LONG-TERM CARE ACT, 1994 / LOI DE 1994 SUR LES SOINS DE LONGUE DURÉE
Report continued from volume A.
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Hon Brian A. Charlton (Government House Leader): Mr Speaker, I call the next order. The next order will be the 42nd order, and I believe the House leaders have reached an agreement that when the debate on second reading of Bill 161 is completed, we will deem that there has been a division and the vote will be deferred until tomorrow after routine proceedings.
The Deputy Speaker (Mr Gilles E. Morin): Is that agreed? Agreed.
REVENUE AND LIQUOR LICENCE STATUTE LAW AMENDMENT ACT, 1994 / LOI DE 1994 MODIFIANT DIVERSES LOIS FISCALES ET LA LOI SUR LES PERMIS D'ALCOOL
Mr Sutherland, on behalf of Mr Laughren, moved second reading of the following bill:
Bill 161, An Act to amend various Taxation Statutes administered by the Minister of Finance and to amend the Liquor Licence Act / Projet de loi 161, Loi modifiant diverses lois fiscales appliquées par le ministre des Finances et modifiant la Loi sur les permis d'alcool.
Mr Kimble Sutherland (Oxford): This bill includes three items aimed at encouraging taxpayers to pay their fair share and making Ontario's tax legislation consistent with other jurisdictions.
First, it puts into effect proposals contained in the May 19, 1993, budget, proposals that will improve the enforcement of and compliance with taxation statutes. These proposals include standardized penalties for late-filed returns and non-payment, daily compound interest on tax owing and refunds, and registered liens on real and personal property of taxpayers who are in arrears of payment.
The bill also deals with the tobacco smuggling issue. As you are aware, Mr Speaker, federal and Quebec governments reduced tobacco tax. This government made a similar decision in February to announce a reduction in the Ontario tax rate on tobacco products. This new rate has resulted in a tax decrease of $9.60 for a carton of 200 cigarettes. The bill includes provisions to refund retailers and wholesalers for the tax reduction on inventory purchased at the old rate. The refund program is already under way.
This government has been working to combat the smuggling of both tobacco and alcohol. Bill 161 will increase fines and penalties for tobacco and liquor offences. It will provide the authority to search and detain vehicles suspected of carrying illegal alcohol and will extend the authority for a search to private vehicles suspected of carrying illegal tobacco.
Under the Tobacco Tax Act, anyone found in possession of five or more cartons of unmarked cigarettes would be guilty of an offence and, on conviction, subject to a fine of up to $10,000 plus $60 for each carton of unmarked cigarettes. In addition, on conviction of unauthorized possession of 50 or more cartons the court may impose a jail term of up to two years.
Amendments to the Liquor Licence Act will create a new offence for the possession of illegal liquor, and increases maximum penalties. Penalties for a conviction of an offence will increase to $100,000 from $25,000 for individuals and to $250,000 -- I repeat that -- $250,000 from $100,000 for corporations. An additional fine of not more than $100 per litre is imposed where a person is convicted of possessing illegal liquor. These Liquor Licence Act amendments now parallel the forfeiture provisions under the Tobacco Tax Act.
Also included in the Liquor Licence Act is an amendment that will require holders of liquor licences, for example, restaurants, taverns and bars, to comply with the Retail Sales Tax Act before licence renewal or transfer is completed. Arrangements for payment of any tax owing can be made in consultation with staff of the Ministry of Finance.
In the area of the fuel tax administration, last year's budget announced an amendment to the Fuel Tax Act to cancel the tax refund on clear fuel for off-road unlicensed use. In order to allow municipalities and commercial transport companies to install the proper equipment related to this change, we extended the refund deadline from July 1, 1993, to October 1, 1993.
In March 1994 the Minister of Finance announced Ontario's intention to join the international fuel tax agreement, IFTA, effective January 1996. Joining IFTA will improve the competition position of Ontario-based carriers, improve compliance from non-Ontario carriers and reduce the administrative burden on Ontario carriers by providing a consistent set of rules for all carriers.
As with every new program, there are startup and implementation costs. To fund the startup and maintenance costs associated with IFTA, a $10 fee will be charged for the vehicle registration decals used by interjurisdictional carriers. This fee will be effective with the registration year starting July 1, 1994.
Ontario truckers have voiced their opinions and are very optimistic about this initiative. The Ontario Trucking Association and ComCar, two prominent trucking associations, fully support our involvement with IFTA and the decal fee and have offered assistance to implement the program here in Ontario. These responses show very clearly that this government is building partnerships with industries and working towards investments in our province.
This bill is really about two things. It's about trying to deal with some of the major issues related to the underground economy, because we certainly know that cigarettes and alcohol were some of the major vehicles of the underground economy, and they were establishing routes for other products to come in. So in terms of some of the things we've done with cigarettes and alcohol, that will help curb some of the underground economy activity.
We also are dealing with the question of possession of illegal alcohol. We've certainly heard and seen reports about illegal alcohol being sold, particularly in some after-hours bars, which are illegal activities anyway, but some of them have been selling illegal alcohol. Besides not paying taxes, we also know, from some of the work that the Liquor Control Board of Ontario has done, about how this is a threat to public health and how some of this illegal alcohol is contained in some very dangerous containers, containers that have had antifreeze in them before, and all kinds of other things. Poisons have been detected in some of this alcohol that has been tested.
Joining the international fuel tax agreement has just got to be one of the best things that could be done. I know that I've had different truckers into my office. They bring in their different books for recording their different taxes in different jurisdictions, and it's quite ominous, actually, the amount of paperwork. Whatever we can do and this government is doing to support and reduce that amount of paperwork for truckers, reducing red tape -- we know the third party talks about it -- this is a clear example of the government moving in that direction to reduce some of the red tape and paperwork associated with truckers.
I'm very confident that most members of the House will be supportive of this bill because it deals with issues that many members from all sides have had concerns about, have expressed their opinions of and, of course, we had public hearings on the issue of the underground economy and some of the things that we needed to do.
The Deputy Speaker (Mr Gilles E. Morin): Questions or comments? Further debate.
Mrs Elinor Caplan (Oriole): I'm rising as the revenue critic to lead the discussion from the opposition perspective to Bill 161. As I hold the bill before me, I don't know if those who are watching can actually see what a thick piece of legislation this is. The title of it is An Act to amend various Taxation Statutes administered by the Minister of Finance and to amend the Liquor Licence Act.
We've seen many pieces of omnibus legislation in this House before, and I think you can make a case for omnibus legislation if it is all primarily housekeeping. Housekeeping would be the kinds of amendments which really did not have a major impact or policy decision but were the kinds of things that the parliamentary assistant referred to: consistency, bringing things into line with other jurisdictions, that sort of thing.
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However, Bill 161, while it does a few of those housekeeping kinds of things, has some very substantive policy initiatives in it as well. When I hear the parliamentary assistant refer to Bill 161 as the government's response to the underground economy, it really does leave me no choice but to stand up and criticize this bill and say that it does not and will not respond appropriately to the issues of the underground economy.
I was on the legislative committee when we had hearings on the underground economy. What we know is that democracy is about the public's willingness to be governed. Democracy is about consent of the public when they believe that governments are acting in the public interest. That's why taxation policies and economic polices become so very, very important.
We have a situation in Ontario today where too much of the public is refusing to be governed by this government, which has systematically taken away the confidence of the people. We've seen, as a result, too many people actively participating and bragging about their participation in the underground economy.
I personally have had this experience and I've had people boast to me that they believe that participation in the underground economy is absolutely okay, absolutely appropriate because Bob Rae's policies do not reflect the public interest, because Bob Rae's taxation policies have led to Ontarians feeling overtaxed, taxed out.
Another reason that I think we see participation in the underground economy is because people are feeling insecure. We know from research that is being done that they fear they may lose their jobs. In that environment of insecurity, people will often attempt to save every nickel they can so that it will help them feel more secure.
I look at Bill 161 and I say, is there anything here that's going to give consumers greater confidence? The answer is no. Is there anything in Bill 161 that is going to encourage the public in a positive way or build incentives for the public to believe that to participate in the mainstream of the province and to cease and desist participation in the underground economy is a better behaviour than what we've seen? The answer is no.
I don't believe that Bill 161 has any of the appropriate public policy responses or carrots or incentives to convince the public that they should be paying their fair share of taxes in order to support the services. I think that people in this province feel generally that government is wasteful, inefficient, that the services it delivers are not delivered in a manner which is convenient, accessible, sensitive to the needs of the people of the province who are attempting to access those services.
Because of that and because of the fact that the NDP government has taxed people during one of the most difficult economic times in this province -- and it taxed them so much that people are feeling they have no recourse, no way of letting the government know how upset they are except to go beyond what is the traditionally acceptable tax avoidance and into participation in the underground economy, which is clearly tax evasion -- this saddens me, because when I hear the parliamentary assistant say, "Bill 161 is our response to that," Bill 161 is not going to respond to those issues.
Bill 161 has a lot of sticks in it. It has enforcements and mechanisms and measures, it has fines. What was very interesting in the deliberations of the committee and what other experts in human behaviour whom I've spoken to on these matters say is that enforcement, fines, policing in matters of human behaviour, particularly in matters of public participation when it comes to paying taxes, simply does not work.
People will put their energies into finding ways to avoid, to resist, and the heavier the fines, the more enforcement that you bring into force through legislation, the greater will be the revolt and the resistance of the very people that you're trying to convince that these fiscal policies are in the public interest and are in fact good for them.
That doesn't mean there isn't a role for enforcement. There is. But as a response to the psychology of those participating in the underground economy, enforcement is the wrong response. So I would say to the minister and to the government, you just don't get. Bill 161 does not give people the right message. It is not an appropriate response to the participation in the underground economy, nor is it going to deal with the issues of people just feeling overtaxed and not getting value for money for the services that they are paying for through their taxes.
I'm not going to spend a lot of time going over and over that same ground. I think it's worth stating, it's important for it to be on the record. The parliamentary assistant has said Bill 161 is the government's response to the problems of the underground economy. I disagree with the approach of the government, and I therefore criticize Bill 161. It is an inappropriate and ineffective response to a very serious problem in our society.
There are some aspects of Bill 161 which I believe are supportable and, as I mentioned, the housekeeping items of Bill 161 I have no problem with. There are some other aspects of Bill 161 which I think people will look at and say, "Oh, hmm, we like that." For example, the bill reduces the income tax rate for manufacturing and processing, mining and farming, logging and fishing income from 14.5% to 13.5%. That's a 1% reduction.
Mr Sutherland: That's the wrong bill.
Mrs Caplan: That's the wrong bill? No, I don't think so. I think that's in Bill 161.
Mr Sutherland: That's the previous bill.
Mrs Caplan: I apologize. Because we're dealing with a number of tax bills all at once, I thought that was included.
Mr Sutherland: That's all right.
Mrs Caplan: I thank the parliamentary assistant. If it were in here, it would be a good thing. The fact that it's not in here means I have less good things to say about this bill than I thought I did, so I do apologize if that's not here. Is that a good recovery? Thanks very much.
The fuel tax response: The fact that you're participating in the international fuel tax agreement I think is relatively positive, but I don't think it's going to send as positive a signal as the parliamentary assistant has said. I think that it's on balance okay. We'll have to see how that plays out and what the effects of that are. I have no objections to that.
The gasoline tax provisions in here: Again, there are more fines for tax collectors who do not respond with tax provisions, and there are a number of measures in Bill 161 which I would argue are complex and the kinds of bits of pieces of information that people may or may not need to know.
There is one feature in Bill 161 that I think is worth mentioning and pointing out, and one that I wish the government would reconsider before third reading. I doubt that they will, but there is an opportunity to think about it.
One of the ways that we measure economic activity in the province of Ontario is by housing starts, and the program which encourages new home ownership, the Ontario home ownership program, I believe there are amendments to that contained in this legislation. Again, that's in the other bill that we dealt with. All right.
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Mr David Johnson (Don Mills): That's in there.
Mrs Caplan: I believe that's in here, the land transfer tax provisions.
Interjection.
Mrs Caplan: That's correct. In this act amendments in this section increase existing fines that are related to the failure to pay land transfer tax. It also ends the rebate for land transfer taxes for first-time home buyers under the Ontario home ownership program.
I want to explain what that means, because I think that this is a significant public policy initiative and one that is -- I won't use the word "hidden," because I don't think that it was put in here nefariously, I think it was just lumped together with a bunch of seemingly other housekeeping items -- but in fact in the 1994 budget the NDP government extended the assistance eligible for initial home purchasers indefinitely. However, the Finance minister did not extend that part of the Ontario home ownership program which gave buyers back their land transfer tax on the home purchase. Only those people who opened an OHOSP before January 1, 1994, will be eligible for the land transfer tax rebate.
That's actually quite significant. The rebate on the land transfer tax was an incentive to first-time home purchasers to go out and buy a home and, as I said, in Ontario one of the things that we do as we review our economic activity, wealth creation, prosperity and so forth is to monitor housing starts and also, particularly, purchases for new home buyers.
Public policies which have encouraged first-time buyers to purchase have always been considered a positive public policy initiative, and I was very disappointed to see Bill 161 ended that incentive for first-time home buyers as part of the Ontario home ownership program after January 1, 1994. I believe that that is regressive and is one of the reasons I really believe that Bill 161 should not be supported.
There are a number of other provisions that deal with law enforcement, when we have seen the government's response to smuggling. I would like to make a couple of points on that.
First of all, in regard to the Liquor Licence Act, there's an amendment here that gives law enforcement officials additional powers to search vehicles without warrants for illegal alcohol. Now, I know that it's important for the provincial officials to be working with the federal officials and I know that the ability to search is extremely important, but I have to tell you I am, as a small-l liberal, concerned about giving powers without warrants.
I really do worry about intrusion and invasion of privacy of individuals who are law-abiding citizens, and the thought that you can be stopped in this province and your car can be searched without a warrant, simply on the suspicion of any law enforcement officer that you might have illegal alcohol in the car, without any evidence, suggests to me that we've gone too far, possibly in the kinds of sticks of law enforcement, that we are intruding on an individual's right to be able to drive their car.
I have no problem, let me say, with customs officers at border crossings, or where you have evidence or suspicion of illegal activity, but I am always concerned about giving these kinds of powers to law enforcement officials too easily. I want to go on the record and express my concern that there is potential for abuse of this particular power, although I think we all recognize that we would like to end illegal smuggling. Actually, all smuggling is illegal. We would like to end smuggling and illegal activity.
We know that smuggling brings in not only illegal products such as alcohol, and tobacco -- less now. I think the federal initiative has been very successful in ending cigarette smuggling, and that was the big trade; we knew the big smuggling trade was in illegal cigarettes. But along with cigarettes and alcohol were also coming guns, and we know that along with guns comes organized crime and criminal activity and that that really does threaten the safety and security of individuals and communities. So I have been very supportive of ending smuggling activity and very supportive of initiatives that would make our communities safer places.
I very much support tough gun control. I very much support a ban on the sale of ammunition to anyone who does not have an appropriate gun licence or an Outdoors Card, something that would be a positive step forward that this government could do. There is a bill before this House that would enact that provision, and I support that unequivocally.
However, you have to look at carrots and sticks, incentives and disincentives, and if the only thing you're doing is giving powers of search and seizure to the police, perhaps we are missing the opportunity to also find incentives that would be equally as positive and not as intrusive. So I want to express some concerns about the warrants without evidence, or the unnecessary requirement for warrants and ability to search without evidence.
I wanted to make some comment, particularly given the previous positions I've held in government as former minister -- and I know how difficult it was for the government to deal with the tobacco act changes. I must admit I was torn, because I very much believe we must have a strong anti-tobacco strategy, that we must do everything we can to keep cigarettes hard to purchase, particularly for young people, and I have been very supportive of the kinds of strategies that would lead to smoking cessation and prevention even before smoking begins.
However, while I believe that the tobacco tax reduction was not good health policy, I do believe it was healthy public policy, because we know that along with smuggled cigarettes came smuggled guns and organized crime. I don't think we should underestimate in any way that negative impact on our society.
While I understand the chagrin of the anti-smoking and the anti-tobacco activists, I share their goals and hope we will see the kind of society that will again lead the world in the kinds of policies that will encourage people not to smoke, and encourage those who do smoke to stop smoking, that will inhibit access to tobacco and to cigarettes.
The reality is that the availability of smuggled tobacco and smuggled cigarettes is making all of those anti-tobacco and anti-smoking strategies useless, because people had access readily on the streets of Ontario, in Toronto particularly, to cheap, illegal, smuggled, underground economy cigarettes. With that reality, I believe the government had to take action to stop that easy supply of underground cigarettes. I believe, as I said, that it was good public policy and healthy public policy, because our first health goal is safe and secure communities, and increased criminal activity, increased guns, increased violence, which all come with smuggling activity, does not lead us to a healthy society.
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I do hope we will soon see the same kinds of important and healthy public policies, smoking cessation and taxation policies, south of the border. We've seen some very good initiatives from the Clinton administration, which are beginning to increase tobacco taxes.
I say to the people of Ontario, you will soon see your tobacco taxes increase, and from a healthy public policy point of view that is appropriate, because we know from the Addiction Research Foundation and others, from researchers, that there is a direct correlation between the level of taxation and the rate of smoking, particularly among young people; that the lower the taxes, the more people have access to cigarettes, and the higher the taxes, it is definitely a disincentive to purchase.
That must be gradual, and there's a message to us in Ontario: We can't be too far out of whack or we then end up with both smuggling and underground economy activity, and that's because consumers in Ontario are going to look and say, "Where can I get the product I want for the best price?" We have to be sensitive and responsive to those kinds of issues as well when we are setting fiscal and economic policy.
I'm not going to go on about that any further, but I did want to be on the record about that, and therefore the provisions in Bill 161 that deal with the tobacco tax I think are significant.
There's one thing I would like to mention that I'm very critical of. It's my understanding, and I think my colleague may speak further to this, that in fact the government has not been fair. We hear a lot about "fairness in how we treat people" coming from Bob Rae and the NDP ministers: "This is fair" and "That's fair." They've actually not treated the small vendor fairly. They have offered rebates for cigarettes on the shelf, where the tax has been paid, to large retailers who have large stock, but it's my understanding, and I stand to be corrected, that for the smaller retailers who have a smaller supply the government is not offering a rebate.
It's my understanding that the federal government offered the rebate, that the provincial government has not, and that there's quite a bit of anxiety over how retailers are being treated. I would ask the parliamentary assistant to check that out and to ensure that any retailer who has paid the tax on tobacco should be eligible for a rebate of the taxes paid. That is just fair. Since the customer is not going to be paying the taxes any longer, the retailer who bought them in good faith and paid the taxes should not get stuck.
I heard there was a 5,000-carton limit on the rebate. I hope that is not true, or, if it is, that you will amend the legislation so that all retailers who have stock and have paid the tax will get the rebate from the provincial treasury now that the tax has been lowered.
Madam Speaker, the last point I'd like to make on this is that this is a very comprehensive, very complex piece of legislation that has many, many sections. As I look through it, I want to tell you exactly how many sections are here. There are actually 39 sections of the bill. We frequently see pieces of legislation that have many sections, that are very large. I don't object to the number of sections. What I do object to is the number of issues and the number of different pieces of legislation. I think it's very hard for people watching this debate to understand all the things that are changing.
My advice to the parliamentary assistant and to the government is that if you want to bring in omnibus legislation, make sure it is only housekeeping, not substantive policy issues. If there is a policy issue that is substantive, the public has a right to see a full debate, hear the discussion in the House and not be confused by the fact that it is a part of another piece of legislation, so that it says "An act to amend various Taxation Statutes...." As you single out "to amend the Liquor Licence Act," people would assume that the primary component of this bill is the Liquor Licence Act. Anybody looking up the statutes of Ontario would say, "Gee, this must be about the Liquor Licence Act," when in fact from the title it's not clear about what is in this bill.
That's about all I have to say on Bill 161. I want to thank you, Madam Speaker, for the opportunity to participate in today's debate and offer my advice and suggestions to the parliamentary assistant, and hope he'll respond to some of the issues I've raised.
The Acting Speaker (Ms Margaret H. Harrington): I thank the member from Oriole for her participation in second reading on Bill 161. Are there any questions or comments to the member?
Mr Sutherland: Let me say to the member for Oriole that I too have had challenges keeping all my notes straight today on four different bills. It is a lot of us having to deal with it.
The member for Oriole has raised a lot of points and detailed discussion of the bill. I didn't wish to leave the impression that this is our only response to the underground economy, and I may have left that in my opening remarks. If I did so I apologize. This is part of the response to the underground economy in terms of what we can do from the finance perspective, obviously, the work of the Solicitor General's ministry and other ministries. It should not be taken as the total response.
The member laments the fact that we took the land transfer tax refund off the OHOSP. I wish too that we could have kept it there, no doubt about it, but the member is also aware of the difficult financial situation the government is in, but we wanted to keep that incentive. I would remind her that in the last budget we did provide $50 million for a housing loan guarantee fund, so there is a different initiative there as well, besides continuing the OHOSP initiative, plus another initiative to support home ownership.
With regard to the concern about the taxation and refund to retailers, I believe the member does have it wrong. It is the provincial government which is offering the refund. The feds did not offer the refunds for what was in place, at least as far as I'm aware, on inventory for retailers. There was no differential.
Mrs Caplan: Did you check that?
Mr Sutherland: Yes, I did check that, so that's my understanding.
As to the issue she raised about the searches, they still have to have reasonable and probable grounds, it's not just random searching, so it isn't a total free rein for the types of searches. Usually, if they've been monitoring for a while, then they'll maybe do it.
Mr Wayne Lessard (Windsor-Walkerville): I'd like to restrict my comments with respect to the amendments to the Liquor Licence Act. As many members will know, I represent the riding that includes Hiram Walker, which is the fifth-largest taxpayer in the city of Windsor. In fact my riding, Windsor-Walkerville, is named after that plant which was established by Hiram Walker back in the 1850s. Over the past few years the employment levels have decreased substantially. The sales of legitimate spirits from that plant, which produces only Canadian Club, have decreased substantially. One of the major reasons for that is because of smuggling of illegal spirits into the country.
It's simple for the member from Oriole to say, "I support tougher measures to reduce alcohol smuggling" and then talk about her concerns with respect to searching vehicles. I'd like to know what other suggestions she may have that we might be able to undertake that might address some of those concerns. Like the member for Oxford, I wish to point out that it isn't just a power to permit police to search vehicles they happen to see driving down the highway, any time they want, for whatever reason, which would raise the spectre of someone driving down the road in their car and being pulled over and their car searched for no reason.
The legislation requires that peace officers do have reasonable and probable grounds to believe that a vehicle contains evidence of a contravention of the Liquor Licence Act. There does need to be reasonable suspicion before a vehicle can be searched, and most often we're talking about truckloads of illegal spirits, not a few bottles in the trunk of a car. I think this is a responsible measure by the government to try and reduce smuggling.
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Mr David Johnson: I was going to save my comments for my period to speak in a few moments, but the member for Windsor-Walkerville has indicated the difficulties he's faced with regard to Hiram Walker. If he were to consult with Hiram Walker on the underground economy -- and this may have been the message the member for Oriole was trying to convey -- when you talk about the underground economy, one of the problems that has to be faced is the high level of taxation in the province of Ontario, and that certainly encourages the underground economy. It puts in place the incentives for people to go underground, to deliver services, to sell products underground.
In the case of Hiram Walker, for example, I'm sure the sales are down, as the member for Windsor-Walkerville says, but my suspicion is that Hiram Walker participated in a study that was performed over the recent past which indicates that the high level of taxation is the main problem they face, as much as smuggling, or one is associated with the other: People are smuggling because of the high level of taxes. So rather than dealing with the smuggling directly, Hiram Walker would say, "Deal with the high level of taxation." We may have different opinions on that. We may say that's not the right way to do it, but that's what Hiram Walker would say, I'm sure.
If you take, for example, a 750-ml bottle of Canadian spirits, $19.45 retail -- that may be the price now -- about 83% is in the form of either federal or provincial taxes and only about 17% or 18% would actually be the distiller's share in terms of the product. So there's the problem: 83% in provincial and federal taxes. That kind of puts your finger on the problem.
Ms Christel Haeck (St Catharines-Brock): As a member who represents a wine region, I wanted to remind the member for Oriole that obviously there's a lot of concern about enforcement among certain employers in my region. They look at bills like this and they do in fact feel there is strong reason to support it. I have heard from people in my area that they feel this kind of bill is warranted and they take heart that it is happening. I would lay that out for you to consider when you're making your remarks.
The Acting Speaker: Now the member for Oriole has two minutes to respond.
Mrs Caplan: I would like to say a little bit more about the concerns I have on search and seizure, and I've heard from members that enforcement measures are supported in some places. I also heard from the parliamentary assistant that in fact there had to be reasonable and probable cause. You asked for some suggestions. We know that most smuggling activity takes place at night. It would seem to me that it might be a reasonable restriction, if you were going to allow these kinds of warrants, that you exempted the individual personal automobile and that you said this was for trucks over and above a certain weight, and that it was also between 9 pm and 9 am.
Those are the kinds of things will at least send out the signal that says: "We are not going to stop an individual in their car and search them without a warrant." This is an intrusion on personal and individual privacy, and as a person who has been a champion of individual human rights and civil rights of individuals, particularly when it comes to the kinds of issues we're dealing with right now with the intrusion of the state, I feel very uncomfortable with broad powers being given to police and enforcement agencies with as broad a definition as "reasonable and probable grounds."
I'd offer that advice and those suggestions for possible amendments so you could limit your period of time and also to the size of vehicle. I know you are trying to go after the big trucks that are coming through at night where you do have some experience with smuggling activity, and I'd like to see that stopped, but not at the expense of intrusion on individual freedom.
The Acting Speaker: Now, further debate?
Mr David Johnson: We are talking about Bill 161, which is entitled An Act to amend various Taxation Statutes administered by the Minister of Finance and to amend the Liquor Licence Act. This is really dull stuff, I have to say, and it is going to be tough to do an adequate job on this.
Mr Gordon Mills (Durham East): So give up and sit down.
Mr David Johnson: The member from Durham is already in agreement.
As the member for Oriole has already pointed out, it has some 39 different sections and pertains to a number of different areas, so I'll try to speak on a few of them and hope I won't put everybody to sleep.
Mr David Winninger (London South): Why should tonight be any different?
Mr David Johnson: Well, it may be more appropriate to go to sleep tonight.
The 1993 budget: We're talking about something brought to us by the Minister of Finance over a year ago. It is interesting to note, number one, that we are dealing here in 1994, about the middle of 1994, with tax measures and compliance measures that were instituted over a year ago. I don't know if that has always been the case in the province of Ontario, but coming from the municipal sphere, as I have, it's highly unusual for me.
Just off the top, there's something that probably nobody else would note or perhaps have a great deal of concern about in a number of the bills we've been dealing with today: Bill 110, the employer health tax; Bill 138, tax on the you-brews and provincial sales tax extension to home insurance, auto insurance, that sort of thing; the tax to institute the corporate minimum tax, and now we have this particular bill. There are a number of clauses contained within the bill that talk about enforcing tax collection. It's like the iron fist of government coming down on a taxpayer and either grabbing the taxpayer by the throat and wringing that last tax dollar out or coming down on the head of the taxpayer, if the taxpayer doesn't pay up. I just look, for example, under the section that deals with the Gasoline Tax Act -- it happens to be on page 14 of this act which has 60 pages to it, of very legalistic wording -- and it says, "The minister may assess a penalty against any person who fails to collect tax that they are responsible to collect under this act or the regulations." The regulations come later. The regulations describe in more detail what the act governs. I guess that sounds fair enough; everybody has to pay the taxes. But then it goes on, on the next page, and says what happens if you don't pay your taxes.
What happens, again in the jargon, is that "Any tax payable or required to be remitted under this act" -- and all the acts say this, by the way -- "by any taxpayer is, upon registration by the minister in the proper land registry office of a notice claiming a lien and charge conferred by this section, a lien and charge on any interest the taxpayer liable to pay or remit the tax has in the real property described in the notice."
If you cut through the red tape, what that means is that they're going to take over your property. If you don't pay your taxes, the long arm of the government comes out, takes a lien on your property and can take over your property.
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I suppose that's no surprise to the taxpayers of Ontario. It describes the type of situation we have today where people are taxed up to here. As the parliamentary assistant has indicated, there is the situation of the underground economy, and by the underground economy, it means that people are simply not paying taxes.
Formerly, and perhaps still to some degree -- I don't know -- if they purchased cigarettes, they purchased cigarettes under the table without the taxes being paid. In terms of liquor sales, I gather liquor now is being distilled or smuggled, and tax in many cases is not being paid on liquor.
But the underground economy goes beyond that. For example, the Ontario Home Builders' Association has estimated that, I think, 41% of all home repairs are underground. In other words, if you want your kitchen renovated or your washroom renovated or something of that nature, then somebody perhaps will come up and say, "It's so much if you pay cash and it's so much if all the taxes are paid and you go through the regular routine," and people are opting to pay cash and not pay taxes. On 41% of home renovations, taxes are not paid. That's a worrisome figure.
What can we do to deal with that? The parliamentary assistant says: "We must deal with the underground economy. We must come down on this problem." His approach is compliance. "We must force people to pay up." I suppose people who are paying their fair share in taxes, as I'm sure everybody in this House does, would say that if somebody is not paying, then they ought to pay their taxes. You know, everybody ought to pay their taxes.
But it's a symptom of the economy in the province of Ontario, and many people are not paying taxes, using the underground economy, for example, not because they have perhaps some devious ploy to sock it to the rest of Ontarians; they simply can't afford to do it. There are so many people who are unemployed, so many people on part-time employment or they're underemployed, their salaries have gone down and their taxes are still going up, and they've said, "I can't afford this," so they've gone underground.
Now what we're doing, through this bill and through other bills, is saying: "Tough luck. The parliamentary assistant has spoken. Tough luck, and what you have to do is pay up." It says right here on page 14 in this bill that the minister may assess a penalty against you if you fail to collect your taxes or pay your taxes, and it says right here on page 16 that if you continue to be a culprit and don't pay your taxes, then the minister or somebody, I guess it's the minister, will put a lien on your property and you might lose your property.
I think somehow the cart has got before the horse here, and perhaps it's time to stand back and say, why are we having all these problems? Why are 41% of home renovations underground? Why are people smuggling cigarettes and smuggling booze and not paying tax? Is it for the sheer delight in frustrating the minister or frustrating the parliamentary assistant, or is it that we are overtaxed in the province of Ontario?
I would submit to you the reason is that we are overtaxed in Ontario. Rather than compliance measures, which is really what this bill is primarily about, compliance measures to force people to pay taxes, perhaps what we should be doing is looking at the structure of our tax system in Ontario. Perhaps if we had a reasonable level of taxation, then we wouldn't have the kinds of difficulties that we have today in terms of collecting taxes.
It's always been my view, certainly from my experience at the municipal level, that the vast majority of people are honest, law-abiding citizens and are sincerely willing to and interested in paying their fair share of the taxes. When you go beyond that, you have a problem.
I know that in the borough of East York that I represented for many years, when the first property tax bill went out with three instalments, in many cases people would come in and pay all three instalments right at the beginning. They didn't have to do that, but they wanted to make sure that they paid their fair share and they got their taxes in and they were paid for. If they feel that they're not being ripped off, then that's the kind of attitude people will take and they will pay.
I might say I don't intend tonight to have too many plugs for the Common Sense Revolution, but that is the basic approach. The Common Sense Revolution, can you see it? There we go. Everybody wants to see it. I see another photo on the other side, there. Yes, very complimentary.
Hon David Christopherson (Solicitor General and Minister of Correctional Services): What exactly are you getting at?
Mr David Johnson: What we're saying in the Common Sense Revolution is exactly that message, to the minister opposite, and the message is that we are being taxed too highly in the province of Ontario. We need to reduce taxes. We're suggesting a reduction in the personal income tax, which is extremely high in the province of Ontario.
I might say, a 30% reduction in the personal income tax in the province of Ontario, and the parliamentary assistant may be interested in this because he's never been able to figure out these mathematics, worth a little over $4 billion -- that's where the $4 billion comes in, to the parliamentary assistant -- would bring the personal income tax down to about the level of Alberta, when one considers the surtaxes involved. That's how far we are above the province of Alberta today, about 30% higher, when you consider it.
Interjection.
Mr David Johnson: Reaganomics. Well, it's Reaganomics if you don't look at the other side and you don't look at the expenditure reduction. The minister I'm sure would be embarrassed if he was putting forward a platform like this that didn't balance the spending along with the revenues. What we're saying is, yes, by itself it doesn't make sense. You can't cut taxes by themselves. You have to cut the expenditures at the same time.
Here in the province of Ontario, and I'll give you credit, Minister, not all of the expenditures have gone up under your regime. Certainly, in the years 1985 to 1990, the expenditure increases were dramatic: I think in one year, three times the rate of inflation. The expenditure increase, somewhere around 1988 I believe, was about three times the rate of inflation.
During that time, from 1985 to the present, the spending in Ontario has increased, even accounting for inflation, even accounting for population growth, by $8 billion over and above inflation, over and above population growth. That's how much the spending in Ontario has increased.
We're suggesting we cut back by $6 billion, which would still bring it $2 billion above 1985 levels, when considering population growth and inflation growth. That would allow for tax reduction which, Mr Parliamentary Assistant, would go a whole lot further in terms of addressing the underground economy than all of the iron-fisted methods, all the enforcement techniques, all the search-and-seizure techniques that one could implement in the province of Ontario.
Lower the taxes, make them reasonable and people will pay them. That's what we're suggesting in the Common Sense Revolution. And yes, we've got to reduce the expenditures at the same time or it doesn't make sense.
Hon Mr Christopherson: Where?
Mr David Johnson: Where is across the board except health, classroom spending and law enforcement. Those are the three areas that have to be protected.
Hon Mr Christopherson: That's about 50% of the budget.
Mr David Johnson: It's a good chunk of the budget, which means that the rest of the budget has to be reduced by about 20%. It leaves about $30 billion; 20% of $30 billion is $6 billion, which is exactly what we're saying the expenditures need to be reduced by.
If you apply your percentages, Mr Parliamentary Assistant, against the proper amounts, lo and behold, you come out with the proper numbers, and that's why the chief economist for Midland Walwyn says the plan will work. Not only will it address the underground economy that is a concern to the parliamentary assistant, and it's a concern indeed to all of us, but it will put in place an economy that will encourage private sector growth.
1910
I was taken to task the other day for saying that governments create jobs, and rightfully so. Governments do not create jobs. If we only have jobs being created by governments we're in deep trouble, because we can't afford the jobs that we have in government today. Here in the province of Ontario we spend $55 billion a year, revenues of $45 billion: $55 billion going out, $45 billion coming in. That's a recipe for disaster. It's a recipe for borrowing $10 billion a year, and that's exactly what the government is proposing to do. As a matter of fact, I guess it's $10.5 billion that they're proposing to borrow this year to make ends meet. Well, that won't work.
The proof is in the pudding. The proof is here in the 1994 budget that the parliamentary assistant I'm sure is very proud of. But this budget shows that because of the borrowing of over $10 billion for the last four years in a row, we have a debt today probably, as we sit here, of over $80 billion, and by the end of this fiscal year it will be slightly over $90 billion. That's what we're leaving for our children and our grandchildren in the province of Ontario. It's not a pretty sight.
The government is fond of saying that one of the problems it faces in balancing the budget and coming to grips with that annual deficit of over $10 billion is that the revenues have gone down in some years. They're projecting an increase in revenues this year, but over the last four years since this government has taken office the revenues have been very flat. I think in a year or two they've actually gone down, and this has caused difficulty in balancing the budget. Sure. I don't disagree. That certainly will cause difficulties.
And why has it gone down? The recession is certainly part of it, there's no question about that, and the underground economy comes into the equation again. People are not paying taxes. When the tax rates are put up, when personal income taxes are put up, as they were a year ago, when the surtax percentages are put up as they were, when other taxes are increased -- the total tax increase a year ago was $2 billion in terms of additional taxes. When that happens, people do go underground, and the parliamentary assistant is correct. When people go underground, apparently there's this phenomenon of hitting the tax wall.
Maybe I'll understand it better as time goes on, but if you look in the numbers, you can actually see that the revenue take is going down in the province of Ontario. The claim is that we have hit the tax wall, and when you hit that wall and continue to put taxes up, actually less revenue comes in because people stop paying. That's what has happened in the province of Ontario.
I wanted just to talk about a couple of other items. As was pointed out by the member for Oriole, part of this bill deals with the land transfer tax and the Ontario home ownership savings plan. This is a plan that I know the Ontario Real Estate Association and all the many thousands of people who are involved in the real estate industry in Ontario have supported very strongly: the Ontario home ownership savings plan. I know that my colleagues the member for Mississauga South and the member for Markham have spoken on behalf of this program in the past.
The program itself is available to first-time home buyers with family incomes, I believe it is, of below $80,000 a year, individual incomes below $40,000 a year. I'm getting the nod that that's correct. I believe as an individual you can save $2,000 a year and as a family up to $4,000 a year and there's a tax credit equal to 25% of what you pay into that program, a tax credit through the province of Ontario.
That particular aspect of the program is not contained in this bill, but the government has announced that that particular aspect will be ongoing. Certainly there are many people happy that that program will be ongoing. The people in the real estate industry are very delighted about that. My colleagues who have spoken on behalf of it are delighted by it. Some 250,000 people have taken advantage of that program. Is that about the right number, some 250,000 people?
There is one component of the program, though, that is referenced in this bill. When you buy or sell property, one or the other, a land transfer tax is involved, and that land transfer tax has been going up in leaps and bounds and it's becoming a significant amount of money. Up until recently, there was a refund of the land transfer tax for those who were involved in the OHOSP program -- OHOSP standing for Ontario home ownership savings plan. You were able to benefit two ways: Once in terms of getting a tax credit as a first-time buyer, and second, through a rebate or refund on the land transfer tax. The land transfer tax, through this particular bill, is being limited to those who signed into the program before January 1 of this year. If you're a resident of Ontario and tomorrow morning you wish to sign into the OHOSP program, you would not be able to get the refund on the land transfer tax. You would have to pay the full tax.
You would still be able to make your contribution up to $2,000 a year as an individual or $4,000 a year as a family and get a tax refund on that, but a portion of the program is being taken away through this bill. I know those involved in the real estate industry are sad to see that go. They're certainly delighted that the main part of the program is carrying on, but still, the program is weakened, and this will be less incentive for people who are interested in making their first purchase of a home, less assistance than it had been formerly.
The next part of the bill that I wanted to talk about was the Liquor Licence Act. I have already made some comments about that with regard to the comments made by the member for Oriole. The parliamentary assistant, with great zeal, pointed out that through this act the government is quadrupling the maximum fine to $100,000 for a contravention of the Liquor Licence Act. The fine would be quadrupled from $25,000 to $100,000 for an individual, and it would be more than doubled for corporations: They would face a maximum fine of $250,000 up from $100,000. Again the concern is smuggled liquor and trying to come to grips with the smuggling, the underground economy associated with the liquor business.
But the release from the Ministry of Finance, dated May 18, signed by the minister's communication coordinator -- at least his name is on here -- makes it clear that the main purpose here involved the revenues to the province of Ontario. The revenues to the province are suffering and they want their revenues, so they're putting up the fines. "Let's make sure we fine people, and if we fine them more heavily, they'll be less inclined to smuggle, to go underground, and they'll be more inclined to pay their taxes and then the Ministry of Finance will have that extra revenue."
1920
That's one approach, and there would be many people who would agree that is a good approach. I don't deny that. But I have a suspicion that this approach by itself is doomed, that it just won't work, and my suspicion is heightened by information that was passed to me by a number of organizations that have combined in what they call the Ontario Stakeholders' Report.
This report was prepared by a number of industries: the hotel industry, the resorts industry, the Ontario Restaurant Association, the Ontario Hotel and Motel Association, the Association of Canadian Distillers -- Hiram Walker would probably have been included somewhere in there -- the Hotel Association of Metropolitan Toronto, the Canadian Restaurant and Foodservices Association, and -- this is an interesting one -- the Hotel Employees and Restaurant Employees' Union, Local 75. The union was involved in this, and I'm sure my friend from Downsview, who doesn't like the studies I quote from the private sector, would perk up, if he were only here, and would say, "There's one we can listen to," because it involves the Hotel Employees and Restaurant Employees' Union, Local 75.
They point out, as I mentioned earlier, that in Canada there is an 83% tax rate on distilled spirits. I don't know if this illustration shows up, but there's a typical 750-ml bottle of something, with a retail price of $19.45. I haven't purchased a bottle recently, so is that still about right? Nobody else knows here, either. We're all sober. Is that about right, $19.45? If you start from the top, it says $1.96 is provincial sales tax, $9.61 is provincial markup, and that is 59.5% of the price of this $19.45 bottle of booze. Then 23% is for the federal tax: $1.14 for federal GST and $3.32 for federal excise duty. So out of the $19.45, that leaves $3.42, which is the supplier's selling price, in other words, the distiller's share of the bottle. About 17% of the price you pay actually goes to the person who produced it and the rest goes to either the federal government or the provincial government.
My suspicion, and the suspicion of the people who signed the Ontario Stakeholders' Report, is that all the search and seizure measures and all the other measures to comply are going to be largely unsuccessful with that amount of taxation level. That is just too tempting. Certainly in terms of the cigarette trade it was very tempting. Cigarettes are very portable. They're easy to carry, much easier than bottles of liquor. It was so tempting in terms of cigarettes that all the enforcement in the world would have had a difficult time enforcing that taxes be paid on the cigarettes, and the people involved in this study had the same suspicion here.
What they claim is that in 1980 the spirits industry in Ontario employed 3,250 people, and today -- and this report is dated April 22, 1994 -- there are 1,808 people, so there has been a job loss of 1,442 people, or they turn that into an economic equivalent of $115 million. The fact is that almost 1,500 fewer people work in the spirits industry today than in 1980. Some people would say that's a good thing, because spirits improperly used are a health hazard at any rate, and perhaps we should have fewer of them. But for the 1,500 fewer people employed, that's not such a good thing for them.
They go on to give several suggestions and make several other comments. I've talked about the employment just in the spirits industry itself, but on the broader basis, in terms of the licensed establishments in the province, there are 140,000 jobs involved and licensed operators contribute some $1.9 billion in taxes, so this is a big industry. The licensed establishments in Ontario employ a lot of people, and what's happening today is a serious concern to them.
They did a poll through this study and asked the people about price of and taxes on spirits. What they found is that 83% of the respondents indicated that taxes were the factor that contributed most to the high price of spirits -- that's not surprising, because that's a fact -- and 68% felt the current price was too high but didn't know how much taxes were involved. Many of these people didn't know, and when they were actually told what the level of taxation was on a bottle of liquor, then 77% turned around and indicated that the tax level is far too high. Not surprisingly, the vast majority of people support a reduction in the taxation level.
I'm sure certain measures are required in terms of enforcement and compliance, but the main problem, many people feel, certainly those involved in the industry, is that the level of taxation is simply too high.
The member for Oriole did mention search and seizure, and I thought it might be instructive to look at what that aspect of the bill actually says. It says, "[a]ny person authorized by the chair" -- the chair is the chair of the Liquor Licence Board, I presume -- "who has reasonable and probable grounds to believe that a vehicle, a vessel, railway equipment on rails or in aircraft contains evidence of contravention of any of these acts and regulations,
"(a) may, without warrant, stop and detain the vehicle, vessel, equipment or aircraft."
The parliamentary assistant has said that you must have reasonable and probable grounds, and I hope that some time during this debate the parliamentary assistant indicates to us, in whose view is it reasonable and probable grounds?
Mr Sutherland: The courts. There's a lot of precedent on that.
Mr David Johnson: However, as I understand this, the courts aren't consulted, because an inspector, without a warrant, can stop, detain any vehicle, vessel, equipment. It'll be interesting to me in terms of how the courts get involved in this to declare that there are reasonable and probable grounds.
I can tell you in another bill that we debated recently, Bill 120, which has to do with basement apartments, there's a suggestion that building inspectors and fire officials may on reasonable and probable grounds enter a premises to do an inspection, and many fire departments and many property standards inspectors have attempted to enter properties to do inspections, saying they felt they had reasonable and probable grounds, but they had to go before a judge and convince the judge that they had reasonable and probable grounds. My experience has been that the vast majority were turned down and that the judge actually said: "No, in my view, in a free society here in Canada you need more evidence than that. You do not have, in my view, reasonable and probable grounds and I'm not going to give you a warrant to enter the property."
1930
Perhaps the parliamentary assistant will address this later, but here we have a clause that skirts around the requirement to get a warrant, to go before a court. An inspector, on his or her own accord, may determine what is a reasonable and probable ground, go in, do a search without a warrant, detain a vehicle and examine the contents, including the cargo. They may seize and take away any of the manifests, the records, the accounts, the vouchers, the papers. They may seize them and take them away and hold them for any period of time.
It seems rather draconian to me. I understand there's a problem, but I think, under cool analysis, the powers that have been given to the inspectors go beyond what we would consider in a free and open, democratic society to be reasonable. I would certainly like a response to that.
I'm going to shift along to the Race Tracks Tax Act. Again, looking at this section of the act, the main intent is to ensure that taxes are paid. For example, on page 45, it says, "If on a particular date a debt as calculated under subsection (2) is payable by any person, the person shall be charged interest payable to the minister at the prescribed rate and calculated in the prescribed manner on the amount of the debt" etc. What is taking place in here is to force taxes to be paid, penalties to be paid, etc. It shows me the intent of this whole thing.
I flip to the next page and it says, "Every operator" -- we're talking about track operators in the province of Ontario -- "who fails to submit a return or who fails to remit the tax collected as required by this act and the regulations shall pay a penalty of an amount equal to 10% of the tax collected for the period covered by the return."
People are having trouble making ends meet. They certainly are in the racetrack industry, I can tell you that. That's an industry that's under extreme duress at this point in time in Ontario. With this act, again the iron fist comes down on them: "You must pay. You must pay a penalty."
Do you know what's happening in the racetrack industry? I'm sure this is not greatly interesting to the members of the government, but the racetrack industry is coming under fire here in this bill and is being told, "Pay up with a penalty." The Ontario Jockey Club, for example -- and this is a report from November of last year; it's a little bit out of date -- employs 2,600 people at its four racetracks. But across the province of Ontario, if you look at horse racing as a whole, there are some 50,000 people who earn income from horse racing. A government study, this particular government, last year indicated that there are 28,000 jobs but about 50,000 people who derive some sort of income from the racetrack industry -- a lot of people involved.
So it's not only the fact that people can go out and enjoy the horse racing, that ordinary citizens can lay a wager and have a little bit of fun, but it employs a lot of people. Of course it employs jockeys, managers, attendants at the tracks, groomers, trainers, vets, blacksmiths etc -- a lot of people employed.
But what's happening in the racetrack industry, that same industry that the government is wringing every last nickel out of through Bill 161 that we're debating here this evening? With the prevalence of betting through the lottery system and now the Windsor casino, the racetrack industry is suffering. The profits of the Ontario Jockey Club, which as recently as 1989 had been over $6 million in profit, for the last three years, 1991, 1992, 1993, the profits -- well, there are no profits. There's a loss. Last year, 1993, there was a loss of $7 million in the industry.
The reason for this is no secret. With the lotteries coming in, with the Windsor casino coming in, the competition is there, but another reason, a reason that perhaps is relevant here tonight -- and I know the members opposite don't want to hear this -- is that the racetrack industry in Ontario is among the most highly taxed in all of North America. In Ontario, the parimutuel tax rates, the tax rates on the racetrack industry, is 5%. The only jurisdiction higher in North America is California. In California, the tax rate is 5.8%. In Florida, where many Canadians spend their time, it's 2%.
Mrs Margaret Marland (Mississauga South): That's where they used to go before they got their health insurance cut.
Mr David Johnson: As the member for Mississauga South is saying, that's where many Canadians used to go before the health insurance was cut. People are having a hard time being able to do that now, even though the Canada health plan says there should be equal health services and payments, no matter where Canadians are. The plan was cut, of course, and emergency treatment now for Canadians in Florida is only $100 a day for a hospital bed as opposed to the average cost here in Ontario of $400 a day. The member for Mississauga South is exactly correct in that.
But if Canadians did want to bet in Florida, the tax rate there by the state would be 2%, less than half of what the rate is here. It occurred to the government that one way to force the jockey clubs and the racetrack operators is to bring down the iron fist and to force compliance. But another way may be to look at the tax rate that's being applied here in Ontario, which is more than double Florida's, which is 10 times the state of New Jersey, which is more than the state of New York, and say: "We're overtaxing that industry. That industry is losing money. That industry is closing down racetracks. Fewer people are being employed. People are losing their jobs in the racetrack industry."
Yes, we've hired a few people in Windsor to run the casino, a great job creation activity: A few people are spinning roulette wheels. Meanwhile, what's happening to the racetrack industry? All the people employed in the stables, selling goods in the food services industry associated with the racetrack, taking tickets, all the people employed -- and these are people, I might add, who are not employed at the high end of the income scale. These are people who are generally earning lower amounts of income and desperately rely on their income from the racetrack industry. Well, they're losing their jobs because (1) the industry's taxed more heavily than any of its competitors, and (2) the lottery games and the casinos are coming in and jobs --
Mr Mills: That's not the truth.
Mr David Johnson: The member for Durham agrees with me on that, I'm sure. I can tell.
Mr Mills: I worked at Barrie Raceway. People stayed away from the races because --
The Acting Speaker: Order. The member will have his turn.
Mr David Johnson: I don't know what the rationale -- he worked at the Barrie Raceway and they're staying away, for some reason.
Mr Mills: Not because of this.
Mr David Johnson: Not because of the high level of taxes, he says, and not because there are so many other -- you know, it all combines together, Mr Member, and when the take goes down, when the times are tough, everything gets pinched, and I'm sure they're having a tougher time getting the competition; I'm sure it all hangs together. But if you lower the taxation rate on the racetracks in Ontario, and don't expand the casinos and give the racetracks a chance, my guess is they would come back.
1940
That's my problem with that part of the bill. I don't think it really speaks to where the real problem is. It's trying to squeeze money out of an industry that's dying, an industry that's pleading for help, an industry that's saying, "We're overtaxed," just as many of the rest of the industries in Ontario are doing. What are we doing? Instead of listening to their pleas, instead of looking at the real situation, we say, "We're going to squeeze some more taxes out of you somehow."
The next part, and I think this may be -- no, the second-last part: All right. I'll speak to a good part of the bill.
The parliamentary assistant has indicated that subsection 2(27) authorizes Ontario to join the international fuel tax agreement; IFTA, it's called for short. This is a provision that the Ontario Trucking Association has requested, and having attended meetings with the Ontario Trucking Association, I know that this certainly addresses a problem of the trucking association in the province of Ontario. I compliment the government for taking this step. It will simplify their paperwork. I believe one of the problems they have at the present time is that all the various states have different arrangements, so that without this, the industry is forced to file numerous certificates to comply. This will be a good thing for the trucking association in Ontario, and it's long overdue.
The only fly in the ointment, and perhaps the parliamentary assistant would address it, is that there is a fee to do this. This is something that probably should have been done a long time ago. Now they have had the annoying feature of adding a $15-per-truck fee supposedly to finance this situation.
It's interesting. If you look at all the revenues that come from the gasoline tax and I believe the gasoline tax generates about $2 billion a year in revenues, and if you look at all the revenues that come from licences and fees from motorists -- I'm not just talking of truckers, but I'm talking of all motorists in the province of Ontario -- there's a huge amount of money that this government already squeezes out of motorists, truckers, those of us who drive automobiles.
According to my calculations, that amount of revenue far outweighs the amount of money that's put back in to improve the road system in Ontario. Perhaps if you throw transit on there, it may be a close equation, but in terms of the money that goes into the road system, there's more revenue that motorists pay than they get back. That will not be a big surprise to any motorists watching here this evening.
Why charge the truckers a $15 annoying fee? I wonder what it would cost to administer this $15 fee. Other than that, though, my compliments to the government. This is certainly a good way to go.
Finally, the cigarette tax: What we're dealing with here, as has been mentioned previously, is back to the problem we faced earlier this year in the province of Ontario -- smuggling, underground economy, taxes on cigarettes too high. The incentive was there to smuggle, and it will be, no matter what the commodity. Whether the commodity is cigarettes, whether the commodity is alcohol, whether the commodity is alcohol, whether the commodity is something else, if the taxation level is as huge as it is, 83% on alcohol, a huge amount -- I haven't calculated it exactly, but I can say that back when this government made the decision to lower the taxes on cigarettes, which is exactly what we're addressing here tonight, to give approval through Bill 161 to lower those taxes, the manufacturer's tax was $8.50 -- this would be on a carton of cigarettes -- $5.50 for the federal excise tax; $5.36 for an excise duty, federal duty; $13 for Ontario tobacco tax: $32 out of $41 in taxes.
It's worse than that actually: There's GST and RST on this too. If you add that all up, there's probably in the vicinity of $36 or $37 in taxes, out of $41 a carton. Is it any wonder they're smuggling when that happens? That's a tremendous incentive for the underground economy, for smuggling. Reluctantly, I'm sure, the Finance minister lopped the taxes, decreased the Ontario tobacco tax from $13 down to $3.40 on a carton and the price fell down to $23 and that now is somewhat competitive to what the smuggled cigarettes were commanding.
I know that many in the health industry were livid.
Mrs Marland: Still are.
Mr David Johnson: They still are, as the member for Mississauga South says. I remember talking to somebody who's very prominent in the health field. I won't identify exactly who he was. He said that Jean Chrétien will go down in infamy for cutting the federal tax. That's how the health professionals felt then and, I believe, as the member for Mississauga South says, that's how they still feel today. But that's what happened and it had to happen, because the tax was simply too high. That's what we're dealing with today.
It brings up the question of what should be done. At that point in time, I suspect the government's options were limited, but certainly there has to be a broader program than simply the tax reduction, to deal with the problem of cigarette smoking.
I'm going to make one fast shuffle. I know we had indicated that we would limit our speaking time tonight, and I think I am being encouraged from all sides to bring a halt to my comments. So I will leave it at that. I hope my colleague from Mississauga South may have a few comments as well.
The basic message that I would like to convey and that I think the people of Ontario are conveying -- they're doing this by taking natural actions: They're being forced into the underground economy. They're being forced to avoid paying taxes because our taxes are too high, too high on cigarettes, too high on alcohol and too high in many other areas in Ontario. That's the basic problem we have. If you come to grips with that, Mr Parliamentary Assistant, then you will really start to come to grips with the underground economy.
The Deputy Speaker: Questions or comments?
Mr Sutherland: The member for Don Mills raised quite a few issues during his comments on the bill. I appreciate that very much. Let me just say on the OHOSP that it has been a very successful program. There are over 300,000 plans that have been registered as of the end of 1993; 231,000 homes purchased with the help of the plan.
He also talks about the search of vehicles and he cited a case where bylaw inspectors weren't allowed to go into homes. The courts have very clearly differentiated between homes and vehicles that can be moved around. They give a far greater degree of protection to your home than they do to vehicles, and they accept searches, if there's reasonable and probable grounds, of vehicles. That's why there is the difference in terms of homes and others.
Regarding the questions about liens, the changes that we are making here are as a result of the 1992 Bankruptcy Act at the federal level. As a result of the changes, they removed the crown as preferred creditor status in bankruptcies. As a result, ownership of assets cannot be transferred until a lien is discharged and all ministry tax statutes are being amended to include these lien provisions. They will not have priority over purchase money security interest, inventory sold in the ordinary course of sales and negotiable securities.
That's the reason we're doing it, because of changes to the federal act that kind of reduced our status there. The government is looking at some of the proposals put forward by the distilled spirits industry, but no decision has been made. As I mentioned earlier, it has been generally acceptable public policy to use taxes to deter excessive drinking of all kinds of spirits, wine, beer in the province of Ontario.
With regard to some of his comments about the racetracks sector being uncompetitive, we have certainly done things through the racetracks incentive program in taking some of the percentage there and reinvesting that. Again, the efforts of the Minister of Consumer and Commercial Relations to bring the Breeder's Cup here are also a significant help to the industry.
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Mrs Marland: I want to congratulate the member for Don Mills on his analysis on this bill. Obviously, when we look at some of the announcements the government made in its budget speech, one of the concerns I had particularly, not only as the Housing critic for our party but as a representative of one of the Mississauga ridings, was that the potential for growth in new home ownership is tremendous.
Although after a lot of pushing from the real estate industry around this province, which knows how important the Ontario home ownership savings plan was to helping first-time home buyers acquire that home, the government announced that it was going to continue it after we pushed -- I asked a number of questions in the House on that issue. When we pushed and pushed, finally the government said yes, it would extend it, it would continue it, but unfortunately, in the same breath it said that it wouldn't continue the land tax rebate portion. Of course, for most people, the most attractive feature of the plan was the land tax rebate portion.
While the parliamentary assistant stands and says, "We expanded the home ownership savings plan," really it's just a little --
Mr Sutherland: I didn't say we extended it.
Mrs Marland: Sorry, you said you continued it, but in fact you didn't continue it in the format that it was in and it's not the help that it should have been and should continue to be. If we're building houses, we're employing people. It's jobs and we need jobs.
The Deputy Speaker: Further questions or comments? If not, the member for Don Mills, you have two minutes.
Mr David Johnson: I appreciate the comments and helpful statistics from the member for Oxford. I certainly appreciate the comments from the member for Mississauga South.
The member for Mississauga South is our Housing critic and she's very familiar with all aspects of housing and has been very involved with the OHOSP program. Anything she says I treat as the gospel when it comes to do with housing. She's been very involved with the OHOSP program and concerned about the fact that the land transfer tax is no longer being assisted.
I also appreciate, I might say, the comments from my good friend from Durham East to my side who's here in support. He told me, from his comments, something pretty interesting. We've worked this out. He worked with the Barrie racetrack and he said the problem was that they couldn't get good horses at the Barrie racetrack. I suggested that the problem they're having is, if you're losing money, how can you pay the purses? You can't pay the same level of purses. If you can't pay the same level of purses, you can't get the same level of horses. So it all ties in.
They're losing money, and I think we've sort of agreed on this. If you're taxed too high -- maybe he didn't agree with that -- if you're losing money, you can't pay the purses, you can't get the horses, and it's a spiral.
The other thing we did agree upon is that many of the people, such as those grooming the horses, have very limited skills, and this is sad. They would not be helped by the Jobs Ontario program to any great degree. They have specific skills, limited skills. They're well employed in the racetrack industry; they find it very difficult to get a job outside that industry, and I think that's a very sad aspect of the closing of many racetracks.
Mrs Marland: Although I had not intended to speak in this debate on Bill 161, I felt that it was important to explain to some of my colleagues across the floor about the significance of not continuing OHOSP in the format that it was in. It's significant for each and every one of you in your ridings whether you're aware of it or not. It's significant because if we don't have government incentives to help people buy their first home, then there is no market for new homes to be built. Whether their first home is a new one or a resale of an existing unit, it does mean, in the ripple effect, that new homes are needed.
If we are really sincere about creating jobs in this province, the Ontario home ownership savings plan was one incentive that would have paid back many times the investment on the part of the government. We're not asking the government to spend more money; we're simply saying that through that savings plan there was an incentive for people to buy new homes and homes for the first time. However, finally, as I said, the government did continue the savings plan feature of that program, but they chose not to continue the most attractive feature of the program, which was including the land tax rebate. It was the land tax rebate portion that was the most important feature for first-time home owners.
The parliamentary assistant mentioned that there were 300,000 plans registered last year. I didn't know what that figure was. I think he said there were 300,000 plans registered and 240,000 homes actually bought through those plans. I think that speaks volumes about the need for that program. Every time the market is created for a new home, the ripple effect of that on our economy is tremendous, because every new home needs a new fridge, a stove, other appliances, a furnace. It needs carpeting, it needs furniture. The impact on our economy of being able to build and sell new homes is tremendous and I do think that the government has made a mistake in not extending the OHOSP in the format that it was originally.
I hope Mr Laughren will look at that decision again. There is no reason why, during the year, he couldn't amend the decision to eliminate the land tax rebate portion and re-establish it as part of OHOSP.
The construction industry, as everyone must realize, is one of the industries that's been hit the hardest during this recession, and it is beyond me to understand why the government wouldn't have done everything they could in this program, in this format. It was something, frankly, that was handed to them. It wasn't a big administration fee; it wasn't setting up a new bureaucracy. It was simply continuing something that existed.
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The public had become aware of what the program was about. They understood it. I talk to young couples all the time who tell me they were registering and applying for the plan because they knew that was their way to get into their first home.
Our Housing minister likes to say it's not important for people to own their own home. She said that in estimates committee in answer to my questions about home ownership, and it's in Hansard. She did say one day there really isn't any difference between people renting money and renting their home or their accommodation.
I was very floored, frankly, the day she said that. This is the current Minister of Housing, the member for Ottawa Centre. I asked, "Do you own your own home?" Yes, she did. I asked her if she had a new furnace, and she'd updated the windows and so forth because she said it wasn't a new home; it was an old home. She had been able to update her home by investing in new windows and new furnace and so forth.
At the time, the significance of that question was that we were discussing the Rent Control Act and she wasn't giving landlords in this province the opportunity to take energy conservation measures which in fact she had taken herself in her own home. But in so doing, there were two things: We had a Minister of Housing who did own her own home, who had helped the economy by buying goods and services to improve her own home. So obviously the choice of people in this province to buy their own home is a choice that must be available to them.
As I say, in spite of the fact that the minister said that a lot of people think there's no difference between renting accommodation and renting money to buy a home, there is a difference, and the opportunity to do that through the Ontario home ownership savings plan is an opportunity that is important to continue for the people in this province, to have that option.
Although there are a number of different taxes that are addressed in this Bill 161 tonight, I think one of the taxes that has the greatest concern to a large sector of the people in this province is the impact of the Tobacco Tax Act -- the fact that it is absolutely contrary to the best interests of public health. The idea that the only way we could deal with smuggling -- and I recognize it was the decision of the federal Liberal government first that this step was made. It was their decision that the only way to deal with the smuggling and the crime related to the smuggling was to eliminate the incentive, the incentive being that there was so much money in it.
So when the federal government made that move, the provincial government said they didn't have any other choice. But if we dealt with all smuggling on that basis, that the only way we deal with it is we cave in by eliminating the market, then I guess that would be a very simplistic solution that in some cases might work and in other cases wouldn't. In the case of the Tobacco Tax Act, there is a great deal of concern about the impact on public health by reducing the cost and making cigarettes again very accessible, especially to the younger generations of our people in Ontario.
So we do have a concern about the fact that cigarettes, quite frankly, are cheap again. If that was the only way to control the smuggling of illegal cigarettes into Ontario, then I suppose the argument could follow, why don't we eliminate all the sin taxes, because there is an incentive to smuggle in all of those areas.
Anyway, I'm aware that there is an informal agreement tonight that this debate will not be prolonged, so I will not prolong it. I have just stated two of the major concerns that I have, and I hope that Mr Laughren, the Treasurer, will look again at the OHOSP, particularly at reinstating the land tax rebate portion.
The Deputy Speaker: Questions or comments? Further debate? If not, the parliamentary assistant.
Mr Sutherland: Let me just address the couple of concerns raised about home ownership and not continuing the land transfer tax. My understanding is that there have been some concerns also about not only the expense of the transfer tax program but also some concerns that there were some ways of abusing that portion of the refund. The ministry people are reviewing some of the files just to ensure that everybody who is eligible met all the criteria they were supposed to, because sometimes at the time the plan was opened a change in income may have occurred which may have made then less eligible etc, those types of things. So those files are being checked.
Let me also remind the member for Mississauga South, as I reminded the earlier member who raised a similar concern, that we did announce in the budget a $50-million home loan guarantee fund as well as another incentive for encouraging home ownership.
I appreciate all the members who participated in the debate, and I think for the most part they raised some very legitimate concerns. I hope throughout the debate and through some of the responses we've tried to provide that we've been able to address those concerns.
The Deputy Speaker: It has been agreed that the vote on this bill will be taking place tomorrow.
LONG-TERM CARE ACT, 1994 / LOI DE 1994 SUR LES SOINS DE LONGUE DURÉE
Mr Wessenger, on behalf of Mrs Grier, moved second reading of the following bill:
Bill 173, An Act respecting Long-Term Care / Projet de loi 173, Loi concernant les soins de longue durée.
Mr Paul Wessenger (Simcoe Centre): The Long-Term Care Act creates a new legislative framework for planning, managing and delivering community-based long-term care and support services for elderly persons, adults with physical disabilities, persons of any age who need health services at home and children who need care and support at home or in school. I would like to begin my remarks by explaining why this legislation is needed and what it can do for consumers who need long-term care and support services.
While Ontario has one of the best systems of long-term care and support services, consumers have continually told both past and present governments that some things need changing. Consumers have told us that they want their services provided at home wherever possible. They do not want to go into a hospital, nursing home, home for the aged or other institution if they can receive the care and support they need at home. Consumers have told us that they see care in institutions as a last resort.
In addition to the preference for increased service at home, the number of consumers who need long-term care and support services is increasing. The growing demand for services stems from the overall aging of the population, improved recovery and survival rates resulting from advances in medical technology and the success of independent living for adults and children with disabilities.
Parents have told us that school health supports and other services are essential in making it possible for their children to lead active lives and participate fully in childhood and school activities.
Acute and chronic home care services continue to provide care and treatment to many people recovering from illness, people with AIDS and other debilitating conditions who otherwise would have to be admitted to hospital to get the care they need.
Despite the growth and demand for community-based services, for too long Ontario has relied heavily on institutional services.
Consumers have told us that they find getting information about services difficult, time-consuming and confusing. If you have an elderly parent who needs help with meal preparation, housekeeping, nursing care or personal support, you may have to contact four different programs to get all the service that parent may need.
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Consumers have asked for simplified access, a one-stop approach to obtaining information about services and the care and support to maintain health and independence. Consumers have told us that one-stop access means making one phone call, not five or six, and making contact with a person who will take responsibility for providing accurate information about what services are available and how to get them; making appropriate referrals to other services as needed; assisting the person to identify his or her needs, including making or arranging for assessments, determining eligibility; developing a plan of service with the consumer; arranging for workers to provide the actual care and services; and following through with the plan of service, monitoring service provision, identifying changes in need and circumstances and making necessary adjustments in services provided.
Consumers have told us that the services they need are not always available when they need them. We know that there are some gaps in home support and home care services in some parts of the province. One community may offer a broad range of care and support services while a neighbouring community may have very limited services. Some communities still have no attendant care or personal support programs.
Consumers have stressed that they want a system that puts customer service first, that provides choices and allows them to participate in the decision about what services are needed and decisions about how, when and by whom those services will be provided.
Consumers have told us that what Ontario needs is a long-term care and support system that responds to a consumer's preference for services at home, simplifies access and creates a one-stop approach to information and services, assigns responsibility to a person for providing and arranging services for each consumer, ensures the availability of a full range of basic services and puts consumer choice and consumer service first.
Bill 173 makes possible a new, consumer-oriented approach to managing and delivering community services and provides us with an opportunity to correct what consumers have told us is wrong with the system.
The centrepiece of the consumer-focused system, and the new legislation, is multiservice agencies. To achieve a one-stop approach to service, the legislation requires that MSAs provide information and referral services regarding long-term care and support services that are available, make the assessments and determine the eligibility for services, develop a plan of service for eligible persons and review that plan when necessary and offer a specific range of long-term care and support services.
One-stop is sometimes mistakenly thought of as only one place in the community where services are offered and where consumers can go. This is not the concept of one-stop access contemplated by Bill 173. One-stop does not mean that all services and care providers have to be assembled under one roof and that consumers have only one point of contact with the community. One-stop means that all the participants in the MSA network must be capable of making the right connections to meet the person's needs. It means that with one phone call consumers and service providers should be able to tap into a well-coordinated network of service. One-stop is achieved by a functional integration of information, referral, assessment, case management, service delivery and follow-up.
By requiring MSAs to make assessments, determine eligibility, develop a plan of care for eligible consumers, review and revise a plan when necessary and provide or ensure the provision of the services set out in the plan, we will ensure that a person takes responsibility for these activities for each individual consumer. In addition, Bill 173 makes it possible to ensure that the appropriate range of basic services is available throughout the province.
Section 12 of the act requires MSAs to provide or ensure the provision of four categories of community services. The mandatory basket of services to be offered through MSAs reflects the advice of consumers and other stakeholders regarding what basic services should be priorities. Specific mandatory services are:
(1) Community support services, including Meals on Wheels, transportation, adult day programs, care giver support services and other home support services provided in large part by volunteers;
(2) Homemaking services, including house cleaning, doing laundry, mending and ironing and preparing meals;
(3) Personal support services, including assistance with personal hygiene, personal care and other routine activities of daily living;
(4) Professional services, including nursing, occupational therapy, physiotherapy and all of the services currently provided through the acute and chronic home care and school health support programs.
Other community services, depending on local needs, may be added by regulation.
No existing programs are being eliminated. On the contrary, all the services offered through the current long-term care and support service programs will continue under the new legislative scheme, with consistent rules and accountability requirements.
The mandatory service scheme under the legislation puts all four types of services and providers, including large and small volunteer agencies, ethnic and cultural organizations, on a level playing field for the first time in Ontario. Community supports provided by volunteer agencies such as Meals On Wheels are equal players with homemaking, attendant care and professional services.
All four service sectors, including the volunteer sector, will be represented in the decision-making process about service priorities and the management and delivery of services.
To further support the one-stop approach to the full range of basic services, the legislation limits the ability of MSAs to contract out or purchase services rather than directly deliver services. This provision will help shift away from the brokerage model of service to one that integrates direct delivery of services with information, referral, assessment, development of a plan of service and follow-up services.
An MSA must not spend more than 20% of its approved budget for each of the four categories of community services. The 20% allowance provides sufficient flexibility to enable MSAs to purchase specialized and additional services to meet particular consumer needs. Services may be purchased from either non-profit or commercial agencies.
For additional flexibility in implementing the 20% limit on purchasing services, purchases from other MSAs or individuals are exempted permanently from the 20% limit.
In moving towards the province-wide establishment of MSAs, it is recognized that some communities will move faster than others. To provide the maximum flexibility and encouragement for local communities in establishing their MSAs, Bill 173 allows the minister to exempt a designated MSA from certain obligations for up to four years.
The exemptions are time-limited from the date of designation with a maximum of up to four years and are not renewable or extendable. The exemptions are discretionary and to be considered by the minister on a case-by-case basis.
The exemption powers are designed to encourage and support early progress towards the establishment of MSAs. The exemptions make it possible for MSAs to develop and begin business without having to meet all of the mandatory requirements of a fully operational MSA before any functions can commence.
However, to ensure that from the outset consumers have a one-stop access point for information about long-term care and support services, MSAs cannot be exempted from the obligation to provide information and referral services. This will eliminate the need for consumers to contact individual service providers, even if the MSA is not yet providing all of the services directly.
Bill 173 provides, for the first time in Ontario, a set of legislative expectations for how consumers receiving long-term care and support services are to be treated, how their choices and preferences are to be respected and how their rights are to be promoted.
First, a fundamental purpose of the act is to "recognize the importance of a person's needs and preferences in all aspects of management and delivery of community services."
Second, Bill 173 sets out a bill of rights for consumers receiving service. The bill of rights provides a clear statement of how consumers should expect to be treated by service providers and how services are to be provided. Service providers are required to treat consumers in a manner that respects their autonomy, their individuality, and their cultural, ethnic, spiritual, linguistic and regional differences.
Consumers are able to exercise choice in giving or withholding their consent to assessment, having their eligibility for service determined, or the provision of any services.
Consumers will also exercise their own personal choices in the development of their plan of service. Service providers are required to provide an opportunity to the consumer to participate fully in the development and revision of his or her plan of services.
In keeping with our commitment to persons with physical disabilities, if communities decide that they prefer to maintain a distinct attendant care program, consumers will have the choice of getting attendant care and assistance with personal support either from a distinct program or through the MSA. The choice is the consumer's.
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In that vein, I would like to bring the attention of the House to the minister's announcement last night of a pilot project of $4.4 million that will enable people with disabilities to hire and train their own attendant workers. The two-year direct-funding project will help people with disabilities become employers and exercise more control of their lives.
Bill 173 also provides new opportunities for consumers to play a central role in planning and managing long-term care and support services. Membership of district health councils and their committees and boards of MSAs are to include consumers.
In addition, the legislation requires the minister, when deciding whether to designate an approved agency as a multiservice agency, to consider whether the composition of the agency's board of directors reflects the diversity of the persons to be served by the agency in terms of gender, age, disability, place of residence within the geographic area to be served by the MSA, and cultural, ethnic, linguistic and spiritual factors.
Besides this consumer input that's going to be required, the minister is also to consider the agency's board of directors to ensure that it includes persons experienced in the social service field and persons experienced in the health services field.
These criteria make it clear that MSA boards should involve consumers and include a balance of health and social service perspectives. We believe the new boards or sponsors of MSAs are needed to meet these criteria.
Other features of the bill that promote consumer service and ensure that consumer service is the first priority include other consumer safeguards in addition to the bill of rights and consistent accountability requirements for all consumer providers funded under the legislation. Other government members will be commenting on these provisions of the bill.
I urge all members of the House to support 173 so that the hard work and efforts of consumers and other stakeholders will not be wasted and that the new consumer-focused service system will become a reality.
Mrs Margaret Marland (Mississauga South): We do have concerns about Bill 173. There are some parts of the bill that we do support and I'm going to leave those comments to our Health critic.
But there is a tremendous concern about the impact this will have on the volunteer agencies or those agencies that depend on volunteers for them to function. In fact, the parliamentary assistant just referred to one when he referred to Meals on Wheels. If you kill the volunteer contingent or the volunteer component of any of these agencies, then you will be placed in a position where the alternative is simply not affordable. There will be a choice: The service will be discontinued or you will be scrambling for money to pay where volunteers previously did the job, and that is really significant.
One of the other concerns, and it's very difficult in two minutes, of course, to identify all of the concerns, but there is nowhere in this bill, that I can find, a commitment to people with disabilities. This has been a big void in the whole review of long-term care in this province. It was a void when the green paper went out, the white paper went out.
We had meetings in the communities, and particularly I can speak for the Mississauga Hospital. The residents' council there had a public meeting and expressed a great deal of concern about the direction that the long-term care reform was going to go in terms of its impact on them.
The Deputy Speaker (Mr Gilles E. Morin): Thank you. The time has expired.
Mr Larry O'Connor (Durham-York): I want to compliment the member from Simcoe for his participation in this debate. One area that he didn't talk about, and it actually was referred to by my friend here from Mississauga, was the volunteer element. We do have limited time this evening, but I would like to maybe add something that he hasn't touched on yet because I think the importance of the volunteers is a key.
I know that there are concerns in the community out there. For example, Brock Good Neighbours Community Care has concerns. They're part of Durham Community Care, and they've got concerns about how the local advisory board works with the larger board. Those concerns have to be worked upon and addressed before we can move forward to some of the other concerns.
For the volunteer element, for all those people who put in the countless hours, hundreds of hours, going out and visiting someone in their home or the millions of kilometres that they drive, Meals on Wheels or helping somebody go to the hospital and make that doctor's appointment, that is important. That isn't going to be affected by this, though there are people who will raise that as a concern: "This is just going to kill that part because volunteers aren't important any more." Even though the critics across the floor are heckling, I want to assure the members that the volunteer element is important.
There's a whole network of care that's involved here. The network includes all the social workers, the homemakers, the Meals on Wheels people visiting. All of that is important. If we had the time to address all of that, I'm sure the member for Simcoe Centre would have addressed that.
We're going to go through a public hearing process and we're going to have an opportunity for people to bring those concerns forward and have them addressed. He may have the opportunity, I hope, to address the announcement made by the minister about --
The Deputy Speaker: Your time has expired.
Mr O'Connor: -- the disabled people being able to direct their own home care funding.
Mr Cameron Jackson (Burlington South): The comments being raised by the government about volunteers: I stood in this House two weeks ago and raised the question with the Minister of Health about this whole issue around volunteerism and its potential erosion. I said to the minister that there is very clear evidence --
Mr O'Connor: Fear-mongering.
Mr Jackson: You listen, Mr O'Connor; you may learn something here. This matter was measured in the province of Quebec and there was an erosion of the volunteer sector in Quebec when they brought in this form of legislation.
All I said was, can we please have an open mind and find out from Quebec what positive strategies were implemented to respond to the concerns that have been raised by my colleague from Mississauga South? That's all we asked. We didn't make any accusations; we just simply said, "There is a province that ran into difficulties."
I asked the minister if she had any strategies to deal with that, and she said no. I asked her if she'd look into the matter and find out what that province did to react quickly, because I'll tell you, what she said in the press conference was, there are 1,200 agencies out there that are volunteer-based and 40% of their operation is bureaucracy that should be wiped out -- her own words.
A lot of people are going to lose their jobs and there's an adverse reaction to this. What we're simply trying to say is, don't go running into this legislation with the presumption that there isn't going to be some fallout. It has nothing to do with the outcome of long-term care, which is an important outcome in this province. But in the journey to get there, a lot of volunteer groups are telling this government that they have very legitimate concerns. When they're talking to their colleagues in the province of Quebec, they're finding out that there were serious problems and erosions with groups like the Red Cross, the VON, Meals on Wheels and a whole host of other services that are vital to seniors in this province.
So take your head out of the sand, look at the problem as it existed in Quebec and what positive things can we do. That's all we're asking for on this side of the House.
Mr O'Connor: A little bit of fear-mongering, that's all you're asking for.
Mr Jackson: Quebeckers are fear-mongers, is that it? The Red Cross is fear-mongering, the Catholic Church is a fear-monger, is that what you're saying? Read the letter.
The Deputy Speaker: Order. The member for Burlington South, you had your time.
Mr David Winninger (London South): I too would like to thank the member for Simcoe Centre for explaining so well some of the salient features of Bill 173 and also to thank the minister for bringing this important bill forward.
To say, as the member for Mississauga South suggested, that this bill does not reflect the needs of people with disabilities, I would like her to know that just yesterday in London the Minister of Health announced $4.5 million. That $4.5 million will be used for a pilot project to restructure long-term care for people with disabilities in London to ensure that the way in which services are delivered to them will be streamlined, coordinated and consumer-driven.
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I was in London later in the day for the official opening of the attendant care services at the Windy Woods co-op in London, which has 17 units for severely disabled people who have moved there from chronic care facilities and nursing homes, who will now have the freedom to live independently but at the same time receive 24 hours of continuous care each day if they need it.
I can tell you, they, just as one group of severely disabled, are extremely grateful that the Ministry of Health has conferred upon them that freedom in lifestyle choice. These are people who are enjoying their independent living in the co-op. I also know that considerable flexibility has been shown in places like London in terms of commercial for-profit care givers to ensure that we bridge the transition in a smooth manner.
Mr Wessenger: If I might comment on the two issues raised, certainly we all recognize the great contribution that volunteers play in long-term care and how essential they are in making the system work well and how they will be so important in the future.
But I think one of the aspects of our long-term care reform is that the planning process is a locally driven process, not one of a centralized position that you might have in the province of Quebec. The input of volunteers into the whole planning process, the fact that they can participate in the development of the long-term care program is going to ensure that they'll be involved. I think it's this ability to participate in decision-making that gives people the interest to continue to participate.
Also, I'd like to say that by having a local planning process there's going to be flexibility in the plans of development. Each locality will have its own particular emphasis and its own particular slant. I think that's very important about the legislation as well.
Secondly, with respect to the question of who this legislation serves, it serves people in several categories: That's the people who require long-term care in the community. The largest number it obviously serves is the elderly, but it also serves people with disabilities and it also serves children with disabilities. It is also going to deal with the question of palliative care, another type of care required in the community. So it is a comprehensive piece of legislation; it's not designated for one single group.
Maybe for clarification I should have indicated that the self-directed program in London came under the long-term care legislation that was introduced in phase 1, so it already exists in law.
Mrs Barbara Sullivan (Halton Centre): Mr Speaker, as you will know, the Liberal Party has been committed for many years to a comprehensive reform of Ontario's long-term care and support services. In fact, it was Charles Beer, the member for York-Mackenzie, who was then Minister of Community and Social Services, who first brought working proposals for long-term care reform forward in 1989.
We knew at that time that reform of the long-term care system would not happen overnight but that in Ontario we needed a coherent and integrated system to ensure that people with functional limitations caused by disability or age would receive the right services, and only the right services, when they needed them.
We needed to build on the foundations of existing in-home and community support services and long-term care facilities, such as our nursing homes and homes for the aged, and to have a system that worked alongside of our acute and chronic care facilities.
What we needed was an orderly and methodical way in which people can access services, can have information about what services are appropriate and can be assured that whether they live in Burk's Falls or downtown Toronto or Carp, there will be an equity in the services offered and an equivalent range of services that are accessible to them.
We believe that one of the major goals of long-term care reform is to ensure that people receive the assistance that they need to function as independently as possible and that they are able to have information to access those services and facilities as easily as possible. That is what consumers and providers tell us is desperately needed.
But changes in our long-term care system must occur for other reasons as well. Firstly, we're an aging society and I think that people in this House, no matter what their field, recognize the impacts of an aging society in many areas of our endeavours. But the number of people over 65 will double over the next 25 years. The number of people over 85 will increase even more quickly. In those years the demands for medical and other health and social services increase dramatically.
Because of our increased longevity, when people require facility-based care their conditions are more acute. Their medical status is frequently characterized by complex and dual diagnoses, and the need for a more complex and more specialized care is readily apparent. But more than that, those people who seek care and services in their own homes and in their communities require more sophisticated services delivered in those places than they would have needed in another generation and in a younger society.
Secondly, we don't have adequate spaces in our nursing homes and homes for the aged, nor, more particularly, do we have adequate funding for services which can be provided in a patient's home, whether those services provide treatment and rehabilitation or include other supports, and many people who don't need to be in hospitals are therefore still in hospitals, at high daily and annual public cost.
I think that for most of us in our own communities we know that there has been, over the past two, three, five, six years, a change with respect to the number of patients requiring a form of long-term care but not necessarily acute care who are in a hospital setting, and that those numbers have in fact decreased. None the less, there are still significant amounts of our resources that are used for people who are living in facilities or in the hospitals because there are inappropriate other services and facilities available to them.
Thirdly, we know that if people who have functional disabilities can receive services in their homes surrounded by their own things and their own families, or if they can obtain the services that they need in their own communities, their health status and their sense of dignity are enhanced and much higher than if they have to spend lengthy periods in a hospital.
But people need to have their dignity respected in other ways: by having their language, their culture, their ethnic and their religious heritage honoured. Twenty-five per cent of Ontarians are born outside of Ontario and outside of Canada, indeed. We don't all share the same religious and cultural heritage in this province. The diversity, the heterogeneity, of our province and its people has to be taken into account in our plans.
Fourthly, we know that many people don't know where to turn or whom to call when they need assistance to live independently, nor how the system works, nor what services are available. In many communities we already have a healthy combination of commercial and not-for-profit services provided through agencies, volunteer organizations, hospital programs and other sources that provide needed services, treatment and personal care. Those organizations include both health and social service agencies and they involve professionals, paraprofessionals, volunteers and families from many backgrounds and a variety of experience. For many areas the only difficulty faced by those who need assistance is where to find it and knowing how those services can be coordinated.
Fifthly, we know that the major care in kinds of care and lengths of care and places of care are provided by a patient's family, by the patient's friends and by volunteers. In fact, it's been estimated that over 80% of the help that people receive now is provided informally by volunteers, families and friends. I believe that fact has a significant implication for long-term care reform and particularly for the discussions that we will be engaging in as we debate this particular bill. We also know that in at least one quarter of the cases of elderly people who require long-term care there is no family member living or available. There are also situations where family members are available -- that is, they're onsite -- but they are incapable of providing care through their own infirmity or through the pressures of work.
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I think that many of us will have seen an article that Helen Henderson, who writes for the Toronto Star, wrote in February with respect to how the health system will serve our seniors. She writes about a woman who's had some experience precisely in that care giver role. I'll just quote this article. She says:
"Listen to the words of a woman of 80 caring at home for her husband, 81. He has just been released from hospital after surgery for prostate cancer. She has arthritis, is legally blind and has difficulty hearing. Only after two friends from out of town went with her 'from department to department' did she manage to get promises of a weekly visit from home care and nursing services.
"'I am writing to tell you what awaits' if more of the elderly are left in their own homes under the province's most recent proposal, she writes.
"'We're alone. We have no relatives and our close friends are miles away...
"'I miss my husband's emotional strength and all the little things he used to take care of -- taking out the garbage, filling the humidifier and so on. I am exhausted and he feels terrible that he cannot help.
"'Neighbours react as I believe they do in cases of death -- all concern the first two days, then withdrawing completely. I feel so isolated -- no phone calls or visits -- I would even welcome a visit with the garbage man.'"
This woman has written to Helen Henderson about her own experience and I don't believe that this is a unique experience. I know from my own community of people who visited me in my constituency office who are aging partners in a marriage who are both in need of services.
I also see parents of young people who are in a care giver situation without any access to services that will give them respite from the very heavy pressures of caring for the heavily disabled or functionally impaired child.
We know that those pressures are not only physical pressures; they're psychological pressures. They are pressures that are accompanied simply by exhaustion, and I thought that the 80-year-old woman who wrote to Helen Henderson spoke quite eloquently of the fear and the loneliness and the abandonment that she felt.
Part of that situation in that case may well have been that she didn't know who to call. The services may well have been available to provide her with the respite that she needed. The services may well have been available to provide her husband with the care he needed and with the homemaking services that were needed to ensure that the two of them could continue to live as they wanted to live: in their own home, independently, and not within a facility.
None the less, I thought the woman who was writing the letter spoke very well of the very personal pressures that people face on a daily basis.
Another person wrote to Helen Henderson and said:
"The government home care program is premised on the assumption that our children are able to look after us. But our children have to be out of the house 10 to 12 hours a day, look after their own children and maintain their own home. It is physically impossible for them to nurse us in addition.'"
Most people in the Legislature will know that in fact the children who are being spoken of mostly in these situations are women, the sandwich generation, caring for their parents and for their children and finding little time to find their own strength and their own way under the mire of obligation.
We in my party agree heartily with the principles of long-term care reform. We agree with many of the goals of reform that have been put forward by this government and certainly with those that were put forward by our government previously. We also believe that many of those goals have been achieved already and that we should recognize some of the successes that have already occurred.
But we have trouble with the particular implementation framework that is included in Bill 173, and that is what Bill 173 is: It's an implementation bill. It specifies one model for delivery of service for every part of Ontario, despite the demographics, the health status, the geography, the unique cultural features of a region, and we have very serious reservations about this model.
I'd like to go back a paper that was prepared by the Ontario Hospital Association in response to the government's first consultation on long-term care reform, and that document was entitled Doing it Right: Ten Fundamental Steps in the Planning and Implementation of Productive Long-Term Care Reform. The 10 steps which the OHA believe are the steps that are required to plan and implement genuine long-term care and chronic care reform are the following: "(1) do not proceed without adequate information; (2) work from a blueprint; (3) build on what already works; (4) build a genuine spectrum of care; (5) recognize a hospital's place in the spectrum; (6) acknowledge the importance of health professionals; (7) strive for a balanced system; (8) test any system devised; (9) don't shut down the old system until the new one is in place; and (10) ensure that long-term care is part of the overall health care system."
Those recommendations and steps which the OHA has put forward as a guideline to planning and implementing long-term care reform are a good checklist of how we should be gauging and measuring the steps that we're taking with respect to long-term care reform. I think there are several areas where we are not able to put the checks in the right blocks of those 10 steps, and there are two or three areas that I'll just highlight now and I will come back to that are highly problematic in ensuring that we have a system and not something that's over here and set aside.
First of all is the recognition of the hospital's place in the spectrum and the importance of health professionals, and I will come back to discuss some of the issues associated with the complex diagnoses of many of the people whom we are going to have to serve through any long-term care reform.
The second area which I think is problematic is the issue of testing any system devised. What we have here is a proposal that has never been tested. It will become law. It will become a statutory requirement for every area in the province and it will not have been tested. "Don't shut down the old system until the new one is in place."
I think that we're going to want to hear, as we go through the public hearings component, how viable a transition plan that the government proposes is being taken account of. We know -- and in many communities and my own community is one of them -- that we do not have the systems in place. By example, reform and restructuring are going on in our hospital sector, and in my community we have extremely efficient hospitals that are now meeting the highest standards of ambulatory care, of day surgery, of reducing length of stays in the hospitals in Oakville and in Burlington. One of the things we find is that when people leave the hospitals, there's no place for them to go. We have the lowest number of long-term care beds in the entire province. We have little incremental funding for our home care services and for our community-based agencies, and frankly we are in gigantic trouble in Halton.
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We have pleaded, the region has pleaded, agencies have pleaded, the district health council has pleaded and, believe me, the new system is not in place and the old one in fact is being dismantled. Once again, I don't believe that's unique to Halton. In fact, as I speak with people around the province, I know that situation occurs in many, many other areas and that the blip required by change is creating more stress and more difficulties for individuals who require care and for the care givers than we can imagine.
The bill that we're dealing with will establish the multiservice agency as the single point of access for individuals who require community support services, homemaking services, personal support services and professional services. The minister will have the power to approve all MSAs and, if their premises are approved, to provide funding to those agencies and for the maintenance and operation of the premises.
I want to speak for a moment about the funding issues, because we've been through another bill on long-term care. That was Bill 101, and that bill dealt with what was called level-of-care funding for long-term care facilities. That bill was to have recognized, through a classification system, the needs of individual residents of the facilities and ensured that the care required, whether it was nursing, personal care, recreational and other activities, along with foodservices, laundry and so on, was in fact provided to a level of quality.
During the course of our hearings on Bill 101, we asked time after time whether the levels-of-care funding that would be provided to nursing homes and to homes for the aged would meet the level of need for care of the residents who stayed in those homes. In fact, we're finding daily and time after time that this is not the case. Wasn't it only a week ago that, once again, nursing homes saw their funding reduced by the province? In fact, the numbers of hours of nursing care that those homes are able to provide to an increasingly acute population --
Ms Christel Haeck (St Catharines-Brock): That's not accurate.
Mrs Sullivan: I think the member opposite said that's not accurate. It is accurate. The nursing home funding was reduced a week ago Friday. A week ago Friday it was reduced. Charitable homes and municipal homes for the aged stayed the same. They were grandfathered. Nursing homes had their funding reduced. Their funding has been reduced to a point where nursing home operators themselves believe they are operating below a safe level of nursing care for their residents.
If that is what we have seen out of what was a funding bill in Bill 101, what are we going to see with respect to the funding implications of this bill? This bill doesn't speak of the level of need of the patients. In fact, what this bill presumes is that funding will be disbursed through district health councils on the basis of the numbers of people within a community. Other demographics, other levels of acuity, other epidemiological data, it appears, will not be taken into consideration. What will be taken into consideration is the population of a given region.
People in the seniors' community and in the disabled community have high expectations for a range of services that are now going to be mandated under this legislation, and I don't believe that the MSAs are going to deliver them because I don't believe the government's going to provide the money to enable them to do so.
The other aspect of that issue is, of course, the loss to the system of the value of the volunteer services that are provided in patient care and delivery of that care. We know from other analyses that 30% of the operations of our charitable and volunteer agencies are represented by fund-raising efforts and by volunteer services to patients which are provided by people who give of their time and their talent to those agencies.
That volunteer component I am not convinced will continue. We are going to be having a transfer agency, a new bureaucracy, and that 30%, it seems to me, will find its way into other community activities rather than into a volunteer structure through a bureaucratic multiservice agency.
For a long time, for I suppose two years now, we've been asking questions about the promises with respect to the $647 million that is committed to long-term care reform. I received, in response to an order paper question that I placed to the minister, a very interesting attachment which indicates that the comprehensive service funding and financial management system will not be put into place until well into next year. The work that was to be done is well over a year out of date. The project completion was estimated for the fall of 1994. It appears that it will not be completed now until the fall of 1995.
Through the consultants' reports, the government has recognized this, and this is a remarkable recognition: "It has become apparent," say the consultants' reports, "that a comprehensive funding system which includes both in-home and community support services must be developed."
We have a bill before this House that will set up an agency that will assess, that will determine the eligibility, that will take over the functions of volunteer agencies, that will deliver care, and we have no idea of what the comprehensive funding system is that will be put into place to enable those agencies to operate.
If we can see irresponsibility in any area, it is the promise that the government has made to people who require this care, who have been working very hard for this kind of reform, without any commitment to ensuring that the funding will be delivered to provide the services or even a knowledge of what the level of need for funding in fact will be. That is absolutely shocking.
Another area that we're concerned about, and once again it kind of follows our concerns with respect to Bill 101, is the appeal process under this bill. If a person goes to an MSA to seek services, to seek help, the MSA is required to assess the person's needs, to determine the person's eligibility for services, to develop a plan of service, to provide or ensure the provision of the service, to establish waiting lists if the services don't happen to be available immediately and to provide an information and referral service.
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If the individual does not feel that the decision that has been arrived at through the multiservice agency is the appropriate one for that person, the person has a right to appeal to the Health Services Appeal Board, a board that may well be located hundreds of miles away, with which the person has never been in contact in the past, has never heard of, has never seen and doesn't know from community activities. I suppose the sop to that person in this legislation is one of timeliness: The hearing must commence 20 days after the application for review is made.
If we have so much confidence in our communities, why can't we have an appeal process that is accessible to the individual within that community? Why can't we rely on an appeal to the board, if necessary? Why can't we rely on an appeal to a district health council committee? Why can't we rely on any other local appeal process that will ensure that the person does not have to truck off to downtown Toronto with a fancy lawyer who's going to cost them hundreds of dollars to appeal the fact that they feel they ought to have been considered eligible for entry to a nursing home, that they ought to have had a different plan of care, that they ought to have been treated in a different way?
We think that this appeal provision is insensitive at best and completely uncaring at worst. Interestingly enough, the bill does include a bill of rights. Surely that bill of rights could include a mechanism for appeal that recognizes not only the dignity of the individual and the importance of the community to the individual but also the right of the person to reasonable access to appeal processes.
We commend the government for including the bill of rights in this piece of legislation. We think that's valuable. Many agencies have their own mission statement that is placed on walls so that their clients will know what their standards are and what the rights for the patients or consumers are. Certainly nursing homes had those rights, which became really almost a model for the operation of nursing homes when the bill of rights was introduced by the nursing homes association, and a comparable requirement is included in Bill 101. But I think that the government must look at that appeal process, and that is certainly something which must change.
The whole issue, though, of community is of singular importance here. A friend of mine -- many of you will know her; in fact, she may well be friends with individual members of this chamber -- is a woman who has done extensive work at the University of Toronto in extra classes and study on the issue of what a community is. There are probably a hundred definitions that are legitimate definitions, she tells us, of what "a community" means. We can conjure up many of them right here and now. They may well mean a geographic community, they may mean a cultural community, they may mean a family community, they may mean a neighbourhood.
One of the things that this bill does, it seems to me, is make a sop to the verbalization of the word "community," but in fact, and under the guise of decentralization, it centralizes more power to the ministry.
Not only does the bill define the very specific services which must be universally provided across Ontario but the shape of the organization that's to provide them, and that shape must be identical in every area of the province. Once again, despite the geography, despite the incidence --
Mr O'Connor: That's not the way it works, Barbara.
Mrs Sullivan: You say that's not the way it works. Your compendium to this bill is very different than what's written in the bill. I am talking about the law that will be passed, not what you will have people believe will be implemented. I think that is a very, very different thing.
Mr O'Connor: It reflects the community's needs.
Mrs Sullivan: But that shadow of decentralization which is purported to be provided here is one that I think people will see through. I think there are going to be significant repercussions with respect to that entire area as we take this bill into the public hearing process.
A very serious concern about this bill, and one that I hope to spend some time on in the public hearing process, is the concern that the aging population and the disabled population, who are the target population for this bill, may suffer from very complex medical problems for which primary care and specialist medical treatments are required and that most people who need the long-term care will need more than the personal care, the homemaking care, the social services and the in-home nursing care that this bill will provide.
I am very concerned that this structure and this model will in fact hinder rather than enhance appropriate medical assessments and the integration of appropriate medical care into a personal care plan. I hope and expect to spend a lot of time with respect to that particular issue in the public hearings process.
Another aspect of that, which perhaps we will receive more clarification on as we go through the public hearings process, is that there appears not to be an integration contemplated through services that may be provided in existing organizations, such as hospitals, that now appear to be required to be a component of the MSA service provision.
Palliative care is not on the required list of services. Although one of the members indicated that it would be covered, it is not on the list. But let me give you an example of an initiative, once again from my own community, where a hospital, the Joseph Brant Memorial Hospital in Burlington, has initiated a rehabilitation project for stroke patients and for others, largely a seniors population, who require therapeutic services and rehabilitative services post-surgery.
The question is, where is the fit between those existing, high-quality, available, popular, well-accessed programs which are offered by hospitals or by other agencies and what will now be included as a compulsory component of the operations of the multiservice agency?
There are also questions, and I hope that we will hear about some of these from the parliamentary assistant, with respect to the role of the MSA, by example, in accessing the assistive devices program, in accessing the respiratory therapy programs and whether that integration of services between acute and home care requirements has been fully contemplated.
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The policy of the government has been to limit purchases of home care services to 10% of the market which will be allowed for private sector providers. My reading of this bill is that the new 20% limit of purchases which is included in this bill applies to purchases of all services that the MSA does not provide itself. We want clarification, and very early clarification, of whether that 10% rule has in fact changed.
My own conclusion is that the government will not be able to provide even the first limited MSA start-up with that 10% government policy limiting private sector participation. It simply will not be able to afford those systems. The 20% limit of services that the MSA doesn't provide itself may in fact, operationally, become for services such as attendant care and other services which are not included in the mandatory basket but which may represent an essential component of a personal care plan.
For reasons of what I think are patient choice, of added value from competition among services, from the point of view of ensuring there is a full range of services available within a community on a 24-hour basis, the private sector component of home care, and of nursing services as well, has served us well in the past. We certainly want clarification as to whether the minister intends to continue to limit the private sector provider to 10% of the market even over the original four years of the legislation, and whether that 20% is a real screen, which I believe it is.
The other aspect is that the bill enables the ministry itself to set up a service which may compete directly with either a volunteer agency or another private sector service which may exist in a community. I think that's highly problematic, and you can be assured that that issue will be covered in our public hearings.
The issue of patient choice has been addressed particularly by those agencies and organizations which provide services that reflect either a unique cultural or religious or language perspective -- or disability, frankly. We certainly in Bill 101 heard very strongly from Reverend Bob Rumball, the head of the very successful programming component for the deaf in Toronto, that there may well be an opportunity, or they hope there might an opportunity, that they may serve as an MSA.
The Catholic Health Association of Ontario has written. They say, first of all, that they believe the pace of development of MSAs as required by this legislation will result in an even greater bureaucracy for those needing advice, referrals or placement, and also that they will restrict, if not eliminate, the degree of choice of services that consumers have enjoyed in the past.
In their multiservice agency fact sheet, they ask the question, "Is consumer choice and preference the cornerstone of our new system?" Their answer is as follows: "Consumers under the new system will have less choice of services and will likely be given their preference less frequently. Mergers of many community-based agencies to fulfil the MSA design will create one mammoth agency rather than many from which to choose services.
"A person will be refused placement in an institutional environment despite their preference for that placement if community-based services are available and deemed to meet the individual's need. A person will not necessarily be granted admission to their preferred institution, but may be placed in another home and then added to a further waiting list creating unnecessary disruption for the individual, their family and the facilities involved.
"There may be less homes to choose from in the event that homes are forced to close or voluntarily do so, and acutely ill persons" -- they use the example of AIDS patients -- "may be forced to accept admission into a home for the aged or nursing home if the appropriate level of acute care can't be provided in the community."
The question of consumer choice that meets language, other than French -- I must say the French language is covered in the bill appropriately -- and the question of cultural and religious heritage, it seems to me are not met in this bill and the government will pretend that in fact those issues are met through the composition of the board which governs the MSA. That's not on. It doesn't follow. It doesn't compute, as my children would say.
I've spoken about the funding formulae for the long-term care facilities.
I hope that we will hear and have a precise and very complete exposition from the parliamentary assistant or the minister on precisely how these MSAs will be funded, on what basis they will be granted the dollars to operate their systems through the district health councils, and what other initiatives, including contributions from municipalities, will be expected to ensure that they are able to deliver the services that the government has not only promised but will be demanding through this bill.
Those demands are quite something. Many of them exist now, but these are the required basket of services that each MSA has to provide. In community support, we see meal services, transportation services, care giver support services, adult day programs, home maintenance and repair service, friendly visiting, social and recreation and so on.
It doesn't indicate, if you read this bill, that those people who are now providing those services will have to integrate into the multiservice agency. In fact, the entire client account will move to the multiservice agency, whether or not the patient and resident wants themselves to move.
The homemaking services -- the house cleaning, the laundry, the ironing, the mending and so on -- that the woman wrote so eloquently to Helen Henderson about will be transferred into the MSA, once again, whether the client wants to go in that direction or whether the client doesn't.
In those instances, as well, for the community support services and the homemaking services, a payment which may be required from the consumer will be established through the regulations, and once again, we want to see full information on the level of payment that's required and what the government's expectations are with respect to the revenue that will be raised.
We know that in Bill 101, the nursing home/home for the aged bill, the government predicted that it would raise $150 million from copayments under that bill. The government hadn't done its homework. The government hadn't measured the demographics. The government hadn't understood or analysed the data with respect to the income of people who are over 65, and in fact the government ended up with a shortfall into the many tens of millions of dollars. In the meantime, the residents of those homes were slapped with a 38% increase, which they were required to deal with on not only a quick basis but virtually without any notice of the new requirements.
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In the personal support services, where no payments will be required, the personal hygiene and routine personal activities of living, assisting a person who can't dress themselves or who can't bathe themselves, will be provided as part of the care delivery through the MSA. Many of those services are provided well to the needed level and to the quality that the consumers now are quite satisfied with. Professional services, those nursing services, occupational therapy and physiotherapy, social work and speech language pathology once again will be required in the basket of services that the MSA provides.
The difficulty here once again is an overlap with many of the services which are provided through other vehicles such as hospitals and the integration of those services into the existing programs, which in fact may well perform at a higher level and with higher quality assurance than what this system will require.
The last point that I want to raise is with respect to the quality issue. If a person is a resident in a hospital or in a nursing home, the person can be assured that those facilities and those institutions are accredited by an appropriate accrediting body and that the quality assurance programs are in place and that there is ongoing and continuous review.
For community services, there is no similar accreditation program available, and it's my view and the view of many of the people who are demanding and who expect quality services that those evaluative mechanisms be put in place, that accreditation programs be developed and that people can be assured that those quality issues are dealt with. Those mechanisms are not in place now and it's a fundamental weakness in ensuring that our services are delivered, not only with the abundance that they ought to be but also with the quality that they ought to be.
We're going to have six or seven weeks on the road in public hearings, I'm told, during the summer. I think this will not be an easy bill for the government to deal with, although, once again, the principles are ones that we certainly support. The principles of long-term care reform we certainly support. This bill has many gaps and problems, and we will certainly be demanding a number of major amendments to it.
Mr Wessenger: I don't believe I can deal with all the issues the member has raised in the short time frame, but just to deal with a few of the issues, first of all, I'd like to reassure the member that palliative care will be under the jurisdiction of MSAs.
Secondly, with respect to the question of other health services, it's the responsibility of the MSA to refer and to provide information with respect to those services mentioned by the member.
Thirdly, with respect to the question of the 20%, the 20% rule basically restricts the purchase of services from other agencies. That includes both the profit and non-profit sectors and there's no requirement for that 20% to be divided in any particular ratio. So her referral to the 10% rule, that's no longer applicable with respect to the purchasing of services by the MSA. I might just also add that of course during the transition period, MSAs will have the flexibility, on the minister's discretion, to exceed the 20% rule.
Mrs Sullivan: Four years.
Mr Wessenger: For the four-year period, that's right.
With respect to the whole question of investment in long-term care, I'd just like to point out that the government has in fact been investing, first of all, a greater percentage of health dollars in long-term care and also more in absolute dollars. Over the last three years, the increase in spending in the long-term care sector has increased by 60%.
Mrs Marland: I want to say again, long-term care reform is needed; that's not in question here. But what is in question are some parts of this bill that really have a great deal of concern for me.
It sounds wonderful, this one-stop shopping, and as the parliamentary assistant said, "One phone call gives a basket of services." The words sound great, but the concern is that when the person, the client, the patient or the family member makes that one-stop call, so-called, it's not going to work unless the stores are stocked. "One-stop shopping" are words, and my concern is that I can't see where some sections of this bill are going to fill the voids that exist today.
Yes, people can be looked after at home, but we're not helping the people who are at home now. We've got all kinds of waiting lists. I can give you an example in my own riding where two people, a husband and wife, both over 70, both veterans of the Second World War, were told when he came home with his colostomy that he could look after himself.
His wife has arthritic hands. The non-profit agency looked at her and said: "Well, of course you can do it. You just have to get used to changing the colostomy with your arthritic hands," and then looked at the patient -- as I say, both of them were Second World War veterans -- and said, "If you can't do it, Mr So-and-so" -- I'm not going to give his name in the House -- "just stand in front of a mirror, and if that doesn't work, ask a neighbour." I'm saying that that kind of care is not acceptable to those of us in this caucus.
Mr Gary Malkowski (York East): I wish to respond to the member for Halton Centre. In her comments she mentioned the implementation issue and she had concerns regarding implementation, although not one word was mentioned by her on solutions in how one might implement improvements in implementation to MSAs. We haven't heard from her on that point.
I'd also like to talk a little bit about the funding for communities. She made allegations that she didn't think the money would flow, when in point of fact in the 1990-91 year, $557 million was earmarked for base funding, with an increase in 1994-95 to $878 million of community funding. That is a record increase of $329 million, and that truly shows a measure of our commitment in providing funds to the MSAs.
I also would wish to tell you I'm very proud of my riding of York East. We have one of the largest populations of senior citizens and we've done a wonderful job. We have wonderful services to those people and we've got wonderful community-based services looking after many of these people and we have Community Care East York, where they are working together to bring people together to an overall, concerted, coordinated effort.
The point of course is to reduce the duplication of services that may be there and also to reduce some of the administrative costs. As seniors, it's very easy for them to become muddled and confused as to where they should go for this, that or some other service. I think East York is providing a fairly good model, a real leadership role, of pulling people together in cooperation. I think it's a wonderful elementary first step, and I would challenge others to take a look at that implementation model.
To the member for Halton Centre, we have to think carefully through the facts. Let's not be partisan in this.
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Mr Steven Offer (Mississauga North): In the time permitted, I would first like to compliment the member for Halton Centre for her analysis of the legislation. I think it is clear that we all recognize there is the need for long-term care reform. The question is, in principle and in substance is this the model that we wish to adopt?
I recognize that this particular piece of legislation is going to be going to committee, but I certainly have some concerns with some of the aspects of the proposal and the legislation as put forward by the government. I am concerned that under the guise of decentralization the bill will further centralize powers within the Ministry of Health. I am concerned that under the area of community participation the bill not only defines services that must be universally provided across Ontario but the shape of the organization that is to provide them, and that shape must be identical in every area of the province. I am concerned about the creation of, far from a decentralization, a centralization. I'm concerned about how community participation, as defined in the legislation, really works in fact.
I am extremely concerned that this bill may very well eliminate existing volunteer agencies from service provision. I believe that under a reading of this legislation in four years we will see the demise of the VON, St Elizabeth's, CNIB, Meals on Wheels, Senior Link, Red Cross homemaking and other agencies whose volunteer corps provide not only support and fund-raising for their work but also the delivery of patient services. I think that as we take a very close look at this legislation we are going to see that these organizations, which in many cases are so crucial to each one of our communities, may be put out within four years if this bill in this form is passed.
Mrs Sullivan: I want to thank the members who've responded to the remarks that I put forward and particularly respond to the remarks of the member for York East, who asks why I have not put forward alternate solutions. I suggest to you, Madam Speaker, and to the House that in fact our proposals were on the table five years ago. We were ready to move, and this government chose not to move in the intervening years. We are now finally having a bill with respect to the community agencies and the delivery of community-based care.
With respect to that same issue of what was on the table then and when it was finally delivered, I think it's scandalous that the parliamentary assistant today announced that the pilot for direct funding was finally made public last Friday. That was promised four years ago by this government. It was ready to go before the last government left office.
The member speaks about reducing duplication. You don't reduce duplication by creating new bureaucracies, and that's what this bill does. You don't reduce duplication by decimating your volunteer services in the community.
The public hearings will help us shape our final amendments that we will put forward for this bill. I can assure you that we enter the debate on this bill in a positive way, but we don't think this model is the answer.
Mr Jackson: As the advocate responsible for seniors in the PC caucus, I'm pleased to be able to participate in this debate. I appreciate that the hour is very late for the members of the House. We have been allocated a certain specified amount of time, but we are certainly not going to take all that time that we've been allotted this evening. But I do feel that in order to put on the record some of the concerns of the Progressive Conservative caucus with respect to this bill we do need a bit of time to put those points down on the record. We will try to be as brief and succinct as possible in respect to the hour.
However, the issue is of enormous importance, and because it's of enormous importance it should not be treated lightly in debate nor in brief terms simply because of the pressures on the House time in order for all of us to get out of here by the 23rd of this month.
I am pleased that the bill will be going to public hearings, because I had been informed at one point that there was consideration that it might not go to public hearings. The reason the public hearings are rather important is because there have been some substantive changes and shifts in policy direction that are manifest in Bill 173 which the public has been studying and working cooperatively towards for the last two years, and now at the 11th hour some very fundamental issues within this bill were changed.
I'd like to begin with some of the comments of my colleague from my region of Halton but not my colleague in caucus, the member for Halton Centre, the Health critic for the Liberal Party. She raised some interesting points, and I want to reflect, if I can for a moment, on the fact that long-term care has been discussed in this Legislature for eight and a half years. That's eight and a half years to get us to this evening.
Yet contained in Bill 173 is a framework which will take another four years before we've completed and fully implemented the process. There will be progress made 16 months from now, we're led to believe, but the full implementation of the multiservice agencies in the vision contained in long-term care in this bill indicates it could be as long as four years away. That means, by the time it's completed, we'll have taken 12 years as a Legislature to deal with this issue.
Hon Evelyn Gigantes (Minister of Housing): The 11th hour.
Mr Jackson: The member for Ottawa Centre, the Minister of Housing, is concerned about it being the 11th hour. If you don't wish to be here to talk about --
Hon Ms Gigantes: I'm not complaining about the time. You were complaining about the 11th hour. I'm not complaining about the 11th hour.
Mr Jackson: I'm going to get to the Minister of Housing about what you've done or haven't done for seniors. If you listen to the debate, you might find out something about the seniors in your own riding.
The bottom line is that the vision contained in long-term care has to do with deinstitutionalization. It speaks to a vision of service delivery in this province which says that the given service should be integrated within the community setting and, where possible, should be provided in a home setting.
Ontario, it strikes me, is a jurisdiction which has pioneered the concept of deinstitutionalization. As a provincial jurisdiction, we should have learned a lot about the process of deinstitutionalization. We should know from a policy perspective how costly it is and what the difficulties associated with it are. So when we take disabled people out of institutions and we offer them community living, and we did that over a decade ago, and began that process, what did we learn from it?
What we learned is that it's an extremely expensive and controversial process, and it requires the creation, development and coordination of a whole series of support services that must be in place. We found that these services are provided at a greater cost to the taxpayer, and ultimately the consumer, than were the original costs in the institution. We have several models that have confirmed that. Yet we're still going to proceed with the deinstitutionalized model of community-based health support systems as it comes to long-term care and support for seniors in their homes.
The reason I want to reflect on that for a moment is because there are some serious flaws in the way this service will be delivered in the province, and it should be reflected upon before we go into our public consultation process with this specific bill.
There are three phases to long-term care, and there are always going to be three phases to long-term care. The Liberals commenced phase 1. Phase 1 was obviously the reduction of the number of institutional beds. In fact, and it's quite well documented, instead of creating the infrastructure in the community, the Liberal government of the day started at the wrong end of the equation. They started cutting the number of chronic care beds and a whole series of beds for elderly citizens who required attention, service and support.
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I remember, because the would-be leader, actually the should-be leader, of the Liberal Party from Huron-Bruce made a major announcement that I was present for, and several members of the House on the governing side were in opposition with me at the time. The Liberal government of David Peterson announced 4,000 new chronic care beds and 4,000 new acute care beds; the largest, single announcement of hospital-bed expansion in the history of this province and in the history of Canada -- the largest, single, one-day announcement of new beds.
It was a wonderful setup on the part of the government, because soon thereafter they began reducing the number of beds in this province. Whether the civil service was responsible for this bold vision, but the Liberals were actually implementing it. What we saw were reductions in the number of beds for homes for the aged, no new expansion of nursing home beds. We saw chronic care hospital beds --
Mr Offer: Tell about Tory times.
Mr Jackson: These are all facts, because you can't tell the public of Ontario that you're going to reduce the number of beds available to you when you're sick in an institution like a nursing home, a home for the aged or a hospital bed in a chronic care hospital and then find out you don't have the resultant coterminous services in the community. What you've done is remove health care from a large group of our population.
I remind members of this House, we're talking about 12% of the Ontario population, 1.2 million senior citizens over the age of 65. We're talking thousands of beds that have been reduced. Since the Liberals set us up with this promise of more beds, we now have fewer beds and we're still losing those beds.
The second thing I want to put in perspective -- because the comments earlier from the Liberal Party were more like a lecture on how, all of a sudden, they think what the government's doing is wrong. What the government's doing isn't all that wrong. We want to try and fix what's wrong with the bill, but the fundamental approach has to be fixed because it's built on a premise that we're going to reduce the number of beds in our hospitals and we better have the services in our community.
The second thing I was concerned about that the Liberals did is they made their first intervention -- the very first dollars committed in Ontario for long-term care was an announcement by the Liberal minister, "We're going to put $75 million into the initial planning and development of long-term care." Then quietly the Liberal Minister of Health walked away and a reporter asked, "Where are you going to get the money from?" They said: "We're going to shortfall the chronic care hospitals. Don't ask me any questions about it."
Where did they get the money? They took it from chronic care hospitals. There's only a handful of them in this province, but they're highly specialized, highly equipped and very efficient methods of providing services for seniors, and these are people who cannot simply return to the community for service. These are people with severe, chronic health problems.
But the government said, "We're going to take $75 million out of that system to study and develop the plan for long-term care." Why that's important for the record is that the very first people who were repaid with their long-term care promise were the seniors who had to make the sacrifice in order to get the policy of long-term care that they were promised. They were promised by politicians of all three political parties and, frankly, we've oversold the concept of long-term care and we're offering far too much in terms of rhetoric and not nearly enough in terms of direct-access services.
So here we go. We now put a gun to the chronic care hospitals in this province and say: "Reclassify your beds so we can reduce even further." We can get the numbers and we will have the numbers of the reductions in the beds, and it's been a dramatic reduction.
Anyway, I've tried to make my point that we went around it backwards. We cut down the number of beds. Our seniors are aging, they're living longer. Technology is keeping them alive longer. Families are travelling greater distances to find employment and the supports aren't there. This network of supports should have been in place first; instead, we just cut the number of beds. Every member in this Legislature can point to a facility in or near their riding which has seen a reduction in the beds that are utilized by seniors predominantly: nursing home, chronic care bed in a hospital, a home for the aged or a chronic care hospital.
The next phase of long-term care was Bill 101. This was supposed to be the resolution of the dichotomy between the Ministry of Community and Social Services and the Ministry of Health, because we had homes for the aged under one ministry and nursing homes under the other. We also had a lawsuit in this province, and it was underscored by a campaign entitled Martha and Mary, the difference between these two women in the two facilities and the gap in funding and the discrimination to these two senior citizens depending on which facility they were in in Ontario. I remember Bob Nixon, the Treasurer, saying, "If there's anything I'll do while I'm in power, I want to resolve this fight between Comsoc and Health over these two types of facilities."
The vision for long-term care was that we get it all into one ministry and get it nicely and properly put into one ministry. Some provinces in Canada chose Comsoc and the Liberal and the NDP government both chose Comsoc as the lead ministry, but without impugning the competence of the minister of the day, the decision was made by the Premier to remove it from that minister and to give it to the Health minister of the day who was more than capable of dealing with the subject. But now it's in Health and it shouldn't have been in Health, and it's not in Health in most jurisdictions in Canada.
There are some problems with that, and those problems will surface again in the future when we start dealing with the funding, because within the context of Comsoc, we now have an opportunity to pull additional revenues from the municipal sector, which is an option that's easy when you're dealing with Comsoc funding and far more difficult when you're dealing with Health funding. This is a policy challenge for the government of the day because long-term care is rooted in particular in the Health portfolio with Health models of delivery when in fact I know the government's original vision was that it be more rooted in a Comsoc municipal cooperation model.
There are lots of problems with funding here, and I'll get to those in a moment. I wanted to put in context that it was a significant policy shift to move it out of Comsoc into Health, and that has created some difficulties. It has created some difficulties because we now are going through the DHCs to develop our multiservices agencies and so on and so forth.
Bill 101, phase 2 of long-term care, also was going to try and help the fact that we had something like 35 or 36 nursing homes that were in receivership in this province, and we had to find some money to help them or they were going to start closing their doors. This is a serious problem for the government because under the law you can't close a nursing home. The province has to come in and take it over and run it.
The second promise that politicians made to the senior citizens, the people who needed chronic care support, long-term care support, was we were going to inject and today there are figures of $650 million. I think the Liberals said, "We'll put $550 million in it," and then when the NDP were elected they said: "We'll do better than that. We'll put $750 million into it."
What they didn't tell senior citizens was that when this government passed Bill 101, almost a year ago -- sorry, it came into effect a year ago -- they pulled $150 million, not from the revenue, not from savings from the Treasurer who passed it on to the Minister of Health to spend as new money; it was on increased user fees or -- what are they called? -- copayments that people pay. Basically, it's pay-as-you-go for these people and $150 million was increased annualized revenue on one day in this province.
We're about to go to public hearings whereupon the government of the day and the staff from the various ministries affected will come before public hearings and respond to questions. I had the privilege of participating in all the public hearings on Bill 101 in a variety of cities across this province, and I had occasion to ask several questions. I'm here to say that there were assurances given at the time before the bill was passed as to how this would affect the income levels of seniors and the service delivery model that don't square with what is happening today after the bill was passed.
I want to serve notice to the government that you can't do that two or three times on the same bill. There are going to be tougher public hearings. When we go to public hearings on Bill 173, the public's going to say, "You were in our town a year and a half ago. You said that my fees weren't going to go up. You said you wouldn't take my husband's salary calculation, which has impoverished me as the surviving senior woman trying to survive at home independently. You promised this wouldn't happen, and in fact that's what's happened."
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So there will be tougher scrutiny in these public hearings. There will be seniors coming forward who aren't just going to state openly and simplistically, "We support long-term care." There will be seniors coming who are going to ask legitimate questions: "Why did my copayment go up by $12,000 last year? Why would my husband's income be calculated, as the higher income, to determine his nursing home care costs, instead of our combined income, which is the fair and reasonable thing to do in this province?"
If the government's going to make any funding promises about this bill, their track record from phase 2, Bill 101, certainly left a very bad taste in the mouths of many thousands of seniors who currently find their home in a nursing home or a home for the aged.
Now, it has been simplistic politics for all of us in the House to say: "We want you to age in place. We want you to receive your services at home." But nowhere has the government looked and nowhere in this legislation are we looking at the total impact on seniors who now are being told: "You won't be able to get the service in a hospital. You will get the service at home, but you have to live in an affordable home."
In an interchange earlier, the Minister of Housing and I had occasion to comment, but I'm very pleased that she's here tonight because I know that being able to stay in your home is as important as finding a home. Many seniors have concerns. What I'm getting a lot of mail about is, "I can't afford to stay in my home in order to receive these services anyway."
Remember, the total number of senior citizens is rising and the total number of beds available in institutional settings is dropping, so seniors are becoming more mobile. They're having to get out of their home and move into a condominium, and then they find they can't afford that. They've got to move out of that and go into an apartment, and a smaller apartment at that.
Affordability problems are surfacing at an alarming rate. Hydro's gone up by 10%. The government adjusted very dramatically the senior property tax grant that the Tories brought in because seniors have been paying school board taxes all their lives and by the time they're 65, you'd think they deserve and they should get a little relief from that. That has been taken away from them.
Again I have to say that we better start discussing the issue of whether a senior can stay in the home in order to receive these services, whether that be in an apartment building in its affordability or whether it be in a residence with rising municipal property taxes.
Now I want to come to phase 3: what Bill 173 promises. First of all, I really don't want to say that the bill is a great bill in its current form and I don't want to say that it's a bad bill and shouldn't be passed. We are committed as a province to finishing and completing long-term care. What's at stake here in this debate and in the public hearings is, are we doing it the right way and the best way? I believe some minor adjustments should be made to this bill, and I hope the public consultation will help in that pursuit. But there are some concerns. These are not fatal flaws in this bill, but these are serious concerns.
The whole issue about the multiservice agencies: It was only two weeks ago that the government announced that the multiservice agencies, this coordinating body that will act as a coordinator of all these services for seniors, from Meals on Wheels to Red Cross homemakers, whatever -- only two weeks ago the government made a fundamental change in direction by announcing that: "Look, we're no longer going to act as brokers. These are actual service delivers."
That is a major shift, and it has caused a rather bitter, a rather angry and an adverse reaction from a lot of people out in the community. That usually means that people had better sit down with them very quickly and make sure their fears are not warranted. But the truth be known that that fundamental shift has occurred.
The second surprise to hit the process of this bill was when the government announced: "I know you've been studying it for a year and a half about developing multiservice agencies through these district health councils. I know you've been working on that and maybe progress has been slow, but we're going to have to get some temporary sites up and running real quick. In spite of what work you've been doing, we're going to receive independent proposals in given communities to proceed with these multiservice agencies."
As I said in the House last week, in some communities that might work. I understand from reliable sources that in the Sudbury-Manitoulin area they've got their act together. They know what they want. There's a tremendous amount of consensus. They would be willing to move fairly quickly.
But my region of Halton is comprised of five separate municipalities. We know the community of Georgetown has been able to back-end a proposal into the ministry's office, and they're looking at it seriously. It's not fair, if you've taken a year and a half to develop a multiservice agency through consultation, to have somebody run in the back door with a proposal. You've got this little community of Georgetown in Halton, this little community of Acton, another community of Milton. What if we decide to have a regional model for an MSA? If Georgetown, the smallest of all these communities, has its own MSA, how are we going to get Acton and Milton to the table to buy into a regional model? They're going to sit there and demand they get the same model Georgetown got.
This process isn't about parochialism, this process is about the most effective delivery mechanism. On the one hand I'd like the minister to get on with the business of getting the MSAs up and running, but the solution isn't to grab three or four or five or six temporary locations -- and I'm sorry, but I'll impute motive -- if there's an election around the corner, simply so we can say: "Look what we did. Look what we got up and running." There are lots of examples, and I don't need to take any more time demonstrating a couple of examples of how we end up spending more money in order to get ready for an election. I don't need to remind everybody. We've been eight years getting this far; let's finish it right.
Another concern has been the one about the volunteer-based supports. I think it was unfair for the member for Mississauga North to suggest this is going to wipe out Meals on Wheels and others; he shared with us an extensive list. I think that was an unfair statement to make, because in no way is this going to threaten all those agencies. It's going to force them to amalgamate, to coordinate, to lose part of their market share in client service; it will do several things, but it will not wipe them out.
I raised with one of the members opposite, the member for Durham-York -- and in all fairness, I've asked that during the public hearings we find out what happened in Quebec. There was some negative fallout. You don't just take, as the minister herself said, 1,200 agencies -- there are going to be several agencies displaced. They won't be needed. Their administrator won't be needed; their communications officer won't be needed.
I'm going to tell you, as a Conservative, we cannot say on the one hand -- take, for example, what we would do in our school system. The services in the classroom we'd protect. What we are saying is that we've got too many bureaucrats running our school systems. To be consistent, we should be looking at this and saying, "Where people provide services to seniors, that's the most important aspect," but not having so many agencies with so many executive directors and so many people managing the books and each one having a legal counsel and each one having its own board room and its own parking lot. There is real merit in saying that more of those dollars should go to direct-access services. For the record, Conservatives would be consistent to support a model which says, let's spend a little less on administration and a little more on direct-access service.
Mr Jim Wiseman (Durham West): You won't get an argument from this side.
Mr Jackson: Well, no. But we have to accept that there is going to be some displacement of personnel here.
The other area of major displacement of personnel is in the area of the commercial home care sector, which has grown to perform large services in this province, and it has grown primarily because there's been demand; it doesn't operate in a vacuum. People are paying for the services, regions are acquiring the services and paying for them, because there's demand and because the public sector can't fill that demand quickly enough.
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Several figures have been floating around about the number of these employees who are going to be fired, let go, lose their jobs. The only time I've spoken directly on that subject in this House is to ask, what are we doing with these women? They're almost 98% women workers and they're not in a high-paying job category. Whether they're in the commercial sector or the public sector, these are not high-paying jobs, so they are very worried about their future, and this bill does nothing to protect it.
This bill speaks extensively about phasing out these jobs, so one could cynically say this a bill about killing jobs, because there's no direct promise of replacing them. But we're asking, why are we not trying to protect these women workers? Why are we not trying to look at protection so they get first right of hiring for the new agencies that'll be created? This is the same thing that happened when the government refused to provide the support for day care workers in commercial day care centres and cast them adrift without any support or any bridging in terms of their benefits or in terms of their seniority.
I guess I'm supposed to stand here and argue for these private sector companies. I'm up here today arguing that we should protect these women workers because they're being discriminated against by this legislation. We should try and do something to correct that because those women workers deserve better. If the government's going to take away their jobs, we have a moral responsibility in that sense to make sure we find them the work they enjoy, that they're qualified to do and that they want to continue to do, and my colleagues throughout the public hearings will discuss that even more fully.
The other issue around the commercial sector, of course, is that you're eliminating consumer choice, and we have to be careful when we do that to any citizen in society. One-window shopping also means the state is telling you that you get one shot for a service, and if you don't accept it you're not getting another service. Right now we have a certain degree of flexibility because people have choices, and unless the civil service is going to provide services late at night or on weekends, services that are not currently being offered by most non-profit agencies in this province for home care, then we are doing a further disservice to seniors by saying we're going to eliminate the sector or reduce dramatically access to the sector which does work those flexible hours so that you do receive the services at home when you need them. That is a consumer choice issue.
I remember when the government went around doing the public meetings on long-term care. It tried to mask its reason for eliminating the private sector based on the strength of one question, and the one question was, "Do you believe people should make profit from health care for seniors?" Well, 80% of the public's going to put up their hand and say, "No, not at all." But if you ask the question, "Your current commercial care worker is providing you a choice and access; would you like that to continue?" you'd also get a 90% yes response.
The government's entitled to its ideological view that everybody who tries to earn a profit is evil. They're entitled to that view, but if they would see this as a consumer issue, consumers deserve rights to choices, and seniors in particular have come to see choice as one of their fundamental freedoms in society. Again, this bill limits that dramatically and we're not providing guaranteed access to services. The proof in the pudding is if you check the wording of the bill of rights in this bill, promised for the people, and having your assessed needs met is not promised in this legislation. You can't make a cause-and-effect link between the right of a citizen to say, "This is what I need," and the state reserving the right to say, "That may be, but we're going to say we just don't have enough money or we don't have the service, so you won't be getting it."
The bill goes on to say it will be against the law to go and acquire these services privately or pay, and that's wrong too. That's why some people go to the United States for some of their operations, why the rich go to the United States for their operations, because in this province we make those decisions in far too many areas in health care; the state will determine what operations will be paid for and by whom and for whom.
I've mentioned the volunteer-base problems, I've mentioned that MSAs would have control over consumer choices, the private home care sector; finally, the funding commitment: The least amount of information we're getting about Bill 173 is very specific numbers of dollar commitments.
I was in the lockup for the Treasurer's budget. If you know the process, and most of you do if you've ever been in a lockup, you get the overall picture of the budget and there's security so you can't leave the room, and a string of ministry officials come in rotation and respond to questions. When the Health team came to visit the Conservative caucus in the budget lockup, the first question was, how much new money is in this year's budget for long-term care reform? The answer was none.
When the minister promises that millions and millions of dollars of moneys will be pledged, that's the truth. She can pledge billions of dollars. The fundamental question is, how much money has been spent and will be spent? What I find interesting is, in all the minister's announcements, she's been careful not to mention what was spent in the 1993-94 budget year, because those dollars are not increasing at the rate of her political rhetoric on how much funding the commitment is. In fact her response in the House was, "It's gone up 5%."
Well, you can't remove multimillions of dollars from the institutional sector and reduce those beds and then simply increase by 5% the moneys that are going to long-term care reform and the MSAs, because a disproportionate amount of it is going into administration, increases in staff of civil servants and things of that nature. If that's your 5%, Minister, we're in real trouble.
The public has some very valid, serious concerns about where the money is going to come from for this. Regardless of who's in government, we're going to set up an expectation and an infrastructure once Bill 173 is passed. If we don't have the funding in place for those services, we are going to spend millions of dollars creating a new level of bureaucracy.
We will say that this is a volunteer board, and it is. All the MSAs will be run by volunteer boards, they'll have their own liability and so on and so forth, but they will be spending millions of dollars to set up their offices, to set up their computers, to set up their networking, to set up their public relations department, all of that. If that's all we're going to create and not allow the funding, then we might have been better off not proceeding down this path at all. I caution the government that unless you can tell the citizens of this province how many dollars you're going to commit, in fact we will have added to the bureaucracy.
I will close with a concern that was shared with me by Ron Van Horne, Ontario's first seniors minister. He was responsible for doing the developmental work on the first known pilot projects on one-stop access. The Liberal government had to take a step backwards from proceeding with long-term care because the initial reports based on the pilot projects were running in the multimillion-dollar figure. Wisely, the Liberals had to look at the cost implications of proceeding down this route. They found out that there were huge, horrifically high expenditures associated with long-term care, so it made them a little more tentative. They proceeded a little more slowly. They had to reduce more beds to balance the cost of long-term care. Those reports still exist.
My newest colleague in the Legislature, from Victoria-Haliburton, actually chaired one of those pilot projects in his jurisdiction and will be speaking to that issue, because they came to the same conclusion: huge expenditures involved here.
So we ask the government, please, when you're doing the public hearings be prepared to discuss in real terms what the costs of the administrative infrastructure will be when we as politicians are going to be out telling the public how wonderful long-term care will be because of your direct access to service. We have a moral responsibility to ensure that those dollars are spent on service to our senior citizens who request the services.
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In summary, I believe in the concept of long-term care, but we have to be a little more frank and a little more honest with the public about how it really works. They gave up their access, in many ways, to institutional beds and we've put a huge pressure on their ability to stay in their home and to have additional community-based supports in order for them to live out their senior years, if there are any medical problems or complications, with dignity and with comfort. We owe that to our senior citizens who made the most substantive sacrifices in our society in their lifetime. If we can't give that to them, then I say we'd better not proceed with long-term care. But if we truly believe we can do that for our seniors, then by all means let's proceed boldly with this initiative and let's proceed on their behalf.
Mr Malkowski: I would like to respond to the member for Burlington South by reminding him that during the time of the Conservative government, a 42-year regime, there were many large institutions that seniors and disabled people were simply shuffled into and left there. Now we're finally bringing people out. Our government is cleaning up a real mess. It's a very difficult procedure, trying to make the necessary changes.
I would like to remind him that there was a lot of talk during the Conservative government's regime. Where was the commitment then and where were you at that time? Now is definitely the time. Our government has made the commitment that's needed to deinstitutionalize people and give people, both seniors and the disabled community, the options and the choices to make people as independent as possible. I wonder whether he can admit to the sins of the past government, that there were 42 years of a real mess, and that's on the record. I don't know whether a public apology can be issued. We certainly would be happy to offer forgiveness for those past sins.
Mrs Marland: It's only fair to advise the member for York East that in 42 years the Conservatives never shuffled the disabled or seniors off into places that were not going to help them. I think that's an unfortunate reference.
I do think, however, that it is wrong to make promises and not fulfil them. The concern I have about this legislation in some parts is that it will raise the expectations of the people who need these services -- not all seniors, but people who are coming home from hospital, people who are trying to stay out of hospital, with supplementary help, in their home.
What really concerns me is when I look at the list of groups that are concerned about this legislation that work in that field every single day, that know what a multiservice agency will mean. It will mean that it will be totally impersonal. There will be a phone call. If they're fortunate, there will be an allocation of service. But I have met with my Victorian Order of Nurses, and I see they're included here on a list of organizations, including lists of facilities in Toronto, like the Villa Colombo Homes for the Aged, that are all part of the agencies that do provide services now. They know their individual clients, they know their individual seniors and their families and they meet those needs on a very personal basis, because the person who goes into their home is the same person who goes in the next day and the next week and the next month, because that's the way they work. That is the goal particularly of the private care provider, not always the non-profit provider.
Hon Ms Gigantes: Earlier in his comments the speaker from Burlington South had gotten quite agitated because I had called out to him, in a friendly way, while he was speaking about his objections to the 11th hour. I've always felt the 11th hour was a grand hour, myself. He thought I was referring to the time and that I was trying to suggest he should hurry up. That was not the case.
I just point out to the member for Burlington South that I was very interested in his comments about pay equity as it affected people who are working in the field of providing services -- support services, health services -- for people who have chronic health problems under the long-term care project.
I was interested to note his concerns, particularly as this government, unlike any other government to my knowledge -- and I've spent some time working on this issue both as a member of this Legislature and outside this Legislature -- has committed nearly $450 million this year to provide pay equity for people who are providing public sector services in this province, among them people working in the long-term care field. If I search my memory, I can't recollect that the member for Burlington South actually supported our pay equity measures.
Mr Chris Hodgson (Victoria-Haliburton): I'd just like to make a few comments about my esteemed colleague from Burlington South, our advocate for seniors in the PC caucus.
Hon Floyd Laughren (Minister of Finance): Esteem, esteem, esteem?
Mr Hodgson: The Minister of Finance is here tonight. I think he would have taken great interest in one of the comments that my colleague from Burlington South mentioned, and that is about the coordination of economic policy with social policy. He mentioned about the focus being that people want to live in their homes longer and the downloading on to municipal property taxes in the form of education grants being cut, road grants being cut, the cost of hydro skyrocketing.
Many seniors on fixed incomes can't afford to live in their houses any longer and therefore will be forced into government housing. One hand of the government's working against the other hand, trying to encourage people to have a healthy community by living in their homes longer. I thank the member for Burlington South for reminding the House of that.
The Acting Speaker (Mr Noble Villeneuve): This completes questions and/or comments. The honourable member for Burlington South has two minutes in response.
Mr Jackson: First, I want to respond to the member for York East, who wondered where the Tories were for 42 years and whether I would offer an apology. I think that's rather sad, his sense of understanding of the history of this province.
Yes, the Conservatives did not have a priority for long-term care in 1980. Our priority was special education reforms and reforms for the handicapped in this province. The member will know that the multi-year plan was developed by the Progressive Conservative Party -- Bill 84, a huge injection of dollars into the educational system for disabled children, to take them out of institutions.
Yes, if you'd like me to apologize to the disabled community, that they were more of a priority in this province than senior citizens, then I'll make that apology, if that's what you're asking me for. If you want to look for an apology, you ask your colleague from St Andrew-St Patrick, because the multi-year plan, while she was the Minister of Community and Social Services, was hijacked by Fred Upshaw in a backroom deal with the union to say, "Protect our jobs in the institutions."
I started this debate on the issue of deinstitutionalization. Either you support the concept as a public policy or you don't. If you want to help the unions protect their jobs, there are ways of doing that, but you don't hold the disabled community to ransom, as that minister did.
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I will not apologize for the 42 years of the government. We could have done more for long-term care, but we have done some outstanding work for the disabled in this community and it was recognized all over North America.
To my colleague from Ottawa Centre, I want to apologize. I did not understand your interjection. My point is, I support the concept of pay equity for those women at the lowest end of the scale. Day care workers were promised that they would be protected and they were not. We protected pay equity for the top-level civil servants in this province. They've been the main beneficiary of pay equity in this province, not workers like day care and home care workers.
The Speaker (Hon David Warner): The member's time has expired. Is there further debate?
Mrs Karen Haslam (Perth): It's been a long night. I don't know if there's anybody left out there watching at 10:30 at night. In deference to those in the House who would like to bring this debate to a close, I have put aside my half-hour speech where I researched --
Applause.
Mrs Haslam: I knew you'd appreciate that. I'm sorry to do this, because I spent a lot of time and I did a lot of a research on it. I talked about changes that were recommended in 1992 and changes --
Hon Ms Gigantes: I'll stay and listen.
Mrs Haslam: The Minister of Housing said she'd stay and listen, and perhaps she'd be the only one left to listen after a while.
I wanted to talk about a lot of different things along the health care lines -- MSAs and the changing demographics around seniors and in particular some of the things in Bill 173 -- but what I'm going to do is deal with one aspect and one bit of information in Bill 173. Rather than go to a lot of issues, I'll stick with the one.
Bill 173 includes an important amendment to the Ministry of Health Act that strengthens the role of district health councils in planning health services, including long-term care and support services. The amendment clarifies their mandate and their functions.
The reason I mention DHCs is that actually Huron and Perth, and I'm from Perth, have just had a DHC set up. We are the last area in the entire province to have a DHC set up. I'm very excited about it. I think we have a lot going for us in our two counties. We have very good people on this district health council, and because there have been some changes in DHCs over the last little while, I'm very pleased to see that we are now at the beginning of our DHC, at the grassroots of some of these changes. I think we'll be very well served by this.
For those who may not know what DHCs are, they are planning bodies appointed by the Lieutenant Governor to provide advice to the Minister of Health regarding district health service needs. Membership comprises volunteers and representatives from communities within each health planning district. In recent years, government continually has asked the DHCs to take on an increasing responsibility for the planning of health services and to assume a leadership role in reforming the health system.
In 1989, the mandate of the DHCs was expanded to include planning and advising the minister with respect to the allocation of funds, human resource requirements in the health field, coordinated regional planning and integration of health and social services planning.
DHCs have also been asked to participate in hospital restructuring and to add mental health reform to their planning responsibilities. More recently, in 1992, the district health councils were asked to assume the lead in planning for long-term care and support services.
The DHCs are expected to carry out these increased planning responsibilities and play a major role in preserving and improving the health system in a climate of economic constraint and increasing consumer demands. In 1992, the Association of District Health Councils of Ontario and the Ministry of Health, with the participation of the Ministry of Community and Social Services, established a joint task force. The purpose of the task force was to define the role and mandate of DHCs, to identify resources required to fulfil their mandate and to strengthen partnerships involved in health system reform.
The results of these activities and the recommendations of the joint task force are outlined in the report Moving Forward: Strengthening Health Planning in Ontario.
The task force concluded that the ability of DHCs to successfully discharge their responsibilities in planning and providing advice to the minister depends on having a clear statement of those responsibilities and their delegation by the minister to the DHCs.
Bill 173 provides that clear statement of DHC responsibilities and the minister's power to delegate responsibilities to district health councils.
At present, the Ministry of Health Act provides general authority for the minister to establish advisory bodies. However, the act does not specifically address the functions, activities of membership of councils or provide clear authority for the minister to make regulations to govern these and other DHC matters.
Accordingly, Bill 173 will amend the Ministry of Health Act to create specific authority for the minister to establish DHCs; to specify the functions of DHCs; to place an obligation on the minister when appointing members of councils to consider the importance of ensuring that the membership of DHCs reflects the diversity of the population in the geographic area served by the council, and through guidelines and regulations, government also will be able to ensure that membership of DHC long-term care committees reflects the diversity of the communities served and includes both health and social service perspectives.
In the case of Huron and Perth, because the DHC was just instituted recently, we didn't want to be left behind in our long-term care planning. Perth has been at the forefront of some of the models of planning around areas in my community that are like smaller communities in a larger community. We took that model and we worked it into a long-term care community association, a long-term care committee, which is working with government officials from the London regional office. Now the district health council has been appointed, they will continue their work and work it into the district health council.
The amendment in Bill 173 also creates clear authority to make regulations regarding rules governing DHCs, including their composition, their structure, their functions, their duties and manner of operation, and the obligation of service providers to submit plans and other information to the minister and to the DHC and to allow the public to have access to the plans submitted.
I'm pleased to see that I've stayed through my 10 minutes that was given to me and I haven't given in to going on for half an hour. But in conclusion, just let me say that for over 10 years governments have talked about improving the current patchwork of services spread unevenly across the province. May I remind you that it was this government that is delivering that program. This is a major step forward in the creation of a coordinated system based on fairness and equity.
It has been two and a half years since we introduced our health restructuring agenda. That agenda has been to ensure more efficient use of scarce resources and to shift the emphasis of our health system from treating disease to preventing it. This bill, Bill 173, is part of that restructuring plan. Such changes have dramatically sped up Ontario's health care evolution. They have led to a system that is better in tune with the needs of people in communities as diverse as Toronto and Stratford, and they have produced a system that is well prepared to meet the needs of future Ontarians and the communities of tomorrow. I look forward to continuing dialogue around these issues.
Mrs Marland: I'm glad the member for Perth referred to district health councils, because I see in notes I have here that Anthony Fusco, chair of the long-term care steering committee of the Metropolitan Toronto District Health Council, resigned February 4, 1994.
The long-term care steering committee of the Metro Toronto District Health Council has the task of planning the multiservice agencies in Toronto. In his letter of resignation, Mr Fusco stated his unwillingness to participate in a government policy which "smacks of the double veneer of political and ministerial staff for the self-preservation of a civil worker caste system."
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There is someone who had a very prominent position with a very prominent -- well, I assume, the largest district health council in Ontario, if it was for Metro Toronto -- and he obviously had a lot of concerns. When I see the kinds of concerns that have been brought to our attention -- one of them of course is the short time frame between the first and second readings, which has really meant at this point that there hasn't been adequate time for the groups and individuals who are involved in the provision of these services to really prepare their comments. Certainly, the utilization of long-term care services in this province has to be looked at by the people who are delivering those services.
I say again that there is a need for nonprofit agencies and the private care provider because it gives the client a choice and it's proven that the private care provider is not any more expensive and, in a lot of cases, is less expensive than the nonprofit provider.
Mr Malkowski: I'd like to respond to the member for Perth's presentation, which I think was very informative in terms of talking about the principles of fairness and the issues of long-term care. She's certainly very right that the government has actually committed to doing something as opposed to just talking about something, which the Conservative and Liberal governments have done an awful lot of -- talking but not acting. I think what she said was certainly dead on.
A point I would like to respond to -- when the member for Mississauga South spoke of the resignation of the director of the Metro district health council. In fact, the Metro district health council just today submitted a proposal to the Ministry of Health, so the resignation of Mr Fusco was not an issue in that; they have in fact just submitted a proposal today.
I know in my own riding of York East, members of the district health council reported that it is very active and that they're cooperating very well between the long-term care in East York and the district health council. I don't think that resignation in any way is going to have an effect on the implementation of the MSA at either the Metro or the provincial level. In fact, people are working together. There are some problems, but they're being resolved, they're being worked out in a very logical and mature fashion.
I would like to respond to her point that in fact what's happening here is some political game playing, that we're trying to confuse the public or cause concerns that aren't justified. I should correct that misleading information, as a point of clarification. In fact, the ministry is working well with the district health councils and we should feel very proud of the success we're seeing happen in this process, and my riding is a perfect example of that in York East.
Mrs Marland: On a point of order, Mr Speaker: Did the member say I had given misleading information?
Mr Malkowski: If I offended you in any way I would certainly withdraw that comment.
The Speaker: That seems to be an appropriate way to handle the question.
Mr O'Connor: I want to take a moment and comment on what my colleague and friend from Perth has said. She talked about a focus that is coming right from the community, the district health council; and not just the council itself, but the long-term care committee of the council. It's not just a long-term care committee going out and talking to the executive director of this organization, be it home care or the VONs, but going out there and talking in the communities, going out there and talking to the consumers and reaching out that much further.
Over the next couple of days, I know my own long-term care committee in Durham region is going to be doing just that. I was talking to one of my local constituents who's on that committee, John Little, and he's going to be out there in Port Perry and Ajax and going out to the community and talking about what's happening with long-term care, how the multiservice agency is going to take a look at what the needs of the consumer are, based on the needs of the consumer within the community. That's exactly what the member my colleague and friend from Perth has been talking about, the role of the district health council.
When she points out some of the needs and the concerns that people have, she has done it in a way that presents it as a challenge, and I know that the long-term care subcommittees out there are actually looking forward to this. They're actually looking forward to being part of a consultation process that will go beyond what we're doing here in establishing the framework through the legislation.
We can deal with the framework part with the legislation, but it's the stuff in the community that's really important, that action right within the community. The district health council is an integral part of that and the member for Perth addressed that. I thought it was quite thoughtful the way she put it across. I appreciate the comments she has made and look forward to participating in the debate later on.
The Acting Speaker (Mr Paul R. Johnson): The member for Perth has two minutes to reply.
Mrs Haslam: Actually, I'm so glad the member for York East was clarifying that letter from Metro Toronto, because I didn't know about Metro Toronto and I don't pretend to know that everyone is the same. For instance, when I was associate Minister of Health and I travelled around, I will tell you that when I went into areas there were some people who said, "You know, the district health council doesn't listen to us, it doesn't listen to the grass roots and doesn't listen to the people." I think that's part of why the amendment in Bill 173 is coming in place, so that you can say the amendment clarifies their mandate, clarifies their functions and makes sure that those people on the district health council do listen to the community they service.
I want to also mention that we do work together in Perth to look at long-term care and health care, and this government does listen to consultation. You mentioned consultation; consultation works. We had one of the largest consultations around this issue that was ever held and we did listen and we did act. They told us what they wanted in long-term care and that's what you're going to see come forward. They wanted one-stop access, they wanted to remain in the their homes longer, and I think you'll see that's what this government is interested in providing for our seniors out there.
Ontario currently spends over $2.1 billion for long-term care services, including institutional care, home care, the integrated homemaker program and other community support programs, but we're committed to moving away from the institutional side and going more into the community-based services. In fact, over the next two years we will be investing an additional $199 million to expand the community and in-home long-term care services, and that's what important, that we have those services in place for people out there, in my community of Stratford and in the community of Metro Toronto.
The Acting Speaker: Further debate?
Mrs Yvonne O'Neill (Ottawa-Rideau): I'm pleased to participate in the debate on second reading of Bill 173, An Act respecting Long-Term Care. Unfortunately, this debate takes me back to the evening of December 2, 1992, when I stood in my place during the second reading of Bill 101, the predecessor of the bill we are dealing with this evening.
"This legislation," I said on that occasion, "lacks many details, it lacks time lines, and in the opinion of many people who have spoken to me in the last couple of days, it lacks real commitment." In fact, as I re-read my remarks from December 1992, I have the impression that I could probably deliver the same speech, had I changed but a few of the dates.
Bill 101, Bill 173 leave more questions than answers. Again, as I said then, "We have new positions in the community and people have no idea what the criteria for these positions will be." The multiservice agencies contemplated in Bill 173 leave crucial concepts undefined. We are still asking, how does the minister define "community"? We do not find that definition in Bill 101 and again we don't find it in Bill 173: a crucial definition.
I said then and I repeat now, many, many details of the concepts outlined in this legislation are left to be specified in regulations, causing us to take a great leap of faith. Vulnerable Ontarians whom this legislation is meant to serve and the families that support them are also asked to risk a journey into the future without a map. I believe it's important to look back to the original goals of long-term care reform in order that we can better judge the results that we have received as we reflect on this legislation, Bill 173, now before us.
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If I may revisit the history of long-term care reform, in 1989 the Liberal government of the day embarked on a comprehensive reform of long-term care and its support services. A document entitled Strategies for Change enunciated that the main purpose of the reform was to build a coherent, integrated service on the foundation of existing in-home community support and long-term care facility services; I repeat, on the foundation of existing in-home community support and long-term care facility services.
This reform process was based on seven guiding principles, some of which I would like to share again with the House this evening, and I believe to be sorely lacking in Bill 173.
I assert, to begin, that individual self-determination will be weakened by Bill 173. The trust and personal touch of the many existing agencies could very well be lost through this bill.
A second principle: independence and choice. This guiding principle includes the individual's freedom to make lifestyle decisions in the course of daily living and reflects the right to make choices and take personal risks. Services should be designed and operate in ways that maximize independence and choice for consumers.
People must be free to choose the services with which they are most comfortable. These services, including placement in facilities, must reflect the cultural, linguistic and faith choices of the people receiving the services. The minister's statement to the Legislature on the first reading of Bill 173, I'm happy to say, commits the government to the provision of services under the French Language Services Act, yet on the other hand we see no real commitment to the provision of services to any ethnic group or faith community beyond that of the Franco-Ontarian.
As my leader, Lyn McLeod, recently stated in a speech to the Catholic Health Association:
"We share your concerns that the proposed multiservice agencies in long-term care reform could well become faceless bureaucracies, severing the historic, philosophic and cultural ties of voluntary organizations which have developed around a religious, charitable, ethnic or other community base.
"The implications of such profound and radical change, such as eliminating services that are sponsored through religious congregations, are far-reaching. We must not remove individual choice, whether that choice be based on faith, culture or religious preferences."
Through Bill 173, multiservice agencies are to be allocated within geographic parameters. I further understand that in areas designated under the French Language Services Act, for example, in my community of Ottawa-Carleton, or in Metro Toronto for that matter, although there may be designated MSAs for francophones, they will only serve those within the francophone community who live within the geographic boundaries of that MSA.
Many fear that this may leave francophone seniors who live within the boundaries of other, non-francophone MSAs without services in their own language. This matter was brought forward in a meeting held right here in Metro Toronto as late as last night.
MSAs to serve other faith and cultural communities continue to be overlooked, I underline. I remind the minister that the concerns of these communities were brought to us over and over again as the standing committee on social development travelled the province on Bill 101.
A third guiding principle is community living. This principle further calls for "the service system to strive to provide services and options that will assist people to live in their own homes and communities whenever possible."
I'd like to share a cartoon with the House. Here we have the Premier and the Minister of Health. The Premier says to the Minister of Health, "Remind me again, Ruth, why are we taking over all the volunteer health agencies?" The Minister of Health says, "Because a lot of our people are going to need government jobs when we lose the next election."
The near-abolition of small business participation in the home care industry punishes the economic recovery in our communities by putting jobs, if not in jeopardy, at least on hold. The Ontario Hospital Training and Adjustment Panel has yet to prove itself. Businesses, in most cases these private small businesses, often run by women, are doing an excellent job of delivering much-needed services efficiently. They do not fit within the narrow ideology of the NDP philosophy, however, and they must go.
I continue with service accessibility. During her press conference while introducing Bill 173, the minister claimed that she was not taking a Queen's Park cookie cutter to the provision of long-term care services. What we see, however, in reality in this legislation is a list of services which each MSA will be required to deliver.
This list does not take local needs into consideration. It gives little flexibility to local communities to design programs to meet their own needs. These lists are Queen's Park cookie cutters. Supportive housing, crisis intervention and assistance, psychological services are all missing from the crucial list in part II of the bill. Queen's Park cookie cutters come in very limited shapes and sizes.
Another principle: support for informal care givers. Every Ontarian recognizes the important role that family members, friends, neighbours and volunteers often provide to individuals. Strategies for Change stated, "Services that complement and sustain informal care giving must be recognized as an integral part of the service system." At this point, we seem to have lost the promise totally of a task force, a task force that I think is yet to meet, that was going to examine and make recommendations on compensation for family care givers. Task forces, commissions, procrastination -- perhaps you get the picture.
In addition, there's a deep-seated worry and a very serious concern that this government's long-term care reform policy, and its MSA policy in particular, could very well result in a weakening of the volunteer sector. That has been brought to the fore several times tonight. The volunteer sector is crucial to the delivery of community-based services and it certainly is crucial to the support of the informal care givers.
Agencies have expressed their concern again and again to this government and to myself and to our party's Health critic that their volunteer base may very well disappear with the emergence of a bureaucratic MSA structure. If Bill 173 is implemented, we will never again see Meals on Wheels, the Victorian Order of Nurses, St Elizabeth's, Senior Link, Red Cross homemaking and the hundreds of small and large agencies across this province as we see them and know them today.
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In a February 17, 1994, London Free Press article entitled "Home Care Changes Confusing Thousands," reporter Sandra Coulson stated:
"The agencies to be set up over the next 18 months will not only coordinate, but take over the work now done by private companies like Comcare and Para-Med, and non-profit organizations like the Canadian Red Cross Society and the Victorian Order of Nurses."
She goes on later in that article to quote Mary Kay Croft, southwestern Ontario manager of Red Cross homemaker services to say, "It can create a monster bureaucracy with little accountability."
In April 1994, this very year, the Ontario Council of Agencies Serving Immigrants stated in its newsletter:
"Many questions have been raised by cultural minority communities regarding the issue of equitable access. Other issues raised by community agencies include the impact of the proposed reform on voluntarism; the emphasis on a health care model; overbureaucratization of the delivery system; and a loss of community access to decision-making. Cost-effectiveness of the MSAs is an additional issue of concern."
A community governance structure, uniform eligibility and service rules -- I ask, with many others, when will we get that clear definition of "community"? When and how will the eligibility and service rules be set and by whom? To date there are no answers forthcoming.
The sixth guiding principle is local planning and management. On June 6, 1994, when the Minister of Health delivered her ministerial statement announcing first reading of this bill, she said that her government has "made community-based health care a priority." She further claimed that her government has "shown this time and time again."
I'm left to wonder about the basis of these statements. Many of the agencies that I've consulted in preparation for my remarks have certainly not seen any improvement in their funding for community-based services. While it's true that there have been some initiatives in some communities for the extension of support services through the integrated homemaker program, there are many agencies which have had to cut back both staff and programs, either as a result of budget measures or the social contract, which has just celebrated its first anniversary. Is "celebrated" the right word? They've had to augment as best they could, these agencies, their own fund-raising efforts.
In fact, in my own community recently the Good Companions Seniors Centre in Ottawa fears that it's going to lose its status as a United Way agency. That would certainly change their life.
Today, in June 1994, agencies have to carry on in an atmosphere of increased uncertainty, indeed in an environment that questions the future of their very existence in many cases. I have to ask the minister, how can this possibly be perceived as an improvement in community-based services?
What this government has demonstrated "time and time again" is a disturbing lack of confidence in the expertise of existing community services and an insistence on redesigning the wheel and micromanaging the existing long-term care system out of existence.
We're being faced with a new bureaucracy, more and more centralized decision-making, more and more power in fewer and fewer hands, much power in the hands of the minister herself. Section 6(a) of the bill states, "The minister may provide community services." Section 6(b) states, "The minister may establish, operate and maintain facilities for the provision of community services."
The minister is to approve both agencies and facilities. This, I find, does not reinforce local planning, management and accountability.
Finally, the seventh principle I bring is affordability. Strategies for Change states, "The service system must be affordable within the limits of provincial fiscal policy, and available resources must be used effectively to meet needs."
The NDP reform policy, with its added bureaucratization and centralized approach to delivery, cannot possibly be cost-effective. The disappearance of the private sector, the elimination of many existing agencies and the construction of a whole new system is not my idea of the efficient use of scarce funds.
The principles I've brought forward tonight were first developed in 1989 to reflect the Liberal vision of the values upon which long-term care reform would be based. I'd like to highlight them again: individualization, independence and choice, community living, service accessibility, support for informal care givers, local planning and management, and affordability.
I close with a strong commitment to these seven principles. I continue to search for them in Bill 173. I will search for them during the hearings on Bill 173.
I get nervous when the ministries of this government talk about major departure from the ways we have been doing business or a major overhaul or a major restructuring. It usually means cutbacks, centralization, restructuring, alternative approaches to services, reallocations and new definitions. All of that makes me and most Ontarians very nervous. A question they continue to ask is: "Can we trust that our real needs will ever be met? Can we trust this government, which so often has changed course?"
On June 4, after the minister's press conference, Mr Alec Mansfield of the consumers' alliance on long-term care reform spontaneously and courageously challenged the minister: "I don't want the seniors again to be raised up here, only to be crushed again." I ask tonight, again, when will we know the answer to Mr Mansfield's important question and concern?
This long-term care legislation must enhance the services for the people who need them. It must not build a maze of new administrative red tape, not create a new, very heavy-handed, centralized bureaucratic nightmare.
I ask, finally, as I asked a year and a half ago, why does so much of the substance of this legislation remain to be determined? Why are we, and indeed all Ontarians, told, "Just wait for the details"?
I'm disappointed that although a long-term care policy is desperately needed in this province, and this government is in the fourth year of its mandate, we are again being given only platitudes and promises lacking in definition, lacking in detail, lacking in commitment. What we really need is a guarantee that there will be fewer gaps in patient services, that waiting lists won't grow. I end by challenging the minister's own statements: "We are getting on with the job"; "Government is delivering on its promises"; "We're talking major steps forward."
Madam Minister, we are not at all as sure of your self-assessment as you are.
The Acting Speaker: I thank the member for Ottawa-Rideau for her contribution to the debate. Questions or comments?
Mrs Marland: I think it's important to put again on the record the concern of volunteer-based groups. I have a paper here that states that the volunteer-based groups involved in the provision of long-term care services are extremely upset with the creation of multiservice agencies. They view MSAs as the forced demise of volunteer-based community groups. They maintain that the loss of volunteers will translate into the loss of dedication to work in governance positions, commitment to provide hands-on services, historic values and commitments, donations and fund-raising ability and consumer choice.
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The point is that if you kill that volunteer agency by having Big Brother take over, then you kill the incentive of the volunteer totally, because they're going to say: "Well, Big Brother's taking over. Let them look after everything." Why would you volunteer for an agency that now is run by the government? Why would you volunteer for an agency that may have been in existence 50, 60, 75 years, if you look at the Victorian Order of Nurses and the St Elizabeth Visiting Nurses and organizations like that, which have survived because of the volunteer nature of that agency?
The Victorian Order of Nurses I met with in my riding are able to provide no-cost services to people who need them, and the way they do that is they have all kinds of fund-raising through the private sector. If you want to turn off the private sector support for these volunteer organizations, this is the way to do it. If this government, which already is $10 billion in debt, thinks that it can afford to give those services and provide those services that are now provided by volunteers without increasing their debt, they are really out to lunch.
The Acting Speaker: I'd like to thank the member for her comments. Time has expired.
Mrs Marland: And I do not need the staff from the Liberal caucus office to tell me when my time has expired, thank you very much.
Mr Offer: First I'd like to compliment the member for Ottawa-Rideau for the discussions she gave on this particular piece of legislation. I think that her thoughts and her comments are extremely useful as we deal with this particular legislation.
There's no question that some concerns have been made, some very serious and fundamental concerns, with respect to the direction this particular bill takes. That is not to say that one is necessarily in principle opposed to long-term care reform, but rather that one is very concerned with respect to the direction and the way in which the government seeks to implement this type of reform.
It is absolutely clear that there are volunteer agencies that are going to be affected if the bill is implemented in the form it is today. It is clear that if the bill is implemented in the way, shape and form it is in now, over four years we will see the demise of the Victorian Order of Nurses, we will see the demise of St Elizabeth's, we will see the demise of the CNIB, Meals On Wheels, Red Cross homemaking and other agencies whose volunteer core provides not only support and fund-raising for their work but in the delivery of patient services.
I think that we as members in this Legislature have to recognize the tremendous service that these particular organizations have provided for many, many years. We must also recognize the credibility that they have within our communities. They are in no small measure the lifeline of many services. They carry a commitment; they carry over years a determination and an effort to meet needs for so many people. It is a very strong fault in the legislation. If the legislation is implemented, we'll see the end of these particular agencies. I believe that this legislation must be seriously changed so that we can make certain and ensure that these organizations and agencies that have served our communities so well over many years will indeed not only continue, but increase in the future.
The Acting Speaker: The member's time has expired.
Mrs Marland: On a point of order, Mr Speaker: I rise in my place to correct my own record. I did not --
Mr Gary Wilson (Kingston and The Islands): Is that a point of order, Mr Speaker?
Mrs Marland: It is a point of order, and I think if you've been here four years, it's time you knew it was a point of order.
The Acting Speaker: The member will get on with the point of order, please.
Mrs Marland: Mr Speaker, I earlier referred to receiving instructions to end my comments. The instructions I unfortunately referred to as being given by the Liberal caucus office staff person, who is a very hardworking, dedicated individual, Mary Lou. I did not mean her. I meant the government caucus office staff member, whose name I do not know but has the beard, who has now left from underneath the gallery.
The Acting Speaker: Thank you, the member for Mississauga South. Further comments or questions?
Mr Gary Wilson: I'm pleased to have a chance to comment on this debate. I noticed the member for Mississauga North talking about the Victorian Order of Nurses, as he said. In fact, it's now called the VON.
Mr Offer: That is like the NDP doesn't stand for New Democratic Party.
Mr Gary Wilson: I point this out just to show that changes can occur in the way services are provided. After all, the Victorian Order of Nurses started in the 19th century, and over that time there have been a lot of changes in our society. Organizations have to adapt to those things in our society to make sure that the needs are met.
When it comes to volunteerism, there has always been volunteerism, and it's what we're trying to do to make sure that the services are met. It's the kind of changes we have to make so that we can make sure that people have the kind of services they need --
Mr Offer: What does the acronym J-E-R-K stand for?
Mr Gary Wilson: -- and that's what we're doing with this legislation: responding to the changes.
People are always willing to give of themselves to help out in their communities. We think that through these kinds of changes that we're proposing, people will be more inclined to volunteer for the needed services in our community.
Mr Offer: What does G-O-O-F stand for?
The Acting Speaker: Will the member for Mississauga North come to order, please.
Mr Gary Wilson: There's no question that the kinds of things that we are proposing here are going to help volunteers in our community. We're not saying that volunteers aren't needed. We'll always need volunteers, and in fact people are willing to give of their time to meet the services and the needs of the community. It's a question of providing the processes whereby they can donate their time and their services.
I think we're responding to things that people have raised in our communities. Certainly I've met with representatives of the organizations that are now providing services, and sure they're concerned about how it's going to change, but they're also aware that society evolves, and we've got to adapt to those kinds of changes to make sure that the services we're providing are doing the things that have to be done in our communities.
Mrs Sullivan: I'm pleased that the member for Ottawa-Rideau raised the issue of the viability of volunteer services with this model of multiservice agency delivery of long-term care, because in fact it is pertinent. It will become more and more of an issue as we examine this bill and the impact that it will have in every single community across the province.
Whether the organizations affected are mission-based, as in many of the religious institutions and agencies that provide services, or whether they are charitable-based and provide services, such as VON or Red Cross homemaking, which rely on a huge complement of volunteers not only for the fund-raising aspects of their service but also for the actual delivery of patient care, the government is asking the entire culture of Ontario to change. If you believe that volunteers will come forward and give of their time and their energy to a faceless, new, large, impersonal bureaucracy, I'll tell you, it's not going to work.
We have done the consultations with the fund-raising experts and we have done the consultations with the coordinators of volunteer patient services, and they tell us all the same things: No matter what the service is, no matter whether it's driving patients to and from care, no matter whether it's taking meals into patients' homes, no matter whether it's going in and reading a story to an individual, the volunteer complement simply will not be there.
The Acting Speaker: The member for Ottawa-Rideau has two minutes to respond.
Mrs O'Neill: I'd like to thank the members who've made comments on my remarks. I would particularly like to take note of the member for Halton Centre, who has done so much work for our caucus on this issue.
I tonight brought forward perspectives that I had heard. I think when you see my remarks in Hansard, most of them will be in quotations, because I brought forward the letters, I brought forward the meetings I've had with people over the last two years on this issue.
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I guess what I find lacking when I meet with these people is a sense that they're respected by this NDP government. Whether they're front-line professional health care workers or whether they're volunteers, they don't know whether they have been heard. They know that we had extensive hearings on Bill 101. They brought many of their concerns forward and they feel they're going to have to repeat that all again in summer 1994.
I find that really difficult, because those people are there; they're doing the job and they're doing it on a daily basis. Several of them have told me how many times they've tried to get meetings with the minister, how many times they've written and not had an answer, and I feel that is inexcusable.
They're full of concerns, they're full of worries, and I really do believe that the private sector feels very, very vulnerable and threatened. They are still doing much of the job, almost half of it. Things are in a real mess. That's what I've been told, no matter where I go. Maybe they will be solved somewhat if we have a good set of hearings on this issue.
A four-year exception, which the minister herself laid on the day she made the announcement of Bill 173, indicates to me that things are not going quite as smoothly as some of the members of the government indicated here tonight. I thank you. I hope the hearings are fruitful.
Mr Hodgson: It gives me great pleasure to speak on Bill 173, An Act respecting Long-Term Care. I hope the member for Ottawa Centre hasn't built up expectations by suggesting that the 11th hour is an exciting hour; nevertheless, like the member for Perth, I'm going to forgo my prepared speech and just comment on a few items that I feel are important.
This is a very important issue to the people of Victoria-Haliburton, the riding that I represent. I believe we have, despite what some of the other claims are, the highest proportion of seniors in the province of Ontario, per capita. In Haliburton county, over 22% of the population is of senior age. Long-term care reform is very important to the lifestyle of these people in our riding and it's also an important component of the infrastructure of our riding. Like roads and low taxes, Victoria and Haliburton also provide quality health care and a quality of life that attracts seniors. That's one of our major economic plans, to attract people and growth, to create jobs in Victoria and Haliburton.
I have had the pleasure of sitting as vice-chairman -- it was mentioned earlier that it was chairman; I just want to correct the record on that -- I was vice-chairman of the long-term care redirectional planning for Haliburton county. I'd like to just give a few comments on how that came about and also a few comments on the bill here tonight.
We've had health care planning in Haliburton county since the late 1970s, early 1980s. As was mentioned by my colleague from Burlington South, I congratulate the government for at least trying to come to grips with this problem. In Haliburton county, the Liberal government promised 18 chronic care beds in the mid-1980s when they were in power. The local community and the county pulled together and raised over $400,000 to see that built. That was in 1986.
All of a sudden, the promise was revoked. They changed their mind. This was back in the 1980s. It might surprise some people, but there is a history to this happening in the province of Ontario when the Liberal Party changes their minds on important announcements.
What was alluded to earlier and spelled out probably better than I will be able to do, as the Burlington South member has mentioned, was the history on this. The Liberal Party was taking people out of institutions and putting them back into the community.
Mr Gary Carr (Oakville South): No money, though.
Mr Hodgson: With no money. In fact, some people -- I wouldn't say that they're paranoid -- suspect that the reason they were doing it was because they were spending so much money in other areas that they wanted to take the costs of the chronic care of Ontario residents off the budget of the Ontario treasury and put it into the nursing home budgets, which is raised primarily from the property tax base.
All of a sudden, we have a mess on our hands in the province of Ontario. To give some credit to the present government, they have done more than just rhetoric in this act. I applaud the goals of trying to create healthy communities in Ontario and the goals of having a bit of foresight and planning in regard to all health-care-related issues. It's not just the hospital facilities or the long-term care facilities or the supportive housing or the in-home services that this bill today addresses. These things all have to work in relation to one another.
The planning that went on after the Premier, Bob Rae, announced in the 1990 election that the Haliburton Hospital expansion would go ahead was that we sat down and identified the needs of our community. This is an important step that I'm concerned this legislation might be missing. The long-term care committees are to talk to the consumers and establish the needs in that community, and then the district health councils, the MSAs, are supposed to implement that.
I have a concern on a couple of areas, but basically on the MSAs delivered by the district health councils. I don't know if that's the right agency or the wrong agency to deliver. It's probably as good as any, but the problem I see arising, and it's been talked about earlier by the member from Mississauga and other speakers here tonight, is that there's a concern about the volunteers losing interest or not feeling ownership in the delivery of this service, and therefore impeding fund-raising and the tradition of their organizations. I'm not sure. I think that can be addressed in committee.
The whole idea of the multiple service agency and the one-stop shopping based on what the consumer said: When they went out and had this mess on their hands, in the province of Ontario, of taking people out of chronic care institutions, the problem didn't go away. We've got an aging society. We have more people who require chronic care. So they relabelled it and had it run out of the nursing home system.
They also went out then and said, "We'll talk to the community." To this government's credit, it did consult. I was part of that consultation and went around and talked to the users, the users' families and the people who actually use the health care system and the social network to provide people to stay in their homes longer.
Mr Bill Murdoch (Grey-Owen Sound): But did they listen?
Mr Hodgson: We don't know if they listened or not, the point being that it might be cheaper to stay in their homes. That's clearly what people want to be able to do. They want to be able to stay in their homes longer, if you can add some supports in the community. My grandfather had a stroke and my grandmother had to stay in the home and look after him, and in rural Ontario there was no support for the care giver in that relationship. It was unfortunate, but it wore out the care giver. I think this legislation, the long-term care reform, addresses those concerns. Adult day care can be incorporated into the planning models, depending on the needs in that community.
The concern is that outlined in the multicoloured documents that are all part of this long-term care reform are a policy framework which was released in April 1993, a local planning framework that was released in May 1993, an implementation framework which was released in June 1993 and guidelines for the establishment of multiservice agencies in September 1993. They're based on having an integrated model when the district health councils take over.
There's a real problem on the timetable of an integrated model. What this legislation does is hand it to the district health council and says, "Have your integrated model in place." The integrated model has to take into account how all the in-home services will be delivered. That's the VON, the Red Cross, home care, and depending on where you live in the province, a variety of private care givers for in-home services.
To have an integrated model ready brings into question the whole role of the long-term care committees. They were supposed to have established the needs in those local communities, and that's what you would base your model on. If your needs were high for in-home services, you would allocate more resources to the in-home services. If the needs in your community were for supportive housing, you would allocate more of your resources for help in the supportive housing units. If it was long-term care, it was flexible to meet the demands of the local community. That's what the role of the long-term care committee was.
I hope this can be addressed in the committee. I think it can be. I know the minister's concerned about that. They've provided some transition dollars, $5,000 to $25,000, to help district health councils bring together the deliverers of the service: the VON, the Red Cross and the home care. I believe they've appointed a special adviser to the minister to try to facilitate this.
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My concern and my worry is that you're getting away from the consumer-driven process. With the transition dollars and the special adviser to the minister and the district health council having to have an integrated model in place, who's going to be driving this process? Is it going to be based on the bureaucracies around the VON, the Red Cross, the home care, and create a monolithic, one-access, one-stop bureaucracy, or is it truly going to be based on the concerns of the consumer and the needs in that community? I have a concern about that and I think it can be addressed in the committee hearings over the summer.
The other is the cost of the one-stop MSAs. If it's for access, I agree with that. If you're sitting in your home and you have needs but you don't know where to access it, it'd be great to have, as the minister refers, one place to phone and they would assess your needs and decide which of the basket of delivery services you should receive.
What I have a problem with, if it's truly access, a 1-800 number and encouraging partnerships in the deliverers of this service might work as well. I'd like to see the cost; that's what I want to see on this. If you're going to merge it into one bureaucracy, one administration, one board, then there should be a long-term plan on how you're going to reduce the cost because you're obviously going to have major problems with the unions and with the employment structures of these service deliverers today. That should be taken into account and there should be a plan shown how this is going to be accountable to taxpayers to deliver the service more effectively but also have the quality.
The other area, as has been mentioned before quite extensively, is the ideological bias about restricting the delivery of service to 20% within four years for the private sector. I feel this takes away from one of the stated objectives of long-term care reform, and that is accountability. Right now, a lot of the per diem rate charged for services delivered is set by the private sector. If you take out the competition, your per diems become base funded and I'd like to see where the safeguards are put in to make sure that is accountable to the taxpayers.
I'd just like to say, in as non-partisan a fashion as I can, that I believe it's an out-dated ideology that limits the private sector's role in this. Even modern socialism doesn't require ownership of the means of production. It goes back to Marxism that you need to own the means of production. Now all you have to do is regulate it, license it and tax it out of existence. You don't need to own it. What I'm asking for is just a jump of maybe 50 years in ideology to allow for the private sector.
Mr Winninger: He's a revisionist.
Mr Hodgson: I realize you're against revisionists. The point is that it doesn't matter who delivers it; the point is that the process here is to deliver the best care to the person in the home. You should set the standards and make sure it's quality service and it's licensed and let the people get on with it. Don't restrict over half of the care givers in this province.
As the member for Burlington South alluded to earlier, you're affecting a whole number of women workers and seniority rights and you're upsetting the delivery of service, and I don't think that's necessary. It's controversial enough having change in the health-care-related fields, in the delivery of social services, than to add this on to them. Also, by denying the private sector the chance to deliver these services which presently exist, it denies consumer choice, and that's been mentioned earlier tonight as well.
In general, I do commend the NDP for at least addressing this problem and for trying to work out solutions across Ontario. It was a problem they inherited from the shortsighted spending ways of the previous government.
I'd like to mention the York East member's comments. For 42 years the Conservative Party in this province met the needs of the community at that time. They also balanced the sustainability of social programs with the ability to pay for them in the future. I think those are pretty good principles we don't need to apologize for; in fact, we should be very proud of them.
In conclusion, I look forward to the public hearings, and I'd like to thank the government again for having public hearings on this, because I'm sure that a lot of the problems that have been addressed here tonight can be solved at the public hearings debate. This is second reading. We can get on with making our communities truly healthy and making it so that they're affordable and sustainable programs for all of Ontario.
The Acting Speaker: I'd like to thank the member for Victoria-Haliburton for his contribution to the debate. Questions or comments?
Mr Murdoch: Mr Speaker, I must compliment you first in keeping a very good House here. Everything seems to be under control. The Acting Speaker is doing a good job.
I also want to compliment the member for Victoria-Haliburton for a very positive speech. Sometimes in the House we hear a lot of negative speeches and it causes a lot of problems, but I think the member for Victoria-Haliburton has been very positive in his speech and said there are some good things about this bill and some bad things, but let's get on with it, let's get second reading over with and get out to committee. We'll be able to look at some of the negative aspects of it, and I'm sure some of the care givers will come to the meetings and bring some of the problems they have with it.
We want to keep the public sector and the private sector involved. We have to find a way that both can work together, and we have to make sure that the free enterprise system does flow out there. I know the socialist government sometimes has a problem with that, but I think in this case the most important issue is the long-term care. We hope we can find solutions for that when it goes out to committee after second reading.
Again, I want to compliment the member, because he did bring up some ideas and in a very positive way. He mentioned some of the silly things the Liberals did, but they found out very quickly that doesn't work when they had an election. We did find that out very soon, and I guess we'd find that out again if they had another chance, but I doubt if they will. I compliment the member for Victoria-Haliburton on a very good speech.
Mr O'Connor: I want to reassure you that my constituents don't think that I'm just any member either; that I'm their member and I'm here speaking for them. I want to compliment the member for Victoria-Haliburton. It's that wealth of information that we all bring. We all bring a little different part of our communities here for discussion. He's brought with him some of that information. He was part of what was happening in long-term care up in Victoria county. It's that type of information that when you bring it here, you get a little bit better balance. That's important.
Sometimes things aren't quite right. Some people get worried because, "It isn't just the way I think it ought to be." He probably has a few concerns, but we go out to public hearings and we hear from people and things get improved. In the long-term care providers' magazine, the president says right here, "We were able to get concessions in Bill 101 requiring the placement coordination service to respect seniors' wishes regarding their care venue."
We heard about it because they didn't see it in the bill. It didn't say we weren't going to recognize that, but they raised it as a concern. Going out to public hearings is about listening to some of those concerns, respecting all the different ideas that come from all sides of this House, going out there and talking to the people who are going to be providing the service and some of the ones who are the consumers, the ones receiving the services. That's the type of balance the member for Victoria-Haliburton has put in there. That's an important thing, that you go out there, have public hearings and reach as far as you can. I hope the committee hearings will take us to many parts of Ontario so we can have as much input as possible into this very important thing.
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Mr Bernard Grandmaître (Ottawa East): I agree that this worthy bill should go to committee, and it will go to committee for the simple reason that it needs to be looked into. Many service providers in the province of Ontario, such as the VON, the Red Cross, the homemakers people, the United Way, are very concerned with some of the content of the bill and I'm pleased that we're moving ahead.
What I find strange about this bill, if I can quote the previous speaker, is that a lot of work has gone into this bill and it's strange that we're dealing with such an important bill this evening and so many people are concerned about the content of the bill. They had four years to circle this province 10 times and consult people and try to get as many people on side, but I see that I get letters every week from different agencies, non-profit and private sector associations, that are concerned about the content of this bill.
I don't know when the government will learn to negotiate and bring before this House a comprehensive bill which will be accepted by all three parties. If some fine-tuning or amendments are needed, then we can deal with these amendments in the committee. But I can tell you that the committee this summer will be very busy trying to bring about some changes, bring about some amendments to this very worthy bill, which was started by the Liberal government but was ruined by the NDP government.
Mrs Marland: I too want to congratulate the member for Victoria-Haliburton. One of the points that he touched on is this whole question of the not-for-profit sector preference.
Personally, I think it's outrageous that this government is passing a bill that limits the private sector to 20% of all community-based, long-term services. Every agency is licensed, with qualified licensed staff to do the same job, whether they work in the private sector or the public sector, and to arbitrarily do with health care services exactly what this government did with child care services is simply not acceptable to the people of this province.
The facts are that the cost to the taxpayer for not-for-profit service will increase since the deficits of the not-for-profit agencies have historically been covered by the government. That's the whole thing. With a not-for-profit agency, the government is always there to bail it out. The best example we can give you in the child care services is the child care centre right here at Queen's Park. When that was opened, it was supposed to be the flagship of Premier David Peterson and it was subsidized every year by the taxpayers of this province.
Commercial home providers pay their employees the same rate as those in the not-for-profit sector, but they do not have the overhead costs because they run it as a business. There's nothing the government can do, including some of the not-for-profit sector agencies, as well as private businesses can, because private businesses are not going to be rescued the way non-profits are by government subsidies and frankly, the private agencies take weekend and night jobs that other agencies do not do.
The Acting Speaker: The member for Victoria-Haliburton has two minutes to respond.
Mr Hodgson: I'd like to thank my friends and colleagues the members for Grey-Owen Sound and Mississauga South, as well as the members for Durham-York and Ottawa East.
I'd just like to say that I would, in response, caution the government to stick to its principles to make it consumer-driven and not to limit itself to some monolithic MSA which is supposed to bring all services under one roof. I'd like to see that costed out so that we don't get into the trap of creating a huge bureaucracy and losing volunteers in our communities and have it so it's not driven from the consumer.
There are also a number of legal costs that are entailed here. I'm not sure if it's going to be more cost-effective to bring it under one roof unless we have a long-term plan to make it run more efficiently.
I'd also like to mention, on the long-term care reform, that it doesn't limit itself just to in-house services. This is a total package and it takes into account, in rural Ontario, hospitals merging with long-term care and providing more than what is traditionally thought of as health care services from a facility. Meals on Wheels can be delivered and prepared at hospitals and facilities like that. That's the model and the ingenuity you can get if you let the local communities look at the needs of the community to see how best to deliver those. Thank you very much. I appreciate it.
The Acting Speaker: Further debate? Seeing none, the member for Simcoe Centre.
Mr Wessenger: I'd like first of all to thank all the members for their participation in the debate this evening. I'm sure we can look forward to some interesting discussion concerning the bill in committee hearings. I certainly anticipate revisiting the long-term care issue from a community base instead of from an institutional base in the next few months.
Mr David Ramsay (Timiskaming): An important summer.
Mr Wessenger: Yes, it's going to be. I'm sure we'll all travel to the same locations again if the Chair has his way.
Just in summing up, I'm not going to respond to all the comments that have been made. It's a late hour. I'd just like to reiterate some of the principles of the bill.
This really is phase 2 of the long-term care legislation, the community aspect. The legislation first of all addresses the orientation really of the consumer. It's consumer-driven, the approach of this legislation.
Secondly, it recognizes the fact that as in the institutional sector we've had to restructure, we also have to look at restructuring in the community sector, to ensure that we get the most efficient delivery of services, to ensure that we use the resources to provide more services. That's certainly a goal we have to work towards, and certainly the MSA is designed to achieve that result.
I'd also like to reiterate the fact that it is a local planning process with respect to the development of the MSA. It's going to be a community, local solution, and there are going to be variations with who delivers the services as the MSA. There certainly can be several models. It could be existing agencies; it could be amalgamated agencies.
Just to clarify one aspect with respect to the MSA, first of all, I'd like to say that regarding the services in the transition period, an MSA may be exempted from two aspects. One is the duty to directly provide all of the mandatory services. In other words, in the transition stage, an MSA can lack one of those four components. Secondly, in the transition stage, the 20% budgetary limit on purchasing services may be waived. It should be understood these exemptions are discretionary. It's only up to a four-year period and it will be dealt with on a case-to-case basis. I must say that I'm encouraged by the progress that many of the long-term care committees are making with respect to developing the MSA models.
With that, I'd like to conclude debate and thank everyone again.
The Acting Speaker: Mr Wessenger has moved second reading of Bill 173, An Act respecting Long-Term Care. Is it the pleasure of the House that the motion carry? All those in favour? Opposed? Carried.
Shall the bill be ordered for third reading?
Mr Wessenger: I would ask that it go to the social development committee.
The Acting Speaker: Then the bill will be ordered to the social development committee.
Hon Anne Swarbrick (Minister of Culture, Tourism and Recreation): I move adjournment of the House.
The Acting Speaker: Ms Swarbrick has moved adjournment of the House. Shall the motion carry? Carried.
This House stands adjourned until 10 of the clock tomorrow morning.
The House adjourned at 2340.