31st Parliament, 4th Session

L031 - Fri 25 Apr 1980 / Ven 25 avr 1980

The House met at 10 a.m.




Hon. Mr. Wells: Mr. Speaker, I would like to inform the House this morning of the government of Ontario’s contribution to the international relief program for Afghan refugees in Pakistan. The government is contributing $100,000 to this program through the Ontario division of the Canadian Red Cross. I will be presenting the cheque this morning to Red Cross representative Mr. Paul Richards who is in the gallery today along with members of the Pakistani community in Toronto.

The International Red Cross Society has launched an appeal for an estimated $10 million which the Pakistan Red Crescent Society urgently needs to accomplish its part of the refugee relief action. It is estimated at least half a million Afghans took refuge in the mountains of Pakistan following the invasion of Afghanistan by Soviet troops. The money raised will be used by the Red Crescent Society to provide medical assistance as well as large quantities of medicine, tents, blankets, clothing and appliances.

It should be noted the Red Cross Society here in Ontario is also helping local groups to promote fund-raising campaigns to aid the refugees. In fact, a major rally was held by these groups on March 23. I had the honour of attending and I would like to commend all those hardworking people of the community here in Toronto for the tremendous job they are doing in support of the refugees. It is my hope the government’s contribution will further assist the valiant relief operations in this area.



Mr. S. Smith: Mr. Speaker, I have a question for the Treasurer which requires, by way of response, basically two numbers. The first number I would appreciate receiving from the Treasurer is the amount of money the government expects to save as a consequence of the new pensioner assistance which it has announced, the money it intends to save by giving some people less. The Treasurer will recall that some people will get less money. How much will that mean to the government as a consequence of those people not getting as much as they got before?

The second number I would appreciate receiving from the Treasurer is what I asked for yesterday, the dollar cost of administering the program in the new way, with the cheques and so on, as opposed to leaving it under the previous income tax agreement with the federal government.

Hon. F. S. Miller: Mr. Speaker, as I told the Leader of the Opposition yesterday, the net amount change was $75 million in addition. We have pointed out that this was a combination of Ontario’s three programs, that is, Gains, tax credit and sales tax credit. Within that, there were certain people who found themselves eligible for a property tax credit who were not paying any. We have targeted to help people who incur the expense. We then assisted those people who have low incomes in the proper way.

When one adds to that something we already knew before we started working on our budget, that there would also be $35 per family in additional assistance from the federal government level for low-income people, we can safely say that even those people who will now get $420 more from the federal government, plus $240 from us per year, regardless of property tax credits, are all ahead on that basis.

Mr. S. Smith: What about the second number I asked for?

Hon. F. S. Miller: This is one case where the member is quite right. It will cost us more to administer this program. The Minister of Revenue (Mr. Maeck) will give me those details, because he will tell me what complement is required to do it.

One of the things government is created for is to provide services to its people. We are providing a service to our people after years of cutting back on staff because we believe paying promptly in the year the cost is incurred, not once but twice, to help these people stay in their homes, is worth some Ontario money. Many people have appeared on television in the last few days saying they will now be able to do just that because of Ontario’s program.

Mr. S. Smith: The question is how much will the administration cost? It is a straight question.

Hon. F. S. Miller: The member has not asked a straight question in his life and he knows it.

Mr. S. Smith: Mr. Speaker, I realize the Treasurer is allowed to answer questions any way he likes or not answer them. I will repeat both questions, because they request very straight numbers.

Leaving aside the federal contribution, in certain instances --

Mr. Laughren: The member is being repetitive.

Mr. S. Smith: I would have thought the member for Nickel Belt would be interested to know how much the government is going to save on the backs of the poor pensioners in Ontario.

I am asking for two straightforward numbers. The Treasurer admits that, leaving aside the federal contribution, some people in Ontario, for whatever reason, will get less from Ontario under the new program than they got under the old program.

My first question is, how much will Ontario save as a consequence of giving those people less under the new program than they would have got under the old program? It is a straightforward question, for a number. The second question is, how much will the administration cost? If the Treasurer does not know, how come he introduces a program without knowing what the cost is?

Hon. F. S. Miller: I can understand why the member stuck to his medical career rather than a financial career.

Mr. S. Smith: Personal insults are no replacement for an answer.

Hon. F. S. Miller: The member has been dishing them out for a long time and he does not like taking them. I have never had to go after anybody in this House before him.

Mr. S. Smith: I asked the Treasurer for two numbers.

Hon. F. S. Miller: Any time a government program is changed, there are always ups and downs.

Mr. S. Smith: What are the numbers? That is all we want.

Hon. F. S. Miller: The fact remains, in toto, everyone in this province on the combination of four programs will be doing at least as well --

Mr. S. Smith: Not from the Treasurer.

Hon. F. S. Miller: The member criticizes us by specifically targeting property tax. He is trying to take that out of a package --

Mr. S. Smith: I am asking the Treasurer for the numbers.

Hon. F. S. Miller: People were entitled to get it who were not paying it before. Now they are not.

Mr. Cassidy: Mr. Speaker, I thought I understood from the motions announced yesterday that the Liberal Party wanted an election rather than to give these benefits to senior citizens. The senior citizens need them now.

My supplementary question to the Treasurer is this: I understand that last evening, at a time when most of us had left this House, the Treasurer made a major concession to the member for Downsview (Mr. Di Santo), who had been pressing the government to ensure that senior citizens not eligible for the old age supplement would be eligible for the entire amount of the new property tax credits and other benefits announced by the province for senior citizens. Since all of us are now together in the House, would the Treasurer confirm that the government has gone along with that very constructive proposal by the member for Downsview, which will benefit many people from the ethnic communities across Ontario?

Hon. F. S. Miller: Mr. Speaker, the members opposite are very quickly trying to get the credit for something. Let me go through carefully what was said last night.

The member for Riverdale (Mr. Renwick) was listening carefully. I always have admired his ability to look at the law and the way to apply it. We were talking of this in our discussion last night in a very nonpolitical way, simply in terms of how to help a group of people who, by definition, are not currently eligible. We pointed out that the intent of this government, if we can find a practicable administrative technique, is to do just that.

We had let them into the Ontario tax credit to make sure that they remained eligible for the basic Ontario programs, but there were certain problems in matching reciprocal rights without negotiation that could, in fact, take away from potential Canadian citizens who may have moved some- where else rights they might have got through negotiations.

10:10 a.m.

We needed to be aware of that kind of thing while we had time to look at this bill. I said I was quite pleased to have the time between now and the time the bill came in to look at those ways and to take along any suitable amendments at that time that met the needs of the people on both sides of that argument.

Mr. S. Smith: Would the Treasurer not agree that the people who are going to get less from Ontario are the people who have little or no taxable income and who are in low rent accommodation? By and large, that will be the group of people who will get less from Ontario under the new scheme.

If the Treasurer agrees with that -- and I’m sure if he does the mathematics he will see it is true -- could he give a guarantee in this House that he will change his scheme so those people who are, after all, among the very poorest of the pensioners in Ontario will not receive any less under the new scheme than they would have received under the old scheme?

Hon. F. S. Miller: I have a hard time getting it through the Leader of the Opposition’s head that there were four component parts to this scheme, and the total of those parts I am told, in virtually every instance --

Mr. S. Smith: In total, except for the federal.

Hon. F. S. Miller: I’m sure the member will find where I am wrong. In virtually every instance in this province the sum total of all four assistance programs will exceed --

Mr. S. Smith: Not federal, provincial.

Hon. F. S. Miller: I have to count federal moves in. If I didn’t, the member would tell me I was throwing away money without paying any attention. Our job in this province is to work with federal governments, no matter what their stripe, in the interests of the people of the province, and we’re doing that.

Mr. Di Santo: Mr. Speaker, I have a supplementary question of the Treasurer. May I ask -- if I can articulate clearly the question the Leader of the Opposition is trying to ask, because he hasn’t got the guts to say he opposes this scheme -- if the government of Ontario --

Mr. Speaker: Order. If I heard the honourable member correctly, that is not parliamentary language. I would ask him to rephrase his comment.

Mr. Di Santo: I withdraw the word. I will say he hasn’t got the courage to say openly that he opposes the rebate of $500, for which we have been fighting for a long time.

Can I ask the Treasurer if the government, finally, at this stage, after so many studies have been done, can undertake to propose a progressive system of taxation which will remove property taxes?

Hon. F. S. Miller: Mr. Speaker, parts of the move on the budget were progressive, parts were not progressive. I think that’s understood. Those that dealt specifically with dollar for dollar payment on property taxes and the sales tax credit could not be called progressive in the economic sense because, in fact, there wasn’t a salary offset against them. We recognize that, but we also had to recognize that definitions of income don’t always tell one the real economic state of human beings out there.

Mr. Laughren: Carry on.

Hon. F. S. Miller: No, they don’t. On that basis we should all live on $12,000 a year. If somebody else can do it, why can’t I?

Mr. Laughren: When it suits his purpose he can use that argument.

Hon. F. S. Miller: I do. I live on $9,500.

Mr. Gaunt: What does he do with the rest?

Hon. F. S. Miller: I invest it in guaranteed interest certificates.

The fact remains that a number of senior citizens have moved into their retirements living in homes that perhaps were up to their income at the time of retirement and have found inflation catching up with them, and really have an attachment to their home. Their taxes, admittedly, are higher than for somebody else who was not living at the same level. They have been caught in the web of inflation, and I believe they deserve the support of this government.

Mr. S. Smith: Is that money, the $500, going to be taxed by the federal government? The Treasurer doesn’t even know if it will. He doesn’t know.

Hon. F. S. Miller: I don’t know if it will be taxed, because I have no ability to read the minds of the federal Liberal government. They change the rules every day of the week.

Mr. Speaker: Order. I call on the member for Ottawa Centre for a new question.

Mr. Cassidy: I have a new question, Mr. Speaker, for the Premier --

Mr. S. Smith: On a point of order, Mr. Speaker --

Mr. Speaker: If the Leader of the Opposition has a new question I will allow him to place it.


Mr. S. Smith: I have a question of the Minister of Labour, Mr. Speaker. The minister may have heard on the radio, or perhaps by some other means, about the memo written in 1948 by an official of the Johns-Manville Canada Incorporated, a man who became president of the company, saying there was known to be evidence of asbestosis among the workers of that company, but the policy was that nothing should be said to the workers because as long as the people felt well there was no point in telling them of this news. It might depress them. It might cost them the benefit of having experienced, long-service workers at the company and so on.

Remembering the question which I asked the minister and which he and I then discussed privately back in November 1978, when evidence appeared in the United States that Johns-Manville had deliberately withheld information by way of labelling here in Canada when they were already forced to warn their workers in the United States, does the minister now have an answer to the question I asked him back then as to whether a lawsuit or charges of negligence should be launched against that company for withholding information from the workers which was very important to their health and wellbeing and, in fact, to their lives?

Hon. Mr. Elgie: Mr. Speaker, as the member knows and as we discussed, under the present Workmen’s Compensation Act such a suit is not permitted. On the contrary, it is in the United States. I know this is a question we have discussed and it is a matter that I have put directly to Professor Paul Weiler to consider in his review of the Workmen’s Compensation Board and its functioning. I think if the member feels strongly, as many of us do, that situations where there has been a wrongdoing deserve that there be a remedy, then be should meet with Professor Weiler and discuss this with him too.

As to whether there should be any other sort of charge laid, I would suggest the member discuss that with the Attorney General (Mr. McMurtry).

Mr. S. Smith: By way of supplementary, may I ask whether the minister is prepared to recommend certain changes which would allow an action to be taken against the company, since there is some evidence that information regarding safety was deliberately withheld in the full knowledge of what the possible ramifications of that withholding might be? Is he himself prepared to recommend a change in the law to permit such lawsuits, if they are not now permitted; and can he say whether the board itself can take action on behalf of workers? Would he ask the Attorney General for an opinion as to whether charges of criminal negligence could or should be laid in this instance?

Hon. Mr. Elgie: With regard to the second part of the question, certainly I am prepared to discuss it with the Attorney General. As to the first part of the question, the member knows, as I think I just told him, I am equally as concerned as he is about the fact that there may be in society, particularly in this particular issue, a wrong that has not got a remedy. That is a matter that I will be raising with Professor Weiler. I would suggest, since I know the member feels strongly about it, that he do so too.

Mr. Cassidy: Supplementary, Mr. Speaker: Since a lawsuit would probably take years, and under this government might take centuries if we take the example of Dow Chemical of Canada Limited, would the Minister of Labour tell the House whether he has taken any steps to accelerate the registry of former Johns-Manville workers, which we discussed in this House last week and which we discussed in this House many times before?

Would he also tell the House whether his ministry has now brought the Canadian Chemical Workers Union into its confidence in order to have its assistance and support in establishing a register to trace the workers who were exposed to asbestos at Johns-Manville?

Hon. Mr. Elgie: Mr. Speaker, as I said last week and as I said before, surely the most obvious place to look for a register of workers is to look at the employee list of a corporation. That is what we have done. We have gathered together the names of those people who have been employed back to 1950 -- it may be a little earlier than that -- and those names have now been checked out and have been sent to Statistics Canada. They have been there for some six months.

As soon as the information arrives from Statistics Canada, I have instructed my staff to sit down and meet with the union to see if it has any comments, additions, suggestions or alterations to make. It is going to be a wide and open discussion about that list.

10:20 a.m.

Mr. B. Newman: A supplementary question, Mr. Speaker: Would the minister consider adding to that list, workers in plants that used asbestos in the manufacturing process, such as Bendix Eclipse that manufactures brake linings and so forth?

Hon. Mr. Elgie: Mr. Speaker, we talked about that last week and I indicated I would discuss that with my staff to see if it was possible to do that.

Mr. Cassidy: The minister’s lack of urgency in this question is absolutely incomprehensible. If Statistics Canada insists on waiting for six months while the names of workers are on a computer, the minister should take action. I would like to ask the minister this: Is he not aware that in the case of the sinter plant workers at Inco Limited in Sudbury, it was the union which had to take the initiative and many names were not on the company’s lists until they were put there from union records? If they were able to be helpful in that situation, why does the minister not call in the union and get the names of all the Johns-Manville workers, using union as well as company records?

Hon. Mr. Elgie: I think that is just what I said. When the list returns we will sit down with the union and if it has any alterations, additions or suggestions, there will be no problem about that.

Mr. Cassidy: Why doesn’t the minister stop defending management and start working for the workers?

Mr. Speaker: Order.


Mr. Cassidy: I have a question for the Premier, Mr. Speaker. On Monday, the Premier told this House he did not want to see a resolution on the boundaries for the Niagara Escarpment planning area until the hearings had been held in terms of the local municipalities and the people affected. Can the Premier tell the House if he supports the ruling the hearing officer brought down on Wednesday of this week that only representations concerning a reduction of the planned boundaries were in order, despite clear indications to the contrary in the Niagara Escarpment Act, and despite the fact that the boundaries in the proposed plans have not been subject to any formal public hearings?

Does the Premier support the hearing officer, who was restricting any representations if they concerned an addition to the boundaries and was only prepared to hear representations concerning a reduction in the boundaries?

Hon. Mr. Davis: Mr. Speaker, I am not in a position to make any judgement as to what the hearing officer is saying. I was responding, as I recall it, to the member for Welland-Thorold (Mr. Swart) who was raising the question of the procedure. That is all I was dealing with and I was going only by memory, because he was calling for a resolution of the House which would, under the act as I recall it, establish the plan.

It is my understanding the hearing is to come up with recommendations which would form the basis for a resolution in this House that would determine the plan. What the hearing officer is saying, what areas he feels he can or cannot deal with, surely are matters for him to consider. It is not a matter for me to pass judgement on.

Mr. Cassidy: The area of the plan within the original Niagara Escarpment planning area has been reduced from 2,000 square miles to about 742 square miles, or about 37 per cent, by administrative decree which has not been backed up by orders in council tabled in this House since 1974. Does the Premier not feel that public hearings about the proposed plan should be able to hear questions when people think the area could be expanded to preserve a part of that unique natural environment and should not be confined to reductions in the planning area?

Will the government ensure those hearings are open to that kind of representation, or is the Premier intent on leaving it to members of this caucus or interested citizens to do the government’s job in protecting the Niagara Escarpment from the depredations of developers?

Hon. Mr. Davis: I have to go back in my memory very briefly, but, subject to correction, they weren’t hearings in the sense that they are now being held. We debated this in this House and I don’t recall what the member’s colleagues said on this then, but my recollection is that members of the Liberal Party were leading the crusade for a significant reduction in the planning area of the Niagara Escarpment.

I recall the discussion here in the House. My recollection is that the commission itself had hearings -- not in a sense of, shall we say, a legal nature, but there were public meetings in all areas of the escarpment. I can recall one which I wasn’t able to attend in Orangeville, orchestrated probably by a couple of members opposite, when large numbers --

Mr. Hall: Jack Johnson was one of them.

Hon. Mr. Davis: Yes, he was there. But I know who initiated it.

All I am saying to the member for Ottawa Centre is that in terms of the general planning area this was a matter of some public debate. In fact, I think it was debated here in this House. The commission made a determination to reduce, for the purposes of moving ahead with what will ultimately be the plan, the size of the planning area. I would have no hesitation in saying to the honourable member that when the recommendations come through from the hearing officer, if there are some areas within the escarpment which some members feel should be included, these would be proper matters for discussion here in the House.

But I wouldn’t want the member to feel there hasn’t been some public debate on these issues going back several years. I can recall them, not in detail, but in terms of public involvement. I can recall some discussion here in the House about them.

Mr. Swart: Supplementary, Mr. Speaker: I would like to ask the Premier if he would try to distinguish clearly between the plan which is ultimately going to come back and the planning area. According to the act the latter must be established by this Legislature and it was established by this Legislature back in 1974. There was a further amendment made in 1975. Does he not realize that act clearly requires that if there be a change in that planning area it must come before this House? If this is the case, how can he justify the fact that the hearing officer is limiting submissions at the hearings to discussions of an area which is only 37 per cent of what this Legislature decided? Shouldn’t it be the full planning area?

In view of this, would the Premier be willing to ask the Attorney General to have this matter referred to court so that it can be cleared up and people will not be denied their rights at this hearing?

Hon. Mr. Davis: I think we have to be careful with the terminology. The member says that people are being denied their rights, but I think the point he is making is that there are some individuals or groups who would like to see certain properties included -- not their own properties, because they can voluntarily do that. The rights I think we are talking about are the rights of the people who have property within the planning area.

I think it is a different issue when certain groups say, “I would like to see that 100 acres owned by John Jones included in the planning area,” even though John Jones may not want it in the planning area and even though the commission may not recommend it be in the planning area. I think they are two separate rights.

I would defer to the member for Riverdale (Mr. Renwick), who always gives us good legal advice, but I think there is a distinction. I don’t think it is fair to state that rights in the sense of rights of ownership -- which is a part of this great discussion going on before the hearing officer -- are being negatively denied in terms of not having a chance to be heard.

That is different from a group, say, in the town of Caledon, which is outside the planning area, wanting to come before the hearing officer and say: “So-and-so’s property should be included in that area,” when they aren’t owners of the property. That is a different right in my humble opinion.

The law officers who have advised us on this process say that what is being done is consistent with what is required in the act. If this turns out not to be the case, of course I am prepared to listen to any such argument. But that is the advice we had. I think most members would acknowledge the hearing officer is a man of some considerable experience. I don’t think the honourable member is suggesting he isn’t competent to conduct these hearings. I wouldn’t say that.


Mr. Cassidy: I have a new question for the Minister of Culture and Recreation. Has the government studied the very serious implications of the proposed sale of Macmillan Company of Canada Limited to Gage Publishing Limited? In particular, has it considered that this sale will destroy Macmillan’s contribution to general publishing in the country and also its service in providing a distribution network for small publishers in Canada? What action does the government intend to take?

10:30 a.m.

Hon. Mr. Baetz: Mr. Speaker, we have been very actively studying this possibility. I am meeting with Macmillan on Monday, and I can report further following those discussions.

Mr. Cassidy: Supplementary: If the minister intends to meet with Macmillan on Monday, is the government prepared to ascertain from Maclean-Hunter Limited what other offers were made for Macmillan besides the offer from Gage, and whether any of those offers would have entailed maintaining the general publishing of Macmillan which has such a distinguished history in this country? Is the government prepared to participate financially if another group is prepared to keep the services of Macmillan both in terms of the general publishing list and also in providing distribution facilities for small publishers?

Hon. Mr. Baetz: I am not prepared to make any specific promises as to what we will or will not be doing. I will be reporting to the House following our meetings.

Mr. Cassidy: Final supplementary --

Mr. Speaker: Obviously, the honourable minister has said he is not prepared to say anything further until he has had the meeting, and perhaps when he does report back to the House there will be an opportunity for further questioning.


Mr. Peterson: Mr. Speaker, I have a question to the Premier in the absence of the Treasurer (Mr. F. S. Miller). I refer him to page 18 of the budget, where it says: “Also, part of this enriched package was transferred in advance of the normal schedule, as part of the province’s 1979-80 spending, to reduce, if not eliminate, the need for local governments to engage in short-term financing.”

Would the Premier agree with me that in fact what happened was the province prepaid about $200 million of legitimate expenses, under at least generally accepted accounting principles, that would normally have been incurred in the fiscal year 1980, so that it would appear the deficit was less? Would he agree, in fact, his deficit is about $200 million higher than shown in the budget and that brings his net cash requirements to an astounding 150 per cent increase this year? Would the Premier agree with that?

Hon. Mr. Davis: No, Mr. Speaker, I don’t.

Mr. Peterson: Does the Premier understand the matter, for a start, because he obviously does not. Would he look into this --

Hon. Mr. Davis: The member asks me if I understand it and then makes the statement that I don’t. Why would he ask me if I understand?

Mr. Peterson: I want to keep the Premier of this province from perjuring himself in this House, and I want to assist him so he won’t say something he regrets.

Would the Premier look into this matter and have his Treasurer or himself report back on Monday about how, in fact, these figures have been obfuscated and what the real deficit, according to generally accepted accounting principles, is this year, because it is much higher than he has shown?

Hon. Mr. Davis: I am sure the Treasurer will be delighted to deal with that. The honourable member, who I assume will lead off the very constructive debate on Monday, can make these observations. He might also, at the same time, say that we should not have preflowed to the municipalities and to the school boards of this province funding which reduces their interest costs which, in turn, saves the taxpayers of this province money.

If he wants to make that statement and say, “This is the official position of the Liberal Party,” on Thursday evening when he attempts to defeat the government, that will deprive the senior citizens of their assistance, and deprive small business of their assistance, and all of those things in the budget he wants to terminate. If he wants to force the people of this province into an election, please make those observations very clear on Monday so that we will know exactly his position on Thursday night at 10:30.

Mr. Peterson: If the Premier wants to take the position that he wants to cook the books to put a better face on a dismal position, then that is his prerogative. He can take that position to the people of the province, too.


Mr. Laughren: Mr. Speaker, I have a question for the Minister of Industry and Tourism, in the absence of the Treasurer who I know would like to be there.

Has the minister seen the Conference Board in Canada’s latest figures for Ontario, released yesterday, which show that rather than the 0.3 per cent growth the Treasurer predicted, we may very well have a negative growth rate of 0.6 per cent in Ontario this year, one of only two provinces in Canada to have a negative growth rate?

If he has seen that, or even if he hasn’t seen it now that he is aware of it, does the minister agree with the optimism of the Treasurer that investment plans by manufacturing are going to be up some 40 per cent this year? If that is true, following his slide show on mining machinery last year, can he give us any assurances that one of the manufacturing sectors in which there will be significant investment will be mining machinery so that we can get on with building that very important sector?

Hon. Mr. Grossman: Mr. Speaker, as the member well knows, mining machinery and pulp and paper machinery are both sectors we have been paying some special attention to over the last period of time. Specifically, mining machinery is an area to which we will be giving some special attention in the current year.

The first part of the question related to the Conference Board’s projections for the economy over the next little while. May I say that a lot of reference over the last several months in terms of the future for this province has come out of the now-famous Department of Regional Economic Expansion study which everyone is saying indicated our economy is in bad shape. I think it would be relevant to look at what it said, in answer to the member’s question. To quote directly from the DREE study: “Real domestic growth in the present year in Ontario will approximate the three per cent level experienced during 1977 and 1978. In the early 1980s, however, it is expected that this level of growth could conceivably rise to the five to 5.5 per cent range.” That’s from the very same DREE study about which the Cassandras of this Legislature have been walking around the province saying DREE says the economic projections for this province are very poor.

I might continue to read out of the DREE report: “The manufacturing base is also far more diversified than in any other province. As well as the more traditional resource-based industries, Ontario has a number of somewhat more sophisticated types of manufacturing, such as electronics, electrical products, machinery, chemicals and aerospace products. In addition, no individual industry is particularly dominant. The industrial structure and urbanization in Ontario have resulted in a large pool of skilled labour. Accessibility to excellent education facilities provide a base for future skill development, although some short-term adjustments as to type of training necessary may be required. Domestically, the outlook has improved” --

Mr. Speaker: I would like to remind the honourable minister that reading at length from documents is not permitted during debates or in question period.

Hon. Mr. Grossman: Mr. Speaker, the point is that I could read at length from the DREE report outlining the excellent prospects during the 1980s --

Mr. Speaker: Not in question period, you won’t.

Hon. Mr. Grossman: I quite agree; I have to read at length because my friends across the floor will not read these parts of the DREE report publicly or privately.

Mr. Laughren: Obviously, the minister was going to read that no matter what the question was.

Hon. Mr. Davis: Some members read the question no matter what is in it to read.

Mr. Laughren: Don’t interject. Since one of the sectors of the Ontario economy that is predicted to have very buoyant growth this year is the mining industry, and since we import 73 per cent of our mining machinery, even though we are number two in the world in the production of minerals, is the minister prepared to say what action he is going to take, because there is a potential 10,000 jobs at stake here, to ensure that this is reversed and that we start producing our own mining machinery in Ontario so that we can have diversified growth and a real shot in the arm for northern Ontario communities where those mining machinery complexes could be located? What is he going to do or is he just going to continue to sit on the sidelines?

Hon. Mr. Grossman: I believe the member himself has indicated over the last little while that there is at least some indication that this government is moving in that area, and our manufacturing shows have been some indication that we are moving in that area.

It is interesting to note too that one of the ways in which governments can lever that sort of investment is by way of the support we have given to the pulp and paper industry which will create --

Mr. Laughren: What about mining machinery?

Hon. Mr. Grossman: Perhaps the member will allow me to answer the question. In terms of creating a domestic market for mining machinery, it would be interesting to know whether the member would approve of the same kind of support we have arranged for the pulp and paper industry and its enormous offshoot in terms of the pulp and paper machinery industry, which will approach the hundreds of millions of dollars.

10:40 a.m.

May I say specifically in answer to the question that we are now working on the kinds of things we can do to further stimulate the mining machinery industry, and over time I hope to be able to report further to the House. I say to the honourable member, I do not think the solution is easy. I do not think the solution is the kind that he has proposed on earlier occasions, that the government go into the industry. If we conclude that it is difficult or impossible to do very much in the industry, then I will be honest enough to report that to the House as well. In any case, the Ministry of Northern Affairs and ourselves are working on that very issue and we can discuss it.


Mr. McKessock: Mr. Speaker, I have a question for the Premier. In view of the fact there is nothing in the budget for farmers, I have been asked to find out why the Premier has changed his mind since he made his statement in February to the Ontario Plowmen’s Association:

“The agricultural industry is one of the most productive of any sector, with the result any investment in the industry has a substantial effect on the entire economy. Each dollar increase in food production in Ontario leads to a further $2.50 of aggregate economic activity in the province. As well, due to the strong multiplier effect when we replace $5,000 of crude imports with domestic production, we generate one additional job in the province. Is it any wonder, then, the government of Ontario is so deeply committed to working with the farmers to ensure the vibrancy of this ministry and encourage its expansion?”

Mr. Speaker: Is that a question?

Mr. McKessock: My question is, does that same dollar the Premier was talking about in February still not turn into $2.50 in the agricultural business, and why has he changed his mind in this regard?

Hon. Mr. Davis: Mr. Speaker, I am glad the honourable member not only read my statement, but also read it into the record of this House. I am sure he will distribute it to all his constituents, noting the authorship and not trying to claim it for himself. From our point of view, what I said in February is just as accurate and relevant today as it was then.

Mr. McKessock: Does the Premier realize that, if we do not give the farmers immediate assistance with the interest rates, not only are we going to lose some farmers in Ontario, but we are also going to lose their production to other provinces in Canada which are giving that assistance? In fact, there are buyers going around Ontario right now buying beef cows for British Columbia and Quebec.

Hon. Mr. Davis: Mr. Speaker, if the honourable member had not done me the great service of reading my speech in the first part of this question, and if he had asked the second part of the question first, I would have understood it.

If he listened carefully to what the Treasurer (Mr. F. S. Miller) said yesterday, and I am sure he did, that question has already been answered. I cannot add anything to what was said in this House yesterday.


Mr. Di Santo: Mr. Speaker, I have a question for the Minister of Industry and Tourism.

Now that Metropolitan Toronto has committed itself to the construction of a convention centre, and given the fact he said on several occasions that the province was willing to contribute to the construction of a convention centre, as well as the fact that it would generate 10,000 jobs in the service industry, can the minister tell us whether the provincial government has come to a determination and at what stage he will be making an announcement?

Hon. Mr. Grossman: Mr. Speaker, we are reviewing the current situation with the federal government because I think it is safe to say we would hope part of the shortfall, which now is about $15 million or $16 million, might be picked up by the federal government. We also have some concern as to whether the federal government is going to honour the commitment made by the previous Conservative administration to give some support to the centre. Once we firm up the position of the federal government on both those counts, we will be determining the level of our commitment. I can assure the honourable member that our commitment will be no less than one third of the capital cost of that structure.

I would also remind the member that this government takes some pride in the fact that a year ago a $72-million convention centre was still a dream. We have taken it from that stage to the stage at which we are $15 million or $16 million short on a $70-million or $72-million structure; so we are pretty close to home. After further meetings with the federal government, we will have a statement to make to the House. That should not be more than two or three weeks from today.

Mr. Di Santo: Since we have a situation in Metropolitan Toronto and in Ontario where unemployment in the construction industry is 30.3 per cent and the new centre will create, according to the consultant’s report, 1,100 jobs, does the minister not think this should be treated as a matter of urgency because, since there are no other major projects under construction or under way, especially in Metropolitan Toronto, this could alleviate the situation in the construction industry, which has no bright prospects for the immediate future?

Hon. Mr. Grossman: Mr. Speaker, I have treated this as a matter of urgency. I have been to Ottawa several times on the matter. I have spoken to the Metro chairman on several occasions. I have been working hard on this situation. In fairness to the federal government, certain events occurred last December which brought its degree of participation into question for three or four months. Now it is in a position to deal with it once again. This government has always treated that as a matter of urgency.


Mr. Bradley: I have a question for the Minister of Revenue, Mr. Speaker. I recognize that he collects the funds rather than initiates the budget. Nevertheless, as the minister is aware, at the present time there is a sales tax exemption on shoes costing up to $30. Inflation has affected tremendously the price of shoes, and particularly the price of leather in recent years. The children who were largely favoured through this are now not favoured because of the increase in the price of shoes. Have the minister and his colleague the Treasurer given consideration to raising this exemption significantly so that the sales tax does not apply to shoes costing up to say, $50?

Hon. Mr. Maeck: Yes, Mr. Speaker, we have considered the matter. I have had many letters on this subject as, I am sure, the Treasurer has. But it has to be borne in mind that the sales tax exemption on shoes was introduced primarily for children, and not for adults. There has been some correspondence regarding the matter of safety boots and so on going up in price. Members will recall that last year the federal government increased the amount of deductions that could be made from income tax to cover such situations.

The member is right that it is a matter of policy usually decided finally by the Treasurer, but it has been considered. Nothing has been done yet.

Mr. Philip: Mr. Speaker, has the minister not considered some of the points made in the letter I sent him a couple of months ago on this topic? Ottawa’s shoe merchants are losing a considerable amount of business to Quebec, which has a higher ceiling. Canadian manufacturers are also losing sales to foreign manufacturers who bring in children’s and other shoes at just under the $30 mark which are more competitive when people consider they have to add the sales tax on top of that in buying the Canadian shoe that frequently comes in at just over $30?

Hon. Mr. Maeck: Mr. Speaker, that matter is also under consideration.

Mr. Conway: Mr. Speaker, since the Minister of Revenue has indicated to this House that it is a matter of policy he is not prepared to change, could he explain why this niggardly, tight-fisted, anti-consumer attitude with respect to children’s shoes obtains at so late a day? Can he explain or try to justify and defend this posture?

Hon. Mr. Maeck: Mr. Speaker, we are talking here about children’s shoes, and not about adults’ shoes. That was the whole thrust of the regulation, and I think it is still possible in this day to buy children’s shoes for less than $30.


Mr. Lupusella: Mr. Speaker, I have a question for the Solicitor General. Is the minister aware of the forensic evidence presented at the Petrolia inquest into the shooting of Doug Powell by a policeman, which evidence states that powder burns and residue on tissue taken from Powell’s forehead after he died March 4 indicated the gun must have been touching his forehead? In view of that, can the minister explain how the coroner could have ruled the shooting accidental when there was clear evidence from Edward Anderson of the Centre for Forensic Science that the gun was touching the victim’s forehead?

10:50 a.m.

Hon. Mr. McMurtry: Mr. Speaker, I am aware of that evidence. I am also advised that it was not the coroner who ruled that the shooting was accidental, but a coroner’s jury, a jury of citizens who heard all the evidence.

I know there is some degree of interest in the whole matter, which is understandable, and I certainly will review the totality of the evidence given at the inquest. I am impressed by the fact that the local coroner’s jury that heard the evidence came to that conclusion. I am not in the position to comment further on the verdict in this respect, at least not at this time.

Mr. Lupusella: I am sure the minister is going to make a public statement in the Legislature after reviewing the evidence.

Would the minister immediately table the terms of reference given to Judge Greenwood for his study of the police use of firearms, and will he assure the House that this study will focus not only on the use of firearms, but also on the measures to avoid the resort to firearms wherever feasible?

Mr. Speaker: How do you connect this question with your original question?

Mr. Lupusella: There was a shooting involved, Mr. Speaker.

Hon. Mr. McMurtry: I heard the part of the question relating to the terms of reference, and I will table the terms of reference. I did not hear the last part of the question.

Mr. Lupusella: If I might, I would like to repeat the last part of my question. Will the minister assure the House that this study will focus not only on the use of firearms, but also on measures to avoid the resort to firearms wherever feasible?

Hon. Mr. McMurtry: I am sorry; I just do not understand the second part of the question.


Mr. B. Newman: Mr. Speaker, I have a question of the Minister of Labour. Is the minister aware of the high and above-average incidence of cancer among employees in the United States who are working in wood-shops and furniture shops, or who are preparing full-scale automobile mockups out of plastics, wood and glass fibres? If the minister is aware of this potential health hazard, would he find out if employees in Ontario industries, such as furniture, toys, mold shops and so forth, are subject to this same hazard?

Hon. Mr. Elgie: Mr. Speaker, I have been aware of that for a short time and have asked my staff to look into it as a matter that should be considered.

Mr. B. Newman: In the meantime, would the Minister of Labour suggest that some type of protective device be used by the employees so that, if he finds there is a real hazard, the hazard is not exaggerated as a result of not taking protective measures now?

Hon. Mr. Elgie: I will be glad to review that matter with my staff.


Ms. Gigantes: Mr. Speaker, a question of the Minister of Energy; it relates to a speech he made yesterday at the Ontario Paint Association in which he repeated the government’s desire to see upgrading of the residual heavy oil left over from Ontario’s refineries.

I would like to know what the minister meant to imply when he suggested the government was interested in seeing the construction of a new heavy oil refinery and went on to say, “We are pressing ahead with this initiative in conjunction with industry.” Does this suggest we will see a government grant to have the establishment of a heavy oil refinery in Ontario?

Hon. Mr. Welch: Not necessarily, Mr. Speaker. There are discussions with industry now with respect to the economic advantages of this type of facility. I have no reason to believe at this stage that it might require anything in the way of a grant, although the feasibility studies are not yet complete.

The principle of extracting more product out of a barrel of oil has to be a very high priority now, when one thinks of the large exports of residual oil from this country at the moment. Once these studies are completed and we have a better idea with respect to the industry interest, then perhaps we can make a further report with respect to our progress.

Ms. Gigantes: While we can all support the principle of getting more useful products out of each barrel of oil, I hope the minister will also bear in mind the principle that there had better be a pretty darned good reason before we give government grants to the likes of Exxon, Texaco, BP, Shell and Gulf these days.

Hon. Mr. Welch: I understand, and I repeat that I have no reason to believe they would require that type of support, although that would depend on the outcome of those studies.


Mr. Conway: Mr. Speaker, my question is to the Premier. Mindful of the fact that he is now responsible for a jurisdiction that has 157,000 young people unemployed, and mindful that the government is committed positively to nuclear power, what specific manpower strategies is the Premier undertaking to ensure that there will be a maximized opportunity for the graduates of Ontario school systems to take advantage of the hundreds and thousands of jobs which exist in that particular sector and which, over these past 20 years, have been fitted to a large degree by imported foreign recruits? What are the manpower strategies?

Hon. Mr. Davis: Mr. Speaker, I do not know what this business of foreign manpower recruits means.

Mr. Sweeney: It means the government is bringing them in instead of training them itself. It is that simple.

Hon. Mr. Davis: Mr. Speaker, I am trying to answer the question.

Mr. Kerrio: We are just trying to help the Premier.

Hon. Mr. Davis: I would like to make one or two observations. I was delighted to see the honourable member at the dinner last night where I had a chance to talk to him.

Mr. S. Smith: The Premier is not answering the question.

Hon. Mr. Davis: I would say to the Leader of the Opposition that his member asked me about our commitment to nuclear power. I was delighted to see him there last night where I restated this commitment.

Mr. S. Smith: What does that have to do with the question?

Mr. Speaker: What does that have to do with manpower?

Hon. Mr. Davis: With great respect, Mr. Speaker, the question had to do with the member for Renfrew North’s statement that the nuclear industry was a great plus; that it was going to stay and it would provide opportunities for employment. That was a part of the question because he stated it. I have to say I am encouraged, because the Liberal Party has not always been as committed to that. The leader has had his people being critical of the nuclear industry over this past two or three years. I think that was a part of the question, and I am very encouraged.

Mr. S. Smith: Mr. Speaker, the Premier has not addressed the question. Would you call him to order?

Hon. Mr. Davis: I would say to the Leader of the Opposition that the camera is not focused upon him at the moment. He need not bother to act.

Mr. Speaker: Will the Premier answer the question from the member for Renfrew North, please?

Hon. Mr. Davis: Mr. Speaker, I think it is fair to state, after some 20 years of experience in this jurisdiction that 90 per cent or more of Ontario Hydro employees brought into the system -- and this applies to those people in the private sector who have been part of the nuclear industry growth here in this province too -- have come from within this province. If there is a degree of security for the nuclear industry, which will have to depend on our ability as a country, and not just as a province, for the export of that technology, it is also fundamental to the growth, sustenance and stability of that industry that we have the capacity to train the people who will be a part of it.

I say to the honourable member, however, it is strange to me to hear him make that sort of observation when I have sensed an ambivalence and a contradiction by his party for a period of time as to its commitment to the nuclear industry, whether for export or for internal use. I say that very objectively.

11 a.m.

Mr. Conway: Since my principal concern and surely that of all members is that our nuclear power program maximize the opportunity for the deployment of Ontarians at a time when so many -- 157,000 -- are unemployed, and in the youth sector particularly, I want to know what are the specific manpower strategies by means of which this government at this time is addressing that situation. Are there any?

As a former Minister of Education and as the current Premier, has he undertaken any discussions with his government’s Minister of Labour to deal with the public complaints that Hydro has made in my area and elsewhere that our immigration restrictions are making its recruitment job very difficult these days? Is that not something about which this jurisdiction -- he and his government, with more than 25 years of commitment -- should be very concerned, if not ashamed? Have there been those discussions with the utility? Has the Premier had those kinds of discussions with the Minister of Labour? What are the strategies, and can he indicate to this House at this time by indicating more specifically what those strategies might be?

Hon. Mr. Davis: Without once again provoking the Leader of the Opposition, I would make one or two observations in very brief terms. There are two aspects to it. One is the domestic part of the industry; that is, the nuclear industry that develops the apparatus, the machinery, used by Ontario Hydro. There is also the need of Ontario Hydro for the skill training or the expertise in the development and operation of their own facilities.

I think it is fair to state that the private sector, the people who are in the manufacturing part of the industry, have been able to satisfy their needs, by and large. I think it is also fair to state, when one sets aside for the short period, say, of construction, where we have had shortages in terms of some of the skills required in the construction of some of these facilities, these have been a short-term problem. The Minister of Education and the Minister of Labour are aware of them, and so is Ontario Hydro, and there have been programs introduced.

There is the third element, which is the operation of the system by Ontario Hydro after completion of the plant. My understanding is that, by and large, Ontario Hydro has been able to meet its needs for the operation of, say, Pickering. I think one will find the majority of people at Pickering are products of the educational system here in this province. I have not heard from Hydro that they have deficiencies in terms of the internal operation of the system as it relates to nuclear energy -- well, not major ones.


Mr. Isaacs: Mr. Speaker, I have a short question for the Premier with regard to the Treasurer’s delaying tactics on the matter of mortgage relief for homeowners.

Does the Premier realize that many families are facing mortgage renewal now and cannot wait until mid-May or later? What does the Premier advise a family to do when they are faced with a mortgage renewal which includes monthly payments they know they cannot afford? Should they sign a mortgage when they know they will be unable to meet the payments? Should they abandon the home to the mortgage holder? Or should they hope and pray that the Treasurer will do something to help them before too many mortgage payments become due?

Hon. Mr. Davis: Mr. Speaker, as I recall the discussions yesterday, I think fundamentally the same question was asked, although not in this great detail or with the same rhetoric, and I think the answer was given. I would be delighted to repeat it, but I think as there are other members who have other questions I will not do so, except to remind the honourable member that the Treasurer made it quite clear that in terms of the farm community we were prepared, without co-operation from Ottawa -- which we still hope to get -- to consider something on our own.

In terms of the mortgage interest difficulty faced by a number of home owners, we are suggesting -- and I think part of the idea came from the member’s own leader -- that we have a very comprehensive study as it relates to the extent of the problem, the nature of the problem and how one might differentiate in terms of how one might deal with it. We do feel very strongly that there should be a program that involves the government of Canada, as it is not restricted to this province. It has a very significant impact on the Liberal government in Ottawa. I think that was, in brief terms, what the Treasurer said in answer to a similar question yesterday.


Hon. Mr. McCague: Mr. Speaker, I have a message from the Honourable the Lieutenant Governor signed by her own hand.

Mr. Speaker: Pauline M. McGibbon, the Lieutenant Governor, transmits estimates of certain sums required for the services of the province for the year ending March 31, 1981, and recommends them to the Legislative Assembly, Toronto, April 25, 1980.


Mr. Speaker: Before we get to routine proceedings, the member for Essex South (Mr. Mancini) raised what he considered to be a point of privilege yesterday. I have had an opportunity to examine the material submitted by him and I agree that if the date, April 1, on the communication of the Deputy Minister of Natural Resources is accurate, then it would seem the minister owes the member some explanation. The communication from the deputy minister consists of the answers to the questions, whereas the letter from the minister advising the cabinet office that the preparation of the answers required more time, is dated April 2. I understand that the minister, who cannot be here today, will be offering a further explanation on Monday.

I agree with the honourable member that there does seem to be some cause for concern, and we are awaiting an explanation from the minister involved.



Mr. Philip from the standing committee on administration of justice presented the following report and moved its adoption:

Your committee begs to report the following bills without amendment:

Bill Pr15, An Act to revive Golden Hope Mines Limited;

Bill Pr16, An Act respecting Co-operative Health Services of Ontario;

Bill Pr20, An Act to revive Fargo Disposal Company Limited.

Report adopted.

Mr. Makarchuk: On a point of order, Mr. Speaker --

Mr. Speaker: What is the point of order?

Mr. Makarchuk: I believe there was a motion from the government House leader.

Mr. Speaker: No, there was not.



Mr. Epp moved first reading of Bill 57, An Act to amend the Municipality of Metropolitan Toronto Act.

Motion agreed to.


Mr. Makarchuk: Mr. Speaker, I would ask for the unanimous consent of the House to introduce a private bill concerning the city of Brantford prior to the completion of the required advertising. The bill has been advertised for two weeks instead of the required four weeks. There is some urgency concerning this bill, and I would ask for unanimous consent to permit the bill to be considered by the standing committee on general government next Wednesday, along with a second bill which is now before the committee concerning the city of Brantford. I therefore request unanimous consent to waive standing order 65(g) and 72(a) with regard to Bill Pr26.

As a matter of explanation, this unanimous consent will not abrogate anybody’s rights to appear before the committee and time is the essence of this bill. If the bill is not passed, the city of Brantford will not be able to enter into a much and urgently needed agreement regarding the downtown redevelopment project.


Mr. Makarchuk moved first reading of Bill Pr26, An Act respecting the City of Brantford.

Motion agreed to.

11:10 a.m.


On vote 3202, institutional health services program:

Hon. Mr. Wells: Mr. Speaker, I wish to table the answers to questions 7, 95 and 110 standing on the Notice Paper.

Mr. Speaker: I presume that will satisfy the member for Algoma (Mr. Wildman).

Hon. Mr. Wells: We are one day late, for which I think there is a reason.


House in committee of supply.


Mr. Chairman: Does the minister have any comments?

Hon. Mr. Timbrell: Mr. Chairman, I had some brief remarks last Friday. I don’t have any more to add to those. I understand there is an agreement among the House leaders that we have to conclude by 12:45 in order for a supply motion to be dealt with. In order to maximize the hour and a half we have, I have nothing further to add at this time.

Mr. Conway: Mr. Chairman, my remarks, as always, will be brief and to the point. The supplementary estimates before us raise a number of questions that I would like to put for consideration today and perhaps for discussion in a more detailed way at the time of our next full estimates.

Item 4, the $4.1-million additional appropriation for ambulance services, gives me an opportunity to inquire after the ministry’s recent court initiative with respect to the private ambulance operators in this province. I want to say to the minister, who I suspect has very deep and well-reasoned argumentation for whatever the government’s position is on the place of the private ambulance operators in the health-care delivery system of Ontario, that I know his position is not that of the former minister (Mr. F. S. Miller), which I gather was one that warmed that heart of the many and varied private operators in the province. They are still trying to absorb the shock of another in the line of Tory Ministers of Health who don’t seem to relate particularly well to the position of his or her predecessor.

I thought the ministry behaved poorly in the matter of the investigation of the private ambulance operators. As I said earlier and as I think I said at the time, it may well be there is a serious case and a serious charge against some or all of the private ambulance operators in this province -- I certainly doubt there is a case against them all -- but it must be understood by the minister that by pursuing the matter, as he has chosen to do, he has left a pall of suspicion over all of those private operators. They feel that suspicion has been unduly placed.

Hon. Mr. Timbrell: How would you do it?

Mr. Conway: My friend from Don Mills asks, not uncharacteristically, how would I do it? I will tell him how I might change his style in this particular connection. I might at least indicate in a press statement, or at the time of the action that was undertaken on his instigation by the Solicitor General (Mr. McMurtry), precisely what I was intending and, more precisely, what some of the concerns were.

I am not a legal man and I shall leave it to the distinguished men of the law to advise him on how more appropriately he might meet that particular condition, but the way is not simply to get himself on to the front page of the national newspaper and others by associating himself with a warrant for the papers of many of these private operators, without so much as a brief explanation as to why this inquiry was being undertaken.

What are his suspicions? It is his departmental officials who have superintended this responsibility for lo these many months and years. If, as some of us are prone to suspect, it is maladministration, are we to assume he chose not to be more specific because there might be at least as much for the ministry to explain as for some of the presumably culpable private ambulance operators?

I well remember the question I put and the answer he offered here last November when the matter of the private ambulance operators and their role in the health-care delivery system was dealt with. It was interesting not so much to read the lines of the minister’s answer but to fantasize what was really intended between the lines.

Hon. Mr. Timbrell: You want to watch your fantasies. Being a former bachelor, I’d say you have to be careful.

Mr. Conway: I will take the minister’s injunction seriously. I will say no more than that, because my friend the Provincial Secretary for Social Development (Mrs. Birch) might be prone to lecture me on similar virtues.

It is important for the Ministry of Health, when it undertakes that kind of investigation, to put it in context. To be sure, it is not expected that the minister should itemize in encyclopaedic form all aspects of what he is after. I can appreciate how, in the deep, dark recesses of the minister’s mind, there might be suspicions that he would not ever want to entertain in the presence of his colleague the member for Scarborough East (Mrs. Birch) or anyone else, but I think it is much more important that he at least put a context for public consumption in so far as those charges and that kind of inquiry are concerned.

I am reminded of the efforts this government undertook with the charts for chronic-care copayment, a position which I continue to accept in principle, but the public relations capacity is inversely proportional to the public relations success over there. The minister has people replete with resources, but apparently there is never an ability to convey what he is after. I use the chronic-care copayment example because he took that initiative with what I understood was unanimous consent on the basis of the select committee and he botched it. He made such a horrendous mess of it that the final results were counterproductive for the policy initiative we could all agree to.

The ministry had absolutely no idea how to make its case to the public -- and, is it any wonder, because of what it had done earlier with the public hospital closures program gleefully entered into by the then minister, now the Treasurer (Mr. F. S. Miller) in the late fall and early winter of 1975-76. In this case it again struck me that the government undertook what looked like, in the absence of that kind of information, a witchhunt that bothered a lot of people in the private ambulance sector who I presume are in no way involved with whatever it is the minister is after.

Perhaps the minister might take that as notice in this case, if he hasn’t already done so, with the able assistance of his many friends in the private ambulance operating field. I don’t diminish or underestimate the considerable friendship that exists for the government party in respect of that section of the health-care delivery system. I hold no brief politically for some of the minister’s close political associates whose lobbying interests in connection with the role of the private ambulance operators he has perhaps seen.

I don’t know whether he got that famous letter some months ago which enjoined the private ambulance operators to prevail upon their best, and good and only true friends in this place who sit there from Peterborough to Don Mills in support of -- ostensibly from that letter’s point of view -- the private ambulance operators’ cause.

11:20 a.m.

I want to tell him, his friends feel very betrayed. I think his friends ought not to feel betrayed, although in this case they have every justification for those sentiments. He should give them an explanation and tell them what this inquiry is all about to the best of his ability. He should confide in them and in us his suspicions and the nature of the reasoning for the inquiry of the Ontario Provincial Police.

I also say to my dear friend the minister, would he take the time to inform his friends in the private ambulance operating field as to what it is he really has planned for them? Even his friends think he, of all people, in the name of socialized health-care delivery is going to do them in. Unlike his predecessor, the minister has no respect for the free enterprise ethic in the health-care delivery system, and he is intending to do in the private ambulance operators.

I don’t know what the minister’s intentions are. I can tell him at another time, if he likes, what I think ought to be done with respect to the private ambulance operators. But I would like him, in consideration of his ministerial affairs, to tell them what he is going to do for and with them, with the tacit support of his friends and my friends on the left, as long as he’s around. Is he planning to phase them out of operation? If not, is he going to give them a place in the proverbial sun?

About the second item, institutional care services, I don’t know what the minister said the other day. I am sure it was a multi-tiered bafflegab about that $58 million or $61 million. I look at that item, and I am convinced that a significant portion of that must surely relate to the process we engaged in in the social development committee last year to provide additional assistance to the institutional sector.

We all are mindful that the ministry, under the colourful leadership of my friend from Don Mills, underfunded the institutional sector to a truly alarming degree. In that connection I want to say something about this vote and how it relates to the budget the other night. It was a real lesson for me to sit here and listen to the Treasurer, in the presence of the Minister of Health, produce that document Tuesday night and to hear them congratulate themselves for the fact that in this budget the government of Ontario is going to provide an extra $487 million in the fiscal year 1980-81, an 11.4 per cent increase, for the Ministry of Health. Of course, all of us Cassandras in the opposition, to use the words of my friend from St. Andrew-St. Patrick (Mr. Grossman), are supposed to clap our hands in praise of that glory.

Over the course of the last five years, this ministry has choked and starved and underfunded the institutional health-care system to within an inch of its institutional life. This is the ministry that doled out last year’s 4.5 per cent increase. This is the ministry that has left the health-care system in this province under those kinds of budgetary restraints. Now the minister comes back here because the social development committee, under the active leadership of the opposition, drew this folly and all kinds of examples to his attention to show how negative was the impact of his misguided restraint program in the health-care field. Because of that success, we were able literally to squeeze out of the government of Ontario the kinds of funds required to look after the system as it has been developed.

After all that, the Treasurer, the man who made his great fame in this province in the Ministry of Health, expects to be able to stand up here and be congratulated after all this misguided restraint -- a restraint which threatened to, and did, reduce the quality of care in our health-care system, without any question in my mind. We can each, in our own way, relate circumstances to that particular point, but it is the government which, over the time of my experience in this Legislature -- the Provincial Secretary for Social Development nods her head with some considerable chagrin.

Hon. Mrs. Birch: It is a simple question of where? Document it.

Mr. Conway: The minister should read the transcript of the social development committee.

Hon. Mr. Timbrell: Which part do you want to start with?

Mr. Conway: I can point to any amount of it if the minister would like to come to the library with me. I know the minister fought, to some considerable degree, a losing battle in cabinet. I am being delicate with the responsibility that I lay on his shoulders. I know the circumstances of this extra appropriation, know the story of a very frightened, a very humble, a very ambitious minister going to the Premier’s office and saying, “I can no longer justify the unjustifiable before the health committee and we are simply going to have to have more money.” I know the circumstances. I know exactly where you and your officials stand with the kind of 4.5 per cent increase that starved the health-care system last year in a way that --

Hon. Mr. Timbrell: What about the $50 million you wanted cut the year before?

Mr. Conway: We wanted it cut the year before, exactly.

Hon. Mr. Timbrell: What about the $50 million you demanded be cut from my budget?

Mr. McClellan: That was the year before.

Mr. Makarchuk: Odd years they cut and even years they cut more.

Mr. Conway: We wanted to cut the year before only in such a way as to make the minister’s estimates square with government policy.

Hon. Mr. Timbrell: Pardon? That is not what you said.

Mr. Conway: You are the one who --

Hon. Mr. Timbrell: Let’s go to the library and dig out the record of the year before. That is not what you said.

Mr. Conway: Absolutely. I would be delighted. Come with me and read the paper of April 1978. My point is, Mr. Chairman, the Minister of Health and the Provincial Secretary for Social Development (Mrs. Birch) know very well, and knew very well, what they were doing with the 4.5 budgetary percentage increase offered last year. The opposition can take more than its share of credit for that additional appropriation. Had it not been for the exercise of the social development committee, I respectfully submit a significant amount of that money would not be in this particular supplementary estimate. I am not in any way ashamed to come here and say that this morning.

The minister, I presume, has learned a lesson from that experience, a lesson which, to his credit, shows up in this year’s transfer. I have said publicly that the rate of budgetary increase this year, while inadequate in some measure, is none the less a significant improvement over the niggardly, miserable confrontational offering of last year.

I wanted to register my personal disgust about Tuesday night, having to sit here and listen to the Treasurer of Ontario (Mr. F. S. Miller) congratulate himself on the wonderful funding arrangements that have been struck for the Ministry of Health this year. It was very interesting to hear the man who went about rural south-western Ontario in 1975 and 1976 make that kind of comment.

11:30 a.m.

Just for the benefit of my good friend from Scarborough East (Mrs. Birch), I sat here on Tuesday night expecting to hear something about a commitment the former Treasurer made to the physically handicapped in this province a couple of years ago to do with the insurability of prosthetic and orthodic and assistive devices. What has come of that promise -- not a very expensive one, I might add? What has the government done in consideration of that extremely well founded claim?

I want to say to the Provincial Secretary for Social Development in the presence of the Minister of Health that I think the time has passed for that inclusion in the insured services of our health-care system.

Hon. Mr. Timbrell: Do you disagree with your leader?

Mr. Conway: The Minister of Health is getting exercised.

Hon. Mr. Timbrell: Mr. Chairman, would the honourable member disagree with the statement made by his leader on September 27, 1978 --

Mr. Conway: Mr. Chairman, I thought it was the custom that once one had the floor --

Hon. Mr. Timbrell: -- that no new social programs should be introduced until we get an awful lot richer?

Mr. Chairman: Order.

Mr. Conway: Thank you very much for bringing the very unruly Minister of Health to order.

Hon. Mr. Timbrell: I take it the answer is you do disagree.

Mr. Conway: That is not the case. I am a perfect example of agreement in this caucus. I am always in lock step with my 33 colleagues, and would that the Minister of Health could say the same for some of his friends in the Provincial Secretariat for Social Development.

But there is, to be sure, a lock-step happiness about this perfect union between the member for Oshawa and the member for Don Mills. It always surprises me. Poor Dennis McDermott and Ed Broadbent made an effort for three years to find the perfect union. We have seen effected here a marriage, the perfection and the lasting quality of which I suspect no divorce court in the land will ever have to worry about.

It is important to understand where that $61 million, or a goodly amount of it, came from. That supplementary appropriation, as I understand it, owes most of its origin to the social development process of last spring. I wanted to take this opportunity to congratulate the committee for the work it did in drawing to the Legislature’s attention and to the public attention generally, the course of action this minister and this government were happily embarked on not so many months ago. The kind of statement that was couched on page 21 of this Tuesday’s budget is, from my point of view, insulting, when one considers the underfunding that was knowingly entered into by this government over the past four or five years, particularly where the institutional health budget is concerned.

Other of my colleagues will be speaking to all or part of these supplementary estimates. I appreciate the opportunity, and I do expect that the minister, in connection with the first point, will seriously review the uncertainty, the suspicion that has been created by this investigation into the private-ambulance-operator situation, and that if he hasn’t already done so, through private or public communications, he will at an early opportunity prepare himself, in this House or in our committee, to indicate precisely what it is that investigation is concerned about and what, if any, policy changes he is planning for the private ambulance operators. I would very much appreciate some comment in the not too distant future on that subject.

Hon. Mr. Timbrell: If I may --

Mr. Chairman: These are the leadoffs.

Hon. Mr. Timbrell: I beg your pardon.

Mr. Breaugh: Mr. Chairman, the member for Brantford (Mr. Makarchuk) indicated he had a bit of a time problem today. I wouldn’t mind giving the minister 10 minutes or so, if he would allow me then to do my leadoff.

Mr. Chairman: I will have to ask the committee members if they are agreeable. The usual procedure in standing orders is that there be a leadoff by each opposition party and a reply by the minister. It’s up to the committee.

Mr. Breaugh: If that is agreeable we could proceed that way; if not, I would be prepared to do my leadoff now.

Mr. Chairman: Does the committee agree?

Mr. Conway: To prove my earlier point, Mr. Chairman, I am most amenable to the point that has been made by my friend from Oshawa. If that is agreeable to the members and minister, then of course it is agreeable to me.


Mr. Makarchuk: Mr. Chairman, I appreciate this kind co-operation on all sides of the House. It might be a portent of things in the future.

What I wish to raise with the minister, Mr. Chairman, is the matter of the intent of the ministry to close St. Joseph’s Hospital emergency in Brantford in the near future. The concern that comes to my mind and to the minds of a great number of people in the community is the fact that the emergency in St. Joseph’s Hospital is located close to the industrial area. If there is an accident -- and there are accidents -- it is very convenient to the industrial area to get the people in and get treatment as soon as possible.

The idea that the minister and his ministry have right now to consolidate all emergency services in the Brantford General Hospital --

Hon. Mr. Timbrell: That was not our idea.

Mr. Makarchuk: Just a moment, you say it isn’t your idea; it certainly is your idea. It is a very dangerous proposition. You are, in effect, putting all your eggs in one basket, in one hospital. You are going to have one emergency service for a population in Brant county alone of more than 100,000 people. The catchment area for Brantford is much larger than that because we have people coming in from Norfolk, Haldimand and Oxford counties. What the result will be is that you will be denying them, should there be a problem in Brantford General Hospital emergency.

Hospitals have accidents; they have fires, certain things can develop. There is a major railway line that runs at the back of the hospital. If we had a situation similar to Mississauga, or anything of that nature, that hospital would be out of commission. What you would have effectively done, because of your actions, is eliminate any hope for emergencies absolutely. If you have one emergency there and if that emergency ward were not in operation, you would deny emergency service to more than 100,000 people in the area. I think it is one of the most irresponsible decisions you have made. You are endangering the lives of many people in the community, as I said, by putting all your eggs in one basket.

The other point I wish to stress is that you are going ahead at this time in implementing this plan when you really do not have an effective health council. Your doctors have left the health council. They are not co-operating with the council. As I understand it, they have agreed unanimously not to have any association with the council.

You are looking at this time to get new people on the health council, and I imagine you will be making your appointments at some time in the near future. But the whole concept of your statement that there has to be community input in health care in the community is negated; there is no community input at this time. The health council is unrepresentative. It does not have on it what one would consider one of the most important elements -- the medical profession. They are not involved in the health council.

Yet here you are proceeding to make a decision that will be, as I said earlier, dangerous, irresponsible and may affect lives in the future. It could cause or create some rather serious conditions in the community in terms of the availability of emergency health care.

I think, Mr. Minister, you should reconsider that matter. You should wait at least until you have a full-fledged health council in place again. You should wait until you have the doctors back working with the health council and try to take into account the wishes of the majority of the community who want to see that emergency service continued -- perhaps not as elaborate as the one at the Brantford General and perhaps not as fully staffed, but certainly as a very necessary facility that is required in that community.

11:40 a.m.

I hope the minister thinks about that or at least delays making the decision until he has a representative health council that may for a change speak and try to express the wishes of the people in the community in the planning of health care.

Mr. Chairman: The member for Oshawa.

Hon. Mr. Timbrell: Was that not to be the leadoff, Mr. Chairman, and then I could respond? Maybe I misunderstood.

Mr. Chairman: As I understood, the committee agreed that the two could be combined. I know it makes it difficult, but I asked for the support of the committee and the members had an opportunity to disagree.

Mr. B. Newman: I understood we would be alternating.

Mr. Chairman: Order. I asked the committee if it was agreeable and no one disagreed. The member for Oshawa.

Mr. Breaugh: Mr. Chairman, I cannot let the opportunity go by without pointing out to the members of the House the advanced state of the art of fiscal control which this Legislature exercises. We are discussing these supplementary estimates nine months after the government decided that additional expenditures were in order.

If I recall the sequence properly, I first read about it in the Toronto Globe and Mail as supposedly a leak from the Treasury office. In the interim, I do not recall a formal announcement by the minister of additional funding. Nine months later the members of this Legislature get supplementary estimates and have before them the first formal piece of paper explaining that there were additional amounts of money infused into the plan.

I think it ought to be a matter of some concern to the members here, aside from the traditional role of the estimates procedure, that members get the opportunity to speak about matters of policy and to review the actions of the minister. In terms of fiscal control, that aspect of it is virtually nonexistent and, unfortunately, is laughable.

None the less, I want to point out that there have been substantial changes in the attitude and the priorities of the government. These are changes which we on this side of the House welcome and which we think members of the Legislature from all parties played some role in making happen. To be positive about it, that is a good thing this Legislature has accomplished. Collectively, we raised the point somewhat diffusely, I understand, but we did manage to get across the point that individuals in our constituencies were having problems with the medical system and that even though we do not have access to complete and up-to-date information on all parts of the health-care system in the province, we do have access to our own constituents.

Their problems were made known. Problems in the more generalized area of hospital budgeting were made known. A committee of this Legislature had an investigation on that and tabled a report. So it is possible to give us some hope in the future. It is possible for the members of this Legislature to say something to the government and to make the government of the day listen.

Although I don’t recall receiving any thank-you notes or even any credit, I suspect that the Minister of Health, in his own mind got some assistance from opposition members in going before the cabinet for additional amounts of money. Perhaps it would be silly of any member on the opposition side to expect to get credit from the government for making such a change, but in reality I think that is precisely what did happen.

As I have said before in this House, I am pleased with the increases and the change in stance of the government on the funding of the health-care system. I would not for a moment pretend that all of the problems had been resolved because many of the problems cannot be resolved by a simple influx of cash, but I do recognize that some movement has occurred. I would, unfortunately, put the caveat that those people who traditionally have not had their roles matched by economic remuneration of the order of $50,000 or $60,000 a year will not get substantial gains, and perhaps those long-standing traditional reward systems that are in place in the health-care system will not change around very much.

In my opening remarks today, I want to raise a number of matters that seem to me to be problems that persist.

I want to begin by reiterating my personal unhappiness with the way the ministry reviews hospital budgets. There has seemingly been for a number of years now some difficulty in getting a handle on effective cost control in individual hospitals or, where they have health councils, co-ordination of that control, particularly by the use of an American consulting firm called Naus-Newlyn.

I want to point out to the members of the House that there is not a small amount of bitter irony in the location of Peel Memorial Hospital in the riding of the Premier (Mr. Davis) of Ontario. Some of the things that were said in committee last year about whether these private consulting firms could actually realize cost savings of the order projected related to that hospital.

A number of us who had visited administrators regularly over the last year were well aware that perhaps five or six years ago there were large areas where changes in procedure would result in rather substantial amounts of money. Yet it was not very realistic for Naus-Newlyn to suggest to Peel Memorial that they would get at least their fee of $462,000 in recovered cost savings.

In the Peel Memorial instance that does not appear to have happened. In fact, the hospital itself is now attempting to recover part of those funds it paid to that private consulting firm to do that kind of study. The unfortunate part is that the reason private consulting firms work in most of our hospitals these days is that the ministry has insisted in its own awkward way that the use of these firms be almost mandatory if hospitals are looking for additional programs or budgetary expenditures.

There are firms available other than this one, and there is also available, of course, the Ontario Hospital Association, but for all practical purposes, many hospitals have been forced to use the one who is knocking on the door with a proposition. That turns out to be the rather aggressive marketing techniques used by this one particular firm.

In addition, aside from the simple fact that it appears to me to be unrealistic to expect that kind of cost saving to occur, the recommendations made by Naus-Newlyn and other private consulting firms very often in my view have a detrimental effect on the day-to-day operations of the hospital. In other words, a hospital is not a factory.

When there are cutbacks on how the food is served or different standards are set on how to clean the wards or how to staff those wards, it is not a simple mechanical process. Intervening in that process is the care of human beings and the interaction between nurses, nurses’ aids, hospital assistants, orderlies, doctors, and a great many other people in that not quite clearly identified, but certainly acknowledged field of human relationships where people are recovering from a health problem.

I am aware that more and more hospital workers are reacting rather violently to the propositions put forward by the consultants. In a number of the places where I have talked to administrators, this firm and other firms do make it a practice to consult with the staff regularly. None the less, a clear conflict sooner or later comes about.

To put it as succinctly as I can, an outsider looking at the operation of a hospital essentially concerned with fulfilling an initial promise to save large amounts of money is sooner or later going to get down to that point where the recommendation is simply that staff be cut. There will enter into the picture then conflicts about cutting of staff, the operation of staff hours and a number of other propositions put to administrators.

If we were looking at the production of automobiles in a factory or other such processes, these measures might be very sensible, time-saving and cost-saving. In a hospital-care situation they are not. Unfortunately those who have least status in the hospital will suffer most. I think that is a regrettable situation and one which I hope the minister would take under consideration. I hope he would back off on the use of private consultants and, in particular, put some provisions on the use of consultants such as Naus-Newlyn when they get to that particular point.

It is my firm opinion that point was reached more than a year ago. There are very few hospitals any more where it is realistic to say that a private consulting firm can come in and save the hospital literally hundreds of thousands of dollars. We should cease and desist that particular practice. I never was very much in favour of it. I certainly think that now the point has been reached in Peel, in Stratford and in a number of other places where that private consulting firm has been used, where it is detrimental to good health care. It will be the hospital-care workers who will bear the brunt of those recommendations.

11:50 a.m.

I want also to raise another matter which has been put before the House on a number of occasions -- I have four examples in hand here -- which is people who are in need of some kind of prosthetic device. I am aware the minister has a committee advising him on this. I am also aware that when I asked him its status in the fall, his response was that in two years he had managed to complete setting up the committee.

I would ask the minister to expedite that matter. There is a large number of our constituents who fail to make the distinctions that OHIP makes about what does and doesn’t qualify for OHIP coverage in this matter. I know, particularly among the handicapped people I work with, they are not always aware that certain kinds of repairs can be done at the local hospital, for example, and they do not have access to that, whereas someone who was working in a hospital on a regular basis has that.

Although it seems on occasion a difficult judgement to make, it becomes, I think, essential. In certain cases where there is a need for eye surgery, where there is a need for breast surgery, where there is a need for devices, that becomes the essential element in making that person well again, or at least in making that person completely mobile within the community, so I view it to be a serious problem,

I note that the member for Cambridge (Mr. M. Davidson) has put forth an example to the minister, and the member for Ottawa Centre (Mr. Cassidy) did another one for the minister. I know that members from other parties have presented individual cases to the minister. I know that I have done so in the past, and I would ask the minister to expedite that process, or at least to allow some greater degree of flexibility in seeing what does and doesn’t come under OHIP.

I understand there is an appeal process, and I understand that many physicians now are recommending changes in that, but I would point out that is a serious problem for a great many people. I urge you to expedite that process and loosen it up so that more people are covered and we do provide those devices to people who need them.

Another kind of raging controversy that is emerging now, which emerged previously in the history of Ontario, is the matter of denturists. I frankly do not understand the fairness for someone who thinks he is practising within the laws of Ontario and winds up with a jail sentence or a $1,000 fine.

I felt, frankly, in the previous discussions, which were held some time ago in this House, that a reasonable resolution had come to pass. Denturists could practise in this province, but where there was at least some question as to whether they were actually just making dentures and fitting them properly, or providing some form of dental surgery, they would do so under the supervision of a dentist. I think all members have received copies of letters from denturists who have been asking dentists to provide that kind of supervision. Apparently, the dental profession is not exactly going along with that previous decision in Ontario.

I would urge the minister to move to some serious consideration of the kind of legislation now in place in Saskatchewan, where it appears to me there has been a resolution of the problem which is somewhat different than Ontario’s resolution and which may not be totally applicable to this province. I think it insupportable that we simply let the current situation float along.

There is a need, and I recognize the arguments are valid on both sides, but it does seem to me that there is a great measure of unfairness in that one side can have an academic argument and the other side is faced with jail terms and sentences and things of that nature. It does no one any good. More important, I guess, it does not any good for the people of this province who need these services to let this whole thing go unresolved.

I would ask the minister to review that. There are several options to him. The minister could go to the dentists of this province and say: “Wait a minute. We did strike in the late 1960s, I believe, what would seem to be a reasonable solution to the problem. It is not working, and we need some assistance in that.” He may move to the kind of legislation that is now in place in Saskatchewan, more clearly defining what a denturist can provide.

At any rate, I find it unacceptable, as it always is, that it will be people who need that kind of care who suffer the most. It may be the denturist who pays the fine or goes to jail -- that person has the opportunity kind of to look at that in several lights -- but the person who requires the service is often having to pay almost double the amount to get the same kind of service from the dentist that he could get from the denturist. It strikes me that the least fair system is the one that requires patients to pay.

I notice the minister has endeavoured to resolve the argument between podiatrists and chiropodists. I do not pretend to understand fully all the ramifications in this field, not having been formally trained as either. I offer a measure of support to the minister. I found his statement acceptable. It will perhaps create some problems while resolving others but he has at least attempted to move on a definition of who can practise foot care in the province.

The overwhelming concern is that it is clearly not satisfactory that we have something like 84 podiatrists who can provide foot care to a population of eight million people. We have a number of other people called chiropodists who can provide good foot care under limited circumstances. The minister has made a move in that direction.

Whether that is going to resolve the problem is secondary in my concern to the fact there was some movement concerning a problem that has been in place for a considerable time. I hope our senior citizens -- and not just senior citizens, because a lot of people who are jogging have that foot-care problem -- will have had some kind of resolution put to them. I offer a measure of support to the minister for doing something. The minister made the right move. I leave to others the argument as to whether the standards and the licensing provisions are adequate.

In my first review of whether the minister has dealt fairly with the existing podiatrists, it is my judgement that by allowing them to continue to practise under OHIP, the Ontario Health Insurance Plan, it is difficult to make an argument that undue hardship has been put on them. I have had correspondence from some podiatrists which indicates they feel the ministry is trying to run them out of business. I did not read that into the minister’s statement and perhaps he should clarify that situation for the podiatrists.

We have a time constraint so I am going to rush through some of these other matters. There is one I cannot let pass. We still have in place this thing called a chronic-care copayment. In response to a written question, the ministry provided me with an estimate of how much money it is pulling out of this plan. It is fairly substantial -- in excess of $13 million. The ministry has retained $10 million and the hospitals something in excess of $3 million -- $3.4 million. That’s a lot of money to someone like me who has never seen $1 million, let alone $10 million. Balanced into the Ontario budget, though, that is not a substantial increase in revenue.

I then have to move to our original argument about whether the idea of a copayment scheme was fair. In our view it is not. Are the circumstances under which this program functions fair and reasonable? In our view they are not. There are individuals functioning within the system, attempting to go through the process as set up by the Social Assistance Review Board. Does that system provide escape valves for those who truly have additional hardship? In our view it does not.

I ask the minister to review the whole concept. It strikes me as unfair. If he does not accept that, I ask him at least to review those cases which have been brought before him as minister which I think do prove a severe hardship to individuals. We are talking facts, not fear. There are people who have lost their life savings, there are people who have lost their houses because of this program.

When he began the program the minister said he was accepting something I would not -- that a chronic-care copayment scheme is a reasonable way to proceed. He also said he would be prepared at the end of a year’s operation to review the scheme and take out those gross inequities which are now clearly indicated. I ask him to do two things: first, to review the whole concept of chronic-care copayments, which I find insupportable, and second, if he is not prepared to accept that, then at the very least to go through the regulations once again to see that people do not lose their houses and their lifetime savings because of serious illness.

12 noon

I want to point out to the minister that though we sometimes become a little emotional on this side on these problems, the very premise upon which medicare was brought into this province was that one would not lose all his life savings and all his major investments in terms of a house or whatever because of serious or long-term illness. It strikes me that this particular program in financial terms is not a drop in the bucket for the budget of the province, so it can’t be a major concern that way.

I think the problems related to the program have been carefully documented now and do affect a fairly large number of people, not all of whom might lose their houses. There is unfairness in the administration of the program because of the option of local administrators to make some decisions about who pays and who doesn’t pay. The scheme is not put in place uniformly across the province. At the very least, I think the minister has an obligation now to review the regulations under which that thing functions. If he is not prepared to take it out altogether, which I would greet with great joy, then he should review it all.

I want to speak too about the matter of opted-out physicians. I want to point out that we have had a great deal of study, discussion and debate about whether they are in or out and whether it is fair or not. Let me again try to set aside my initial bias, which is that I believe if we sat down once and for all and bargained reasonably with the OMA though the proper committee we would come to one seen-to-be-fair-by-both-sides fee schedule or method of payment for physicians in this province and that both sides would then adhere to that.

Even in those areas where they are not going to accept that, you could still be reasonably content, if that is the way to put it, with the level of opting out. There are a number of areas in the province where most of the physicians have remained within the plan with a slight trend showing of physicians opting back in.

We have brought to your attention on a number of occasions, for example, from my area and from the Sudbury area, the case of people who go to their own physician locally and have been participants with that doctor for some time now. The doctor has opted in but there is a need for specialized services. Then the doctor refers them to somebody in Metropolitan Toronto where there is a higher concentration of opted-out physicians, particularly in the specialist fields.

There remains that perplexing problem that the people are not informed that this physician has opted out. Even if they are informed, their options are extremely limited. If you ask me to come up quickly with the name of two specialists in any given field in Metropolitan Toronto, I couldn’t do it. These people are in no position to do it. The physicians who are referring them to specialized care in Toronto obviously can’t do it.

The end result is someone who began treatment with an opted-in physician winds up somewhere in a downtown Toronto hospital with an opted-out physician providing the care. Subsequently, the argument begins about whether that is fair or reasonable, whether they should pay it all or whether they should pay part of it. Some of the correspondence back and forth between the opted-out physicians and the patients has a reasonable tenor to it, but some of it does not. The people who are using the system do not understand what this argument is all about.

It is not a theoretical argument about the practice of medicine. There is that side to it. More important, they were sick and thought they were covered by the government of Ontario’s medicare plan and they subsequently found out that they were not, at least in part.

I understand some of the arguments. I wouldn’t be one to stand up here and say that the anaesthetists on the way into the operating room stop the wagon in the hall and say, “Wait a minute. We have got to have a half-hour discussion because I have to tell you that I am opted out.” But I do think there are practical measures the minister could take that would resolve the problem. Certainly, when referring patients from an opted-in physician to an opted-out one, there ought to be at least the occasion there, nice and clear and without any panic, where a complete and full explanation could be given and where alternatives could be found.

It has been my experience, which I want to reiterate in order not to be unfair, but to be clear, that I do not find the OMA hotline service to be worth -- I can’t use that language -- but I do not find it successful. Let me put it that way. I have found that in cases, for example, from Sudbury or any outlying area where people have been referred to the OMA service, there is a little different perspective in the day-by-day practicalities given than was presented in the initial press releases and announcements of the minister setting up this particular scheme. It doesn’t work.

There doesn’t seem to be any urgency at the Ontario Medical Association to find somebody. They will point out some places where the patient could go and dig it out, but I must say, though I’m a little more familiar with the system than most patients would be, I am rarely successful at finding those services either. I think the minister must address himself to the very thorny situation that there is no legal obligation on the part of a physician to notify the patient that he is opted out and is going to charge in excess of the Ontario Hospital Insurance Plan approved rate. Second, if the patient is in need of some alternative source of service, there is no good mechanism in place to provide that.

The minister may argue, and I would accept that argument in part, that we’re not talking about the vast majority of cases, but we are talking about human beings who need care, who have a proper and I think realistic perception that they pay for their medical-care services here in this province in a number of ways. They pay a premium; they pay taxes to two or three levels of government and they make private donations, They have paid for the system already and it is unreasonable to expect them to pay once again.

I want also to deal with a second aspect of that. I noticed that the minister has written to the chairmen of boards of hospitals. I know a number of steps have been taken in this regard to try to provide in the publicly funded private hospitals that we have in this province, the services at the approved rates, so you get around this matter of opted-out physicians. I do not find the consensus that should be there after a year’s argument and discussion on the matter.

I know the minister has written once again to the chairmen of boards of hospitals discussing the agreement that was reached with the OMA. I cannot get away from the basic notion that, at least in the hospitals built by the public of Ontario that they by and large pay for through their tax dollars and their premiums now, you ought to be able to get any care that can be provided in this province at the approved rates.

I’m backing off an original position, which many people in my party would take, that physicians should not charge outside the OHIP fee schedule. We’re not at the position where we’ve negotiated a realistic fee schedule either, but at least in our hospitals, you ought to be able to get care at the approved rates.

It can happen, because the ministry has changed regulations, that even an opted-out physician can provide care in a publicly funded hospital at the approved rates. This causes some problems in its own right about whether there are really two levels of care.

None the less, after all this argument, after all the documentation that members from all sides have brought in to the minister, we still do not have a resolution to the problem. It strikes me as a situation that cannot go on much longer.

We’ve had the opportunity to debate individually, and collectively in committee. The OMA has debated it. I know the minister is writing letters to people all over the place. I proposed a private member’s bill which was essentially an attempt to get at the same thing.

I still cannot accept the notion that that happens in a hospital that is paid for, by and large, with public tax dollars. If it didn’t get all the funding from that source, it got it from private donations -- coming from the same people, most likely. The public sees that as being a public hospital. Even though I know it is a publicly funded private hospital, it’s pretty hard to go to the people in Oshawa and say that the Oshawa General Hospital isn’t a public hospital.

It certainly is not a private hospital in the commonly accepted sense. People do not understand, nor do I, why at least in that place, using publicly funded buildings and overhead, publicly funded equipment, publicly funded support staff, there isn’t one rate, and that’s the OHIP rate.

I’m going to ask the minister once again to go back at that one. I understand the problem. I keep up with his correspondence to the OMA. We get copies of his letters to the hospitals and to the chairmen of hospital boards, but the problem remains. It is not yet resolved.

I understand in the case of anaesthetists and with other kinds of specialized care it is a little difficult. I appreciate that in one of the hospitals -- Northwestern General Hospital in Toronto -- he is attempting to put forward a different method of payment for people who provide that kind of service. I have also read some correspondence from other doctors who do not think that is quite a workable way to go about your business.

12:10 p.m.

What I am saying here is that I reluctantly hear the arguments that are put on both sides of this issue. But when it happens that we put up the buildings, we put in the equipment, we pay for the support staff, and all of that is publicly funded, I don’t think there is a whit of an argument left in there to say that should not be done at the OHIP approved rates. The minister has all kinds of options to exercise in terms of going at alternative funding formulas, different methods of having them set up, but I do think there is a problem in that regard which is substantive.

I want to include in my remarks some continuing problems that seem to have gone underground somehow. If you recall in this House about this time last year there was a good deal of discussion about psychiatric care, about the closing of Lakeshore Psychiatric Hospital, about whether or not all these people could be absorbed within other psychiatric care institutions in the area, about alternative forms of care, about where these people would go and who would look after them. Would there be community-based programs cranked up to go into place? We had this long and involved argument in committee and in the House as to whether that was a reasonable thing to do, whether alternatives were available and whether they have worked.

I note, too, that little birds whisper in my ear on occasion that the ministry is sensitive to this issue. In fact, it is said to he doing some interviewing of staff at the Queen Street Mental Health Centre and other psychiatric institutions to get a shakedown of whether or not what they said a year ago would happen has happened successfully. I note, too, that there are recurring problems with setting up the community care programs that we asked for. A year after the closure of Lakeshore hospital was announced, and a little better than nine months after it actually happened for the most part, we still don’t have the complete funding of a community care program in place.

I note, too, in my own area, part of the minister’s announcement at that time was that he was going to rebuild Whitby Psychiatric Hospital. Again, there would be consultation with the community, there would be community care programs set up, there would be a number of things done.

Just a little while ago I met with the administrator at Whitby Psychiatric Hospital. They are not even sure yet what the building will look like, whether it will be up by the Baseline Road or down by the lake. There has been no real ongoing consultation with the community, although the community has attempted to do so. There is a proposal now before the Durham Regional Health Council which suggests in part, as one of its alternatives, that perhaps you could take the Doctor Joseph O. Ruddy General Hospital, which is plunked in the middle of the property, and turn that into a psychiatric institution and forget about rebuilding the Whitby Psychiatric Hospital.

So the problem in a nut is this. A year after the government announced it would close Lakeshore we do not yet have in place the community care programs and support programs that were so essential to that move in the first place. We do not have a resolution to the problem of the psychiatric institutions themselves and whether they can handle the capacity that is generated by the closure of Lakeshore. We are still not terribly sure of where these people went.

I have this unease in my own little body here that people have just gone somewhere, and it is somewhere around here in boarding houses. Those in group homes might be a little better off because they have been identified, but there are lots of people who need psychiatric care, at least on a day basis, at least in the community care institutions, at the very least in a group home, who have just gotten on a bus and gone somewhere. They may well be coming back for some kind of medication from time to time, but that is hardly a satisfactory solution.

I know there have been issues raised, and the minister has made his point clear, that once patients are discharged they are on their own. I suppose if one wants to deal with it in a legal sense, that is correct. But I think what we are faced with here is that we do not have the luxury of dealing with this problem in a strictly legal sense. It is a health-care matter. It is a matter of providing for people who need ongoing care through community support programs that are not there now.

I understand the minister has made several announcements about promises of funding for these kinds of community-based projects. I also know that there is more than one ministry involved in the process. But I happen to have been part of, and get correspondence and telephone calls regularly from, people who are attempting to put in place the community care programs we talked about more than a year ago in this House. They are not there yet.

To be as polite about it as I can, surely it does not take a year after the closing of an institution such as the Lakeshore hospital to put these things in place. We had long philosophical arguments about whether this exchange of service, this deinstitutionalization should happen immediately, concurrently, 30 days later, or 50 days later. I did not hear anybody saying it was acceptable to any member of this Legislature that more than a year after attempting to deinstitutionalize, the House still has not put in place corresponding community care programs. I think that ongoing thing is totally unacceptable.

I note in the announcements made in the budget the other night a lot of money was allocated -- just slightly under $500 million, I think -- for increased health care, and more money was allocated in community and social services. We have made inquiries as to where this money is going. It appears these dollars are in a somewhat fluid state. The money is allocated somewhere and no one quite knows where it is going to go.

I would welcome an announcement that all the community care programs in Durham region, here in Metropolitan Toronto and in the rest of Ontario are finally going to get the funding they deserve. Maybe that is where that money is allocated. We do not know, and I have to put on the record here that it is just as clear as day to us that you do not know either. I am asking you in the next little while to find out and to make some commitment so that community care programs or mental health programs and other kinds of programs get the kind of treatment they have been looking for for so long.

There are two other matters I want to raise. One is the matter of what are called in this province health service organizations. You may recall in this House, Mr. Chairman, I and a number of other members raised the question of funding problems for these community clinics. There are 29 of them in operation, many of them having different characteristics and being set up in different ways. Some are extremely sophisticated, providers of good medical care on a really large scale, such as the Sault clinic. Some are much smaller in scale.

It was my information the minister was finally beginning to recognize their value to the communities in which they were located. He was finally beginning to provide funding for nutrition, social workers, nurse practitioners, many of whom were having some difficulty finding their place in the health care system. I understand there has been a bit of a political controversy brewing about one of the HSOs. I want to reiterate to the minister that that should not in any way inhibit, change, alter or damage what I thought was a renewed commitment to this concept.

I believe that to be the most workable, cost-effective way to provide health care to the people of this province I have seen anywhere. I am not saying it is a panacea, but it is clearly a recognized alternative here and in other jurisdictions that deserves its fair shot. I would hope the minister would not get weak knees at the last moment and start chopping that budget. I could give you a short list of places where he could do a little chopping, Mr. Chairman, but the HSOs would be at the top of my priorities.

I will raise one other matter and then I will let the minister respond. Once again I want to indicate our support for a proposal here in Metropolitan Toronto for a special care unit for high-risk pregnancies, a prenatal care unit at Mount Sinai Hospital. Many of us, I am sure, have visited similar kinds of special care units for high-risk pregnancies in other jurisdictions, at McMaster University Medical Centre, at Women’s College Hospital. That is a supportable notion.

I understand from my reading on the subject that many of the techniques in terms of the setting up and the functioning of these prenatal care units originated here in Canada with Canadian doctors. We should, of course, be very proud of that. I am also aware, though, that very little of the machinery used there is generated in Canada. Most of it is imported from the United States. A very small group of highly skilled and specialized physicians runs it. I was told at McMaster that the cost of running it was something like $2,500 per day. It is a pretty expensive piece of business, but a necessary program; no argument from me on that.

12:20 p.m.

The alternative, however, has been put forward, most dramatically by a nurse here in Toronto touring Hamilton, by Cynthia Carver, a doctor here in Toronto, and by a number of other people who appeared at a forum at the St. Lawrence Centre about three weeks ago. It struck me from the way the meeting was set up there was perhaps a lot of symbolism involved. There were two gentlemen on the right-hand side of the stage presenting the technological arguments. I was impressed. I am one who spends a lot of time looking at flow charts, slides and statistics. I must say I have never seen a finer set of numbers or a cuter set of slides put to a large audience in my life. These gentlemen had eminent qualifications to put that kind of an argument and they put it well.

On the other side of the stage were two women, one a doctor, and one a person who I believe lectures at York University. They put a different kind of an argument, but in my mind they put it even better than the kind of high-priced technological presentation made by the two gentlemen. We were talking about high-risk pregnancies, so it would be my natural inclination to listen to two women as opposed to two men, if only from the point of view that it is unlikely the two men will ever use such a special care unit. It is possible, I am now told, but unlikely. It would most likely be women who would be users of that particular facility.

They were making an argument, not definitively against that specialized care unit but for an alternative to see that women as consumers had another option. The option has been fairly well outlined by Doreen Hamilton that there is a need to go into preventive care, to identify high-risk pregnancies much earlier than on the delivery date and to provide alternatives.

That is oversimplifying it for sure, but to attempt to be succinct about it, for someone who doesn’t have a proper diet a high risk is created by not providing the advice and the support systems that a nutritionist might offer to that person. With respect to an individual woman who is perhaps on her own and pregnant, her needs very early in the pregnancy are being ignored by and large now because there are no consultation services available, no nutritional services, no counselling for the woman, and no social worker who can actively work with that person.

In other words, the women at that particular forum were putting forward an argument that there is a raft of these which are not yet fully being considered. They were not particularly negative in their tone and they did acknowledge that the unit at Women’s College was in place and working well and had some room for expansion. Dr. Cynthia Carver on that evening went so far as to say that the unit should be supported and even expanded and properly funded. I understand there are some funding problems there.

She went on to make the eloquent argument that other needs of women have to be recognized as well. In considering this kind of judgement, it isn’t always an either/or thing that is in place, except that right now it is kind of an either thing because the alternative is not in place. I would add to those two women who made that eloquent argument that evening my own humble remarks and say to the minister, “Please provide the alternatives. Look after other needs as well.”

In part, I guess it comes down to this. One of the faults I think the current system has is that when looking for what we should do next and how we should order our priorities, we always tend to go back to the same group to get our information. I am asking the minister to consider other people, in particular in this instance people who might aptly be described as consumers of health care. In this instance where it is clear it will be women who need that kind of care, there ought to be options available. There ought to be alternatives explored. They ought to be equally funded. To be fair and to be reasonable about it, we can’t make a good judgement unless we have reasonably identical and identifiable circumstances under which to operate.

If we have one kind of special care unit set up at something like $6 million a year as a budget and if we have another one over there operating at something like $600,000 a year, we can’t make a reasonable and fair comparison between the two. I know it is an incredibly complicated and difficult piece of business to do. But I do note that the Toronto Board of Health now has a unit looking at preventive care, providing alternative forms of the argument and planning how to take that kind of budgetary allocation and implement a preventive care program in the community.

I want to conclude on that remark because I think that is the single most important thing the minister has before him now. I support the moves to change the system, not radically but to provide for the people of Ontario alternative forms of care where they are reasonable and where they have been carefully thought out. In this last particular example which I used, it is clear to me that the alternative is carefully thought out and deserves the full support and consideration of the ministry.

I understand the minister intended to attend that forum that evening and could not. We all run into that situation. I want to report that the arguments presented on both sides that evening were at least equally balanced. In my perhaps biased view, the women won that argument hands down. They certainly did with that crowd. Even if there had been no one in the hall and they were presenting it to the minister, to myself and to the Liberal health critic, I think we would have had a vote and said that they won. They had a clear case. They had thought through what they wanted. It was a reasonable, practical alternative and it deserved a chance.

In that instance and the others I have mentioned, I am simply looking for sweet reason, for us, as a people, to explore alternative forms of care which may not be traditional. I do not want to get into a confrontation with the medical profession, though I would hardly back away from one.

The purpose of the exercise, however, is not to have an argument. The purpose ought to be to change a health care system which is now geared to the curative factor, almost to the exclusion of prevention, and to move it to one which stops people from getting sick. I want to make an outlandish statement which I am sure you will use all over the place -- I would be happy to pay every physician in this province more money than anybody else in our society if all of us could be made to be never sick a day in our lives. That would be the best investment we could ever put out

Hon. Mr. Timbrell: Mr. Chairman, I seek some direction. If we are to conclude the estimates today, I will respond now; if not, and other members want to add something, I won’t do it now because I have 15 minutes to respond to an hour and a half.

Mr. B. Newman: Mr. Chairman, I want to raise an issue first presented to me by the member for St. Catharines (Mr. Bradley). He is unable to be here because he is attending the standing committee on administration of justice. He mentioned that a person on the Canada Pension Plan who receives disability payments and also has a small pension of his own finds himself having to pay for his drug benefit. He is disabled, yet he does not get free drug care. He is under 65 years of age, but he has no source of income and the member for St. Catharines thought such a person should be given some consideration when it comes to the provision of drug benefits. I will leave that with the minister who can reply to it later.

I want to apologize to the minister for not being present when he made his presentation in Windsor concerning what he had in store for the community. I had spoken with him earlier in the afternoon and had mentioned I could not be there because of other commitments in the House.

The minister in his presentation promised 100 additional, permanent nursing beds. In the provision of those additional beds, is he going to have them in use before he eliminates some of the active treatment beds now being used in the hospitals to accommodate nursing home patients? If he first cuts back on the beds, there is no place for these individuals who require nursing home treatment to go. They are at present in active treatment beds in the hospitals. The remedy should be in place before cutting back on the active treatment beds.

12:30 p.m.

In spite of the rosy picture of the minister and his officials, individuals who are on staff in the various hospitals keep telling me they are suffering from staff shortages, that there are staff shortages in practically all of the hospitals and that they are extremely overworked. As a result, the quality of the care the patient is receiving may not be up to the quality that he or she would normally have received if the patient/hospital-bed ratio were the same as it was before the cutbacks were implemented by your ministry.

There are other issues that I could raise, Mr. Chairman, but I will when the minister’s estimates come up. I know we are pressed for time here but I would appreciate receiving answers to the few issues that I have raised.

Hon. Mr. Timbrell: Mr. Chairman, to start with the member for Windsor-Walkerville (Mr. B. Newman) with regard to the drug benefit question, my understanding would be that if the person is in receipt of social assistance, whether it’s through the General Welfare Systems Act or under the Family Benefits Act, he or she is going to qualify for drug benefits. So if he or the member for whom he is asking the question can give me a particular case that we can check through, we will see What the problem is there.

I won’t say that I remember the exact details for the Windsor situation but I don’t recall that any further beds were restrained in any of the calculations this year for their budget. We are going to add 100 permanent nursing home beds in Essex county.

Mr. B. Newman: What’s the time frame?

Hon. Mr. Timbrell: We will be calling for proposals I would think within about a month, and it depends on the response. When people make application to open unused space in existing facilities, obviously that can be brought on a lot faster than cases where they are proposing either to add to the existing homes or build completely new homes. But I would say within 12 to 18 months at the longest, all 100 beds should be on stream. As well, we are introducing the chronic home care program into the county of Essex as of July 1. All of that will take a lot of pressure off the existing institutions.

With regard to staff shortages -- I hope I can get the figures -- my recollection is that last year we actually saw an increase in the number of paid hours in the hospitals in the province, not a decrease. I can only say that there are a number of checks and balances that come to bear.

First, just about every hospital in the province is at present accredited and works hard to stay accredited. One of the things looked at first by the accredited teams that come in is staffing levels and not just on the day they are there -- if I may answer the suspicion which may be in some people’s minds that you can beef up the staff for that day and impress them -- but they go back in six to nine months and they take anywhere from 40 to 50 to 60 cases out of the records and look at how those people were treated and what were the staffing levels noted in the record of the hospital on those days.

As well, of course, the medical advisory committees of the hospitals on a regular basis review problems, as do the nursing directors. If they find shortages developing or problems developing in particular areas of the hospital, those are drawn to the attention of the board and then the board really has a variety of options open to it. They can agree and shift resources within the hospital or they can disagree and say that in their view the unit or the program is adequately staffed -- and let’s not forget that ultimately they are responsible for the hospital -- or they can agree that they don’t have the resources and will make an appeal to the ministry. That happens all the time; it has since the Ontario Hospital Services Commission was established, and where the cases can be made, adjustments are made as well.

I would like to deal with the concerns of the member for Brantford (Mr. Makarchuk) next. I want first of all to correct the record: the program that has recently been agreed to in Brantford was agreed to by all of the hospitals and the medical society, all of whom, including the medical society, were members of the rationalization committee. I make that point because the member expressed concern about the Brant District Health Council as such and the difficulties that have occurred in the last few months in the membership of that body.

The rationalization committee is the body that has done the work for the last year in developing a rationalization proposal. That body carried on uninterrupted, chaired as it is or was by the former chairman of the health council. The medical society was involved throughout and signed the rationalization proposal which went to council and has come to us. Members of the medical society continue to be involved in most, if not all, of the committees of the health council.

I would hope as we look to restructure the council and add members back, that now or in the not too distant future we can continue to involve members of the medical profession. I wanted to correct the record and say that the members of the medical profession in that county certainly are involved in most, if not all, of the committees of the council.

The member expressed concern about one of the aspects of what the hospitals and the medical society have agreed to, namely the development or the move to place at the Brantford General Hospital a 24-hour-a-day staffed emergency department. I emphasize that, because at present there are two emergency departments that are not staffed 24 hours a day. In fact, what made that aspect of the proposal so attractive to them and to the council subsequently was that this would raise the level of emergency services in the city of Brantford significantly.

I want to point out that it is not unusual, and I ask you to consider the example of Sudbury, to have a central 24-hour-a-day staffed emergency department. The Sudbury General Hospital serves the same function for that community that is proposed to be served for Brantford out of Brantford General Hospital.

I think everybody is aware that there can be times of emergency. The honourable member referred to the main railway line through town and what might happen if there were a major crash of some kind. Every hospital in the province has and regularly tests a disaster plan, and if something -- God forbid -- were to happen of major proportions that was to plug up the Brantford General Hospital, then as part of the disaster plan there would be provision for diverting emergencies to other hospitals while that crisis or that emergency prevailed. So, in fact, that is part of the regular day-to-day planning of such services.

If I can move to the comments of the critic of the official opposition, let me deal first with the question of the ambulance investigation. I want to say, first of all, that the investigation in question has been carried out by the Ontario Provincial Police at our request following a number of audits which were done by our staff over the last couple of years. I make that point because I think it should go on the record that the raids in February were carried out as a result of the material being provided to the police by us, but it was their decision.

Secondly, we did not issue a press release as such to say, “Listen, world, we swooped in on six ambulance operators in the province and they are terrible people.” In fact, we were just as concerned as the honourable member opposite and members of the ambulance operators’ association that the actions be put in their proper context. When we were called by the press, we had a standard response which was given to every representative of the media and I will read it into the record.

“In response to public inquiries, the following statement has been issued today by the office of the Minister of Health: Officers of the Ontario Provincial Police and Ministry of Health audit branch today simultaneously attended at the head offices of privately operated ambulance services in Leamington, Trenton, Gananoque, Woodstock, Hamilton, Fleetwood, London and Chatham and took possession of records and other documentary material under warrant.

12:40 p.m.

“The action is part of an investigation undertaken by the police on the basis of information provided to crown law office by the Ministry of Health. Further action may be forthcoming. Meantime, the Ministry of Health is taking any necessary steps to ensure that ambulance service to the public in these centres is not impaired.”

Mr. Conway: Did you make any recommendation to the police as to whether they should do such and such?

Hon. Mr. Timbrell: Once the audits are turned over to the police, it is entirely their responsibility to decide, based on those audits, what further action is required: whether to lay charges at that point; whether to subpoena or to seek voluntarily other information; or whether, as in this case, in order -- because six people were involved -- not to have the due processes of justice thwarted by perhaps serving a lien on one and having word spread as to what they were after, to do it all at once, at the same time, in those centres around the province and get the records.

Mr. Conway: The question is, did you turn those audits over with recommendations?

Mr. Chairman: Order. The honourable minister has the floor.

Hon. Mr. Timbrell: Mr. Chairman, I am not sure what he means by “with our recommendations.”

Mr. Conway: Recommendations as to whether they should lay charges.

Hon. Mr. Timbrell: That is entirely in their court.

Mr. Conway: So you made no recommendations of any kind?

Hon. Mr. Timbrell: Once the audits were done, there Was sufficient cause for concern that we turned them over to the police for further investigation. It is as simple as that. The matter proceeds from there.

We believe private ambulance operators have a significant role to play in the future of the ambulance service in the province. We think we have a good mix, where the ministry operates some of the services and the private sector operates others. Some are operated by municipalities, as is the case in Metropolitan Toronto. Others are operated by hospitals. We do not intend to develop or promote a policy that would see the ministry put the private sector out of the ambulance business altogether.

If I can move on, in the brief time available: Two of the members have referred to orthotics and prosthetics. I share their concern in that area. That is why I asked for the report to be done in the first place, a couple of years ago, to review the situation. It is before the interministerial committee. I hope we will be able to complete that review -- including a review of the experience in other provinces where they have introduced programs and what they have done by way of controlling the mode of prescription of them, the cost of them -- in order to arrive at a policy in the not-too-distant future.

Mr. Conway: I thought you and the Provincial Secretary for Social Development (Mrs. Birch) were the dynamic duo whose clout was unbeatable in the government.

Hon. Mr. Timbrell: I get to wear the cape this week, though.

Mr. Conway: I am saddened.

Hon. Mrs. Birch: I am too.

Hon. Mr. Timbrell: Mr. Chairman, a great many matters were raised by the member for Oshawa (Mr. Breaugh). Inasmuch as I understood the House has to deal with a matter of supply today at 12:45 p.m., let me say that most of the issues he raised I can deal with in the regular estimates, in four or five weeks.

I welcome his support on the question of chiropody. I think it’s a very important area, important to the whole population, but particularly to elderly people.

With regard to denturists -- or denture therapists, to use the proper legal term -- I did try extensively to reach a meeting of the minds between the denture therapists, as a group, and the dentists, as represented by the Ontario Dental Association and the Ontario Royal College of Dental Surgeons. We tried extensively to make the existing provisions work to everybody’s satisfaction.

I want to take issue with one thing the member said when he referred to a gentleman who thought he was within the law and ended up in jail. If the member were to ask that gentleman, I think he would tell him he knew he was not within the law because he does not agree with the law. Therefore, he went ahead, in the full knowledge that at some point he might very well be charged, and faced the consequence.

Being unable to arrive at a meeting of the minds between dentists and denture therapists, I asked the Ontario Council of Health in February -- I cannot remember the exact date -- to conduct a complete review of policy with respect to denture therapists, in particular in relation to partials. I think those of us who were here in the House six or seven years ago when the matter first arose recall very well that in the end we had to acknowledge that when people were dealing with full dentures and not with any live teeth, with the proper training, either for new graduates through Humber or for previous graduates by way of examination, that was no problem. But what we were all concerned with at the time was with people dealing with live teeth and fitting partial dentures around live teeth.

I have asked the council of health to review the matter -- and may I say to the sceptical member from the Pembroke area I think we will have that report within about six months -- and to advise whether changes would be appropriate in the public interest.

The member refers to costs. Certainly, cost is a serious consideration. As I said to one of my own constituents just two days ago at a senior citizens’ centre, if costs were the only matter then we would open it up entirely. I have to be concerned and all of us in this House have to be concerned that whoever is dealing with the public, in this case dealing with them with respect to partial dentures, is qualified not only to make and to fit partial dentures, but also to identify potential pathological problems of the mouth around live teeth and to refer patients to the dentist for necessary care. That is a very serious consideration and one which will be at the forefront of the review by the council of health.

Let me say, with regard to chronic payment that our staff is sitting down with each of the individual hospitals that are chronic hospitals or have chronic units to review with them the use of the form seven exemption form and the possible use of the Social Assistance Review Board.

Let me give an example. I think my friend from Renfrew North (Mr. Conway) may have raised the issue in the fall. There was a case that eventually ended up on the late CBC Ombudsman program. It was very interesting. When the lady sat down with the social work staff at the hospital and when the case was worked through with all of the exemptions available on the copayment, the copayment was reduced to $104 a month. When they worked through all of the additional income available through supplements and Gains, the income went up $94 a month. In fact, the net copayment in that case worked out to $10 a month.

I have to say from the information available to me, I think the concern we all share that people are going to be put out of their homes or lose their life savings is not well-founded. If we can ensure that both the staff of the hospitals and the patients are aware of the exemptions available and the opportunities of additional income, then that can significantly change the situation. I am amazed by the number of cases that come forward where a supplement would be an entitlement for the individual but it has not been applied for, or the separation allowance that the federal department brought in a couple of years ago has not been applied for.

On the question of opted-out physicians, I note the example given by my friend from Oshawa about a person going from the family physician who has opted in to a specialist somewhere. He pointed to Toronto, but it could be any health sciences centre, I suppose. That is a serious concern. I would have hoped, and I have heard this is the case, that the directory we produced in answer to a Notice Paper question, which the member himself placed last year, would be helpful to those referring physicians. Certainly, I think one of the responsibilities of a family physician or a referring physician, where the person is concerned that it be an opted-in physician, is to use that directory or any other means available, but I think that is a very effective one, to assist the person in doing just that.

We are going to reproduce the directory. It will be effective as of April 1, and it should be available by early June. We will redistribute it to the members and to the libraries. I have given direction that it is to go to all the information centres in the province of which we have record through the Ministry of Culture and Recreation. It will have a very wide distribution and will assist the public in making those kinds of decisions about physicians to whom they are going to go.

Let me say on the question of the Whitby Psychiatric Hospital that I will be meeting very soon with representatives of the health council out there and discussing that matter with them. There is a committee established under the auspices of the Durham Regional District Health Council drawing people from the mental health association as well as the institutional sector from a very broad geographical region, not just the region of Durham because Whitby Psychiatric Hospital has a very wide catchment area.

12:50 p.m.

I would like to see the work of that committee brought to a head in the next few months so that we can get on with that and determine, as you say, whether it is going to go up by the Baseline Road or is it going to go down by the lake and what its configuration is going to be. Let’s get on with rebuilding it.

As regards the community mental health programs, I think it is fair to say that not all of the programs that were approved and announced late last September out of the moneys coming from the Lakeshore Psychiatric Hospital are all up and running. Some of them haven’t got going at all at this point and some are only partially going, but the money is there for all of them. Some of them have had difficulties recruiting staff, others in getting quarters and that sort of thing; but the money is there.

I am trying to remember the percentage increase. I don’t think I will be too far out if I say in the last two years the percentage increase in money allocated for community mental projects is something in the order of close to 60 per cent. It may even be higher. There has been a significant increase in funding in that area.

I am advised that 20 of the programs are now at full strength. There were more than 25, I believe -- 25 or 28, or something like that -- so most of them are up and running at full strength.

It is interesting to note that last year, while we had approximately 4,000 inpatient beds in our psychiatric hospitals, we had 128,000 outpatient visits, two aspects which are indicative of the shift in the development of psychiatric services.

I am pleased to have the honourable member’s support of the HSO program. I agree with him; I think it is one of the most significant things for the future. I was disturbed at some of the media attention that was given to an item currently being reviewed by the public accounts committee as regards an HSO in St. Marys. The very point of the HSO program is to provide an incentive to see people less and to give them more appropriate and preventive services. With respect to one paper in particular, I think that fact was turned and twisted around to make it look as if somebody was ripping somebody off. I don’t think that is happening at all.

I will try to wrap up as regards the high-risk pregnancy matter. We have now had the benefit of reports from two groups. The Hospital Council of Metropolitan Toronto and the University Teaching Hospitals Association, in conjunction one with the other, have produced a very good report for Metropolitan Toronto. The administrative advisory committee on reproductive care has produced a very good report for all of Ontario. I don’t take the issue to be one of prevention versus treatment. I think both reports have a balance. Both of them recognize that there is need for prevention and treatment.

I think we forget the great advances we have already made in the province. The fact that in the last decade the perinatal death rate dropped from almost 22 per 1,000 live births to about 13. We have already made a lot of progress and we can do a lot more.

I promised the group I met at the forum that I would do two things. I had already indicated I would go to Montreal and Cleveland to look at perinatal, if you will, technical networks. I promised that I would also, before making the final decisions, look at some systems they would recommend to me, wherever they are -- I think they are on the other side of the pond -- but they think our model is on the preventive side. But I don’t see the issue as being prevention versus treatment; it really has to be both.

Mr. Chairman, I am sure there are many other items I haven’t responded to, but once my estimates come up in the next five or six weeks, we will have lots of time to deal with them.

Vote 3202 agreed to.

Mr. Chairman: That completes the supplementary estimates of the Ministry of Health.

On motion by Hon. Mr. Timbrell, the committee reported certain resolutions.

Clerk of the House: Mr. Edighoffer from the committee of supply reports the following resolution:

That supply in the following supplementary amounts and to defray the expenses of the government ministries named be granted to Her Majesty for the fiscal year ending March 31, 1980.

Reading dispensed with.

Resolution concurred in.


The following bill was given first, second and third readings on motion by Hon. F. S. Miller:

Bill 58, An Act for granting to Her Majesty certain additional sums of money for the Public Service for the fiscal year ending March 31, 1980.

The House adjourned at 12:57 p.m.