LEGISLATIVE ASSEMBLY OFÂ ONTARIO
ASSEMBLÃE LÃGISLATIVE DEÂ L'ONTARIO
Monday 30 November 2009 Lundi 30 novembre 2009
The House recessed from 1648 to 1845.
ORDERS OF THE DAY
ORDER OF BUSINESS
Hon. Monique M. Smith: I believe we have unanimous consent to arrange this evening's business as follows:
The first order of business will be Bill 177, and we will follow that up with Bill 179;
There will be 30 minutes apportioned equally among the recognized parties allotted to the debate of each of these orders of business, following which the Speaker shall put every question necessary to dispose of each item of business; and
Following completion of both orders of business, the Speaker shall adjourn the House without question put until 9 a.m. tomorrow.
The Speaker (Hon. Steve Peters): The members have heard the motion as read. Agreed? Agreed.
AND SCHOOL BOARD
GOVERNANCE ACT, 2009 /
LOI DE 2009
SUR LE RENDEMENT DES ÃLÃVES
ET LA GOUVERNANCE
DES CONSEILS SCOLAIRES
Ms. Smith, on behalf of Ms. Wynne, moved third reading of the following bill:
Bill 177, An Act to amend the Education Act with respect to student achievement, school board governance and certain other mattersÂ / Projet de loi 177, Loi modifiant la Loi sur l'Ã©ducation en ce qui concerne le rendement des Ã©lÃ¨ves, la gouvernance des conseils scolaires et d'autres questions.
The Speaker (Hon. Steve Peters): Debate?
Mrs. Liz Sandals: Higher levels of student achievement is our government's top priority in education. Good governance by our trustees and directors of education is necessary to support higher levels of student achievement. That's why we introduced the Student Achievement and School Board Governance Act to support them in their important roles.
I would like to take the opportunity to thank all the educators and parents who presented at the committee hearings that we held recently. Our approach to publicly funded education has been and will always be one of respect, collaboration and consultation with our education partners. The legislation before the House tonight reflects much of our education partners' input and demonstrates our respectful and collaborative approach.
The proposed amendments to the Education Act, if passed, would make student achievement the number one priority for all school boards.
In 1998, the previous government introduced legislation that fundamentally changed the publicly funded education system in Ontario. That bill, however, did not address the necessary changes to the governance structures within school boards. Since then, several major reports have called for a governance review to see if the structures in place are operating as effectively as they should.
In fact, we assembled the governance review committeeâÂ"which had broad participation from school boards from all sectorsÃ¢Â"to examine how well the current governance structure is serving Ontario's education system. The committee's report found strengths in the current system, but it also identified some areas for improvement. This legislation was designed to address many of the committee's recommendations, and it demonstrates our government's high level of respect for trustees, school boards and directors of education.
The proposed legislation would clarify the roles and responsibilities of school boards, trustees, board chairs and directors of education. It would build on good governance practices and promote sound financial management by authorizing regulations respecting audit committees and trustee codes of conduct. The proposed legislation provides a mechanism for school boards to enforce their codes of conduct. These are all tools that will help boards to govern themselves more effectively.
School board leadership plays an important role in student learning. Bill 177 clearly states that boards are responsible for promoting student achievement and well-being. One change would involve direction on handling board resources effectively. This would help ensure that board resources are managed wisely, that effective education programs are delivered and that students are encouraged to pursue their goals.
Other changes highlight the important leadership role that board chairs have, like conducting meetings according to the board's procedures and practices, acting as spokesperson to the public and providing leadership to keep the board focused on its strategic plan. While these are all common practice in existing boards, they've never been formally legislated and defined before.
Trustees play a valuable role in supporting local decision-making. Bill 177 would strengthen their role by ensuring, among other things, that they contribute to the collective goals of the board, participate in board meetings and committee meetings, consult with parents and students and constituents on the board's plan, and bring the concerns of parents, students and constituents to the board's attention. Trustees would maintain their focus on student achievement and well-being.
We held committee hearings and we heard from a broad range of education stakeholders. In response to that, there were a number of amendments made to the bill. In fact, the amendments in many cases were unanimously proposed by all three parties, because all three parties were, of course, hearing the same input.
To give you a flavour of some of the things that we've changed as a result of the amendments: Interestingly, the Education Act has never had a purpose clause, which, given that it's a book this thick, is a little bit surprising. We had proposed a purpose clause. But Martha Mackinnon of Justice for Children and Youth and some of the democracy advocates here in Toronto said, "You really haven't reflected, in the role of public education, its role in strengthening democracy." That hit a particular resonating note with me.
If we reflect back to the father of public education here in Ontario, Egerton Ryerson's thinking on having a publicly funded education system was that having a literate, educated society was one of the foundations of a democratic society. We have amended the purpose clause to reflect that by inserting the requirement that public education build a civil society. So the opening purpose of public education is, "A strong public education system is the foundation of a prosperous, caring and civil society."
On the more technical side, one of the things that we heard from a number of stakeholders was that if we are going to change the roles of school trustees, who are democratically elected by electors in their own communities, we need to come to the Legislature to do this; that this is a very important change. So with the unanimous consent of all parties, we deleted a clause that would have allowed, in the original bill, that to be done by regulation. It will now require legislation. That was a suggestion made by a variety of stakeholders.
When we looked at the duties of boards, it was pointed out by some boards that the duties of the boards didn't actually include monitoring and evaluating the performance of the director of education, one of the primary responsibilities of the elected board of education. So we made amendments to reflect that all boards are responsible for setting up a monitoring and evaluation system of their chief executive officer, the director of education.
One of the things that some of the stakeholders pointed out was that in the duties of the board, although we had always assumed that the duties of the board are to uphold the Education Act, that was never explicitly stated. So we introduced a clause that said, "A member of a board shall ... carry out his or her responsibilities in a manner that assists the board in fulfilling its duties under this act, the regulations and the guidelines issued under this act, including but not limited to the board's duties under section 169.1" to clarify that everything must be done in accordance with the act.
Some trustees were concerned that the wording that had been initially proposed might be interfering with their freedom to dissent. We clarified that the requirement in the duties of members is to uphold implementation and that, in fact, they are still free to speak out in dissent if they disagree with a decision. They are still free to bring motions of reconsideration. They simply must not interfere with the actual implementation of a decision once it has been democratically made.
We made it clear that the duties of board members include entrusting the day-to-day management of the board to its staff through the board's director of education, because it's important that the board focus on its role of student achievement, policy setting and fiscal accountability, rather than intervening in day-to-day management of the schools.
That will give you a little bit of a flavour of the sort of things that we did implement. We respect that trustees do play a valuable role and that we need to make sure that continues. In fact, all partners in the education system have a role to play in enhancing student achievement and well-being, closing the gaps in student achievement and maintaining confidence in Ontario's publicly funded education system.
That's why we passed Bill 78, the student performance bill, two years ago. There are still some pieces that we need to deal with coming out of that act as well. What I want to do tonight is commit that as we implement this act and Bill 78, we will continue to consult extensively with our education partners.
The Acting Speaker (Ms. Cheri DiNovo): The member from NepeanÃ¢Â"Carleton.
Ms. Lisa MacLeod: It is a pleasure to be debating this evening. I think it's only fair for me to comment firstly on two courageous colleagues of mine, the members from BruceÃ¢Â"GreyÃ¢Â"Owen Sound and from LanarkÃ¢Â"FrontenacÃ¢Â"Lennox and AddingtonÃ¢Â"it's the longest name ever. We're here tonight in a truncated way because they're speaking up for taxpayers in Ontario.
We're talking about Bill 177. As we talk about Bill 177, one only needs to look at the front of the bill. This bill was introduced for first reading on May 7, 2009Ã¢Â"six months ago. This bill was introduced six months ago, and only now are we getting to third reading. Yet two weeks ago, this Liberal government decided to ram through the Ontario Legislature the largest single sales tax increase in Ontario's history without adequate public consultation and without the support of a majority of Ontarians.
That's a problem because in six months they've debated on Bill 177, and it hasn't even done the job it's supposed to do. You'll recall I had a bill that you supported, Madam Speaker, Bill 130, which would have created mandatory reporting in our schools. Unfortunately, Bill 177 was sort of a circling of the wagons on the issue that was raised by my colleague from Burlington, Joyce Savoline, and also my colleague from WhitbyÃ¢Â"Oshawa, Christine Elliott. Those two women fought tirelessly in this Legislature for mandatory reporting so that child-on-child abuse in the schools would be adequately reported. Instead, what the Liberals have done over six months ofÃ¢Â"who knows what they've been doing, but over the last six months they've angered teachers, they have angered trustees and they have angered parents, because they did nothing to resolve the issue that we first brought up.
But it brings me again to Bill 218, a bill that we expect to have a fulsome public discussion on. Yet they have at every step of the way refused to allow us to participate in a debate not only amongst legislatorsÃ¢Â"which they have, by the way, refused, because they continue to call for time allocation; their most recent time allocation bill was nothing more than draconian. We have not had an adequate ability to debate that fully in this chamber. We have not had that ability to take it across Ontario to various communities so that taxpayers, whether they're middle-income moms and dads, soccer moms, hockey dads or Ontario seniors; whether they're a small business person or a doctor, a physician who is operating a clinicÃ¢Â"there was no public debate for them. That was only, of course, in a two-week spanÃ¢Â"because when you're dealing with the second-largest tax increase that the government has brought in, but the largest single sales tax increase in the province's history, Mr. McGuinty thinks that you shouldn't even have debate on that.
In fact, it's six months that this bill has basically sat idle, and they're just getting around to it now. It speaks to their priorities. To me, if you really want to talk about child safety in the school system, it would have been more urgent. Dealing with the large single sales tax issue that we're dealing with with the HSTÃ¢Â"they should have actually done what Brian Mulroney did: He spoke to almost 300 people before he rammed the GST through. I can't even say "rammed it through"; it took three months. With these guys here, if we get through three weeks of debate on the HST in Ontario, we'll be lucky. But they just want to nail taxpayers.
Mr. Robert Bailey: They can't wait to do it.
Ms. Lisa MacLeod: They just can't wait to do it.
It brings me back to my colleague from LanarkÃ¢Â"FrontenacÃ¢Â"Lennox and Addington and my colleague from BruceÃ¢Â"GreyÃ¢Â"Owen Sound. I can tell you one thing: There is a big difference between the two of them and backbenchers over here. I can tell you that. They'll speak up for their people, and I've already had the tremendous opportunity to speak to my constituents in NepeanÃ¢Â"Carleton, who support them, who appreciate the fact that they're standing up for the people of this province. It's a special type of courage that those two gentlemen have. I can tell you that they're standing up for the people that they represent and the people that the Liberal backbenchers represent.
I just see, over this period of time, that today was a very interesting day in the Legislature, something more than I've ever experienced. I'm sure it was a once-in-a-lifetime experience. But in our capacityÃ¢Â"and we have tremendous resolve in the Progressive Conservative caucus, and that's why we're going to continue to support these two gentlemen. Not only that, but we're going to continue to say that Bill 177 is not adequate. We're not going to support it. If there was ever an example of rearranging the deck chairs on the Titanic, it's Bill 177. My colleague from Burlington, our former education critic, will tell you that. She has met time and time again with school boards and educators and parents who are opposed to the way this McGuinty government has been mishandling child-on-child or student-on-student abuse.
Mrs. Liz Sandals: Maybe you didn't notice, Lisa; Liz Witmer's your critic.
Ms. Lisa MacLeod: You know, it's really hard, Madam Speaker, to speak among the heckles. I'm going to continue because I have tremendous resolve. If the member from Guelph actually wanted to say something reasonable and useful in this chamber, she'd oppose the HST, like her constituents do. I can tell you, we're getting the correspondence, the petitions, the letters and the e-mails from her riding. They don't support the HST.
In fact, the other thing isÃ¢Â"we're dealing with an act to amend the Education ActÃ¢Â"these Liberals can't even get it right. First of all, we're dealing with a $25-billion deficit, and what are they doing? They're bringing in universal daycare. They're bringing in the daycare forÃ¢Â"what is it?Ã¢Â"$1.5 billion. They're also trying to change the Education Act in the HST bill. We, of course, have asked for that to be severed, but they've put the Education Act changes into the HST bill. Then we've got this education act, Bill 177. What I don't understand is why you can't get it right and can't do it all at the same time. I guess why that is is because the HST act, all you would like to do, Ms. Sandals, is ram it through and any changes that you don't like and Ontarians don't likeÃ¢Â"it doesn't matter because you're going to hide it. You're going to cover it under the dark of night like they're doing tonight, keeping us here until midnight. That's why my colleagues from BruceÃ¢Â"GreyÃ¢Â"Owen Sound and LanarkÃ¢Â"FrontenacÃ¢Â"Lennox and Addington are opposed to what this Liberal government is doing.
If they wanted to have a fulsome debate on education in the province, Bill 177, the education component in Bill 218 and their full-day kindergarten/universal daycare, they would actually have that. They would hold public hearings in Ontario about that very issue, but they refuse to, like they refuse to on Bill 218, because they can't get it right. They can't get administration right; they can't get taxation right.
In fact, I heard a rumour that they're probably going to be turfed out of office in two years. It's going around like wildfire, that rumour.
Ms. Lisa MacLeod: I must say again that it's so difficult to speak among all the heckles by the Liberal members. I try so hard. As meek and mild as my personality is, I try to collect my thoughts and speak about the seriousness of Bill 177, but you choose instead to drown my small, feeble voice out.
As I close with my last 29 seconds about this bill, Bill 177 is not the answer. It is not the solution. We'll be voting against it, and we're going to continue to call for public hearings on the HST. We're going to continue to call for public hearings on the changes they're making to the Education Act that they're not telling Ontarians about.
The Acting Speaker (Ms. Cheri DiNovo): Member from TrinityÃ¢Â"Spadina.
Mr. Rosario Marchese: It's really going to be hard to summarize this bill in 10 minutes because normally you need more time to deal with this bill, the Minister of Education and the parliamentary assistantÃ¢Â"normally half an hour, but really an hour is what you needÃ¢Â"really. I'm going to do my best.
I've got to tell you, there are three pieces of legislation this government has introduced that I detest. First, the harmonized sales tax is going to whack the middle class like we've never seen before. That's the first offensive thing this government has done. They're getting rid of progressive income taxes, which they are proud of doing, which they announce every day, and they're introducing flat taxes, i.e., the harmonized 8% sales tax on a whole lot of services like funeral services, gasoline, hydro, vitamins and so on. The list is long. That is the biggest one.
The second one is labour mobility, which this government is rushing through in the space of just a couple of weeks. Nobody even knows what the bill is about. It has nothing to do with labour mobility. It's got to do with trade liberalization and extension of NAFTA, and that's what the bill is about. The Liberals want to hide that under the carpet as best as they can, and they want to get rid of it as fast as they can. That's the second most offensive bill they have introduced in this Legislature, which they're killing by Thursday.
The third is this bill, Bill 177. I don't know how many fine Liberals have read this bill because if you hear the parliamentary assistant, you think it's a good bill. If you didn't know any better you would say this is about trustees; this is a bill that helps trustees. This is the most offensive piece of legislation that trustees have ever, ever seen, but the parliamentary assistant from Guelph makes it appear like this is about them; it's about helping them. If you listen to her, she is helping the trustees. This bill is not about trustees. This bill is about her and the Minister of Education, and it's about how you belittle and diminish trustees as best as you can.
Nobody could have done better, not even Mike Harris. Not even Mike Harris could have done better than the parliamentary assistant and the Minister of Education did. Mike Harris would have been proud of this bill. And when you hear Liberals introducing this bill, you've got to worry. When Kathleen Wynne, a progressive trustee, introduces this bill along with the parliamentary assistant, you have got to worry. It is the worst piece of legislation I have ever seen and/or read and/or debated.
Mr. Rosario Marchese: David Zimmer, the member from Willowdale, was there. He knows. He's a lawyer, by the way; I think he reads bills more than some others. He was there.
Mrs. Liz Sandals: Rosie, I've read every word of that bill.
Mr. Rosario Marchese: The parliamentary assistant has read every word of this bill. The first part of this bill that this parliamentary assistant has read, God bless her, is the purpose. This bill is divided into two parts: one, the purpose; and the second, which I will get to, has to do about governanceÃ¢Â"and it has nothing whatsoever to do with governance.
It all has to do with the purpose of this bill, which is the first part: "All partners in the education sector have a role to play in enhancing student achievement and well-being, closing gaps in student achievement and maintaining confidence in the province's publicly funded education systems."
Mrs. Liz Sandals: And that's bad?
Mr. Rosario Marchese: I'm going to get to it, Parliamentary Assistant.
This bill is about achievement, which is test scores. This government, through the parliamentary assistant and the minister, is obsessed with test scores; that's all they give a hoot aboutÃ¢Â"test scores. It's not about the whole child; it's not how the whole child learns. It's about how that child does on that test score and about school boards delivering on student achievement, and that's it. It does not say anythingÃ¢Â"
The Acting Speaker (Ms. Cheri DiNovo): Member from Guelph, order.
Mr. Rosario Marchese: It's okay.
Mrs. Liz Sandals: Well-being, Rosie. It's about students' well-being.
Mr. Rosario Marchese: Well-being, yeah, and test scores is all she cares about. It's about the test scores, and that's it. The student does not exist outside of the test scores; that is it.
And "closing gaps" means that teachers and boards are all having to devote their energies to closing gaps through the test scores. It's got nothing to do with the parliamentary assistant or the minister giving money and/or support to those poor teachers who have to deal with mental illness, who have to deal with poverty issues. She was a trustee. She was in charge of OPSBAÃ¢Â"she was. She was active and should know better, and she defends this crap.
Mr. Rosario Marchese: That's not so bad, because that's what this bill is.
The Acting Speaker (Ms. Cheri DiNovo): Could you retract that and call it fertilizer?
Mr. Rosario Marchese: I take it back immediately, because I've only got five minutes. I take it back.
Mr. Rosario Marchese: I took it back. I already withdrew my comment.
Mr. Mike Colle: Say "withdraw."
Mr. Rosario Marchese: Speaker, stop the clock.
The Acting Speaker (Ms. Cheri DiNovo): Stop the clock, please. Could you withdraw?
Mr. Rosario Marchese: I withdraw.
The Acting Speaker (Ms. Cheri DiNovo): Thank you.
Mr. Rosario Marchese: So the purpose of this bill is test scores and nothing else; they don't care about kids in any other way. They don't learn in any other way except through the test scores, and poor boards and teachers have got to do the job of dealing with kids who've got so many problems on their own. NowhereÃ¢Â"nowhereÃ¢Â"did this ministry say, through the parliamentary assistant, "Teachers, we're going to give you the resources you need to deal with kids who've got so many different problems." And when we introduced that amendment, she didn't support it. That's the first one.
The second one: "The Lieutenant Governor in Council may make regulations governing the roles, responsibilities, powers and duties of boards, directors of education and board members, including chairs of boards." That was the most offensive piece of legislation.
Mrs. Liz Sandals: We deleted that.
Mr. Rosario Marchese: Even they voted against it, because they realized how bad and dumb and stupid it was.
Mrs. Liz Sandals: We agreed. Everybody agreed. We deleted it.
Mr. Rosario Marchese: They got rid of it, and even she agreed with it. I couldn't believe it.
Mrs. Liz Sandals: We all agreed.
Mr. Rosario Marchese: All right. Will you be quiet? I've got three minutes.
So they voted against it.
The Acting Speaker (Ms. Cheri DiNovo): Member from Guelph, order, please.
Mr. Rosario Marchese: Be quiet. I've only got three minutes.
The next offensive thing: "ensure effective stewardship of the board's resources ... deliver effective and appropriate education programs...." As if boards don't do that. The government gives them money, and they deliver the best programs they can. This part on page 3 makes it seem like the boards are just wasting billions of dollars that they don't get from these people. They make it appear that boards are frivolously spending money that should be going to the poor students, and they're not; they're going into their own pockets.
Mrs. Liz Sandals: Twenty billion dollars.
Mr. Rosario Marchese: Please. The parliamentary assistant, with all the experience she's got, tries to say so much about so little.
"Every board shall effectively ... use the resources entrusted to it for the purposes of delivering effective and appropriate education." As if boards do anything but that.
The other one: A member shall "attend and participate in meetings of the board." What do trustees do except attend meetings? Is that a problem? No. That's what they do. Why state the obvious? It's so dumbÃ¢Â"dumb.
"Consult with parents." What do trustees do except consult with parents? It's dumb to put it in. "Bring concerns of parents, students and supporters" to the board. That's what trustees do. It's dumb to put it in as "Conduct of members of school boards." This is their duty. Do you get it? It's treating trustees like little kids. It's utterly stupid to do that.
The other one: "Support the implementation of any board resolution." They change the word from "support" to "uphold." Why do that? Why is it that you feel the need to say that? "Refrain from interfering in the day-to-day management of the board." What is it that trustees do? They are elected. They are supposed to represent parents, and that sometimes means interfering. I say to the parliamentary assistant, who used to be a trustee a long time ago, what is wrong with that?
My God, there's so much. With 10 minutes, I have one minute left; I can't believe it.
Then they have another section which talks about how chairs of the board shall represent the interests of the board. It says it provides that the chair of the board shall "act as spokesperson to the public on behalf of the board, unless otherwise determined by the board." Only chairpeople represent the interest of the board. What happens to trustees? Why do we need them? Why do we elect them? That's what this government, through this minister, has done. Why do we need elected trustees with this bill?
This is one of the worst pieces of legislation I have ever seen. It is bad, dumb politics. It hurts trustees; it belittles trustees. Liberal MPPs should be elected out of office, and they should get unelected soon. I can't wait.
The Acting Speaker (Ms. Cheri DiNovo): Ms. Smith has moved third reading of Bill 177, An Act to amend the Education Act with respect to student achievement, school board governance and certain other matters. Is it the pleasure of the House that the motion carry?
All those in favour of the motion will please say "aye."
All those opposed to the motion will please say "nay."
In my opinion, the ayes have it. I declare the motion carried.
Be it resolved that the bill do now pass and be entitled as in the motion.
Third reading agreed to.
REGULATED HEALTH PROFESSIONS
AMENDMENT ACT, 2009 /
LOI DE 2009 MODIFIANT DES LOIS
EN CE QUI CONCERNE
DE LA SANTÃÂ RÃÂGLEMENTÃÂES
Ms. Matthews moved third reading of the following bill:
Bill 179, An Act to amend various Acts related to regulated health professions and certain other ActsÃÂ / Projet de loi 179, Loi modifiant diverses lois en ce qui concerne les professions de la santÃÂ© rÃÂ©glementÃÂ©es et d'autres lois.
The Acting Speaker (Ms. Cheri DiNovo): Now we recognize Ms. Matthews for a short statement.
Hon. Deborah Matthews: Thank you very much. I am delighted to be able to be here tonight to kick off third reading debate for Bill 179, the Regulated Health Professions Statute Law Amendment Act, 2009. I would like to begin by thanking all of the people who worked collaboratively to make this bill a reality. I'd like to thank Barbara Sullivan, the chair of the Health Professions Regulatory Advisory Council, all the members of the council, those who contributed to the HPRAC process, and all the people who made submissions and were part of the debate around this bill. I would also like to pay a special thanks to my parliamentary assistant, Bas Balkissoon, for his dedicated and collaborative work on this bill.
If passed in third reading, the bill would support the government's HealthForceOntario health human resources strategy, ensuring that Ontarians have access to the right number and mix of qualified health care providers now and in the future by increasing patient access by better utilizing health professionals and reducing barriers to their practice, and by improving patient safety by strengthening the health professional regulatory system. In short, if passed, the bill would mean access to safe, high-quality health care in more places.
Let me give you some examples. Instead of waiting in the emergency room to see a physician, a fracture could be set by a skilled nurse practitioner. Need an inhaler refilled? The pharmacist could do that in one trip, instead of two trips: one to the doctor and then one to the pharmacist. A physiotherapist could order an X-ray to better examine the cause of knee pain. A dietitian could take blood samples from patients to check blood glucose levels.
The proposed amendments affect several professions under the Regulated Health Professions ActÃ¢Â"the Nursing Act, for exampleÃ¢Â"and would expand the scope of practice for various health professionals. It would increase access to health care for Ontarians by allowing nurse practitioners, pharmacists, physiotherapists, dietitians, midwives and medical radiation technologists to deliver more services that they are now qualified to provide. It would increase access by changing the rules for administering, prescribing, dispensing and selling drugs in practice for chiropodists and podiatrists, dental hygienists, dentists, midwives, nurse practitioners, pharmacists, physiotherapists and respiratory therapists. It would also remove restrictions on X-rays that can be ordered by nurse practitioners and enable physiotherapists to order X-rays for specific purposes.
If passed, Bill 179 would allow all of these regulated health professionals to better utilize their hard-earned skills and training. We want all health care professionals to have the opportunity to give their best, to give all Ontarians the very best care.
Based on the recommendations made by HPRAC, the Health Professions Regulatory Advisory Council, we're taking steps to better utilize all of Ontario's health professionals. The proposed legislation will increase teamwork among all regulated professions and build on existing highly successful team environments like nurse-practitioner-led clinics and family health teams.
The proposed changes are all about putting more tools in the hands of people who are at the front line of health care delivery. It would help promote a health care system that is more efficient and more easily adaptable to new technologies. Timely care is good for patients; that goes without saying. It's also good for the health care system as a whole, having our health care workforce work better together.
The standing committee conducted public hearings, and as a result made amendments to the bill with respect to certain professions. Some of those amendments include amendments to the Nursing Act, 1991, which would remove restrictions on the drugs that nurse practitioners could prescribe, dispense, compound and sell. It would authorize registered nurses and registered practical nurses, in certain situations, to dispense drugs that have been prescribed for patients. Amendments to the Social Work and Social Service Work Act would authorize appropriately educated members of the Ontario College of Social Workers and Social Service Workers to use the title "doctor," subject to certain restrictions.
Bill 179 would support our goal of reducing emergency room wait times in a number of ways. More health care providers, hopefully with expanded roles, delivering better front-line primary care is a critical component of any emergency room strategy. It means that Ontarians are better able to manage chronic diseases like diabetes, which means we would see fewer people with diabetes in our ERs. It means that Ontarians with mental health challenges get the care they need without having to visit an emergency room. All of this cuts down on emergency room traffic in our hospitals.
While we know there is a long road ahead, we remember that in the past year alone we have reduced ER wait times by nearly an hour overall. Our job is to build on this success while maintaining a steadfast focus on our government's two biggest health care priorities: reducing wait times, especially in our emergency rooms, and increasing access to family health care.
We're working hard to restore Ontarians' trust, and to show them that we're building a health care system for the future and that we're spending their tax dollars wisely. The people of Ontario expect both a strong health care system and fiscal responsibility. The proposed changes to Bill 179, making the best possible use of all the members of the health care team, will go a long way in addressing both.
I would like to thank members of all three parties who were part of the committee hearings. We had amendments from all parties, and I'm really proud of this piece of work. I think it demonstrates that when we do work collaboratively, we can really do good work for the people of Ontario.
The Acting Speaker (Ms. Cheri DiNovo): Further debate?
Ms. Lisa MacLeod: I am privileged again to rise tonight to debate another bill, and I'm very, very pleased to be able to do that.
Ms. Lisa MacLeod: Listen to my colleagues opposite. There is just no respect for this chamber anymore.
Bill 179 is an interesting piece of legislation. Of course, it was introduced last May. It not only went through first reading last May; it also went through second reading. Here we are six months later in third reading. A lot of work has indeed been done, and a lot of work, we must remember, took us to this place. While the first two readings of Bill 179 went through this chamber and then to committee, the entire Ministry of Health was sidetracked by something called eHealth, the $1-billion waste of money. A boondoggle is what it's called by the taxpayers of the province.
While that happened, of courseÃ¢Â"someone correct me if I'm wrong, but this probably went through two or three Ministers of Health before this bill was finally completed. I'm pretty pleased to be able to say that my colleagues in the official oppositionÃ¢Â"under the leadership of Tim Hudak and also Christine Elliott, our health criticÃ¢Â"will support this bill.
But as my colleague Christine Elliott will say, the devil is in the details, and our support for this bill is qualified. Why is it qualified? There's a series of reasons that she has outlined here. As with all things, she does believe that the purpose and intent of Bill 179 and its many provisions are sound. She also believes there are many opportunities lost in Bill 179 that were either overlooked or ignored by legitimate concerns of several health care professionals, meaning that many options to make significant positive change have not been realized. My colleague used the term in her remarks, "the devil is in the detail."
If you look atÃ¢Â"
Mr. David Zimmer: The devil is in the Tory caucus.
Ms. Lisa MacLeod: I think you ought to rescind that comment. I think you ought to take that back.
The Acting Speaker (Ms. Cheri DiNovo): Member from Willowdale.
Ms. Lisa MacLeod: The devil is in the detail. Bill 218, much like Bill 179, is all in the detail. That Bill 218, the HST legislation, has several pieces of legislation that need to be severed so that we can actually have a legitimate debate. But no, they will refuse to severe that legislation. They are ramming through this legislation, and that's why the devil is in the detail.
My colleague from Willowdale says the devil is in the Tories, which I resent. I actually think the Speaker should demand that he apologize. He refuses to because that's how they decided to debate the Progressive Conservative caucus: through slander and through insults.
One of our biggest concerns in 179 has been echoed by several health care professionals, just like eHealth was echoed by Ontario taxpayers. Of course, Bill 218, the HST bill, is echoed by Ontario taxpayers.
One of those big sections was 24 of the bill and its amendments to the Regulated Health Professions Act, 1991. The government's amendments add a new statutory official under the act known as college supervisor. Subsection 5.0.1(1) provides that "The Lieutenant Governor in Council may appoint a person as a college supervisor" on the recommendation of the Minister of Health and Long-Term Care. This allows the government to appoint a college supervisor on the recommendation of the minister when the minister deems it appropriate, and how and for how long the minister sees fit to fulfill duties assigned by the minister.
Now, in committee, we were advised by the minister's parliamentary assistant that this provision was intended to ensure that, "The supervisor will be appointed in cases where the college has failed to carry out a request made by the minister." With all due respect, the mandate of the professional college is not to carry out the wishes of the minister.
But that's when we all must rewind the tape and look back at what has happened from May throughout the summer of scandal that the McGuinty Liberals had and see that everything in the health department was done as a result of what those ministers wantedÃ¢Â"whether it was right for Ontario or not. We've only have to look at some of the scandals with eHealth, the political direction there and the fact that Mr. McGuinty actually hand-picked Ms. Kramer to sit as the CEO of eHealth. We must only look at the fact that Alan Hudson was his own personal health adviser. We must not look very much further to find out that some of the key players in the eHealth spectacle were former assistants to the previous Minister of Health.
Indeed, the mandate is to carry out the wishes of the Minister of Health. We, on this side of the House, are very concerned with that, given their lacklustre performance over the past six years. In keeping with the theme of undermining the power of the colleges, the measure that was introduced without consultationÃ¢Â"and without consultation, I might add, is why my colleague from LanarkÃ¢Â"FrontenacÃ¢Â"Lennox and Addington and my other college from BruceÃ¢Â"GreyÃ¢Â"Owen Sound are standing here today to make a public point. PeacefulÃ¢Â"
Hon. John Gerretsen: Peaceful?
Ms. Lisa MacLeod: It's peaceful. They're making a peaceful demonstration within a chamber of democracy. They're choosing to sit here and protest the draconian measures of this current government.
But let's get back to Bill 179, because in keeping the theme of undermining the colleges without consultation, the government's change to the Regulated Health Professions Statute Law Amendment Act has raised serious concerns for the College of Nurses of Ontario and the Ontario Dental Association, the College of Dietitians of Ontario, the College of Chiropodists of Ontario and others. After hearing the heated opposition to the provision, we in the Progressive Conservative caucus introduced an alternative in clause-by-clause review, which represented a compromise between the government's motion and the concerns of the colleges. This proposed amendment would have provided safeguards against government intrusion into the affairs of colleges and mitigated the impact of government interference.
Again, I think it speaks to the pattern that has developed over there, this pattern of behaviour where it's "Do as I say," direction from the minister which is obviously coming from the Premier, and public consultation be damnedÃ¢Â"talk to the stakeholders and the taxpayers and the patients of this province only after this legislation has been passed and its negative effects have been seen. Rather than do the right thing and fulfill its obligations and commitments to the people of the province of Ontario, they are abusing their power.
Bill 218: they are refusing to hold public hearings. More than that, we've had Bill 218 on the books for less than three weeks, yet old Bill 179 has been withering out there for six months with first reading back in May, second reading back in May, and here we are, six months later, presumably only because they've been dealing with the crisis at eHealth and the $1 billion that they flushed down the toilet that was intended for patient care. We're back here; we're dealing with this legislation now. But we're not dealing effectively with HST. That's why my colleagues from BruceÃ¢Â"GreyÃ¢Â"Owen Sound and LanarkÃ¢Â"FrontenacÃ¢Â"Lennox and Addington are holding a peaceful demonstration within the Ontario Legislature tonight. That's why the PC caucus is united in its resolve to support them. And that's why we're going to continue to fight tooth and nail for these guys to do the right thing: actually hold adequate public hearings on legislation and make sure that you do your due diligenceÃ¢Â"not just introduce something, forget about it and six months later deal with it, and not just introduce it within three weeks and limit public debate. There has to be a happy medium. They have never found it.
The Acting Speaker (Ms. Cheri DiNovo): Further debate? Further debate?
Mme France GÃÂ©linas: Merci, madame la PrÃÂ©sidente, for your numerous calls there. It is my pleasure to speak about Bill 179. Bill 179 has to do with amendments to various acts, and basically it is to recognize the scope of practice of the different health professionals here in Ontario. If we are serious that we're going to move forward with an integrated team approach to health care, we have to let each and every one of those professionals practise within their scope of practice. Only then will we achieve the benefit of interdisciplinary care the way it should be available to the people of Ontario. It will improve health.
Bill 179 makes some concrete steps for some of the professions in some of the scopes of practice, so it is a step in the right direction. But you have to realize that some of those professionals have waited a decade to see changes to their scope of practice, and they need that much change and they get an inch. Sure, they're happy that they've got those little changes to their scope of practice, but what they wanted was to be able to practise to their full scope, to let the people of Ontario know what they're able to offer and to help make them healthier. So they came in droves. We had to have three days of hearings. We gave those associations, those colleges, 10 minutes each. That's it; that's all. They had to spit it all out in 10 minutes, tell us everything that needed to change with Bill 179, and we did that for three days straight, 10 minutes at a time. This is how many changes they wanted. That's for three days; we listened and we listen. We listened to good ideas that were well formulated, that really showed, with best practice to support, that if we were to make those changes, the health of Ontarians would improve; the health care system would run more smoothly.
Then we tried to put amendments forward. We put 89 amendments forward. I can tell you that zeroÃ¢Â"yes, you can count them, zeroÃ¢Â"NDP amendments got voted for. The government had it set in their head that this was what was to be given to those professionals. It didn't matter what they brought forward for amendment; it didn't matter how convincing their arguments were. We often had the professional college working with the association, working with the teaching institution, all showing us that it is safe, that it would improve public health, that it would make our system work better, but to no avail. The government had their agenda and they stuck to it. They made little steps for some of the health care professionals that had waited for such a long time. For the rest of them, they will have to wait. I hope they're not going to have to wait for another decade, but chances are they will, because those kinds of bills don't come about very often.
To look at it in more detail, I'd like to talk about nurses for a while. Nurses are the only 24/7 bedside professionals in our hospitals. They have so much that they know and that they can offer, but when we limit them because we limit their scope of practice, it's like an opportunity wasted. We see all of that talent, all of that knowledge, gone to nothing because we don't allow them, if they have the appropriate education or knowledge, to cast simple fractures or dislocations; we wouldn't do this. We allow them to dispense, but we don't allow them to compound and sell drugs, to communicate a diagnosis, to prescribe forms of energy. It doesn't matter that their college said that they could do that safely, that their association said that the profession was ready, that the universities and colleges say that they teach this, and that nurses can do this in a safe fashion. The government didn't listen. They had their set agenda and they stuck to it.
The same thing with expanding the scope of practice for nurse practitioners: Did it change? Yes, it did change, and alleluia; I'm really happy. But here again, we came short of giving them their full scope of practice. We have an opportunity at some time in the future to maybe give them full prescribing. To prescribe from a list is ridiculous. Drugs change so quickly that you are forever trying to update that list. So now the government has opened the door to say, "Maybe we'll look at it in regulation." We need to act now. As new nurse-practitioner-led clinics are rolling out, those professionals need to be able to work within their full scope of practiceÃ¢Â"not at some point in the future, once we've had the process to look at regulations, and maybe if the stars align with seven moons we'll get there. We had an opportunity to do this right here, right now, but we didn't do that. So those professionals will continue to wait and prescribe from a list that will forever be outdated, and I will be forever arguing that in order to do their job properly, they need full prescribing.
I want to talk about pharmacists and remote dispensing. There's a lot of uncertainty about remote dispensing, but the government is moving ahead. We want a simple thing. Let's define what "dispensing" means. Let's make it clear what we mean when we say "remote dispensing" and let's make it clear what we mean by "remote," so that the urge for profit does not trump quality of care. But none of that was listened to.
We also ask that the profession be given the right to distinguish between commercial marketing campaigns and health promotion campaigns, because sometimes there's money to be made by promoting what looks like health promotion but really is only a disguised marketing campaign. No, we're not going to be allowed to do this, so we will continue to see this.
There was a list of what we would have liked pharmacists to be able to doÃ¢Â"prescribing for minor ailments; schedule 1 prophylactics; prescribing products for chronic disease management. We made a little step in the right direction, but never the full scope of practice that would allow pharmacists, who know so much about drugs and dispensingÃ¢Â"but we put them in handcuffs so that we cannot get their full scope of practice, and the health care system or their patients cannot benefit from their knowledge and skills.
About midwives: There are about 480 midwives, and they deliver about 10% of the babies in Ontario. The care that midwives give is equal to none. Women love getting their care from midwives. But here again, we needed modification for midwives. Midwives should not be prescribing from a list. We need them to be prescribing from categories of drugs so that as drugs change but they are within the same categories, midwives would be allowed to use them. But no, we're stuck with a list that is forever outdated and that is forever in need of change. We made some little steps forward, but why can we not take a full step forward, a full step that will recognize that those professionals can really bring about a change to our health care system? They can bring about better health for their patients and allow us to benefit from all of their hard work and knowledge. But no, we'll have to stay on our appetite for this.
The same thing goes on with dietitians, who still won't be allowed to give diets in hospitals without a doctor's signature.
We made some movement forward with naturopaths in terms of prescribing, but here again they're not allowed to ask for a lab test. Well, lots of what a naturopath does needs to be monitored through blood tests, but here we go again: We'll have to send you back to your primary care physician or nurse practitioner so that the naturopathic doctor can do his or her work.
I want to talk about the appointment of supervisors. I don't know where this idea comes from, but it is such a bad idea that I can't say enough bad about it.
Ms. Sylvia Jones: It's offensive.
Mme France GÃÂ©linas: It is offensive, exactly.
The colleges are independent. They are there to protect the public, and we should let them do their work. For the government to assign itself the power to assign a supervisor to an independent body is completely ridiculous, and I still don't understand why we have this.
The Acting Speaker (Ms. Cheri DiNovo): Thank you.
Ms. Matthews has moved third reading of Bill 179, An Act to amend various Acts related to regulated health professions and certain other Acts.
Is it the pleasure of the House that the motion carry? Carried.
Be it resolved that the bill do now pass and be entitled as in the motion.
Third reading agreed to.
The Acting Speaker (Ms. Cheri DiNovo): Pursuant to the order of the House earlier this evening, I do now adjourn the House until 9 a.m. tomorrow.
The House adjourned at 1946.