FEDERATION OF WOMEN TEACHERS' ASSOCIATIONS OF ONTARIO
ONTARIO SECONDARY SCHOOL TEACHERS' FEDERATION
CONTENTS
Thursday 14 January 1993
Pre-budget consultations
Federation of Women Teachers' Associations of Ontario
Margaret Dempsey, president
Joan Westcott, executive director
Beverley Gardner, second vice-president
Ontario Secondary School Teachers' Federation
Chris Malkiewich, chair, education finance committee
Liz Barkley, president
Larry French, legislative researcher
Ontario Public Health Association
Audrey Danaher, chair, public policy and resolutions committee
Nancy E. Day, president
Peter R. Elson, executive director
Ontario Council of Regents
Richard Johnston, chair
Barry D. Moore, chair, Council of Presidents
Ontario Medical Association
Dr Michael D. Wyman, treasurer
Darrel J. Weinkauf, director of economics
STANDING COMMITTEE ON FINANCE AND ECONOMIC AFFAIRS
*Chair / Président: Hansen, Ron (Lincoln ND)
Vice-Chair / Vice-Président: Sutherland, Kimble (Oxford ND)
Caplan, Elinor (Oriole L)
*Carr, Gary (Oakville South/-Sud PC)
Christopherson, David (Hamilton Centre ND)
Jamison, Norm (Norfolk ND)
*Kwinter, Monte (Wilson Heights L)
*Phillips, Gerry (Scarborough-Agincourt L)
*Sterling, Norman W. (Carleton PC)
*Ward, Brad (Brantford ND)
Ward, Margery (Don Mills ND)
Wiseman, Jim (Durham West/-Ouest ND)
*In attendance / présents
Substitutions present / Membres remplaçants présents:
Conway, Sean G. (Renfrew North/-Nord L) for Mrs Caplan
Coppen, Shirley, (Niagara South/-Sud ND) for Mr Sutherland
Harrington, Margaret H. (Niagara Falls ND) for Mr Wiseman
Johnson, Paul R. (Prince Edward-Lennox-South Hastings/Prince Edward-Lennox-Hastings-Sud ND) for Mr Christopherson
Swarbrick, Anne (Scarborough West/-Ouest ND) for Ms Ward
Clerk / Greffière: Grannum, Tonia
Staff / Personnel: Richmond, Jerry, research officer, Legislative Research Service
The committee met at 0936 in committee room 1.
PRE-BUDGET CONSULTATIONS
The Chair (Mr Ron Hansen): We will resume the hearings on the pre-budget consultations in the standing committee on finance and economic affairs.
FEDERATION OF WOMEN TEACHERS' ASSOCIATIONS OF ONTARIO
The Chair: The first group on this morning is the Federation of Women Teachers' Associations of Ontario. Would you come forward, please. I'd like to welcome you to the standing committee on finance and economic affairs. They're not unfamiliar faces, but Hansard can't see you, so perhaps you wouldn't mind reading into the record who you are.
Ms Margaret Dempsey: Yes, certainly. Good morning. My name is Margaret Dempsey and I'm president of the Federation of Women Teachers' Associations of Ontario. With me this morning are Barbara Sargent, first vice-president of FWTAO; Joan Westcott, executive director, FWTAO; and Bev Gardner, second vice-president, FWTAO. We also have with us this morning several members of our FWTAO board of directors and an executive assistant for political action-public relations from our office.
The Chair: Come forward. One can sit beside Mr Carr, and there's another seat on that side. Don't be shy.
Ms Dempsey: FWTAO is pleased this morning, on behalf of our 41,000 women teachers who teach in our public elementary schools, to present to you, the standing committee on finance and economic affairs. As for the last number of years, we want to speak not just about adequate funding for the education of the young child but about some wider social issues as well.
Let me acknowledge right up front that we as women teachers, along with most other people in Ontario, do recognize the serious problems within our economy and how difficult it is at this time for a government even to maintain existing funding for the current programs. But the responsibility facing any government, regardless of the economic situation, is to determine the priorities for public spending. So what we will deal with today is our view of what the government's priorities should be, given the limited financial resources available. We will be discussing the financing of education, including the funding of junior kindergarten programs, poverty, and the integration of services to children.
Reduced spending in education contradicts the government's policy on training a workforce that can compete effectively in the global economy. FWTAO is well aware of the need to prepare young people with the foundations for lifelong learning. In 1988, in a submission to the select committee on education, we presented, on the philosophy and goals of education, these words in part:
"Schools can help prepare children for tomorrow's workplace...but with that base for future learning, young people can go with confidence to post-secondary institutions or directly into the workforce for more specific skills training according to the changing requirements of business and industry."
Decreased funding to the school system undermines the objective of developing a skilled workforce that is capable of competing in the world economy. What happens to children in the early school years largely determines whether or not they will be successful in school and whether or not they will remain in school. As women teachers we are pleased with the growing public awareness of the importance of the early years in a child's education. The government's initiative to reduce class size in grades 1 and 2 is, we believe, a recognition of the importance of the early years.
We are counting on the government to carry out its promise to ensure that junior kindergarten programs are in place in every school board by 1994. FWTAO has long believed in the provision of quality junior kindergarten programs for children. However, we do alert you as to the need to provide adequate resources, including proper classroom space, transportation, adequate materials and supplies, class size limits, professional development for staff and adequate services for children with special needs. We are counting on the government to carry out its promise to provide properly funded kindergarten programs in 1994. Research has shown that money spent on early-years education is money saved from future remedial and social programs.
While the financing of education in this province is a key focus for us as women teachers, our main concern is for the child. Therefore, we must address with you this morning issues which are the mandate of other ministries, as well as education.
Helping poor children: This committee received a brief from our organization in January 1990 entitled Poor Children in Ontario Schools. It was a call to action and it remains as true and urgent today in 1993 as it did then.
In this province we are doing a disservice to both individuals and to society. Poor children are 2.2 times more likely to drop out of school. Our teachers on a daily basis, including right now as we speak, see the effects of poverty on the faces of their students: hunger, abuse, neglect, drugs and violence.
In specific reference to the issue of violence in our society, let me take a moment to say that on behalf of FWTAO we are gratified to see the establishment of the violence prevention secretariat. The issue of violence and the eradication of violence from our society ties very strongly to women teachers' agenda and to the agenda of FWTAO.
We have undertaken a mammoth two-year, province-wide No to Violence campaign in which women teachers are serving as the catalysts within their local jurisdictions to reach out to students, parents, trustees and community groups. We can do something to eradicate violence from our society.
In terms of the violence prevention secretariat, it is also our understanding, as FWTAO, that this secretariat was created using existing resources currently within the ministry. Also, the word "prevention" is keenly noted within that title.
Numerous studies indicate the need for collaboration across professional and sectorial boundaries in order to meet the needs of all children. FWTAO believes that the coordination of services may be a better use of current resources and has the potential to help children to develop socially, emotionally and educationally. We commend the current government for establishing the integrated services for children and youth secretariat and we look forward to the implementation of its action plan.
Last spring we surveyed our 41,000 members on the delivery of services within their respective schools and their communities and we found a wide variety of services that are currently being offered through the coordinating of resources of schools and local service agencies. These models of integration, we believe, should be publicized so that other communities can build on the current experiences and integrate those services within their communities.
We do not believe that extensive funding will be required, but yes, there is a need for more coordination. In some cases a reorganization of the current resources, to prevent duplication, for example, or to fill the gaps, could achieve perhaps a better overall service to children within that community.
One particular project we've highlighted on page 7 of our brief this morning refers to the integrated services for northern children and that this program provides services to children with special needs in underserviced areas of the province. As far as we have determined, the funding is shared by a number of local community sponsors as well as by the government ministries of Community and Social Services, Health, Northern Development and Mines.
At the bottom of page 7 we suggest as an organization both short-term and long-term priorities that we believe should be priorities for this provincial government: provincial funding for school meal programs and nutrition counselling; a substantial increase in low-cost and non-profit housing; funding for health care professionals to be in the schools; eliminating the feminization of poverty through government action on accessible, affordable child care; fully enforced pay equity; mandatory affirmative action, and better training opportunities for women.
We urge you to give priority to the needs of poor children, to the needs of women and poor families. When the poverty cycle is broken, we will all benefit. We know as women teachers that a child who comes to our classroom in the morning hungry or hurting or frightened will not be able to learn.
These are the priorities of FWTAO. We hope you share them and we hope they will be reflected within your recommendations as a committee. Thank you for the opportunity to be with you this morning.
The Chair: We have a few questions from the committee. We have Mr Phillips up first.
Mr Gerry Phillips (Scarborough-Agincourt): How much time do we have, Mr Chair?
The Chair: About five or six minutes apiece.
Mr Phillips: I appreciate the brief. I think you've really focused on one important area for us. In some respects, some of the funding would normally come from other portions of the provincial budget, the Community and Social Services budget.
I'm also interested in your comment about what we should be expecting as a result of the planned transfer payments to school boards for next year and what impact, if any, your federation sees as a result of that. We were anticipating originally that the government was going to transfer 2% in transfer payments this coming fiscal year and then 2% the following year. It ended up, as I think you know, being essentially 0%-0%, with a 2% transition fund. I think the committee would be interested in just what impact the federation sees as a result of that. Should we expect no problems as a result of that, should we expect to see larger classes or should we expect to see larger taxes in the property tax? You people know this well and we'd value your advice on that.
Ms Dempsey: Certainly, on the basis of what we have collected already, there are staff and program cutbacks within many school board jurisdictions, and the children and the classroom teachers are feeling the impact right now. To anticipate where we would be a year from this time or in the spring of 1993 is of grave concern to us. We are already recognizing, as you heard yesterday, that when you cut consultants and resource people or teachers who are there to benefit the most vulnerable children, children with special needs, for example, and to be a support to the teacher, you can only cut those programs and personnel once. So yes, we do share concerns about what action has already been taken within many jurisdictions because of the transfer payments and have grave concerns about what lies ahead.
Mr Phillips: Have I got more time, Mr Chairman?
The Chair: Almost three minutes.
Mr Phillips: Almost all of your recommendations involve focusing on areas that wouldn't traditionally be ones where the money would be flowing to the teaching profession. They would be areas where the money would be flowing elsewhere. Therefore, the message I'm getting from here is that that's your priority. The committee likes to get expert advice from people like yourselves on what's happening in the schools as a result of decisions we're making here at Queen's Park. It would be helpful to me if you, in whatever way, could be specific with the committee in terms of, as we look at funding for education and trying to allocate scarce resources, what's actually happening in the schools? Are we seeing larger classes or are we seeing virtually no change, that we're just being more efficient out there? I take from your comments here, because there is no comment on the transfer payments, that the federation feels that's a reasonable response by the government in today's economic climate.
Ms Dempsey: I'll refer to Joan Westcott, executive director.
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Ms Joan Westcott: As we noted on page 2, we are concerned that there will be no additional funds available for the per-pupil grant this year. We wait, as do other educators in this province, to find out how the additional 2% fund will be dispersed for this year. We are very concerned. We are hoping teachers will continue to be involved at the local level in the discussions that will be held at the school board level to see how best those few resources can be allocated.
We're hoping there will be some increase. It is very simple just to say that the current education program cannot survive without some additional funding, but that's about the point we're at, because we know the problems every school board is facing in trying to maintain the current program. So financing continues to be a concern of this organization as it has always been.
Tying into the presentation from the Ontario Teachers' Federation yesterday, I believe you had some examples in that document about what's happening at the local situation. Our teachers continue to be concerned about that. What we are hoping is that the best use of the money that has been announced will be used at the local level. We urge also that the government not back off its commitment to things such as class size and junior kindergarten, because we believe these are key in being able to maintain program in light of the economic times we're in.
Mr Monte Kwinter (Wilson Heights): I notice you stress the need for funding to provide for the mandatory junior kindergarten program. What are your contingency plans for both destreaming and junior kindergarten if the government maintains its stand that it's going to keep the funding to what has been announced with no increased amount of funding?
Ms Westcott: In regard to junior kindergarten, we know there are many junior kindergarten programs in place already in the province. A number of our members who are teaching in primary and kindergarten are qualified and prepared to teach the junior kindergarten program. As to contingency plans, we think it's a matter of assisting the board in putting the necessary resources in place curriculum-wise -- resource materials and equipment -- for those junior kindergarten programs.
Regarding changes for the transition years, we are working with our teachers in the grade 7 and 8 programs to assist them in preparing for the changes the government is proposing with the transition changes, with the expectation that we will attempt to make the changes as we can in light of the resources that can be available under the current economic situation. It is a matter, again, of detailed planning at the local school board level based on what's available there.
Mr Norman W. Sterling (Carleton): As the son of a mother who taught in the elementary school system for 25 years and raised four kids on the basis of a salary of somewhere around $7,000 or $10,000 a year during the 1960s and early 1970s, I know how hard some elementary school teachers work. I know my mom was out the door at 7 o'clock in the morning, out in the school yard on cold mornings, putting work on the board; late into the night, she would stay up marking papers. I know how much extra work she gave to all of the children.
Since that time, things have changed quite dramatically. My mom, who is still alive at the age of 83, watches the teaching profession and watches what's going on in provincial politics from time to time.
We heard yesterday that there's some evidence that Ontario spends more in the education area than just about any other jurisdiction in the world. There's some concern that we don't get a product as a result of that. That kind of question was put to some of the people in here who were from the post-secondary education sector. They indicated that there were not excessive amounts of money being spent in their area, but excessive amounts of money were being spent in the elementary and the secondary school areas.
If we are spending the most in both of these areas, I'm definitely getting signals from my taxpayers that there aren't any more taxes to be collected. Your brief asks us to recommend to the Treasurer that the elementary system be given even more money. We are spending $1.20 for every $1 we're collecting now in the province of Ontario. Our federal government is out of money. Is it realistic to ask for more money at this time? Where is the money going to come from?
Ms Dempsey: Like yourself, I recognize the investment in education that the taxpayers and the government do contribute financially, but I believe that education for children and youth is an investment and it is an obligation that we as adults have and need to take very seriously and continue to do so.
One of the ways we, as women teachers, are proposing in terms of meeting the needs of the whole child is to look at the coordination of services interministerial, and that is occurring. Along with Health and Comsoc, along with Education, we need to focus on the whole development of the child and youth. As an educator, I'm charged with a very serious responsibility of the education component, but if there was better coordination of financial and human resources among the ministries, we might be able to take a more coordinated approach to achieving that investment, because I believe we're all after the same thing, and that is quality lifelong learning for our children and youth.
Mr Sterling: Nobody can argue with the goals. It's like motherhood, in terms of the proposals you put forward; everybody sees that. But there's a problem here that nobody coming in front of the committee seems to be realizing: There isn't any more money. We're spending more than we can afford already. What things are you going to take out of your own system in order to put what you believe is more important in place? Nobody who appears before this committee seems to understand that. Is there anything we can take out of the system in the elementary area, anything significant, so that we can reallocate these funds to some of your priorities?
Ms Dempsey: The elementary system is stretched to the limit at the present time, Mr Sterling. In terms of taking out, I'm trying to understand where you're coming from. I'm trying to refocus it back to the obligation which we as adults have within this province for the quality lifelong learning of our children and youth. That has to be a priority and I believe that has to continue to be our focus.
Ms Anne Swarbrick (Scarborough West): Both as a member of a government that's trying very hard to do progressive things in spite of governing in the midst of the worst depression since the 1930s and as somebody who hears a lot from my own constituents as well about the great concern over taxes, deficits, but protection and improved quality of the services they need, I want to say a very big thank you for your presentation in terms of (1) the recognition you gave of the problems we're facing, (2) the kind of positivism you've expressed around some of the things we have been able to do and policies we are trying to put in place in spite of the difficulties of today's economic climate, and (3) to very much recognize the spirit of strongly progressive commitment you've expressed as an organization. I don't think I've heard one word of self-interest; instead, simply the massive commitment I know your organization has to the wellbeing of the children in this province.
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I want to say a very big thank you, because it seems to me that today there is too much of a spirit in this world of people being so me-oriented instead of other-directed, and I think you express the spirit of being other-directed.
I think what you're hearing in the questions from all of us on this committee, though, given our shared concern, also what we're grappling with in terms of that economic climate I've made reference to -- I'm wondering if there's anything you might say with regard to the issue of whether there are any ways we as a province can help you any further within the school system, in terms of the kind of creative redistribution that might need to happen to try and help meet what you see are the real needs of the children? Or do you feel there are some specific extras in terms of financial resources you need, and can you give any added specifics with regard to what you feel is absolutely mandatory?
Maybe I should have asked that the other way around, because I'm hoping to hear more that you feel there are ways we could help further in terms of the creative redistribution.
Ms Beverley Gardner: I think the creative problem-solving you are speaking about can occur and does occur at the local school level when teachers and resource people can get together to deal with a specific problem that is presented to the school.
Perhaps I can give a personal face to it. My responsibility for the last few years has been as an elementary school principal. With the staff in a school that would be seen to be fairly typical and somewhat privileged in Ontario, in comparison to children in schools elsewhere, the face of the school has changed. We had a group of teachers come together and look at how we can integrate children who come to us with severe behavioural difficulties, have a lot of difficulty fitting into the routines in school. We know those kids are right to be there and we have a responsibility to see that they get the best education possible. My concern as an elementary school principal is that if we can't continue to provide at least the baseline support we have in terms of resources other than a classroom teacher, I don't know how more creative we can be in helping keep those kinds of kids productive and happy and changing the direction they might otherwise be in.
I'm coming at it a bit backwards. We need to be sure that the resources that are in place -- the child care workers, the psychological services, the additional counselling that's necessary, the administrative staff in schools -- aren't reduced any further. My fear is that there is no other place to reduce, and boards have reduced at the support level.
The Chair: Presenters, I'd like to thank you for coming before this committee. Some of the information you've given us is a little different from some of the other presenters' and we appreciate it.
ONTARIO SECONDARY SCHOOL TEACHERS' FEDERATION
The Chair: The next group we have is the Ontario Secondary School Teachers' Federation. Would you come forward, please. For the purposes of Hansard, we all know you, but as I said earlier, we need to put it in print, if you don't mind identifying yourselves
Mr Chris Malkiewich: I'm Chris Malkiewich, chair of education finance, OSSTF.
Ms Liz Barkley: Liz Barkley, president of OSSTF.
Mr Larry French: Larry French, legislative research, OSSTF.
The Chair: Do you work for the Legislative Assembly, Larry? Okay; I thought you were one of those guards up there.
Ms Margaret H. Harrington (Niagara Falls): Mr Chair, Mr Malkiewich is from Niagara Falls.
The Chair: Okay; thank you. You may begin and we have until 10:30. If you can leave some time for questions at the very end, I know the members of the committee will have quite a few and I'll have to cut them off, I imagine, at times. You may proceed.
Ms Barkley: Good morning. We are very pleased to be able to present to you today the OSSTF report, Fair Taxation for Responsible Education, in which we have 43 recommendations to make the system of taxation fairer in Ontario. This report was produced by the OSSTF funding initiatives and new directions committee, the FIND committee, and is our submission to the Ontario Fair Tax Commission.
With me today are members of the FIND committee. They are Larry French, OSSTF director of external policy, and Chris Malkiewich, the chairperson of our educational finance committee. We'd like, really, to address the question of where funds could be changed and could be accessed for the educational system. Within our report we have two presentations to make.
The genesis of the FIND committee can be traced to the 1990 provincial elections. At that time OSSTF undertook a campaign based on the slogan, "Underfunding public education is child neglect." During that election campaign, the NDP promised to return to 60% funding of real education cost, a stance which won it significant support among our members. We were further pleased when the government set up the Fair Tax Commission to investigate and recommend better, fairer ways of taxation. But since the election this government has reduced its share of educational funding even more drastically than did the preceding government, with the result, I know personally, that many educators across the province are very disappointed with the gap between promise and performance.
That aside, OSSTF is pleased to present its report with its 43 recommendations. OSSTF/FEESO recognizes the terrible physical jam in which many property taxpayers and the government find themselves. We also recognize that Ontario must have an excellent educational system. We believe that answering the concerns of taxpayers and giving the best service to society are not incompatible. It is possible to provide excellent service to our society without taxing it to death. This indeed is an absolute necessity as we are facing the most serious challenge to the universality of publicly funded education we have ever encountered in Ontario, and its major expression is in the tax coalitions and the several tax revolts happening in various parts of this province.
I am not, however, going to attack these groups. In fact, the FIND committee in some ways finds itself in agreement with some of their approaches. Taxes are too high on property taxpayers. We agree with that; they are too high. There is too much duplication, most of all in education, with three publicly funded systems -- three. We cannot afford that. OSSTF is completely supportive of the property taxpayer who is unable to understand why, in a period of low inflation, he or she is getting walloped -- well, hit -- with double-digit percentage increases. But what has spawned the tax revolt has been the economic policies of the federal government. We are here not to simply lambaste the federal government for its policies, but to recommend relief.
First of all, we recommend that low- and middle-income earners should receive a tax break. This is always the group which gets hit and it's time, we feel, that they got a break. The other group we say must get relief are property taxpayers. The property tax, especially when it is expected to be the major source of funding for education, is enormously regressive. Tinkering with rebates and allowances is just that: It's tinkering. If this government thinks property taxpayers are going to continue to cough up money from a bottomless pit, it is sadly mistaken.
It is time the NDP started to make good on its promise to restore 60% provincial funding of real education costs. Many educators supported them in the last election just because of that promise: 60% funding.
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The issue then is, where does Ontario find the money to give this relief? OSSTF recommends several steps. First of all, cut out systemic waste. We have to learn to maintain the constitutional guarantees for public, French and Catholic education while creating a sensible structure -- I underline "sensible structure" -- to deal with the enormous costs of running three duplicate systems.
The confederated school board is our proposal to accomplish these goals. It is well delineated in our brief here. I know this is not a popular thought among some establishments in Ontario, but many people now -- as far as we can ascertain, the consumers of educational services -- by and large are beginning to agree with us. We must eliminate needless duplication, thus saving millions of dollars. We are not talking of undermining constitutional guarantees again. We are talking about common sense from a business, administrative and educational point of view.
We are also suggesting a solution to the pooling of taxation for separate and public education. Right now, across Ontario both separate and public boards have hired staff to go out after assessment for their own boards, on salary. A board can argue that an assessment hunter -- and we call them that -- will pay for her or his own salary, but you and I know who's really paying those bounty hunters, and that is the taxpayer. Let's get these dollars back to education instead of to the bounty hunters. If Ontario confederates boards as we have recommended, then OSSTF is willing to support the local pooling of assessment. Goodbye, bounty hunters.
Like the other people in this room, I welcome the opportunity to pay my fair share of the burden of maintaining an advanced, well-educated society, but OSSTF believes that taxpayers more than anything else demand and must have fairness. Fairness is not fair, nor is it perceived to be fair when major corporations manage every year to whittle away their share of the tax burden. We recommend that there be a minimum corporate tax, that the share of revenue from corporate taxation be fixed in a ratio to the personal income tax as a percentage of gross domestic product.
Just as an example, in 1988 through 1990, each year the insurance industry had profits of $1 billion and paid no taxes, and it is not the only corporate sector where that occurs. Since 1984, when the Mulroney government came to power, the share of taxation paid by corporations has fallen from 15% to 8.7%. That does not seem fair.
Right after the war, the corporations paid 50% of taxes of the total revenue: 50% was paid by the corporations. In 1984, they paid 15% of the total and now they pay 7% of the total, and many pay nothing at all while personal income taxes continue to escalate along with sales taxes.
As part of this package of recommendations that OSSTF is presenting, we recommend that many of the loopholes open to the well-to-do and corporations be closed. "Fair is fair" should apply to everyone, not just middle-income earners. The other place where there should be real revenue for Ontario is from federal transfer payments. If you look on the first page of the executive summary you can see -- and I won't read them out to you -- what we mean by the --
Mr Phillips: Are you reading from somewhere or is this --
Ms Barkley: No, I'm reading a totally different thing, trying to get everybody to pay attention, you see.
Mr Phillips: And then you told me to look on the page here and you threw me off.
Ms Barkley: Fooled you. I'll start that again.
We were talking about federal transfer payments now and the problem that they're causing to both provincial and of course municipal governments. What has happened is that the federal deficit has been pushed on to provincial shoulders and subsequently on to the shoulders of the municipalities and then to their property taxpayers.
It's time that we woke up, that all people woke up. The property taxes cannot carry the federal deficit, and that is what Mulroney has done to it. He has forced provincial governments to underwrite the federal deficit and property taxpayers are shouldering the greatest part of this increase. No wonder there is a property tax revolt.
We also believe that our government should pull itself into line with other public servants. You're not going to like this, but let us end the tax-free salaries for MPPs, MPs and senators. They should not be out of pocket for public service, for sure, but they should also not be given private pork barrels. Their pensions should also fit the rules for other public service funds. As it is now, age 55 is, for most people, the earliest at which they may claim a pension. MPPs, MPs and senators should live by the same rules.
Finally, let me stress that the real key to adequate and fair education funding is prosperity. We know that. We need to keep in mind that Canada's competitiveness is only enhanced by its investment in education, and we have a huge workforce of highly motivated people who are returning to high schools, hundreds of thousands each year. We need to make sure that we give these people the educational services they need. In that way, we will go a long way to maintaining and enhancing the competitiveness of the Canadian workforce, and these are people mainly over 18.
Now I would like to ask Chris Malkiewich to give you a five-minute overview of the follow-up to the FIND report, the OSSTF proposal -- this is the blue one -- for education funding in Ontario, Adequacy, Equity and Democracy. We will obviously be pleased to answer questions at the end.
Mr Malkiewich: Adequacy, Equity and Democracy contains 36 recommendations for looking at the system that funds education and how we can change it. Let me state, first of all, that most of the problems, or some of the problems that have occurred in the funding system have come not because of the province's fault, but because of federal programs as well. The system started off as one of the best funding systems anywhere in the world.
Having been at the American Education Finance Association conference for several years and seen presentations from around the world and having done studies comparing our system, it stood up very well for very many years; however, it's now stretched to its limits. Part of the problem is competition for the same funds and duplicate boards, competition from duplicate programs, and also the introduction of new program after new program after new program with no new resources.
Education needs a real costing, and not just from the people at the ministry but from the people who deliver it, all people who are involved in the programs and all stakeholders; for example, the cost of destreaming. Special education needs need to be addressed and costed in a realistic fashion, otherwise these people will be lost.
Part of the problem which now exists and may exist in the new grade 9 program is a change in funding where a student now crosses a street, changes from an elementary to a secondary level and changes category and, therefore, funding.
Lifelong learning needs to be dealt with and we need to address training at all levels for those who need to come back and be competitive in a workforce. A possibility for doing this would be to provide a flexible school day and different sites for education delivery. This would allow boards more freedom in how they actually spend their money.
We also believe that there should be boards to allow for a local level and local input. Confederated school boards would get rid of duplications while guaranteeing all rights. Pooling of commercial and industrial taxation should exist where there are confederated school boards.
It's interesting to note in a study done by OSSTF that in the last 15 years the greatest increase in costing occurred at the administrative level.
Transportation, with the little yellow school buses that cause so many problems, needs to be looked at. One of the ways to help solve this problem is to provide a minimum walk distance set by the politicians; also, the use of local transit to a greater extent.
A database which is accurate and which is available to all needs to be produced so that all people looking at education funding can take a look at the reporting and also the costing of education in real life. Real money and grants, not fake money or reassigned money, need to be handed out when grants are put out. Quite often when grants are announced, that money does not really exist, nor is it ever handed out. It makes it very difficult for boards to plan and provide services.
Long-term plans for integration of students who are both physically and mentally challenged need to be addressed. You cannot expect boards, in a time of very little money being put out to them, to provide all services at all locations. In this light, new designs for schools with multiple uses and community access should be used. There needs to be the addressing of adult basic education. FSL, ESL and credit courses need to be looked at.
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We also suggest that flow-through moneys from the ministries of Health, Transportation and Tourism and Recreation be set up. Part of the problem in education is the fact that some of the services which used to be provided by these ministries are now in the jurisdiction of the school boards and no funding has come from them.
A corporate surtax to replace the business tax for training needs to be set up. The number of trustees, directors and superintendents needs to be changed so we can share these facilities and again save money. The mandating of professional support people for education with flow-through money needs to be addressed. Part of the problem that was made at the presentation before is the fact that there are long waiting lists and there are no support groups within schools which ensure a high success rate for students.
The rest of the recommendations are in the book and what I've tried to do is group them together for you, Adequacy, Equity and Democracy, the blue one.
The Chair: I guess we'll start off with Mr Sterling, and don't get Liz upset -- she's already wound up this morning -- because I can only bang the hammer; I can't protect you. Go ahead, Mr Sterling.
Mr Sterling: I must say, as a member who put forward during the debate on Bill 30 an amendment during the process that at least boards of education be given the opportunity to amalgamate, which was rejected by both the Liberals and the New Democratic Party at that time, we do have some empathy for at least a voluntary kind of situation which could take place in order, hopefully, that some efficiencies could be taken.
I guess it's perhaps being a bit of the devil's advocate. An MPP gets paid around $65,000 a year when you add in everything. That's roughly equivalent to a senior teacher or perhaps an assistant department head. A principal in my area gets paid about $90,000 and a director of education gets paid about $125,000. I'm elected by about 90,000 to 100,000 people, my job is up for review about every three and a half years, the average life of an MPP is about -- I guess it's less than five years now. I'm just wondering, where do you rank an MPP in his importance or his responsibility --
Ms Barkley: His or her.
Ms Swarbrick: Or hers; thank you, Liz.
The Chair: I told you, Norm.
Mr Sterling: I mean, if you want to put other things into it. Where do you rank his responsibility with that of those within your own profession? Do you think he or she is more or less responsible than a teacher and the vulnerability of his position or her position is equivalent to a principal or a director of education? You can't have it both ways. You're taking a crack at us, yet you are one of the very highest-paid public professions in this province. Give us your evaluation.
Mr French: That's a very interesting question. OSSTF has long believed that our political leaders and elected leaders should be compensated adequately, and it's our opinion that you're not. The leadership you must show must attract good people, must retain them and must recognize that. What we are worried about is the tax-free allowance, that the perceptions of a tax-free allowance are not any good. It should be folded into salary and everybody pay taxes like everybody else.
However, in defence of the teaching profession, the teaching profession, education, underlies all other public enterprise, you might say, and in order to produce doctors, lawyers, whatever, MPPs, we must have a good basic education. It's of fundamental importance to society, and therefore educators have to be recognized too. We have one of the highest-qualified staffs in the world in Ontario, we're pleased to say, and I think they can stand up with any teaching corps in the world. Our society is getting to the point of recognizing that, and we think it's healthy. If you don't, you end up with what's happening in England, where we've got something like 10,000 teachers who are teaching outside their subject area. They can't get these people. Chris has pointed out in some of his educational finance committee studies that in the States up to 90% of the teachers of science and math are not qualified. They can't get the qualified teachers. In Ontario, we're still doing that.
Mr Sterling: So you think we should get paid more, is that your answer?
Mr French: And it should be taxed.
Mr Sterling: That's fine.
The Chair: Mr Sterling, I've got to go on to Ms Harrington. Ms Harrington has the next question.
Ms Harrington: Thank you very much, and it's nice to see Chris here. I believe we taught together. Was it science, about 15 years ago at Westlane?
I found this process very helpful both yesterday and today. Yesterday we heard about the basic inequities in the funding and the property tax crisis, of course, which you have again mentioned, the need for less red tape and the capital grants process between boards. So there are a lot of really important things coming, and what you've proposed today is a fundamental type of change in the system.
The question I would like to ask you is that I think more and more people, as well as politicians and the people out there whom you're speaking about, are probably coming to some of those same conclusions. As times get tougher, change looks easier, or at least we're pressured towards more fundamental change. My question is with regard to the profession, the other federations. There needs to be a broad consensus for change before it can happen. We can't just impose it from the top down. Have you been working closely with other groups in education to come to these same kinds of conclusions, or are you at the initial stages?
Ms Barkley: There is a twofold answer to that. Initially, when we proposed this, it was very threatening, particularly to the separate school system, so they still have many questions around it. It would not be threatening, I don't think, to any of the public school associations. What the separate school teachers and French teachers would want to make very sure of before this was pursued was that their constitutional rights both to the French language and the Catholicism of the separate schools were protected within whatever model was pursued.
We know that many trustee associations, certainly in the public sector, agree with it simply from a very pragmatic point of view of costs. Metropolitan Toronto really reflects that, I think, and the Ottawa area reflects a duplication more profoundly than any other area in the province. I would assume, just knowing that change is slow, is that what will occur, almost by necessity, is that in the proposals from any government -- your government, any other here -- would be that some of the duplication that exists now within the system, ie, the buses etc, would be mandated. They would be changed because they are expensive, excessive etc, and then slowly, as people began to find this amalgamation, confederation or whatever you want to call it less threatening, I think we would find more and more we would go towards one system, again making very sure that the constitutional rights of all the constituent parts were protected.
We're dealing with community meetings now through OSSTF with destreaming, decrediting, the "de's," and one of the things the parents are saying to us is that the systems are too expensive. We bring forward this particular proposal and it is one that, regardless of the religious background of the person, as long as you say, "You're protected," they seem to find very, very worthwhile, and it is a saving. It is a fundamental saving, and we think educationally very sound.
Ms Harrington: I would urge you to work with the groups and I would urge us to work in our ridings doing that.
The Chair: Mr Ward wants a question.
Mr Brad Ward (Brantford): One quick one.
The Chair: Yes, you've got time for one quick one.
Mr Ward: I'd like to thank you for your presentation. I think you're one of the few groups that suggested not only what you feel is important in expenditure but also how you think the government can raise the revenues to pay for that direction.
The one thing you would like the Treasurer to hear as far as the OSSTF is concerned loud and clear, is it not, is that the government should this year begin to move towards the 60% funding as far as provincial education is concerned. Is that the one message you'd like the Treasurer to hear?
Ms Barkley: We have a multiple message. That's one, because it has been a promise. We recognize it's difficult to achieve in this period of economic crisis; there's no question. But a move in that direction, not away from it, would certainly be something we and the teachers would look on very happily.
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The confederated school board is very important. We would also ask you to deal with the questions that were asked earlier, I think. We would ask you to look at the 43 recommendations that we think reallocate resources and bring some new things into the system without disrupting the economy and would improve the system and would improve education. There are 43 recommendations here which we think deal with fairness. The 60% funding certainly is one, and the confederated school board, but also look at the changes in the tax system as well.
We sort of have it as a package. If we had to say one, certainly 60% funding is important; the confederated school board, too.
The Chair: I'm going to go on to Mr Phillips, the man who had his hand up first.
Ms Barkley: I bet I can guess.
Mr Phillips: An area that we need your advice on is in many respects the big money item in the budget, and that's the pensions. As you recall, the government was supposed to pay the teachers' pension, this fiscal year, $938 million. The government paid $438 million and delayed paying you $500 million. I've been critical of that, not with the teachers but with the government, because we're paying 11.25% interest on that. That's $50,000 a day extra interest payments we're making just for the optics. It's a complete waste of taxpayers' money. The teachers are quite correct in asking for the 11.25%, but the government is wasting $50,000 a day on it, because we could have borrowed the money $50,000 a day cheaper on the marketplace. So I've been quite critical of that.
Next year, the government is supposed to pay you $1.044 billion in the pension plus the $500 million that it owes you from what should have been paid this year and is being put into next year. By the way, that's 1% of the budget which has been delayed just for the optics of saying we're spending $500 million less.
My question to OSSTF -- to Larry, I guess -- is: Is it your expectation that the government will pay you both your payment for 1993-94 -- that is, the $1.044 billion -- plus the $500 million it owes you from this fiscal year in 1993-94, the upcoming year?
Mr French: Our understanding of it, Gerry, is that through the OTF, the partnership arrangement, all those things have to be negotiated by mutual consent. I think we would agree with you that the most economical way of putting the funding into the pension fund is the way to go. The way I think it was explained to us was that it wouldn't be a major increase cost to the government because either it pays the money first outside the fund or it goes into the fund and it earns the revenue from within the fund. But I don't think there was any agreement, certainly that we've been informed about, that there would be a major change in the funding into the fund.
Mr Phillips: I know Monte has got a question, but I wouldn't mind maybe a follow-up letter just on what your expectation is, because in my opinion the numbers are understated by $500 million this year, and it's a penalty of $50,000 a day. Next year we have a decision: Is it going to be a $1.044 billion or is going to be $1.6 billion?
Mr Kwinter: In the two documents that you presented there are 78 recommendations. I find it strange that there isn't one single recommendation where the teachers themselves feel that they are a part of the problem and that something should be done about that. I have had constituents over the years call me complaining about things like 12 months' salary for nine months' work, professional development days, teacher tenure, all of the areas that have to be addressed somewhere along the line, whether it's year-round teaching or things of that kind.
Could I get some kind of a comment as to why the teachers have not looked at themselves as being part of the problem and offered some solutions?
Ms Barkley: We do, I think, often try to offer solutions as we proceed. The way we offer the solutions normally is through the collective bargaining process. I think you know that. For example, we've not disagreed with year-round schooling. We have just said that the rights of teachers within that year-round schooling had to be protected. Boards, simply through lethargy or whatever, just have not incorporated that.
We're trying to deal with the whole curriculum reform by trying to make very sure that what was happening last year -- for example, when they would destream grade 9, you would say this was the teachers' fault, if you had a grade 11 son or daughter, that they were putting more resources and smaller classes into grade 9 while doing away with some programming, and large classes in 11 and 12. You would say that's the teachers' fault, or the timetable or the school, but it wasn't. It was a problem of something external, and we always try to at least bring those things in.
When you indicate that we are paid a 12-month salary for 10 months of work --
Mr Kwinter: Nine months.
Ms Barkley: Would you go away?
Mr Kwinter: I have been a teacher. My wife is a teacher.
Ms Barkley: I know your wife's a teacher in Scarborough. We don't agree with that at all. I find it quite ludicrous. I wonder what you think we do over March break and Christmas.
Mr Kwinter: I know; my wife comes with me to Florida.
Ms Barkley: Your wife's going to get into trouble right now. I can't speak for all affiliates -- it would be unfair for me to -- but we have an awful lot of teachers, particularly now, over 70%, who are taking summer courses of some variety to try to prepare for all the changes that are occurring. That is almost continuous.
I'll tell you one thing, though, that you may not understand. The workload on teachers, because of all the changes -- decrediting, detiming, holistic etc -- has increased markedly. We have the second-highest burnout rate, compared to air traffic controllers, in the workforce. Unless you want a dead teaching force, there has to be some time for them to breathe, and there's an awful lot of requalification that goes on.
Remember something: As you criticize salaries, which I think you're about to do, as you've done to me before, you have to really take into effect that we've got the best teaching force here now. We do. We don't have everybody rushing to the private schools, as you do in the United States, or a very inferior situation, as in Britain, where you don't have qualified teachers, you have 10,000 empty classrooms and those who can afford it get a good education. We're trying to preserve within the context of Ontario the universality, the equity of education for all, while still trying to retain its pluses.
I would suggest to you that we are always open to any change. You propose concrete changes of how we should change the teachers or what we do. We would be very happy to dialogue with you. We do change. We change very quickly because we get the impact out there in the society of new forces coming into the school. We're constantly changing, but we would be happy to hear any proposals from you.
The Chair: Okay; time has expired. I can say one thing, Liz: In half an hour you were able to actually talk what would take someone else one hour. I had to listen really closely, because you talk very fast. I'd like to thank all of you for coming forward to this committee for your presentation.
Ms Barkley: I just want to stress one point here, because I know, as Gerry was pointing out, that the documents got a little confused. This is an actual model for funding, a model for across the province. The other is much more dispersed. Thank you very much. I appreciate your hearing us.
ONTARIO PUBLIC HEALTH ASSOCIATION
The Chair: The next group to come forward is the Ontario Public Health Association. I'd like to welcome you to the standing committee on finance and economic affairs and our pre-budget consultations. You are familiar faces, your group. We have half an hour. We'll go till 11:05. If you can leave some time after your presentation for members of the committee to ask questions, and if you could identify yourselves for the purposes of Hansard, you may begin.
Ms Audrey Danaher: I'm Audrey Danaher.
Ms Nancy Day: I'm Nancy Day.
Mr Peter Elson: I'm Peter Elson.
Ms Day: I would like to extend appreciation for the opportunity to once again address this committee about the issues, as we see them, in the public health area.
The mission of the Ontario Public Health Association, OPHA, is to strengthen the impact of people who are active in community and public health throughout Ontario.
Our members are drawn from every discipline and location within the province of Ontario, from Windsor to Thunder Bay. They include people from community health centres, public health units, universities and community agencies.
Community health centres provide a comprehensive response to specific populations. Public health units are the only structure in place in Ontario with a mandate by the provincial government to promote health and prevent disease. This activity covers the whole province and every community within the province.
Public health workers work collaboratively with community literacy groups, schools, social service agencies, community residential facilities, and commercial food and recreational facilities to prevent disease, educate, foster healthy and supportive environments, and inform and refer people to other human service organizations in their community. As one district health council executive recently stated, "Public health is the first line of defence in a community and it's the first line of opportunity to create a healthy community."
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In the past year, OPHA has become increasingly concerned about the lack of concrete action taken to implement the strategic directions for provincial health reform, as announced by the minister, the Honourable Frances Lankin, on January 19, 1992. This lack of action has had a direct impact on public health.
Last year, OPHA came to you with the message that an investment in community and public health is an investment in healthier places and healthier people; an investment in prevention contributes to keeping Ontarians as healthy as possible for as long as possible in places where they live, work and play; an investment in prevention pays dividends in a reduced number of accidents at work, on our highways and in the home.
Someone wasn't listening.
Ms Danaher: Public health units throughout Ontario are experiencing an unprecedented erosion of their capacity to fulfil their mandate, as defined by the Ministry of Health. This week, a potential layoff of 20 public health staff was reported in York region. In Kitchener-Waterloo, public health staff watch as 30 positions are put on the block. Managers and supervisory staff across Ontario are taking unpaid leaves. Gapping, using current workers to take over the workload of anyone who leaves, has become the order of the day. While maintenance agreements for computers might be considered part of the cost of doing business, training budgets for dedicated professional and support staff have either been slashed or eliminated in their entirety.
What do these cutbacks mean? School students will miss public health input in classes on human sexuality, nutrition and smoking. What do these programs prevent? A wide variety of sexually transmitted diseases, diminished health status due to poor eating habits and lung and other diseases resulting from tobacco use.
As other programs are eliminated, we can expect increased isolation, neglect and premature institutionalization among our growing population of seniors and incidences of family violence which could have been prevented. Therefore, while government policies champion the virtues of disease prevention and health promotion, the very people who work on their front lines and communities across Ontario justifiably feel that their work and their positions are being devalued.
While the shift to community-based services has the full support of OPHA and its 3,000 members, the gap between the rhetoric and the action continues to widen; in short, less support to health workers and community groups at a time when our economic and social fabric is being tested to its limit.
We support the action which has taken place in the last year on hospital reform, review of laboratory services, the drug benefit program and long-term care. This needs to occur if we are to shift towards a system which is focused and based in and with the community, yet to date we have not seen any resources committed to the structural and systemic changes necessary to support health reform based on the health goals for Ontario.
OPHA calls on the government to develop a comprehensive financial strategy to reallocate resources to community-based services.
We have followed the government's various announcements regarding the tremendous difficulties encountered in dealing with the deficit, yet we believe it is possible to address the deficit while phasing in the incremental allocation of dollars to community-based services.
Therefore, OPHA calls on the provincial government to make a commitment to reallocate 0.25% for 10 years to shifting the resources to community-based services. In 1993-94, this would amount to $35 million from a health system management budget of $14 billion.
For public health units, even a reallocation of resources will be reduced to rhetoric unless attention is given to disentanglement. We have no evidence that this government is prepared to put public health on its disentanglement agenda with the Association of Municipalities of Ontario, yet the existing double-jeopardy funding arrangement between municipalities and the province continually strikes at the heart of public health programs and services. This must be addressed in the context of health reform.
OPHA calls on the government to initiate negotiations with AMO in the next 12 months.
Ms Day: The Healthy Communities Coalition, of which OPHA is a part, calls on the government to support the healthy communities movement as a cornerstone of health reform in general and community health in particular. OPHA adds its recommendation to others who have seen this concept adopted worldwide from a health conference which took place here in Toronto.
Healthy communities support active participation by their citizens in decisions which affect the social, environmental and economic health and wellbeing of their community. It provides a framework to assist communities to make better use of existing resources and assess the impact of local governments' decisions in promoting health and wellbeing, and fosters intersectoral partnerships.
The provinces of British Columbia and Quebec have already made a substantial investment in healthy communities for these same reasons. We call on the government of Ontario to do the same.
Mr Elson: Healthy and safe communities: The value of an investment in the prevention of heart disease and tobacco-related illness has been well established. OPHA is here today to bring your attention to an issue which we feel is equally important: injury prevention.
In Ontario, injury is a leading cause of death for the under-44 year age group. It is the fourth leading cause of death for all age groups. Motor vehicle crashes, which are only one type of injury, claim one life every seven hours in Ontario. More than 120,000 people reported personal injuries from car crashes; that's in one year. Head injury is the primary or contributing cause of death in about 80% of bicycle fatalities, yet of the 2.5 million bicyclists 16 years of age and older in Ontario, 90% report never wearing a helmet.
The direct and indirect cost of injury in Canada is approximately $11 billion. On the basis of proven strategies, 29% of all childhood injury deaths and 85% of motor vehicle accidents could be prevented. An estimate of the direct and indirect cost of injury in Ontario amounts to more than $4 billion a year.
In 1985, the United States National Academy of Sciences stated that "injury is probably the most underrecognized major health problem facing the world today, and the study of injury represents an unparalleled opportunity for reducing morbidity and mortality and realizing significant savings in both financial and human terms -- all in return for a relatively modest investment."
Therefore, OPHA is justified in asking, what is being done to prevent injuries in Ontario? Injuries can be prevented and predicted. Known strategies reduce injuries, yet Ontario has no comprehensive system to coordinate injury prevention programs, no provincial goals for injury prevention and a minuscule budget.
OPHA has conducted a comprehensive study of injury in Ontario and has established the following priorities for action: prevention of motor vehicle occupant injury in 16-24 year age group; prevention of cyclist injury in the 5-15 year age group; prevention of unintentional falls for the elderly; prevention of motor vehicle occupant injury in all age groups by increasing correct restraint use and by decreasing the incidence of impaired driving.
What, OPHA asks, is the current government doing to prevent injuries on roads, bicycle helmet injuries and falls among the elderly? The current direct investment by the Ministry of Health in injury prevention is approximately $500,000. A modest 0.1% investment in prevention programs and strategies to combat injuries would be $4 million.
OPHA calls on the government to use existing and proven strategies including public education, legislation and engineering knowledge, existing research expertise and existing non-government organizations and community agencies to reduce the incidence of injuries on streets, roads, in homes and in workplaces.
Unless injury prevention goals for the province are established and financial resources are both allocated and coordinated to address these themes, people will continue to die or sustain crippling injuries. Ontario has invested tens of millions of dollars in treating injuries. Now is the time to invest in injury prevention.
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Ms Day: In conclusion, a reallocation of $3.61 for each citizen of Ontario within the Health budget to community and public health in 1993-94 will reduce visits to physicians, illness, hospitalization, family violence and injuries while promoting healthy places and healthy people throughout Ontario. OPHA supports health reform. This reform requires commitment, policy and action. A Vision of Health: Health Goals for Ontario provides the policy. We've heard about the commitment. Crisis or opportunity: It's your choice.
The Chair: I'm going to Ms Coppen. I didn't see her wave her hand, but I was going to ask her to ask the first question because she's involved with healthy lifestyles, I believe in the Port Colborne area, and has been promoting health care in her area. So not even looking at any one else, you've got the floor, Ms Coppen.
Hon Shirley Coppen (Minister without Portfolio): This seems ironic, because I'm so sick with a cold right now. I haven't been following what I've been preaching. If I could ask you a couple of quick questions, who do you get your direct funding from, municipalities?
Ms Day: Our funding comes from a variety of sources. We have a small sustaining grant from the Ministry of Health. We have membership dues because we are a nonprofit association. We also do projects and get grants for doing those projects and that also helps with our funding.
Hon Mrs Coppen: When you talked about injuries and the different programs, correct me if I'm wrong, please, but when we talk about injuries in the workplace, there has been an intensive education program by the Ontario Federation of Labour, from the Ministry of Labour. I was a health care worker in a hospital and there was a very good training program from the Ministry of Health. When we talk about potential injuries out in the public, our local police departments, with the community-based policing, are out there educating people. I see a duplication over and over, and these people are helping out in the community.
Mr Elson: Yes, there is. At this point there are very sort of fragmented and uncoordinated, basically, programs, if you want to call them that. They're a program a particular police department might evoke but it's not necessarily province-wide. There are some programs public health units are engaged in, but in many cases they're not necessarily coordinated with what the police are doing.
Hon Mrs Coppen: If I'm correct, then you see an umbrella from the public health making sure that every community in the province is serviced and all the safety programs are made known to the citizens, correct?
Mr Elson: Yes. As I said in the brief, there are no injury prevention goals for the province, so in fact there has not been an opportunity to date for all those multiple stakeholders -- the police, the fire departments, the ambulance attendants, the schools, the public health people -- to actually come to --
Hon Mrs Coppen: So it's been haphazard.
Mr Elson: It's been extremely haphazard, and in these days of diminishing resources, there are some things -- you may have, for example, a group that's doing a program on snowmobile safety in one area.
Hon Mrs Coppen: To reduce your anxiety about the head injuries on bicycles, about people not wearing bicycle helmets, we have a very progressive member, Dianne Cunningham, who is from the Tory party, and she led the fight in this House that there be mandatory bicycle helmets. In my own riding, I am hearing people complain about it. Can you believe that? We all owe her a big thank you that she was so progressive and pushed for it in this Legislature.
I wish you well. Thank you very much for your presentation and your message has been heard.
The Chair: Mr Ward.
Mr Ward: I was only kidding.
The Chair: Oh, you were only kidding; okay. Mr Kwinter.
Mr Kwinter: In your presentation you call for a reallocation of resources from the institutional health care to the community health care. Yesterday, we had a presentation by the Ontario Hospital Association, and one of the comments made was that there was monitoring, that there were standards, that there was control over the institutional health care sector but that this didn't exist in the community health care system. Do you have any response to that? Do you have any comments?
Mr Elson: Just a point of clarification: You said "standards"?
Mr Kwinter: The point they were making was that in a hospital there are international regulatory agencies that monitor the hospitals, regulate them as far as their operations are concerned and that they all have to be accredited. They have to be accredited by the various organizations that take responsibility for these hospitals, and most hospitals take great pride in their accreditation. Their comment was that this does not take place in the community health sector. I'm just asking for your comments as to whether or not you agree, what the standards are and what is happening out there.
Ms Day: What is happening in the public health area is that the Ministry of Health has developed mandatory programs and guidelines which all 42 health units are required to implement. Each year we are sent forms which we are required to fill in to address what we have done under each of those. Under the act, we are required to fulfil those mandated programs.
Mr Elson: In addition, contrary to the statement that was made, in fact there is an accreditation program, in which the public health units in Ontario take equal pride. The Ontario accreditation program has been in place for some time, and independent auditors review the performance and the activities within the health units on a rotating basis. So that program does exist and it's in operation.
Mr Gary Carr (Oakville South): Thank you very much for your presentation. I agree with Shirley about Dianne and the great job she did with the helmet bill, and I'm glad to see you support that. There's another one: You pointed out the accident deaths of people 16 to 24. I went to speak to a high school a little while ago, St Thomas, and I thought the big questions would be on health care or education or getting jobs. All the kids wanted to know was about the bill they'd heard about, which was graduated licences. Of course, they were opposed to it: "I want to drive. When's it coming in?" What is your feeling about that bill, the graduated licences to reduce the number of accidents among our young people in this province?
Mr Elson: A licence as a right of passage, as it were, is something that has certainly been with us for some time. I have made available to the committee the research report that we did on injuries in the province, and there's absolutely no question that the age group of 16 to 24 years of age not only results in a combination of more accidents, but I think when a young person gets severely injured or killed, it's a tragedy that's hard not only for parents and families but also for communities to live with.
I think it has to be put in that context, that the risk is known: When you combine inexperienced driving with hazardous conditions or impairment, the combination is lethal, and it has been. We have to recognize that. There has to be responsibility, because we pick up the cost of that not only in social service agencies and in families but also in the emergency wards of hospitals right across the province.
Mr Carr: Plus I know it's a big issue in our area because we had a group of kids who were killed at that age and they were piled in. So I appreciate your support and input on that. I want to go to another issue, the issue of funding. The Treasurer came before this committee earlier this week and complimented Frances Lankin. I notice you talked about the cutbacks and were a little bit critical of the funding issue. He came before this committee and for the second time that I can remember -- because I remember he did it in the House -- said she has been a fantastic Health minister, that she's made all these cuts, that the growth has been less, that it's been the best we've ever had in health care increases, that she's done a terrific job and that there hasn't been any effect on the health care in the province.
In my particular area, I had to miss a meeting this morning with my hospital in Burlington, Joseph Brant. It's going through some more layoffs and cutbacks. One of the questions I asked them was, "What has happened in terms of delayed surgery as a result of some of these cutbacks?" They said, "We don't keep the stats." My feeling is a lot of the negative stats that may be out there saying, "We've delayed X number of operations this week because of cutbacks," aren't kept because they would embarrass the government.
You've got a Treasurer who comes in and says there's been no impact on the health care system. You come in and say, "We're at a crisis point." What would you say to the Treasurer, who says there has been no impact on health care with the cutbacks that his minister, Frances Lankin, has done?
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Ms Danaher: First of all, I think everyone recognizes that there is enough money; we do not need more money in health. The health budget has an adequate amount of money. What we are saying is that funds need to be reallocated from institutional-based care to community-based care.
One of the difficulties is that there are a lot of issues that are not identified in terms of numbers. It's difficult to talk about the numbers of child abuse cases that are prevented or the number of people with mental illness or the number of family violence issues. A lot of those issues can be addressed through preventive programs and it's difficult to see the effect right away, but definitely we are seeing an erosion of services in the community. If you look, there are a number of cutbacks in public health units. We already have an existing structure in place. There's a commitment on the part of the government, it says, to shift to community-based care, but that structure is being eroded. I think you are starting to see the effects of that, and will continue to, over time. The amount of money in institutional-based care, I would say, has been adequate and needs to be reallocated. We need to prevent those people from going to surgery.
Ms Day: I think that if you're talking about seeing an impact on health of these cutbacks, the institutional sector is demonstrating an impact on illness. Today, we want to talk about and have you think about health. Health is not determined by the number of hospital beds or the number of surgeries that are done. The determinants of health, as defined by the Premier's Council and a lot of research that has been done, are housing, a lot of social security issues We're talking about income and education.
The impact this recession has had in those areas is significant, and yes, it doesn't happen like an accident, where the accident happens now and half a second later you see the blood. It is slower. We are talking about reallocation of a very small per cent, 0.25% a year, over to the community sector to start to build on the determinants of health, to bring together the people, who already know how to address those issues, to work on it. We are calling for strategies to support that.
Mr Carr: Have you had direct discussions with the minister on the amount of funding that you outline here, and if so, what has been the reaction of the minister to what you've proposed?
Mr Elson: We met with the deputy minister last year related to disentanglement. I think we have to look at that, because the issue of funding from the ministry, if there aren't matching funds, as I said, is double jeopardy. If there aren't matching funds from the municipality, if the municipal tax base is starting to decline and it doesn't have the 25 cents for the dollar, then it really doesn't matter how much money the province has; it basically can't be flowed. It's the nature of that arrangement.
Mr Carr: I know that's what provinces do. They commit the money and then they say -- I'm not saying specifically this government -- "See, we allocated. The municipalities wouldn't give their share. It's not our fault, it's theirs." It's this mindless finger-pointing. You'd like to see, then, the responsibility for this be with the province 100%?
Mr Elson: We want to make sure that issue is on the table, for sure.
Mr Carr: But you don't have a recommendation.
Mr Elson: Not at this time. I think there have been a number of recommendations. The recognition of the relative responsibilities as well as the viability of the contribution by municipalities is important. We believe equally that in fact the programs need to be responsive to the communities. There needs to be ownership within those services and that allocation of resources within the municipality. What that necessarily looks like will need to be done, but when we met with the deputy, it was very clear, as I said, this wasn't on the agenda at this time. It's something that for us and our members comes up every single day. Like you say, that mutual finger-pointing is something that -- you know, if the energy that was taking place in the finger-pointing was resolved, there would be a release of a tremendous amount of energy that could go into something much more productive.
Getting back to your other question, though, in terms of what this looks like -- for example, in many cases, particularly in rural communities, the budgets are such that the capacity of public health nurses to visit isolated seniors living in rural communities has basically disappeared. There's a move towards a sort of community-wide program, where the onus is for the community to come to the program, as opposed to the expertise to go to those individuals. When those public health nurses, for example, visit those seniors, it's not just foot care or eye care; they're dealing with safety around the home. As I said before, it's the primary intervention to prevent any institutionalization that might come up. They are involved with such a wide variety of programs that they play a tremendous information referral service for people.
The Chair: Mr Carr, time is sort of running out. Would you allow me just two questions?
Mr Carr: For you, anything.
The Chair: Okay. The two questions are: Do you work with the school boards across the province?
Ms Day: Yes, we do. Each health unit has, to varying degrees, liaison with and definitely works on curriculums.
The Chair: Do you work with Niagara south?
Ms Day: Personally, I don't. I'm not in that health unit.
The Chair: I'm going to tell you what the problem is. I've got two younger children and I try to tell them that pop and chips and all the junk food, we don't eat that. "But," he says, "at school I can buy it." I just want to leave that comment with you. You don't have to answer it, because I'm the Chair; I can't interfere in the hearings here. But I just want to give that point --
Ms Day: We hear you.
The Chair: -- and say that I think that's where it is too. If they're learning in school it's all right to buy these products, then when they get home, they say, "But Mom and Dad, at school I can get it," because they look up to their teachers. But in Lincoln it's a little bit different; they get into the juices. But there are some school boards I think you'll have to talk to there.
Okay, thanks for appearing before the standing committee here, and have a safe trip home.
ONTARIO COUNCIL OF REGENTS
The Chair: The next group we have is the Ontario Council of Regents. Would you come forward, please? If you don't mind identifying yourselves. Okay, you may begin, and welcome to the committee.
Mr Richard Johnston: I'm Richard Johnston, the chair of the Council of Regents. We're making a joint presentation today. With me is Barry Moore, the president of Fanshawe College and chair of the Council of Presidents. We had hoped to have Doreen Delouzio with us, who is the chair of the council of all the boards of governors of the system, but logistics got in the way and she couldn't come.
Last year we decided, rather than the Council of Regents alone speaking to you, that we wanted to have the management, if you will, of the college system speak to you as one, with our differences of opinion, but to at least let you know that we're trying to work in some kind of cooperation in the system.
We're going to take a slightly different approach today. If I might point a little further past this particular budget line and into the future a little bit, then Barry is going to talk a little bit about where we are as a system at the moment and then we'll be happy to field questions from you, if you have some at that point.
This is the 25th anniversary of the college system since Bill Davis established it a number of years ago. I think it's maybe important to start off with what's happened since and where we were at then and where we're at now.
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Before the colleges were established, there were nine technical institutes in the province of Ontario, with about 8,000 students going to them for technical training past the secondary level. When the colleges were established in the late 1960s, about 13,000 full-time students registered the first year, or about 30,000 if you bring in all the part-time students who were participating. This year we will have about 130,000-plus full-time students, almost a million people taking part-time courses in the colleges, and a fairly significant number, which we don't have the figures for at moment, but probably in excess of 100,000, in training of one sort of other which is not post-secondary-related. So there's been a massive growth in the numbers of people availing themselves of this particular form of education.
I guess the context I want to put this in is that if you look at the 1950s, a grade 8 education was seen as all the majority of people needed to get by in society. By the end of the 1960s, grade 12 was definitely the requirement -- a grade 12 technical or a grade 12 academic. Either was seen to be appropriate.
It's my sense that we have not had an educational reform of any major consequence structurally since the late 1960s. Yet the need in our society today for education has changed dramatically and any of the stats that you've probably seen out of our national government or things that come out of the United States would indicate that most of the jobs in the 1990s will require at least two years of college education equivalent; in other words, 14.5 or 15 years of education rather than the 12 years upon which our whole system is still based at this point. We have not made any structural change in that matter.
If you then look at the fact that we went from a very small percentage, about 5% of the population, participating in this part of post-secondary, and a total of about 18% of the population going to universities or colleges during the early 1960s, to about 35% of the population going to those institutions at the moment, ironically, there are more going to universities than to the level underneath that in terms of the technical expertise and things that we need to move our economy. That is a matter I'd like to come back to. But we have, during that whole period of 20-some years, people who are in the workforce now, with probably another 20 years to go in the workforce, finding they're being displaced in the workforce because of all of the major restructurings that are taking place and without the adequate education to move on.
At the same time, our graduates out of the high school system are being primarily directed through an OAC-driven curriculum, if I can put it that way, into the university sector and not into the colleges. So a huge number of our people, whether they're dropouts of the high school system or graduates, are still not availing themselves of the post-secondary education that they require in order to be able to participate in a modern economy.
Where we are at the moment, it seems to me, is at a point where we need some new vision of what the organization of education should be in the province of Ontario. The position I would like to put forward to you is that in fact we need a major extension and investment in the college-style level, if I can put it that way. I don't think we need 23 new colleges in the province of Ontario and that kind of massive capital infrastructure change, but we need an emphasis on where people should be getting educated, for our economy, that we don't have at the moment.
We're getting bits and pieces of that vision coming forward, and I think Barry will talk a lot about how the colleges are trying to respond to that at the moment. But I don't think we have a holistic view of it, if I can put it that way, and I think it's time that we did. If you look at the clarity of vision that was there in the 1960s for establishing the colleges and expanding the universities, I think something equivalent is needed now, although the answer is by no means the same.
The argument I would make is that OTAB's development and the Jobs Ontario developments are all parts of a puzzle, but if we try to focus only on job-specific training at this point we will be selling short the needs of the majority of our citizens. That is to say that you can train people for a specific job and in three years that job could be gone, the way technology is moving. If you've not given them generic skills to enable them to move to other kinds of advanced training as they're in their employment and to prepare for change, we're going to have this continual displacement of people, high welfare rolls and a lot of people on unemployment for the next period of time.
The place where at the moment we have applied learning and generic skills put together most effectively, I would argue, is the college system, where all the courses are related to prospective jobs. Right now, even in the depths of this recession, the latest figures I've seen, which are not released yet, show that we're still finding jobs for over 80% of the students who go into our colleges, which is remarkable given the nature of the downturn of the economy at this point.
It's clear as well, if you look at stability of employment, that major stability comes with the level of education you're at. The greater your general level of education, the greater your capacity to remain employed. Again, from our perspective it's time to think about a massive new shift in direction to make sure everybody gets at least a college level of education. Then you can't stop at that, because if you do, I think you're running into a dead end as well. That is to say that one of the flaws, perhaps, of the system when it was established in the 1960s was that there was no direct linkage to the universities out of the colleges, partially because the universities did not want anybody messing around with their degrees, frankly, and being able to offer degrees like they could.
In part that's been useful to our system, and I would argue it's been more effective than the CEGEP system in Quebec because we have much better technical programs than it does. They are a junior college system and everything is oriented to getting people through a classical education into the universities, whereas we are actually producing people who are better equipped to deal with the economy than the CEGEPs are.
However, the need to make the linkages to the universities is crucial. If we now start to see general education moving to not being grade 12 but, say, two years of college, we have to make sure that's not a dead end but that people can then move to other kinds of superior training, and hopefully the work that Walter Pitman's up to at the moment will point some directions for us in terms of how that can be done.
I'd like to come back to some of these comments at the end, if I might, after Barry's had a chance to talk a little bit, but there are linkages that are just crucial. We've got to change the way colleges and high schools work together. We've got to change the way colleges and universities work together or, more importantly, don't work together at this point. We've got to talk a lot more about federal-provincial shared visions and shared resources, because we are being decimated in certain aspects of what we're doing in the colleges by problems with federal funding at this stage.
We need to think more clearly about how income maintenance programs, like those operated through Comsoc, should be directly integrated into training and education, and not just through a Jobs Ontario kind of project but much more intrinsically organized. I'd like to come back to that after Barry's had a chance to tell you about how we're trying to manage at the moment with the financial difficulties we have.
Mr Barry Moore: It is a pleasure to be here. My comments all refer, in a very brief fashion, to the notes, which I think were circulated to you, Ontario Colleges: Well Positioned to Support the Province's Economic Renewal. There are a number of headings there which I think describe the reasons for that.
One does have to do with access. Richard has mentioned the tremendous growth in the system over the past 25 years -- that's the same across the country -- but if you would look at the first chart that's in your handout indicating the figures, a very recent period, 1988-92, you can see a very substantial increase in enrolment there. This is just in the post-secondary area of our operation, not the training side where there are similar kinds of things happening, but you can see the tremendous increases.
I think one of the things that's important for members to be aware of as well is that colleges don't just deal with individual students, full-time or part-time. We deal with a lot of agencies and a lot of industries, through continuing education, through the skills development offices. I know in my own institution of Fanshawe College the skills development office at any one time is dealing with between 300 and 400 small and medium-sized businesses in our southwestern Ontario region, enabling those companies to develop educational programming for their own employees. We're not just talking about individual students; we're talking about our connections to agencies and industries and so on throughout the whole province.
In terms of access, access will be greatly aided by the prior learning assessment activity which is coming. We can come back to say more about that, if you wish. Distant education programming is being looked at on a much wider basis than it was previously.
On the quality issue, there are a number of ways in which colleges do a good job. One is certainly by the strong connections they have maintained over the years with their local communities, having programs driven out of real, local community needs. Another part of that is through the fact that most colleges have very strong program review processes in place. As a very quick aside on that, even before I came to Fanshawe College in London, five years ago now, I had heard a number of years before that, out in British Columbia where I worked previously, about the superb program review process that was in place at Fanshawe College, where virtually every program in the institution -- and this is matched in many colleges in the province now -- is reviewed about every three years, primarily by employers who hire the graduates. So it's quality control that I think really does work.
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The other quality issues: Richard has already mentioned the strong employment record, still going out in the teeth of the recession. Our graduates, about 80% of them, are getting employed in areas directly related to their education and training, and another 6% or 7% are finding work. Many of the others are on to other things, other forms of education. A very small number are still looking for work.
We also, I think, have a pretty good record of high satisfaction with the results of the college work. There's going to be -- and we can't refer to it too publicly today because it will be announced tomorrow. The Ontario Institute for Studies in Education is circulating a document tomorrow, reviews of a thousand folks here in the province of Ontario which provides some rave reviews for the college system. We were anxious about what might be found. We are now overjoyed by what is in that report, and there will be more, I think, available on that.
Responsiveness: You can read what's there as well as I can say it. There's a tremendous diversity of activity in our institutions, and that's one of their strengths. I think also that we have been quick to respond to labour initiative needs. You can see the list of things there, labour force adjustment activities and increasing numbers of mature students in our institutions. The figure that's there -- this in the second-last bullet under "Responsiveness" -- refers in the fall term of 1990, in the post-secondary area, to about 20% of our students being 25 years of age or older. I would suspect that probably has increased dramatically over the past couple of years. We don't have that information yet, but my own faculty indicates that even this year there was once again apparently a dramatic increase in the age of the students, many of them casualties of the recession, and we are indeed the prime institution of choice during the time of recession.
A lot of partnerships, and that's important to this government; I think it should be important to any government these days, for trying to work things out. I think too long, right across the country, we tried to do things in isolation from one another. You can see a list of the kinds of things that colleges have been involved in and are working on. One of the reasons that colleges are a good bet to do that is because we are so connected to our local communities, and if you are tied in there, then the ability to operate in isolation is much more difficult.
The accountability area: We are a crown corporation. Some of my colleagues complain about that a little bit at times, but, for better or for worse, that means we are very closely connected to the requirements of provincial and indeed federal governments in having their programs -- social and economic and other programs -- come into place. You can see some of the ways in which our accountabilities are maintained.
With regard to restructuring, if I could ask you to look at the second chart -- fortunately, I guess they hang together fairly well. One of the dilemmas we have right now is that you can see the enrolments are up very, very substantially. If you look at the chart, and particularly the grant per funding unit, which is the bottom line of figures, you can see that the funding unit for our institutions over the past three or four years has gone dramatically down. So it's very possible for us to say, I think quite accurately, that we have already been involved in restructuring for the past three or four years. I think there is a point now, however, where those numbers are starting to collide in a very, very difficult way, and I think that's partly the reason for our visit today.
Mr Kwinter: Mr Chairman, a question. Is that funding unit the student body?
Mr Moore: It's not exactly a student body, because full-time and part-time sometimes get a little bit mixed up, but you can certainly equate that to a student. If we had the accurate information on students, it would show exactly the same picture.
The Chair: Maybe for clarification, I think Mr Kwinter is saying it might take five part-time students to make one full-time. Is that how you're counting? The clarification could also be for the Chair.
Mr Moore: No. The funding unit would relate very directly. You could equate it to full-time students.
The Chair: But you count five part-time equivalent to one? Is that how you're doing it here? In other words, if you had people going part-time and they were taking only one course whereas maybe you're taking five as a full-time student, it would take five of them to give you one.
Mr Moore: I would say 99% of the document here refers to our full-time operation. The 900,000-plus people we operate through the other side of our organization are funded in quite another way.
The Chair: I think Mr Johnston was saying one million part-time students.
Mr Johnston: It's around 900,000 or so.
Mr Moore: I'll conclude, because I know our time is just about up. The point we want to make is that whatever we've done over the past 25 years, I think we've put together an infrastructure that really is poised to do some continuing new and dramatic things. It was just 25 years ago that we began. We have an infrastructure that's deeply rooted in every community in this province, we have a good record of partnerships, and I think we are poised to move in the directions the province wishes by way of rebuilding the economic and social base that's necessary for the future.
Mr Johnston: What we are missing at the moment is the clear direction the government wishes us to go in. We're getting lots of hints of it through a variety of various programs, and, as Barry said, we're trying to adjust to them at a time of fiscal restraint. But it seems to me we need more clarity on: How much is going to be done by high technology? How much can be done by self-directed learning? How much can we do through prior learning assessment of older people coming into our system? And just what is the overall vision of where the shift will be in terms of our education system, hopefully for the next 25 years, because it's still primarily designed on a 1960s model.
Mr Phillips: I think the thing that will impact you the most is OTAB. I think this is a fundamental shift. I'm interested that you're supportive of it. Many of the things you do right now in my opinion will shift over to OTAB, and it will be an independent agency. I think there are some major risks in it. It is not accountable, in my mind, to the public. It's accountable to the 22 directors and their constituency, which is a limited constituency. It is going to have a fundamental shift. Many of the things you say you do is in their mandate, that's going to be their role now. Under OTAB, as it picks up the responsibility for the partnership with employers, with sectoral training, with all those things, won't that fundamentally shift your role? You will be a supplier to OTAB.
Mr Johnston: Both of us will probably want to say something on this. Barry?
Mr Moore: I think it's very important to note that OTAB is not primarily a delivery mechanism. It's a coordination mechanism.
Mr Phillips: I understand that.
Mr Moore: We are really saying that the college system is the prime delivery mechanism that is available to put the programs out. We do about 70% of the training activity in the province right now, for instance. We see it from an operational perspective. While, as you pointed out, while there are some difficulties with OTAB, when it finally begins to operate, it will be so much better than the absolutely sporadic diversity and confusion that's out there about who does what and when at this point that it will be a blessing.
Mr Phillips: Good. I'm glad to hear you say that.
Mr Johnston: One of the advantages for us through it is that when it has local boards, we're well tied into those local communities, and we're expecting that colleges will still play a major role.
The other thing we recognize is that the colleges can't do everything. When I talk about the new vision, I don't think that means that every training program in the province needs to be dealt with in a college. The generic skills base is something that I think a college can deliver better than any of the others. Sectoral partnerships are things we can do better because we have institutions all around the province to be able to help with sectoral things, but there are many kinds of training that could be done better by private trainers, by boards of education. We need to work that stuff out and rationalize that stuff out better.
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But from our perspective, we're worried a little bit about the potential of being shut out of an OTAB in the way you're portraying. But we just look at what's happening to us with federal dollars at the moment: A college like George Brown or Fanshawe, which does an awful lot of training at the moment, is getting devastated by arbitrary cutbacks, as we would see it, of money from our system, without having any input. At least with OTAB, we'll have a voice at the table and will be able to try to say: "We can do this part of things. We're happy to have open competition and lose this other matter but there are certain things a college can do that others can't do." So on balance, we prefer that to the status quo.
Mr Moore: We welcome the competition.
Mr Phillips: Very interesting.
Mr Sterling: I have a whole host of questions I'm interested in. We've heard some evidence in front of this committee that Ontario is paying huge amounts of money for its education system and we're not getting a good bang for our bucks. Because you're at the end of the system that has been seen as more of a training function, you probably aren't receiving the same kind of criticism that other ends of the system might be.
I don't know how long your teachers teach; I don't know how well they're paid. I understand they're paid roughly equivalent to secondary school teachers.
Mr Johnston: I wish. That's part of our problem.
Mr Sterling: But they're only teaching for a fairly short period during the year, September to the beginning of May or something like that. We have to get a better bang for our bucks, whatever we're talking about. How are we going to address this within your area? It's nice for everybody to come here and say, "The feds aren't giving us" -- you know, the supply side is down, but there aren't any more bucks, I don't think.
Mr Johnston: I think you put your finger on a problem. When we went into collective bargaining last time with the faculty, our big problem was that the gap between high school teachers at max and our professors was going to be $6,000. It's strike time when that kind of separation happens, because always the comparators have been between those two systems and between ourselves versus the universities, which is another $20,000 or so above our faculty's level, at this point. So our people were quite nervous about that.
On the other hand, we as management wanted exactly the kind of reconsideration of workload and participation in the classroom etc that you're talking about. As part of our agreement, we have now what's being called an effectiveness committee or quality of education committee, jointly with management and the union, which is going to be looking at ways we can reorganize how we're operating in the classroom and elsewhere to try to make ourselves continually more efficient.
To follow up on what Barry said, we have been making efficiencies by necessity: to have a 30% growth, as we've had, in the number of students in this last period of time, with the small amount of increase, when we've had increases, in terms of the pass-through or grant. We've already been making those efficiencies, but we're at the edge of what we can do now within our present collective bargaining structure, and we're trying to work at new ways of rethinking that.
That committee we're hoping will be up and running effectively in the next month or so, and within the next year or two will tie in with our restructuring committee, which is looking at many large issues of technological change, in terms of delivery, compressing the school year for our mature students, a number of things of that sort, and see how we can meld the labour reality with the desires for reorganization. We have some hope we'll be able to manage that.
Mr Sterling: I think the taxpaying public is going to demand even more from all parts of the education system.
Can I ask another question which is very important to me? The college system, when it was originally set up, was an alternative route for some people in our society, to go to community college to obtain more practical skills, and in some cases for people who had less academic qualification to obtain another level of education.
It seems that those very people whom the system was designed for are getting squeezed out, because we now have university graduates who are coming back into the college system and squeezing out the people the system was meant for originally. It may lead to the fact that you are getting 80% of those people who were, first of all, university graduates, then trained, then are out, so I'm not sure the 80% is a reflection of people the system was originally set out for.
Can I add another part to it? Is there some logic to ending education for some of our people within our secondary schools at, say, a grade 10 level and then transferring them into the colleges, because you are then talking about the transfer of resources from one system to the other? I think we had the Ontario Institute for Studies in Education come in here two or three years ago and say: "You know, in a lot of cases, there isn't any justification for keeping kids who are 16, 17 and 18 in high school. We really don't know why we're doing that."
Mr Moore: On the first question with regard to whether the college system is still serving those for whom it was originally intended and, for instance, not primarily those who may have been recent university graduates or something who are bouncing back in, in my own situation in London, where there are certainly some students who have come back from part of a university or a total university pattern, I think the publicity that has surrounded a lot of that is much larger than the actual numbers.
When you start to look at the actual numbers in classes, particularly in the health area -- a lot of our health programs seem to draw a large number of those people -- you will still find, I think in most colleges anyway, a preponderance of recent high school persons or persons without university education in them. There is sometimes a lot of publicity when students can't get into particular programs. Of course, there are thousands of those at this point, but I think the driving out of those for whom the college system was intended is not a huge problem. It gets a lot of press.
Mr Johnston: It could have been a problem, however, if we had not continued to admit as many people as we have, because the squeeze might have happened. The debate continually takes place in the colleges, because the range of things they do is from Ontario basic skills level, the upgrading of individuals who don't have a grade 10 kind of a level, to doing very high-tech stuff which is not even done in universities in some cases. There's always that debate: Can we do all of this? Up to this point, the colleges have said they still want to be the welcoming kinds of institutions they were established to be in the 1960s.
Mr Moore: On the grade 10 issue, on the question with regard to whether there should be transfers to colleges, a number of jurisdictions have thought of that and contemplated it -- British Columbia did some years ago -- and there just seemed to be so many problems associated with it.
My own personal answer to this, and some of my school colleagues won't appreciate this too much, is that in some ways the dropout rate in high schools may not be enough and it probably would not hurt many people to drop out, find their way, dramatically decrease enrolment in the school system and return back to adult education and retraining when they are truly motivated, and moving on to that much more quickly. That would shake loose millions of dollars. But as I say, that's not too popular with my school colleagues.
Mr Sterling: Just in response, I guess my question was put because I believe you could prevent a lot of the dropout rate if you took a certain segment after grade 10 and said, "We're now going to train you specifically on a path which you see as useful to your ends."
Mr Johnston: I would not disagree. The only thing I would say at the moment is that there are some steps we could take even before that in terms of making the curriculum at the high school level an awful lot less biased towards trying to move people into universities and more into getting them prepared for the workplace and for college.
Ms Swarbrick: One clarifying question and then one of more substance: Am I understanding correctly from the document you presented that the federal funding is direct and that therefore it's not included in this chart?
Mr Moore: That's correct.
Ms Swarbrick: I assume it would make your picture look even worse if you had a chart of it.
Mr Moore: Yes.
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Ms Swarbrick: The question of greater substance is that I was at the retirement dinner for Bev McCauley -- I believe you were too, Barry -- and I was talking to a number of the community college presidents there, some of whom were advocating having greater freedom to be able to raise money for the college system independently. I was wondering if you would comment on that, and if the two of you disagree, whether you would each comment on that.
Mr Moore: I don't even know whether we disagree. I know a number of colleges are involved in capital campaigning or other campaigning. My own institution is among those and is doing quite well at it, thank you, for first ventures. In most cases, this is new for colleges because we were prohibited from doing it by the government here in Ontario until just before my time, about five or six years ago. Those ventures, I think, are quite positive, again not only from the perspective of the funds which are raised -- they don't relate to operating colleges; people at this point anyway in Ontario are not willing to consider giving money for operating the institutions -- not only the money, but it is the important community partnerships that those activities bring.
I think all the colleges that have been involved in fund-raising have found that their connections to large- and medium-sized and other corporations that give them things, dollars or equipment, are often done on the basis of some kind of activity that then links them together with the institution much more strongly. From that perspective, it's much more than the money, and I strongly support that kind of activity. There's a lot of it going on.
Ms Swarbrick: I understood that some were throwing around the pros and cons of a greater freeing up than what exists now in terms of raising money, maybe for operating money, some of the cons being that I gather there are problems in the United States where that is wide open and there are some problems with it. I wonder if you can comment on that.
Mr Johnston: The real difficulty is structural, in my view. It's not like a university, which has an independent charter and has a great deal of autonomy. Colleges are crown corporations, extensions of the Ministry of Colleges and Universities, and therefore to try to attract money for operating purposes is a very difficult thing to do because people presume the government should be doing it. If you started to get successful doing it, then I'm sure the government would also start to reduce its funds. If you look at some of the colleges in the United States and their economic problems, it's because of that. They've gained some on the private side and then they've lost enormously in terms of the public side involvement, so I think there's a lot to be lost.
I look at some of the projects that have come out of our colleges for capital stuff, and there's wonderful cooperation, so the government gets asked for, say, a quarter of the dollars required because of all the local input. It seems, in terms of startup of the economy and things, funding more of those capital projects, which have a lot of local community involvement, would be a very wise idea.
The Chair: The time has expired. We've actually run the clock a little bit over. I'd like to thank you for coming before this committee.
Mr Johnston: It's a pleasure. I've always liked being on this side of it.
ONTARIO MEDICAL ASSOCIATION
The Chair: The next group we're going to hear from is the Ontario Medical Association. I'd like to welcome you to the standing committee on finance and economic affairs on our pre-budget consultations. We ran over a little bit. We're just getting extra copies of your brief for members of the committee, so I wasn't letting them have extra time, but to keep the committee going.
If you wouldn't mind identifying yourselves for the purposes of Hansard and the committee here, we have until 10 after 12. Mr Phillips, we'll be going 10 minutes late for lunch again today. Sorry, Gerry. You may begin, and leave some time at the end for questions from the committee.
Dr Michael Wyman: I'm Dr Michael Wyman. I'm a family physician in North York and I'm the treasurer of the Ontario Medical Association. I have with me Mr Darrel Weinkauf who is the director of economics of the Ontario Medical Association. We'll try to keep our brief brief, so that perhaps you might be able to hit lunch closer to time.
On behalf of my colleagues in the medical profession, I'd like to thank you for the opportunity to come this morning and address the committee. Based on recent comments, the Treasurer of Ontario is cautiously optimistic about the economic prospects for 1993 and 1994. Economic growth is expected to be moderate, but it's also expected to exceed the growth in other G-7 countries.
As the Treasurer has pointed out, despite the severity of the recession in 1991, Ontario's gross domestic product per capita was greater than for Canada as a whole and was the largest of all G-7 countries but the United States. While the recession has clearly had a significant impact on the economy, it's important to keep it in perspective. As well, we should also keep expenditures on medical services in perspective.
The latest figures available to the OMA place the budget of the Ministry of Health at approximately $17 billion for 1992-93, or one third of the total operating expenditures of the Ontario government. Expenditures on physician and medical services are less than a quarter of that amount. In 1992-93, the government of Ontario will spend roughly $413 per person for medical care. In comparison, total health care expenditures from all sources, both public and private, will likely reach more than $2,100 per person.
Extrapolating on historical trends, each person in the province sees a physician, on average, 11 times per year and receives 2.5 medical services per encounter. This means the cost to government is $37.60 per visit or $15 per service. Physicians do not believe that such fees are excessive, especially if one considers that, on average, 42% of a doctor's income goes to cover office overhead.
We do with the Treasurer's recent statement that the increased need for social programs, including health care, presents the government with a fiscal challenge. However, physicians fear that to help meet its budgetary objectives government intends to lessen the fee or the price it pays for medical services. We feel strongly that this is not a viable solution to controlling health care costs and would in fact be detrimental to the significant progress we have achieved in this area.
One objective of the framework agreement reached in 1991 between the profession and the government is "to ensure fair and equitable compensation for physicians." We urge the government of Ontario to remain faithful to the spirit of this agreed-upon objective. However, we would like to stress that doing so will in no way prevent the government from fulfilling its fiscal responsibility.
The profession is acutely aware of government's need to control expenditures and to ensure that fiscal resources are used effectively and in a manner conducive to the wellbeing of the public. Certainly, moderating the growth of publicly insured services will reduce costs, but any success in this area can be a double-edged sword. At some point -- many of us on the front line would argue that this point has been reached -- the decline in services may severely threaten the quality of care we provide.
We believe that fiscal responsibility and quality health care are not to be mutually exclusive. It can be achieved by promoting the efficient delivery of medical services. In this sense, we are partners. While the framework agreement requires both parties to ensure fair and equitable compensation for physicians, it also commits the medical profession and the government of Ontario to providing more effective management of health care and physician services and to enhancing the quality of care.
The commitment of the profession to these tasks is substantial. We do not take the opportunity to be an active partner in the management of the system lightly. Through its participation in the joint management committee, JMC, the profession has made an enormous investment in improving the delivery of medical services in Ontario.
The JMC has established a sound infrastructure and has begun to address major challenges in earnest. The Institute for Clinical Evaluative Sciences, ICES, which is the JMC's research arm, is now fully functional and will rely heavily on the critical experience and expertise of Ontario's physicians. It is clear that improvements we achieve in the management of the system will be due in large part to the insight of physicians as front-line health care providers.
Let me assure you that the profession will not shrink from making the difficult decisions ahead and that it is determined to provide leadership in the areas of physician resource planning, utilization review and quality assurance. Through the JMC we are working closely with government to tackle such difficult issues as the development of clinical guidelines, training and licensure of international medical graduates and physician distribution. The tasks before us are formidable, but they would be even greater without the cooperation of government and the profession, the expertise of ICES and other researchers and the support of the public.
Already we have seen a significant decline in the growth of medical services. Following an average annual increase of 5.5% over the last decade, and averaging about 7.2% over the previous three years, medical services grew by only 3.2% in 1991-92, the first year under the framework agreement. For 1992-93, it is currently running at only 1.5%. This represents a reduction in expenditure growth of nearly $250 million over the last two years.
Furthermore, the profession has agreed to work with government to ensure that medical services used to meet the requirements of third parties are not billed to the Ontario health insurance plan. Although we do not have firm estimates, those figures that we do have, combined with what we can learn from other jurisdictions, suggest to us that this could represent a savings of $90 million to $120 million in each and every year.
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The medical profession has also shown considerable restraint in its negotiations with government. At a time when the expenses of operating a medical practice were rising by 6% per year, the profession agreed to a modest 1% increase in the OHIP schedule of benefits. In addition to these costs, physicians must now also absorb the employer health tax, which will reduce net fees and incomes by a further 1%.
Many people from many walks of life have suffered the effects of this recession, and physicians are no exception, but we will continue to meet our commitments under the framework agreement and work to ensure access to quality medical care in a cost-effective fashion. We recognize the need of government to show fiscal restraint, and at the same time we are acutely aware of the needs of our patients. Clearly, a balance must be struck, but we urge government, as it sets the budget, to remain sensitive to the health care needs of our society. We must be vigilant that in striving to contain costs we do not jeopardize the quality of the system that we have all worked so hard to establish. Thank you, Mr Chairman. I'd be more than happy to answer any questions.
The Chair: Okay, from the Conservative Party, Mr Carr.
Mr Carr: Yes, I'll go first. Thank you very much for your presentation. I had a question relating to the cap on doctors' salaries, the $400,000. I have spoken to many doctors. Way back when I was 18, I tore up cartilage when I was playing hockey, and a doctor by the name of Dr Jackson, who went on to become chief of surgery and so on, did the operation. To this day, it's been terrific. I went through six years of playing pro and have had no problems up to and including last weekend.
They tell me he has now left to go to Dallas, where he'll make a substantial amount of money doing teaching as well. The people we will lose with this cap won't be the regular GPs, because quite frankly they say the States won't take us; it's a tough time. But the ones we will lose are the top in their professions. This incidence was Dr Jackson. Do you see a lot of our top specialists leaving because of the cap that was put on by this government?
Dr Wyman: That's a very difficult question to answer because while there are a large number of people who do migrate to the States, it is difficult to obtain the numbers that have gone in the last two years. We've been trying to get those figures, and mostly they are anecdotal.
Mr Carr: They don't report in and say, "I am leaving."
Dr Wyman: They often don't; they often will maintain their Ontario licence even though they move away. But the preliminary estimates are that there has not been a dramatic increase in the number of people that are going. There's no question that we in Ontario, through our educational establishment, have created a large number of world-class physicians. There is also no question that the American system provides these people with significantly more money for research facilities, for hospital and operating room facilities and for personal income than we can offer in Ontario.
Has the $400,000 cap significantly changed that? I think it has affected some of the people going, and I think it will probably continue to do that. But I think some of the other efforts that have gone through in the budgetary concerns, the budgetary cutbacks, related more to hospitals than to physicians' incomes, are going to have significantly greater impact on people leaving.
Mr Carr: I hope this is isolated, but I've also heard of some specialists who say: "That's fine. We've got a cap on $400,000. I'll work the six months, nine months, and then" -- they might be a specialist in hand surgery -- "I'll be down in Florida, and I could work seven days a week, 24 hours a day because of my specialty, and I'm just not going to do it." I hope that's isolated, because I don't think doctors get into it -- in spite of what some in the government think -- for the money; they do it because they care about people.
But I want to touch on another issue. I was supposed to go to a meeting today at my hospital in the Burlington area, Joseph Brant, which has been ravaged by cutbacks, has laid off a tremendous number of nurses and services have been cut back dramatically. When we went to the finance meeting -- and I know yesterday some of the government members said they keep everybody involved. They have; they've had nurses there, they've had workers, they've had the chief of surgery, they've had everybody, including MPPs. We can't even fit in the boardroom.
But one of the problems they've got is that they do not keep records of postponements of operations. So the hospital can't say, "I'm sorry, this week, because of cutbacks, 13 people have had to wait for elective surgery." As the medical profession, what is your assessment? Can you give us some numbers on what the health care cutbacks are doing in terms of, let's say, surgery being postponed? How many people are being pushed back that we don't know about? You've got a Treasurer saying, "See, nothing has happened in the health care system," and no one knows about the number of operations being postponed. Could you give us an idea of what's happening in that area?
Mr Darrel Weinkauf: This information is anecdotal. One of the problems we have with our --
Mr Carr: Just quickly, if I could -- and sorry to interrupt -- why is it anecdotal? If you could just explain that too.
Mr Weinkauf: I was about to explain that.
Mr Carr: Okay, sorry.
Mr Weinkauf: Actually, the difficulty we have with our information system is that we don't get final information until, very often, a year after the fact. Most of the changes you're talking about, these squeezes, restrictions in hospitals or access to hospital services, have occurred in the last year. We expect that, shortly, we'll be able to give you a better estimate, but at the moment all we know is that it is happening.
Actually, I'm wondering if I can comment just briefly on your question on thresholds. Again, it is anecdotal. We will get better information, but I think it's clear that it does in fact induce physicians to reduce the level of care they provide to the community. Many of them incur this penalty and I believe the government expects it will recover about $37 million from physicians for providing services above the $400,000 range. But once you get above that, most physicians are not really willing to pay 33-cent dollars for those services. In many instances it costs them money to provide that care.
So, again, I don't have figures, but I think you can be confident that it does have that effect.
Mr Carr: One last question, too, in regard to your relationship with the government. This is a difficult one and I'll play devil's advocate. The problem you've got is that you, of course, negotiate with the government and many doctors have been critical of your association because they said it hasn't taken on the government. It's a delicate balance. I firmly believe that in dealing with this government you have to do like the police did: confront it and stand up to it.
Many doctors are coming to me, saying -- and forgive me for saying this -- "They are not going hard at the government like they should on our behalf." Knowing you have to negotiate with them is a lot different, because you can say that when you're not sitting at the table with them in the open here and knowing it's going to get back to the government. How would you categorize your relationship with the government today? How's that for an easy question for you?
Dr Wyman: I think in the last couple of years there has been a shift in the relationship between organized medicine and the government, and I think it's been a positive one. Going back over the five, six, seven years previously, we've had a very antagonistic relationship.
Mr Carr: When you were throwing the rolls in the legislative dining room.
Dr Wyman: Yes, it's not been a pleasant time. I think, as a result, the provision of care has suffered. I think there is a need for a cooperative approach between medicine and the government towards management of the system. At the same time, that does not mean we have to roll over and play dead. If there are specific issues we are unhappy about, I think it is absolutely appropriate for us to be stating that loudly and clearly. There are some current issues that in fact the profession will be stating loudly and clearly very shortly in terms of government follow-through on some of the things it has committed to do that it hasn't. That will be coming out within the next couple of weeks.
I don't think the fact that we have a cooperative management approach towards the system in any way means we are either in bed with the government or that we can't be critical of things that deserve criticism.
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Ms Harrington: I'm glad to hear you have a better relationship. I have two questions. You mention in the report here that one objective of the framework agreement of 1991 is "to ensure fair and equitable compensation for physicians," and "doing so will in no way prevent the government from fulfilling its fiscal responsibility." I would ask you to be a little more specific here, because what we're talking about is that people are not willing to pay any more taxes. Where do we cut back in the health care system?
My second question: You talked about the joint management committee and addressing major challenges in earnest together, which is great. That's the way it should be. You have an evaluation committee which is actually looking at the management of the system. Improvements, you say, "will be due in large part to the insight of physicians as front-line health care providers." My question to you is, how would you see the place of, say, nurse practitioners as part of those front-line health care providers?
Dr Wyman: In answer to your first question, the framework agreement is a six-year agreement between the government and the profession, and has a series of objectives. One of the main objectives of the agreement, of course, was to provide fair and equitable compensation for physicians. "Fair" and "equitable" are terms that are defined under the Canada Health Act, so it's not a matter of what one person deems to be fair; it requires sort of a national as well as provincial perspective and in comparison to other sectors of society.
We have an ongoing set of negotiations with government and are currently in the process of negotiations with government to determine a fair and reasonable price for services. What has often happened in the past as we've gone through that is that there has been confusion between price and income. One of the ways we've started to deal with the income side of things is in looking at the utilization formula and the way in which the system is being used.
As data is becoming available, the joint management committee is beginning to review and develop a better understanding of how in fact the system is being utilized. One of the direct outflows of that is the component of the recently signed agreement between the government and the profession with regard to third-party services, a large number of which had previously been billed to the Ontario health insurance program, were never intended to be and should not have been. Through a conjoint effort between the government and the profession, we are in the process of letting the population of Ontario know that these things are not a public purse responsibility.
It's by reviewing that type of utilization process, it's by looking at the way in which services are being provided, that the total budget, the globe, can be maintained at a reasonable level while not negatively impacting upon what is a fair and reasonable price for the services being provided.
Ms Harrington: So you're saying that by working together you can look at other things around the direct health care provision as to how to do it -- even from what we've done so far, cut back further. There is something there we can cut back.
The Chair: I'm going to get my hammer out, Margaret. You had two questions. I've got to go on to Mr Phillips.
Mr Weinkauf: Perhaps I could make one comment on that, though.
The Chair: A short reply.
Mr Weinkauf: Dr Wyman said we have to differentiate between considerations on price, fees paid for medical services, and budget. That's what you alluded to. How do you not compromise quality of care, given the fiscal restraint that the government hopes to impose? That is, of course, the dilemma that faces us. Efficiency, the JMC, improving efficiencies within the system, will take us so far, but you're right. If we are as efficient as we can be and the government wishes not to spend any more money, it will have to face the decision about cutting back. It is as simple as that.
Ms Harrington: You didn't actually answer my question about the place for nurses.
The Chair: I'm sorry, but I've got to move on, Margaret. You put one question forward at a time so you can get that one answered, because sometimes when you put three or four --
Mr Phillips, after being on committee for three years now -- two years? -- knows the rules. Go ahead, Mr Phillips.
Mr Phillips: I've been waiting for two years.
What was that again? I have to ask it all in one question?
The Chair: One question at a time, not put five questions in one question.
Mr Phillips: How much time do we have?
The Chair: You've got five minutes, Mr Phillips.
Mr Phillips: Just as an aside, that's an interesting observation. I think we have to keep in mind, when we think that we are cutting back on health care spending, that there's $120 million that would normally have shown up as government expenditures that now is being taken not in taxes but billed directly to employers. So as we think of how we're managing the system and what we're spending on health care year to year, I think it's helpful for the committee to have those numbers in our minds, because the government is quite proud of its record on health spending, part of it real, part of it illusionary, because it's simply --
Mr Sterling: Transferring.
Mr Phillips: -- transferring it, privatizing it, and extra billing on it.
I really appreciate your comments on the framework agreement and how well it's working, because I think it was a breakthrough agreement. I happen to think the OMA did a very good job on that negotiation. I think it's a very good agreement for the doctors. I know not all of your doctors share that view, but I think over time they will find that it was a very good agreement for the profession.
The thing that I think is on our minds is just what we should be thinking about for budgeting purposes for health care in the upcoming year. I can't remember exactly the framework agreement, but I guess you know it pretty well; there are several components in it. What sort of year-over-year increase should we be expecting in budgeting for that provision, for that framework agreement? I see you're thinking that utilization may go up 1.5%, is that right?
Dr Wyman: It's currently running at about 1.5%.
Mr Phillips: Fees may go up 1%. Is there anything else we should be thinking of to put in that budget?
Dr Wyman: There is a normal growth curve in the population, there is an aging curve, there are demographic shifts within the community we all serve that have to be included. When we put the agreement together, the anticipation was based on historical principles that the system should expand by 3.6% on an annual basis in order to maintain a status quo, and that is not including any price increase.
Mr Phillips: And is that what we should be expecting next year, is it, a 4.5% increase?
Dr Wyman: I think in fact there has been, at least from the medical perspective, a decrease below that level. I think that's because there's been a decrease in the number of services being provided.
Mr Phillips: I see. I'm not sure if you have that number today, but it may be useful for the committee to have some idea of the total amount you think may be required in that, because that's a collective agreement, I guess, that will be signed shortly?
Dr Wyman: There are negotiations going on currently with regard to price. That negotiation table has opened and we're trying to come up with some answer on that. Obviously we would hope the amount of the price increase would not be predetermined by the budget before those negotiations are finished. It's always been a major concern to us that we get constricted before the fact rather than on a fair and reasonable basis.
But the use of the system itself I think you have to assume should, as an historical process, increase by 3.5% to 3.6%. Hopefully, through the continued efforts of the JMC and the utilization process we've been going through, we may be able to moderate that somewhat, but I wouldn't want you to think in numbers much less than that.
Mr Weinkauf: Except that I could add, and it was pointed out in Dr Wyman's statement, utilization for 1992-93, at least those figures that we do have for the first seven months, suggest a growth in the system, at least the medical sector, of about 1.5%, and that is exclusive of any price adjustment. As you know, we signed an agreement that adjusted benefits by 1% effective October 1, so that will serve to affect expenditures by an additional 0.5% that year. For next year, yes, we do not negotiate the budget; we negotiate the price, and what we would urge is that there is separation --
Mr Phillips: But the 3.6% is built in, isn't it?
Mr Weinkauf: No, the 3.6% you're referring to is in the utilization formula. It says that to the extent that utilization or growth in medical services exceeds roughly 3.6%, the profession and the government of Ontario will share equally, and the profession's share is taken back in the form of a reduction in payments.
Mr Phillips: But if you were just speculating, because the budget has to be prepared shortly, what increase should we be thinking of putting in for the physicians' portion of the budget in gross terms?
Mr Weinkauf: For 1993-94?
Mr Phillips: Yes.
Mr Weinkauf: You're asking us to do the impossible, really. We would have to predict the --
Mr Phillips: A settlement? But exclusive of the fees.
Dr Wyman: Exclusive of price. You would have to build in, based on historical trends, an increase of between 2.5% and 4% to the system just for normal demographic changes.
Keep in mind that the 1.5% we've gone through so far has not included any epidemics; we haven't had a real flu problem for the last couple of years. That hasn't been included, so if we come up with a March flu, that utilization number will go way up.
Mr Phillips: We've got to pray for good weather. That's very helpful, thank you.
The Chair: I'd like to thank you, gentlemen, for coming before this committee today.
Dr Wyman: Thank you. It's always a pleasure.
The Chair: I'd like to say to the committee that we're going to be adjourning until February 22. Sorry. I'm correct about pre-budget consultation, but we'll be going to Bill 164 on January 25; some of the members will be changing. What we need is a subcommittee meeting to look at presenters for the week of February 22. The closing date is January 15, I believe. Mr Phillips, are you on the subcommittee?
Mr Phillips: Yes, I will be.
The Chair: I didn't know whether Elinor would be there. And Mr Carr?
Mr Carr: Yes.
The Chair: We're trying to fix 1:30 on January 19, if it's convenient to the subcommittee members. I'm having the clerk send out a list of all the presenters so you can go through the list ahead of time and see which ones your caucus would like to see come forward, because you might not agree; you might have different areas you want to bring forward.
Mr Carr: The only thing I was going to suggest, Mr Chair, with committees being what they are -- speaking to some of our caucus members, they sometimes don't know where they're going to be and who's not going to be on that day, so we're a little bit all over. If we got them --
The Chair: Submit a list?
Mr Carr: The list: Do you actually need to be here? If I say, "Here it is" --
The Chair: That would be a lot easier. We'll have choices. I don't know how many will be coming in, but we'll have to say, "These are your priorities; this many."
Mr Carr: And if worse comes to worst, divide it by three to get the total.
Mr Sterling: Just as a matter of interest, if you say the cutoff day is the 15th, that's tomorrow. Presumably, you haven't.
Clerk of the Committee (Ms Tonia Grannum): It's February 15.
The Chair: February 15?
Clerk of the Committee: I think so. The deadline's in February.
The Chair: Forget everything I said. Sorry. I've got that other bill in my head, 164.
Mr Carr: How many do we have now, do you know?
Clerk of the Committee: We have about 30 people.
Mr Carr: For four days, right?
The Chair: It's two weeks, because each caucus is going to be writing its own report in the end.
Mr Carr: We've got two more weeks of finance hearings?
The Chair: Correct. We'll get those lists out as soon as we can on the closing date, and we'll call a subcommittee meeting at that --
Mr Phillips: The 19th?
The Chair: No. The other one is February 15, not January 15, for the pre-budget consultations.
Mr Phillips: That's good, because tomorrow is January 15.
The Chair: That's the Bill 164 deadline; that bill's coming to this committee. I don't want to confuse you.
Mr Phillips: Why did you, then?
The Chair: This committee is adjourned.
The committee adjourned at 1214.