

PROTECTION OF PATIENTS

Mr. D. S. Cooke: I have a question for the Minister of Health. Is he aware of the latest death of a person in restraints, this one at Hôtel Dieu of St. Joseph Hospital in Windsor? This is the fourth one in the last couple of years. It occurred on May 23. Is the ministry considering adequate regulations to protect patients while they are in restraints, whether it be in nursing homes, hospitals, homes for the aged or whatever the institution?

Hon. Mr. Elston: I am not aware of that latest incident. I will look into that matter and get back to the member on it. It concerns me greatly that this has been the fourth in a series. I will check to see what has been the cause, not only of the latest but also each of the other three the honourable gentleman brings to my attention.

Mr. D. S. Cooke: The minister should be aware of them. Margaret Oakes choked herself while trying to get out of the restraints. Lau Szeto set herself on fire while trying to get out of restraints at Windsor Western Hospital. George Louis Sova, in a similar situation, set himself on fire while trying to burn off restraints.

Is it not time the ministry looked at the relevant issue, that of adequate staffing in our hospitals to take care of these people so that these types of devices, restraints and tying people in beds are not required?

Hon. Mr. Elston: The question of adequate staffing is one that we are always addressing and looking at in the review of what is happening. The operation of each individual hospital and the staffing levels are very much up to the administration and board people.

I can tell the honourable gentlemen that I will look into each of the situations he mentioned. I will report back to him on the findings and will indicate clearly what role the staffing level had to play in each death.

OCCUPATIONAL HEALTH AND SAFETY

Mr. Barlow: I have a question for the Minister of Labour. Is it the policy of the Ministry of Labour to lay charges under the Occupational Health and Safety Act without first questioning all the parties involved to see if the charges are warranted, such as was done in the case of J.K.M. Custom Fabricating of Cambridge?

Hon. Mr. Wrye: Yes, it is the policy of the Ministry of the Labour thoroughly to investigate an incident and to have the matter investigated with all the appropriate people. Then the report, as I said earlier in question period, goes through a number of steps before a decision is made on whether charges will be laid.

Mr. Barlow: I think the ministry assumed in this case that the company was guilty until it was able to prove its innocence in a very costly court appearance. Even though senior ministry officials stated that the charges would not have been laid if they had been aware of all the facts of the case, the ministry still refused to drop them.

3:20 p.m.

Will the minister assure the assembly that J.K.M. Custom Fabricating and its employees will be reimbursed for their financial losses as a result of the erroneous charges, which were dismissed by the court, and for the $7,000 it cost the company in legal fees to defend itself? Will the minister issue a formal apology to this company for his ministry's lack of common sense?

Hon. Mr. Wrye: I am aware of the specific incident and, quite frankly, I am a little surprised to hear those kinds of comments. This was a very critical injury. The worker suffered a broken leg, five cracked or broken ribs and lost the use of his spleen and half of his pancreas. This was not some kind of a minor incident.

The matter was thoroughly investigated and it was determined that a charge was appropriate. As I understand it, the charge was heard in April of this year and the justice of the peace found that the ministry had proved a prima facie failure to comply with the appropriate section of the regulation but found that the employer had taken every reasonable precaution in the circumstances. That was the finding of the justice of the peace, but on the basis of the information the ministry had, it believed at the time that a prosecution was appropriate.

PROVINCIAL PARKS

Mr. Laughren: I have a question of the Minister of Natural Resources, who, I know, is wrestling with the problem of what activities to allow in our provincial parks.

Does the minister not think it is reasonable to forbid activities such as hunting, mining, the building of hydro dams and logging in our provincial parks unless the public hearing process indicates that is what people really want done in those parks?

Hon. Mr. Kerrio: I inherited the parks situation from the former government. I had been given information that those kinds of public hearings had taken place, particularly in Caribou, one of our parks in the far west bordering on a park of similar nature in Manitoba that, incidentally, has the uses described by the member.

Having taken that into account and looking at it from the ministerial standpoint, we as the Ministry of Natural Resources decided we would take lumbering out of the park use, which was done.

About 101 of those parks have been put under regulation and there are those that are not under regulation yet. I have taken time to pause to see whether there was information from the public sector among those who have that kind of an interest. There is somewhat of a disappointment that there had been a resolution reached at a public forum where everyone agreed. Each one made some concession to the other so that they could very properly have multiple uses in a park. It seems to me those very people now want us to re-examine it. We are going to do that, and I think that is fair.

We will take a good look at the whole circumstance and make a decision as to where we should go. It is in abeyance, and we are going to go from there. I just did not want to rubber-stamp a Tory undertaking.

Mr. Laughren: I commend the minister for not wanting to rubber-stamp anything the Tories have been doing for 42 years.

Does the minister not understand how reasonable it would be to have none of these activities going on unless the environmental hearing process indicated the public at large wanted those activities to go on in our parks? Is that not a reasonable compromise on the part of parks enthusiasts all across this province?

Hon. Mr. Kerrio: The member makes uncommonly good sense. That is why I am pausing now, to see whether I can look into those matters. In keeping with the kind of dialogue we have with the third party, I agree to look into those things.

I suppose the big disappointment would be that there is an entirely different concept about the people in northern Ontario, who have a very difficult time right now as it relates to jobs in many of these areas. That is going to be one of our considerations while we look at the whole park issue. The member's recommendations will be taken into account.

EASTWAY FORD

Mr. Speaker: The Minister of Consumer and Commercial Relations has a response to a question previously asked by the member for Leeds (Mr. Runciman).

Hon. Mr. Kwinter: The member for Leeds yesterday asked me a question about a car dealership in St. Thomas known as Eastway Ford. I have looked into the matter and can advise him as follows: I understand Eastway Ford has been charged 18 times with operating on a Sunday in violation of the Retail Business Holidays Act and has also been charged with misleading advertising. A number of complaints have been received by the Solicitor General (Mr. Keyes) and the registrar of motor vehicle dealers from other dealers in the area as well as from a United Auto Workers local about the unfair competitive advantage Eastway Ford is getting by breaking the law.

Under the Motor Vehicle Dealers Act, the registrar may revoke a registration if the past conduct of the dealer affords reasonable grounds for belief that he will not carry on business in accordance with the law. On May 8, the registrar of motor vehicles advised the Ontario Automobile Dealers Association that if it is proven to my satisfaction that any dealer is deliberately flouting the law, I will not hesitate to make a proposal to revoke the registration of the dealer.

I am frankly surprised by the member's question. He appears to be in support of Sunday openings in spite of the findings of his party's task force, which recommended against Sunday openings.

Mr. Runciman: I was not suggesting by my question that I support Sunday openings. Eastway Ford is no longer open on Sundays. It was open for 18 consecutive Sundays and it is not open on Sundays now. My concern and that of my party was 70 jobs in St. Thomas, the involvement of the Premier (Mr. Peterson) and his office, which was indicated by ministry staff, and the commitment of the minister's staff to pull this individual's licence.

I asked the minister then and I ask him now, does he feel that type of involvement by the Premier's office is appropriate?

Hon. Mr. Kwinter: I have been informed that the registrar sent the letter to the auto dealers' association on May 8. The first time the Premier heard about it from his constituents was May 10. There was no involvement by the Premier. It was an involvement by the registrar.

REMOVAL OF CARCASSES

Mr. Sheppard: I have a question for the Minister of Natural Resources. Last week in my riding, a deer was struck and killed in front of the home of one of my constituents. This woman was informed by a conservation officer in the district office of the Ministry of Natural Resources that picking up dead animals was not necessarily the ministry's responsibility. Furthermore, as of July 1, the ministry's policy will change to place the responsibility for the removal of animals upon the land owner, who in turn will require a permit from the ministry to do so.

In the interest of public health and safety, does the minister not agree that the handling of dead wild animals is best left to trained ministry staff?

Hon. Mr. Kerrio: I had a report on that incident. We could not find the evidence when we went to pick up the animal. Therefore, I am not sure how to handle this situation.

Mr. Sheppard: This constituent was very distressed by the fact that it took 24 hours and several phone calls before someone would remove the dead animal. Does the minister not think we should have another conservation officer in our area?

Hon. Mr. Kerrio: I know I am not supposed to ask a question of the member, but I would like to know whether the person he would like hired is a friend of his.

LIQUOR WAREHOUSE

Mr. Breaugh: I have a question for the minister responsible for the sale of booze. It concerns the world-class, high-technology, fully automated liquor warehouse in Whitby. Can the minister tell us why the thing does not work?

3:30 p.m.

Hon. Mr. Kwinter: I question whether the member's facts are correct. Members will know there is an extremely expensive facility in Whitby that is used for the warehousing of alcoholic beverages. It was not built by this government. Having said that, I can say I am concerned about its cost. It seems to be working most times. The story I get from management is that because of the high technology and the time it takes to train the employees, they are expecting far better results as they go along.

Mr. Foulds: How far do they drop the bottles?

Mr. Speaker: Does the member for Port Arthur (Mr. Foulds) want to ask a question? Is there a supplementary?

Mr. Breaugh: The minister is aware that this thing is costing $200 million, four times the original estimate, and that it is two years behind schedule. Will he provide us with a report that will address the allegations that there are high numbers of health and safety violations in the plant, that there is an incredible amount of breakage of bottles and that they are mixing up orders for the stores a great deal? Will he table some information so we can judge whether perhaps in our lifetime this thing will begin to function properly?

Hon. Mr. Kwinter: I will be happy to look into that matter and get back to the member.

INSURANCE AGENTS

Mr. Runciman: I have a question for the Minister of Financial Institutions. The minister no doubt is aware that more than 40 per cent of part-time insurance agents are women, yet his government plans to ban part-time agents. I understand it will be dealing with the regulation either this week or early next week. Can the minister let the House know his views on this very serious matter?

Hon. Mr. Kwinter: I am sure the member is referring to A. L. Williams, a company in the United States that specializes in selling term insurance and recruiting part-timers. Very serious concerns have been expressed by both the superintendent of insurance and people in the insurance industry. I have asked for comments from the industry. We are looking at that situation and will be making a determination shortly.

Mr. Runciman: I am not referring specifically to A. L. Williams. The concern on this side of the House is about the female work force in this province. We feel the proposal before the government is discriminatory and anticompetitive and will only serve to worsen the job prospects for women. I ask the minister to take a very serious look at this question in the light of these implications for the female work force in this province and to set aside the A. L. Williams situation. Will he commit himself to do that?

Hon. Mr. Kwinter: In our review of the situation, we are not dealing with it as a male or female problem; we are dealing with it as a part-time insurance sales force and with the problems and ramifications of that. We are looking at it, and I will get back to the member as soon as we make our determination.

ONTARIO HOUSING CORP.

Mr. Philip: The Minister of Housing will recall that four weeks ago I brought to his attention the fact that Ontario Housing Corp. refuses to give transfers to larger apartments to tenants who enlarge the size of their families by adopting a foster child, because it says foster children are not permanent. Will the minister inform the House what action he has taken in the past four weeks to change that ridiculous, stupid and discriminatory policy?

Hon. Mr. Curling: I have great respect for those who want to become foster parents. Having said that, the position of the Ontario Housing Corp. on people who have taken that step and who want to be in OHC housing is that the involvement of foster parents lasts a very short time. We would have to put them on a priority list and displace people, and it would be for a very short time. We do not regard placing those people as a priority.

Mr. Philip: Is the minister not aware that many people who are foster parents take one child after another of the same sex and that therefore it is not a temporary situation? In the case of the Anderson child that I brought to his attention, that boy had been living with the family for two years and had been sent there by the children's aid society.

Is the minister not aware that the number of foster homes in Metropolitan Toronto has declined to 441 in 1985 from 506 in 1981? Why is he taking actions through Ontario Housing to discourage Ontario Housing tenants from becoming foster parents when there is such a need to place foster children, particularly teen-aged children?

Hon. Mr. Curling: The OHC feels the children's aid society feels the environment is appropriate when it makes a decision to accept them as foster parents. When a person asks afterwards for a permanent position, we do not have that kind of accommodation because of the demand we have for other people.

RENTAL ACCOMMODATION

Mr. Harris: The Minister of Housing will know that in estimates I raised concerns about housing in North Bay and the Renterprise program. I have a headline from the North Bay Nugget, which reads, "City's Vacancy Lowest in Country"-not in the province, not in northern Ontario, but in Canada.

The minister refused to make any allocation for North Bay in the Renterprise program at that time. I asked whether, if another allocation became available, we could look at North Bay. He thought that was a very positive suggestion. Since only 60 of the 150 units allocated to Cambridge have been picked up, is the minister prepared to allocate those 90 units to North Bay?

Hon. Mr. Curling: I am not prepared to allocate those 90 units that dropped off. I am prepared to allocate those that could not be taken up; and I will consider North Bay.

Mr. Harris: We had that answer last fall and when the minister came out with his assured housing policy. We still have not seen a unit built anywhere in the province. Here is a program which some people in the province do not want and others do. Why can the minister not live up to his commitment to the people of North Bay and allocate those units right now?

Mr. Brandt: Yes, right now.

Mr. Gillies: North Bay now.

Interjections.

Mr. Speaker: Order.

Hon. Mr. Curling: Should I respond to all that nagging, Mr. Speaker?

Mr. Speaker: Just to the supplementary.

Hon. Mr. Curling: What was the question again?

Mr. Harris: Very briefly, the minister has made a commitment to the people of North Bay if all the allocations were not taken up by other areas. I pointed out to him that he had made grave errors in the allocations and that some did not need them badly. Cambridge is one area; he allocated 150, and only 60 were picked up. In North Bay, many builders are desperate for the allocation; it also has the lowest vacancy rate in the country. I ask the minister, why will he not give them the 90 units he has right now?

Hon. Mr. Curling: As I said, I will look into it and consider North Bay if those people definitely drop off.

REPORT BY COMMITTEE

STANDING COMMITTEE ON REGULATIONS AND PRIVATE BILLS

Mr. Callahan from the standing committee on regulations and private bills presented the following report and moved its adoption:

Your committee begs to report the following bills with certain amendments:

Bill Pr42, An Act respecting the Waterloo-Guelph Regional Airport.

Bill Pr50, An Act respecting Renfrew Victoria Hospital.

Motion agreed to.

3:40 p.m.

INTRODUCTION OF BILLS

CITY OF NORTH YORK ACT

Mr. McCaffrey moved first reading of Bill Pr2, An Act Respecting the City of North York.

Motion agreed to.

EMPIRE LIFE INSURANCE COMPANY ACT

Mr. South moved first reading of Bill Pr10, An Act respecting the Empire Life Insurance Company.

Motion agreed to.

CITY OF CORNWALL ACT

Mr. Guindon moved first reading of Bill Pr17, An Act respecting the City of Cornwall. Motion agreed to.

ONTARIO ASSOCIATION OF SPEECH LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS ACT

Mr. Reville moved first reading of Bill Pr1, An Act respecting the Ontario Association of Speech Language Pathologists and Audiologists.

Motion agreed to.

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 rose yesterday, we were in the middle of the amendment from the member for Windsor-Riverside (Mr. D. S. Cooke) to add a subsection 2(3) to Bill 94. Is there any honourable member who wishes to speak on this amendment? If there is none, we have to vote on the amendment.

Mr. Harris: I will be delighted to lead off. Which amendment are we on?

Mr. Chairman: We are on the amendment by the member for Windsor-Riverside to add a subsection 2(3).

Mr. Harris: Can you refresh my memory?

Mr. Chairman: It is Bill 94.

Mr. Brandt: We know the bill.

Mr. Chairman: I was not sure whether members were aware of which bill we were on. The member for Windsor-Riverside has moved that "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 and particulars sufficient to identify the nature of each service and the charge therefore."

Mr. Harris: I have a good number of concerns on this section. The member for York Mills (Miss Stephenson) will express them to the House right now.

Miss Stephenson: It is inconceivable to me that the member for Windsor-Riverside is not aware that any opted-out physician in Ontario, any optometrist or any dentist for that matter, who intends to submit bills to patients and to the Ontario health insurance plan does precisely that at present.

A statement of account is submitted to the patient after each and every service provided. In 1974, long before it was ever required by any piece of legislation or regulation, the code of ethics of the Canadian Medical Association made it obligatory for all physicians to provide full information on every service given by an opted-out physician to a patient in order that the patient might achieve the full benefit of his insurance program.

A statement of account is delivered to the patient by each opted-out physician in Ontario, and a statement of account in the form required by OHIP is delivered to the plan. I do not believe that what the member is suggesting is going to provide much in the way of useful service to anyone since it is a duplication of the current activity of the practitioners of this province.

If he were suggesting that the insurance plan in Ontario provide to every beneficiary of the plan, that is, every patient, a statement of account of all the services rendered and paid for by opted-in physicians, about which most of the patients know nothing, then I believe he would be providing us with a useful amendment to this piece of legislation.

It has been stated many times by many people that the best consumer of any service is a well-informed consumer. A consumer of the services of an opted-out physician, for example, in Ontario is well informed about the level of billing the physician or practitioner exercises and is aware of the benefits the plan provides as a result of the billing that is submitted.

I believe the member is probably suspicious and is imputing motives, suggesting the figures on the statements that are submitted do not coincide. They do. In my experience, which is relatively broad, physicians provide the information to OHIP about the amount that has been billed to the patient. That is the thing that is necessary. OHIP then makes the decision about what it is going to provide in the way of payment. That payment is based upon its assessment of the coding provided on the card.

The member is on the right track when he suggests there is a need for greater information for a considerable number of patients in Ontario. It is not the patients of opted-out physicians who are in need of greater information but the patients of opted-in physicians who do not know, in most instances, because there has not been a mechanism in place to provide the information about the payments that have been provided on their behalf by the insurance program for the services rendered.

I feel very strongly that we should not support the amendment suggested by the member for Windsor-Riverside, but along with my colleagues, I have drafted a supplementary amendment, which is probably much more appropriate and which we will be delighted to have the member for Windsor-Riverside support if he is trying to provide that patients be well informed in Ontario. We request the support of the minister as well for that amendment.

To attempt to suggest the requirements that are in place now in the practices of those physicians of this province who are opted out should be duplicated for some reason is an inappropriate kind of amendment.

3:50 p.m.

Mr. D. S. Cooke: I point out to the member for York Mills that one of the reasons for this amendment is that it was brought to my attention by a constituent, and then through follow-up conversations with OHIP, that many of the bills submitted to OHIP underestimate the amount of the extra billing. I have a specific case, but the generalization was made by OHIP.

Many opted-out doctors in this province submit their bills to OHIP, but the reality is that the bill that goes to OHIP underestimates the amount of extra billing. The amount that is actually extra billed is inaccurately reported to OHIP. This has not been checked extensively by OHIP because it limits the penalty to the province as a result. Therefore, I believe there is a requirement in this legislation to make sure an itemized account, which is the same itemized account, is provided both to OHIP and to the individual.

I ask the former minister, in thinking about and discussing the amendment she is going to propose later and in discussing it with the Minister of Health (Mr. Elston), to consider the implications of her amendment for confidentiality.

Miss Stephenson: I ask the member to give me the evidence upon which such a statement has been made by the officials of OHIP that there was an underestimate of the billing that was provided to the patient as a result of their review of the cards submitted to OHIP. I have no such indication. I have never heard that this is any kind of problem or that it was a matter of concern in any place.

Hon. Mr. Elston: There is no requirement that the extra-billed amount be reported. In the majority of cases, there is no reporting to OHIP of any amount being extra billed, because OHIP reimburses on the basis of a schedule of benefits or, in limited circumstances, on the basis of the finding of a medical review committee for special procedures.

There is no reporting to OHIP of the amount extra billed. That is one of the reasons an estimate was agreed upon between the federal government and the previous provincial government at the level of $53 million. There is no reading of the amount of extra billing here by OHIP. There is no requirement to report that.

Some doctors have told me they put on the cards what they are actually billing, but they are not in the majority; that is an exception to the situation rather than the rule.

Miss Stephenson: I am interested to hear the minister's response. Having inquired of the officials at OHIP whether the amount billed by opted-out physicians was recorded on the cards submitted to OHIP, I have been assured that in almost all circumstances it was; it was not that the majority of cases had no such annotation. I would like to be absolutely positive that is the situation before I even consider the kind of suggestion the member for Windsor-Riverside is making.

If the member for Windsor-Riverside wants to ensure there is a duplication, I suggest the OHIP card be sent in duplicate to physicians, who can complete it and send one copy to the patient and submit one copy to OHIP. It should be the responsibility of the insurance plan or of the Legislature to ensure this is done, since we are the ones who want to impose it.

I doubt this is going to solve any problem. I am not at all sure this is the area we should be pursuing if we are trying to ensure that we have well-informed patients.

Mr. Henderson: It is a pleasure to rise and ask a question that I do not think is going to get me into any trouble over here. I have a question for the member for Windsor-Riverside, who was kind enough to let me have a look at the proposed amendment. I must confess I do not quite understand, psychologically speaking, where it is coming from. If the problem is-

Mr. D. S. Cooke: Do not talk to me about psychology.

Mr. Henderson: Then administratively speaking, I do not understand where it is coming from.

If the problem is that we do not have a way of knowing how large the problem of extra billing is in dollar terms, because the physician does not indicate on his card the actual fee he is charging for the service-the minister said something such as that, and I think he is right-then the amendment I have just read does not address that. The amount the practitioner records for the patient can still be different from what is on the card.

Perhaps the member can help me understand the intent of this amendment a little better than I do right now.

Mr. D. S. Cooke: There will still be doctors who are opted out under Bill 94, but they will not be allowed to extra bill. The difficulty will be in trying to identify for patients whether they are being extra billed and do not know it. We are suggesting they should have an itemized account from opted-out doctors that would be the one OHIP would get. OHIP and the patient would readily know whether there was extra billing. We do not wane tipping, as the member for York Mills wants.

Mr. Henderson: The bill as it stands amended now says that if a physician is opted out, he can bill only at or below the amount of the OHIP tariff and that he cannot expect or insist on being paid until the patient has already been reimbursed. Surely that is enough of a control.

Surely we do not want an amendment that is going to insist that every practitioner, every time he bills a patient, show cause not to be found in defiance of the law. That contravenes the principle of being innocent until one is proven guilty and a lot of other principles too. That means it is required every time one bills a patient to show evidence that one is not breaking the law.

That is going far beyond what I and any reasonable person would consider to be a fair expectation of a professional practitioner.

Mr. D. S. Cooke: I know when I have lost an amendment, so I do not want to continue to debate it. The point is that unless a patient knows what the bill is, it is going to be difficult in some cases to enforce the act properly. The amendment we carried yesterday has a provision that if a patient consents to pay before he gets the money from OHIP, he can. I would rather not have that section in, although it would have been very difficult and probably unreasonable not to allow someone, upon consent, to pay earlier than when he got his refund from OHIP.

We all know that in some cases pressure will be exerted on patients to pay immediately after the service has been provided. Just as there are people who break other laws, there will be people who will try to break this law. By getting an itemized statement, it would be easier for a patient to determine early whether he has been extra billed. Therefore, it would enhance the enforcement mechanism the minister has suggested.

4 p.m.

Miss Stephenson: I perceive that this kind of amendment is to be anticipated from someone with such a malignant and malevolent view of the goodness of humanity generally. I have difficulty in suggesting-

Mr. McClellan: On a point of order, Mr. Chairman: You heard what I heard. Is that parliamentary language?

Mr. Chairman: That was bothering me. The malignant view.

Mr. McClellan: Malignant and malevolent.

Mr. Chairman: Malignant and malevolent view. It is not very useful language. Maybe the member for York Mills would withdraw the words.

Miss Stephenson: Mr. Chairman, since the description is accurate, it pains me for you to suggest I should have to withdraw it, but if you insist that I withdraw it, then I shall.

I believe firmly there are those who appear to perceive that no one has any honour, integrity or commitment, except certain members of a certain party in this House, and everyone else should be controlled by some piece of legislation that is going to ensure that they behave in some kind of fashion which even the members of that party do not follow most of the time.

It is not a useful exercise to pass this amendment. It is not going to achieve anything, it is not helpful and it will not provide information. It will not add anything to this already dreadful piece of legislation, except more confusion, more distress and more disturbance. I recommend strongly that we all vote it down.

Mr. D. S. Cooke: The fact that this amendment has the member for York Mills upset means it has achieved something.

Mr. Chairman: Does any other member wish to speak to the amendment?

All those in favour of Mr. Cooke's amendment will please say "aye."

All those opposed will please say "nay." In my opinion the nays have it.

Motion negatived.

Mr. Chairman: Because of the nature of this amendment, we have another amendment to section 2 of the bill moved by the member for Lincoln.

Mr. Andrewes moves that section 2 of the bill be amended by adding thereto the following subsection:

"(3) The plan shall provide to each insured person, on an annual basis, a written itemized statement of all payments made by the plan on behalf of each insured person for insured services."

Do members have copies?

Mr. Andrewes: I have supplied the table, the minister and the member for Windsor-Riverside with copies.

I must admit I have not had an opportunity to run this amendment past legislative counsel. The wording and the intent are sincere none the less, but they are of my own composition.

Hon. Mr. Elston: On a point of order, Mr. Chairman: It seems to me legislative counsel will be thankful the member has not had a chance to run this amendment by them, since it has been so quickly drafted.

Mr. Chairman: That is not a point of order.

Hon. Mr. Elston: I was just expressing thanks on behalf of legislative counsel.

Mr. Andrewes: That may well be. None the less, it is quite clear that what is asked for in this amendment is that the ministry, through OHIP, provide on an annual basis to each of its subscribers a complete itemized accounting of the services that have been paid for by the plan during that annual period.

We move this amendment because there is a very strong feeling among many of the population today that the general public is not nearly well enough informed about the costs of operating the health care system in this province. In many cases, visits to medical practitioners and visits to emergency areas of hospitals are made for less than real health care needs. Individuals and families, in assessing their health care requirements, are not putting those requirements in the context of the costs they are incurring to the tax base of the province and nation.

At the same time, it is important that there be some type of monitoring system. It is important that individuals who are receiving insured services know that practitioners are submitting accounts on a timely and reasonable basis for the services that are delivered and that hospital services rendered to insured persons are being submitted accurately and fairly to the plan for payment. We have embodied this in this amendment.

We appreciate there may be some concerns expressed by the minister about the fact that such an amendment would be unwieldy and that it might be difficult to determine what type of mechanism could be put in place that would retain the confidentiality of a doctor-patient relationship. For instance, members of a family might visit a practitioner or a hospital for medical care and not wish other members of the family to know why they made that visit, or members of a family might refrain from obtaining medical services or advice-and it is not our wish to cause this kind of grief-because they have some fear that other members of the family might find out that they are seeking that advice or service.

4:10 p.m.

However, in all things there are situations where one has to set aside legitimate concerns for the sake of adding some effective accounting to the whole system. We put forward this amendment so that those who subscribe to the plan, those who are seeking the services from the plan, can examine the cost of those services and retain some perspective on that cost while at the same time providing a reasonable auditing method whereby it can be determined that the services have been provided and billed for fairly.

Mr. Brandt: I would like to share some of the comments of my colleague the member for Lincoln with respect to this particular amendment and propose to the Minister of Health that he take the suggestion very seriously.

It has been brought to my attention on a number of occasions, and I want the minister to know-and this is obviously the point my colleague is attempting to make-that the vast majority of users of our health system in Ontario have no idea of the current costs of the system whatever. There are numerous cases of some abuse of the system as a result of overuse, particularly of our emergency services, when a somewhat more sensitive use of the system could reduce the cost. The abuse and/or overuse of the system tends to increase the cost.

I suggest part of the reason for that is there is no accounting, there is no discipline and there is no balance built into the system to indicate in any way, shape or form the cost of using that system.

I think when we have reached, if I may suggest this, the point where over 30 per cent of the tax dollar of Ontario going to the health system-

Hon. Mr. Elston: It is 32 per cent.

Mr. Brandt: I said over 30 and I imagine that 32 is somewhat over 30; so I was correct in suggesting that.

Hon. Mr. Elston: I thought the member was talking about his age.

Mr. Brandt: My age is in the same range as well. However, when close to one third of the total provincial budget is being set aside for the delivery of health services in this province, we have to start looking at some ways and means-a ban on extra billing not being one of them-of curtailing the runaway costs that are built into the system.

I have to suggest that very few people in this province know the cost of a hospital room today, either private or ward system. They have no idea of the cost of a visit to a doctor's office. They have no idea, when the doctor comes to their home, of the cost associated with that particular visit.

We can take a look at the whole vast array of services that is provided in our health system, and I have to say, and I use this term charitably, that the vast percentage of Ontario citizens is simply unaware of those costs. When one takes a look at the tremendous amount of money that is being put into the health system without any accountability, without any invoice, without any recognition whatever of what those costs really amount to, I think it is time the minister took a look at some system of at least advising people that it is tremendously expensive and that it does require his attention in some unique, different approach that might be taken by his ministry.

This concern has been raised by many of my constituents. I have had a number of letters on this. I say that to the minister by way of an admission, going back to the time I sat on that side of the House. In spite of the fact there was no action taken on this issue by the former government, perhaps this is one thing the minister could do that would be right for a change. It is one thing he could do that might respond to the interests of some of the citizens of Ontario who feel there should be some balance built into the system that makes some sense and that would show and reflect the true costs of receiving health services in this province.

I could go on at some length. I know the minister wants me to do that and I am more than willing to embellish or amplify my remarks if they are not as well understood as they should be, but I will retire at this point and look forward to participating in the debate at a later point.

Hon. Mr. Elston: I would like to rise and speak on this. I have had some of the same correspondence as the member for Sarnia (Mr. Brandt) and the member for Lincoln in terms of sending out statements with respect to the cost that has been incurred on a patient's behalf, but I think the overriding concern I have at this time is from the standpoint of the confidentiality.

My concern is that we have some problems administratively. It is an unwieldy sort of system to put in place because we do not at this stage have all the addresses of all the patients in the province. We could have problems in sending out statements that might end up being delivered at someone else's house, thus making available to people other than insured persons information about their health treatment and otherwise. That would really cause me great concern.

The other issue, which the member for Lincoln acknowledged-we had spoken about it a little bit before this committee debate started-was the fact that it might deter some members of a family from actually seeking treatment, because they might be concerned that their treatment was not being kept confidential and was being made known, inappropriately, to other members of the family.

Those concerns are large enough for us to consider this amendment certainly not timely. I can really sympathize with those people who would like to know the costs of the system, but the overriding factor for me is confidentiality. From that standpoint, I cannot support this amendment at this time.

It might be a different set of circumstances if there was a way we could identify each particular insured person in the province. It might be a different set of circumstances if we could absolutely guarantee that the health information of each of those people was not going to go astray. It would be a different circumstance if I could come up with some hard information that the provision of this statement would have some mediating effect on the consumption of health services. In fact, it was tried, as I understand it, in Quebec and was discontinued after a couple of years, but I am not certain of that. It was started at least in sending out statements. The member for York Mills shakes her head. I stand corrected if that is not right, but I think I have been advised of that.

For the purposes of the member for Sarnia, some hospitals do send statements to patients. Not all of them do, but some do. There is a little bit of that going on in some hospitals.

Mr. Brandt: Only if there is an extra charge.

Hon. Mr. Elston: Not only in that situation. Sometimes a statement is provided even if there is no extra charge. It is not done widely.

We had a public forum on this in Kingston. An economist there had advised that, although the desire in sending a statement out is to reduce the consumption by making people aware of the costs of the health services consumed, in some situations, from the analysis he had done-and he advised us of his analysis-it had the opposite effect. People felt they were not getting their money's worth for the premium they were paying because they were consuming less than what their premium was. That was brought to our attention at a forum in Kingston. There is an argument on the other side of the salutary effect of sending out these statements.

I have put all those items together to advise people there are real problems in bringing this together. I have some sympathy for the idea and the concept behind it, but from my standpoint, it is not something we can make work properly while ensuring the integrity of the confidential nature of the health services delivered to those insured in the province. I cannot support this type of amendment at this time.

Mr. D. S. Cooke: We will not be supporting this amendment, and I encourage the Conservative caucus to withdraw the amendment. I do not think they considered the implications for confidentiality. I am sure the member for York Mills as a professional would understand that confidentiality is absolutely essential not only to the medical profession but also to social work, to psychology and to psychiatry.

If we are talking about disrupting the patient-doctor relationship, this kind of amendment would absolutely destroy it. What happens if someone moves who has received treatment for venereal disease and was exposed to that?

Miss Stephenson: You do not put that on it.

4:20 p.m.

Mr. D. S. Cooke: The member is telling me this kind of information will just be codes that will be meaningless to the patient anyway. It would absolutely destroy confidentiality. I do not think that party thought of this implication when it decided to put this amendment forward. Let common sense prevail and withdraw the amendment. Let us get on to the next one.

By the way, there are 14 million OHIP numbers and only eight million people. Where are those extra six million annual statements going to go?

Mr. Brandt: If there is anything that will destroy the doctor-patient relationship in this province, it is Bill 94. It has nothing to do with the problem of confidentiality in the proposed submission of bills to patients or a statement of the visits that patients make to their doctors.

In response to the minister, who has escaped for the moment, it is recognized that it is against the law for someone else to open one's mail and that a good deal of care and sensitivity would be taken into account in such a statement that would be delivered to a patient. If there was, as the member for Windsor-Riverside suggests, an area of mental disorder or some other area of health concern, that would not be reported in a blatant way in such a statement. It could be done in such a way as to simply indicate a visit to a doctor without giving away the total information on what the nature of that visit was all about.

It is against the law to open someone else's mail. There are a lot of confidential documents relating to bills, such as Visa bills or income tax reports, a whole series of things that someone may prefer that another member of the family not see but that come to our homes on a regular basis. I see no reason this type of information could not come to the home on a regular basis as well.

To suggest, as the minister did, that because people pay an OHIP premium or have a certain amount invested in the health system on an annual basis, they would automatically want to use up that credit in some fashion really boggles the mind in some respects.

If that logic were followed, then every time one got insurance on one's car, one would make sure one had an annual accident that would be at least up to the level of the premium paid on the policy. One would make sure that one burned down one's house once a year, would one not? One pays a premium on one's house insurance and therefore one automatically has to recover one's investment. Lord help us if someone has insured another member of the family. I guess one would have to dispose of him or her as well to collect the insurance on that.

That line of reasoning is so illogical that I am sorry the minister is not here to listen to some of my responses to that ludicrous situation he has put forth, that people would automatically use up their premiums. Logically, I would think it would be the other way around.

Most people simply do not know the costs associated with the services they are getting today. If they saw what those costs were, how expensive those services were to deliver to those people, they would stand back and, out of a sense of responsibility, would say: "I am going to do something about this. I am not going to abuse the system. I am not going to overuse the system. I am not going to use emergency services when I do not have to use them. I might go to the hospital during regular hours."

Mr. McClellan: Wait for a house call.

Mr. Brandt: I might get a house call in some circumstances, but the fact of the matter is that to suggest that all the people of Ontario, or a good portion of them, would automatically use up their credit through this measure we are proposing is simply ludicrous.

Mr. McFadden: Listening to the minister's response to the amendment proposed by the member for Lincoln moved me to intervene and make a couple of statements.

First, in relation to the value of people knowing what their health care costs might be and whether that has been the pattern at other institutions in the health care field, I simply point out to the minister that I know the Hospital for Sick Children has a practice of providing to parents, when their child is discharged, a statement itemizing the cost of that child's stay.

About two years ago, my daughter was in the Hospital for Sick Children for a three-day stay for treatment of a condition known as cellulitis. When she was discharged, we received a statement from the hospital showing that the cost of her care in the Hospital for Sick Children was something over $900 for the three days. The thing I was struck by was not the desire to get her back into hospital so that I could utilize the space more the next month, the following year or two years later. I really appreciated the fact that the taxpayers of Ontario had incurred an expense of $900 to help my little girl get better. I felt it was one of the best things I had seen to point out to me the real cost of health care in Ontario.

We can talk about $10 billion and these gigantic sums. The average person cannot understand or appreciate what that means, but one thing the average person can appreciate is the cost of the care for himself, his children or his relatives. In my mind, that particular policy by hospitals is something I can even see being a requirement across Ontario because I believe people would appreciate far more what they were getting for their tax dollars and the tremendous cost of health care if they were to receive statements for all aspects of health care from hospitals through to charges for their doctors.

With regard to the doctors, as the amendment sets out, the same principle applies completely. Today many people have a feeling the treatment they are receiving is free, that it is not something they really have to pay for, though obviously somebody pays for this service. It is every single taxpayer and individual in Ontario. It is an extremely good service, and I think it is worth the money that is being paid for it. I do not think we have anything to hide by providing to patients an outline on an annual basis of the cost of their health care.

I find it remarkable that one of the major reasons put forward that this cannot work is that the statements cannot be sent out. There is a problem here somehow with getting statements to various people who should get them. I have not been struck by the fact that OHIP has any difficulty getting bills to people on a timely basis. I fail to see why there would be a problem getting out annualized statements to patients throughout Ontario on the cost of the medical service that was provided to them individually.

We have also heard that the taxpayers might not be responsible, that if they got a billing that showed they did not utilize the service enough, they might feel they had to go in and start using doctors a lot more. I have a lot more confidence in the taxpayers and citizens of Ontario than to believe that millions of Ontarians would start over-utilizing the system because they got bills that showed they had not been sick much that year and so they should get to their doctors right away and start spending a lot of the public's money. I do not believe the taxpayer would react that way.

Sure, there is the odd person out there who would receive a statement and say: "My goodness, I spent only $100 visiting the doctor this year. I had better get out there and spend another few hundred dollars, go in and get a whole bunch of tests done and see the doctor on a weekly basis to get more of my tax dollar back." I do not believe there is a reasonable person who would do that and, as a consequence, I do not believe that kind of lack of faith in the taxpayer of Ontario should be used as a basis for speaking against this motion.

4:30 p.m.

As for whether this would deter people from seeking treatment, I do not think there is anybody in need of a physician who would not go to a physician because a statement would come out once a year outlining his utilization of the system. It is not logical, it is not sensible and no one I have ever heard of reacts that way. If he has to go to the doctor to receive a service, he will go to the doctor. Getting an annual statement is not going to deter him. I cannot think of a single professional service for which one is not billed, let alone receiving a statement.

What we are talking about here is essentially not an annual billing that people will have to pay. All we propose is that people have a statement in which there will be an outline of the services they have received and the cost of those services. It is amazing to me that anybody would say that in some way would deter people from having treatment.

There are other government services for which we do not receive specific statements, but on the other hand, this is a unique service in the sense that it is being provided by a professional to a person. There are very few other services I can think of in government where there is a direct relationship between the recipient of the service and the professional providing it.

The education system, which accounts for a large part of government expenditure, at least in Toronto, provides a statement annually to the taxpayers about how the taxes are used with respect to education costs. That goes to every taxpayer. There does not seem to be any valid reason this professional service provided by the medical profession should not be accounted for and a billing or a statement of account provided to each and every patient annually. I cannot see a good, rational reason.

There could be some functional problems, but in this era of advanced technology-and we have heard about how Ontario is about to become world-class, as if it is not already, in technology and technological innovation-surely it is not beyond human ingenuity to find an efficient and effective way of getting a statement of his utilization of the health care system to every recipient once a year. I do not believe it is beyond the ingenuity of mankind. I do not believe it is beyond the ingenuity of the Ontario government. All we have to do is look at the tax system and all the other systems where statements are sent out to know timely statements can be sent out in a fashion that would meet our needs.

This is a departure from the past, but this legislation is a major departure from the past. It seems to me it is only fair and reasonable that the taxpayers receive a statement in an itemized fashion once a year.

Mr. Henderson: May I again ask for a point of clarification? I like the idea of this amendment, because it seems to me many people do not begin to appreciate the crushing and astronomically increasing costs of health care services. I am sure the intent of this amendment is to try to address that failure and to try to encourage people to take some interest in the incredible deployment of resources in personnel and materials that go into the provision of health care.

I may not have caught this when the statement was proposed. Would the statement go to the patient or the plan holder at the end of the year? Has there been some consideration about what happens if the patient is a minor or if there are issues of mental incompetency and so on? I am concerned that this be thought through very carefully before an amendment of this sort becomes operational. It might turn out to be more difficult and more complex in the implementation than it is in the principle, with which many people would agree.

Miss Stephenson: The complexity is of concern. It was never intended that such a statement would detail specifically the kinds of services that have been provided for each patient. It was intended that for each member of the family there would be a listing of the total amount paid to physicians or other health professionals, the total amount paid for laboratory services, for hospital admission or for other health services that are benefits under the act.

In addition, as I said, this would apply for all members of the family. It would provide a total for all members and then a breakdown for each. There was not an intent that there be any release of confidential information regarding any diagnosis. That is not part of this recommendation at all.

The amendment we have produced meets the requirement that has been stated clearly by a number of economists. I never cease to be amazed that when a group of economists get together, if there are five economists, one has six opinions, the opinion of each one plus the group's. The assistant deputy minister of Health is no different from any other health economist; they all have their own points of view.

However, enough health economists have agreed it is necessary for subscribers to an insurance program to understand the amount of money that has been expended on their behalf. One does not receive benefits of any other insurance plan without knowing how much has been paid on his behalf, primarily because in most instances either it is paid directly to him or a copy of the cheque that is sent to a repair company is sent to him as well, or he has an estimate.

In this instance, ever since the introduction of the health insurance in Canada, no mechanism has been put in place on a universal basis which would ensure that those patients, who never see the account that is submitted, would have any idea of how much was expended on their behalf.

The hospitals tried. Early in the 1970s, on a fairly widespread basis throughout Metropolitan Toronto and in some other parts of the province as well, the hospitals began to provide at the time of discharge an itemized statement which informed each patient exactly how much the health insurance plan was supporting the delivery of health care on his or her behalf. It seemed to me that was not vigorously encouraged by the Ministry of Health at that point, and there was no specific provision made in the arrangements with hospitals which would allow this to happen with any ease.

The information that is now available within the OHIP computers would not make this administratively difficult; it would be very easy. The diagnosis and the codes do not necessarily need to be part of the statement, but the statement can be produced, because the codes are there and are easily accessed to provide the information that is necessary.

We have been very much concerned about confidentiality. I recognize the rationale that is the basis for that concern. I practised medicine long enough to be very much aware of the need for confidentiality in some very stringent and strange circumstances when one would have thought one member of the family, particularly one member of the marriage, would be delighted to tell the other precisely what was going on. That is not always so. It is necessary to ensure that kind of breach of confidentiality is not achieved by this sharing of information.

I believe, as has been said before, that it is not beyond the ingenuity of technology and of those involved in administering that technology in Ontario to achieve this form of useful information dissemination which, in the minds of many economists, would have a very beneficial effect upon the over-utilization. I will say that clearly and loudly, because there is over-utilization. The members see it and I see it on a regular basis. Nobody phones grandmother any more to find out what to do about a sore throat; instead, one goes to the emergency department to cost the system a rather large amount, just short of $100 in most cases, to find out that all one needs to do is to keep the child in bed and have the child gargle a little.

4:40 p.m.

There is no doubt in my mind that it would have a very salutary effect on the mindset of many members of society in this province and that in the long term it would be beneficial for the health care system as far as the rate of utilization and the rate of growth of utilization are concerned. That is a reasonable direction to pursue.

The confidentiality of the doctor-patient relationship already is potentially breached as a result of some aspects of Bill 94. We do not intend to breach it further, but we do intend to provide for an informed citizenry who will be able to make decisions based on facts rather than on a nebulous understanding that since everybody pays for this, every service that is received is gratis to the individual recipient.

That mindset and attitude can no longer continue when the growth of utilization and of cost increase by geometric progression, as they do in the health care field. That must be controlled. Truthfully, the only way it can be controlled is for the individual member of society to control the use of the system in a more appropriate way than seems to be occurring now in many instances. Therefore, I believe this is a very rational, reasonable, appropriate kind.

Mr. McClellan: We do not want any unnecessary tonsillectomies wholesale.

Miss Stephenson: The member for Bellwoods should know that one does not do tonsillectomies wholesale. That might have been some kind of fad at the time he was an infant, but it no longer is. It is a procedure that is carried out only when it is proved to be absolutely necessary. Within this country, perhaps there are many more responsible practitioners of health science than in some other jurisdictions. These difficulties are not the kind we have to face on a regular basis.

This is a rational, reasoned amendment that would improve the circumstances surrounding the delivery of health care in Ontario, that would make the individual subscribers more informed and that would help them to understand better the consequences of utilization of the health care system. It would ensure that they would use the system in a much more informed and intelligent way than many of them have in the past. This amendment is very worthy of the support of all parties in this House.

Mr. D. S. Cooke: I am not surprised at the focus of the Conservative Party in this amendment. The focus has nothing to do with consumer education. The focus of the amendment is that they think patients in this province by and large abuse the health care system. That is what the member for York Mills said.

Miss Stephenson: I did not say that.

Mr. Brandt: Nobody said that.

Mr. D. S. Cooke: That is exactly what the member for York Mills said. I listened to every word she said. The member for Sarnia was not even in the room.

Miss Stephenson: On a point of order, Mr. Chairman: For 10 years, I have listened to my words being distorted by the member for Windsor-Riverside.

Mr. Chairman: Order. That last word was not necessary. We are getting close to imputing motives to the member for Windsor-Riverside. "Distorted" is not proper. Will the member for York Mills please be seated? Those are not suitable words. The member for Windsor-Riverside may carry on.

Mr. D. S. Cooke: I heard the comments that were made by members of the Conservative Party. I said their view was that there are people who use the health care system who need not use the health care system. That is it exactly. The member for York Mills gave the example that people should be gargling.

Mr. Brandt: On a point of order, Mr. Chairman: I would like to point out that the words currently being used by the member for Windsor-Riverside are entirely different from those he used a moment ago, which was the point of order my colleague stood up on.

Mr. Chairman: I asked him to use different wording from what he used before.

Mr. Brandt: I would just like to point it out and make it clear in Hansard that he is using different language now.

Mr. D. S. Cooke: What I said was that the Conservative Party was accusing the people of this province of abusing the health care system. That is exactly what the member for York Mills did. The member gave the example of people who go to see a doctor instead of gargling for a sore throat.

The fact of the matter is that if the member for York Mills and the Conservative Party are very concerned about the abuse of the health care system, they may want to look at one of the basic principles of our health care system, fee for service, which encourages doctors to see people time after time and be financially rewarded. That is a basic problem in our health care system. As long as we pay by piecework we are going to have that kind of system.

We all agree with the principle of consumers being informed. The practicality of the amendment the Conservative Party has presented us today is impossible to accept. The member for York Mills can say they are going to code the annual statements, but the reality is-let me be very specific-if an 18-year-old daughter who is still at home has an annual statement sent and a procedure was performed during the year that cost a few hundred dollars, then the family, whom she may not want to have know she has had a therapeutic abortion, could be identified.

There are real problems of confidentiality. If the Conservative Party cannot respect and accept that its amendment has not been thought out, the bottom line is that this amendment is absolutely stupid. Let us defeat it and get on with the next section.

Mr. Andrewes: Before I go too much further, I have to give the member for Windsor-Riverside a living example of the point the member for York Mills and others were trying to make.

Last Thursday evening, as I was about to embark on a sports endeavour, I was suddenly, and to my surprise, struck down by an errant baseball. After a series of consultations with my colleagues, who did not include the member for York Mills but did include a number of others and members of the gallery who came to my rescue-the member for Sarnia gave me his hankie, and so on-it was decided I should journey to the Toronto General Hospital emergency department.

There, in spite of the activities or non-activities going on in our health care system in the province generated by the act of terrorism that the minister has perpetrated on the medical practitioners in Ontario, Bill 94, I was treated with extreme courtesy and very quickly.

I was taken to an appropriate room in the emergency department and attended to very quickly by the floor nurse. I was provided with ice packs and all the other usual necessities. I was examined by a doctor, who indicated he wanted another opinion on this major injury I was suffering from. He called in a specialist, who examined the injured tissue.

Mr. Philip: Is it true they did a CAT scan and found nothing?

Mr. Andrewes: I am not sure the member for Etobicoke (Mr. Philip) knows what a CAT scanner is.

Mr. Philip: It is what they use to scan a cat. I took my cat to the veterinarian; he did a cat scan last week.

Mr. Chairman: Order.

4:50 p.m.

Mr. Andrewes: When there is a hospital in that member's riding that wants a CAT scanner, he will find out what it is and he will be the first one to know.

To continue with my example: Following the second opinion that was given about my injury, I was taken to the X-ray area and a series of X-rays was taken. The X-rays were examined by the doctor who had first seen me.

Mr. Chairman: Speaking to the amendment.

Mr. Andrewes: I am. He sought a further opinion from a radiologist. All of this took place in a matter of two and a half hours. Following that, I was released and allowed to go home, and I was asked to report back in a week.

To this day and I expect to time immemorial, unless this amendment is accepted, I will not know what that evening cost the health care system. I will not have any idea what fees were charged for those specialists who visited me during that time. I will have no idea what fees were charged by the radiologist who examined the X-ray plates at the request of the individual. I will have no idea whether the system has properly reimbursed the doctor or whether the Toronto General Hospital has been properly reimbursed for those services.

The member for Windsor-Riverside suggests our party is focusing on the abuses of the system. With the whole question of utilization being the major factor driving the increased costs of health care not only in this province but probably in every other province in this country as well, responsible legislators who are being asked to vote this year for in excess of $9 billion of taxpayers' money towards supporting the health care system should not be ashamed to suggest that there should be some reconciliation for those expenditures.

The member is blind to those facts. He wants to pass off the blame on a fee-for-service system. Even the medical practitioners might agree it is time the system needed some further examination.

Miss Stephenson: That is what they have suggested.

Mr. Andrewes: They have suggested that, and they are only waiting for the government to sit down quietly with them, once this whole current kerfuffle has been resolved, to sort out a method by which they can effectively examine the system and give it some scrutiny and advice.

I do not make any apologies for putting the amendment. The member for Windsor-Riverside has been somewhat embarrassed by the amendment and is trying to cover up his embarrassment by diverting our attention to other matters.

Mr. D. S. Cooke: I might have a solution that the Conservative Party, our party and the government could support. I tabled an amendment with the Conservative Party last week on section 2; it called for itemized statements. I will read it.

"(2) A practitioner who renders a service that includes an insured service to an insured person shall give to the person and to the plan an itemized statement of the amount charged for rendering that service.

"(3) this statement shall be prepared in the prescribed manner."

The Conservative Party has made some good points on education of consumers, but we have supplied adequate information on the problems with its proposal. This one would apply to opted-in and opted-out doctors. Perhaps if the member for Lincoln would agree, he could withdraw his amendment. I could then move this, we could support it and get on with the next section.

Mr. Andrewes: I might explore that possibility if the member agreed to include laboratory fees, hospital charges and other costs that are incurred by individuals in the health care system. I would also agree that we could explore those possibilities if the system itself, rather than the practitioner or the deliverer under compulsion, produced this receipt.

Mr. D. S. Cooke: The fact is that the Conservative Party does not like this amendment because it does not want to do anything that forces any accountability for the practitioners in this province. All it wants to do is to put in place systems that it thinks will deter patients from what it calls abuses of the health care system.

Miss Stephenson: The amendment suggested by the member for Windsor-Riverside is an interesting first step in the direction of ensuring informed consumerism in the health care system. It does not include the many other items within health care that are benefits under OHIP that should be itemized in whatever information is provided.

I believe informed consumers would understand that things have changed rather dramatically in the past 25 years. I am terribly distressed the member for Windsor-Riverside is such a juvenile that he does not remember the days when parents did care for their children and made the first stab at treatment in the most appropriate way because they understood it was a parental responsibility. There is no doubt in my mind that many parents do that now, but there has been and continues to be an increase, which is frequently not entirely appropriate, in the additional utilization of many facilities and services that are not necessary for the preservation or improvement of health.

The minister would have to agree that the provision of health care services under our national health insurance program has not decreased morbidity very dramatically, nor has it decreased mortality very dramatically. The major improvements in those factors for human beings are primarily a result of the human being taking responsibility for the maintenance of his or her health with the additional assistance of the health professionals who are available.

A useful and straightforward suggestion has been made in our proposed amendment, which I am sure can be administered in a way that would overcome the possibilities of the very distressing breaches of confidentiality, such as the one suggested by the member for Windsor-Riverside, and would obviate difficulties that might arise within a family. However, there is merit in looking very carefully at some mechanism that would ensure the subscribers to OHIP in Ontario have some understanding on a regular basis of the total expenditure that the taxpayers of this province provide in support of their utilization of the health care system. I believe that is a reasonable kind of proposal.

No one is attempting to lay blame at anyone's door. No one is attempting to suggest it is not sociological change that has inspired many of the current practices of asking for professional help immediately instead of utilizing some common sense of one's own to try to solve problems. No one is suggesting that any specific blame is to be attached to any group within society, certainly not to parents, patients or anyone else. What we are suggesting is that it will be helpful if those who utilize the system and those who provide the services are as informed as possible about the cost of providing those services.

5 p. m.

One of the things that worries me at present is the fact that the medical students today do not know what the cost of laboratory testing is. As a result of the kinds of defensive medicine they feel compelled to practise as a result of litigation and other kinds of activities, I believe they are over-ordering laboratory testing. The cost of that is astronomical.

I firmly believe that if those students and all physicians were aware of the cost of the individual testing programs that are utilized on behalf of patients, they would be a good deal more sensitive to the requirements to define the specific tests that need to be used for specific patients. I would much rather have them use what is available within the contents of their craniums to sort out the patient's problem than rely on the capability of testing machines that will simply run the gamut of all the biological and physiological testing that can be done to try to determine what the problem is.

I am not suggesting that is not a problem as well. I believe information regarding the cost of the provision of service must be provided not only to those who are subscribers but also to those who are providing service. This is simply a mechanism for ensuring that the subscribers receive some of the information, and I hope we will find a mechanism to ensure that the providers receive the appropriate information, so both can be equally responsible in their participation in the health care system in this province.

5:25 p.m.

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

Ayes 35; nays 59.

The Deputy Chairman: Mr. Andrewes moves that section 2 of the bill, as amended, be struck out and the following substituted therefore:

" 2(1) A physician or an optometrist who does not submit his or her accounts directly to the plan under section 21 or 11 of the Health Insurance Act or a dentist shall not charge more or accept payment for more than the amount payable under the plan for rendering an insured service to an insured person who,

"(a) is 65 or more years of age;

"(b) is receiving,

"(i) premium assistance under the Health Insurance Act,

"(ii) assistance under the General Welfare Assistance Act,

"(iii) benefits under the Family Benefits Act,

"(iv) unemployment insurance under the Unemployment Insurance Act (Canada),

"(v) a disability pension under any public or private pension plan,

"(vi) vocational rehabilitation services under the Vocational Rehabilitation Services Act, or

"(vii) any public financial assistance prescribed by the regulations; or

"(c) has no choice but to have that particular physician, optometrist or dentist render that service because of the need for emergency treatment or because it is not reasonably practicable to delay treatment.

5:30 p.m.

"(2) Subsection (1) does not apply to a physician, an optometrist or a dentist who charges more or accepts payment for more than the amount payable under the plan for rendering an insured service to an insured person described in clause (1)(a) or (b) without knowing or having reasonable grounds to believe that the person is a person described in clause 1(a) or (b).

"(3) A physician, an optometrist or a dentist who accepts payment for more than the amount payable under the plan for rendering an insured service to an insured person described in clause (1)(a) or (b), on becoming aware that the person is a person described in clause (1)(a) or (b), shall forthwith pay to the person the amount by which the amount received exceeds the amount payable under the plan.

"(4) A physician or an optometrist who does not submit his or her account directly to the plan under section 21 or 11 of the Health Insurance Act or a dentist shall not charge more or accept payment for more than the amount payable under the plan for rendering an insured service to an insured person without first giving the person reasonable prior notice of the amount by which the charge exceeds the amount payable under the plan."

Mr. D. S. Cooke: On a point of order, Mr. Chairman: I submit to you that the amendment presented by the Conservative Party is substantially similar to an amendment put forward by the member for Humber (Mr. Henderson), which has already been voted on and defeated. I suggest it is out of order and should be ruled as such.

Hon. Mr. Elston: On the same point of order, Mr. Chairman: If you examine Hansard of yesterday or the day before, you will recall the member for Lincoln stood in his place and indicated this was an amendment that was better drafted but substantially the same as that placed by the member for Humber and supported by his party. In addition, a second speaker indicated clearly his feeling that the Conservative amendment was better drafted but was also to the same extent.

We have already decided upon having a limited ban included in this bill by voting, as committee of the whole House, against the amendments placed here by the member for Humber. That having once been decided, it would be out of order for us to be asked again to vote on a similar motion that is substantially the same but changes only with respect to different words that have been added to the section.

Mr. Andrewes: By his own admission, the minister has indicated this amendment has undergone a better drafting, although I now have had some errors drawn to my attention by legislative counsel and we would be glad to make sure those errors are addressed before we come to some final decision on this amendment. Since it has undergone substantive change and is in a form more in keeping with the legislative style and wording we are accustomed to in legislation, you, sir, have no choice but to accept this amendment and put it out for debate.

The Deputy Chairman: I ask my honourable colleagues to wait for a few minutes.

After quickly comparing the two amendments that were proposed, that of the member for Humber and that of the member for Lincoln, I am of the opinion that the member for Lincoln has expanded the amendment. Therefore, I suggest he continue debating.

Interjections.

5:40 p.m.

Mr. Andrewes: I was waiting for the exchanges to die down so we could carry on.

We have put this amendment to the House principally because of our concern that the discussions that have taken place to date between the government and the Ontario Medical Association have not produced a negotiated settlement that would negate the-

Mr. Callahan: On a point of order, Mr. Chairman: I have no right to challenge your ruling, but under standing order 19(d)3, I submit with respect that my friend has no right to speak on any of the points in his proposed amendment that were decided earlier during the current session. He can speak on any of the new ones but not on any of those that have already been dealt with.

The Deputy Chairman: I remind the honourable member that I have rendered a decision, and therefore I should abide by it.

Mr. Andrewes: I am sure the member for Brampton (Mr. Callahan) is prejudging what my comments might be with respect to the amendment that is being put. Perhaps it is his privilege to make that prejudgement. In the case of our amendment, what were his other words?

Mr. McClellan: Why do you not tell us about your trip to the hospital again?

Mr. Andrewes: I might tell my friend about my trip to the hospital.

Mr. McClellan: I am sure you will. I am sure you will waste everybody's time.

Mr. Andrewes: I do not intend to waste anybody's time. If the member listens carefully, he may learn something.

The reason we have put this amendment, of course, is that the government has not been able to bring to a reasonable conclusion its negotiations with the OMA and has indicated it is pressing forward with the debate on Bill 94 and has the intention of implementing Bill 94.

I want to go back to the discussions that were held last fall, I believe, in which the district health councils were asked to convene a series of meetings in communities across the province.

Mr. McClellan: Which year was this?

Mr. Andrewes: It was 1985, during which the minister, his staff and others, along with interested members of the public-few that they were, as we understand it-were able to come to those meetings to discuss what had been publicly indicated as the government's intention to end the practice of extra billing.

Mr. McClellan: Boring.

Mr. Andrewes: Boring?

Mr. McClellan: Did somebody say "boring"?

Mr. Andrewes: That is almost as bad as "silly."

These sessions were intended to convince the public, although I assume the minister will suggest to me that they were educational sessions intended to allow the public to come forward and ask their questions to gain information on the whole subject of the billing practices of the medical profession. On the basis of the attendance at the forums, they did not reach out to many of the general public to stir their concerns about a very important issue, which is the preservation of the health care system.

There were perhaps other discussions that took place informally between the government and the OMA during the time those public meetings were convened. Those discussions, by the minister's own admission during the estimates process last fall, were not effective. Nothing meaningful was accomplished in them, and nothing meaningful was gained out of those meetings.

It brought us to that date in December when the minister rose in his place in this House and introduced Bill 94. It was described by many as draconian. The intent of the bill was even described at one time by the Premier (Mr. Peterson) as draconian.

Bill 94 is the reason we are here today. That bill, after receiving a reasonable debate in the Legislature, went to committee, where a series of public meetings was held.

Mr. Foulds: You were not there.

Mr. Andrewes: Unfortunately, I was not in the committee during that period. I would have been delighted to have been in the committee during that time; however, I was about other matters, as the Treasury critic of the New Democratic Party knows full well. In fact, he may remember some of those discussions we had on gasoline prices where he said oil prices were not going to go down nearly as much as they have now. No, I do not want to get off the topic, but I am sure the member for Port Arthur (Mr. Foulds) will well remember those discussions.

The minister has indicated to us that he held a series of 11 meetings with the OMA-I believe it was 11-which he called formal negotiations. No doubt he was aided and abetted in those meaningful discussions-I do not like to call them negotiations; I will come to that argument in a minute-by his colleague.

Hon. Mr. Elston: On a point of order, Mr. Chairman: The member is not speaking directly to the amendments. He should not be commenting on some historical analysis of what took place or did not take place with respect to negotiations. In my understanding of this, he should be speaking directly to each part of his amendments, which you say he can address. This historical analysis has nothing whatsoever to do with the amendments.

The Deputy Chairman: Will the member for Lincoln please address the chair?

Mr. Andrewes: I am sorry if I have strayed from the amendments. I have some carefully prepared remarks here, and I am following a sequence of events that led up to the introduction of Bill 94 and the subsequent discussions that went on both in this House and outside the House. Although we were not privy to those discussions, we understand bits and pieces of that information keep coming forward. My remarks lead up to why we are introducing these amendments to Bill 94; so I will ignore the interjections of the minister and will proceed.

It is our understanding that during the series of 11 meetings which took place between the government and the OMA, the government being represented by the Minister of Health and by the member for St. David, the Attorney General (Mr. Scott), tabled a 10-point program. This was outlined quite clearly by the minister just last week in a speech in Sault Ste. Marie, I believe, in which he indicated the government had tabled a 10-point program.

We read in the papers today that even the OMA admitted that in the context of that program it felt it had the substance to reach some resolution of this dispute.

In his answers to questions, the minister has said that during these negotiations he was exploring opportunities for settlement and looking at options. He has indicated obliquely, and the OMA has indicated in very strong terms in a letter to him, that during those discussions the minister agreed to the following. I will quote from a letter to the minister from Dr. Scully, chairman of the board of directors of the OMA.

"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 fail to produce an agreement. 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."

5:50 p.m.

The Deputy Chairman: Order. Please keep your remarks on the amendment you have proposed.

Mr. Andrewes: I intend to do that. I believe I am well within those confines. However, I will try to be a little more direct.

We have proposed these amendments for the following reason. As a result of the 11 meetings and the failure of the government to reach an agreement with the OMA, the OMA came forward to the standing committee on social development and made a proposal which in its view-and I have no reason to question its figures; perhaps others might-would address about half the instances in which individuals were billed beyond the OHIP fee schedule.

In other words, the 3.5 per cent of the services that were rendered in this province and billed above the fee schedule would have been reduced by approximately half by an undertaking from the OMA not to extra bill seniors, people on public assistance and those receiving treatment in emergency areas.

This amendment enshrines into Bill 94 the position taken by the OMA during that submission to the social development committee. It does not end extra billing; we recognize that. However, it does go a long way towards resolving substantially the problems of the billing practices that have arisen in Ontario.

Our amendment, coupled with the indication from the OMA in its recent proposal to the minister that it would provide all services to all people in any part of the province at the OHIP rate, moved this association and its representatives a long way from the position they had taken at the outset of the negotiating process. I am sure the minister would acknowledge that position was one of not being willing to recognize at all that there was a significant problem with billing practices.

Two parties came to the table: the government and the OMA. Through 11 meetings, we see that one side of the discussion moved substantially towards reconciling the problem. The other side at the table moved little or not at all. I will qualify my last statement by referring once again to the articles in today's Globe and Mail and Toronto Star in which Dr. Scully indicates that in a letter to the Attorney General they thought they had the germ of a solution to the problem, but in fact that was not the case.

We have put forward these amendments to enshrine in a legislative form an offer made by the organization that represents the physicians in this province that would be a step towards a resolution to the rancour that currently exists. Through the amendment, we have enumerated a number of instances and categories of individuals. Medical practitioners agree they should not be billed for more than the OHIP fee.

In this amendment, we have indicated to the minister that practitioners are prepared to move towards this solution and by our subsection 4 have enshrined once again the principle that no individual in Ontario should be required to pay extra unless he or she has been given proper notice prior to the treatment and the bill being rendered for that treatment.

Mr. Laughren: Time.

Mr. Andrewes: My colleague from northern Ontario says it is time. I will be glad to stand down so he will have an opportunity to speak in a fulsome way on this amendment.

Miss Stephenson: The amendments being proposed are a very reasonable direction to pursue-

Mr. D. S. Cooke: On point of order, Mr. Chairman: if we were operating on a municipal council or a school board, the member for York Mills would not be allowed to speak, because it would be considered a conflict of interest.

The Deputy Chairman: That is not a point of order.

Miss Stephenson: I am intrigued to know that suddenly some kind of concern about integrity has hit the member for Windsor-Riverside. That is an unusual situation for him. I have represented the constituents of York Mills in this Legislature for almost 11 years. I do not involve myself actively in the practice of medicine. I am and am proud to be a physician. I am proud to be a graduate of the faculty of medicine of the University of Toronto, 40 years ago this weekend, as a matter of fact, and we are celebrating our 40th anniversary.

I believe I do not have a conflict of interest in pursuing this discussion. I do however have a slightly more complete knowledge of the kind of situation that is prevalent within the province in the area of health care delivery by physicians, and I believe it is my responsibility to share that with the members of the Legislature. If I were not to do that, I feel I would be derelict in my duty to the members of the Legislature and to the people of Ontario and of my riding.

Is it appropriate, Mr. Chairman, that I then be allowed to continue with my participation in this discussion?

The Deputy Chairman: Yes.

6 p.m.

Miss Stephenson: Thank you, sir. I appreciate that.

I believe the amendments that have been put forward by my colleague the member for Lincoln are not only appropriate but also meet the problem in the most significant way and will ensure that we have a continuing high-quality health care system in Ontario. The amendments we have suggested and propose to the Legislature at this point would ensure that no citizen over the age of 65 would be billed for any service at a level beyond the level of benefit that is provided by OHIP.

The individuals involved are not, in many instances, financially bereft, but it was the proposal of the medical profession and a reasonable position as accepted by large number of those in this category as an appropriate move to prevent discomfort or any kind of distress on the part of those over the age of 65 whose incomes were limited or were relatively fixed and who would be in need of service with more frequency than many other members of our society.

Mr. Laughren: It's tin-cup medicine; means-test medicine. Do you want welfare or medicare?

Miss Stephenson: It is difficult to continue to debate in reasonable form in this Legislature when the member from Capreol continues to suggest that the member standing at present is, as was suggested earlier by a colleague of the member for Nickel Belt (Mr. Laughren), reverting to support for what they are pleased to call charity medicine.

I remind those members again that they know not what charity is. I remind them there is a very important passage of the Bible, which it would be well that they read with some frequency, which states that the virtues-these were stated, I believe, by the offspring of our Supreme Being-that are important in this life are faith, hope and charity, and the greatest of these is charity.

Charity is love for one's fellow man, and it is assuming responsibility on behalf of those individuals as a result of that love. Unhappily, those two members of the New Democratic Party do not understand that, do not have any, and therefore cannot participate in this discussion except through the annoying and dreadfully pejorative suggestions that somebody is going around with a tin cup.

Mr. McClellan: Is there not also something about "Judge not, lest ye be judged"?

The Deputy Chairman: Order. Just ignore the interjections.

Miss Stephenson: I believe the most appropriate thing for me to do is to develop an earplug for my left ear so I cannot hear the silly remarks coming from the left on this side of the chamber.

In addition to those who have provided for us the excellent society within which we function and for whose health care needs this amendment is attempting to ensure security, we believe there are others who should receive the benefit of that kind of security.

Any individual who requires or is provided with premium assistance under the Health Insurance Act-and that matter is under the control of the minister and can be amended on a regular basis-will benefit from this, as will those in receipt of assistance under the General Welfare Assistance Act or the Family Benefits Act who are obviously appropriate recipients of this kind of measure within this legislation. We felt those who were unemployed and who were in receipt of unemployment insurance benefits were facing sufficient difficulty in that period of unemployment, which can be very dislocating, very distressing and very disturbing, particularly for a family, and should be included within this. We felt very strongly that kind of circumstance was one that should be recognized.

Those who are in receipt of disability pensions, either at the public or the private level, were very significantly a part of our thinking in determining those who should never receive a bill beyond that which is covered by the OHIP level of benefit.

In addition, the Vocational Rehabilitation Services Act provides for very specific assistance on the part of federal and provincial governments for the purpose of ensuring there is an improved acquisition of skills so the individual may become more self-supporting or entirely self-supporting. However, the primary purpose of the Vocational Rehabilitation Services Act is to assist that individual to become a whole human being with a feeling of self-worth and a capability of understanding that he or she has a role within society. Those individuals have very specific problems which are not easy to address in all circumstances, but their insecurity in that area should not be increased by the insecurity of not knowing whether they were going to be beneficiaries of this action within the legislation of Ontario.

In addition, there is a section which ensures that when the government of this province or the government of Canada determines there is another group or another individual who warrants assistance from the funds made available by taxpayers, it can determine by regulation that those individuals should automatically be included within the group to be listed within this segment of the bill that is before us.

We felt very strongly that in emergency situations where the individual has little opportunity to make a decision about whether he is going to seek medical or optometric services, and there are situations of that sort, the additional trauma or strain of the possibility of billing beyond the OHIP schedule of benefits was one that should not have to be endured.

It was felt, therefore, there should be this protection within this legislation, not just in those situations which we call emergencies because we recognize there is a fracture, a major laceration, an acute psychiatric disturbance or an eye injury, but in those situations in which it is undesirable in terms of the ongoing health of the patient to delay treatment.

We have established the categories which have been listed in section 1 of our amendment. Those categories are comprehensive, and I believe they will reduce the incidence of accounts rendered to OHIP beyond the level of the OHIP schedule of benefits to something in the order of one per cent of the total number. That is a minuscule percentage of the total amount that is provided by the taxpayers of Ontario.

Many of us in this Legislature have had a great deal of communication from individuals who wish to have the freedom of choice of the physicians in this area maintained. Many of us who had the opportunity to hear the presentations of delegations within the standing committee on social development heard from a number of individuals who expressed very clearly their concerns that they believed the freedom which was being attacked in the current form of Bill 94 was inappropriate in a democratic society.

6:10 p.m.

The minister, unhappily, did not have the opportunity to hear all those. I recognize he had responsibilities elsewhere, but those of us who were there very frequently heard a great deal about this from individuals who were not physicians, optometrists or dentists. To recognize the concerns expressed very clearly by those individuals and those groups is a responsibility of the members of this Legislature. No matter what our ideological focus may be, we do have a responsibility to listen to those who have made presentations to us.

An Hon. Member: On a point of order, Mr. Chairman: I would like to ask if you could call the members of the New Democratic Party to order.

Mr. McClellan: He is not in his seat.

Mr. Laughren: Is that where he sits?

Mr. Chairman: The member is not in his seat.

An Hon. Member: All right; I will move.

Miss Stephenson: I recognize the discomfort of the member for Fort William (Mr. Hennessy). The noise at that end of the House is at such a high level of decibels that it is extremely difficult to think, let alone hear what is going on.

The snide remarks of the member for Bellwoods (Mr. McClellan) will not succeed in moving me from my desire to present to this Legislature and to the members on all sides of the House, including the member from Capreol-

Hon. Mr. Nixon: Nickel Belt.

Miss Stephenson: I know he is the member for Nickel Belt, but he is from Capreol, and that is an appropriate place to put him at this stage of the game. I know a couple of physicians in Capreol who would be delighted to deal with him.

The lists of exceptions we have developed do address the problem of the vast majority of difficulties that might arise related to the action of physicians or optometrists in billing at the level that is directed or guided by their professional association as a part of their ethical behaviour. Extra billing is a pejorative term, probably devised by the members of the New Democratic Party to ensure there was some kind of illegal or immoral attachment to that kind of description.

In fact, the actions of these physicians in most instances are to pursue the ethical direction provided for them by their profession. When it was determined and when they agreed-and they have agreed-that it might provide a problem for a significant number of people, they proposed a means of dealing with the problem for that significant number of people. The New Democratic Party fails to recognize that any action has been taken. Unhappily, that is a circumstance which does not usually lead to any resolution of problems.

There has been very significant movement and agreement that the kind of direction we are proposing in these amendments not only would solve the problem but also would lead to a solution that would ensure there was no continuation of confrontation and no maintenance of the kind of difficult circumstance in which many people find themselves within this province at this time.

Obviously, there are going to be exceptions to the rule. The exceptions that have been established within our amendments are very reasonable directions to pursue as well. The exception that probably could be most troublesome is the exception based upon ignorance, if one likes. There is no means at present, although one has been suggested on many occasions, of quietly and without any major kind of disruption assuring those individuals who would be in receipt of this kind of assurance that it could be made available so those who are responsible for delivering the services would not make the mistake of billing to the level of the professional fees in those circumstances.

It seems to me it is not impossible, as the province and governments have done for many years, to provide a card which has an identifying number or mark or something that does not leap out and hit one between the eyes but which would ensure that those people who are dealing with those cards on a regular basis would be able to be positive they were not going to be billing beyond the level of the OHIP benefits for those who should benefit from this piece of legislation.

I urge the minister to think very seriously about the way in which this can be done. There seems to be no problem at all in the utilization of what is known as a drug benefit card. A drug benefit card is made available to many of those we have identified in the list we have provided, and this does not seem in any way to be demeaning to those who utilize those cards with some regularity.

I would doubt that any individual would find it particularly distressing personally to have one additional group of numbers attached to his OHIP card to ensure that the benefit outlined in our amendment would be available to him or to his family. Therefore, we feel very strongly that one of the exceptions should be if this does not happen, and the physician, optometrist or dentist, as a result of not knowing whether the individual should be a beneficiary of this amendment, bills beyond the level of the OHIP schedule of benefits, in that instance, we feel it should not be considered a criminal act or a violation of this act, but immediate correction of the action would resolve the problem rather than leaving the health practitioner with a record as a result of the action taken.

When the health practitioner, be he optometrist-I hope those in the House who are of the female gender will not worry about my use of the pronoun "he," which I consider to be a generic pronoun since it applies to "man," which is a generic noun and obviously, therefore, encompasses both genders. When the health practitioner has mistakenly sent or delivered an account beyond the level of the OHIP benefit to an individual who should be a beneficiary of this legislation, we have suggested the mistake be corrected forthwith by a payment by the physician to the patient of the amount by which the account has exceeded the OHIP level of benefit.

That is the appropriate means for solving this problem, rather than going through the bureaucratic maze that will be necessary with the suggestion I believe the minister has made, that retribution would occur as a result of withholding amounts of money from the next payment to the physician. If it takes the usual length of time to provide the funds, the individual patient who is so reimbursed may wait for several weeks, and at times months, before that restitution is provided by the government.

We feel this immediate form of ensuring that the individual patient who has mistakenly been charged at a level beyond the OHIP level of benefits is reimbursed is a much more appropriate means of dealing with a situation that can arise relatively easily unless a step is taken to provide some quiet means of identification of those who should receive this benefit regularly as a result of this legislation.

6:20 p.m.

The fourth part of our amendment to section 2 ensures that when the individual patient who is to receive service from an opted-out physician is to be billed at a level that is beyond the OHIP level of benefits, reasonable prior information must be provided to that patient. Most of the complaints we have heard about the lack of or the difficulty with prior notification have been in the area of anaesthesiology, where the individual admitted to hospital is informed by the anaesthetist the night before or on the morning of the surgery that his level of account is beyond the OHIP level of benefit.

We have provided a means to ensure there will be adequate prior notice so that if there is a problem, the patient may ask his or her family physician to make other arrangements in order that the problem will not exist. It is one of the responsibilities of the physician who assumes responsibility for the primary care of a family to ensure that this kind of situation, which might be embarrassing or difficult for a family or its members, does not arise.

I can tell the members truthfully that this action is taken by a very large number of very responsible family physicians in this province, who ensure through their communications with their patients and with their colleagues that if no account should be rendered beyond the level of the OHIP benefit, it simply does not happen. In all circumstances the co-operation of consultants, anaesthetists and any of those who are involved in providing additional health care services has been outstanding.

I can honestly say that in all the years I have practised, I have never been refused that consideration for my patients when it was appropriate and necessary, and I have never hesitated to ask. I know most of my colleagues do precisely that. There are some who do not at present. I believe they do not do it because they have not been informed sufficiently of the difficulties that may arise as a result of the inappropriate action of the specialist or consultant to whom the patient has been referred. That is a responsibility the medical profession must undertake, and one I know it can undertake and achieve, given the right motivation to do so.

I feel strongly that there will not be the kind of professional motivation to pursue the courses of excellence in the development of health care that have been a hallmark of the system in Ontario unless we move in this direction, unless we move to ensure that some vestige of freedom is left for the profession to make choices and that there is no ruling which ensures that there is, in the words being used by many of my colleagues, "conscription of the medical profession" into a relationship significantly different from that which has traditionally been part of their practice function, a relationship that ensures there is never any responsibility on the part of the patient in terms of the remuneration of the health professional.

I do not think I can overemphasize the need to have within a health care system those who are delivering the service highly motivated, satisfied in their relationships with the others who are involved in health care, concerned about their continuing relationship with their patients and concerned about the further development of the health care system. I do not believe a profession that is totally subjugated by legislation such as Bill 94 is going to be capable of proceeding in the directions that will continue to maintain the high quality of health care we have enjoyed in Ontario.

This amendment is similar in some instances to that put forward by my friend the member for Humber, but with some differences-some additions and some deletions-and with some different means of recourse in terms of the provision of action to ensure that patients are not disadvantaged in any way. Unless we pursue this type of amendment, we shall have a health care system that will not be maintained at the level we think is appropriate in this province.

Therefore, I feel very strongly that through these amendments, we have given the members of this House an opportunity not to reconsider but to consider the course of action they are about to take. They must consider whether they want to ensure that one of our major priorities is the quality of research done by family physicians in Ontario and carried out by practising consultants in Ontario, and the quality of health care research that has made us world leaders in a considerable number of areas in the delivery of health care through medicine in this province.

It is all very well for those who have never functioned in a role that is governed by a professional self-government to be unaware of the attitudes and the sense of responsibility engendered in the vast majority of the members of the profession who are within that situation. I have no doubt that those who have not been subjected to the continuing example and lectures of many of the teachers whom I enjoyed when I was a student, and whom many of the medical students are enjoying at this time, will not truly understand that the primary responsibility of any professional is directly to the patient in all circumstances. Any disruption of that understanding of the relationship is one that ensures there will be some disturbance within the process which is not likely to be of great benefit either to the patients who will be served or to the system wherein the patients are served.

I remind the members of this House that the structure of the health care insurance plan in this province has been based upon freedom for the individual patient to make choices and freedom-

Mr. D. S. Cooke: On a point of order, Mr. Chairman: I point out that this is day three of the debate. Thanks to the Conservative Party, patients have been billed $600,000 which they will never recover.

Mr. Chairman: That is not a point of order.

Miss Stephenson: It is interesting that the member for Windsor-Riverside continues on a daily basis to spout a figure that is not an agreed-upon figure. I am informed by members of the Department of National Health and Welfare that the assumptions upon which that figure is based are considerably out of whack and probably quite erroneous and that the amount of money being talked about is considerably less.

The members of this House should be aware of the fact that what they are proposing to do is to ensure that there will be a profession primarily responsible for the delivery of health care which could be maintained in its present productive, energetic, enthusiastic and very helpful stance to the Ontario government if the amendments that have been proposed by my colleague the member for Lincoln are accepted. If we pursue another direction, I hesitate to make predictions about the dire straits in which the future of the health care system in this province will find itself.

Mr. Andrewes: I rise to correct the record before we adjourn. As I read this amendment, the third line of subsection 2(1) reads "under section 21," and then I read "or 11," which should be " 22." If you go to the second and third lines of subsection 4, which reads "directly to the plan under section 21," I then read "or 11," which should be " 22."

Mr. Chairman: Members will amend their copies as such.

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

The House adjourned at 6:31 p.m.

4 juin 1986