Freedom Party of Ontario: April 4, 2000 "Fiscal Imbalance" Motion

DEBATE CONCERNING THE APRIL 12, 2000 MOTION
of Premier Mike Harris concerning federal funding for Ontario health care

ORDERS OF THE DAY

HEALTH CARE FUNDING

Hon Michael D. Harris (Premier): I move that the Legislative Assembly of the province of Ontario:

(a) Condemns the government of Canada for cutting, by $4.2 billion annually, base payments under the federal program that supports health care, the CHST, while provincial governments have increased health spending;

(b) Urges the government of Canada to repudiate the statement attributed to a spokesperson for the federal finance minister, the Honourable Paul Martin, that increasing health funding would be "just shovelling money into a hole that's going to open right back up again";

(c) Urges the government of Canada immediately to restore permanently the health funding that it has cut and to assume its fair share of increased ongoing funding to meet the health needs of our country's aging and growing population;

(d) Reminds the federal Minister of Health, the Honourable Allan Rock, that the sincerity of his commitment to medicare and the principles of the Canada Health Act would be best demonstrated not by idle rhetoric and vague words but by restoring the health funding he has cut.

I would like to split my time with the members from Kitchener-Waterloo, Waterloo-Wellington, Dufferin-Peel-Wellington-Grey and Willowdale.

This is the first motion we introduced for this session. I believe that we have provided some time to all opposition parties. Notice that (a) we said we would introduce the motion, and (b) we introduced it yesterday so we'd have some time for all members to consider it.

During the mid-90s, the federal Liberal government made a very historic decision. This was a decision that would have an enormous impact on the people of Canada, a decision that we are still struggling to deal with today. The Chrétien government began making the biggest cuts to health care funding in Canadian history. Whether they want to admit it or not, that decision hurt this country's health care system and it hurt this country's people.

Today, annual base funding for the CHST-this is the federal program that supports health care-is still $4.2 billion lower than when the Liberals began cutting. Tax points, as phony an argument as that is, have not changed in the last 25 years. They were there 25 years ago, they were there 20 years ago, they were there 15 years ago, they were there when the Chrétien government was elected, and they are there today in exactly the same form as they were 25 years ago. What has changed is the actual federal dollar contribution to health care. That has been $4.2 billion, real dollars, not indexed for inflation, not indexed for the cost increases in health care-4.2 billion real dollars less each and every year from the federal government.

As well, every third party, every independent, every government document from every ministry, including every budget document, indicates clearly that they have cut $4.2 billion, regardless of whatever rhetoric they may have in paid advertising or in speeches. This has left every province in Canada struggling to make up the difference, to close the funding gap created by the federal government's cuts. It has left every province struggling to increase funding even further to provide more and new services to patients. But, although the federal government's health care funding has decreased, our people's need for health care has not decreased. Ontario has maintained a quality system. I want to repeat that: We've maintained a quality system despite the federal cuts. Not only have we made up for the federal cuts costing Ontario $1.7 billion; we've increased annual funding by $3 billion more, on top of that, since we took office. Even though we've called on the federal government time and again, the recent federal budget provided no permanent health funding.

Our government has launched an advertising campaign to convince the federal government to give back over $4 billion that Ottawa cut from health care across the country. This $3-million advertising investment is to get $4.2 billion back into the hands of our provincial health ministers, where those dollars belong.

You know, as the Minister of Health has said, "We have no choice but to increase pressure on the federal government, since its cuts continue to put serious pressure on all the provinces."

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The calls to restore funding aren't just coming from the government of Ontario; they're coming from health providers, they're coming from all other Premiers and territorial leaders, they're coming from all other health ministers, they're coming from doctors, from nurses, from professionals all across the country.

Newfoundland Premier Brian Tobin was interviewed during the recent federal Liberal convention, a pretty well identified federal and provincial Liberal. Here's what he said: "We"-meaning the federal Liberal Party whose convention he was attending-"need to put our money where our mouth is."

Ontario's doctors, nurses and hospitals have published an open letter to the Prime Minister. They say: "Now, in an era of large budgetary surpluses and strong economic growth, it is time for the federal government to reinvest in our health care system and fully restore transfer payments to the provinces. Mr Prime Minister, we look to your government to reinvest in our cherished health care system. We ask that you work with the provinces to ensure health care services are maintained at the level Canadians expect and need."

When we launched our advertisements, the Ontario long-term care association issued a statement. They said, "The association and its members are supportive of the message contained in the public awareness campaign launched today by the provincial government to address the issue"-to address the issue of the underfunding, to put pressure to restore the $4.2 billion and to educate Ontarians and indeed Canadians as to what has happened to federal health care funding since the Chrétien government was elected.

We must, as a government, and I believe as individual members of the Ontario Legislature, condemn the federal government for failing to restore permanent health care funding, particularly now, at a time with such significant surpluses.

We must condemn the recent statement by a spokesperson for the federal finance minister, who implied that increasing health funding was a waste of money.

Despite earnest-sounding commitments to medicare and the principles of the Canada Health Act, Allan Rock will actually commit to one thing, and one thing only: talk, time frames for more meetings-not money, not real reform; time frames for more meetings.

I explained yesterday that while Allan Rock likes to talk about reforming the health care system, last week he wasn't ready to engage in meaningful dialogue about reform. I think he clearly lacked a mandate from his government, his party, his Prime Minister and his Minister of Finance to do so. The meeting's failure was directly attributable to the federal government's failure to do its homework, failure to come prepared to talk about reforms that the federal government had claimed to want to discuss.

Our Minister of Health went to those meetings prepared. She brought to Markham information and figures about Ontario's reform agenda, our health action plan. She was happy to explain to Allan Rock the reforms we are in the process right now of implementing, what they cost, what it would take and the cost to extend Ontario's reforms nationwide, home care, community care, pharmacare, expanded long-term care, primary care reform, hospital restructuring, and investments in new technology.

Allan Rock didn't come to the meeting with a commitment to provide stable long-term funding, and while that was a disappointment, it was not entirely a surprise. What was surprising is that he did not even have anything to say about our health reform agenda. Does the federal government support these reforms? Does it oppose them? Does the federal government think Ontario should be moving faster? Does it think we should be moving slower? Should we be doing things differently? Does the federal government take any position on the reforms now being implemented in each province all across this country? What new ideas does the federal government have? What new ideas does the federal health minister have? We don't know, because the federal minister won't, or he didn't, say.

Instead, Allan Rock talked about process. His call for more meetings was simply more foot-dragging from the federal government. They implied-they have done this through the media, the Prime Minister, the Minister of Health, the Minister of Finance. They've left the impression that there's more money for the system if the system is reformed. Well, Allan Rock may not have noticed, but we've already moved from plans and process to action. Reform is underway. The reform train has left the station and they are not on it. They are not trying to get on it. They don't seem to want to be on it.

We are already improving our health care system in Ontario, and the other provinces are too. Consider some of the so-called new ideas that Allan Rock has mentioned, ideas that for some reason he was unable to discuss in a meaningful way last week.

First, expanded access to family doctors on a seven-day/24-hour basis. Health experts call this primary care reform. We announced primary care reform in July 1996. We have pilot projects running now in seven communities. We're working with the Ontario Medical Association to expand public access to family physicians. Since we're already at work, we don't need rhetoric from Ottawa; what we need is federal funding. Ontario already spends $4.2 billion annually on physician services. So today I ask Allan Rock, aside from the federal contribution to start-up costs, what portion of physicians' compensation will the federal government cover?

Second, Allan Rock has talked about home care and community care. These services take pressure off the hospital system by allowing patients to be treated at home or close to home-a good idea, but not exactly new. Ontario's home care program is already the most generous in the country. As we continue to expand community- and home-based care, we don't need more talk from Ottawa, but federal funding would certainly help. Ontario spends nearly $1.5 billion annually on home care and community care. So today I ask Allan Rock, what portion of that will the federal government cover?

Third, pharmacare. Allan Rock has talked about helping patients pay for drugs. Well, guess what? Ontario already offers the most generous public drug plan in the country. Except for modest deductibles and fees, the provincial government pays the cost of prescription drugs for seniors, social assistance recipients and families burdened by catastrophic illness. We continue to increase our support for drug care. We don't need words from Ottawa, but federal financial support would be welcome. Ontario already spends $1.6 billion annually for drug care. So today I ask Allan Rock, what portion of that will the federal government cover? I ask Allan Rock, what kind of national pharmacare project do you support?

As I said yesterday, if there are to be future meetings, Allan Rock needs to do his homework and he needs to come prepared with ideas. He should tell us what new national reform programs he is prepared to support. He should come prepared to tell us which provincial reforms he doesn't support. He should tell us what else he thinks we should be doing. And when he comes, he must know how many long-term, stable, inflation-adjusted dollars will be available to the provinces to embark on these reforms.

Provinces are leery of new national programs without guaranteed funding. We're happy to talk about upping the standards to Ontario's level of pharmacare, long-term care and home care. We're happy to discuss how we can have a national program so Canadians from coast to coast in some of the have-not provinces can have these very real, cherished and tangible benefits that we have in Ontario.

But why are we leery of a new national program without guaranteed funding? Think of medicare: 50-50 to start, 50% federal and 50% provincial. The New Democratic Party plans to introduce a motion, I believe, called the Tommy Douglas bill: 50-50, Tommy Douglas said, 50% federal and 50% provincial. Today in Ontario it is 89% Ontario taxpayers, 11% federal taxpayers. That sums up the federal government's health care record: less funding. More talk, lots more talk, but no ideas and no financial support for reform.

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Allan Rock talks about innovation, but either he does not have any new ideas or he is not prepared to talk about them. Why? We're not sure. We don't know if he's waiting for this fall or next spring. We don't know if he wants to wait until after an election before he talks about them. But I'll tell you, that's the impression he leaves with Canadians when he says he has ideas. He says, "I've got money if we'll just have reforms," but he won't tell us what reforms and he doesn't acknowledge the reforms taking place all across Canada. He does not acknowledge the changes that are taking place. He does not acknowledge the contributions that provincial governments across this country have made to reform at the same time as we've had to do it with two hands tied behind our back because the federal government slashed funding.

Provincial governments have been innovating for years, despite the federal cuts to health care. Provincial governments are reforming to meet the needs of our growing and our aging population, despite these cuts. My colleague Premier Gary Doer of Manitoba recently summed up the situation quite nicely. Upon hearing that Allan Rock wants to talk about getting home care implemented before he offers more federal funding, Premier Doer pointed out Manitoba has offered home care for 25 years. He wondered why Allan Rock has been so slow to catch on. Premier Doer said, "The next thing you know, he'll be showing up in bell-bottom pants."

By the time he comes with money, maybe they'll be in fashion; I don't know. But here's a new idea, something we haven't heard of in quite some time, something Allan Rock hasn't considered yet: restored base federal health care funding, full restoration of the CHST, the federal program that supports health care.

I ask members for their full support for our resolution on federal health care funding. It contains four main points: First, it condemns the federal government for cutting $4.2 billion in base funding annually from the program that supports health care while the provinces, each and every one of them, have increased their health funding; second, it denounces the recent statement that compares health funding to "shovelling money into a hole that's going to open right back up again"; third, it urges the government of Canada to restore permanent health funding immediately and assume its share of rising costs; fourth, it reminds the federal Minister of Health that talking about preserving medicare and the five principles of the Canada Health Act is not enough.

As we said in our Blueprint, "Our government is fully committed to the principles of the Canada Health Act, including universal access to a publicly funded health care system." But the system needs more than words. It needs more than a phony promise that federal money will come once we agree on reforms, especially when the provinces and health professionals are already working hard at those very same reforms and improvements. It needs money.

This is a resolution that is in the best interests of the people of Ontario. It is a resolution whose time has come, and it is a resolution that I believe every member of this Legislature can and should support.

Today I know there will be other points of view in the debate. I know there'll be some criticisms of our government, perhaps other provincial governments. But I believe at the end of the day, when it comes time to vote, there can be unanimity to send a clear message from this House straight to Ottawa. That unanimity should send that message, that talk is cheap but reforms cost money. If you believe in reforms, if you support the reforms now underway, commit to the stable, long-term funding needed to support those reforms that will meet the needs of our aging and our growing population.

The Acting Speaker (Mr Tony Martin): Further debate?

Hon Elizabeth Witmer (Minister of Health and Long-Term Care): I rise in the House today to support the resolution put forward by my Premier, which calls on the government of Canada to immediately and permanently restore the health funding of $4.2 billion that it has cut since 1994-95.

Further to that, I echo the words of the Premier when he calls not only for restored funding but ongoing funding to meet the health needs of our country's aging and growing population, the cost of new technology, innovation, drugs and innovative medical treatments. As the Premier stated in his resolution, I too reminded federal Minister Rock that as the federal government has cut $4.2 billion annually in base payments under the federal program that supports health care, the CHST, all provincial governments have not only made up that $4.2-billion shortfall, but they have all increased their health spending.

Furthermore, it is important to remember that this was the most massive cut to health funding in Canadian history, this $4.2 billion.

Last week, when I met with my colleagues, provincial and territorial ministers in Markham, with Mr Rock, we reminded him of these funding cuts and the impact it was having on the respective constituencies we represented. We also took the time to share with him the innovation and reforms that we had initiated in our respective jurisdictions and that we had done so with the support of our stakeholders: our doctors, our nurses, our long-term-care stakeholders and our hospitals.

We have all moved forward in order that we can meet the health needs of Canadians not only today but into the future. That is why sustainable, long-term funding is absolutely necessary in order that we can continue to meet those future needs of all Canadians. Every one of us informed Mr Rock that it was the provincial and territorial governments who had taken the lead on reform and who had taken very decisive action-all of this at a time when we have seen absolutely no action from the federal government. We have seen no new ideas; we have seen only talk.

Last month, leading up to last week's meeting in Markham, we had observed a federal government that was trying to run to the start of a parade on health reform that had already begun a long time ago without them present. I reminded Mr Rock last year about the fact that the Ontario government has been working very hard with its stakeholders for the past five years on reforms and innovation to the health system as we implement our vision for health care.

Our vision is that we are committed to a health system that promotes wellness and improves health outcomes for Ontarians through accessible, integrated and quality services at every stage of life and as close to home as possible. Ontario reforms include investing in new technology, expanding home and community care, reducing waiting lists, hiring 12,000 more nurses, focusing on illness and injury prevention and health promotion and opening 20,000 new long-term-care beds.

I told Mr Rock that we've shown our commitment to health care by increasing annual health spending by $3 billion since 1995, from $17.6 billion to $20.6 billion, despite the federal funding cash cut of $1.7 billion since 1994-95. I am proud to say that our government, under the leadership of Premier Harris, has recognized the need for additional health funding. We will be increasing health funding by another 20%, to $22.7 billion over the next four years, to make sure that our health system continues to meet the needs of our growing and our aging population.

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I shared with Mr Rock one of the most telling statistics I have heard recently as to why we need more funding. In this province today, and I know that they have a similar situation in other provinces, 50% of our health care costs-in other words, 50% of our $20.6 billion-is going to support 12.6% of our population, those over the age of 65, and in the next 10 to 20 years that group will bulge as the baby boomers reach that age. And so it is absolutely imperative that we plan now to meet that increased need for services that we're going to be seeing in long-term care, home care and drug benefits.

As well as responding to the needs of a growing and aging population, we are also facing the challenge of increased public expectation. Today, people are better informed. They read and they learn about new technology, treatment and drugs through the Internet and the media, and they are demanding that those services be provided not only in Ontario but throughout Canada.

In response to the challenges that we face, we shared with Mr Rock about our restructuring, our strengthening and our modernization of our hospitals, with an eye to ensuring that services are available closer to home. In our own province we are expanding cancer services and we are constructing five new facilities in St Catharines, Sault Ste Marie, Kitchener-Waterloo, Mississauga and in Durham.

We're also expanding cardiac services to bring services closer to home, and again, we have new services in York county, in Mississauga and in Kitchener-Waterloo.

In the area of dialysis, where we're seeing an increased need for services as our population ages, we have approximately 25 additional dialysis services closer to home. One of the most recent services was introduced in Penetanguishene in order that people don't need to drive the long distances every day. Our government will continue to ensure that those vital patient services are made available closer to home.

We're expanding MRIs to 36 and we have plans for more.

We all indicated to Mr Rock that not one of the provincial or territorial governments had waited, nor could we afford to wait, for the federal government to take leadership in the area of reform.

Let me talk about the home care program where we in this province recognized early in our mandate the need to expand home care services, not only as an alternative to hospital care but in providing a continuum of care that includes prevention, primary care, hospitals, home care and long-term-care services.

We have established one-stop community care access centres, 43 to be exact, to offer health care and support services to Ontario residents in their homes. In 1999 alone, the CCACs helped more than 420,000 Ontario residents receive services such as nursing, homemaking and therapy. In addition, in this province we have committed $1.2 billion to create 20,000 new long-term-care beds to meet the needs of our aging population as well as reconstructing 13,200 beds again so that they will meet the new design standards in order that we can enhance the quality of life for our older citizens.

In one of the most generous programs in this country, Ontario today spends about $1.5 billion each year on home and community care. That is a 49% increase in funding for home care since 1995.

As I talked about home care, I had hoped that Mr Rock would recognize the initiatives that we had undertaken, the increase in services and funding, and that there would be some offer to share, and also an offer to work with us in further addressing these issues. But he did not.

I shared our plans and our implementation of primary care reform. In order to improve access to doctors, nurses and nurse practitioners, our government has established a 1-800 Telehealth service to residents in northern Ontario which provides after-hours health advice as well as enhancing health educational services. We will be expanding Telehealth to other parts of the province in order that we can provide 24-hour-a-day, seven-days-a-week access to health professionals.

In partnership with Minister Hudak and the Ministry of Northern Development and Mines, we are working to expand telemedicine services to the remote areas of this province in order that those people can have equal access to health care services.

In addition to improving access to primary care, our government has already established innovative programs to recruit and retain primary care physicians to small communities in rural and northern Ontario. We have provided $90 million in alternative payment plans for 85 small and rural hospitals to improve access to physicians and hospital emergency rooms.

We have also expanded the number of community health centres in Ontario, adding three last year, in order that we can bring services closer to home for more Ontario citizens.

I also told Mr Rock about the pilot program that we had undertaken in this province in the area of primary care reform. We have demonstrated that this is a priority. We have worked in partnership with the Ontario Medical Association since 1995, and I'm pleased to say that we presently have seven pilot projects underway. These innovative pilots will expand access to family doctors, nurses, nurse practitioners and other health professionals on a seven-day-a-week, 24-hour basis. Indeed, I am pleased to say that we have been encouraged with the acceptance of the primary care pilot project by the physicians and the patients who are participating.

We do certainly continue to recommend that there be choice for physicians, choice for patients, and that we not make this mandatory for physicians or we not eliminate choice of physicians for the patients. We believe that we need to encourage physicians, we need to encourage patients, and we need to ensure that it moves forward in a co-operative manner. We also need to ensure that we can properly evaluate the new system to ensure that it is providing quality health care.

I was hoping that Mr Rock would jump in and tell us about any other ideas that he might have for improving access to primary care. I was hoping that he would let us know how we could continue to move co-operatively forward to improve the primary care reforms that have been undertaken not only in Ontario but elsewhere.

I also, in the days of last week, shared with Mr Rock our plan in the area of pharmacare, as did my colleagues. I realize that we have one of the most generous provincial drug plans in all of Canada. We have taken a leadership role, despite the $1.7 billion in federal cuts in Ontario. Our drug plan today pays 44 million prescriptions every year for more than two million seniors and social assistance recipients.

We have another program called the Trillium drug program, which assists another 100,000 Ontarians who need expensive drugs to treat serious illnesses such as cancer, HIV, schizophrenia and cystic fibrosis. In fact, our government continues to make new drugs available on the formulary and we have added more than 1,000 new drugs since 1995. Today we are spending $1.6 billion annually on drug programs, an increase of $500 million since 1995.

Again, all of the provinces were waiting for ideas from Mr Rock as to how we could continue to move forward collaboratively on ensuring that our citizens had access to the new drugs that were coming on the market. But, again, there was no indication of any financial support or of any plan for pharmacare.

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I just want to indicate at this point in time that that is one of the fastest-growing areas of health care costs in this province and all across Canada. We are increasing spending from about 10% per year to about 15%, and in some of the other provinces the increase is even greater. So there is an absolute need for the federal government to get back into the health care game and support the provinces in providing for new drugs to treat illnesses in this province and across Canada.

I also mentioned to Mr Rock the initiatives we had taken to complement primary health care delivery in this province. It was our government that in 1998 proclaimed legislation to recognize the role of nurse practitioners. These nurse practitioners can write prescriptions and provide certain health services that used to be performed only by doctors. To date, I am proud to say we have provided $15 million in funding to support 226 nurse practitioner positions. These nurse practitioners are now working with doctors and other health professionals in communities across Ontario to ensure that Ontario's citizens have improved access to primary health services and services in the long-term-care centres. Again, there was no response by Mr Rock to increase the funding to support these nurse practitioners or any new ideas.

All of us, the provincial and territorial health ministers, spent most of our first day of the meeting educating Mr Rock on how we were assuming our health care responsibilities and being accountable to our constituents in the delivery of health care services in order that we could respond to their emerging needs. Each of us learned that we were not alone in the challenges we face on a daily basis. That the financial crunch is felt as strongly, if not more strongly, in other parts of the country came through loud and clear.

One of the ministers reminded Mr Rock that it is us, those of us on the front lines, who are the legitimate representatives in the area of health. That minister reminded the federal health minister that temporary transfers, as we received this year, are unacceptable because health care needs are not temporary. We need permanent, sustainable funding.

Another minister pointed out to Mr Rock that his province spent eight times more, proportionately, on health than does the federal government. In Ontario we've been spending nine times more to date. In fact, today the federal government provides a mere 11 cents of every health care dollar spent in Ontario while Ontario citizens provide 89 cents.

Another minister told Mr Rock that he was tired of hearing the tax point argument. He said: "Tax points are not cash. They should not be in the equation." He reminded the minister that a long time ago the provinces gave the federal government tax points, but he said, "No longer can you mask the truth of the fact that you've cut health care funding."

Indeed, if we take a look at the federal government's own campaign platform, they acknowledged and said, "It is a fact that during our first mandate this government reduced transfer payments to the provinces." Health Minister Rock confirmed the same point to the Canadian Medical Association in 1997 when he said: "I will not stand here and tell you that the cuts in transfer payments we made were insignificant. They were not. And I won't tell you that they have not had an impact. They have." So today, let's not try to mask the fact of the federal health cuts with the tax point argument, because even Mr Rock, and the federal red book in previous years, acknowledged the fact that cuts have been made in transfer payments and that they have had a detrimental impact on what we're able to do in health in our respective provinces and territories.

We collectively told Mr Rock that we needed long-term, sustainable funding in order to do long-term planning, but we heard no response on either funding or a plan for action. When Mr Rock spoke to the media at the end of the first day, he said he found the session very informative. A reporter asked him, "Didn't you already know those things?" and he responded that he guessed he did. I'm not so sure he did know the extent of the reforms we had undertaken in Canada and in Ontario. Based on the cuts to funding that the federal government has been making, one cannot be at all sure that it has a strong sense of what the provinces and territories are doing on the front lines to provide high-quality, accessible health care services to our citizens.

I also want to let you know that in some provinces health costs today are consuming 40% of the total provincial government budget, and they are rising. One of my colleagues, in response, said that they are going to be forced to reduce some of their children's services. Another one said that they're going to have to increase the contribution to drug costs to maybe somewhere in the neighbourhood of a $1,700 deductible. That's a long way from our $100. In fact, in the province of Saskatchewan they discussed the fact that perhaps there was some threat to medicare. Well, when we talk about medicare and we talk about the idea of 50-50 funding for health care services, I think you can see that we've moved a long way from the sharing of 50-50. In this province we're getting only 11 cents, and we are now supporting the health system with 89 cents and will continue to do so.

Coming out of the meeting last week, what is the next step? I believe it is important to try to get the federal government to move forward, to not abandon our health care system, that today is an example to the rest of the world. The federal government must again assume the responsibility for cost-sharing health care that they have abdicated since 1994 and 1995, and that they have acknowledged has had a significant impact. They must get back into health care; they must make a commitment to the people in Canada. We are prepared to work collectively with them as we move forward in order to ensure that happens.

At the conclusion of last week's meeting on Friday, my colleagues and I unanimously agreed that the federal government must do the following:

(1) As a minimum, immediately restore the Canadian health and social transfer to 1994-95 levels, with an annual escalator to ensure that funding for health through CHST keeps pace with the economic and social factors that impact on the sustainability of the system.

(2) We also question their commitment to the Canada Health Act, so we have asked them to reaffirm their fiscal support for the Canada Health Act.

(3) We also recognize and want them to know that the provinces and the territories are, and always have been, willing to consider any proposal at any time to ensure sustainability of the publicly funded Canadian health care system.

It is remarkable that governments of all political stripes-whether the NDP governments in Manitoba, Saskatchewan and BC, whether PC governments, whether the Liberal government of Newfoundland or the government of Mr Bouchard in Quebec-all unanimously agreed that there must be immediate restoration of the health cuts, that there must be a reaffirmation of the federal government's commitment to the Canada Health Act, and also a willingness on our part to continue to meet to address the health care needs of all Canadians.

Today I conclude my remarks by urging this House to unanimously support the resolution introduced by our Premier. It is only by uniting our voices that we can convince the federal government and the Prime Minister to reinvest in the publicly funded, universally accessible Canadian health care system, and it is only by uniting our voices that we will be able to encourage them to support the provinces in their reform and to work with us to ensure that accessible, quality health services continue to be provided to all Canadians not only today but also in the future.

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Mr David Tilson (Dufferin-Peel-Wellington-Grey): I too would like to participate in this debate of the resolution put forward by the Premier. I will say that this debate about the funding of health care has come upon us really as a part of the frustration as to what the federal government is doing. Originally the Canada Health Act was a 50-50 cost-sharing measure. It was changed, I believe, by Mr Trudeau in 1977, who turned it into a block funding type of arrangement. Gradually, from that point to the present, we are now seeing the federal government contribute 11 cents on the dollar as opposed to 50 cents on the dollar.

Of course, Mr Chrétien has put forward ads saying that's not true. You know, it is true. Stats have come forward to us from all sources indicating that that information simply is not correct.

I have a couple of quotes-

Mr Bart Maves (Niagara Falls): I'd love to hear them.

Mr Tilson: I'd like to give them to you.

This philosophy of the federal government making cutbacks with respect to health care isn't a new issue. The famous 1997 red book said, at page 71, "It is a fact that during our first mandate, this government reduced transfer payments to the provinces." So they are acknowledging it. This is the federal Liberal red book. They're acknowledging that transfer payments were reduced.

In the Toronto Star on October 27, 1996, Mr Chrétien said, and this is a remarkable statement, "We need to squeeze medicare in order to save it." I don't understand that. I'm not going to go into the information that was given by the Premier and the Minister of Health with respect to why the cost of health care is increasing, whether it be the increasing cost of drugs or the increased aging of our population. We're in deep trouble in this country, not just in Ontario but across the country.

As the previous speaker said, this isn't just Ontario; the provinces are united on this subject. The federal government keeps saying, "We have to restructure." Mr Rock and Mr Chrétien say, "We must restructure our health care before we give you any more money."

Interjection: That's what we've been doing.

Mr Tilson: That's correct. What have we been doing since we came to office? Members of the opposition have been quite critical of the government and the restructuring that has been going on in this province. On the other hand, Mr Rock says, "We're not going to give you any more money until you are restructured." Then, in a speech to the 130th annual meeting of the Canadian Medical Association in Victoria on August 20, 1997, three years ago, Mr Rock said: "I am part of the problem, not the solution. It was my government that diminished the size of transfer payments." He acknowledged that the federal Liberal government cut back transfer payments. He acknowledged that the country needs more funding.

The final quote I would like to give you was also by the federal Minister of Health on August 20, 1997. Allan Rock said: "I will not stand here and tell you that the cuts in transfer payments we made were insignificant. They were not. And I won't tell you that they have not had an impact. They have." Well, duh, of course. That is why we're in the mess we're in.

This resolution that has come forward to this House is made hopefully to urge the opposition parties to participate with the government members, as is going on in every Legislature across this great country, to urge the federal government to come to their senses.

The Ontario government has an action plan for health care reform. The Ontario government, since coming to power in 1995, has moved aggressively to reform all areas of the health care system, to eliminate inefficiencies and to bring services closer to home for Ontario citizens. We've been working with doctors, hospitals, nurses and many other health care professionals to find innovative ways to reform our health care system so that we'll meet the needs of Ontario residents in the new millennium.

The minister heard from her provincial and territorial colleagues that they too have been reforming their health care systems for a number of years. It seems the only person who is not aware that health care reform is already underway is the federal government. So, federal government, as one recent supporting actor said in the Oscars at a recent movie, "Show us the money." That's what we need.

Mr Ted Arnott (Waterloo-Wellington): I'm very pleased to have the opportunity to join my colleagues this afternoon in speaking in support of this resolution on behalf of my constituents in Waterloo-Wellington.

The resolution reads as follows: Be it resolved "That the Legislative Assembly of the province of Ontario,

" (a) Condemns the government of Canada for cutting, by $4.2 billion annually, base payments under the federal program that supports health care, the CHST, while provincial governments have increased health spending;

" (b) Urges the government of Canada to repudiate the statement attributed to a spokesperson for the federal finance minister, the Honourable Paul Martin, that increasing health funding would be `just shovelling money into a hole that's going to open right back up again';

" (c) Urges the government of Canada immediately to restore permanently the health funding that it has cut and to assume its fair share of increased ongoing funding to meet the health needs of our country's aging and growing population; and

" (d) Reminds the federal Minister of Health, the Honourable Allan Rock, that the sincerity of his commitment to medicare and the principles of the Canada Health Act would be best demonstrated not by idle rhetoric and vague words, but by restoring the health funding he has cut."

I see this as an opportunity for all members of this Legislature to send a strong signal to the federal government. I stress the need for all-party support, because the government of Canada and the people of Ontario must know that, firstly, the paltry 11 cents on the dollar the federal government contributes to Ontario's health care system is completely unacceptable, especially in the context of a projected $100-billion federal surplus over the next five years, and it's a far cry from the 50-50 proposition for medicare that started over 30 years ago; and secondly, that rising cost pressures, driven by factors including changing demographics, our aging population, new technologies and a growing population, combine to demand from the federal government an urgent, real and understanding commitment to the future of health care in the province of Ontario.

Colleagues in this Legislature who know me and have worked with me over the years should know that I believe that with the right approach you can actually bridge the differences which divide the political parties in this place and work together for the public good. We've done it in the past. When I first discussed federal funding for health care in the fall session and tabled my own private member's resolution last December on this issue, I did so because I felt that health care was one of those issues for which we should bridge that divide.

I'm delighted that this initiative has been recognized by the Premier and largely incorporated by the government resolution that's up for debate today. I would take this opportunity to thank my honourable friend the Minister of Health, who for some time has challenged the federal government to restore its commitment to health funding. As she said, "It's time for them to get back into the health care game." She has been steadfast in this endeavour and has, in recent months, emerged as the most significant health minister in Canada, providing leadership in the void which I call Allan Rock.

Turning now to our friends across the aisle, I want to thank the Leader of the Opposition for recently taking a stand relative to the federal government's shortcomings in the area of health funding. His resolution, which he tabled yesterday, quite rightly points out that the funding from the federal government is insufficient to modernize Ontario's health services so that we can provide the quality care that Ontarians need and deserve. He had an opportunity to put forward this position earlier, and, as he should know, I sent a letter to his health critic right after the Christmas break, asking for her support for my resolution. I mailed the letter and faxed it to her constituency and legislative offices on, I believe, January 5. I would have appreciated a response to this letter from the member for Thunder Bay-Atikokan, but I've heard nothing in response. I guess at that time, when I sent the letter, the Liberal position was uncertain. Perhaps the Leader of the Opposition did finally have his own meeting with the Prime Minister, as he said he would, and talk to the Prime Minister, as he said he would. And perhaps he was as unimpressed as our Minister of Health was in Markham last week when it appeared, after more than five years of cutting health care, that the government of Canada has no new ideas of its own for health care. That is part of the reason why I come back to this non-partisan effort that we should put forward today. If this resolution today receives unanimous support, then we in the Legislature will speak with one voice which the federal government must acknowledge and heed.

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The Leader of the Opposition supports our position, but he has tabled a resolution of his own, which is fine. He says he's doing this because he doesn't like advertising. Well, the more people who know the truth about the paltry 11 cents on the dollar that the federal government contributes in cash transfers, the better chance we have of achieving a stronger commitment from them. The stronger the federal commitment, the better off Ontarians will be. Health care is too urgent to wait until a federal election this fall.

The Leader of the Opposition also questions sincerity on the basis of the timing of these advertisements. Again, where was his support when I tabled this resolution in the fall session? Where was his party when I wrote the subsequent letter to the health critic asking for support in advance of the tabling of the federal budget, when Paul Martin was still consulting before the final decisions had been made on the federal budget? The Leader of the Opposition's challenge to sincerity is difficult to reconcile with his own actions. Not a year ago, his election platform, which he called 20/20, made absolutely no firm commitment for health care spending. When questioned later, before and during the election campaign, he promised to spend as much as we're spending, or even less, depending on which paper you look back on.

Our party, on the other hand, clearly spelled out a 20% health care increase over a five-year period. We always said that a stronger economy, supported by tax cuts, a balanced budget and a debt reduction strategy, means stronger health care for all of us for the long term.

We know where the federal government stands, or at least where they stood. Let's see.

First, immediately after their budget in February, hearing the outcry from all the provinces, they accused the provinces of letting money sit in the bank. Then they were reminded that they had imposed the conditions that required the money to remain in the bank over a three-year period, so they stopped talking about that excuse.

Second, they tried to muddy the waters with talk about tax points, going back to 1977. To this, I quote Prime Minister Lester Pearson's top adviser, Tom Kent, who said that the tax point argument is "misrepresentation." Mr Kent is also referred to as the father of medicare, and he went on to point out that a cash transfer, on the other hand, is money that the federal government provides to the provinces out of its taxes, not theirs. Clearly, tax points and cash transfers are two totally different things.

Now they're trying to dispute the numbers. Last week they said they paid 34% of the total health care bill; in today's paper they're now saying they pay 55%. I say that's hogwash. We know their problem: They want to assume control but evade responsibility for the issue.

Based on what I heard yesterday, the Leader of the Opposition says he wants to fight for something, not against someone, and he deserves credit for that stance. Then I would say to the opposition members opposite that they had better ask themselves, who understands Ontarians' health care needs and concerns best? Do the citizens of Ontario want to hear about phony tax points from 1977? I don't think so, and I'd suggest that we start listening to what Ontarians have been telling us. They are telling us that health care is their number one priority, now and in the future. They are telling us that we must take whatever measures are necessary to preserve and enhance health care. They supported a major restructuring of health care to improve access to services wherever and whenever health care is needed, something that was ignored by previous governments. And they expect their elected representatives of all political stripes to pull together when needed, to strengthen the integrity of fiscal federalism and demand in unison that the government of Canada take responsibility and provide the funding to meet health care demands in the future for all residents of Ontario.

I urge all members of this House to support this resolution this afternoon.

Mr David Young (Willowdale): I appreciate having this brief time, and I do emphasize that it will be brief. I think it's important, before we move on to the members opposite in this debate, to understand just what we are talking about when we talk about the amount of money that is being spent on advertising. First of all, the number at issue that the federal government has clawed back is $1.7 billion; that's the outstanding shortfall. The amount per Ontarian, the amount per person in this province that we are spending on advertising-an investment to try to get back that $1.7 billion-is 50 cents a person, for a family of four $2, about the price of a token to get on the subway in Toronto.

If we are successful-and by all indications we are achieving some degree of success to date. If we are successful, the amount we will get back for each family is-

The Acting Speaker (Mr Michael A. Brown): Thank you. Further debate?

Mrs Lyn McLeod (Thunder Bay-Atikokan): Mr Speaker, I will be sharing my time today with my colleagues from Windsor-Sandwich, Hamilton East and Windsor-St Clair.

I'd like to begin my participation in this debate by just taking a step back from the partisan, mudslinging kinds of attacks on federal government, and the federal government debating with the provincial government what the share of the spending is, and just start by talking a little bit about the kinds of concerns that I hear from people in this province about access to health care, because the concerns of people are very real.

If you go out to any of the 100-plus communities that have an undersupply of family doctors and talk to any of the 25% of Ontario citizens who don't have a family doctor, they'll tell you that they're worried about whether they're going to be able to get access to the health care supports they need 24 hours a day, seven days a week. That's almost a mirage for those people. They just want to know that they've got a family doctor, somebody they can call when they're concerned about illness and a family member. That's one of the concerns I hear.

I hear from people who are concerned that if there's a trauma, a serious illness or an accident, they're not going to be taken to the nearest emergency room, that the ambulance is going to have to bypass and go to another hospital at some greater distance because the emergency rooms are overcrowded and they're on critical care bypass. That is still the situation today, even though the flu epidemic is no longer a reality.

People are concerned about the situation that happened to the woman from Brampton just two weeks ago, going into premature labour with twins, a high-risk delivery anticipated, and there was no bed for that woman in any hospital in the greater Toronto area. The country's largest metropolitan area had no bed for a high-risk pregnancy, and a woman in labour-

Interjection.

Interjection: That's the way it should be.

Mrs McLeod: -had to be flown to Ottawa.

Four hundred and fifty kilometres away and the member opposite says, "That's the way it should be"? No bed in the greater metropolitan area for a woman who's going into premature labour? No wonder people are concerned about the state of health care in Ontario today.

People are concerned about long delays for surgery. People are concerned about surgery being cancelled because there's either no critical care bed, or there's no anesthetist or there's no specialized nurse to provide the care, because this, after all, is the government that thought we could lay off 10,000 nurses and is now surprised to find this difficulty hiring them back.

But one of the most tragic cases I heard about this fall was a man who called our office who was due to have a lung transplant. We know that this government, as part of their so-called reforms, has urged that there be more donors for transplants. This particular lung transplant never happened and the lung was lost because there was no critical care bed for that lung transplant to take place in Toronto.

People are concerned about not being able to get cancer care at home. This is an advertisement that I found, I believe in the Globe and Mail, this winter. It says: "Attention cancer patients. Why wait months for treatment you need now? Treatment may be available for you in the US." It says, "Contact cancercare4u.com" and "inquire about OHIP coverage." The Ontario government, because of the crisis they created in cancer care, is having to send cancer patients to the United States to get the care that people believe they should have here at home.

Those are just some of the concerns I hear from Ontarians who are genuinely concerned about the health care system in Ontario. They are concerned. They know the system, as they see it in Ontario in terms of their access to that system, is in trouble, and they do want their governments to respond. I think people want from government a very clear commitment to protect the medicare that the people of this province and of this country want to protect. They value it. They want to protect it. I think they want a willingness from both the provincial governments and the federal government to work together for health care, to stop fighting about health care and start fighting for health care, as our leader said yesterday in this Legislature.

I think they want more than words, as the Premier suggested today, but they want more than words from both levels of government. They do not want more finger-pointing, more blame-laying, more pass-the-buck kinds of cop-out for dealing with effective management of health care in the province of Ontario, and that's what this motion is all about. It is nothing more than that. It is nothing more than finger-pointing, infighting, partisan buck-passing abdication of responsibility for health care in Ontario.

This motion is absolutely nothing about making a real commitment to health care. It's like the advertising, yet again a $3-million taxpayer-paid advertising campaign to try and convince the Ontario public that black is somehow white or grey or something in the middle. False advertising, I would suggest, because the advertising, as I recall-both the television ads and the brochure that I got in my home the other day-talks about a plan. It seems to me that just last week the government's own duly appointed commissioner, the head of the Health Services Restructuring Commission, the very body that was to develop the plan that this government would implement, said quite openly, quite publicly, that this government had no plan, that it had no vision, and that it's very difficult to get where you're going if you don't know where you're going. So how can this government advertise its plan, let alone use $3 million of taxpayers' money to do that?

Our leader presented a motion yesterday in which he condemned both levels of government for spending taxpayers' money in a blatantly partisan attack on one another-an advertising war-when that money was needed for health care. Our leader's resolution agreed that there needed to be more money put into health care, more money from both levels of government. His motion read, "The current levels of health care funding provided by both the federal and provincial governments are insufficient to properly modernize Ontario's health care services and to provide the quality care that Ontarians need and deserve."

I don't like the health care cuts that the federal government made. I don't want to see health care cuts by any level of government. And no, I don't believe that there was enough money for health care in the last federal budget. I wanted to see more money for health care. I will put my money on money for health care before I will put money into tax cuts. I've said it to the Harris government time and time again, and I would say it in terms of the federal government's choices of how much money they're prepared to put into health care, whether we believe more money should go to health care.

I look at the most recent statistics we have in terms of international comparison, 1997, when Canada was 19th in an international comparison in terms of its real per capita spending on health care. The increases in health care spending that the federal government has made in the last two budgets will have changed that position somewhat, I suspect. I don't have most recent numbers, so I want to acknowledge that we may no longer be 19th. There has been an increase in funding since those numbers were presented. But I think that as 19th in an international comparison, we as a country have some room to move to provide more funding for health care, if medicare is indeed one of our most fundamental values and of highest priority to Canadians.

Then I look at that figure and I look at Ontario. Ontario, which in 1992 was the second-highest per capita spender on health care in the country, by 1998 had slipped to being the sixth-highest spender. Sixth place-only four provinces in this country spending less per capita than Ontario. Again, I will acknowledge that there has been some increase in health care spending in Ontario. There will also have been increases in other provinces, and I haven't seen the comparisons since 1998. But to slip from second to sixth under the watch of this Harris government says to me that the Harris government is not on a very strong platform to lecture any other level of government, provincial or federal, on its lack of commitment to really increasing health care spending on a per capita basis.

I hear the arguments, the debate that's going on, I see the advertising, I hear the discussion about provincial governments not wanting to acknowledge tax points, and the federal government says, "Indeed, we have raised the level of health care transfers to the province back to where they were at the peak point if you include the tax points," and I think there's truth in that, most definitely. I hear the provincial government saying: "Don't talk to us about tax points. That doesn't count; it's not cash." It was pointed out to me earlier today in a transcript of Hansard that it was Frank Miller, our previous Conservative Premier, who argued that there should be more transfers through tax points rather than cash, because indeed it gave more flexibility to the provinces to do with those dollars what they felt was most appropriate. I don't think that's a debate we really need to get into in this House, because I don't think that's the public's concern.

I think you could argue the numbers-11 cents from this government-although I noticed that the member opposite used seven cents. The numbers seem to change on a regular basis, but that's the proportion of the federal spending on health care in Ontario. The federal government says, "No, it's more like 33 cents," or perhaps something higher than that. Nobody knows. You make assumptions about how much of each province's transfers is actually going to health, as opposed to post-secondary education or welfare. We can have a long debate about what the balance should be of dollars going to each of those areas. I don't think that's what matters to people in Ontario when it comes to health care. All they know for sure is that they can't get the care they need when and where they need it. Surely that should be the focus of this debate.

What needs to happen so that the people of this province start to have a renewed confidence that when they need to access our health care system, they're going to be able to get that care? I believe, as my leader suggested in his motion yesterday, that there needs to be additional funding from both federal and provincial governments to provide adequate health care for Ontarians and for Canadians. I also feel very strongly that if there is to be additional funding from the federal government to the province of Ontario under Mike Harris's watch, it has to be absolutely clear, signed on the bottom line, what that money is, how much it is, where it is going to be spent and how it is going to be spent.

The flexibility that Frank Miller argued for and that other provincial premiers argued for some years ago might have worked if you believed that there was a real commitment to use all the available dollars for health care. But I don't trust the Mike Harris government when it comes to health care, and I think I've got lots of evidence as to why my lack of trust has some basis. I just look at the shell game that the Harris government has played for the last year alone-I'm not going to go back beyond just the last year-with health care numbers. This is a government that promised absolutely, in its campaign and in its budget papers the week before the campaign, that it was going to spend $1.6 billion on health care; $945 million was going to come from the federal government and another $700 million was going to come from the province itself.

When you actually looked at the budget documents, what you found out was that the government had played this kind of shell game where some $1 billion in what they called one-time funding had just kind of disappeared. We never did find out which shell it was under. So, in fact, the Harris government didn't increase its health care spending in its budget estimates by $1.6 billion; it increased it by $332 million. Nice work if you can get it: Claim you're spending $1.6 billion, take $945 million from the federal government as part of that and then use about $1 billion to help pay for the next instalment of the tax cut. Well, that was the budget plan.

Then there was another shell game. The third-quarter finances came out, and I think there was some anxiety about the examination that was being done of those original budget figures. So we had another little bit of a magic manoeuvre with the numbers and we found that, my goodness, they hadn't spent as much in 1998-99 as they thought, maybe about $300 million less than they intended to spend. Numbers, you know; if you just put them in your budget and you don't spend them, it's pretty easy to move them from year to year. So about $300 million less was spent in 1998-99, and another close to $300 million that was planned to be spent in this current budget year hasn't actually been spent yet. The dollars haven't actually gone out. It's just a shell game with numbers to make it look as though maybe the government was increasing its health care spending by more like $887 million-still short, well short of the $1.6 billion they said they would spend on health care this year, and even short of the $945 million that was transferred to them from the federal government.

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On top of that, I think we should, in fairness to the federal government, point out that this government, that is now launching motions and running advertising campaigns condemning the federal government for not providing enough money to Ontario for health care, chose-deliberately chose-not to take the money that was available from the federal government last year. They could have taken $1.5 billion. They chose instead to take $945 million. Why? Why was a government that is now launching advertising campaigns to demand more money from the federal government not prepared to take the money that was available to them last year? One reason: Because this Harris government didn't want to increase the spending on health care by that much. They wanted to keep the spending levels down.

I guess that makes me very nervous about asking for any money from the federal government and receiving it without there being an absolute guarantee that every cent of new money that I want to see and they want to see from the federal government will be in addition to the commitments that were made in the Harris campaign to increase health care spending by 20% over the next four years and to have $22.78 billion spent on health care by 2003-04, regardless of what funds the federal government transfers in that time. The Minister of Health was not prepared to make that commitment in her press conference last week. She was not prepared to guarantee that new federal funding would be in addition to the commitment they had made. But surely if the government believes, as their motion suggests, that this issue of health care needs more dollars, they should be prepared to make a commitment up front that any new federal funding from this point on will be in addition to the $22.78 billion that they've committed to spend by 2003-04.

We've heard from the government members today a long litany of the reforms which they claim to have been introducing in the province of Ontario and which they want the federal minister to understand and to support financially. I too want to call on the federal minister to support real reforms in Ontario. I want to call on the federal government to support real reform in Ontario. I want to call on the Harris government to start to understand what real reform in the province of Ontario in health care might actually mean.

I would like the Harris government to acknowledge, for example, that if you want to bring about real reform in the way we provide health care, if you want to do that through the notion that you restructure hospitals and provide care in an appropriate setting in the community, where it is less costly than providing care in the hospital, you have to start by investing in community care. You can't start by taking $800 million out of the hospital budgets, creating chaos in the hospital system and dumping the people who are being discharged out of hospitals earlier, sicker and quicker, on to a community care system that is barely up and running to provide support to the frail elderly. This is not reform; this is sheer chaos. That's what we've had in hospital restructuring in Ontario.

Talk to anybody who is involved with community care. Have we had real reform in community care in Ontario over the last four years? No, we have not. What we have had is an offloading from acute care hospitals whose budgets were stretched beyond their limits on to the community care, people being discharged out of hospital early, and virtually all of the dollars that have been given to the community care access centres to provide community support in the home are going to provide acute care for people who have been discharged out of hospital early.

Community care reform means providing support for those who are frail and elderly so they don't fall and break a hip and end up in hospital. You have to have those supports in place before you know how much of your acute care you're going to be able to move out to the community. You don't cut the acute care first, before the community supports are in place. You don't shut down hospital beds on the grounds that, "Many of the people who are currently in acute care hospitals should be in long-term-care settings or chronic care settings, so we'll shut down the acute care beds and move them into chronic beds or long-term-care beds." You don't do that if you're already shutting down 40% of your chronic care beds, and your long-term-care beds have waiting lists of 18,000 people. You say, "Don't worry, we're going to build 18,000 long-term-care beds," except you shut the acute care beds down first and there's no place for people to go. There are no beds out there. That's not how you reform a system. If you're going to reform a system, you invest in the community care, you invest in the long-term care, and then you begin to realize the savings in the acute care sector.

That's not how this government did it. The government put the cart before the horse. They were so determined to get $800 million out of hospitals so they didn't have to put any new money into health care, so they could use every dollar they could find for their tax cut, that they just made the cuts first and hoped the rest would sort out. That's not reform and it certainly isn't a plan.

The government has talked about primary care reform. It's our belief on this side of the House that when it comes to primary care reform, to actually providing access to 24-hour care seven days a week, this government is moving almost nowhere at a very slow pace.

I believe there are currently some 65 communities that have requested community health centres. If the government was serious about primary care reform, they wouldn't focus all their efforts solely on the Ontario Medical Association negotiation table. They wouldn't feel they have to have the approval of the OMA for every step that was taken. They could look at some other ways of moving forward. Why could they not look at some of those 65 proposals for community health centres? Why could they not look at how community health centre models might actually be integrated with other models of primary care reform? The whole issue is, how do you get care to people in a community? Surely the government doesn't have to go tiny step by tiny step when 65 communities, as I understand it, have asked to move forward in a very positive direction?

There are going to be some very real limitations to what can be achieved in primary care reform because we have a very serious shortage of family doctors, who are extremely important to primary care reform; another area where the government has virtually refused to acknowledge the reality of the shortage. Now that we have a report from Dr Robert McKendry that came in shortly before Christmas that says, "Yes, Minister of Health, yes, Premier, there is a shortage of family doctors and other specialists," the government is still reluctant to move ahead with any sense of urgency to deal with a problem that will really get in the way of access to 24-hour care seven days a week.

Those are just a handful of the areas in which I think there is an opportunity for real reform in health care, an important opportunity that should be seized by the Harris government as well as by the federal government. Yet the Harris government has not been prepared to move in a way which constitutes real reform or is the basis for truly positive change.

I was intrigued to hear the Premier of this province one day about two weeks ago describe himself in virtually one breath, one sentence, saying that he had been a defender of medicare from the day he was born-which is intriguing because medicare hadn't actually been developed as a concept at the time he was born, but he must have been quite prescient-but he would have no alternative but to privatize health care.

I believe the concern about funding in health care becomes the reason, the excuse I should say, for the Harris government to move ahead, which has truly been its real agenda from the day it took office. I believe the Harris government, from the day it took office, has been more concerned with creating a crisis in confidence in publicly funded health care than in building confidence in publicly funded health care.

I believe this government truly believes that the answer to the problems and the challenges facing medicare is to move increasingly to privatized, for-profit medicine and ultimately to private-pay. Ontario has the highest rate, along with Alberta-let me qualify that; I believe Alberta may be as high-of privately paid for health care in the country. By the ministry's own figures, 41% of the total spending on health care in this province is paid for privately. We have seen under the Harris regime more and more delisting, more and more costs of health care being paid for out of people's private pockets. No wonder they need tax cuts to help pay for the health care that's being increasingly privatized.

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It shouldn't have come as a surprise to any of us that one of the first acts of the Harris government was to change the Independent Health Facilities Act to take away a preference for not-for-profit Canadian companies. That preference had to be given in licensing any new independent health facilities under the old act. The Harris government changed it. They changed it also in such a way that there didn't have to be any public process for giving a licence for new independent health facilities. The Minister of Health can decide who gets to set up a new independent health facility, and can do it without anybody knowing what's happening and without any preference for not-for-profit Canadian care.

The Harris government was ahead of Ralph Klein in Alberta. Ralph Klein hasn't even dared to go as far as Mike Harris just quietly went with legislative change, creating a clear legal field, opening the door wide to what I believe they want to do, which is increasingly to privatize health care in this province and increasingly to have health care provided through for-profit American companies. I understand Ernie Eves says that user fees are the answer, that that's the way to go. We should have user fees; I understand that was a suggestion he made at a recent Tory convention.

I believe we have to stop fighting about health care and start fighting for health care. I want to take all the words about the commitment that people have, the fact that we need to have more resources, and see them translated into a real commitment to improving health care, access to health care and to bringing about real reform.

To bring about real reform we need investment upfront. If this government and the federal government are serious about change, about reform, about protecting medicare, there will need to be a commitment of funding from both levels of government. There will need to be a real plan, not something advertised that doesn't actually exist. Both levels of government will need to set aside the blame-laying, the federal-bashing and the buck-passing and find some way of working together to develop a positive way forward. That's what I believe we need.

But if this government is determined at this moment in time to debate and vote on what is clearly a partisan federal-bashing, blame-laying motion, I think the motion should at least be fair and balanced. With that in mind, I would like to move an amendment to the motion. I would like to move the following motion:

That Mr Harris's resolution be amended by deleting parts (a), (b) and (d) and substituting the following sections, which would then read:

" That the Legislative Assembly of Ontario

" (a) Condemns the Harris government for its finger pointing, blame-laying and complete failure to accept responsibility for the management of health care in the province of Ontario;

" (b) Further condemns the Harris government for launching an irresponsible advertising attack that uses taxpayer dollars for its own partisan purposes when those dollars are needed to improve health care for Ontario residents, and for falsely advertising that the Harris government has a plan for health care when the government's own commissioner has said that the government has no vision for health care;

" (d) Demands that the Harris government stops playing shell games with the health care budget figures, allocates all the currently available federal funding immediately to health care without reducing its commitment of provincial dollars and meets the commitment it made to actually increase the health care budget in 1999-2000 by $1.6 billion instead of increasing it by only $887 million."

And that it be further amended by adding the following sections:

" (e) Demands that the Harris government make a clear commitment that any new federal funding will be added to the commitment to increase health care spending to $22.78 billion by 2003-04;

" (f) Demands the Harris government reverse the cuts to hospital budgets so the chaos of overcrowded emergency rooms and cancelled surgeries can be addressed, build long-term-care beds rather than simply reannouncing them, and adequately fund community care so that the entire budgets of the community care agencies are not going to support people who are being discharged early from hospital because of the lack of hospital beds and so that there are funds to meet the needs of the frail elderly population;

" (g) Demands the Harris government make an immediate commitment to move forward with primary care reform to ensure that people can have access to care 24 hours a day, seven days a week;

" (h) Demands the Mike Harris government make a commitment to providing health care for people close to home, rather than creating the crises that are forcing cancer patients to go to the United States for care;

" (i) Demands the Mike Harris government acknowledge the growing crisis in access to cancer care in chemotherapy and cancer surgery and take immediate steps to avert this crisis;

" (j) Demands the Mike Harris government take meaningful and immediate action to address the shortage of physicians which has led to a crisis in access to care in 100 communities across this province;

" (k) Demands Mike Harris stop posturing as a defender of medicare when his government has been moving more and more to private health care and has been deliberately opening the door to for-profit American companies; and

" (l) Demands that both the federal government and the provincial government stop fighting about health care and start fighting for health care."

The Acting Speaker: Mrs McLeod has moved-dispense? Further debate?

Mr Tilson: On a point of order, Mr Speaker: I submit that the amendment is totally out of order. It substantially changes the content of the resolution. In fact, it rewrites the resolution with the Liberal Party's own resolution. If they want to put forward their own resolution, they should wait for a day when they can debate their resolution. But they can't simply rewrite the resolution totally. That is what they have done.

Mrs McLeod: Mr Speaker, I disagree. Section (c) of the resolution "urges the government of Canada immediately to restore permanently the health funding it has cut and to assume its fair share of increased ongoing funding to meet the health needs of our country's aging and growing population," which I had thought, from the debate today, was the crux of the government's motion.

The Acting Speaker: I would rule that the amendment is in order, and point out that according to Erskine May, "The object of an amendment may be either to modify a question in such a way as to increase its acceptability or to present to the House a different proposition as an alternative to the original question."

Further debate?

Mr Dwight Duncan (Windsor-St Clair): I am pleased to join this debate and I begin by reiterating that Ontario Liberals have said, and we believe, that we need to fight for health care instead of fighting over health care.

Let me add my voice to the voices of members of our caucus in saying that I regret that the federal government did not have more cash for health care in its recent budget. I regret that. I believe they should have put more money into health care. I say that publicly today in this Legislature, as I have said it previously.

I would like to add that the purpose of our amendment to the resolution is so that members of the government don't forget that their government is in fact responsible for the management of health care in this province. It is the position of the Ontario Liberal caucus that you ought to quit this fighting with the federal government and wasting taxpayers' money on useless advertising campaigns. I know a lot of people in my riding received this $3-million piece of propaganda, $3 million that could have been used in our emergency rooms in Windsor. It could have been used to prevent people in our country having to go to the United States to receive radiation therapy.

I think it's important that we on this side acknowledge the failure of the federal government to provide an adequate enough increase for health care to the provinces in its recent budget. But for the Harris gang to somehow abdicate or try to deny the damage they have single-handedly done to our health care system-let us examine the record, as has my colleague from Thunder Bay-Atikokan.

First, cuts were implemented to operating budgets for hospitals. Second, community care access centres-funds are not keeping pace with the growth in demand. Just this winter, one of my constituents, a frail, elderly blind man, had his homemaking service cut. What happened? He had to start preparing his own meals. And guess what? His apartment caught fire and he was almost killed. We can go through those examples, and we will, because with this resolution-we know how much the government want to talk about this. We'd like to talk about this so that each member of our caucus can get an hour of time to talk about the situations in their ridings.

We know you won't use closure to stop this debate. We know you won't try to use closure, because you wanted this debate, and we want to debate this for another month too. We want to have an hour each, and we're going to ask that each of our members have an hour to talk about these and many other examples in their own ridings.

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Your know, the absolute hypocrisy of this government, of the Tory government in this province, that has gutted our health care system and doesn't want to take-

The Acting Speaker: You might want to reconsider the word "hypocrisy."

Mr Duncan: Certainly, Mr Speaker.

The creative verve of this government in its attempt to try and diminish its role in diminishing our health care-

Interjections.

The Acting Speaker: You have to withdraw the word "hypocrisy."

Mr Duncan: I withdraw the word "hypocrisy."

Again, the absolute irony of the situation will not fall on deaf ears in this province. It was the Harris government that has mismanaged health care in the last five years. There's no question about that, first and foremost. It is Harris and his band of merry men and women who are forcing cancer patients to go to the US for treatment. It is Harris and his band of merry men and merry women who have so messed up our home care system that people in our province, whether they be frail elderly or recently released patients from hospitals, can't depend on quality home care for themselves and their families at this difficult time. We want to debate those points as well, and that is the purpose of our amendment today.

It is always so challenging to listen to the Premier in this House talk about his heartfelt concern, a heartfelt concern that appears to be missing. I remember very well in December 1992 the then leader of the third party telling the then Premier of Ontario to quit whining about federal transfer payments, that, "We have the money," that, "Ontario can be the master of its own destiny and its own fate." My, how times have changed. He had the fist then too, just like that: "Quit your whining. Ontario can do it all on its own." What an absolute joke.

You don't have to go far from this chamber to see the damage that's been done to our health care system by the Harris government. We intend to talk about that, hopefully for the next 35 or 40 days, on the floor of this Legislature, case by case, because you have systematically prevented the opposition from having its day. You have systematically denied us the opportunity to have a meaningful debate on health care. Instead, you replace it with this cheap partisan grandstanding that's serving no one's interests-certainly not the interests of health care users in the province of Ontario. We will hold your feet to the fire, because I know you will not have the guts to bring in closure now. You won't, because you wanted this debate. You put it on the floor and now we're going to hold you to it and we're going to talk about it for 35 days because the truth of the matter is you're both responsible, you and the federal guys.

You know what? We're going to set it right, but we're going to do it in the context of our debate tonight. I'll remind members opposite that according to the rules of this Legislature, you have to debate the amendment that's on the floor, not the resolution. We intend to keep talking about that amendment. We intend to keep talking about it tonight and tomorrow and the day after. We'll go for 40 days. We want to, just like we know you want to.

It's sad, really, that it has come to this. It's sad, really, that the government of Ontario would resort to cheap advertising, cheap partisanship at the expense of a meaningful debate as to how to fix our health care system. In those 30 or 40 days of debate we're going to talk about our 24-7 plan-24 hours a day, seven days a week of quality, accessible health care for everybody in Ontario-and we will lay out the details of what we stand for, instead of this cheap nonsense that reinforces the cynicism the public feels toward politicians going like this, blaming each other, instead of sitting down in a meaningful way, debating the issues and arriving at consensus positions.

Your minister undermined that health ministers' conference by her intransigence and by the intransigence of your government. We're going to hold you to account for it in the next 35 or 40 days on this issue. We're just delighted you gave us the opportunity to do that.

The Acting Speaker: Further debate?

Mrs Sandra Pupatello (Windsor West): I am delighted that this government chose to put health care on the floor of this Legislature so we can debate it, because time after time and week after week we asked the Premier to reconvene this Legislature so that we could come back in here and tell you what was happening at home, in every one of our home ridings, which have been dealing with issue after issue of hallway medicine, where I come from and where every member of this House comes from. Finally, this government chooses to bring a motion like this to the floor, and thankfully we have prepared amendments to speak to the real truth about the tragedy of health care in Ontario.

What we have in Ontario is a health act that governs hospitals. It's the hospital act for Ontario. That is an Ontario law, made for and controlled by the government of Ontario, as to how hospitals are to be run, the policies and regulations around those hospitals. That means what has happened to hospitals in Ontario for the last five years is at your feet, so you can't throw stones when you live in glass houses.

I wanted to ask the government, how dare they choose to speak out of both sides of their mouths, like they've been doing for the last several months, and try to shift the blame to some other level of government. At the same time, you select more partisan advertising-a waste, dollar for dollar, on government ads like these fancy coloured brochures that are arriving at every household in Ontario-instead of serving the needs of the people in Windsor, instead of the people who are in the St John's wing of Hotel-Dieu Grace Hospital right now, being serviced by only a few nurses who are being absolutely run off their feet because we don't have enough nurses in our hospitals.

I wanted to ask this Premier, who wants to bring this debate today to this floor, why, when we have a job fair for nurses at my university in Windsor, we have every American hospital there to pilfer our nurses away, and our Windsor hospitals aren't there to try to keep our nurses at home. Because the only nurses they're hiring are part-time, casual nurses, when our hospitals are desperate for more hands on our patients. That's what this debate should be about today. That's what the Ontario Liberal Party believes in: actually providing service to people in health care.

Tell me why all of us should be relaxing at home in front of the Frasier show on television, and suddenly what appears is another government ad on television, right in the middle of prime time. How can this government possibly afford that out of Ministry of Health dollars? Prime time, during the news segment, I've got to watch another government advertisement on health care so that you can bemoan your position, when you drive the ship in Ontario health care, that is, the hospital act of Ontario.

You talk about bringing in amendments to the Long-Term Care Act because you govern home care in Ontario. You are responsible for these community care access centres that are delivering home care to our patients because the hospitals, self-acknowledged, are throwing the patients out sooner and sicker than ever before. Now you've created this monster everywhere in Ontario to deliver home care into the home so that when these people leave the hospital they're supposed to have a nurse within a half hour of their arrival home. These families are up until midnight because the nurses aren't coming, because they don't have the nurses, because those private institutions won the bidding practice that you put in motion, and they didn't have the requirements and enough nurses on staff to cover the workload. That's what this government has been responsible for, and you've got the gall today to talk about health care.

We want to talk about health care. We will be talking about health care. You bring forward motion after motion and I will give you case after case of your laws that did not work and your funding that has let us down time after time. Next time I sit down in front of the Frasier show, I want to know how you wasted hundreds of thousands of dollars on an ad on television instead of the nurses in the St John's wing of Hotel-Dieu Grace Hospital. I want to know why we don't have enough maintenance staff in our hospitals, why I have to see dirt on the floor in my hospitals, and not just in Windsor. I'm talking about dirt on the floor in every hospital in Ontario. The place that's supposed to be the most clean has dirt on the floors across Ontario. That's your legacy to Ontario's health care, and you've got the nerve to want to call Paul Martin and talk about the budget federally?

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We want to talk about the hospital act of Ontario and what obligations you have as a government to your people right here. How much more about health care do you want to talk about? How many more examples do we have to bring you of people who cannot walk, cannot talk, cannot see? Your government chose to allow community care access centres to cut homemaking services. So this blind man my colleague just spoke of tries to boil his own soup on the stove and practically sets the house on fire. The firefighters appear because they know, they got a 911 call. The place is practically burning down because this man can't care for himself. That's your act.

That is a government that instituted a home care policy with no standards, no appropriate procedures, and you let the horse out of the barn without having that in place. This isn't just happening in Windsor. It is happening across the board in this province. Tell me why, when you own the hospital act of Ontario and are charged with the policy that regulates our hospitals, all of a sudden, since 1995 when Mike Harris took over as Premier of this province, we have 50% of our Ontario hospitals in debt. That is new, and that is new under your watch. It is you that funds our hospitals.

It is you that took $5 million out of an ORC sale that should have gone to our Ontario hospitals. Day after day we'll hear case after case of money that you let fly out the window through the Ontario Realty Corp while our minister sits there babbling on and on with some notes prepared by his staff-the legions of staff-telling us about how appropriate that process was, that we're flipping Ontario property: one day for $1 million, sold the next day for $5 million. And you want to talk to me about requiring health care dollars? You want to talk about flipping properties at a profit for the private resident at the expense of the Ontario taxpayer? You want to talk about advertising-full-colour brochures to every household in Ontario-about health care, and you've got the gall to be talking about federal dollars in the same breath? The federal government shouldn't give you money. You don't know what to do with it.

All we can say is that at the same time that we see a meteoric rise in salary of various positions-

Interjections.

The Acting Speaker: Order. One speaker at a time. The member for Windsor West.

Mrs Pupatello: Thank you kindly, Speaker. Clearly they don't want to hear the real story behind health care in Ontario. Clearly this government doesn't want the public of Ontario to know who is in charge of health care. Let me tell the people of Windsor West what they know full well.

The Ontario government has an act called the hospitals act, and they have another act called the Long-Term Care Act which they think they're going to amend now to make it better. They fund our hospitals. It's this government that does it, this government that made choices, bad choices-so bad, in fact, that in 1996 my private member's bill was supported, including by some members of the Conservative Party, and passed in this very House. That was to change the order of things in health care in Ontario and it was supported by these members of this House at that time. The tie was broken by the Speaker at that time. That's because you saw what was happening under your watch. I would ask this House today to continue the debate on health care because we have much more to say.

Mr Dominic Agostino (Hamilton East): I'm pleased to join the debate. I first of all congratulate our health critic, the member for Thunder Bay, and my colleagues for what they've added to the debate and to the very reasonable and very well thought-out amendment that has been added, unlike this partisan, one-sided political attack resolution brought forward by Premier Harris.

To add to what my colleagues have said, we certainly hope this debate goes on. As the whip for the official opposition, I have had a request from every single member in our caucus to speak for an hour. We certainly hope that the government will give us the 30 or 35 days we need to do this because this is an important debate. The government has to deal with it.

Interjections.

Mr Agostino: It is an important debate. I know that colleagues are laughing and heckling across the floor, because they don't believe health care is serious. They don't believe the health care debate in this province is serious. What they're more concerned about is pointing fingers.

The reality is this. I will admit, as my other colleagues have, that the federal government has not done enough. We know that. We understand that. But we also understand that health care is a responsibility of both the federal and provincial governments and the way we're going to resolve this problem is by working together, not by simply trying to point fingers, as you have and as Minister Witmer has. She basically hijacked and disrupted the health ministers' conference here in Ontario, where clearly, as some ministers were working for a solution, Elizabeth Witmer was just too busy out there being propped up and being the puppet of Mike Harris to go out and spin the Mike Harris line every single day of simply attacking Jean Chrétien. I'm glad the minister has joined us for this debate, because she could have added constructive dialogue.

I'll give credit to the Minister of Health in British Columbia. I'll give credit to Michael Farnworth, who I think was the only minister who came out of those meetings and said: "Look, we can't just simply point fingers at each other. This is too important. We've got to work together." Our minister didn't say that. Our Premier didn't say that. This resolution today simply adds to that. Instead of bringing forward a resolution that would encourage the federal government and the provinces to work together to find some solutions to health and to the problems we're having today, we have this one-sided resolution.

I find it ironic that Mike Harris, who, as my colleague pointed out earlier, chastised Premier Rae for pointing the finger at the federal government, has now become the biggest whiner in the history of this province. Whine, whine-that's all he ever does. Remember Mike Harris when the budget was brought down by Paul Martin and cuts were made. He said, "It's a step in the right direction, but it's not enough." That was Mike Harris a few years ago. It was not enough. The cuts were not enough. That was what your Premier said. Then during the election, you know what? He took all the federal money which he didn't use for health care and used it as part of his election platform and then said, "We're going to fix health care with or without the federal government." That was your Premier.

Now he gets the heat. He realizes the decisions made by this government in health care are destructive to Ontarians and to the health of Ontarians. So what does he do? He does what Mike Harris does best: He plays the blame game. For health care, it's the nurses, it's the federal government. For education, it's the school boards, it's the teachers-on and on. Every single problem Mike Harris faces, he's got to point the finger somewhere else because he doesn't have the guts and the courage to take the responsibility for decisions he has made.

We have seen the examples in our community. Hamilton has been devastated by the cuts to health care as a result of this government. Right now our community is in a crisis over the potential closure of emergency services at the Henderson hospital. My colleague the member for Hamilton Mountain, Marie Bountrogianni, has led the fight and is continuing to lead the fight to try to convince this government to ante up more money and to give us what we need in Hamilton. The Hamilton Health Sciences Corp has a $41-million debt. Do you know why? It's because they have chosen, despite the massive cuts by this government to health care in our community, to carry on programs.

One example: This government-and you talk about the wisdom of the policies you bring in-allocated 50 of what are really heart-saving devices, basically implantable defibrillators that can save lives, that have been proven very effective in saving heart attack victims from repeat heart attacks. This government says, "We're going to give you 50 a year." They ran out of these 50 life-saving devices by September. If we followed your government policy, every other person who walked in the door and needed one of those: "Sorry, we can't do it. We don't have the money. You can go off and take your chances and maybe die." What did they do? They went out and purchased as much as they needed to ensure that every single person who walked in through that door had one of these life-saving devices available to them. Those are the kinds of decisions that have led to the situation we're in today. Again, had it been left to you, people would have died because they would not have had access to that. That is one example.

I can tell you that tomorrow my colleague from Hamilton Mountain is bringing hundreds of people into this Legislature so that you can see the faces and talk to the people who have been impacted by your decision, who are going to lose an emergency department and are going to lose extensive services and possibly a cancer centre on Hamilton Mountain because of your decisions. You can't run away from that. As much as the minister, Ms Witmer, likes to blame everyone else, the reality is it's her responsibility. It's her decisions and your government's decisions that are forcing the problems at the Henderson hospital on the mountain.

We've seen the crisis in the emergency departments. We've seen the ambulances in Hamilton on redirect 20% to 25% of the time in the last year; 20% to 25% every single day, Hamilton hospitals are either on redirect or critical care bypass. That's the situation you have forced us into today.

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The federal government is wrong in spending money on ads attacking Mike Harris. Mike Harris is also wrong in spending $3 million on ads attacking the federal government. Just a single round of ads would have hired 60 nurses for one year; 60 additional nurses for one year would have been hired. Instead, Mike Harris thinks it's more important to spend that $3 million on pointing fingers rather than hiring nurses.

Most Ontarians, if you ask them, will tell you they'd rather have that $3 million being put into front-line health care services. That is the priority of Ontarians, not the priority of this government. You talk about priorities. You claim you don't have enough money for health care, but you have $5 billion a year that you can give for tax cuts to your richest friends. You talk about priorities: $3 million on ads rather than hiring nurses. You talk about priorities: $5 billion-billion with a b-dollars a year on tax cuts. Even if you put half of that money back into the health care system, you'd alleviate many of the problems we're facing today. So again it's a question of what's important to you and to this government.

I believe there is, as there was in education, a deliberate attempt by the Mike Harris government to put health care in such a state of crisis that people will start thinking and looking at options that, frankly, were unthinkable before.

You have taken a page out of the Ralph Klein book. There's no doubt in my mind, as you have privatized many parts of the health care system already, that you would love nothing more than to attempt what Mr Klein is attempting, and even worse, to bring in an American-style health care system here in Ontario. That's what you're trying to do, and you're doing it through the back door. You're doing it by creating enough chaos, making sure there are enough problems that people are going to say, "Hang on, we need some radical changes." I don't think that's an accident. I believe there's a deliberate strategy here. It is dangerous. It's playing with the lives of Ontarians. We have fought for years, on all sides of the House, previous to this government's idea of dealing with health care, for universal medicare across this country and across this province, and you are single-handedly attempting to destroy that principle. You want the American-style system because your friends can benefit.

We've seen the contracts that have gone out on home care. We've seen the contracts that have gone to many other areas you've privatized, to all your big donors. People who donate significantly to your party just happen, by coincidence, to also be receiving many of these contracts.

I don't want American health care in this province or in this country. I can tell you horror stories, because I've got friends who work in the American health care system, particularly a story told to me by a friend who works in a hospital in Miami. He is so disgusted that he's coming back here. He has been directed by doctors to bypass patients that are more seriously ill and look after patients that have bigger insurance policies, have more money and can pay more. That is the reality of the health care system when the private sector takes over. So often he's had to abandon someone who's seriously ill because their insurance policy only covers so much per day, and spend more time with someone who doesn't need as much help because their policy pays more. Is that what we want in this country? Is that the kind of health care system that we have built in this country over the years by all governments of all different political stripes? I think this is dangerous.

I think this debate is important. As I said earlier, I believe we should have 20, 30, 40 days of this debate, because Ontarians need to know what is happening with health care here. I think this one-sided attempt by the Premier is disgraceful. It's an insult to Ontarians, but more importantly, it's playing games, political games, with people's lives. This is what our health care system is all about.

I would urge this government to look at it and work collectively with the federal government, with the other provinces, with all three parties in this House, to look at how we can best use the resources we have to maintain our health care system, to maintain a universal health care system and to maintain an Ontarian and Canadian system, not one that our friends south of the border have, which I detest and which is clearly against every principle that we as Canadians believe in when it comes to health care.

There is a way that this can be fixed. Our federal government needs to play a role in this debate. Our federal government should put more money into this. But Mike Harris then also has to guarantee that every single cent that gets transferred for health care goes into health care.

Interjection.

Mr Agostino: He hasn't done that yet. He has not done that. There has been money received for health care in this province that has been diverted to other areas. Harris can't even make that commitment.

I ask colleagues in the House to support the amendments made by my colleague from Thunder Bay. I believe it makes a great deal of sense. I believe it talks about working together. I believe it talks about both the federal government and the Harris government having a responsibility and having to take some of the blame here. But, more important, stop pointing fingers at each other. Start working toward health care for Ontarians, not trying to look at who's to blame for the situation we're in.

Ms Frances Lankin (Beaches-East York): I am absolutely thrilled to have an opportunity to do the leadoff for our caucus and spend the time that is allotted to me speaking about health care and health care reform and the directions that I think are so important for the sustainability of medicare.

I've been listening with some amusement. I'm sure some people would agree with me when I say maybe I've been here too long. I have a hard time when I hear members of this Legislative Assembly stand and say, "I want to have this discussion on a non-partisan basis"-I heard a member of the government speak to that; I heard a member of the official opposition speak to that-and then they go to rant about each other's positions and platforms, they go on to attack where it politically suits them: the government to attack the federal government or the official opposition to defend the federal government. None of that has much to do with what has to happen in health care and the reforms that need to happen in health care.

I believe we should support the resolution that is on the floor put forward by the government-although I also will be moving an amendment to it-for a pretty simple reason. It is clear that the federal government-and I don't include only the current federal Liberal government; the previous Conservative Mulroney government actually began the process of decreasing transfers to the provinces, to the provinces of Alberta, British Columbia and Ontario. I believe that successive federal governments, by exiting the field of direct funding and share of funding of health care in this country, have abandoned the moral ground, as well as the fiscal clout they had, to enforce a national health care program. I believe medicare should be a national program with national standards, with national principles and national protection for those principles. When a federal government no longer transfers and shares in the funding, they have no ability to enforce the principles of the Canada Health Act.

I want to take people back to the time when then Prime Minister Mulroney began the process of decreasing transfers to the provinces. The then hysteria of the day was about deficits. The latest hysteria of the day has been about tax cuts. Now we're moving back into another hysteria of the day about the sustainability of medicare. These are old stories that keep coming around in the political cycle. Perhaps, as opposed to the finger-pointing across the floor that we've heard so far today, we could learn from some of the consensuses that have been built in the past, the truly non-partisan consensuses that were built in the past, in the days of provincial and federal accords around the direction of health care reform required to preserve medicare, and I believe with the genuine intent on the part of all governments of all political stripes in those days to actually preserve medicare. I no longer believe that that genuine intent is present in this country, and that's what worries me about the debate that we have entered into at this point in time.

Prime Minister Mulroney began the reduction in transfers by placing what was referred to fondly then, or not so fondly, as the cap on CAP, the Canada assistance plan.

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That was a cost-sharing program for social welfare. It was 50-50, much like the Premier talked about medicare when it was first introduced. But Prime Minister Mulroney determined at a certain point in time, in order to reduce federal expenditures to deal with the federal budget situation, that he was going to put a cap on the transfers to what he described as the three most prosperous provinces at the time: Ontario, Alberta and British Columbia. Over a period of years, the collective transfer payments for social welfare, health and education, in different pots but connected together, were beginning to be squeezed and squeezed. It meant that provinces no longer had the federal government as a partner with respect to those particularly important and very large budget items in provincial government budgets.

At the time, I remember the province of Ontario and the then Premier, Bob Rae, pointing out to this Legislative Assembly the road we were walking down, the problem that was inherent in that and the inability of the federal government to ensure that national standards would be maintained if we continued down that road.

I also remember at the time-just a little bit of irony, because I had this conversation earlier directly with Premier Harris, reminding him of it. I remember him sitting in the front row, right in this section, the third party, looking at Premier Rae when he was talking about the cut in federal transfers and saying, "Sounds like whining to me." At the time we were in the midst of the greatest recession since the Great Depression. For the first time in the history of the province government revenues were actually declining from year to year. The institutionalized costs of government to take care of people, things like welfare programs, as people were losing their jobs as a result of the adjustment happening in our economy from free trade and other sorts of policies, the monetary policies of this country-high interest rates, propping up the dollar at that time, a number of things affecting the economy. I remember the now Premier, then the Leader of the Opposition, saying, "You don't have a revenue problem; you have a spending problem."

I remember the budget of the Ministry of Health, because I was honoured to be the Minister of Health at that time, a budget we were essentially flatlining for two to three years because of the huge fiscal problems facing the government of Ontario. Now we have a government that is committing to a 20% increase, and no one knows into what pocket, or into whose pocket, the money will go, as opposed to funding a vision of reform of the system, of restructuring the system to make it sustainable.

I remember him saying: "You don't have a revenue problem; you have a spending problem. Don't complain about the federal government. It sounds like whining to me. It's all one taxpayer." I want to remind us of that. It is all one taxpayer. It is one taxpayer whether it is the Ontario government that is giving away tax cuts or the federal government that is giving away tax cuts, all of them giving away their capacity to invest in health care, which they both seem to be saying needs more money. Go figure. There is a difficult imbalance in this equation that we see being put forward in Ontario with respect to this issue of funding of health care.

I find it interesting that in the view of the Minister of Health and the Premier, the restructuring of the health care system in this province began in 1995, and nothing was done before that date along the road to restructuring the health care system. I find it self-serving. I find it without class. If they were doctors, they'd be taking a Hippocratic oath. If I changed a letter to say what I really think, I'd be out of order. But that's what I think, in terms of how the government talks about what has gone on in the health care system in this province.

I remember, as Minister of Health, spending time talking about changes that were happening and, where appropriate, talking about the role of former Health Minister Murray Elston or former Health Minister Elinor Caplan. I remember bringing about a discussion within this province with respect to shifting resources from our hospitals, from our illness treatment system, to our illness prevention system. I remember taking some of the hard steps, going to the Ontario Hospital Association meeting and saying boldly, to the shock of many people in that room, that 30% of what we do has no proven value, to get a debate going about the need to restructure hospitals.

I remember 30 communities that were in the process of hospital restructuring before this government took office, where they, through the process of imposing an outside body, simply took the responsibility away from the communities but ended up with much the same result in terms of the end product. Yet in many of those cases, they have not moved forward. I'm frankly tired of the rhetoric without substance and of the revisionist history that is being put forward.

I had the honour, as the current Minister of Health did last week, of attending federal-provincial ministers of health meetings. I remember the tremendous energy and excitement about the vision for reform in this country, which understood a number of key factors: that in order for medicare to be sustainable, the changes had to be made within the funds that were currently allocated to health spending in this country, understanding that there would be inflationary adjustments both for dollar inflation and for growth of population and aging of population and that we had to maintain appropriate increases in health spending to match that need, but understanding the huge pressure in the system that would occur as a result of a rapidly aging population and the need to spend the time to think through a wellness strategy that committed our resources to keeping people healthy instead of committing all our resources to waiting until they needed treatment.

That began with an understanding-again, one that was embraced across this country-of the determinants of health and an understanding that what we do in doctors' offices and in hospitals is only a small part of what builds a healthy population. If people are to be healthy, they need enough food to eat-they need appropriate nourishment; they need to live in conditions other than abject poverty; they need to have a roof over their head-suitable, decent housing; they need to have a job; they need to have a clean environment-there has to be clean water to drink, clean air to breathe, an absence of toxins, an absence of chemicals that induce cancers in their bodies.

The understanding of the need to invest in the determinants of health was an all so obvious but revolutionary moment in the debate about the preservation of public health care in this country. I have to say it is sad to see that we have lost our way in that debate. Without spending a great amount of time on it, I think even the government members would admit that cuts to welfare rates, an end to social housing programs and affordable housing programs, a cut to environmental regulations and the ability to enforce whatever regulations are left-all those things run contrary to the concept of investing in the determinants of health.

We've had impassioned pleas from people like Fraser Mustard about the need to invest in the early years. We've had some response from the government. But when such a large proportion of our children are living in poverty, where their parents are struggling, losing their housing in order to give the kids enough to eat, and not necessarily good, nutritious food, and they're living in conditions that expose them to environmental factors that affect their health at such a young age, what do you think we're going to be facing in terms of population health five, 10, 15, 20, 25 or 50 years from now?

We are building into our future a generation whose health will be affected by the public policy decisions being taken today, at this time. You can't de-link those things, and you can't de-link them from the debate about health care. Simply talking about the need for the federal government to be at the table isn't enough in terms of our responsibility with respect to the future if we really are interested in preserving quality public health care and building healthy populations.

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To the aspect of the federal government's role with respect to the Canada Health Act, to simply ask the federal government to reaffirm its principles in the Canada Health Act to my way of thinking is also not sufficient. Not only do they have to be players at the table with the dollars so that they can enforce national standards, but they need to understand that health care is changing under the very feet of the Canada Health Act. As we do less in hospitals and in doctors' offices and we do more in the community and in people's homes, those services in the community and in people's homes are not covered under the Canada Health Act. People think of them as part of the health care system, but what is insured by the principles of universality and portability and public administration are hospital services and doctors' services, not nurse practitioners, not chiropodists, not home care, not personal support, not nursing homes, not long-term-care beds.

As more of our services are provided in the community as a result of changes in technology and a change in pharmacological procedures, those services must be included under the Canada Health Act. The challenge to the federal government is not only to ante up their fair share at the table so that they have the moral and the fiscal clout to enforce a national medicare program; they must also make the changes necessary in the Canada Health Act to stop Alberta's Klein approach to privatizing health care, to stop the proliferation of privatization of services in long-term care and home care like we're seeing in Ontario.

That's why they need to be at the table. I'm sorry, but it's a game of chicken to say, "We won't put the money there until we have the guarantee back that it won't go on a tax cut," when they're spending their money on tax cuts as well. Let's stop the game of chicken. Let's have a real debate about our desire and Canadians' desire to preserve the public health care system and what it takes in terms of changes in public health care principles contained in the Canada Health Act.

My time is running out for today and I will have an opportunity to return to this when this item is next called for debate, but I do want to place on the floor an amendment that we will be speaking to. This is now listed as an amendment to the amendment by adding the following words:

" And that the government of Ontario adopts the following four principles: A ban on Ralph Klein-style private, for-profit hospitals; a freeze on the delisting of health services; an end to the proliferation of private, for-profit long-term care and home care and a tougher inspection system and stiffer penalties for independent health facilities."

I will have an opportunity to speak to that at more length, but I want to say that the amendment that has already been put forward on the floor by the official opposition is one that I'm quite sure while it is fun to-

The Acting Speaker: We'll just get the amendment on the record. Ms Lankin has moved an amendment to the amendment by adding:

" And that the government of Ontario adopts the following four principles-

Ms Lankin: Dispense.

Mr Duncan: No.

The Acting Speaker: "And that the government of Ontario adopts the following four principles: A ban on Ralph Klein-style private, for-profit hospitals; a freeze on the delisting of health services; an end to the proliferation of private, for-profit long-term care and home care and a tougher inspection system and stiffer penalties for independent health facilities."

Further debate.

Ms Lankin: Thank you, Mr Speaker. I will have an opportunity when we return to this debate to give further explanation of those principles. But the amendment that has been put forward by the official opposition I suspect-I'm guessing, prescient in the way I am-the government members will vote against.

The amendment I'm putting forward is not an amendment that lays blame in any direction. It is an amendment that says, as we bring the federal government to the table, there are some things in Ontario we need to do today in order to halt the dismantling of the public nature of medicare and ensure that the reforms that the minister has talked about and that I will talk about in the remainder of my speech, reforms where I think we will find a consensus in terms of the direction that medicare needs to go, have the opportunity to take place.

If more are delisted, if more home care services are privatized before they're brought in under the Canada Health Act, if we don't inspect and toughen up the Independent Health Facilities Act, if we don't return to a process where there is public accountability in that we are providing those services through not-for-profit providers-if we don't do those things, then we will end up, through the back door, having watched the dismantling of public health care just by virtue of the change in location where it takes place and the fact that out in those other sectors we are seeing a growing portion of that being provided by the private for-profit sector.

I will conclude my remarks today. I look forward to the opportunity to return to this. When the minister stands and has an opportunity to speak from her experience as Minister of Health, I hope that the time I spent as Minister of Health and my insights might also provide to this debate a focus to find unanimity about the direction, if in fact there is an agreed intent on preservation of public health care.

The Acting Speaker: Further debate?

Ms Lankin: No.

The Acting Speaker: No? You're adjourning the debate?

Ms Lankin: It's 6 o'clock.

The Acting Speaker: It being 6 of the clock, this House stands adjourned till 1:30 of the clock tomorrow afternoon.

The House adjourned at 1757.

==============================================================

Hansard, April 6, 2000

[...]

ORDERS OF THE DAY

HEALTH CARE FUNDING

Resuming the debate adjourned on April 4, 2000, on the amendment to the amendment to the motion by Mr Harris relating to health care funding.

Ms Frances Lankin (Beaches-East York): I'm pleased to have the opportunity to rise to continue debate. I had an opportunity in starting off, on behalf of our caucus, to outline some of the concerns I had with the tenor of the discussion that had been taking place thus far in the House.

I indicated our support for the Premier's resolution calling on the federal government to restore transfer payments to the provinces with respect to health care. I indicated that I thought the federal government needed to be there in order to regain both its moral authority and its fiscal clout to enforce the principles of the Canada Health Act.

I also indicated that I felt that doesn't go far enough, that it is time in this country that we bring to the table a debate about broadening the Canada Health Act. As we see the very nature of health care services in all the provinces change through reform and restructuring, as we see more services being delivered after patients are being discharged from hospital, more services being delivered outside doctors' offices, we see those services delivered in a manner and in locations that are not covered under the principles and guarantees of the Canada Health Act. It is time for us to challenge the federal government to truly bring about national standards and national principles that cover the entire gamut of what we view as our health services within the provincial jurisdictions.

I also indicated that I thought the gamesmanship of a provincial government saying, "We will perhaps delist more services unless we get this money," "We won't move forward in certain areas unless we get this money," or "We will continue to privatize our services and look for private investment unless we get this money from the federal government," contrasted with the federal government saying, "We won't give the money unless we get a guarantee that every cent of it is in addition to what has been budgeted for and projected in the future and that none of it goes to other resources within the government," is not serving the public of this province, and in fact of this country, well with respect to the reforms we need to see in order to preserve our public health care system.

I also indicated that a consensus had been arrived at in this country about the reforms that were needed to preserve medicare, that I believed the content of that consensus, which had been arrived at with governments of all political stripes in the early 1990s, stood in good stead today and still was an appropriate road map for us to follow. I want to spend some time talking about the elements of that and contrasting it with what I actually see happening in Ontario, and then hopefully set out a suggested road for the future.

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I also want to indicate that we have placed on the floor an amendment, in addition to our support for the Premier's resolution, calling on the federal government to take action in terms of fair funding of health care, an amendment that addresses the provincial government role, and asking for the adoption of four specific principles at this point in time, those principles being a ban on the Ralph Klein style of private, for-profit hospitals, a freeze on further delisting of health services under OHIP, an end to the proliferation of private, for-profit long-term care and home care services and a tougher inspection system and stiffer penalties for independent health facilities.

I will have an opportunity, over the course of the remainder of my address today, to speak specifically to the amendment to the resolution and to why we believe those are important measures to be taken today in order to preserve enough of our health care system to maintain medicare while we work on the federal level to ensure that the Canada Health Act is amended to bring various aspects of the health system under the protection for the principles contained therein.

The ministers of health from the provincial and federal governments who met in the early 1990s saw ever-escalating health care budgets at a time when we knew the population was continuing to grow and to age, and that we would be facing a tremendous expenditure down the road as we dealt with that growing and aging population. Those ministers of health struggled to find a way to contain growth and health care spending at the time to preserve the essential qualities of public health care.

There was a multilateral, multiparty agreement that Canadians cherished medicare and public health care and that Canadians did not want to see us go the way of Americanized two-tier health care. I believe the Canadian sentiment remains today. What I fear is that the consensus among political parties has been lost. I see evidence of that in actions that have been taken, for example, in the province of Alberta, with the proposal for the new private, for-profit hospital that would have overnight stays and deal with surgical procedures. It would be similar to hospitals that exist in jurisdictions like the United States and Australia. I see evidence of that in the province of Ontario, where provisions that had been put in place in the past to limit the growth of private, for-profit services in the delivery of home care services, homemaking services, nursing home long-term care facilities, have been repealed by the current government. In fact, we have moved to a competitive bidding system, which has ensured that the vast majority of the expansion of those services has in fact gone to the private, for-profit sector.

I see a willingness on the part of the government, as evidenced by action already and by rumours of intended action through the OMA negotiations, to further delist medically necessary services under OHIP, meaning that people will be paying for more services out of their own pockets. All of that combined is evidence of a backdoor privatization of the health care system. There may not be a bill in the Legislature to focus the debate, as there is in Alberta, but rest assured that day after day, more of our health care in this province is being delivered by the private, for-profit sector, I believe, directly contrary to the wishes of most Ontarians and in fact most Canadians who want to see medicare and public health care preserved.

I recently sent a letter out to constituents on a mailing list within my riding who had indicated an interest in issues of health care in the past. I talked about the re-emerging debate about public versus private, about whether medicare is sustainable. I talked about the consensus that had been arrived at in the past by politicians of all stripes on the advice of many people like health economists, medical reformers and others who put a great deal of time, thought and energy into putting forward constructive suggestions to ministers of health and those suggestions which had been adopted.

I was absolutely amazed at the level of response I got to the letter I sent out. MPPs will know that when you send out materials in your riding, there will always be some people who will take the time to contact you by phone or by letter or by e-mail to let you know what they think, and we always appreciate that feedback. It is usually a relatively small number of people who take the opportunity to communicate back to you. Most people will receive the information, review it and make up their own mind about what you had to say about what you provided to them.

Within a few hours of the first of those letters hitting mailboxes within the riding, the phones started to ring at my constituency office. People who had read the letter started to call and express their desire for us to continue the fight to preserve public health care. By that evening and over the next day, the e-mails started to come, and they continued over the period of a week. Over the course of the first week I had some 45 e-mails, and then in the second week another 30 to 40 e-mails came in. The letters started to come after that, and the phone calls continued. I have never had a response quite like that and, as I stand today, we are still receiving communications from the public. All but one of those responses wholeheartedly endorsed the public medicare system and called on politicians of all stripes to stop the finger pointing, to stop the wrangling, to get in there and make the changes necessary to ensure that that system is there for us to pass on to our children.

I think it's worthwhile to review in a very abbreviated fashion some of the elements of the road map to reform of sustainable medicare that have been identified and agreed upon in the past. We often talk about the need to understand our system of insured services under medicare, currently best described as an illness treatment system.

Tommy Douglas, the founder of medicare, who fashioned the way in Saskatchewan when he was Premier of Saskatchewan and then went on as a representative to the Parliament of Canada on behalf of the people of Saskatchewan to bring and forge a consensus in the national Parliament to make what was then an insurance system in the province of Saskatchewan a national medicare program, often talked about the universality of insurance for doctors' services and hospital services being just the first step. The second step was for us to move out into the community, to bring services to people in the community and to focus on health promotion, on well-being, on illness prevention, to have a system of community clinics accessible to people where a range of health services would be there and available under the provisions of medicare, of public health care. That vision still stands unfulfilled today. But he was right then and his vision is right today.

The consensus that has been built is that we need to transform our system from an illness treatment system to an illness prevention system. We need to focus as much of our resources on health promotion, on preventing people from going down the road of becoming ill, as we do on treating them when they do become ill. We need to understand the role of the determinants of health. It's not simply what we pay for in our doctors' offices and our hospitals that builds a healthy community, healthy public, healthy people. We need to understand that investment in adequate housing for people, investment to ensure our kids are getting proper nutrition, investment to ensure that families are not living in abject poverty, investment to ensure that we have tough environmental regulations and tough enforcement of those regulations so that we have clean water to drink and clean air to breathe, investments in an education system that give all kids the resources they need to have an equal chance at winning in this world-all of those things that we build the strong, healthy communities, the neighbourhoods, the networks on-are what make people healthy, and the absence of those things makes people sick.

I have to again comment on the fact that while the Minister of Health purports to support health care reform, purports to talk about having services available to people as close as possible to their home and to focus on health promotion, this is the government that immediately upon being elected slashed social assistance rates so that the poorest of our community are even poorer; slashed environmental regulations and environmental enforcement so that we have more toxins in our air, more pollutants in our water system; slashed, cut, abolished all affordable housing programs in this province so that there are more people living in shelters and more people living on the streets.

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In so many areas of the determinants of health this government has gone in the direct opposite direction of what the national consensus had been that governments needed to do to invest in healthy populations. The short-sightedness of it is that we will in fact spend those resources, we will spend those dollars, but we will spend them in the health care system and many other aspects of our social welfare and justice systems. We will spend those dollars treating the problems that we in fact could have prevented.

Along with this notion of shifting from illness treatment to illness prevention, there is a consensus that we needed to shift from institutionalized-based services to broader-range community services; that we needed to take the budgets, which were in the early 1990s in all provinces under tremendous strain as this country and most particularly this province suffered the greatest recession since the Great Depression, that we needed to take that envelope of funding and within that we needed to see a change from ever-escalating drug benefit programs, OHIP billings, through the medical profession and services in hospitals and hospital budgets. We needed to contain the growth in that area and needed to see massive expansion in community services through primary care reform, community health clinics and various other models where people access their first service in terms of health care, community and social support services, home care and long-term-care facilities.

We needed to understand that as we, with technology and pharmacology, could do things differently in our hospitals, treat more people on an ambulatory care basis, for example, the resources that had gone into supporting hospital beds at that point in time needed to be shifted within the hospital budget to support these other areas and other methods of treating people. We needed to understand that primary care reform meant challenging the long-standing practice of medical doctors as the gatekeepers to our health care system and of their method of payment from the provinces, that being the fee-for-service system.

As most people will know, when they go to see their doctor, the visit and whatever procedures and tests are ordered and whatever other treatment flows from that is billed back to the province under billing codes for the particular service that was provided. They receive a fee for each service they provide. I'm talking very particularly about family medicine; I'm not talking about issues of specialists and surgical specialists and other fields of medicine. In the area of family medicine, the irony in the fee-for-service system is that those doctors who provide the very best quality care for their patients, who spend the time to do health education, who work on health promotion, who bring in other health professionals-because what the patient may need is not to see a medical doctor, it may be the patient needs chiropody services or social services or a nurse practitioner's services, a range of other health care professionals. Family practitioners who do perform or do operate their services in that way get paid the least under the fee-for-service system, because it takes time, it takes energy and commitment, it takes sharing the pool of money with other health care professionals. They get paid the least.

I am by no means suggesting that there aren't many very good family doctors out there, but we all do know there are also some bad ones. Those who practise the worst of family medicine, often referred to as "revolving-door medicine," where patients come in and are seen for five minutes and there are four other patients in other waiting rooms and it's boom, boom, boom, and over the course of the day 80 patients have been seen, and they're sent for tests and called back to get their test results when it could have been a simple phone call, on and on and on, those who practise the absolute worst medicine, get paid the most in this system, because it's on a fee-for-service basis.

Surely everyone in this Legislature, irrespective of political stripe, can see not only the irony but the folly in that system, that there needs to be a rethinking. That rethinking has been taking place for a long time. For over 15 years in this province, we have had experiments with alternate forms of delivery of family medicine and family health care. We have seen community health centres-the minister stood and said proudly that they had added three new community centres since they've been in government. I remember that when I was Minister of Health, I alone approved over 20 new community health centres. While my successor, Ruth Grier, approved a number more and made announcements for five more just prior to the election of the Harris government, only three of those five that had been budgeted for-although the sites had not been chosen yet, the process for selection was underway-have now been announced, six years later.

Community health centres are a way of organizing delivery of health services in an alternative to fee-for-service. They are funded under a global budget. They are funded for programs that they offer. They could be health babies-healthy mothers programs, chiropody programs, social supports to seniors-a range. The thing that's really wonderful about community health centres is that they work hard to meet the population health needs of the community they serve, and they put forward their request for program funding based on the needs of the population they serve.

Community health centres have a range of health care professionals working there. When a person comes in, they are triaged to see the appropriate health professional. It doesn't start with a visit to the doctor and go on from there. That's one model of primary care that's already out there.

Another model is health service organizations. Health service organizations are much like what people talk about in terms of primary care reform, in that they are compensated on a basis called capitation, where patients enrol and enlist and become members of a particular clinic, and then government transfers money on a capitated basis, per capita, per person who has enrolled. The thought there was that while it was slightly different from the way of funding community health centres, the goal would be the same: that the work within that clinic wouldn't depend on just treatments and billings for services, but that the money, being there, could be used to work on health promotion and preventing people from becoming ill. In fact, there was also a provision called the ambulatory care incentive program, ACIP, that was attached to health service organizations. This was a bonus if that practice was able to keep a percentage-the bonus would depend on however large the percentage what be-of their patient clientele out of hospitals, out of using emergency and other hospital services, if they were able to keep their patients healthy.

It was a very good idea. I have to say, though, as with all of these things, they need to be reviewed and fine-tuned. What I found when I was Minister of Health was that a problem arose under the HSO system. It wasn't mandated that it had to be a group practice, and so a number of HSOs were established that were sole-practitioner practices-individual doctors, not a group of doctors, and not with other health professionals. In fact, there was no limitation on where the HSO could be established, and we began to see a trend of a number of solo practices being established in very well-to-do, high socioeconomic communities. One of the factors we do know is that income, economic well-being of families, related very closely to their health well-being. Members of families that live in poverty have a lot more health problems, and families that have higher socioeconomic status tend to use the health services less.

So what happened, in a very bizarre way, under what was really a good intent, was that these sole-practitioner practices in very high socioeconomic neighbourhoods who spent none of the money on doing outreach programs, health education programs, health promotion programs, who just operated like any other doctor's office, were receiving huge bonuses because the general health status of the population they serve and not related necessarily to any actions of that clinic. The general health status tended to be high.

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We put a freeze on expansion of HSOs at that time because we were worried that it wasn't quite getting it right and that we needed to fix that problem. At the same time we established the primary care reform working group. This is where I get so annoyed when I listen to the Minister of Health that no work had ever been done before on this. They point across: "You had five years in government. Why didn't you do it?" Well, let me tell you, during a period of time of tremendous fiscal restraint, we flatlined hospital funding, brought down doctors' fees through OHIP, and the Ontario drug plan increased only minimally. There were huge expansions in delivery of community services and a large number of new community health centres added. While the freeze went on HSOs, we continued to work on another model, CHOs, comprehensive health organizations-and there are a few of them in the north and worthy of evaluation-and continued to support organizations like the Sault Ste Marie Group Health Centre, which is renowned in terms of a model for group practice and multidisciplinary practice in serving the population needs of the community, and pre-existed any government's attempt to look at primary care reform.

We set up the primary care working group and brought all of the players to the table; not just the Ontario Medical Association, but the doctors, the nurses' organizations, the community health centres, the HSOs, and the other alternative payment plans that had been put in place in other parts of the province. We truly wanted to build that consensus, and at the same time we knew that we were going to have to drive that through the process of negotiations with the doctors as well as with other health professionals.

At the negotiating table, for a number of reasons, in order to free up money in an ever-growing OHIP pool to redirect into community services and primary care reform and long-term care and home care, which I'll talk about in a minute, we moved to put a cap on the overall billing. We knew with that cap there, we also would have the ability in negotiations with the doctors to talk about serious reform of the system.

Again I have to say that when Mike Harris first sent his health minister to the table to negotiate, they got wrestled to the ceiling, as the saying goes, when we talk about negotiations with the doctors. They did away with the cap and they also agreed that any money that would go into paying for alternative payment practices like primary care reform would come from outside that OHIP pool of money. Talk about giving away the store; not just giving away the store, but talk about making it nearly impossible for a government to proceed in a meaningful way on primary care reform.

That's what we see in this round of negotiations-much talk, much ballyhoo about primary care reform and the government's commitment to it-the bottom line being that both the Premier and the Minister of Health have said on a number of occasions: "It will be voluntary. We're doing what we've always done. We have five, now seven. Congratulate us. We've moved it to seven pilot projects." There are already some 50-odd community health centre pilot projects, three comprehensive health organization pilot projects, the Group Health Centre in Sault Ste Marie, umpteen numbers of HSOs, and they have seven to point to? This is the new revolutionary world of primary care reform? The minister in her statement to the House said that she told Mr Rock about their plan to expand primary care reform. She didn't say that they're planning to do it at a snail's pace, which appears to be the case.

In the consensus that had been arrived at, we also understood the need to use a multidisciplinary team of health professionals. The minister stood and said they were the first government to bring in nurse practitioners. Wrong again. Nurse practitioners have existed in this province in the past. In fact, at a certain point in time the health nurse practitioner training program disappeared in this province, so we weren't producing any more nurse practitioners. It was back in 1993 that the Rae government took the decision to budget for the next year to reinstate nurse practitioner training programs. So the nurse practitioners who are now, six years after Harris took government, beginning to be funded for their services through various community clinics and other locations are only there because of the training programs that were reinstated. This government committed at the beginning of its term to establish nurse practitioners. It took six years before the first funding actually went out to any organization to hire those nurse practitioners, six years from announcement to realization.

Again, referring to the consensus, we also understood the challenge of a rapidly aging population as the baby boomers start to hit their forties and begin to have more health problems. I hadn't been in a hospital all of my life-I think once when I was a baby with a problem and then never again-and you know what? In the last year and a half I've had about five minor and major operations. I don't know; you hit 45 and it's all downhill from there on, I guess.

Interjections.

Ms Lankin: Some of you who are younger are fearing that, I can tell. It's coming. You just wait.

But the fact of the matter is, and the minister referred to this herself, that about 40% to 50% of our budget in health is currently expended on about 12% of the population, those who are the most elderly. It does make sense, doesn't it, that as we age-as we get much older than me-our health does tend to fail and there are more interventions and more experiences with the health care system. Of course, there are many statistics about how much of the health care system is spent in the last six weeks of people's lives, but again that makes sense, because if at the end of it a person has in fact died and it happens to be through an illness or through a trauma or accident, there would be an extensive use of resources at that point in time. So that's not a surprising statistic.

But surely we should understand that with that baby boomer generation as it comes along and it reaches into the senior years, there will be tremendous demands on the system. I just can't understand why, from what I see happening, this government doesn't seem to acknowledge this. We know that if we put the right supports in the community for seniors in their homes, the vast majority of seniors can be helped to live at home with health and dignity and not have to take that step of institutionalization. But without those supports they can't remain independent and in their homes, and they end up needing to go into nursing homes, where it is much more difficult to provide the quality of life that we would want the senior members of our society to enjoy, and it is much more expensive to provide the accommodations and the services there. Why don't we wake up and get this right, what we need in place in our communities: the community supports, the social supports, the crisis intervention, the long-term-care supports for people?

We hear in the minister's statement that she told Minister Rock that they have a plan where they're expanding home care for Ontario citizens and that they've increased funding to this support program by 43%. I went back and took a look, and during the Rae government, again at a time when we were in the biggest recession since the Great Depression and with the fiscal challenges facing the government, something this government never had to contemplate at all, we increased spending in long-term care by an equal amount over a five-year period. We're talking six years for this government. Not only have the resources that have gone out there been organized in a different way, being delivered more and more by private, for-profit services, but because of the restructuring of hospitals and the way it has been done, because of the cuts to hospital budgets which have forced hospitals to discharge patients sicker and quicker, and because of the regulations and the directions that the government put in place with respect to home care, that those sub-acute patients being discharged from hospitals get priority for the services, they've now gone on to put a maximum cap on the number of hours of home support services that people can get. So the seniors population, where we were trying to have massive expansion of home support and community support services to the seniors, is now getting less than they ever got before and more and more of them are unable to be maintained and supported in their own homes.

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Because there are no long-term-care bed facilities to go to-and that's another story in terms of how this government has delayed on that-they're ending up in unregulated retirement homes, and we hear horror stories all the time in terms of the inappropriate treatment of these citizens. These are citizens who have spent their lives contributing to build our communities, contributing tax dollars to these and predecessor governments, and we are failing them sorely.

But just think down the road, with the massive growth in the number of seniors that we know is coming. You know it's there. The demographics are clear. Just think what the problem is going to be. We would not need the new nursing home beds and long-term-care beds that this government is still announcing will be coming if they would put in place the appropriate home support services. I don't understand other than the short-sightedness of it. Think of the short-sightedness, because the other thing this minister said is that she supported reform of the system and she told Minister Rock all of what they've done in terms of hospital restructuring.

I remind you again, the consensus had been that we needed to expand community services, we needed to relocate services from hospitals to the community, and then we could restructure our hospitals and maintain budgets at a level to serve population needs in terms of what had to be done in the institutional sector.

What did this government do? They came to power, and they cut between $600 million and $800 million out of our hospital budgets before they restructured. They went in and created a restructuring commission and took away the work that was being done by local communities in arriving at local solutions to this. They forced the restructuring of the hospitals then after the money had been taken out and before they had invested in the communities.

They gave the restructuring commission a mandate to make orders with respect to hospital restructuring but did not give them a mandate to make orders with respect to community investments. So we see hospital budgets cut, hospitals restructured, lack of community investment, overcrowded emergency rooms, not enough beds for people, and now money being thrown back at the hospital sector because of crises of deficits, legitimate crises of deficits, but crises that this government started in the first place.

We see the OHIP pool of budget growing dramatically because of what they've done in negotiations with the doctors, and we see the lack of expansion of investment that is needed in the community sector and what is there being taken up by subacute patients being discharged earlier from hospital. Boy, did we get that wrong in this province. No wonder you've been able to re-engender the debate about "Is medicare sustainable?" We know what the road to sustaining medicare is. We have to question whether or not you in fact intend to do that.

The privatization of home care and long-term-care services came about as a direct result of your government. The minister says that it's the same as it was under the NDP or under the Liberals. I can tell you as a former Minister of Health, in the Long-Term Care Act that we brought forward, which was finally passed in 1994, there was a limit on the proportion of any community's budget that could be spent on for-profit services. We recognized that some were already out there, and we weren't taking a step to drive them out of business, but we said that only 20% could be spent on for-profit services; 80% had to go to the not-for-profit sector.

This government eliminated that position, so do not tell me that it is the same as it was under previous governments. What we see now is that virtually 70% to 85% of all contracts being awarded-depending on whether you're talking the long-term-care nursing home beds sector or the home support sector-are going to the private for-profit sector, some of them to the most odious American companies with some of the worst records in terms of delivery of quality of care.

Our amendment, which absolutely puts a ban on bringing the private hospital system of the US and Australia here, the Ralph Klein system, is a first step to say we really mean it when we say we want to preserve public medicare. Our amendment to put a freeze on the delisting of health care puts an end to the rumour that if you don't get the money from the federal government, you're going to delist more services. How could you even begin to justify that at a time when the economy is growing and government revenues are growing, and you're not facing a revenue crisis of any sort? I suspect because it's on the table, the negotiations with the OMA. We want a freeze on delisting of health services, an end to the proliferation of private for-profit long-term care and home care. Bring back the 80-20 rule. Bring back a cap that stops any further expansion in the growth of those services by the for-profit sector.

We want to take the independent help facilities that we do have, where we have seen a growing number of complaints and inspectors noting problems with quality of care, and have tougher inspections and stiffer penalties.These provisions are contained within an act that will be brought before this House by my leader, the Tommy Douglas Act to preserve Medicare. We invoke his name because he is the father of medicare, the founder of medicare. His daughter, Shirley Douglas, is now criss-crossing this country in defence of preserving medicare.

I hear this government talk that they want to preserve medicare. I don't see the actions that match it.

We will support the resolution. We hope you will support our amendments. We hope you will give some truth to the words of the Premier and the minister that they believe in public quality health care.

Ms Marilyn Mushinski (Scarborough Centre): I will be splitting my time with the member for York North this afternoon.

It's my pleasure today to rise in the House to speak in favour of the resolution introduced by the Premier in the House on Monday.

I don't believe that you will find one member in this Legislature who does not understand the importance of a strong health care system in Ontario. We all believe that our constituents expect and deserve nothing but the finest health care system in the world. When 18,000 Scarborough Centre residents cast their ballots for me in June 1999, they didn't just do so as a rebuke of Sid Ryan and organized labour; they cast their ballots for me with the expectation that I would fight on their behalf on issues of critical importance, such as quality health care. My constituents expect me to work with my caucus colleagues, with local hospitals and caregivers and representatives from all levels of government to ensure that we have a reliable health care system.

Like the rest of the members in this House, I take this responsibility very seriously. That is why I strongly support the Premier's courageous stance on the federal government's refusal to properly fund public health care.

We are all aware of the numbers: Over $4.7 billion slashed from health care transfers to the provinces; $1.7 billion annually stripped from Ontario's health care system alone by Allan Rock, Jean Chrétien and the federal Liberals; a traditional 50-50 funding arrangement unilaterally altered by a federal Liberal government that lacks vision and the political guts to make tough decisions; a provincial Liberal opposition party with even less willpower and a leader whose vision changes more often than most of us change our socks. If the story of his political career were turned into a television series, it might well be entitled As the Poll Turns.

Recent history has seen the erosion of the federal government's contribution to health care funding and their commitment to the health and well-being of all Canadians. From the traditional 50-50 cost sharing arrangement, we have watched the federal government continually reduce their share of the cost, to the point where Mike Harris's Ontario government is now footing the bill for a full 89% of the cost of health care in this province. That leaves the federal Liberals to pay for a paltry 11% of the services that Ontario's aging population relies upon.

We in the Mike Harris government could have easily sat by and watched Allan Rock and Jean Chrétien walk away from their obligations to Canadians. That's exactly what the Ontario caucus of 101 Liberal sheep have done. After all, if the polls didn't show the importance of health care, that's exactly what Dalton McGuinty would well be doing today.

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We know that health care is too important to play that game. We have a duty to the people of Ontario. That is why we have made up for the failures of the federal Liberals. We have made up the $1.7 billion that they cut annually from health care in Ontario. We've even gone one step further by increasing Ontario's health care budget by an additional $3 billion a year. I have a sneaking suspicion also, Mr Speaker-some may call it a woman's intuition-that the Honourable Minister of Finance, Ernie Eves, will see fit to increase the health care budget even more in the very near future. This is permanent funding, not a one-time payment that vanishes in non-election years like other governments have done, of course.

Look at our efforts in home care. We spend $1.5 billion annually on home care and community care. Since 1994-95, funding for community services has increased by 49% and in-home services funding has increased by 56%. We are investing $550 million to expand and enhance community services such as in-home nursing, therapy and homemaking, supportive housing, attendant outreach, and services for individuals with physical disabilities. To date, the Ministry of Health has announced over $160 million for investment in community services. Now, Mr Speaker, that takes leadership. Sitting on the Hill in Ottawa and criticizing provincial governments who are forced to deal with their irrational health care cuts-that's irresponsible. Repackaging health care reform initiatives that provinces have been implementing for years and then trying to sell them to the public as their idea-that's Allan Rock/Dalton McGuinty style liberalism.

The best examples of our leadership can be seen in my own home riding of Scarborough. Our community care access centre has been one of the great success stories in recent years. The Scarborough Hospital, which is an amalgamation of the former Scarborough General Hospital and Scarborough Grace Hospital, has thrived with reinvestment after reinvestment.

I sat on the board of governors of the Scarborough General Hospital from 1985 to 1994. I saw ministers of health come and go. I remember the requests that we made to each successive minister. We asked, we begged, we pleaded for renal dialysis for nine years. We asked for magnetic resonance imaging. We asked for the capital to improve and upgrade the birthing centre, the emergency room and the critical care wing. We had the Liberals and Elinor Caplan in office for five years. We received nothing. We had the NDP and the honourable member for Beaches-East York and we received a very sympathetic, "I feel your pain" type of smile and, again, nothing.

Guess what? Since we came to office in 1995, the Scarborough General Hospital has received that long awaited renal dialysis unit. Just over a month ago, I was at the official opening, with my colleague the Honourable Dan Newman, of the MRI unit that the NDP told us not to hold our breath waiting for. Work on the birthing centre and emergency room improvements is underway. The funding for the critical care upgrade has been allocated and work should be underway shortly.

As an aside, I would like to recognize Ron Bodrug, Colonel Irene Strickland and the rest of the staff and administration at the Scarborough Hospital for all the hard work they have done and for all they have accomplished.

Our work in Ontario has made a difference as we build toward a health care system that will be able to accommodate the stresses and strains that will inevitably be placed upon our health care infrastructure as baby boomers, including myself, age. As I look toward the future, I know the quality of the health care I receive as I age will be built upon the structure that we lay down today.

We could not afford to wait for the Liberals in Ottawa to give us direction, and we haven't. But the time has come for the federal government to participate in this process. The time has come for Allan Rock and his cohorts to become a real partner in the delivery of health care. The time has come for the federal government to return the $4.2 billion they have taken from the provinces to allow us to put that money toward expanding primary care, community care, home care, long-term care, cardiac care, cancer treatment, improving emergency room services, the Trillium drug program, and the list goes on and on. In failing to restore the transfers even to the pre-1994/95 levels, the federal government is inhibiting our ability to provide the services that will enhance the lives of everyday Ontarians.

I am proud of the Premier and his courage to take a stand and fight Ottawa for the sake of quality health care. In fact, I will follow his lead right here, right now, and publicly demand that my federal counterpart, John Cannis, meet with me to discuss the future of health care for our Scarborough Centre constituents. When and if I have the opportunity to speak to Mr Cannis, I will let him know that I feel very passionately about our health care system and the role that each level of government must play. His government must once again become a significant and reliable player in the funding of health care.

The resolution put forth by the Premier and the recent media compaign are right on the mark. Ottawa has been getting a free ride on their embarrassing health care record. Unfortunately, the task of holding them accountable for their misdeeds has fallen to provincial governments across Canada.

I am proud to support this resolution and lend my voice to the chorus of provincial governments-of all political stripes, I might add--and everyday Canadians telling Ottawa that it's time they pay their fair share.

Mrs Julia Munro (York North): I rise in the House today in support of the motion put forward by Premier Harris, which calls on the government of Canada to immediately and permanently restore the health care funding of $4.2 billion annually that it has cut since 1994-95.

I understand that the federal Minister of Health, Allan Rock, claims he would like to see some health care reform before he is willing to discuss restoring the billions that the federal government has cut to the provinces. We are here in the House today to tell Mr Rock that Ontario is well underway in health care reform, as is every other province in Canada.

Let me explain: primary care, for example. The Ontario Ministry of Health and Long-Term Care and the Ontario Medical Association first introduced primary care networks in four Ontario communities-Hamilton, Paris, Chatham and the Kingston area-in May 1998. In September 1999, the primary care networks were introduced in three more communities: Ottawa, Parry Sound and Thunder Bay.

Primary care networks are made up of family doctors joining together in their communities to provide easier access to health services and better coordination of health information through computers. The networks will help reduce waste and duplication in the health system. About 200 family doctors will participate in the primary care network pilot projects across the seven communities, and nearly 400,000 Ontarians could eventually join or enrol with their family doctors as part of the new service model, which will provide 24-hour, seven-day-a-week access to health care.

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Some 100 family doctors in Hamilton and Paris, the first to inform their patients about the new way of providing medical care, are reporting that most of their patients have accepted their invitations to enrol by signing patient agreements. By signing the form, patients agree that their family doctor and their doctor's primary care network will look after their primary health care needs. Illness prevention, health education, diagnosis and treatment are all part of what family doctors do to provide their patients with health care. Primary care also includes family doctors making referrals to specialists. Referrals can also be made to another of the network's doctors who may have more expertise about the patient's condition.

Primary care networks are designed to offer convenient and quality service. Such services include that the patient's own doctor normally sees them during regular office hours; that the patient has access to a doctor in the network with extended office hours; after hours, on holidays and on weekends, patients can call a number provided by the network and speak to a registered nurse; the nurse may suggest ways for the patient to take care of that health concern, recommend that the patient make an appointment with his own doctor, or recommend that the patient go to an emergency room.

Health service is of a higher quality because there is better communication about the patient's health. The family doctor, nurse or other health care professional the patient deals with will keep his own family doctor informed about his own health problem.

If a patient speaks to the nurse staffing the after-hours phone service, his own family doctor will know about it the next day and may follow up to see how that patient is doing.

There is improved sharing of information about the patient's medical history or medications through computers, and this leads to better advice and treatment.

Patients do not give up their rights to second opinions and the power to decide when they are in an emergency situation requiring immediate hospital care. Patients can still choose other health care providers such as chiropractors, physiotherapists and dieticians, but may want to ask the family doctor to recommend someone with whom they regularly work to help ensure continuity of their care.

It is the patient's choice whether they join their doctor's primary care network. There is no cost to join and it is easy to cancel an enrolment agreement.

Mr Rock, this is health care reform. The Ontario government has made great strides in the area of health care reform since elected in 1995. If Mr Rock is not satisfied with the levels of reform that have been presented to him on numerous occasions by our Minister of Health, the Honourable Elizabeth Witmer-and, I might add, from many other provincial ministers of health across Canada-then we might ask the question, what is Mr Rock's vision? Where is Mr Rock's vision? It is one thing to claim to be in favour of health care reform; it is quite another to offer a vision. He needs to take a look and see the examples of health care reform that have been taking place all over this country.

I am also very interested in what Mr McGuinty thinks of health care funding and what are his suggestions for so-called federal-style health care reform. Recently, Mr McGuinty and his Liberal caucus were meeting in the beautiful riding of York North and I sent him a letter asking him to join us in our quest to have the federal government restore health care funding to the provinces. In part, this is what I suggested:

" I understand that you are in retreat with your caucus at the Briars for the next two days, and would like to take this opportunity to welcome you and your members to the beautiful riding of York North, which I am privileged to represent.

" Although most of my constituents have been fortunate to share in the prosperity that has returned to Ontario since 1995, they are concerned about health care, as are Ontarians everywhere. No doubt you and your caucus will be turning your attention to this issue.

" This, coupled with the fact that the federal, provincial and territorial ministers of health will meet in Markham, has prompted me to ask your assistance in ensuring that the federal Minister of Health is made aware of the concerns of Ontarians. As you will know, the recent federal budget was a great disappointment to Ontario in that it again failed to restore the health care funding ... You yourself have said, `I was personally disappointed with the budget because it did not assign the priority to health care that ordinary Ontarians have been telling me that they assign to it.'" That appeared in the March 6th issue of the Toronto Star.

" I am asking you to speak out in a similar but more direct fashion by endorsing the attached letter to Minister Rock," which I believe outlines "the urgency of the funding issue....

" On behalf of my constituents, thank you for your attention to this matter."

I signed it.

Mr James J. Bradley (St Catharines): I am probably as pleased as anybody that this debate in health care is here, because now we'll have our chance to counteract some of the propaganda the taxpayers of this province are paying for in the form of advertising.

People out there who happen to be watching this afternoon or this evening should know that this government has already squandered $100 million on self-serving, obviously blatant partisan advertising, as the member for Scarborough Southwest well recognizes as he mouths the same words as I say them. He recognizes it. The people in the back rooms, the whiz kids, they think this is really smart. But when I go to the places where there is a predominance of Conservatives, some of the groups that I speak to where I know there is more than a small sprinkling of members of the Conservative Party or the Reform-a-Tories, as you are over there now, I ask them: "While it may be smart politically for the party which you support, is it really good for the democratic process? Is it not an abuse of public office?" The answer to me is obviously yes. Is it not an abuse of the taxpayers of this province to take at least $3 million, probably much more, to spend on advertising attacking another level of government?

If the Progressive Conservative Party, which has ample funds from all those fundraisers you hold where the developers fill the pockets of the party with funding-if you have ample money to advertise, I guess I can't quarrel with that. I may quarrel with the content; I cannot quarrel with that tactic. But when you take taxpayers' dollars-you, the so-called penny-pinchers, the so-called defenders of the taxpayers of this province, taking money out of the pockets of Ontarians, hard-earned money from people who are poor, even, in this province-to use for government propaganda, that is simply unacceptable. You will never hear any government backbencher ever concede that, except of course when they're on their way out.

I found the ministers' meeting interesting, when I saw the health ministers meet together in the north of Toronto, in Markham. Sometimes I would like to be a reporter, because I would like to have the questions that one could ask. I would have asked the question of all those provincial ministers: "How many of your governments are cutting taxes? How many of you who want more money for health care are in fact taking the money you're getting now and giving it away in tax cuts?" That's exactly what the Harris government has done. The Premier used to say: "There's plenty of money in the health care system; it's simply how it is distributed that is important. We need reform."

First of all, I should go back to the advertising. I found the advertising-in this case, paid for by the Conservative Party-the one about tax cuts, rather interesting. Before the federal budget, all we heard about was advertising saying, "Please give tax cuts." There was not a word in those ads-paid for, in that case, by the Conservative Party-about health care, just tax cuts, the old mantra: Keep taking money out of the system, keep de-funding every public sector institution that we have in Ontario, keep dismantling the levels of government which would intervene on behalf of poor people, not the rich and powerful, who this government represents, but average, middle-class and economically deprived people in this province. You're taking that money now and you're firing it away on advertising.

I watched over the last five years as this government took the funding it got from the federal government for health care and gave it away in tax cuts. The government didn't even spend the most recent amount of money that was given last year. Instead, it squandered it away, again, to finance its tax cuts, which benefit the wealthiest people in this province the most. So when people look at this Legislature and this government, they should know that if you have no social conscience at all and you've got lots of money and you're a powerful person, then you should be supporting the Harris administration.

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Health care is at risk because members of this government, in the back rooms particularly, do not believe in the kind of health care system we have today. The real agenda is to find an excuse to have a two-tiered health care system, one where if you're rich enough you buy yourself to the front of the line, and if you're a poor person, well, it's just too bad; one where you start delisting drugs which are essential to combat disease and afflictions; one where you make people who are sick pay-in other words, the only thing they've done wrong, and of course that isn't wrong, is that they've become ill.

Compare the United States system, which these people idolize, to our system. One thing I think all Canadians of goodwill can be proud of, and I could say three political parties in this province in years gone by, is the kind of health care system we have built in the province of Ontario, universally accessible to people in this province regardless of where they might be in the economic strata of this province. That is now being removed. Now, item by item is being privatized in this province. We know there are people in the back rooms of the Conservative Party who seek to privatize as many of these services as possible so that the rich will get the best service and the rest will just wait until it's their turn.

I think we should build on the strengths of the system we have now. I advocated for the members of the government. The member for Mississauga West, Mississauga Centre now, who has a sense of humour, would recognize that I was being less than humorous on the occasion-a little bit of humour involved maybe. What I essentially said was that I had a plan for you, a plan that would allow you to bash the federal government and still fund health care adequately. That plan was to abandon yet another tax cut that you people have promised to implement, and what you could do is what most people in this province want you to do, that is, invest that money in health care. Then you could say, "Look, we're not going to proceed with the tax cut because we need the money for health care and we consider that more important." You can blame the feds. You can say, "It's the federal government's fault that you're not getting the tax cut." You can go ahead and say that. I'll let you say it. I'll support you. I'll say, "Sure, that's their good excuse."

But time and time again, when it has come to a decision between the public good in terms of those services which government had provided, which are needed for the people of Ontario, and tax cuts, you have opted for the extreme right-wing agenda of simply giving money away in tax cuts, and those tax cuts, of course, benefit the richest people in this province the very most in terms of the actual dollars they receive.

If you're a senior level of government, in this case-first of all, I get a laugh out of this. The member from Niagara Centre and I find this amusing, that you people talk about downloading or a senior level of government not accepting responsibility. In the Niagara region, you have had a transfer of services with them where $18 million of new money is now the responsibility of the local level of government. You've simply dumped it on the local government and then you blame them when the service isn't provided. Then you have the audacity to criticize another senior level of government when you do exactly the same thing. Of course, once again, it's because your choice is tax cuts and your choice is giving money away, very often to the very people in this province who don't need it, that is, the wealthiest people in this province, who can well afford the tax regime which is in place.

For a federal government, of any stripe, dealing with the Ontario government, what you would advise them, if you wanted to be wise, would be to spend directly on health care, because if you transfer it to Mike Harris he just gets it and gives it away in a tax cut again.

Mr Jean-Marc Lalonde (Glengarry-Prescott-Russell): And on advertising.

Mr Bradley: And on advertising, $100 million worth of government advertisement.

So if the federal government is going to spend money, the solution would be that they should spend it directly. Go into the hospitals and say, "OK, we have an infrastructure program and we're going to pay this portion of it now," or "We're going to pay half the cost of an MRI" or any other piece of equipment in the hospital, because the provincial government pays zero right now for that; they give the approval, but they pay zero in terms of the capital cost.

I have a good solution for them, that is, put the money directly in. Every time they have given you people money for services like post-secondary education or health care, you take the money and give it away in the tax cut, and then you whine.

My friends in the New Democratic Party will well remember some of the present members of this government who stood in the House and criticized Bob Rae. They said he was whining, he was complaining. Doesn't he understand that the provincial government can cope with the fiscal realities of the province? They tried to put him down for that, when in fact he was in difficult economic circumstances at the time. Unlike you, he was facing a huge provincial deficit. He was facing difficult circumstances-

Interjection.

Mr Bradley: Well, let's look at it. You can't blame the NDP-I know you people like to blame the NDP for deficit financing. They were in a situation where the American economy was in a downturn. You are in a situation where the American economy is in an upswing. What has caused the prosperity in this province has nothing to do with your silly tax cuts; it has everything to do, first of all, with low interest rates, which are the responsibility of the federal government, and has everything to do with the low Canadian dollar, which makes us extremely competitive, particularly in the automotive industry, and it has everything to do with the booming American economy. Because we export so much to the US, which is nice when the economy is booming-

Interjection.

The Acting Speaker (Mr Michael A. Brown): The member for Brampton Centre, you're not in your seat.

Mr Bradley: Our economy is booming. So this mythology from the whiz kids that they give you in the government backbenches is all baloney. It's phony baloney. That's exactly what it is. Yet you people get up and read that stuff. I don't know how you can read it. Just tear it up and admit the fact that it is low interest rates, which business loves; it's that low Canadian dollar, which really helps the exporting industry; and it's the booming economy in the United States. That's what the prosperity is coming from in this province. It has nothing to do with your silly tax cuts.

I well remember, and my other colleagues in the House who were here then will remember, when the federal government announced a number of years ago a fiscal plan for restricting its expenditures. Mike Harris said, "Don't worry, we can handle that." In fact, he often said to the federal government of the day, "You didn't cut enough." Today he's lining up to whine, because his real agenda is to try to elect the Reform-a-Tories. This is not the federal Progressive Conservative Party, who are relatively moderate people. We're talking about the Reform Party with its new name, whatever it is. I don't know what it is. I understand you're not supposed to say it in this House or any place where people can hear it-it's called C-R-A-P or something like that.

Interjections.

Mr Bradley: I'm trying to hear the member for Etobicoke to help me out with how you pronounce the name, but those are the initials. The real purpose of this government now is to take taxpayers' dollars to try to defeat another level of government. Well, they should manage their own affairs.

One thing you can say about the Harris administration and the whole bunch of them is that they're first in line to accept the credit and last in line to accept the responsibility. The member for Eglinton-Lawrence has a new name for them.

Mr Mike Colle (Eglinton-Lawrence): Pass the buck.

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Mr Bradley: The pass-the-puck government. Whenever there's something, they blame local government or the federal government or the NDP or the Liberals or something, but they never take responsibility themselves for things that go wrong in this province.

What I have watched this government do is simply close the doors of hospitals and have emergency wards backing way up. We have long lineups of people waiting for bypass operations, for instance, necessary cardiac surgery. We have many people-a large number of them elderly-who are waiting for hip replacements or knee replacements. We have people who need cataract surgery. And here you are, putting the cap on ophthalmologists in the Niagara region when we don't have enough ophthalmologists. Therefore people have to wait for many months before they're able to get the kind of eye care they need.

What you people do in the extreme right wing, aided and abetted by the Fraser Institute, the National Post and your friend Conrad Black-

Interjection.

Mr Bradley: I know you wanted me to mention Conrad Black. What you people are trying to do is cause a crisis in any public institution. You try to create a lack of confidence in public institutions so that people will accept a radical solution which they wouldn't normally accept. What you're trying to steer towards now is privatized health care. People will have such lack of confidence in the health care system that you're going to say: "We've got the solution. We're going to do what Ralph Klein does. We're going to start setting up private clinics, private facilities." That's what your agenda is on the other side.

You did the same thing in education. You created a crisis so that people would lose confidence in public education and accept radical solutions. They say, "Well, maybe we have to close our hospitals," as if that wasn't crazy. I call it crackpot realism when people fall for the kind of trap you people on the other side set.

I want to mention as well something you forget. I'm not here to look at what the federal government argument might be, but I remember Frank Miller asking for what was called "tax points." The government members laugh at this, because they know it's too hard to explain. "We have the simple message, and the simple message is the easy message. We'll just put that out in our ads and that's it." But what the provincial government asked for was room in taxation. The federal government said, "OK, we'll give you this room in taxation so you can have it and spend it as you see fit." I think the federal government shouldn't have done that. I think it was a mistake on their part to fall for a Conservative government asking for this kind of tax room.

The reason I say that is because there's no guarantee about how you're going to spend it. You bought an oil company-you were part of an oil company. You squandered it on Minaki Lodge. You were going to buy, for the comfort and convenience of the Premier and members of the cabinet of this province, a jet which was made in Houston, Texas, a Challenger jet worth $15 million. You had money for that in those days.

What I'm saying to you is that-

Mr John Hastings (Etobicoke North): Don't try to reinvent history.

Mr Bradley: Before I go to that, I hope you people will vote for the amendments to your motion put forward by the Liberal Party and the New Democratic Party. If you voted for the Liberal amendment, we'd probably vote for the motion. If you allowed it to be amended, we would vote for the motion. Everybody could agree. But I don't think you'll do so. Guy Giorno has said you're not going to do it, and that is exactly what's going to happen.

Some of us know also that the CCACs, the central agencies which look after home care, out-of-hospital care, are vastly underfunded at this time and not able to cope with the responsibilities that have been thrust upon them as you fire people out of hospitals much more quickly.

Far more people today have to hire private nurses in the hospitals in order to get the appropriate level of health care. Is it because the people working there are not doing their job? Of course not. It's because there are not enough of them. You fired 15,000 nurses out the door when you were downsizing. Now you have to pay for the severance packages for them and you say, "Look at all the money we're putting back in for severance packages." In essence, you always have money for tax cuts which benefit the richest people in the province the most, and you always have money for self-serving, blatantly partisan propaganda paid for by the taxpayers of this province.

What you should be doing is strengthening the health care system, taking the money you are going to put into a tax cut in the upcoming budget and applying it to health care. That isn't the only solution. I listened with a good deal of interest to the member for Beaches-Woodbine, as I still call it, and a former NDP Minister of Health, who I thought, by the way, was one of the least partisan people in the House on this issue. I think the reason is that she's had the responsibility of being the Minister of Health and recognizes there are changes that may come about and are required, and it really requires the building of a consensus and not simply a mudslinging contest that we see going on now, a phony mudslinging contest. What you've got going now by spending your money is you've got the federal government spending taxpayers' money to retort. A plague on both your houses for the money that you're spending on advertising.

I have to remind my friend Mr O'Toole, who started this, who threw the first snowball in this particular fight. It's time to put that aside. It's time to rally to medicare, as it was established by the federal Liberal government on a national basis and by the New Democratic Party in Saskatchewan under Mr Tommy Douglas. That is the kind of health care of which we can be justifiably proud, and I will be in this House and on the campaign trail any time to defend public health care as it is in the province of Ontario.

Mr Peter Kormos (Niagara Centre): This is an important debate. It's important not only because of the substance but because of why we've been drawn into it at this particular point in time.

Let's speak very directly to the whole matter of the Paul Martin budget and the two cents for health care for every dollar in tax cuts.

The Acting Speaker: To the member for Niagara Centre, I've made an error, and in the rotation apparently it is not your turn. So we'll turn to the government party. The member for-

Interjections.

The Acting Speaker: Let's hold up here just for a second while we get this straight.

My understanding is that the New Democrats skip every second rotation on a substantive motion. The member for Brampton-Gore-Springdale-Malton.

Mr Raminder Gill (Bramalea-Gore-Malton-Springdale): It's pretty close, thank you. In fact, it's Bramalea-Gore-Malton-Springdale.

Earlier this week, Premier Harris tabled a resolution in this assembly to have Ottawa restore $4.2 billion in transfer payments to Ontario. This resolution is about taking leadership in representing what is in the best interests of Ontarians. Premier Harris's resolution is also seeking to clarify federal and provincial responsibilities in health care.

Ontario wants clarity from our federal government about health care spending. Ontario's request for clarity should not surprise Mr Chrétien and his Liberal cousins across the aisle. As a matter of fact, one would suspect that they would want to follow in the spirit of the glasnost which recently swept through Ottawa. Our Liberal friends were insisting on clarity: clarity of question, clarity of who will be the next Liberal leader and clarity of what the future holds for Mr Martin and his gang of rebels.

We know that Liberals everywhere have only recently discovered clarity, except perhaps at HRDC and Shawinigan-or shenanigans, for that matter. Those are Liberals, after all, and Ontarians have come to expect double-talk and hypocrisy from them. First, our Prime Minister was clear about what he will do about the GST. He was clear about what he will do about the free trade agreement. The list of Liberal hypocrisies and double-talk goes on and on.

Ontarians like clear and honest leadership. That is why they endorsed Premier Harris's Common Sense Revolution in 1995 and reaffirmed that support in last year's election.

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The resolution introduced by Premier Harris urges the federal government to come clean and fess up about health care spending in Canada.

For the audience at home, let me reiterate. Section (a) of the resolution reads: Be it resolved that the Legislative Assembly of the province of Ontario "condemns the government of Canada for cutting, by $4.2 billion annually, base payments under the federal government program that supports health care, the CHST, while provincial governments have increased health care spending."

The resolution goes on to urge the federal government of Canada to permanently restore the health care funding that it has cut and to assume its fair share of increased, ongoing funding to meet the health needs of our country's aging and growing population.

For Ontarians everywhere, even Liberals, this resolution is clear. The federal government has massively reduced health care spending by cutting transfer payments to Ontario by $4.2 billion annually. This might shock our friends across the aisle, but cutting money from the Canadian health and social transfer program means cutting health care. I'm sure some of my Liberal friends across the aisle might doubt that their cousins in Ottawa would cut health care spending. I'm sure they're saying, "Liberals would never do a thing like that, not us," not even when they're caught with their hands in the cookie jar.

Let me quote the 1997 red book for all the members of the House. It says on page 71, "It is a fact that during our first mandate, this government reduced transfer payments to the provinces." Jean Chrétien said, in an interview with the Toronto Star on October 27, 1996, "We needed to squeeze [medicare] in order to save it." Let me repeat our Prime Minister's words, "We needed to squeeze [medicare] in order to save it." Jean Chrétien needed to squeeze medicare in order to save it. I'm sure he says that about protestors too-but I digress.

I am sure the members of the opposition would condemn the Prime Minister for squeezing medicare.

Mr Bradley: What did Bart Maves tell you to say there? What note did he give you?

Mr Gill: Mr Maves told me not to listen to the rhetoric of the opposition and continue with the message.

I am sure Mr McGuinty will do something that he has failed to do so far: show some leadership when it comes to defending health care in Ontario.

Interjections.

Mr Gill: All four of the members opposite are listening, I'm sure.

Speaking about leadership, I am sure the members of this House are wondering: "Where is our Liberal Minister of Health, the Honourable Allan Rock? What does he have to say about the CHST and medicare?" Allow me to share with you the comments made by the honourable minister at the Canadian Medical Association meeting on August 20, 1997, in British Columbia. Mr Rock said to Canada's health professionals, and these are his words: "I am part of the problem, not the solution. It was my government that diminished the size of transfer payments." The honourable minister went on to add: "I will not stand here and tell you that the cuts in transfer payments we made were very insignificant,"-he said they were not insignificant-"and I won't tell you that they have had no impact. They have."

There we have it: Liberals telling the truth. I know that this is not a common occurrence, but let us accept the Prime Minister and the health minister at their word. They've acknowledged that their government, the federal government of Canada, cut transfers to the provinces and it had a major impact on provincial health care. It is the federal government cutting the $4.2 billion in Canadian health and social transfers, while it is our government which has increased spending to make up for the federal cuts. Today, Ontario is spending $3 billion more than we did in 1994-95 on health care. The federal government is spending $1.7 billion less in 2000-01 than it spent in 1994-95. That is a huge margin of difference. The facts are clear: Mike Harris is working to save health care, and Jean Chrétien is squeezing it by cutting $4.2 billion in order to, as he puts it, save it.

Ontarians are tired of the rhetoric from Mr Chrétien and Mr Rock. They do not believe the ads the federal Grits are running in the morning papers. These ads claim that Ottawa increased spending in transfer payments by 55% over the previous year. But when you're spending a small amount and you increase it by a few dollars, you could make the claim that you have increased transfer payments dramatically. That is the Liberal math. The facts speak for themselves. I'm sure my friends across the aisle realize the truth by now: The Chrétien government is spending $1.7 billion less in 2000-01 than it did in 1994-95, and the Mike Harris government is spending $3 billion more over the same period.

Only one party has cut health care spending in Canada and that is the federal Liberals. In urging the members of the House to support the resolution introduced by our Premier, I would like to remind everyone that now that the deficit has been eliminated the provinces have a duty to get back the dollars the federal government cut from health care; if we don't, we all know that those crafty Liberals in Ottawa will only find new ways of spending our money.

Hon Rob Sampson (Minister of Correctional Services): Jane Stewart will find a way.

Mr Gill: A boondoggle of $3 billion, that's what it is.

We all know that in Ottawa our federal government is already finding new ways to misplace billions of our taxpayer dollars. They are happily wasting taxpayer dollars on golf courses and water fountains in the Prime Minister's riding, but when it comes to restoring funding for health care, Mr Chrétien and Mr Rock are nowhere to be seen.

Hon Mr Sampson: Would that be the riding of shenanigans?

Mr Gill: Shenanigans, that's it-Shawinigan, I guess.

In asking all members to support the resolution before the House, I would like to remind you that when we entered into the medicare program with the federal government years ago we had an arrangement whereby they were going to pay 50% of the costs. That was a 50-50 agreement. Today, after years of cutbacks to the provinces, Ottawa is only paying 11 cents on every health care dollar. The provincial government is spending 89 cents, while Ottawa is only spending 11 cents. What happened to the partnership? Whatever happened to the 50-50 agreement? If they had any sense of honour or integrity, Mr Chrétien and Mr Rock would be restoring the $4.2 billion they have cut from Ontario immediately. Instead they are out on their high horse galloping around the country engaging in rhetoric and doublespeak on health care.

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Ottawa has a responsibility to ensure that all citizens in Canada have the best health care possible. Members of this House also have their responsibility. This is why Premier Harris tabled this resolution. It is now up to the leader of the official opposition to recognize our joint responsibility and join with all the members of this House in supporting a strong health care system for Ontarians. To do otherwise, Mr Speaker, would be a dereliction of duty. I urge all the members to support the unanimous adoption of this resolution.

Mr Bart Maves (Niagara Falls): Unfortunately, I only have about five minutes, so I won't start off by telling everyone I'm going to be non-partisan in this debate. I'm sorry; I feel the need to be just a little bit partisan. Had I had a full 20 minutes, perhaps I'd do a whole spiel on the health care system and where we need to go, but after hearing some of the rhetoric I've heard the past few days about this debate, I feel I need to engage in a bit of discussion which, unfortunately, will be a little partisan.

One of the reasons I think it's absolutely essential for the federal Liberals to come back to the table and increase money in health care spending is because they have to find a cure to the disease that they're all afflicted with, federally and provincially. That would be foot-in-mouth disease, Speaker. If you look back at the record of some of the changes of policies, some of the flip-flops that the Liberal Party has made both provincially and federally, they are certainly afflicted with this disease and they certainly need some help.

In a recent press release that the provincial Liberals put out, and Mr McGuinty's office I believe would have put this out, he talks about how recently they wanted to call a motion calling on Queen's Park and Ottawa to spend more money on health care. The Liberals provincially condemned both the federal Liberals and the provincial Tories for not spending enough on health care.

Well, it's interesting if you read the record, Speaker, some of the comments made by provincial Liberals. Here's a quote from Ian Urquhart's column back on March 6, 2000, from Dalton McGuinty. "Just throwing more public money at medicare will not save it as a single-tier system," according to McGuinty. So McGuinty, on one hand, wants to bring forth a motion saying, "You guys need to spend more money on health care federally and provincially," then on March 6, 2000, says that's not going to save it.

He's done that before. Way back on September 22, 1996, he said, "I'm convinced that there is enough money in the system." That's back in 1996, Speaker. As everyone in this House knows, we've replaced a lot of the money the federal government has taken out, plus added our own money on top of that.

Here's another quote from Mr McGuinty. A caller on a CFRB radio show earlier this year says, "I'd like to know what Mr McGuinty specifically proposes, because I don't think putting more money is the solution." McGuinty's response? "I agree." So, Speaker, you can clearly see McGuinty takes one position publicly in the House earlier this week, his very recent comments, and even his comments back in 1996 are completely counter to that position.

But he's not alone. Here are some comments from some other folks in his party that show how deeply this foot-in-mouth disease and the flip-flop problem of the Liberals run through that party.

Here's Gerard Kennedy. Remember, he was the Liberal health critic for so many years. While running for leadership a few years ago he talks about de-listing. Now, in the House, any time the OMA and the Ontario Ministry of Health come up with de-listing some non-essential services, it's a hue and cry from Mr Kennedy, but here's what he said about de-listing: "We have to look at a combination of patient responsibility and doctor responsibility. We want to make sure that we take some of the non-essential stuff out of the health care system." So one thing then, Speaker; a totally other thing when he's here in the House.

Again, Dwight Duncan, another member opposite who ran for the leadership, talks about health care. Now he's ranting and raving every day in this Legislature at us to spend more; a little softer on his federal Liberal cousins. He says: "Specifically, in my view, we are spending enough in health care. I was part of a process that reduced in my community from four hospitals down to two hospitals and reinvested in a number of integrated delivery systems." That's Dwight Duncan, a member from the Liberal Party across the way.

It's interesting. I think it was called a win-win committee. I remember one day when Ms Pupatello from Windsor was in here ranting and raving about hospital closures in her riding. Then we found out that, lo and behold, she was part of this win-win committee in Windsor that had actually advised the closure of those hospitals. So one of the key reasons they need to put some money back is they have to find a cure for their own foot-in-mouth disease.

I find it very frustrating, after four years of very difficult change in the health care system in Ontario, where we have moved to more home care, an 87% increase in home care in the Niagara region alone and a lot more around the province, where we're committed to 20,000 new long-term-care beds-we are moving the health care system and reforming it in a direction that all the experts say we should go in. Allan Rock comes along and stands there and says: "Well, maybe we'll put in more money, but we need to reform the system. We need to change the system. We need to move to more home care, more long-term care."

I see that, and as a member from Ontario who has worked very hard to reform the system over the last four years I get very frustrated and I want to know, where is this fellow's riding? I thought he was a member from Ontario. Has he been completely oblivious to the change that has been happening in our health care system, to the difficult process that we and other provinces before us have gone through? I believe he has. He needs to quit playing political games and he needs to truly sit down at the table and talk turkey with the rest of the provinces.

Mr George Smitherman (Toronto Centre-Rosedale): I join this debate-well, actually, "debate" might be a little rich for what's going on here. I join this mud-slinging session with an extraordinary sense of despair and of shame. I have to say that the way this debate is taking shape simply seeks to assess blame for failure. That's the easy side to be on. I want to be on the side alongside those whose legacy will be that they made our system of health care better. Nothing-I repeat, nothing-means more to me. Nothing defines my country more than the principles behind our universally accessible system of health care. And nothing could be more important to the constituents in my riding, Toronto Centre-Rosedale, many of whom are poor, many of whom suffer through challenges that require them to have access to a very good, universally funded system of health care.

My riding is also home to a co-op named after Tommy Douglas, who has been referenced in this House many times and to whom we owe a great debt of gratitude. I would say that the leaders of our country, the politicians, my colleagues in government, are spending every waking hour focused not on how we can improve our system. These same leaders spend every waking hour on the task of fixing responsibility for who has screwed it up. What will be left when all is said? Have no doubt, more will be said than done. But when will we get on with the task of improving the system? What will be left of the system? Which Canadians will still have confidence in it? Which health care professionals will still want to work in it? What foreign country will be attracted to locate here because of it?

I think as politicians we all fancy ourselves pretty savvy marketers. But if we had a product with pretty good fundamentals, would we focus on the need to improve it, or would we simply drive it into the ground? I think that's what we're doing. I'm embarrassed, as a new generation of politician, by our collective failure to seize our opportunities and our responsibilities. Not that long ago in this country, a different generation, acting in good faith, created a system that people all around the world have marvelled at. Now, 30 or 40 years later, we're playing hot potato with an essential, defining part of my country. I don't like it. I don't like that one little bit. Canada's system of universally accessible health care is not a suitable subject for a high-stakes game of chicken. I don't want to be partisan about this, because there is only one taxpayer and on this issue what I'm afraid of more than anything else is that there's only one politician. Do my constituents watching on TV today see me as an opposition member? No, they see me as part of their government. To that end, I think we all owe it our constituents and to ourselves to take a hard look at what we're contributing to.

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This debate has become so heated and so polarized that it's probably heresy for me to say that Allan Rock is a friend of mine, that I have confidence in him and that I believe he has the best interests of Canadians in mind. And I certainly know that it's heresy for me to say that I believe our own Minister of Health thinks she's acting in the best interests of Ontarians. But can you imagine in the current environment that any progress is going to be made, any progress whatsoever? What with all of the briefing spent every day for communication strategy and spin sessions, do you really think the ministers in the provincial ministries of health or our leaders or the Minister of Health in Ottawa are spending their time working with their deputies to improve the system? I don't. I think they're spending way too much time working on who can get the advantage, who can have the best spin, who can hammer the other side. I think that's disgraceful, and we all collectively, as politicians, owe more to our constituents.

Who's responsible for creating this environment? I mean, who really cares? We've all contributed to it. I want to know what it's going to take for someone out there to decide that there's more at stake than this, that there's more than this pissing match, that it really matters that we get together and work-

Hon Dan Newman (Minister of the Environment): Oh, come on.

Mr Smitherman: They're awake. I withdraw any reference to that. The Tories have finally woken up to what they're involved in and find it distasteful, but every single day that's what their contribution to this is.

As Liberals, we wanted to introduce a motion that basically said both governments should be and are responsible for some of the problems and challenges in the system. I believe that if members were to talk to their constituents and not be partisan about this, most of their constituents would say that they're tired of governments, provincial and federal, hammering each other with salvo after salvo after salvo and not getting on with the real task of finding improvements in the system. There is plenty of blame to go around, isn't there? Does it just come down to which level of government is going to ask the taxpayer for how much money? Is that where we're at in Canada in the new millennium?

I was thinking the other day about the success of John McCain's campaign in the United States. His Straight Talk Express was seen as so remarkable because for a brief shining moment he let it all hang out. He dropped the spin and his guard, he cut the crap, he told the truth, he called them as he saw them, and that was considered to be such a big deal.

Mr Maves: That was straight talk.

Mr Smitherman: You know what? You can't travel for hours and hours and hours and be full-time spin. Perhaps the member can.

Now don't get me wrong. I'm not pretending to be anything like John McCain. I've never had a chance to do anything the least bit heroic. But, at a bare minimum, what I decided to do last night was try to contribute to this debate by being straightforward and clear and by making some confessions.

The first confession I want to make is that I believe our health care system provides an extraordinary amount of terrific care every single day; that we need to build on the core values that we have as Canadians; that I embrace the opportunity to participate in a meaningful debate about reforming our health care system; that we recognize that with something this big, affected as it is by so many changes and growth and science and technology, reform is appropriate; and that in the riding of Toronto Centre-Rosedale I'm ready to work with the government to reform health care in a way that will help my constituents.

We have a lot of work to do. We still haven't delivered in Toronto Centre-Rosedale, as an example, on the Health Services Restructuring Commission's call for an ambulatory care centre that was to come in place of the Wellesley Hospital, which will be closing shortly. The diverse needs of my inner-city riding and the neighbourhoods there need to be served by a street-level, easy-to-approach institution that can try to provide care in a cheaper forum than emergency rooms.

Earlier this week there was a story in the paper about frequent flyers, those people who are not rooted in the health care system, who do not feel that they have primary care as provided through a physician. The burden that those individuals are placing on our health care system because they seek care in emergency wards is just one example. My riding of Toronto Centre-Rosedale can be a place where ambulatory care centres can be instituted, where care can be delivered on a more grassroots basis and in a much cheaper way than emergency wards, where people are receiving that care now.

We can stem the trend towards the flu-invoked wintertime chaos in our ERs by reaching out again at the grassroots level. We can begin to implement a plan now, rather than simply waiting for the flu season to strike again and for our ER wards to be full and for a full crisis to emerge.

I don't know if that was straight talk, but I believe that in attempting today to participate in this debate and make a contribution which seeks to focus on the need to reform the system, which highlights the extent to which I'm willing to play a role in that, that's a benefit, and that my constituents are better served by that than another 20-minute speech in this place seeking only to heap blame and responsibility on people of a different partisan stripe than me.

We have, as I said at the outset, an incredible system here. So much time has been spent in the last little while-the newly minted Minister of the Environment from Scarborough scoffed at the word when I said that most politicians think they're pretty savvy marketers. But I do believe that each of us, in our own way, is a marketing product. We work in our constituencies, we work hard to get elected, and we work hard in the years after that to try and make sure that our constituents know that we're working hard for them, that they know what we're doing and what we stand for.

But when we look at the health care system and how centrally important it is to Canadians, as politicians, of late and for longer, instead of focusing on the extent to which the system can provide and does provide on a daily basis good health care, we focus only on this battle, this mudslinging effort. I believe that at the end of the day, the real danger to all of us who celebrate the system and want to see it improved is that we will demean it to such an extent that we will devalue it, that we will run the product down, that there will be a feeling of crisis emerge that is far greater than the extent of the problem itself. I believe that if we're participating in that knowingly, as members of this Legislature and as politicians across the breadth of this country, then we're failing our constituents and we're failing the taxpayers and we're failing one of the greatest legacies of this great country of ours. I urge members, as they participate in this debate and this discussion with their local media and with their constituents, to be more mindful of that, because I do believe that this has gotten way, way out of hand.

I mentioned earlier that I want to be a participant in this debate, with respect to my riding of Toronto Centre-Rosedale, to try and make sure that the system as reformed serves my constituents even better. I have a riding that has an extraordinarily large number of hospitals in it-many fewer than it had not that many years ago. In the move towards merged operations, there are challenges, and some of those challenges are not being met. I'll say again that we've got a challenge in Toronto Centre-Rosedale to open an ambulatory care centre, which was to be a more modest venue to provide services to some of the harder-to-service communities in my diverse inner-city riding, and yet we haven't seen any action on that. The Health Services Restructuring Commission recommendation goes without any body, without the Ministry of Health in Ontario, ensuring that the community which was promised such a facility actually gets it.

I'll be working in the next little while to try and make sure that the Minister of Health, taking some time away, I hope, from the kind of communications efforts that she's been involved in, can try and help make sure that my community gets the ambulatory care centre that it was promised, that it deserves and that it most certainly needs.

There are so many other priorities and challenges. The member from Niagara mentioned a few minutes ago that there have been increases in the extent to which the government funds home care. The numbers may speak to that, but any of us as members know of the extraordinary challenges in the community care access centres. My riding of Toronto Centre-Rosedale is home to communities like Regent Park and St James Town. These communities are typically defined as hard to service. One of the problems that we're having is not just with the amount of money available to the community care access centres, but we're having a real problem finding adequate and properly trained individuals who would deliver that care. I am working to try and assist in finding a new crop of people who would be able to go and provide those services in those communities that are hard to service-again an example of what I want to do as a member.

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What I want to be known for is not my ability to toss as much mud as possible but to participate on the most important issue facing us in this place. The most important thing that I will ever do in my time here as a member is contributing to an improvement in the health care of the constituents of my riding of Toronto Centre-Rosedale.

In recent days, we've seen an effort on the part of the government around mental health care reform. These are some long-overdue efforts. My colleague the member for Ottawa Centre has been leading this and introduced, I believe, three private member's bills on this issue. This is a tough issue. It's a controversial issue. In my constituency people will come down on both sides of it.

I had a conversation recently with a woman who is the executive director of the Regent Park Community Health Centre, a fine, new facility and, I would say, the major achievement of my predecessor, Al Leach. This centre is struggling every single day in a much more modern facility with the burden of delivering service, again in a hard-to-service community, targeted at too many people who are without other primary care and who expect and need mental health services that frankly are not accommodated in the modest budget of that place.

We need to find additional resources to treat people who are making their home in the inner city, who are my constituents and who require assistance. This is the kind of thing we need to focus our energy on, not just on being briefed for the communications challenge of winning the battle of assessing blame for the challenges there are in our health care system at the moment.

We know as well that there are challenges in a number of other areas. I've had too many constituents write to me and talk to me with respect to their problems in accessing cancer care. I believe that all of us as Ontarians have sympathy for situations where people don't access care early enough and where too often the care they require is not available in any proximity to the place they call home.

To be blunt about it, this is something that has bedevilled our health care system. Do we have any energy as politicians and as leaders to focus on that problem, perhaps to make it right once and for all for the next people who will receive that frightening diagnosis, or will we spend all our time and energy on this resolution, day after day, tossing as much mud as we can at people who have a different partisan stripe than ours? I hope not. That's an easier speech to give. That's easier work to do. But I hope members will want to be on the side of trying to leave a legacy of a better publicly funded and accessible health care system.

I know we've had to talk, as an example, about some of the challenges for new and expectant moms. I know my colleague, our health critic, Lyn McLeod, cited the example of a mother who was flown from Brampton to Ottawa to deliver her twins. Less than a year ago, my executive assistant's sister-in-law was to fly to the US from downtown Toronto when she went into premature labour, only to be airlifted to Kingston at the last minute. She was stabilized and sent home. A week later she was almost flown to Ottawa, this time because no high-risk prenatal care was available in Toronto or anywhere in southern Ontario for that matter. She settled instead for medium-risk care in Toronto. I think we would all acknowledge that at the end of the day she got care, but did she get it in the most optimum way? Did she get it in a way that was most efficient and that delivered the best possible result for her, for our taxpayers and for our province?

We need to see from this government as well a recognition that while the greater Toronto area is growing at extraordinary leaps and bounds, as are other parts of our province, the city of Toronto is not in decline from the standpoint of population. I mentioned in an earlier debate today that my riding of Toronto Centre-Rosedale is going through an extraordinary explosive growth with respect to new condominiums and infill housing that will add density and improve communities throughout my riding: in the Yorkville area, 15 new condominiums; in the King-Parliament area, almost an equal number. These are not just empty dwellings. These are homes to people who require care. At the same time, we see a diminishing quantity of care available in the downtown core at least as measured by the hospital access we have.

We see that the government has made significant commitments with respect to numbers of long-term-care beds but taken very little action on that. Many people have commented, in a partisan and in a non-partisan way, with respect to the planning that went into the government's decision to eliminate beds in hospitals before replacing them in a long-term-care setting. We still have a lot of work to do to live up to the communications effort that has been made to announce those beds, and certainly I have many constituents who are in very dramatic need of those.

My party has been working in the last little while to help, we think, to offer suggestions. The government will often stand and say that the opposition parties merely make criticisms. This week, we began to speak about the need to have access to primary care physicians, and my leader has talked about 24-7 care. We use terms in this place all of the time and in the health care system that mean very little to our constituents, that don't address them in a way that they understand.

It strikes me that we have to find a way to better gauge what our constituents' needs are. It strikes me that a patient's voice sometimes is best represented in the public opinion polls that show enormous concerns. Does the public feel well served by the debate that has been raging all around us, with their millions of dollars of taxpayers' money-and there is only one taxpayer, as you will often remind us-being spent on advertising? I doubt it.

The strategy of the provinces, and especially in Ontario, seems to be: Throw as much you-know-what as you can and see what will stick. Sometimes the opposition has a vantage point that allows a little perspective. This week my boss, Dalton McGuinty, made a good suggestion when he said, "I don't want to fight about health care; I want to fight for it." Me too.

Mr Kormos: The most interesting part of this debate isn't so much the motion by the Premier as the amendments being offered up by the respective opposition parties. The Premier's motion speaks for itself. I'm sure New Democrats agree with the sort of baseline sympathies expressed in the motion.

We all read the budget of Mr Martin some weeks ago now, and I'm sure there were even Liberals who were disappointed at the fact that there were but two cents new money given to health care for every dollar in tax cuts. I'm confident that many Liberal Party supporters don't agree with that proposition; I certainly don't. But I've been here long enough to get the sense that it's a proposition that the Conservative Party not only would agree with but has set the pattern for. Having said that, my colleagues in Ottawa, Alexa McDonough and New Democrats there, have been raising the health care issue, the issue of funding, on a daily basis. They don't get a whole lot of press exposure doing it. I understand that better than anybody here does. I understand what it means to be in a small caucus, to be the third party. The New Democrats have been confronting the government with that on a daily basis.

I would ask the public to consider this: Where have the Reform Party members been on the issue of the Martin budget and what I will tell you are inadequate levels of support for health care? Preston Manning, leader as he was then of the Reform Party, as it was then, has preferred to focus on any other number of things, virtually everything but the inadequacy of the level of funding for health care and the trade-off of tax breaks, inevitably for the richest people, at the expense of health care.

It's not a unique phenomenon. It's certainly not unique to Ottawa. Notwithstanding it's the Martin budget of the federal government, I'm very familiar with the exercise. We've seen it happen here through the course of five years now in a number of budgets, as we've seen health care in this province gutted by this government, health care being gutted so that this government can fund tax breaks for the very richest people in this province. So I make that observation first.

Also, there has been a little bit of talk about the years 1990-95. I'm fascinated by those years-I am-for a variety of reasons. I remember when the Conservative Party was here in third party position. I remember its leader. I remember him before his election as leader and after his election as leader. I remember it.

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A Conservative earlier said: "Oh, we wanted CAT scans and MRIs in 1993. By God, it was hard to get them." Not that they didn't ask. I remember them asking. I remember when the government of the day would explain that there were some problems with the level of federal funding of health care and that there were serious problems with provincial revenues because we were in a recession. Revenues had dropped through the basement floor.

As in a recession, you had high levels of unemployment; then it was the recession, in the worst of times because it was a recession that followed promptly on the heels of Brian Mulroney's free trade agreement, which gutted industrial and other manufacturing jobs here in Ontario. We had high levels of new employment as a result of the free trade agreement. We saw those jobs hemorrhaging out of Canada into the southern United States. Of course, that process carried on with the North American free trade agreement.

I recall speaking with American legislators at the time who wanted to know how we organized opposition to free trade, because now the shoe was on the other foot, you see? There were Americans in the southern United States and other places who were seeing their jobs being transferred yet further south, into Mexico. You've read about some of those jobs recently, haven't you? Some of the Toronto papers-Linda Diebel, I think, from the Toronto Star did some major stories on the new manufacturing zones in Mexico.

I've seen the vehicles, the cars that are being manufactured there. It's interesting: The cars that are manufactured in Mexico cost no less. When you go to buy a small-sized Chevy Cavalier, the Chevy Cavalier that's manufactured in Mexico doesn't cost any less for us to buy here in Canada than the one that's manufactured in the United States or Canada, yet the Mexican worker is being paid, I recall, $2 or $3 an hour. The Mexican worker making that Cavalier in Mexico could never afford to own one. You see, that's what free trade did. Free trade gutted Canada, and most specifically Ontario, of value-added manufacturing jobs, let them into American jurisdictions that had anti-union legislation, again similar to what we're witnessing here, the models for Mike Harris and the Tories and the revolution.

We had Brian Mulroney and the Conservatives' free trade agreement accompanied by a very deep recession. We are reminded oh, so frequently, by the Conservatives, as they call themselves today-but I've got a feeling that not all of the Conservatives here are Conservatives. Heck, 27 of them were lined up to support a Reform Party, I mean a United Reform-the "CRAP" party. I liked that from day one; I really did. But 27 of these Conservatives were prepared to line up to support a Reform Party, United Alternative party, CCRAP party-I don't know what the heck it's called, but that western-it's the Social Credit Party. That's what it is.

Interjections.

Mr Kormos: It is; it's the Social Credit Party. I'm old enough to remember that. I remember Social Credit from out west-a pretty wacky party. Many things haven't changed. I'm not sure we are really dealing with Conservatives here.

In any event, I have a situation down in Niagara Centre. I hear and they hear what the government states by way of their propaganda. They see the newspaper ads. Mr Bradley has made reference to them already. The timing of those newspaper ads is spectacular because we're in a pre-election period federally. I don't mind attacking the federal Liberals on a policy basis, because I'll be engaging in a campaign and I'll be doing that, but I'll be doing it with money raised by supporters of the candidate for the New Democratic Party whom I'm going to be working with and supporting.

Interjection.

Mr Kormos: We can do many things well and we can do other things better.

I don't mind that criticism, but I resent as much as every other taxpayer that they should be drawn into what is effectively a pre-election political campaign with their tax dollars when in fact this government is as guilty, if not more guilty, of everything they accuse the federal government of. If anything, this government is but a co-conspirator, nothing more and nothing less. The government is engaged in a five-year process of slashing health care, shutting down hospitals, firing nurses, reducing public health services in each and every one of our communities and reducing other health programs that were available to kids. Mental health programs down in Niagara region and in the Windsor area are virtually non-existent, struggling on the most modest of budgets, although there are increasing and incredibly high levels of demand.

I know about the folks in Niagara Centre. I know they understand about health care. They know that not only is there not appropriate health care available but in many instances there is close to no health care available. Families where I come from are discovering that if they don't partake actively on a daily basis, if they don't attend at the hospital and actually participate in administration of medications and in the care and treatment of the family members that they love-the parents, the child, the grandparents-that treatment isn't going to take place.

Ophthalmologists in Niagara region: Niagara region is an aging community, one of the oldest communities in Canada, second only, I'm told, to Victoria, BC. So those infirmities that accompany old age or aging are very frequent in Niagara, and that includes things like cataract surgery. What is happening to our senior citizens down in Niagara suffering from a cataract condition, an affliction of aging? They are being told they have to go to Hamilton for treatment, because the handful of committed, enthusiastic and professional surgeons doing this type of eye surgery in Niagara has been capped. They've been told effectively by this government that they can't take on any more patients-that's what it amounts to-even though the government promised in 1998 and exempted them from the billing cap but then immediately restored it.

The problem is that the Hamilton doctors doing the same surgery say: "We're already full to capacity. We're right at the limit. We can't take on these Niagara patients." So this government's abandonment of health care means that seniors in Niagara Centre and across regional Niagara, in every community of Niagara, are being denied medical treatment that used to be their right as Canadians under a publicly funded and publicly operated, non-profit health care system.

I'm eager to hear the Conservatives on the issue, for instance, of Ralph Klein's private, for-profit hospitals. Clearly the pattern is being set. Clearly these Conservatives have far more in common with Ralph Klein and his enthusiasm for privatized, for-profit health care than they do with any semblance of a commitment to ongoing publicly funded, not-for-profit health care.

Interjection.

Mr Kormos: You have. You've been undermining publicly funded health care to the point where you've created these huge vacuums in service to justify and argue and explain away the coming in-talk about cross-border shopping. They're lined up over there at the Peace Bridge and at the Rainbow Bridge, a mile long and three across, the American corporate, for-profit sector, ready to provide the health care that you people have destroyed here in Ontario.

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Mr Hastings: We don't have any lineups here in Ontario.

Mr Kormos: Well, they're there waiting, and once that American for-profit private sector is welcomed to Ontario by Mike Harris and his Conservatives, it won't be your OHIP card that you'll need to present when you attend for medical treatment; it'll be your gold card that you will need when you attend for medical treatment. Only the richest people will be able to access health care. It's only those people who will be able to afford the treatment, who will be able to take their kids, their parents, their spouses and other family members to the doctors, never mind to any sort of treatment regimen, surgery or hospitalization that's subsequently required.

I'm old enough to remember a time when we didn't have public health care. I'm old enough to remember the fight by Tommy Douglas and CCFers in Saskatchewan to build public health care. I remember what it was like for folks to have to sit around a kitchen table and debate whether you take a kid with a fever that's been there for three days to the doctor or keep that $10 in the drawer in the kitchen to pay your rent. I'm old enough to remember that, and a whole lot of Ontarians remember that too, because it wasn't that long ago. It's been in relatively short order that you Conservatives here in Ontario have been taking us back to that time. And, let me tell you, those weren't the good old days. Kids died, and people were crippled-

Mr Hastings: People don't die today.

Mr Kormos: My friend, a Conservative backbencher, talks about people not dying in Ontario today. Can I show you newspaper clippings to remind you of some in the recent past here in Ontario as ambulances are sent from one emergency room to another, to another? There weren't deaths? You're damned right there have been deaths. There certainly have been, because emergency room doors have been barred, bolted, locked, shut to the public, because those same hospitals have been defunded by this government, because this government is far more committed to tax breaks for its rich friends than to public, not-for-profit health care.

I agree with the Official Opposition observation that this government should be compelled to ensure that monies it receives from the federal government dedicated to health care remain spent in the area of health care. Just as this government demonstrated, or rather was exposed, earlier today-this government is prepared to reach into the pockets of women and kids under the family support plan and the Family Responsibility Office and gouge them, impose new taxes on them to the tune of $1 million a year, not to be applied to the Family Responsibility Office but to go into general revenues.

Families in Niagara understand what's happening to health care. They understand what your glitzy television ad campaign is all about. They're not at all happy with the Liberals for having cut transfer payments. The Liberal Party and its federal candidates will have to deal with that when the New Democrats confront them in the next federal election and challenge them on that issue. But you cannot fool them into thinking that somehow Mike Harris and his gang here have become champions of public health care, because they know what you've done to public health care. They know that you've pulled the rug out from under it, you've gutted the funding of it, you've shut down hospitals, you've fired nurses, you've left what nurses are left in our hospitals incredibly stressed and overworked and frustrated. You've put families in positions where, yes, they endure shorter and shorter hospital stays and then more and more incidences of post-operative infection and other diseases, which mean going back into the hospital. That's what has happened. That is happening to families in my communities, and that is happening to families in your communities if only you'd be candid about it, if only you'd be straightforward about it.

Ms Mushinski: They want to get out. Believe me-

Mr Kormos: Oh, believe me, I visit those people. I'm with those folks in the hospital, lying on gurneys in emergency rooms waiting to get into a room and then, in their hospital room, being told, "You're out." I'm with those people. If seniors don't have kids who are able to take care of them and take them into their home, they're in serious trouble, because your home care services are pathetically inadequate.

Every time there is a radio talk show about it or a television phone-in talk show and you people are on a panel, you are inundated with horror story after horror story of senior citizens or recuperating post-surgical patients who are put into a deteriorating condition because of your failure to provide adequate levels of home care, or indeed even more desperate positions where they are forced into institutionalization where they're denied the independence of living in their own home.

Audiologists: You continue to play games with audiologists in the province. You continue to force them to play a little bit of sleight of hand, where rather than treating people directly in a huge demand for their services with an aging population and among the youngest people in our communities, you remain thoroughly unresponsive to audiologists and their request to participate actively and in a far more efficient and cost-effective way in the health care system.

I'm not about to let the Liberals off the hook and neither are the folks of Niagara Centre. But, by God, I'm not about to let you guys off the hook either. Let me tell you, my friends, this is the pot calling the kettle black. You guys are but co-conspirators of the Chrétien Liberals and their slashes to health care. In fact you guys are the originators and the authors of the sorts of policies of lower taxes for the rich and less money for education and health care. Pay for lower taxes by gutting health care. That's what this government is all about. The people of Niagara Centre understand that fully. They understand it well, and they don't it like it a bit.

The Speaker (Hon Gary Carr): Further debate?

Mr John O'Toole (Durham): It's my privilege to move adjournment of the debate.

The Speaker: Is it the pleasure of the House that the motion carry? Carried.

[...]

=============================================================

Hansard, April 8, 2000

[...]

ORDERS OF THE DAY

HEALTH CARE FUNDING

Resuming the debate adjourned on April 6, 2000, on the amendment to the amendment to the motion by Mr Harris relating to health care funding.

Mr John O'Toole (Durham): It's my pleasure to rise and address this very important issue facing Ontario but indeed all Canadians, I might say. I could preface this by saying it's really an issue of fair share. I think if I look at the current information that is before us in the press, in the media, we've certainly got the attention of the people of Ontario.

Here on the public record I want to thank our Premier, Mike Harris, for taking the lead on this very important initiative on behalf of all Canadians. I believe the federal government for too long has been getting off the hook, avoiding its ultimate responsibility of providing its full support; that is, 50% on every health care dollar was initially supposed to come from the federal government. To bring everyone up to date, and I'm sure we'll hear this repeated many times during the debate-by the way, Mr Speaker, I would say that the other speaker sharing my time will be Mr Hastings from Etobicoke North.

The debate really does come down, unfortunately, to providing the right level of service, which of course means money, for the people of Ontario. Not just the people of Ontario-I think we should get on the record right from the beginning that this is about all Canadians. Ontario has always been a leader, not just in health care but of course in many areas.

We were elected in 1995. At that time our health care funding was $17.4 billion. The election of 1995 was clearly an election where the issue of health care was front and centre. I know the current opposition party at the time committed to spend something under $17 billion. In fact, our commitment was to maintain health care funding at $17.4 billion. What has happened, because of demands and of course the reductions in transfer payments from the federal government, which is really the nub of the story here, is that we've had to increase the spending.

For the record-it will be repeated-I can tell you that we increased funding to $20.8 billion in 1999-2000. So you can see it has gone from $17.4 billion to $20.8 billion, a significant increase. In contrast, I might add, in 1999-2000 Ontario will receive $1.7 billion less from Ottawa under the Canadian health and social transfer payments than the province received since the beginning in 1994-95.

I'm just looking at a Toronto Star article dated April 8. The title of that article-not normally known for complimenting this government, the Toronto Star, but nonetheless it does report what is news. The top headline here is, "11¢ or 34¢: What is Ottawa's Health Payout?" The article goes on to say that the transfer to Ontario is spent on other areas. It goes on to say that it's spent on allocation for post-secondary or higher education and social programs, as it should be. You can see that the province of Ontario has tried to invest enormous amounts in post-secondary education to have the spaces available for students of the future. There's a very high demand. I think we have the highest percentage of post-secondary participation of all the provinces, so that of course takes additional dollars. I would argue that if we looked into the numbers, we'd find even there reduced dollars from the federal government. I suspect that if you looked at their recent millennium scholarship fund, there's a case in point, where many students who felt they were getting additional funding indeed at the end of the day found they weren't.

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Leading the battle in health care reform, what I have argued is that there has to be more clarity and more commitment to the funding. That's first and foremost. Going back to the original agreement on Canada's health care system, I think it was founded on a shared principle. Under the Canada Health Act, I would think there's the responsibility of the federal government which outlines those services that are required to be provided by the provinces. I certainly endorse that. I don't have a problem at all with the federal government's lead role there for all Canadians, whether they're in Prince Edward Island or in BC. Setting standards and maintaining at least minimum standards is absolutely critical, because we've defined ourselves by our health care system.

Again, it's not just money. It's providing the right services, whether it's in remote areas of Ontario or remote areas of Canada, and making sure that we have solved the issues of doctor distribution and access to a higher order of services, whether it's MRI-I might just say that Ontario has excelled in the expansion of access to magnetic resonance imaging, which is the latest technology in diagnostic medicine. I think Ontario has more MRI machines per population than any other province in Canada. Having those kinds of equipment and technology available to people is absolutely critical.

You should know that I have to compliment the previous government, because when we were elected it had already begun restructuring health care. Under Frances Lankin, who I believe was the health minister at the time, they started the restructuring of health care. In our area at that time I was a regional councillor, and the district health councils reported the acute care study. In the acute care study they agreed that we had to restructure the delivery of health care, ie, hospitals. Some later speakers may get up and criticize the government for the way it approached that, but nonetheless we were getting on with the job.

In that restructuring plan, at about the same time, we announced in excess of $1 billion for 20,000 additional long-term-care beds. Those long-term-care beds were part of the new delivery model which was taking long-term and chronic care out of the hospital setting and into the community setting. Adjacent and complementary to that, you would know that we also took new initiatives to set up 43 community care access centres, CCACs. In Durham it's called Durham Access to Care. That was expanding the level and delivery of health care in the community. These are home supports where people will not any longer recuperate in a hospital setting, where it's very expensive and people are perhaps exposed to high virus risks etc. People have told us repeatedly that they're more comfortable and recover quicker in their own homes. So those two fundamental changes of providing an increased number of long-term and community beds as well as providing community care, which is home supports, were absolutely part of the whole restructuring of delivery of health care.

I believe the work of Dr Wendy Graham with respect to primary care reform was also a very important initiative taken on by the government. As we know-we've heard that question in the House-there are seven or eight pilot activities across the province to provide support.

Another thing is the expansion into using the nurse practitioner. I can tell you, I've been very supportive of individual nurse practitioners in my riding and indeed practices in my riding who wanted to use the services of the nurse practitioner.

I believe the issue here today is that there are reforms required in health care. Ontario is moving forward, as it should. I challenge the federal government to be there as an equal partner, whether it's in home care, hospital budgets or physician services budgets, or in the expanding and ever-increasing role of prescription medicine, which in the future will outstrip any ability to pay, I believe.

With that, I would like to share my time with the member for Etobicoke North, Mr Hastings.

Mr John Hastings (Etobicoke North): I'd like to continue this story of reform that the Ontario government initiated some five years ago, to contrast actual reforms that have produced effective results with the federal government's approach, which is to really just talk about reforms but not deliver.

If you take, for example, the whole area of pharmacare or the example of home care, we have heard from the current Minister of Health in Ottawa, Minister Rock, that he would like to do something about this: bring in home care, bring in pharmacare. That was some two and a half years ago, when he was appointed minister, but where are the practical results today? Hardly anything. If you look at his current position, when he presided over the meeting of the health ministers of Canada in Markham recently, again he reiterated that we needed to work together, that we needed new reforms. But did we have any specifics? None whatsoever. You would think that under his leadership we would have had some specific proposals brought forth, particularly in home care, which is one of the areas he likes to talk about so much. He has a new Canadian Institute for Health Information; he has the Canada Foundation for Innovation. Have we seen any monies put into these areas to help him along? Not at all.

Contrast that with what the government of Ontario has done under our current Premier. We have introduced some 43 community care access centres and brought about some fairly effective home care for those folks who can't stay in hospital as long as they would like to because of new drugs, new therapies, new technologies. I can recall that back in the late 1980s, early 1990s in Etobicoke North, there was hardly anything called home care-people were practically on their own-and when money was allocated for this particular activity, this very vital service, most of the money went to the old city of Toronto. In fact, we are still looking for some $800,000 that was allocated to Etobicoke back in 1994-95; we haven't seen it yet.

It's the same with pharmacare. We have one of the most effective drug plans-Trillium-that you can find across Canada. The modest user fee is approximately $100, compared with some other provinces, especially Saskatchewan, which is going to be nearly $1,700. It's quite a contrast when you compare that with Saskatchewan, a province which was the original home of medicare.

I think the Premier is right in initiating this discussion and forcing the federal government to come back to the table with the money of which it has deprived Ontario since 1995, some $4.2 billion. It's not just a matter of reform, it's a matter of money, and if you don't have the money, which is rightfully ours because it came from the taxpayers of this province-and that's what the federal government has to do first: pony up the $4.2 billion, instead of pretending to talk about health reforms.

The current federal health minister likes to talk about Ottawa being an equal player in this field; it is hardly a 10-and-a-half-cent player, let alone a 50% player, which was the original design of the whole medicare arrangement. We don't have that presence today of the federal government, yet it wants to insist under the Canada Health Act that it will be the standard player in designing the real innovations, the real reforms that the provinces have initiated, whether it be home care in Manitoba or many of the pilot projects initiated in Ontario: primary care reform, new investments in dialysis equipment, the community care access that I was talking about, and particularly the hospital realignment.

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In our own community we have managed, through the effective leadership of president Leo Stevens, to bring about three hospitals under the William Osler Health Centre: originally Peel Memorial, Georgetown public hospital and the Etobicoke General Hospital. These three organizations had large bureaucracies; now they have one slimmed-down administrative arrangement. Where did that money in savings go? Right back into front-line patient services.

That's something we're constantly criticized for by the parties opposite, but when it comes to the real reforms, we don't see them joining with us to demand that the federal government restore the $4.2 billion that Ontario and its taxpayers rightfully deserve so that we can put it into health care spending that will produce effective and positive results in a whole set of areas.

I must point out that we have heard from members opposite, particularly members of the opposition party, perpetuating the myth that they brought about some fantastic health care reforms in the 1980s. Let's revisit for a moment what the Peterson government did manage to establish.

Back in 1985-86 we had a massive doctor walkout thanks to the so-called innovations of the health minister of that day. They were out for a good length of time and that brought considerable anxiety to people who were looking for medical services that were of quality, that were effective and brought results in restoring their health. Those doctors went out because of very serious concerns, but the health minister of that day trumpeted it as an innovation. I don't know how you can end up with an innovation when you have doctors walking out, who are key players in the delivery of health services.

Another innovation they brought along later, about 1989, was the job-killing employer health tax levy. That certainly brought about a tremendous reform in health care under their administration.

If they had followed through on some of the things they were talking about, we would be a long way down the road to the reform that we had to initiate in 1995.

So for the record, let us be very clear that when it comes to the implementation of reforms instead of imposing new restrictions, don't look to Ottawa in terms of pioneering innovation. If you look to Ottawa, all you'll get, forever and a day, are the placebos out of the Canada Health Act, which, incidentally, was not motivated and introduced for bringing in quality health care or making quality health care affordable, universal or portable. If you go back and look at the debates of those days, it really had to do with cost containment. Back in 1977 the cost of health care started to rise enormously. That's when the feds got anxious, got scared, and they started to jump ship on their full-scale commitment to health care, to medicare in this province.

Not only is it the $4.2 billion they need to pony up before they become full players again, but they have a long way to go in becoming 50-50 partners in health care in this country. It seems to me their leadership is lacking, their innovation is nearly non-existent and their proposals for reform in terms of the changing needs and changing demographics of people, not only in Ontario but across this country, are severely wanting.

Let me conclude by saying that we need a federal government that gets back as a full player in health care, because right now, all they are doing is talking about reforms but they never really get down to the specifics. They need to bring back the $4.2 billion which they took out of this province, instead of reducing their own internal administrative expenses back in the mid-1990s, when Mr Martin had his war on the deficit. They need to refocus a lot of the money they're putting into things like the questionable millennium expenditures over the last six or eight months. They need to re-examine all the billions they're pouring into the black hole known as Human Resources Development Canada, the Export Development Corp owing nearly $22 billion, folks, and other like-minded questionable expenditures; get back to the core functions of government, like we have for the last five years: quality health care and effective education, instead of handing out cheques before people can pony up to the trough. If they don't do that, they really are not going to be an effective player at the table.

Finally, you can't trust either the provincial Grits or the federal Grits when it comes to the administration in the future-

The Acting Speaker (Mr Ted Arnott): Further debate?

Mr John Gerretsen (Kingston and the Islands): Let me just pick up on the last point that was made by the member. If there's one thing that the people of Ontario are absolutely united behind, it's the notion that you cannot trust the Tories with health care. It's a known fact. It's the Tories throughout this country who are talking about privatization of our system, the Americanization of our system. It's out there, and for him to even suggest that the Liberal Party, which throughout the last 40 years has been the chief advocate of a universal health care system for this country-that simply would not be telling it like it is. This member knows that.

You know, it's kind of interesting: I look at the resolution that the member for Waterloo-Wellington has brought forward. That's going to be debated this Thursday. Let's just read what he says about this whole situation. He wants this passed this Thursday, and I agree with him. He states:

" That, in the opinion of this House, the government of Canada should take immediate action to fully restore the Canada health and social transfer to 1994-95 levels, and work to establish a fair funding approach which ensures that these cash transfers increase to keep pace with future cost pressures faced by provincial governments in their delivery of health services."

I totally agree with that.

Now let's look at the tone of the resolution that the Premier has brought forward. He says:

" That the Legislative Assembly of the province of Ontario,

" Condemns the government of Canada for cutting ... the base payments under the federal program;

" Urges the government of Canada to repudiate the statement attributed to" some spokesman. The resolution further "reminds the federal Minister of Health ... that the sincerity of his commitment to medicare" is in question, etc.

The people of Ontario and the people of Canada quite frankly aren't interested in the blame politics that are clearly evident in the resolution as put forward. They want solutions to this problem. There is no question in my mind that over the last four to five years the central issue that people talk about more than any other is the declining quality of their health care system here in Ontario. You can blame the province, you can blame the feds, you can just keep on blaming everybody if you want, but the bottom line is this: The quality of our health care system is declining, and the people of Ontario quite frankly aren't interested in who to blame on the issue. They want to see results and they want to see action.

It's very interesting, you know, that the same Michael Harris who has proposed this resolution-let's just hear what he said on October 21, 1996, about the federal transfer payments. I'm quoting directly from Hansard:

" I could do as you used to do in government: blame it on the federal government and their cutbacks and the transfers and the layoffs, but I won't do that, because we've actually been supportive of the federal government trying to get its house in order and reducing the number of people it employs as well."

That was the Premier back in October 1996. He didn't want to throw blame on the federal government. He wanted them to get their house in order. We all remember that when the Liberals took over in Ottawa in 1993 the annual deficit that we were incurring in this country was at the rate of $42 billion per year. There was an overall recognition by everyone that something had to be done, in the same way that something had to be done with respect to the $11 billion that we had as a provincial deficit left by the New Democratic government back in 1994-95. No question about that.

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Now, what did Harris say on June 19, 1996, exactly the same year? He went even one step further. He said: "We support the federal government balancing its books, getting its affairs in order. We even support them reducing the transfers to the provinces...." That's what he said then. I assume he meant it. What's he saying now?

Let me make it absolutely clear that I, as does the member from Waterloo-Wellington, agree that both levels of government have to come to the table. Our publicly funded and accessible health care system is truly at risk and at stake. I'm sure that each and every one of us has heard horror stories in our own constituency office of people who are on waiting lists for six months, nine months, over a year, before they can see a doctor or get the necessary surgical procedure done in the hospital or get hospital care.

You can just go on and on. We've heard these stories and quite often we are powerless to do anything about it. We've even heard of situations where, as the Provincial Auditor, an independent agency of this Legislative Assembly, clearly pointed out in his audit report last November, only 32%-that's less than one in three-of those individuals who have been diagnosed with cancer are getting radiation treatment within the prescribed period of time, which is usually four weeks. That is a stunning indictment on our system.

I could go on and on and mention all sorts of horrible things that are happening out there. How about the critical bypass situation here in Toronto and elsewhere as well, where basically ambulances have to scurry from one hospital to another because emergency rooms are full, and in the meantime precious time is being lost and the person who needs the immediate medical attention isn't getting it.

We've all heard those kinds of stories. Now, what do we do about it? That's the real question. Spreading blame from one level of government to another level of government, particularly by a government that at one time was fully supportive of the federal government doing what it had to do as far as the cuts in transfer payments are concerned, isn't getting us anywhere.

Even when the transfer payments were cut by the federal government-and we all know it happened, back in 1995, 1996 and 1997-this government had a clear-cut choice. It could do away with its tax cuts and say: "Look, the financial scene has changed. We are not getting as much money from the federal government as we used to in the health care portfolio. The rules of the game have changed, but we believe in a truly quality, publicly funded health care system, and so we're not going to give tax cuts. We are going to put that money that we're not getting from the federal government into the much-needed health care system."

Why didn't they do that if they felt that strongly about it? If they felt that strongly about it and if that money was really required for our health care system, which it was at the time, why didn't they forget about the tax cut and put it into the health care system?

Mr Frank Mazzilli (London-Fanshawe): The Liberals have forgotten about the tax cuts.

Mr Gerretsen: The member says Liberals forgot about tax cuts. As far as I'm concerned, sir, and as far as my caucus is concerned, the most important thing is to make sure that there's adequate funding for our publicly supported health care and education system. Then we can talk about tax cuts, and what's probably even more important, we could start talking about paying down some of the public debt that we have.

I always find it ironic-and all of my business friends in Kingston whom I speak to from time to time, even they can't understand it-how we were able to get tax cuts for the last three or fours years when in effect we were still running a deficit on an annual basis. As a matter of fact, this province went into debt by a further $25 billion between the time the NDP government was finished back in 1995, and they had accumulated a debt of some $88 billion, to right about now, when the public debt of this province is over $115 billion. The other statistic that comes out of that, which I always find fascinating and which most people are completely disbelieving of, is the fact that even in these days of low interest rates we spend more on paying interest on the public debt on an annual basis than we do for all the social services of this province. Most people don't believe it or they find that a very hard statistic to understand. We've spent $9.1 billion annually on interest on the public debt and, according to the government's own last budget, something like $7.9 billion for social services.

But getting back to the medical field, the government likes to talk about how it has improved the situation. When waiting lists have increased, when emergency bypasses that we've heard about in the Toronto area have increased, when there haven't been any long-term-care beds built as yet, or they aren't available as yet-I know the government has promised to add something like 18,000 new beds, but as far as I know, not one single bed has so far been added to the system-when, in effect, 45 hospitals have been ordered closed in this province, I don't know how our health care system has improved. It hasn't improved. Even Duncan Sinclair, a man whom I've got great admiration for, a former neighbour of mine, a hard-working individual-remember he was the individual who headed up the health care restructuring commission-admits that the whole premise of hospital restructuring and hospital closing was based on the fact that the community care facilities and services would be out there before these closures would take place.

I don't have any problem with the notion that whereas at one time people may have spent seven days, 14 days, 21 days in a hospital for a particular procedure, if they can be discharged to their homes earlier in a safe and competent way and be looked after properly, that we do it that way. I can remember being in the hospital some 40 years ago with an appendix operation. I was there for 17 days. Now it's a day or two or three and you're home, and that's fine. But it's based on one principle, and that is that once those people go home, there are necessary community care services available for them. Many elderly people get discharged on a daily basis. I heard a story over the weekend. This person, who has been somewhat sympathetic to the government from time to time, couldn't believe that her husband was being discharged when really she was not able to take care of him at home and there were no services available for this individual.

The point I'm trying to make is that there is nothing wrong with home care, there's nothing wrong with nursing care, but it has to be there for the people before they are discharged from hospitals. As a matter of fact, I would go even one step further. In the new sets of discussions and negotiations that undoubtedly are going to take place between the provincial governments and the federal government, we're going to have to start taking a look at mandated home care nursing services. If that is the wave of the future, then we'd better make sure those services are available. They may very well have to be made available under the Canada Health Act. Those are some of the new innovations we should be looking at.

Our party and our leader, Dalton McGuinty, have made a commitment that the system we are striving towards is that anyone who needs medical care will get it 24 hours a day, seven days a week. How anybody could disagree with that is beyond me.

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Surely if there's one area in which we are totally different from the Americans, it's our belief in our health care system and that everyone should be entitled to the best quality of health care that's available, regardless of how much money you have in your pockets. That is something that we in this country have believed in for the last 40 or 50 years, started initially by Tommy Douglas-give him full credit for it-and implemented by Mike Pearson and Paul Martin Sr many years ago.

Anything that takes away from that takes away from all of us. It takes away from our quality of life, and let's remember that as far as the United Nations is concerned, we have the best quality of life of any country in the world and our good-quality health care services, publicly funded health care services, completely totally accessible health care services form an integral part of that.

Rather than passing blame off from one level of government to the other, why don't we work together, particularly now that all governments across this province and across this country and all provinces pretty much have beaten the annual deficits. It's kind of interesting, as we're probably the last province to do that, and if you hadn't had your cuts for the last three or four years, in effect we would have been able to balance our budget some time ago. But the point is that we're now in a position to do something with the so-called fiscal dividend or with the excess money.

Mr Mazzilli: What about the federal fiscal dividend?

Mr Gerretsen: I grant you, sir, that the federal government will have to come to the table and all the provinces will have to come to the table as well.

Interjection.

Mr Gerretsen: I look forward to the gentleman's comments a little bit later on.

The other thing that's very interesting is something that really hasn't been talked about all that much, although I noticed that one day our Deputy Premier, the Finance Minister, got very upset about this. You may recall that last year, $1.3 billion of extra money was made available by the federal government to the provinces for health care. I understand that $755 million or almost half of that money hasn't been expended into the health care system. It's been sitting in the bank gathering interest. What I can't understand is, if this government really needs the money to make our health care system the best in the world, then why the heck isn't it spending that money? Why is it banking that money?

Hon Chris Stockwell (Minister of Labour): Where? Chase Manhattan? Get a grip.

Mr Gerretsen: I've got a grip, all right, sir.

All you have to do-in the last two and a half minutes that I have left-is look at the tremendous chaos that you have created in the health care system in my own community of Kingston. The Health Services Restructuring Commission came in there and basically closed the hospital. It did even worse than that: It basically said to the other hospital, namely the Kingston General Hospital, "You can take over the Hotel Dieu Hospital and run your programs out of there," and that should have happened according to the health care restructuring order, I believe, some time late last year. It basically told a religious order that has been operating a hospital there for over 150 years that their services were no longer required, thank you very much. "Now the other hospital can now come in and run their programs out of your facility."

You can well imagine that for the people of my area, who have always had excellent care at both facilities, this was quite a shock. Petitions were taken up, signed by some 70,000 people. As a matter of fact, the matter went all the way to the Supreme Court. The Supreme Court ultimately ruled that the province could do what it wanted in that regard.

What happened of course ultimately was that the Premier came to town about three weeks ago for a fundraiser, and he was asked, "Why aren't you allowing the sisters to continue to run the Hotel Dieu Hospital, and keep their governance and keep their management of their facility?" The Premier said: "Oh, is that what you wanted? Yes, it's done." All of a sudden, on April 5, a letter went out from the Minister of Health to the board of directors that, first of all, says the sisters are allowed to continue to govern and manage the programs at the Hotel Dieu site until a new ambulatory outpatient facility is built. Sure, they're happy, but why did you cause this chaos for two years?

You did it once before with the ferry system, you may recall, where you were going to cut off their funding and these people would have had to raise the taxes on the two islands lying just outside of Kingston by something like 800% to 900%. Then all of a sudden the province came along and said: "Well, I guess we didn't mean it. We're going to fund you again."

Governing shouldn't be about threatening people. It shouldn't be about intimidating people. It should be about governing in the best interests of all of the people. That's one aspect that this government has forgotten. I implore them to get together with the feds, and let's get the best quality health care system we can in this province.

Mr Gilles Bisson (Timmins-James Bay): On a point of order, Mr Speaker: I have here some notes that I think would be important to bring to the attention of the Legislature.

The Acting Speaker (Mr Brian Coburn): That's not a point of order.

The member for Thornhill.

Mrs Tina R. Molinari (Thornhill): It's a pleasure today to speak on the Premier's resolution that "condemns the government of Canada for cutting, by $4.2 billion annually, base payments under the federal program that supports health care, the CHST, while provincial governments have increased health spending." I will be sharing my time with my colleague and seatmate, the member from London-Fanshawe.

Since 1994-95, the federal government has cut $4.2 billion from health care transfer payments. Over the same period, Ontario has increased spending on health care over $3 billion. The 2000 budget was a big disappointment. The federal government failed to live up to its commitment to Ontarians. Once again the federal government has failed to recognize the needs of the growing and aging population in Ontario; $2.5 billion in one-time funding is clearly not enough.

I want to bring to the attention of the House the Economic Update. It's a special Budget 2000 edition that was put out by Maurizio Bevilacqua, MP, who is the chairman of the standing committee on finance. Under "Budget 2000 Priorities" it says: "Announces the fourth consecutive federal enrichment of the Canada Health and Social Transfer to help provinces and territories meet what Canadians have identified as their highest priorities: health care and higher education."

It goes on to say, under "Canada Health and Social Transfer," that "starting in 2000-01, CHST cash will reach $15.5 billion, almost 25% higher than in 1998-99." The reality is that it is still $4.2 billion less than it was in 1994-95.

Ontario has increased spending on health care by over $3 billion. The only government that has cut funding for health care is the federal Liberals.

I turn in the same flyer to "Sound Financial Management," and I quote: "Total program spending in the coming year will be $4 billion below the 1993-94 level." I wonder where that money is coming from.

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I also want to bring to your attention Budget 2000: Making Canada's Economy More Innovative. It's the Caplan report that was put out on a funding/budget town hall meeting. It goes on to talk about research and development, environmental technologies and sustainable practices, infrastructure-

Hon Mr Stockwell: Which Caplan?

Mrs Molinari: Elinor Caplan, the MP for Thornhill.

But any mention of health care funding and health and social transfer payments is suspiciously absent from this flyer. Coming from a previous health minister, it's truly a disgrace.

Where are the provincial Liberals and where do they stand on health care? I would like to quote the Globe and Mail, April 4, where McGuinty says, "If we don't modernize medicare we are going to lose medicare." He goes on to say, "I want a system where your doctor is part of a team of doctors, nurse practitioners and nurses, one of whom will always be available to you." In the same article, "Mr McGuinty later told reporters that he would not force the system of rostering and 24-hour care on doctors." He's quoted as saying, "I am convinced that if we make it a priority, people will want to work together on this." On one hand, he says he wants a system that will always be available; on the other hand, he says he will not force the 24-hour care for doctors.

I also want to quote a letter that was in this weekend's Toronto Star, Sunday, April 9. It's titled, "McGuinty Not Up To Job." I will read the letter.

" I find it laughable for Dalton McGuinty to accuse Premier Mike Harris of `not being on the job' (March 31). McGuinty's one to talk.

" When the federal Liberals held their policy convention in February, the Ontario Liberal leader was nowhere to be found. In the weeks before that convention, Mike Harris and NDP Leader Howard Hampton signed a joint letter calling on the federal Liberals to increase health care spending.

" What did McGuinty do? He refused to stand up for Ontarians, he refused to call upon his federal cousins to reverse their health care spending cuts.

" Never mind not being on the job, when it comes to important issues like health care, McGuinty is not up to the job."

Mr Gerretsen: Who wrote that letter?

Mrs Molinari: The letter is written by Reg Jerome and it's to the Toronto Star.

Since 1995, our government has been expanding health care services to bring them closer to home for the people across Ontario. Because we restructured the hospital system, we have been able to make major reinvestments in our hospital facilities and in long-term care. There is $1.2 billion of hospital construction underway, and we plan to spend another $2 billion to continue improving and enhancing hospital services.

Thornhill is located in York region. It's in the southern part of York region. We are served by three main hospitals: York Central Hospital, Markham-Stouffville, and the York County Hospital.

In the southern corner of the York Central Hospital campus, something almost unprecedented in Ontario's health care system is happening. A new, 240-bed continuing care, long-term facility is being built for the people of southern York region. The people of Thornhill are very happy that we're recognizing the services where they're needed and putting them in place. The $25-million expansion, along with the growth recommended for York Central Hospital by the Health Services Restructuring Commission, will double the hospital's size and budget. Expansion will also occur in other areas, such as the emergency department, critical care and obstetrics. Frank Lussing, the CEO, believes that the expansion will ultimately translate into a higher level of care for patients.

The new continuing care centre of 158,000 square feet features 100 nursing home beds, plus capacity to increase to 116; 90 chronic care beds; 32 rehabilitation beds; rehabilitation facilities; an adult day program for people with cognitive impairments, brain injuries and physical disabilities; and a community and hospital child care centre for 50 children.

The riding of Thornhill has benefited directly in addition to the 100 beds at York Central Hospital. The Baycrest Centre for Geriatric Care received a contract to build and operate a new 120-bed nursing home also servicing the Thornhill community. York region, as of the end of 1999, received $192 million in increased health care funding since this government took office in 1995.

Our local paper, The Liberal, had a headline, "$20 Million Invested in Child Mental Health." I want to congratulate the minister responsible for children, Margaret Marland, on the announcement recently of the investment of $20 million that creates a four-point plan to improve children's mental health services. The four-point plan includes $11.9 million for intensive child and family intervention services provided in homes, schools and communities; $5.5 million for new mobile crisis response teams to respond to children and families in acute crisis when and where needed; $400,000 for telepsychiatry access to highly specialized psychiatric services for children in 10 rural and remote communities; and $2.2 million to serve more families and better identify and respond to increased service needs. This includes the use of province-wide intake instruments to help identify children who need immediate service, an assessment outcome instrument to assess an individual situation and monitor the effectiveness of treatment, and the introduction of a children's mental health information system.

The funding for telepsychiatry would allow physicians such as York County's Dr Leonora Pinhas, who helps treat teens with eating disorders, to lend their expertise to smaller hospitals without having to travel outside the community. The Health Services Restructuring Commission recommended that York County be funded to offer in-patient beds for mentally ill youth and was designated as the regional hospital responsible for child and adolescent mental health.

As the minister has stated several times, 50% of our health care resources is spent on 12.6% of our population-people over the age of 65. In just 10 years, the first of our baby boomers will reach 65, so we have to plan now and make sure that the health care system is prepared to meet the increased demand for health care services like long-term care.

All the provincial governments have been reforming health care for years while the federal government is still just talking about it. In 1996 the government began working with the Ontario Medical Association on new ways to provide patients with 24-hour, seven-day access to family doctors and other practitioners. Through our partnership in health care reform, over 200 doctors in seven communities across the province will offer 24-hour health care to more than 375,000 patients to make sure they have access to the best possible health care.

I want to focus on another article in the Toronto Star, where the headline is "11¢ or 34¢: What is Ottawa's Health Payout?" We are talking about actual, permanent health care dollars for Ontarians, not some intangible benefit that was provided decades ago and has long since been reclaimed. The math is very simple: Ontario is spending $20.8 billion, operating and capital, on health care in 2000-01. Federal health care dollars in Ontario, on the other hand, total $2.3 billion. You do the math. That equals 11 cents of every health care dollar in Ontario. We demand that the federal government recognize and go back to the 50-50 that was originally planned and take an interest in all of the provinces' needs for more health care dollars.

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Mr Mazzilli: I'm pleased to join in this debate, and I want to thank everybody on this side of the House for sharing their time with me. I know this is an important part of what they believe in, and everyone wants an opportunity to speak in this debate. In my community of London we have the London Health Sciences Centre, which is a world-known health facility, and this is an important issue for them as well as for the St Joseph's Health Centre.

Let's focus on what this resolution says. Be it resolved that the Legislative Assembly of the province of Ontario:

" (a) Condemns the government of Canada for cutting, by $4.2 billion annually, base payments under the federal program that supports health care, the CHST, while provincial governments have increased health spending;

" (b) Urges the government of Canada to" withdraw "the statement attributed to a spokesperson for the federal finance minister, the Honourable Paul Martin, that increasing health funding would be `just shovelling money into a hole that's going to open right back up again';

" (c) Urges the government of Canada immediately to restore permanently the health funding that it has cut and to assume its fair share of increased, ongoing funding to meet the health needs of our country's aging and growing population;

" (d) Reminds the federal Minister of Health, the Honourable Allan Rock, that the sincerity of his commitment to medicare and the principles of the Canada Health Act would be best demonstrated not by idle rhetoric and vague words but by restoring the health funding he has" slashed.

Ontario has received no answer from the Prime Minister, who has refused to meet with the premiers over this issue. It's an important issue because, in order for us to sustain a health care system in our province, the federal Liberals must restore the $4.2 billion they have slashed.

Ontario is the leader in health care. We have increased funding from $17.4 billion in 1995-96 to $20.8 billion in 1999-2000. In contrast, Ontario will receive $1.7 billion less from Ottawa, or from the federal Liberals, under the CHST than it received in 1994-95. I guess that's the thanks Ontario gets, the thanks Ontario workers get for creating a vibrant economy that has filled the federal Liberals' coffers in Ottawa. They have surpluses at this stage.

This is about priorities. The Mike Harris tax cuts have not only eliminated the provincial deficit once and for all, which needed to be done, but it has also eliminated the federal deficit once and for all, bringing the federal Liberals into a surplus. So what did Ontario do? What did the leadership of Mike Harris do with this growing economy? It invested it in health care by increasing the funding. What did the federal Liberals invest in? Let me tell you what they invested in: $3 billion in HRDC grants-allegedly, for about $1 billion there is no paperwork to be found for where this money went.

Who benefited from that $3 billion? Certainly not real Ontarians. In some cases, we've heard that some multinational companies received millions of dollars in grants, while Ontario taxpayers, real Ontarians with real needs, have received nothing from the federal Liberals.

It's interesting that the member from Kingston talks about tax cuts not being important, because we now know what the Liberal position really is. Tax cuts are not an option-

Mr Gerretsen: On a point of order, Mr Speaker: The member should not state something in the House that I didn't say. He should stick to the truth at all times.

Mr Mazzilli: It's interesting that the Liberals don't want to take a position. On one hand, when they enter the debate they say, "You shouldn't cut taxes." Then, when you say they said that, of course they deny it. There's no leadership on that side of the House. Dalton McGuinty clearly is not up to the job.

The Mike Harris government will continue to cut taxes, which will continue, at this point, till the deficit is eliminated, create a surplus, pay down the debt and reinvest in health care. But while we're doing that, the federal government is reaping the benefits of approximately one third of Canada's population being in Ontario, the growing economy. They have filled their pockets on the backs of Ontario workers, on the backs of Ontario small business people.

And through this, what do they do with it? Where are their priorities? Well, in the Prime Minister's riding, of course. We hear about it; most of us have not seen it because real Ontarians are going to work every day, paying their taxes. In the Prime Minister's riding, with taxpayer-funded money, they're building fountains. That is clearly not a priority for real Ontarians. We will continue, on this side of the House, to make real changes that benefit real people.

At this point in time, the only ones who see fit for this resolution not to pass are Dalton McGuinty and the Liberals. With the NDP, Howard Hampton has clearly demonstrated leadership. He has seen that the NDP and its supporters believe that Ottawa is shortchanging Ontario workers, and fully supports this resolution. Again, the NDP and the Conservative government will continue to support real changes that benefit real people, and the Liberals clearly are not up to the job.

Mr Sean G. Conway (Renfrew-Nipissing-Pembroke): I am pleased this afternoon to have an opportunity on behalf of my constituents to address the health care debate, which is, as I think all members understand from talking to their constituents-and I suspect not just in Ontario but in Alberta and New Brunswick-the pre-eminent concern of citizens, regardless of where they live in Canada.

I want to begin my remarks today by asking members, if they didn't hear this broadcast, to see if they can access the tape. I think it was last Tuesday that CBC Radio ran a radio commentary slot at 8:15 in the morning from a woman in a hospital bed in Ottawa, a woman, as I recall, who was seriously ill and who was speaking, from the perspective of a citizen in need of help and hospital services, about the current health care debate and addressing her remarks to the community at large. I must say I found that commentary a powerful and an arresting one. As I've listened to this debate today and last week, I wonder what that woman in Ottawa would think of all of us as to the kind of debate that's going on here and elsewhere.

At the risk of being a little censorious, let me say that if I were in a hospital bed and I was listening to this debate, I'm not so sure that I would feel particularly confident about the ability of the political class in 2000 to solve my problem.

I just simply want to make the point that if you didn't hear that broadcast, it might be a useful thing for honourable members, seized of their political instincts, to go back and ask CBC to rebroadcast for your edification that two- or three-minute testimonial from that woman at the Ottawa hospital.

I can tell you that as I travel around my constituency in eastern Ontario, whether it's in a larger town or city like Pembroke, or in rural communities like Douglas and Westmeath or the research community up at Chalk River, Deep River, everywhere I go people tell me of their concern and their increasing upset about what is happening or not happening to their local hospital, to their health service and to, quite frankly-how shall I say this politely?-just a general frustration that the politicians of whatever stripe just don't seem to get it.

I think, and I can say this because I've been around here I guess longer than any of the rest of you, that we're playing with fire, all of us, if we think we can glide through this with just some kind of a trite, predictable political response. Are there problems? Yes. Is there blame to go around? Absolutely. There's not a provincial government, whether it's Tory, Liberal, Social Credit, New Democrat, nor is there a federal government that does not have blame to accept. Are there opportunities? Absolutely. I would hope that it is within the interests and the power of my generation to amend and to adjust a plan that was developed by my parents' generation, a public health plan that more and more Canadians feel is a fundamental part of their Canadian entitlement and citizenship.

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You know, it's interesting to me, as I listen to the debate these days, where it came from. This hospital and medical plan of ours is one of the crowning achievements of the generation of the Great Depression and the war. People of my parents' generation went through a great deal of deprivation and loss, and one of the decisions I think they made collectively was that they were going to provide for their children a better life than they had had themselves. They hadn't fought and died in western Europe and in Asia to return to the society of the 1920s and 1930s. They wanted something better. When the Parliament of Canada enacted, in 1957, the Hospital Insurance Act, and when it enacted a decade later the Medical Care Act, it enacted two pieces of legislation that enjoyed broad-based support in the community. The last thing the St Laurent government did before it went to the polls in an election that it lost in the summer of 1957 was to proclaim the Hospital Insurance Act of 1957. The Diefenbaker government which took office a few months later did not change in any significant way that commitment; in fact, I think it's fair to say that the Diefenbaker government actually improved the Hospital Insurance Act of 1957. I tell that story simply to remind us of what we are dealing with here.

Again, if you have an idle moment, I would say to my friends, all of them, go up to the library-in fact, I brought a couple of volumes down here today. Two of the people of that generation in the political class most associated with public health insurance in this country were Paul Martin Sr and Tommy Douglas. I'm not going to bore you with a long story about their upbringing, except that in both cases they had one particular thing in common: A young Tommy Douglas, while he was in Scotland, was afflicted with osteomyelitis that caused young Mr Douglas and his family a great deal of personal and financial hardship over many years. Paul Martin Sr, who grew up in Pembroke, was stricken as a very young boy with spinal meningitis. He couldn't walk for the first seven or eight or nine years of his young life. Is it any wonder that people like Paul Martin Sr and Tommy Douglas had a commitment to hospital and medical insurance? No wonder at all, because they and their families understood keenly the enormous problems, financial and otherwise, that attached to regular families if they did not have or could not get or afford hospital or medical insurance. That's why we in my generation have had the benefits of the programs that we have come to take for granted.

Mr Bisson: Thank you, Tommy Douglas.

Mr Conway: And the whole generation of people who made it possible. I'm in this debate today because one of the things that concerns me most is a growing sense among my generation of, "Let's throw these commitments to the wind and let's go back to a market-driven health and medical insurance plan." Well, I stand here on behalf of the tens of thousands of people I represent to say, over my dead political body will that happen. I understand how the rich and the powerful will applaud that, but I'll tell you, if you are a farmer in the Ottawa Valley, a retail clerk in Pembroke-the vast majority of people I represent, according to Statistics Canada, are below the provincial household income level. One of the most important programs they get from government is the health insurance plan. They want me as their representative to stand here and say, "Support that plan and fix that plan, but do not reduce that plan or reduce my entitlement to quality hospital and medical insurance, particularly in rural, small-town eastern Ontario, when and where I need it." That point of principle I want to stand and affirm as categorically as I can.

When I read the press today and I hear all of this twaddle about, "Let the market decide"-well, let me tell you, if you were a logger in Barry's Bay, a farmer in Westmeath, a shopkeeper in Chalk River, the health market is probably not going to be very interested in you or is not going to treat you with very much justice if history is any guide. What was done with medicare was to bring underserviced areas like rural Canada, rural and northern Ontario, up to an acceptable standard that has been enjoyed and taken for granted in a number of other, largely urban, communities around the country.

I want to make it very clear, medicare has been an enormous social and economic advance for the people I represent, and it is a scandal that parliaments and legislatures of this land, more prosperous today than at any time since the end of the war, are hacking, cutting and subtracting from it, at a time when our cup runneth over.

Now, I'm not here to say that all is well with the plan. I look back at some of the design of the medical care plan of the 1960s and say, "This plan would not and could not stand, for example, demographic changes of the late 20th century." It's clear that the architects of the plan in the mid-1960s reflected a society that was, on average, much younger and much less technologically advanced than we are today.

I'm not one of those people who stand here and say that everything the United States has done in health and medical coverage is bad, because it's not. I think one can go into places like Minnesota, for example, and find some very interesting models of good health care delivery, particularly in rural communities. But, you know, the Americans can do a number of things that we're not able to do, because they simply say 30% of the population is left on its own, with little or no coverage. Well, if you take that as a position, let me tell you, for the other 60% or 70% or 80% you can provide better coverage.

There is something basic to the Canadian instinct that I think we should be proud of that says there should be general coverage for all citizens. Remember what health insurance is philosophically: It is a commitment by the well to help look after the sick. That's what it is philosophically. Let the market decide? I'll tell you what the market will do with a young Tommy Douglas, with his osteomyelitis, or a young Paul Martin with spinal meningitis. You all know what a market would do. Does anybody here, other than the editorial writers of the National Post, want to return to that kind of antediluvian world? I don't. I can't believe that anybody elected to responsible office in 2000 wants to turn the clock back.

I remember as well, 22 years ago, being honoured with membership on the select committee of the Ontario Legislature looking at health care costs and financing. It's an interesting report, ably chaired by Dr Elgie and Bruce McCaffrey, known to some of you people opposite. What did we find out in 1978? That's almost a generation ago. We found out then what we know today: that we're spending basically what Emmett Hall said in his royal commission back in the early 1960s we would be spending in 1978 or now in 2000. Yes, we're going to spend more money, because our population is aging. I forget the statistics, but I think the health planners tell us that we will consume something like 75% to 80% of all our hospital and medical services in the last three months of our lives. If you think about that, it probably makes some sense. So as this population ages, yes, we are going to be spending more money, in relative and absolute terms, and we're going to have to come to terms with that. Yes, we're going to have to reconfigure a system that was built at a time when the demographics and the technological realities were quite otherwise.

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One of the things the politicians of my ilk-and it was a tripartisan commitment back in the 1970s and 1980s. We all said, all of us, "We need less institutional care and more community care." We were deficient, if not gutless, in a couple of respects. We never seemed to understand or we certainly didn't want to admit that that meant something. That meant hospitals were going to have to close-very painful-but we never much confessed it.

People have said, "Well, you didn't do anything for 10, 15 or 20 years on the hospital front." Another accurate charge. The reason we didn't, as I've said here before, was that back in 1973-74 Frank S. Miller, B Eng, MPP, Minister of Health, went out into western Ontario with a plan to downsize and close some hospitals. And how far did he get? I am not here to pass recriminations, because it was a bipartisan assault led by people like Larry Grossman and Eddie Sargent. The only hospital that was closed in about 20 years was the East Parry Sound General up at Burk's Falls, and it was reopened about six months or a year into the Harris government's mandate, for reasons that I entirely understand. So yes, there have to be adjustments and yes, we're going to be spending more money.

One of the questions I have for the health planners is, we are talking today about more and more community care. There's a massive privatization involved in community care because built into that is the assumption that the family is going to carry a much bigger part of the load. My question, particularly for suburban Canada in 2000, is, who's at home to do the heavy lifting with the 85-year-old parent who is increasingly frail but does not yet meet the requirements for an admission to a long-term-care facility or chronic care hospital? Who's at home in Surrey, British Columbia, in Kanata, Ontario or, quite frankly, increasingly in the rural Ottawa Valley that I represent? Who's at home who's willing and able to do the heavy lifting over months and perhaps years? Has anybody really thought that through?

When I look at the current debate, I am enraged and I'm humiliated to see governments spending millions of dollars on ad campaigns, one attacking the other. I meet nurses, I meet technologists, I meet volunteers in places-I was a patient the other day in one of my community hospitals. I must say, not a big deal, a self-inflicted leg problem from a little fall on some winter ice. One of the things that I want to say today is, the small community hospitals-Arnprior, Renfrew, Deep River, Barry's Bay and certainly the Pembroke General in my community-provide a very good level of care. I met a person from Ottawa the other day who had come up to their cottage at Calabogie and was actually getting some treatment done at the Arnprior hospital because they found it very patient- and user-friendly. Not that the Ottawa hospitals are less able, but people understand, just as they do around the Pembroke General, that restructuring has just begun.

As my friend from Kingston rightly observed, we are a long way from the completion of that story, press reports the other day reminding members of the Legislature and the Ontario citizens generally about just how far away we are from meeting targets. Every time I get a press release from the Ministry of Health, I see another substantially enhanced allocation for an about-to-be-restructured hospital because the original estimates were wildly off the mark and understated.

I read about more and more communities having to go to their upper- or lower-tier municipalities to go at the property tax base to raise tens of millions of dollars. We are a long way from completing that story. It's certainly not easy. I have my own very strongly held views. I'm not going to take today to grind a lot of axes.

I have to say to the Premier of Ontario that when I look at this resolution of his, I am not very impressed. It is the best and worst of old Mitch Hepburn, and I can say that as somebody who knew something about old Mitch. Boy, a great dust-up between Queen's Park and Ottawa.

My question is, how many sick people, how many needy people is that going to help? If I were the Minister of Finance for Canada, I've got to tell you, when I listen to these provincial finance and health ministers going on about tax points, I'd be very tempted to say: "All right, all right, I hear you. Let's just pull that back and we will make it directly targeted funding." I don't have much sympathy for Ottawa, because they were told by Parliament and they were told by a lot of other people that their retreat was going to lead to precisely this kind of a day. That's why there is a lot of blame to go around.

I just simply want to say, on behalf of people in communities like Calabogie and Killaloe and Stonecliffe and Douglas and La Passe, members of Parliament, members of the Legislature, cut the crap, stop the partisan bickering and get on with fixing the problem. Get on with fixing the problem because I am losing my patience with the inability of the political class to fix and adjust and amend, as I know it must be adjusted and amended, a core economic and social benefit that my parents and grandparents fought and worked so very hard to put in place and that you people don't understand, or seem not to understand, the centrality and the importance of. Big, fat, wealthy Ontario is the last group of men and women who should be complaining about their financial incapacity to provide an adequate level of hospital and community-based health care in this first year of the new millennium.

Mr Howard Hampton (Kenora-Rainy River): I am very pleased to have an opportunity to take part in this debate and I am pleased that we're having this debate. I see this debate as the foreshadowing of another debate which I believe needs to happen.

As you know, I've been calling for a leaders' debate on health care. I want people to see clearly where the leaders of the three parties stand. This debate will help us to cut away some of the fog, but a leaders' debate would help us to further ensure that some of the fog is cut away and people in Ontario could clearly see the choices for them.

What's the problem? Why are we here? We're here, first of all, because Liberals in Ottawa some time ago decided that health care funding wasn't a priority any more. When you sort through everything they've done on health care, you find they have cut, on an annual basis, $4.2 billion from health care funding. Worse than that, in the most recent budget, the Liberals in Ottawa, instead of replacing the money that's been cut from health care, put $58 billion into tax cuts for the well-off and corporations and could find only $1.25 billion for health care. In other words, for Liberals in Ottawa, their priority isn't health care. Their priority is the same tax cuts for the well-off and corporations that is the priority for the Harris government. The Liberals in Ottawa talk a good line about medicare, but at the end of the day they have the same priority as Mike Harris and his government in Ontario: Tax cuts for the well-off and corporations come before health care funding.

What happens as a result of that? What happens when Liberals in Ottawa and Conservatives in Ontario would rather finance tax cuts for the well-off? I can tell you what happens. What happens is this: Governments like the Harris government in Ontario and the Klein government in Alberta use the then underfunding of health care as an excuse to move more and more of the health care over to private, for-profit, American-style health care. That's what's happening in Ontario. There's all kinds of evidence of that.

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Look at what is happening in home care. Five years ago in Ontario, home care was for the most part being delivered by not-for-profit community agencies like the Victorian Order of Nurses, St Elizabeth and the Red Cross. What's happening now in Ontario? More and more of home care is being delivered by private, for-profit corporations like Olsten, an American private, for-profit health care organization which has a terrible record in the United States.

What's happening in long-term care? Seventy per cent of the new long-term-care beds that have been announced in Ontario are going to be put over to private, for-profit deliverers.

What's happening in ambulances? The Harris government is downloading ambulances on to municipalities, and not providing municipalities with any money to run them. Municipalities are already cash-strapped because of earlier downloading, and so municipalities, as we're already seeing, are looking at private, for-profit delivery.

Public health, which is so important in terms of ensuring that our citizens have the information and the tools they need to take greater responsibility for their own health, is being downloaded on to municipalities without any additional money. Municipalities are already cash-strapped, caught between a rock and a hard place, and they're looking at turning some areas of that over to private delivery.

If we look at home care, long-term care, ambulances and public health, piece by piece this government is moving Ontario's health care system to the American-style, private, for-profit delivery.

What do the Liberals in Ottawa have to say about it? What the Liberals in Ottawa are doing, because of the kinds of cuts they have made, is simply opening the door and holding open the door for this kind of privatization of our health care system, for this kind of undermining of medicare.

Why is it wrong to move to the American style? I want to say this clearly so people across Ontario understand. Americans actually spend more money on health care than we do in Ontario. They spend more per capita than we do in Canada. The Americans spend about 13% of their GNP, 13 cents on the dollar, on health care. We spend about nine cents on the dollar in Canada. The Americans spend more money, but at the end of the day, when you look at it, 42 million Americans have no health insurance whatsoever. People need to understand that it's working people, it's people who have a job and pay taxes, 42 million of them, who have no health insurance in the United States. There's another 55 million Americans who think they have health insurance but when you read the exemption clauses, the exclusion clauses, the exception clauses, the limitation clauses, they're not ensured for anything. So, literally, close to 100 million Americans have in effect no health insurance. Over a third of the people who live in that country don't have health insurance, yet they spend far more on health care than we do.

Why would anyone want to adopt a system that spends more money but leaves over a third of the population out of health care coverage? That's where we're going. That's where the Harris government is taking us, that's where the Klein government is taking us, and the Liberals in Ottawa are holding open the door to allow that to happen. What is even worse? Rather than either the Liberals in Ottawa or the Conservatives in Ontario showing any leadership, what do they do? They engage in advertising programs to blame one another while something that is a Canadian institution, something that we are recognized around the world for, the quality of our health care system, is being undermined. Liberals in Ottawa and Conservatives in Ontario do nothing more than spend millions of dollars blaming each other. I say, a pox on both their houses, shame on both their houses.

What needs to happen so that Canadians and Ontarians can have the kind of quality health care system that we need if we're going to live productively in an increasingly sophisticated society? First, the Liberals in Ottawa have to stop talking about medicare and have to put the $4.2 billion back in. That has to happen and it has to happen now. The $4.2 billion would be on the short end, because since that money was cut our population has aged, our population has grown, and something called inflation has eaten away at least 1.5% a year. Putting back $4.2 billion a year into health care funding would just be the minimal effort that is needed from the Liberals in Ottawa.

But the Liberals in Ottawa have to do something else: They have to stop their rhetoric about the Canada Health Act and do something to enforce the Canada Health Act. The Liberals in Ottawa have allowed this government to piecemeal change medicare into private, for-profit American medicine, and they've allowed Ralph Klein in Alberta to do the same thing. For the years that the Liberals have been in power in Ottawa, they have done nothing, absolutely nothing, to enforce the Canada Health Act. As I say, the only thing that they've done, besides not enforce the Canada Health Act, is to hold open that door to ensure privatization happens and happens quickly.

So those are the first two things the Liberals have to do. But then something has to happen here in Ontario. I'm intrigued, listening to Mr Harris and the Liberal leader, Mr McGuinty. Mr Harris has been saying since 1985 that he believes in primary health care reform. He believes that we have to do something in terms of primary health care reform, move away from fee-for-service and move to physicians and nurse practitioners and nurses working in teams where they're paid a salary and we get rid of the inefficient fee-for-service system.

He has been saying that since 1985. We've now had two sets of negotiations with the Ontario Medical Association, and nothing has happened. What does he say when he's questioned about that? Well, he believes in a voluntary change. A voluntary change. Then the other day Mr McGuinty was spouting off about how he believes in primary health care reform, but at the end of his statements, what does he say? He says the same thing Mike Harris says, that this should be voluntary. Intriguing. The more I read the fine print, the more I find there is absolutely no difference between the position of the Conservatives over there, the Liberals over here and the Liberals in Ottawa. They're all drinking out of the same trough and they all spew the same empty propaganda.

I want to say categorically that unless there is some leadership shown on primary health care reform, it won't happen. If it doesn't happen, medicare will be further undermined by Liberals and Conservatives. It must happen, and it must happen now. Why is it so important? It's so important because what we see in Ontario today are all kinds of families who do not have a family doctor. The doctor is not in for them. At the same time, we see nurse practitioners, who can perform many of the health care services people need, yet there is no effective mechanism for them to be utilized in Ontario. We see nurses who have skills and those skills are being underutilized.

Let me give you an example. I'll use something out of my own medical history. Many people will note that I have a bit of a scar above my right lip. I got that playing hockey in my hometown. A friend of mine lost his balance, his stick came up, got under my shield and cut my lip. It just so happened that another friend of mine, a physician, was on the ice and said: "Come on, we're going to go to the emergency room. We're going to stitch you up." When we got to the emergency room, he looked at me and he said, "I'm going to give you a lesson in health care economics." He pointed to the emergency room nurse and he said: "You know that nurse over there, she does better stitches than I do. Based upon her salary, at about $25 an hour, it would take her a few minutes to stitch up your lip. It might cost the health care system $10 for material, her time and everything. When you came back in, in five days, it would take her 30 seconds to take the stitches out. It would cost virtually nothing."

He said, "I'm going to do this procedure, though, because under the rules in Ontario now, the fee-for-service rules, I as a physician get to do this, and as an emergency procedure, I'm going to charge the system close to $100, and when you come back six days from now and I take the stitches out, I'm going to charge the health care system more money." He said, "Howie, can you explain to me why I'm going to do the stitches and charge the health care system over $100, when that nurse over there can do it for $10 or less and she does better stitches than I do?"

That is the essence of primary care reform. There are too many services now where the rules say, "A physician must do this." A physician sees the patient for 30 seconds, two minutes, and then the nurse performs all of the procedure. This is a very inefficient system.

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Moving to a system where physicians work in teams with nurse practitioners, with nurses, with other health care providers, where they are on salary-we have a decent pension system; the overhead is covered-would allow us to use to the optimum the skill, the knowledge, the ability of nurse practitioners, and the skill, the knowledge, the ability of nurses, and it would free up physicians so that physicians could be there for all the families of Ontario, not just a few.

The Conservatives under Mr Harris and the Liberals under Mr McGuinty show no leadership. They are not prepared to show some leadership on this; they are prepared to let it dwindle away. Let me say that New Democrats are prepared to show leadership on this. We insist there must be primary care reform in Ontario and it must happen now.

Let me give you another example of what needs to be done, in my view. We know, from report after report in Ontario, federally, from other countries in western Europe and states in the United States, that if you want to make some really cost-effective investments in health care, one of the things we should be investing in are the things that prevent people from becoming ill, the things that help people to exercise more control over their own health, that help people to be well. What are some of those things? Affordable housing is one of them. Lack of quality housing is intimately linked to poor health. If people don't have adequate, affordable housing, their health deteriorates very quickly.

All you have to do is walk into any one of the emergency shelters here in Toronto and look at the standard of health of people who are being forced to live in those emergency shelters; the incidence of tuberculosis; the incidence of things like the flu, pneumonia; the problems of mental health that result. Because this government and the Liberals in Ottawa refuse to invest even a little bit in affordable housing, the health of literally tens of thousands of people is degrading on virtually a daily basis-a very simple investment. In fact, the investment in affordable housing would cost less than what is being spent now on these emergency shelters, which get us nothing in terms of quality of people's health.

What else could we do? It's very clear that when people don't have an adequate income their health deteriorates. I would say to this government, if you want to have an impact on people's health, raise the minimum wage so it can be a living wage, so that people can afford to buy the food, have the clothes on their back and a roof over their head and buy some of the medicine that they and their children need in order to sustain their health-a very simple thing, very cost-effective.

What's another? The linkage between smoking and serious diseases like cancer, heart disease, hardening of the arteries, a number of other lung disorders, is overwhelming. Yet, at both the federal and provincial levels, there is still not a serious strategy to help people stop smoking and to prevent people from ever beginning to smoke.

These are simple, practical, workable things that could be done, but they're not being done here by this government and they're not being done by Liberals in Ottawa. Instead, each of them is contributing to the further Americanization, the further privatization of what has been one of the best health care systems in the world, and when the public catches them at it, they blame one another.

Those are the kinds of thing that we need to do. Those are the kinds of things that we as New Democrats are going to bring to this Legislature because we insist that this debate must continue. We are going to present a private member's bill. I call it the Tommy Douglas Act to preserve Medicare, after Tommy Douglas, who was the person who has done the most in Canada to pave the way to fight the battles, to take on a doctors' strike, to ensure that medicare was enacted.

What do we intend to do through that act? I want to outline what it's all about. We intend the Tommy Douglas Act to slam the door on any further plans to privatize and move to an American health care system. What will it do? It will do a couple of things.

First of all it will ensure that, in terms of long-term care, there is no further move toward private, for-profit delivery of long-term care; second, it will put the brakes on the further privatization and further for-profit delivery of home care, and it will ensure, over stated deadlines, that we move back to a system where it is integrated, publicly funded, publicly administered, where we can get the kinds of savings that come when you have a fully integrated system.

Perhaps people don't understand what I mean by an "integrated" system. I simply want to say that all you need to do is look at some of the things that go on in the American health care system. Recently I had the chance to talk with a physician in Windsor who worked in a hospital in California. He related the difference. He said this was a private hospital in California. They dealt with a number of insurance companies. He said that the thing that was most absurd to him was the fact that the hospital actually had as large a department of clerks for dealing with the private insurance companies as they had nurses. Can you imagine that-a health-care system where you spend as much money dealing with the private insurance companies as you budget for nurses to look after patients?

That's what happens when you move to that American private, for-profit delivery. You spend more and more money because you don't have an integrated system. We want an integrated system, and that's why we we're going to present the Tommy Douglas Act to preserve Medicare in Ontario, and we will have the debate then. There needs to be, still, a leaders' debate on this issue in Ontario so that we can present clearly to people the choices they have.

Mr Doug Galt (Northumberland): I appreciate the standing ovation as I begin my presentation for the next 20 minutes or so-very thoughtful on their part.

I enthusiastically support the resolution that has been brought forward by the Premier of Ontario: "Be it resolved that the Legislative Assembly of the province of Ontario,

" (a) Condemns the government of Canada for cutting, by $4.2 billion annually, base payments under the federal program that supports health care, the CHST, while provincial governments have increased health spending." I can't understand how anybody could possibly disagree with that particular part of the resolution.

" (b) Urges the government of Canada to repudiate the statement attributed to a spokesperson for the federal finance minister, the Honourable Paul Martin, that increasing health funding would be `just shovelling money into a hole that's going to open right back up again.'" Who designed the Canada Health Act in the first place? Of course it was a federal Liberal government, and it's hard to believe that they'd come back and say it's like shovelling money into a black hole when they started out with 50% funding.

" (c) Urges the government of Canada immediately to restore permanently the health funding that it has cut and to assume its fair share of increased, ongoing funding to met the health needs of our country's aging and growing population."

We're not asking to go back to the 50%; we're just asking to go back to the level in 1994. That's not a horrendous step from where we're at: $4.2 billion for Canada, $1.7 billion for Ontario.

Indeed, the final point in this resolution: "(d) Reminds the federal Minister of Health, the Honourable Allan Rock, that the sincerity of his commitment to medicare and the principles of the Canada Health Act would be best demonstrated not by idle rhetoric and vague words but by restoring the health funding he has cut."

There's no question that our government believes very much in the Canada Health Act. It's very unfortunate that the federal government can't say the same thing. With the way they've been reducing funding, it's obvious that they do not support this Canada Health Act. Maybe they did once upon a time, but it may be something like the Minister of Finance's staff saying, "Just shovelling money into a hole that's going to open right back up again." That's how much they believe in the Canada Health Act.

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I think it's rather unfortunate that we've got to the point in Ontario where money had to be spent to expose the federal Liberals as to what they're really doing on health care. Now the people of Ontario are starting to understand what we have been struggling with for the last five years. We're spending some 50 cents per family to try and recoup some $650 per family on an annual basis. That strikes me as being a reasonable investment, and the feds are coming back, talking about tax points and totally confusing the public, but they're starting to understand this 11 cents. It started out at 50 cents; now it's 11 cents. If you were to look at the calendar, 11%, would suggest that the federal government is funding health care in Ontario from January 1 to February 9. From February 10 to December 31, the total funding would come from the province of Ontario. That's one way of looking at 11% versus 89%. I think it makes a lot of sense to look at it in that respect, especially when the Fraser Institute has drawn a comparison to tax freedom day. You might call that a health freedom day for the federal government come February 10, although that same government lays the taxes on us, so we don't get a tax freedom day until late into June, although the government of Ontario certainly backed that up considerably, with our reduction in income tax and some of the payroll taxes that have been reduced in Ontario.

When we took office, approximately $17.4 billion was being spent on health care. That particular year, that increased to $17.6 billion that was actually spent. Currently, we're looking at a budget of $20.6 billion. That's an increase of $3 billion, and it's probably going to end up more around $20.8 billion. So you can see from the time we took office to the present time, it's well in excess of $3 billion, and we have compensated for those reductions from the federal government. Unfortunately, if it would just come down to the 11%, that might not have been too bad to begin with, but it went all the way down to slightly under 8% when they made those cuts a few years ago, and they're taking great pride in bringing it back up to the 11% level. I think it's about time they took it back to the 1994 level. We're not talking about 50%, which would be very nice, if they would come back to the level they started out at, but it's probably not going to happen.

We hear a lot from the Liberals about what they're going to do with a health care plan. Back in 1997, Dalton McGuinty said he was going to roll out their Liberal health plan, and I haven't seen it. In 1999, at election time, he said again they were going to roll out a health care plan. We're still waiting for it. You know, if they just got together with the Liberals in Ottawa, I'm sure all this advertising wouldn't have been necessary. They can do something other than just complain and criticize the present government. They could work with the government to try and get a fair share from the government of Canada. When you talk about the government of Canada, the federal Liberals, in terms of fiscal responsibility, which is totally lacking there-you look at the things they've been doing: raising the employment insurance rates, raising the Canada pension plan costs-they're raising those faster than we can cut taxes, and it makes it difficult for some Ontarians to really appreciate that there has been a tax cut in Ontario. It's very accidental that the federal Liberals have actually balanced their budget. It's only the tax cuts and the fiscal responsibility in Ontario that stimulated the economy that have given them the chance to get those dollars through the high taxes they have. If it hadn't been for the province of Ontario, I can assure you that the federal government would never, ever have balanced its budget. They'd still be wallowing around in deficit for some time to come.

It's interesting to look at some of the quotes we've seen. Brian Tobin, the Liberal Premier of Newfoundland, who also was in Chrétien's cabinet, said, "We need to put our money where our mouth is," referring to the feds. I don't know how long we've been dialling 911 from the provinces, but the feds don't pick up the phone. Then in Calgary on March 10, Allan Rock said: "All the innovations in the world will not sustain our public health care system unless it's adequately funded by governments. Preserving medicare is going to cost more than words and the federal government must be there to do its share." I couldn't agree more with Minister Rock's comments. You would think he'd get aboard and make sure Martin had the dollars that are necessary to fund this.

When I think of the health care crisis, all I can think of is the front page of the Toronto Star. That's where the biggest health care crisis is going on in Ontario, and in the Liberal caucus as they chase ambulances to come up with new and different stories. I don't know which ambulances they chase to get these stories, but that's where the health care crisis seems to be in Ontario, other than funding, and I can understand the concerns with funding.

On the health care crisis and the concerns, I'd like to share a letter with you-it's in my words because the letter was back in January and I don't have it with me. It was in the local community press. A woman from the community of Tweed came to Scarborough because her mother had the flu. They called 911 because she didn't know how she was going to be able to move her mother; she seemed to be immobile. The ambulance came, non-emergency, and they loaded her mother on to the stretcher and put her into the ambulance. They said, "Where would you like her to go?" and she said, "Scarborough Grace." They radioed ahead to the hospital, but it was on critical bypass. So they radioed some other hospitals in the area and they were also on critical bypass. We often hear these stories here, don't we?

Finally the daughter from Tweed said, "I don't want to go way out to west Toronto to look after my mother when she's in the hospital." The paramedic said, "If I help you get her into the car and you drive over to Scarborough Grace, I think they'll probably take her." So they did. The daughter was thinking: "When I get over there, I'm going to have to wait eight or 10 hours. The emergency room will be jammed, and it will be quite a while before they see my mother." She went over and parked her car in front of the emergency entrance and walked in. Do you know, there wasn't a soul in that emergency room-not a single soul. She got a wheelchair, went out, got her mother and took her in, and she was seen immediately. This was a hospital on critical care bypass. I don't know whether the other hospitals had anybody in emergency, but this was Scarborough Grace, on critical care bypass, and the mother was seen right away. The last line in the letter said, "Who is playing games with whom?" I suggest that some of the Liberal games we see being played in this House are similar to that letter.

I had an experience this past summer. I was in and out of four different hospitals overnight, two or three times in one. I was very impressed with the triage approach to handling my problem, which was a kidney stone. It was kind of tender at the time. I appreciated getting to the front of the line quickly. When I went back for some routine X-rays, three or four other people passed me. Triage is working extremely well in our hospitals.

Then I was in and out of the Trenton Memorial hospital, an excellent hospital. Right now we're building a new one there. Mr Speaker, you may recall that your government promised to build that hospital back in the late 1980s. I'm sure the NDP will remember that they again promised to build it in the early 1990s. It's finally being done under this government, and they're quite pleased with that.

I'm getting sidetracked in my story. My mother-in-law was in there for over two months, and I was going in to see her. Again, there wasn't an ongoing crisis in that emergency ward. Generally, two or three people were in the emergency waiting room when I would go through.

I'm coming back to the point I made earlier: I think the crisis is in the Liberal caucus and on the front page of the Liberal Star.

I hear an awful lot of talk about restructuring. The feds are coming back and saying, "We'll give you more money if you spend it all on health care, and we might consider giving you more if you were to restructure." That was what the members of the Liberal official opposition were so critical of the Health Services Restructuring Commission for. It was tough. We knew it was going to be tough going. But out of that, we're building a new hospital in Trenton, which is part of my riding, the Trenton Memorial Hospital. By the way, we also have clearance to go ahead an build a hospital in west Northumberland, probably located in Cobourg. This is the Northumberland Health Care Corp. It has had some difficulties, and I can tell you that the biggest difficulties came when the leader of the Liberal Party came to town.

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They came into Cobourg back in, I believe, late March or early April on a retreat. They had so many retreats last winter; I couldn't figure out what they were retreating from. But a couple of weeks prior to that retreat, the member for Thunder Bay-Atikokan came to town. I guess she was part of an advance team to check out what was going on there, and found out that things were really in pretty good shape. In spite of finding out that there was 70% funding for a new hospital and things were moving along quickly, maybe she didn't advise her leader very well. They still came to town and it seemed they were out to destroy what was being developed there.

Of course, I wasn't advised of this visit. If I had been, I would have had a parade for them and welcomed them to town. I'm concerned about their wandering all over Ontario and not being warmly received, and I could have looked after that for them. But I wasn't advised, and I understand there is a courtesy expected to notify the local member.

When I was in the riding of Hastings-Frontenac-Lennox and Addington with my task force on rural economic renewal-by the way, I am very honoured that the Premier appointed me to manage that task force. When we were there, the member for that area, who happens to be a member of the Liberal caucus, took great pains to tell the audience that my invitation to her to attend must be still in the mail. So I take for granted, if that came from the Liberal caucus, that they would expect that kind of invitation. Maybe the invitation from the Liberal leader is still in the mail and I'll get it. I know the mail is rather slow at times. But we had in fact alerted that member's staff. Obviously the problem is in her office. I guess her staff didn't bother to tell her the task force was coming. Probably that was why her nose was a little out of joint because of that visit.

What I'm coming around to is, with the entourage coming to town, it seemed very important to upset the community, and I can tell you that the leader of the Liberal Party indeed did that. He questioned the local people, questioned the local hospital board: Could they in fact raise the 30%? I can tell you that he left town leaving a very bad impression in west Northumberland, questioning that they might not be able to raise the 30%. I can assure you there is absolutely no question that raising that 30% is more than probable. Studies have been carried out, and there's absolutely no question that those dollars can be raised.

The time is slipping along very quickly. A little earlier, the leader of the third party was talking about home care and privatization. I think we should bring to his attention some things that have been happening with home care and privatization.

Private companies have delivered home care in Ontario since the early 1970s. When the NDP left power in 1995, almost 50% of all publicly funded homemaking services were being provided by for-profit agencies, as well as 13% of all publicly funded nursing visits. Not-for-profit and private agencies have an equal opportunity to compete for service contracts. Ontario has not lost a single existing provider of community services. We have gained a number of other new providers in the province, to the benefit of Ontario's citizens.

In addition, I think it's interesting to note, in case the leader of the third party is interested, that during their term there was an increase of some 34% in privatization. I find it rather surprising to hear him speaking a few minutes ago, so concerned about this. With that kind of activity and those kinds of things happening during their term, I'd think they must support privatization when so much of it was going on at that time. Certainly they were not doing much about it.

I've been speaking a bit about restructuring and the feds expecting restructuring in Ontario. I've talked quite a bit about the Health Services Restructuring Commission. Certainly we're working on some 20,000 new long-term-care beds. In the period 1985 to 1995, there wasn't one single long-term-care bed created in Ontario, while at the same time the Liberal government from 1985 to 1990 closed a lot of beds. From 1990 to 1995, in that full 10-year period, some 10,000 beds were closed in Ontario, but not a single long-term-care bed was created to help with the closing of the acute care beds.

They talk federally about pharmacare; in other words, supplying pharmaceuticals to our seniors and to those who are on social assistance. That's what we already have in Ontario. We'd appreciate a little bit of support from the federal government. I think it's up to something like $1.6 billion now that it's costing for that program. It started out around $400 million. That would be $0.4 billion. That was roughly in 1985. You can see how significantly it's gone up. We have a deduction for those who can afford it of $100. I understand in Saskatchewan it was around an $800 or $900 deduction per person and it's now increasing to something like $1,700 or $1,800, in that neighbourhood. We have one of the most generous drug programs right across the nation.

We talk about primary health care. That's already been started in this province, and I would think the federal government would be able to recognize some of those things that we're doing.

We've also restructured home care with the CCACs and what they're doing to assist people going from hospital and being able to stay in their homes longer than they have been able to in the past.

I'm not saying the system is perfect. There are still some bugs to work out of it, but it has certainly come a very, very long way.

In closing, I just very enthusiastically support this resolution that was put forth by the Premier and will be coming up for a vote tomorrow, I believe, to encourage the federal government to give reasonable equitable funding to the province to support health care.

The Acting Speaker (Mr Michael A. Brown): I would remind members that we're speaking to Ms Lankin's amendment to Mrs McLeod's amendment to Mr Harris's motion.

Mr Mario Sergio (York West): Mr Speaker, I do thank you very much for allowing me this time and reminding the House about what we are really speaking about. I've been listening for the past couple of hours or so and I've heard everything except what's really for discussion in front of us here today. But then again, anything goes when it comes to bashing, criticizing or attacking, except speaking to the point to which we should be addressing ourselves.

First of all, with respect to the NDP amendment to the Liberal amendment to the motion of the Premier, Mr Harris, let me just go over the few amendments put out by the NDP. It has, I believe, four parts to it. I'd like to mention to the House that the first one says, "Let's ban Mr Klein's"-he's a Premier, I believe, somewhere out west, just a bit further west than Ontario; calling for stopping the privatization of the health care system. It's, what do we say, motherhood, fatherhood issues. We've been saying all along, "Well, Mr Harris, let's not play games with our health care system the way we know it, the way we have come to know it, not the way we're knowing it today under the Harris government." I think it's hard to disagree with the principle not to touch the health care system and not privatize it.

I think it would be very nice if once in a while we heard the Premier, their ministers or some members of the government saying, "We want to have something for the people in Ontario that reflects our views, something made in Ontario for the people of Ontario." I would support very much that we don't go that particular way.

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The second says, "a freeze on the delisting of health services." There again, it's very fine to say, "Let's not delist it," and it's hard to disagree because I think this would entitle the people of Ontario to receive every possible care that they are entitled to and care should be available when it's needed by anyone in Ontario.

The third one is to end the proliferation of private, for-profit long-term-care homes etc. Again, it's hard to disagree with that. It is something that we have been saying and fighting for in the House for many years with respect to privatization and for-profit and the care that is given in those particular homes to our senior community in Ontario.

Of course, the fourth point in the NDP amendment is for tougher inspections within the system and stiffer penalties. Again, this must stem from the fact that lately in the House we have brought on many occasions too many incidents that are happening with respect to the health care system in those particular homes, especially the nursing homes and retirement homes as well. With respect to that, I believe that not only we Liberals, but the government side is jumping on the bandwagon and wants to introduce their own private member's bill or change the way the health care system is delivered in the nursing homes and retirement homes. That's fine.

But since it seems that it's a free-for-all in here, let me address for a moment both the intent and content of the motion by the Premier himself. We are all of a sudden perhaps now finally coming to realize that we don't have a Premier who leads. He has become a reactionary. Every time he hears a complaint he has to react. That's the way we are being governed nowadays in Ontario. Because of what happens, he says, "Well, let's do something about it." But it's not something positive that he does about it. It is not providing more health care, when people are screaming about the particular system we are inheriting under today's government. So he has retreated. He repudiates by attacking other levels of government, namely, the federal government. He has become a master in buck-passing, as we say, or blaming somebody else. I find that quite ironic, because in his own bill-and I would hope that we will have more time to debate that, because I will try and spend the few minutes that I have on the amendment by the third party. I hope that I can come back and have some more time, that we all have plenty of time, to address the emptiness of Mr Harris's motion. I will try to just attach a few words to that. At least I want to get it off my chest, because it is so ridiculous that we have the Premier of Ontario come into the House and do nothing but bash and attack the federal government without suggesting any positive solutions as to how to deal with the crisis that he himself and his government have created here in Ontario.

The only thing that he's doing-and I will go step by step on his own motion here-is bashing, and he's got a full bag of fed-bashing. He's blaming the Minister of Health, he's blaming the Prime Minister and he's blaming as well the finance minister for the cuts they have made. Now, does this remind us of something, going back to 1995, when the actual Premier, Mr Mike Harris, said prior to the election, "Not one penny will be cut from the health care system, and closing hospitals is not on my agenda"? I find it very distasteful that we have to deal with such a serious issue and we can only resort to accusing somebody else for our own failure, for the cuts that we have made in Ontario. I find it quite appalling that the previous speaker, the member for Northumberland, said, "The feds have balanced their books cutting health care." My goodness, if there are some people who should be complaining in the House or outside, it should be the people of Ontario, it should be the people in this House, saying: "Mr Harris, what the heck are you talking about? You have championed the causes for cutting, and the only way you managed to give your 30% tax cut was by cutting directly from the two major institutions, that is, health care and education." That's how he has accomplished those 30% tax cuts.

But he did not balance the books yet, so please, the Premier should not be attacking the Prime Minister, the Minister of Finance, the federal Minister of Health. At least they have balanced the books. At least they recognize that, yes, they have shortchanged the provinces on health care, but they have allowed money. What is sad is that of the money that has been allocated for health care spending in Ontario, our government, Mr Harris, has not spent those monies on the health care system. I find that very sad, because as of late, in the last federal budget, there was about $1.7 billion allocated to the province of Ontario to be spent directly on health care. And what do we have here? On a daily basis, we have the Premier and other ministers travelling the province making all kinds of ritual announcements-one day in, one day out-and at the same time, they have over $800 million sitting in the bank earning interest and they're not spending it on the health care system. I find that quite distasteful.

I want to speak on behalf of the people in the area that I represent. They are very hard-working people. Day in and day out, they work hard. They want to come home and find peace and contentment. When they need some assistance, they want to make sure it's there, because they are entitled to it, because they are working very hard, paying taxes, all kinds of taxes. A lot of them don't understand, unfortunately, and we shouldn't hold them responsible for not understanding, because that is why they elect us and other people at other levels to speak on their behalf. When there is that particular need, it should be there.

The hard-working people I represent-and I would say that I speak for most people in Ontario, because I think we have a wonderful community of hard-working people all over the place-don't want to know if it is Mr Chrétien or Mr Harris or whose minister it is. It is a fact, and we know and they know that since 1995 we have been subject to too many cuts all over the place. They say, "But they were necessary." But they were not necessarily in the right place at the right time and in the right amount.

Interjection: And for the right people.

Mr Sergio: Yes, and of course for the right people. If I have the time, I will try to address the plight of the seniors who are in need. We have no idea how many thousands, perhaps hundreds of thousands, of seniors are living below the poverty line, and no one is speaking on their behalf.

Interjection: User fees.

Mr Sergio: "User fee" is a wonderful way of saying it's another form of tax.

What does the motion of the Premier really say? Absolutely nothing, because number 1 says, "Condemn the feds for what they have done, for the cuts."

I'm going clause-by-clause so at least the people who are listening and able to understand know what the heck we are really doing, what we are talking about and what the Premier has introduced here in the House.

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Number two, it's attacking directly and viciously the Minister of Finance, Paul Martin, for not giving enough money, attacking again.

Number three, "restore funding permanently": He more than anyone else should give back all the cuts he has made since 1995 to the health care system. Had he done that, we wouldn't be in the situation we are facing today with the generalities of the health care system, but mainly a couple of points: emergency rooms and cancer patients. I don't think that prior to 1995, considering the situation that we went through as well, we saw the flood of our people we had to send south of the border, spending American money and going to a different country to provide health care for those people. I don't think that is acceptable today and I don't think it was acceptable yesterday. Certainly I can't tell the Premier today that he is right when he says, "We want to ask the federal government to permanently fund the health care system in Ontario." They are saying, "Pay your fair share." Mr Premier, are you paying your fair share? Why are you closing so many hospitals? Why are the emergency rooms always full? Why do people have to go south of the border? So far there is absolutely nothing but emptiness in the motion by the Premier.

The last point: He is attacking the Minister of Health. You can't ask for co-operation when you have contempt, when you attack so blatantly another member at the federal level, especially the one you should be co-operating and working with, for a lack of sincerity in his commitment to the health care system or the Canada Health Act, whatever it may be-attacking the minister for vague words and idle rhetoric.

If I were the Minister of Health, I don't think I would really be too kind to the Premier of Ontario when he himself is not saying anything positive to solve the situation. As I was saying, the people I represent don't want to hear any head-bashing. They don't want to know who is right and who is wrong. They don't want to see any government spending millions of dollars to accuse and attack another level of government. This is where the Premier, when he comes into the House and faces the questions, should tell the people of Ontario the way it is, that since March 24 they have started this vicious campaign, spending taxpayers' dollars to the tune of, as somebody says, $3 million, and as somebody else says, $6 million, to tell the people, to tell the federal government: "You are not giving us enough money. We want more money."

The federal government says, "Look, you haven't even spent, you haven't even asked for all the money that we have allocated to you in Ontario for the health care system." Why are they holding on to $700 million and still going to the expense, using taxpayers' dollars to attack the federal government? Indeed in situations like this, the only thing my people understand is that it makes them sick when they see one level of government attacking another one.

Briefly, let me tell you, because I've heard all kinds of rumblings of "Liberals this and Liberals that," what we would do as Liberals if we were in place to assume the leadership role the Premier has here today. Let me tell you what we would do instead of reading from six years' promotional advertising material or whatever. The people want to know today what the government is doing today. They are in power. He is the Premier. They control the funds, they control the money, and they have lots of money. They've got so much that they can't even spend the money the federal government has allocated to the Premier of Ontario, to the people of Ontario, to be spent on the health care system.

The people in my area-if I were allowed to I would say it in their own language so that perhaps they may understand better: Why is the Premier of Ontario not spending the money? The federal government is saying: "Look, it's here. It belongs to you to be spent on health care in Ontario." Why aren't you getting it? Why are you not spending it for the people in Ontario?

If they don't have enough, at least say, "Well, we have $700 million that we could spend in many, many ways," and I don't have to tell you in how many ways we could spend it. But let me tell you what we would do as Liberals here in Ontario.

Interjection: Be honest with the people, first of all.

Mr Sergio: Absolutely. We are not limiting the blame only to Mr Harris and his government. I think there is a time and there's a place to attack other levels as well, but fairly and squarely. I think they both deserve to be criticized for failing to reach a consensus, to reach an agreement and deal directly with the problem the way we see it. I'm not letting my cousins up there in Ottawa escape free, you know. After all, yes, they have a responsibility as well, but they have a responsibility as well throughout Canada. When the feds are saying, "Look, we're balancing the books," and the Premier himself says, "Cut, cut cut"-

Interjection: He told them to cut.

Mr Sergio: Yes, he told them to cut, but at the same time he's giving them the money necessary to do the job that they're supposed to do on a daily basis.

We would, number one, stop pointing the finger at who's to blame. There is nothing to gain for the people of Ontario when day in and day out they say "Well, you're to blame"; "I'm to blame." They want a responsible government. They want a health care system that is there when they need it, that is available, that is accessible and that is affordable, as well.

Interjections.

Mr Sergio: Yes, absolutely. Oh yes, you're pushing a very sensitive nerve.

We would assume full responsibility as Liberals and we would deliver responsible service to the people of Ontario. Above all, we would stop paying with taxpayers' dollars to promote themselves, which I think was $6 million, and $100 million prior to the last election. I wonder how much service we could deliver to the people of Ontario. So I'm calling on the members and the Premier to stop passing the buck and deal with the issue.

Mrs Brenda Elliott (Guelph-Wellington): I'm very pleased to rise this afternoon and join in the debate on the government notice of motion 32, which is a resolution by our Premier. Just to remind those who are watching, the Legislative Assembly of the province of Ontario condemns the government of Canada for cutting $4.2 billion annual base payments supporting CHSC, which is our health care social program fund, and urges the government of Canada to repudiate a statement by the spokesperson for the federal finance minister that increasing health care funding would be just shovelling money into a hole that's going to open right back up again.

There are two more points on that resolution which I'll come to in short period of time, but I'm finding it interesting to hear the debates that have been going on in the House this afternoon. One colleague across the way was saying that it's inappropriate for us to criticize the federal government at all, as though we were doing something terrible. I was trying to imagine what it that would be like if I were a citizen watching at home who wasn't part of this Legislature, wondering if it would appear to them that in fact this was one government foolishly, perhaps for political purposes, heaving insults at another government. Would that be how it was perceived?

I would say to you and to my colleagues here in the House that the people in my riding of Guelph-Wellington wouldn't appreciate that in any way, shape or form. The people in my riding in Guelph-Wellington, and I think people all across the province, are looking for leadership from their elected member.

I'm thinking that the people in my riding, as in most ridings across this province, would say that health care is the number one priority, and I would actually agree with one of my colleagues who was speaking earlier about the importance of health care in our milieu of being a Canadian. I think for many people, a strong health care program is indicative of the kind of caring, warm, thoughtful society we have here in Canada. I think we pride ourselves on the kind of health care program that we have, we're very concerned that it's sustainable in the long term, and we all have come to recognize that given the demographic changes-the aging population, the growing population-that the pressures on health care are going to be enormous as time passes.

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I want to speak to a couple of quotes that passed my desk, which respond particularly to the speaker who came just before me. He indicated that somehow this is a problem our government is just making up, and I think he should be alerted to these two quotes.

" But I am part of the problem, not the solution. It was my government that diminished the size of transfer payments." That's a direct quote from Allan Rock in a speech to the 130th annual meeting of the Canadian Medical Association on August 20, 1997.

Here's a second quote from our federal Liberal health minister: "I will not stand here and tell you that the cuts in transfer payments that we made were insignificant. They were not. And I won't tell you that they have not had an impact. They have." Guess who? Again, Allan Rock, our federal Liberal Minister of Health, who has acknowledged that (a) he's made cuts, (b) they have been to the provinces, and (c) they have been very significant and detrimental. He has, by his own words, admitted he is guilty of cutting the transfer payments.

A whole series of numbers have been tossed out over the past few weeks: 6.3, 3.9, 4.2. To the ordinary voter, those are very large numbers. They all end in "billion," and so they're almost incomprehensible on that point. But what is really important to simply understand is that the federal Liberal government has cut transfer payments to the provinces by approximately 33%. This is an enormous cut in the face of governments who have been trying to balance their budgets and who recognize that health is a priority.

I said earlier that I was trying to imagine how I would feel if I weren't in this Legislature and was an ordinary citizen turning on the television, hearing the ads, reading the newspapers and seeing the two governments argue back and forth. Would I be thinking that this is a serious issue or just a bit of a cat fight between one government and another? This is what would make me understand that this is very serious: Aside from the fact that we're talking about very large numbers, 33% of the biggest transfer from one level of government to another, we are seeing premiers and health ministers of every political stripe, right across this country-Roy Romanow, an NDPer from Saskatchewan; Brian Tobin, a Liberal from Newfoundland-all saying the same thing to the federal Liberal government: "It is time to bring your money to the table. Yes, we'd be happy to talk about programs; yes, we all have ideas from our own jurisdictions. But without base funding, it is very difficult for us to proceed." To see all these political leaders in health, as well as premiers, standing shoulder to shoulder to say the same thing and agree is very unusual. I think it speaks to the depth of concern that all of these leaders in their own provinces have about their priority program-health-and how difficult it is for them to be able to manage.

It is very important for all our constituents to understand that in our province the only government that has cut health care funding is the federal Liberal government. When we were elected in 1995, our health care budget in Ontario was $17.4 billion. We have steadfastly added to that budget every single year to try to meet the pressures. We are now up to a little over $20 billion, and we have committed to at least $22.7 billion. By all predictions at this point, we are going to need more money and we're going to need it sooner, because we are listening and we know the challenges we have in this portfolio.

What I'm saying here is that we have a united concern across Canada, directed to the federal Liberal government. It's not just here in Ontario's Legislature. We've all recognized that health is a priority, that it's a growing priority and a problem, and that Ontario's commitment to improving and expanding our health care budget is unequivocal. We have been very steadfast in that.

The speakers before me have been talking about a number of different actions that have been taken. Because I represent the riding of Guelph-Wellington, I want to point out some of the things that have happened in my own riding, based on the principle that actions speak louder than words. In our party and in our government, we have undertaken a number of initiatives, whether you look at home care, pharmacare, restructuring, nurse practitioners or long-term care. We have been leaders in all of those programs, and we've taken very definitive actions, with extensive investments.

The question is, do those numbers actually translate into projects, into new programs in our own riding? I was trying to think about what has happened in Guelph-Wellington. My colleague Dr Galt referred to a new hospital being built in his riding that was promised under the Liberal government, not delivered; again promised under the NDP government, not delivered. The interesting thing is that that happened exactly the same way in my riding, and I'm very pleased to report that in my riding right now the Guelph General Hospital is being completely rebuilt and refurbished. That is a promise that has been ongoing and very controversial and upsetting in my riding for over a decade now. The St Joseph's long-term care hospital is now under construction. Again, promised by the Liberal government, no delivery; promised by the NDP government, no delivery. But Mike Harris, before he was even the Premier, came to town and said, "We're going to deliver." Hallmark of our government: We keep our promises. Guess what? Both are under construction, both being built, and I can tell you my constituents are very happy about that.

Interjections.

The Acting Speaker: Order. I'm having a great deal of difficulty hearing the member from Guelph-Wellington. Members would know that only one member may speak at a time.

Mrs Elliott: Hospital restructuring and delivery on capital and infrastructure has been unequivocal in our riding, and it has been the Mike Harris government that has delivered, hands down.

I look at things like health centres. We've had a community health centre that has been delivering service to our community for several years now, and its mandate is to deliver health services to people who are hard to serve, primarily street people and people who have a lot of health challenges. We are going to now have a brand new community health centre that's going to be strategically placed right downtown, exactly where it should be. It's our government that is making this capital investment. The tenders have just been opened recently. Work is underway, and I think the total is something like $6.3 million. The interesting thing about this project is that it's not going to be just an isolated community health centre. They're renovating an existing building down town, and they're going to have tenants come from all around the city delivering all sorts of different kinds of services so that in fact it will be a true community health centre in every sense of the word. We're very excited about that.

I mentioned the hospitals and nurse practitioners. Ours is the government which established legislation for nurse practitioners. We have pilot projects all across the province where nurse practitioners are now taking leading roles. One was just announced, again at St Joseph's hospital in my riding, a nurse practitioner to deal primarily with geriatrics, something people are very excited about, because they do see this as a very practical solution for primary care reform.

Dialysis: I did a statement in the House the other day. People in my community always had to go to Kitchener-Waterloo, to Grand River, for dialysis for years and years and years. We now have a satellite project right in the city, right next door to our new hospital. It has been beautifully designed. It's actually designed a bit like a home; you go in and it's not hospital-like at all. This was actually as a result of a number of leaders in the community. Lisa Arntz, who's an interior designer, came and added her expertise to make this facility much more home-like for people who have to undergo dialysis three times a week, which is very stressful. Our government has made huge investments in dialysis units all across the province so people could get the service where they need it, when they need it, close to home. We have seen those practical results in Guelph-Wellington.

Alzheimer's was another one that came to mind. Recently there was an article in the paper recognizing Ken Murray. Ken is a local constituent and a philanthropist and community leader who has been instrumental in getting the Alzheimer movement underway. He was recently recognized for all of this work. Of course, it's our government that has the Alzheimer strategy underway with the Ministry of Health and the ministry responsible for seniors.

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What I'm saying is that when Allan Rock says, "I'm not going to give you money unless you give me plans," our government has had plans. We've had action underway. We've been making unprecedented investments in health care all along. It's the federal Liberal government that just doesn't get it, and everybody knows it. Not only that, but they've actually admitted it.

A recent newsletter came out in my riding from my federal member, also, interestingly, named Brenda. It had a whole section in it devoted to something called "tax credits." I've never heard of something like this-tax points. I thought, what is this all about? I don't know. The article was essentially saying that our province, along with others, has been given some tax points which should make up for this tremendous 33% reduction in CHST payments. So I did a little bit of homework on this and I found out that this whole idea of tax points actually originated in 1941 at a federal-provincial conference where Prime Minister Mackenzie King obtained the agreement of the provinces to cede their entire personal and corporate income tax bases to the federal government for a period of five years in order to finance the war effort. From that came something called a rental payment to key provinces. This was renegotiated several years later, in 1947, where the federal government wanted to extend those tax rental agreements. Ontario and Quebec at that time chose not to participate and chose to reintroduce their own personal and corporate income taxes. So-and this is the key-Quebec and Ontario received a credit of 5% of federal income taxes collected within their borders. This credit was then increased several times, but-and here's the key-it ended in 1962 when they were replaced by tax collection agreements under which all provinces except Quebec began to levy personal income taxes as a percentage of basic federal tax payments.

For the life of me I can't imagine why federal MPs across this province are trying to persuade our constituents, who know full well what's going on now between the federal government and all of the other provinces-why they would try to present pretty weak and mute arguments about something called tax points. Perhaps they thought if it was obscure enough, nobody would actually take the time to figure it out and know what was going on.

If any of my constituents are watching and wondering, "Well, Brenda, are you really telling us the whole goods?" the national accounts prepared by the federal government's own Statistics Canada include revenues that originated from the 1977 tax transfer as provincial revenue. They say this is the province's own source revenue. Their national accounts have a category that identifies current transfers that the province receives from the federal government. The tax transfer or tax point revenue is not included in this category.

This is a very common expression, but the bottom line is, these are big words trying to confuse ordinary people. I came across a chart. These big words are trying to confuse people that the federal Liberal government is not living up to their promises. This is a graph of the money that the federal Liberal government has cut from the transfers to the provinces. I don't know if you can see it, but it's a big box and there's a big scoop right out of it, just like a great big ice cream scoop, a great big piece right out of it. It's about a third of it gone. That's the money that has not been given to the provinces by the federal government. In fact, it's over $10 billion. Ten billion dollars has to be thought of in this way: Right now Ontario spends a little over $20 billion for health care; $10 billion would be half that budget over again. That is an extraordinary amount of money that could be invested in very specific programs like dialysis, like Alzheimer's that I mentioned, like more hospitals, more nurse practitioners. It just goes on and on. Health care, hip and knee replacements, all of these things, our people want to know about.

Our Minister of Health was very diligent when she recognized that Allan Rock was asking her, "Show me the plan before I show you the money." She got some notes together and outlined very clearly what we've been undertaking here in Ontario. It's extraordinary:

In primary care reform, we've got 200 doctors in pilot projects offering 24-hour, seven-day access.

I mentioned the nurse practitioners earlier.

Three drug programs: These are marvellous programs. Some 44 million prescriptions were filled in 1998-99 under the ODB plan. As my colleague mentioned earlier, we have a minimum cost of $100 on that program, and in most other jurisdictions it's at least nine or 10 times that. We have the Trillium drug program. The expenditures in that program alone were $45 million in one year, delivering very expensive drugs for people who have serious illnesses like cancer or HIV, to over 100,000 people.

Home care has been a wonderful success in my riding. We were underfunded in Guelph-Wellington for many years. When our government came to power, I was very pleased to see more equitable funding being distributed all across the province. But we've increased that program, in addition to making it more equitable, by 43%.

In closing, I just want to say that people in Ontario who are wondering whether or not Ontario being cross to the federal government is a fair thing to do can be reassured that it is very fair. The numbers speak for themselves. Allan Rock, the federal health minister, has acknowledged that he has cut the funding significantly. The challenge for us is to find ways to cope with this, and we are taking action clearly in so many different fields.

But the bottom line is, money has to come. These are priority programs, particularly at a time when we're talking of a federal Liberal government which has a huge surplus, and they got that surplus on the back of each and every province as they cut transfer payments. It's challenging when it's a program like health.

Lastly, I'm going to say that in my riding of Guelph-Wellington people have been so concerned about this that they are starting to sign petitions asking the federal government to share 50-50, asking them to contribute more than 11 cents, which is unconscionable, asking them not to create new health programs before properly funding existing programs.

I'm very pleased to add my voice to this debate today. I think it's about time that our citizens stood up beside us and asked the federal government to bring the fair money to the table for all citizens so that we can deliver better programs across Ontario.

Mr Michael Bryant (St Paul's): I'm going to reserve most of my comments this afternoon to talk about the poor cousin of our broken health care system, our mental health care system, in particular a nightmare, a tragedy that has visited a family that lives in my riding and a community in which a family member of theirs lives.

First, a couple of comments, because I can't let this debate go by without saying that in my riding we had a hospital close. The Hillcrest hospital, sometimes called the Toronto Rehabilitation Institute, is slated for closure. Now, let's be clear here: Dalton McGuinty is righter than right but neither left nor right when he says it's time to stop fighting over health care and to fight for health care.

That said, let there be no mistake: It's not the federal government, it's not the federal health minister and it's not the Prime Minister who closed Hillcrest hospital in the riding of St Paul's. It's Mike Harris who closed that hospital. The hospital restructuring commission made a decision for which this government must be held to account. The people in St Paul's, in June, voiced their opinion as to who is cutting in health care. I can tell you, you can spend on advertising until you're blue in the face, government members, you can spend all you want, but you will never convince the people of Ontario that it is not you, the government, that has cut health care, as opposed to another government.

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Another thing I'd like to say is that I was elected here to speak to provincial issues in a provincial House as one of 103 provincial MPPs, and this government would like to spend its time talking about another House. Their response to the health care crisis is: "Look over there. For goodness' sake, don't look there." This government-

Interjections.

Mr Bryant: Mr Speaker, I can't hear myself over the cacophony.

The Acting Speaker: The member for St Paul's is right. There is too much noise. I'm having a great deal of difficulty hearing him. If you have conversations that don't relate to this debate, please take them outside. The member for St Paul's has the floor.

Mr Bryant: Having canvassed those first two points, I want to speak to this issue of our mental health care system.

There is a family in my riding and they've asked that I mention their name. It's the Whitmore family. Ian Whitmore's brother suffers from schizophrenia and has been convicted for a violent offence. If there's anybody in this province who needs the assistance of government, it is somebody who is afflicted with schizophrenia. Necessarily, in a rational society with a Criminal Code and rational laws, we anticipate and expect people to obey those laws and to be responsible for themselves, but as everybody understands, those who have schizophrenia aren't living in the same universe as us when they're not on their medication. Those who have a history of violence are the very people our government and our society need to assist, not only for them so they don't hurt themselves but so they don't hurt members of our community. It turns out that this category of people, schizophrenics with a history of violence, is the very group of people for which there's absolutely no assistance provided within our health care system. I'll walk everybody through this, and we'll have to follow the bouncing ball as we're bounced from ministry to ministry.

In a nutshell, if you are a schizophrenic, then you are to go to a mental health facility, but the mental health facility won't take you because you have a history of violence, so you're sent over to a supportive housing facility which has no supervision whatsoever. In the meantime, there's no way for these people to comply with their sentencing and parole orders and to take their medication, so they go back to the hospital, but the hospital won't admit them because they have a violent history, and on it goes.

Of course it's a nightmare, and this family is living this nightmare. We all know it's a nightmare waiting to happen. So what's our public health care system doing about these people? They're doing nothing.

As a final addendum-and I want to get to the case, but I want to say this-I think we all agree in this House that something has to be done to our mental health laws. This government, by its own admission, has said that amendments have to be made. Nonetheless, notwithstanding that admission, this government decided to pass an act which intended to-and unfortunately has had no effect-sweep the mentally ill off the streets under the squeegee bill. That's the effect. Those who are aggressively panhandling-and we all know that often the mentally ill fall into that category, at least according to the Golden report. Those people need mental health treatment and facilities, but instead of doing that first before bringing in the squeegee and panhandling bill, this government decided to bring in the bill first, by its own admission, sweeping these people off the streets and throwing them into jail.

Mr Galt: On a point of order, Mr Speaker: I believe the debate is on the resolution that the Premier put forward, not the squeegee bill. The safe streets bill has been passed. I think that's over and done with. What we're debating today is the resolution brought forward by the Premier of Ontario.

The Acting Speaker: An interesting observation.

The member for St Paul's.

Mr Bryant: This is a case in point: You just don't get it. You don't see the connection between the failure of our public health care system and those who need assistance, those who are sick and those who are on the streets. But then again you wouldn't know anything about what's happening on the streets of Toronto other than what you read in your speaking notes.

I'd like to get back to this serious issue and off the efforts of this government to distract. I can assure you that the Whitmore family will not appreciate the fact that in the midst of having their story told to this province, this government has decided to play politics. You should be ashamed of yourself for that point of order.

Scott Whitmore was released from the Millbrook Correctional Services Centre on August 24, 1999. Prior to his release, a letter was sent to the Minister of Correctional Services, Mr Sampson. An attempt was made, knowing he had been convicted of a violent offence and was going to be released, to arrange for a place for him to go. They were told, "This is not a correctional issue; you're going to have to talk to the Ministry of Health."

So let's follow the bouncing ball. Over we went to the Ministry of Health. There we were told: "Yes, there are homes for special care, mental health facilities. But because he has a history of violence, he will not be admitted to those facilities. And while there are a few facilities that could treat him, there's no room at the inn. Those beds are full, so there's nowhere for him to go." So the Ministry of Health told this family and told our office, "Off you go to the Ministry of Housing."

The Ministry of Housing said, "You can go to a halfway house." But of course there are no more halfway houses. Moreover, even if there was a facility for him, he would have to go to supportive housing, notwithstanding the fact that in terms of supervision the supportive housing facilities have a recreation worker and a cook. When this person isn't taking his medication, by the family's own admission and by his own admission, there is a history of and a tendency to violence.

So where does he go in our public health care system? This is Ontario. We're told by this government that we are living in times of great prosperity. So one would think that now is a time when our health care system would be able to help those who can't help themselves, help this family living through their nightmare and help the community in which this man is living.

We've had so many inquests calling for changes that I can't begin, in my allocated time, to go through all of them. The Zachary Antidormi inquest of September 1999 said that the Ministry of Health should study existing legislation, including the Health Care Consent Act, to consider whether legislative changes are needed, and of course they are. But we've known that for years. This is one of a long line of coroner's inquest findings.

Then it's time for him to get treatment, and he needs to have his OHIP card. But when you're incarcerated you lose your OHIP card. But because he's schizophrenic, he's not capable of going back and getting an OHIP card. So yet again he falls between the cracks because there are not facilities to assist him in getting that card.

Recently it's been reported that this man has been slipping into a worse mental state. He's not taking his medication. He has tried to check himself into a mental health facility, but there's no room in the inn at the hospital he went to. He was not admitted. He was told that all beds were full and that there are different admission procedures for him, and again he just fell between the cracks.

Mr Speaker, you're standing.

The Acting Speaker: It being 6 of the clock, this House stands adjourned until 6:45.

The House adjourned at 1800.

Evening meeting reported in volume B.

The House met at 1845.

ORDERS OF THE DAY

HEALTH CARE FUNDING

Resuming the debate adjourned on April 6, 2000, on the amendment to the amendment to the motion by Mr Harris relating to health care funding.

Mr Michael Bryant (St Paul's): I was discussing a tragic case and again I want to put it in context. A government member stood up and said: "Why are we talking about the mental health care system? Why are we talking about sweeping the sick from our streets when we're supposed to be debating this resolution?" That's the very point. This government doesn't get it, that in fact this is an integral part about our public health care system and it's turned out to be the poor cousin in a bankrupt health care system. While the provincial government and the federal government fight over who's to blame, in the meantime the people of Ontario are watching millions of dollars being spent on advertising that could be devoted to our health care system.

The victims of this are the families, the patients and the communities in which, for example, we get this story, which comes out of the riding of St Paul's, of the Whitmore family and a schizophrenic with violent tendencies who has nowhere to go in our public health care system. Those diagnosed with schizophrenia and having been in a correctional facility for crimes relating to their illness have no place to go. There's a gap in our public health care system. You can try and blame Ottawa, and Ottawa can complain about what's happening here in Queen's Park, but the point is that there is a gap, and it's this family, the Whitmores, and it's the community in which this man suffering from schizophrenia lives that are at risk.

He was released from jail in August 1999, homeless, without rehabilitation, without supervision, without medication and without the means to fulfill the very sentence that he was given; that is, to take his meds. Everybody who works as an MPP knows that because probably in their community they have come across a family who has a member who suffers from schizophrenia. They know that the key to this is to take the medication.

Well, he couldn't take the medication because he couldn't afford to take the medication. OHIP didn't cover the medication, but even those services that OHIP did cover-he didn't have his OHIP card because he had been in prison, and because he was schizophrenic and dysfunctional, he couldn't go and get his OHIP card. The use of the medication is obviously critical for him to operate as a healthy citizen within his community. He's been unable to find that facility because mental health facilities in Ontario can't take people with a history of violence. These are the people who need the most treatment, who pose the greatest danger to themselves and to others, and yet there's nowhere for them to go.

I've told this House of our efforts in contacting a number of agencies. We wrote the Minister of Correctional Services and he sent us to the Ministry of Health. We wrote the Minister of Health and this is the letter, and I want to repeat it in this House, that I wrote on behalf of the constituent, Mr Whitmore. I wrote the minister on March 6:

" Specifically, his concern," I say of Mr Whitmore, "is on behalf of his brother ... who suffers from schizophrenia and anti-social behaviour. He was released from Millbrook Correctional Centre on August 24, 1999, without any form of supervised housing provided for him and is now living without supervision. He's unable to care for himself; there is no one there to prepare his meals or ensure that he is taking his medication, which keeps him stable.

" Within Ontario's health care system there is no assistance provided to schizophrenics of a violent nature, such as Scott Whitmore. The importance of providing mental health services to someone like this cannot be understated. This is a disaster waiting to happen."

As I wrote, "I have contacted your ministry"-this is to the Minister of Health-"on numerous occasions and have ... been given the same response: It is a housing issue which can be dealt with through the Ministry of Municipal Affairs and Housing." As I write, "It is time for you, Minister of Health, to take responsibility for those who require treatment for mental health disabilities."

We also contacted the parole officer, who said there's nothing he can do to ensure that this man takes his medication. You can write it in the sentencing order. It is in the sentencing order, and that's right, but that's as far as it goes.

As I said, this man is slipping into a worse mental state. He tried to check himself into a mental health care facility and was turned away. No room at the inn.

We have also contacted officials to try and take advantage of one option, which is unfortunately again not available because of his history of violence, to receive counselling as a day patient where he would not require a bed, but instead only be in for counselling during the day and return home in the evening. He has attempted to check himself into a facility of this type, but again he has been told that there is no room at the inn.

We desperately need new legislation. We desperately need the appropriate funding in order to serve people such as this. We've contacted every single ministry official that you can imagine on this issue, in addition to a number of organizations which tell us, unfortunately, that this is not an anomalous case. We spoke with the Schizophrenia Society of Ontario, the Canadian Mental Health Association, New Dimensions in Community Living and the former Clarke Institute on Queen St.

These organizations tell us that this is not anomalous, that we continue to have a situation where our mental health care is the afterthought to our public health care system. This debate about tax points which nobody understands, this debate over the jargon, "primary health care reform," which nobody understands-these are important debates, of course, and we are to have them in this House. We are here to do the business of the people. But in the meantime, the money that is being spent on advertising by both first ministers and by both ministries of health could be providing for medication, for supervision, for housing, for people like Scott Whitmore.

Instead, we've got an institutional gap. It's not as if we're just missing some funds for this person; there is nowhere for this person to go. One facility says, "Go to the other facility," the other ministry says, "Go to this ministry," and everybody continues to pass the buck.

From those who have expressed concern in the Millbrook Correctional Centre, to those who expressed concern in the Ministry of Correctional Services, to the Minister of Health, they are all aware of the problem. We are all aware of the problem. Members sitting here are all aware of the problem. But what are we doing about it?

Well, what we're doing about it is debating over who is to blame with respect to the state of our public health care system. It doesn't make sense. The people in my riding and, I think, the people of Ontario have had enough of governments playing politics over our public health care system. We've had election after election, debate after debate over its state. It's supposed to be this great Canadian tradition and icon of our public health care system, yet we're seeing it transform into the equivalent of an old Soviet Union bureaucracy, full of nightmares, full of gaps, institutional and otherwise. So what do we do?

I commit myself here to continue to assist the Whitmore family. I won't give up. I know that those families who share this similar nightmare don't want their members of provincial parliament to give up. I look forward to a response from the Minister of Health. I sent the letter on March 6, in addition to repeated efforts previously to contact the minister. I know we're going to be seeing some legislation in this area, and I look forward to seeing and being assured and hopefully convinced during debate-yes, debate-that in fact we're not just going to change the laws without having the facilities in place to ensure that there's somewhere for these people to go.

There's no point in simply bouncing Scott Whitmore from department to department or, under this new legislation, from penal institution to penal institution. These people need care. This is the place for affirmative government that takes a community of private sector combined with the public sector. Here's a moment for the government to do something. We all need to remind ourselves of the effect of our bankrupt public health care system, and here is one sad story that comes out of it.

The Speaker (Hon Gary Carr): Further debate?

Ms Marilyn Churley (Broadview-Greenwood): Mr Speaker, I'm not sure if, in terms of rotation, I'm supposed to be the one up. I am, am I? OK. Thank you. Sometimes, because of the skipping, we get some wrong advice from time to time, don't we, Todd? That's in the record now. So here I am, still writing my speech Todd.

I'm pleased to have this opportunity to speak to Ms Lankin, who's the member for Beaches-East York, the NDP health critic, and, I believe to her amendment to the Liberal amendment to the resolution on health care put forward by the Premier.

I welcome this opportunity to speak to this, although I certainly recognize that perhaps the sole purpose of the resolution put forward by Mr Harris is to embarrass the Liberals, both in Ottawa and here in this House. I welcome the opportunity because it gives us here in the Legislature the opportunity to have a much-needed serious debate about what is happening to health care, not only in Ontario but across our nation. There is absolutely no doubt that people right across the nation, as well as here in Ontario, are extremely concerned about the apparent move-and it certainly is happening in Alberta and it's happening by stealth here in Ontario-to privatization of health care, the two-tier system, and they have a right to be concerned.

What I'm hearing is that the public is getting very tired of the partisan nature of the debate. I know it's very hard for us in this House not to get partisan. I've observed in the debate so far that people stand up and say, "I'm not going to get partisan because this is too important a debate," and of course we all do. We all fall into that, accusing each other. The Tories like to pretend that no other government that ever did anything right or progressive on health care existed before. We all know that isn't true. We all tend to yell at each other and go after each other, nut the public, our constituents, don't want to see us do that. They are concerned about what is happening to health care.

We have a resolution before us that attacks the Liberals in Ottawa, and I'm very pleased that the amendment to the amendment from Ms Lankin, the member for Beaches-East York, put forward what I suppose is really a non-partisan amendment that everybody in this House should support, and I urge every member to support it. It doesn't mention specifically a level of government. It just talks about the four principles of the health care system that we need to affirm in this House as of now to give all of our constituents, no matter what party we represent in our own ridings, comfort that there is a full commitment from all of us to uphold these principles. I'm going to read that amendment again:

" And that the government of Ontario adopts the following four principles: a ban on Ralph Klein-style private, for-profit hospitals; a freeze on the delisting of health services; an end to the proliferation of private, for-profit long-term care and home care and a tougher inspection system and stiffer penalties for independent health facilities."

The constituents in all our ridings recently have been subjected to a series of ads. Before the federal Liberal budget we were subjected to a multi-million-dollar ad from the Tories here in Ontario urging the Liberal government in Ottawa to give us tax cuts. There was a lot of pressure from the Reform Party-I forget what they are actually called now-and generally from the right wing across the land to give us that tax cut. The Tory government here put out a very effective ad, and spent millions of dollars doing so, urging the government to cut taxes. The Liberal government in Ottawa did what they were asked to do: They gave those tax cuts.

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I did not hear, and I wish that we had heard, the Premier of the province at that time before the budget. I would expect that members of his own caucus would have liked to see, if they were going to spend money on ads, an ad urging the federal Liberal government, as they have done in this resolution before us, to provide more funding for health care in Ontario, and that wasn't done. Then what did we see after the federal Liberal budget came out? Indeed yes, the tax cut they had campaigned for was there. In fact, we saw a $4.5-billion cut from health care funding. Then in this year's budget, for every dollar in tax cuts, the federal Liberals found only two cents for health care. The Liberals gave $58 billion for tax cuts and $1.25 billion for Canadians' top priority: health care. The Liberals in Ottawa were under a lot of pressure from a lot of people, including this Conservative government, to give us that tax cut. But then, after we received the tax cut, we started to hear from the Conservative government complaining about the fact, quite rightly-I totally agree with the sentiment here-that the Liberals didn't restore the funding to health care.

Interjection: Well, not quite.

Ms Churley: No, they didn't restore it at all. When you lo`ok at inflation and the aging population and the growth in population, it's not a restoration at all. It would have been of benefit to all of us here in Ontario had the Tories, before the Liberal budget, campaigned for the restoration of the cuts to health care.

The Tories don't talk about it, but I certainly still feel the pain of it after all these years: When the NDP was in government-and Mr Speaker, you'll remember this very well because you sat over here at the time-I do recall members, including the Premier, who was then the leader of his party, accusing the NDP and Bob Rae, the Premier at the time, and our health minister of whining when we complained when Mr Mulroney started cutting the so-called cap, a cap on the cap, for social services and for health care. Mr Mulroney at the time started that trend of cutting the transfer payments to the provinces, particularly the three largest provinces. We were accused at the time. We got no support from the Tories who were sitting there to help us lobby the then Conservative government, as they now accuse the Liberals sitting here of being weak on lobbying and speaking out against what the federal Liberals do. They did the same thing when they were in the third party here when we needed their voice and their support, especially during the deep recession that we were in.

That's what I find so regrettable about this whole debate and what is so regrettable about the tone and the nature of this place from time to time. I think we would all agree that there are times in this Legislature when it's not good enough for a Tory member to stand up and crow and get lots of loud applause and smiles and laughter from her own caucus about something nice that happened in her riding and that the Liberals didn't do and the NDP didn't do, but, by God, the Tories did it. That's not what this debate is all about. I could complain about the Riverdale Hospital almost being shut down in my riding and the results, the mess it's in now in terms of the negotiations about where to go from here. I could complain about a lot of things. I could stand here and talk about a lot of good, progressive work that we did when we were in government, and I know my colleague Ms Lankin did that. I urge people to read the speech that the member for Beaches-East York gave, because as a former Minister of Health she has a very good handle on what we did when we were in government and the reforms we had started. It isn't correct for the Tories to say that nothing was going on until they got into government. That isn't true facts, and that is the reality. I think my colleague did a very good job of pointing out the work we did and some of the misinformation that is continually put forward by members of the Tory caucus about what we did and didn't do. We made a lot of good reforms, and that's outlined in her speech.

I want to talk about where we need to go from here and how we can all start working together to make it happen. That is what people want, and generally there is now a consensus on where we need to go. The buzz words are "primary care reform." By now I think most people in the population, and certainly all of us here, understand what that means. It's not a new idea; it has been around for some time.

Several years ago I worked in the South Riverdale Community Health Centre. It was many years ago. I worked with people like Michael Rachlis, a doctor there at the time, Phillip Berger, Debbie Copes, Maryanne Cheatham and others. Maryanne Cheatham was a nurse practitioner and still is to this day. They were in the forefront of reform and I was, in the sense that I had the opportunity to work for a while in one of the very first community health centres. That was, and still is today, a model of what we are talking about here.

We had doctors, nurse practitioners, nutritionists, an environmental health officer and others all working together. Quite often, when patients came in, they would see the nurse practitioner first. If they needed to see a doctor, they would; if they didn't, then that was a saving right off the bat, and they got the care and attention they needed. Overall, it was not only a saving for the taxpayers-I prefer to call us citizens-for the citizens of Ontario, but it served the patients well.

We all know we are at a crossroads in our health care system. It is an extremely serious debate that we are having here, and I fear that we are not taking it seriously enough. It is an opportunity for all of us to engage in real dialogue about where our differences are, where we can agree and what we can do together to make it happen, working with the federal government. I fear that the resolution before us is just all about blame. We now have to go beyond blame and get on with tackling a very difficult problem. But it really isn't all that difficult, because the groundwork has already been laid. It's just that we need some real leadership, both from the federal government and from the Tory government here in Ontario.

I think it's time for the blaming to stop and for the federal Liberals to get off their high horse and stop the punishing tone of, "We won't give you extra money until we are guaranteed certain things." It's time for the Tory government here in Ontario to say, "We want to move forward; here are some steps we want to take," and sit down with the federal government and come up with a plan. That is what the people of Ontario want, because they're frightened. As the population ages, and I'm in that category, I'm frightened, because we see ourselves going down that two-tier road more and more. We continually hear the threats from the Tories here in Ontario, "If the Liberals in Ottawa don't give us this funding, then we're going to have to de-list all kinds of services." We know what de-listing means. It's more services that people are going to have to pay for.

I very much want to see the politics of blame stop around this issue. Perhaps it's too much to ask, but I would ask that we all attempt to have the serious debate we need to have and talk in a constructive way about where we go from here.

1910

I have a very strong interest in determinants of health, that is, health prevention. I'm going to give you an example. I suppose it's one of my hobbyhorses, and we don't talk about it very much here. As we know, there are all kinds of health determinants, and people have spoken to it. It's around housing and having enough money to live on so you can eat nutritional meals and have good dental care, good community health and all that kind of stuff.

I want to talk briefly about primary prevention of cancer, because we know that we have an epidemic of cancer right now. The focus is very much on finding a cure, which is fine, but there is all kinds of good work.

In March 1995, when Ruth Grier was Minister of Health, and as you know, she had been Minister of the Environment, she brought the two together and commissioned a report from some very good experts in various fields who wrote a report on things that we can do, mostly in our lifestyles, but with recommendations for government action. Several years ago, I put forward a resolution, which passed unanimously in this House. It just took one piece of this report on cancer prevention, and it was the environmental aspect of that.

There is growing evidence that there are all kinds of pollutants in our environment, in our food, in our water and in the air we breathe that are leading to cancer. We are seeing certain kinds of cancer more and more among young people. We're seeing a sharp increase in breast cancer in women and testicular cancer and prostate cancer in men. There is growing evidence that some cancer is caused by environmental factors.

The good news is that there is actually something we can do about it; the bad news is that we're not. It's hardly being talked about, but I can assure you that there is a very active group of people in our communities across Ontario who are working hard, still, to get government's attention and to bring forward some of these recommendations.

My recommendation was specific to phasing out or completely getting rid of known carcinogens or suspected carcinogens that lead to cancer. That resolution was passed in this House unilat-by everybody. I almost said "unilaterally"; that was a slip. It was passed by everybody in this House, and there has been no action on it to date. That in itself could make a big difference in the future in terms of the number of people who end up with cancer, and not just elderly people but more and more children are getting cancer. A very good friend of mine's young son was recently diagnosed with cancer, and it's agonizing to watch that family try to cope with the horrible aftermath of that and the treatments and the fears.

That's just one aspect of the kinds of things that we have to be paying attention to. The road map has been drawn for us in all of these areas. So when we have this debate about where we go with health care, we need to affirm our commitment to these four principles within the amendment that our caucus made, and we need to affirm our commitment to looking at health determinants. We need to quickly bring in primary health care. I know it's tough. It can be tough to negotiate with doctors. I know when we were in government we put a cap on the salaries; it was very tough. This government took it off. But we need at this time to sit down and make that commitment and make it happen. The baby steps the government is now taking are not good enough. If we don't do something quickly-and that's why people are so worried and so concerned and so scared. They're hearing a lot of talk and they're hearing a lot of argument and blaming, but they're not hearing people talk about implementing the solutions that are already there.

Earlier today I felt a little sick listening to some of the debate, frankly, because I thought that the level of this discourse, this discussion, given the seriousness of the debate at this time, would warrant more serious commentary. I will end by saying that I very much look forward to hearing that discourse happen.

Mr Wayne Wettlaufer (Kitchener Centre): I welcome getting an opportunity to speak to this resolution, but it's also of concern. It's a concern that we've gotten to this point at all that we have to bring forward a resolution to ask the federal government to pony up. My recollection is from the 1960s, when I was a little younger than I am today, and the discussion came up about a national medicare program, that the federal government was going to contribute 50% of the total cost of the medicare program. Over the years, that has been reduced unilaterally by the federal government-no discussion with the provinces such that this year there will be an 11% contribution by the federal government to the total cost of medicare in this country. Let me see now, 11%: That takes the federal contribution to the national medicare program in this country from January 1 to about February 9, 2000. In this province, Ontario, the taxpayers pony up for the difference from February 10 until December 31 of this year.

In my riding this was foreseen by some very active individuals who took a leadership role, and they have done an awful lot in raising funds and contributing funds-people like the Hallman family and the Voisin family, who have been very generous. Frank and Glady Voisin raised their family and taught their children that this was the way to get along in life, as did Lyle Hallman and his late son, Peter, who have done so much to contribute to the well-being of our community, and not just in other areas but also in the health care field, directly aiding the establishment of divisions within the hospitals, aiding in the construction of buildings, raising money for that. I give them credit for the leadership roles they showed.

We have an obligation. The people of this country expect the federal government to take a leadership role as well. We asked the Prime Minister, the provinces asked the Prime Minister, in February, before the advent of the federal budget, to please sit down, hold a first ministers' conference and discuss the future of health care in this country. What did the Prime Minister do? His response was to ignore that request, suggesting in its place, after the federal budget, that the provincial health ministers meet.

The provincial health ministers met. The federal health minister had no mandate to make recommendations, he did not come with a health care plan and he could not make any decisions. He did not have the authority to make any decisions. The provincial health ministers are left wondering why there was a health ministers' conference. The leader of the third party, Mr Hampton, and the Premier of this province signed a letter requesting more substance from the federal government. Where was the leadership of the opposition party, the Liberal Party?

Ms Marilyn Mushinski (Scarborough Centre): There is none.

1920

Mr Wettlaufer: That's right, there is none. Where was Mr McGuinty? He refused to sign the letter. What kind of leadership is that? Is that because he's a Liberal? I believe it's because he's a Liberal.

Mr Gilles Bisson (Timmins-James Bay): I think so too.

Mr Wettlaufer: I say to my friend the member for Timmins-James Bay, M. Bisson, who says he thinks so too, I agree; no doubt about it.

We were very disappointed that the Prime Minister would not come to the table. He thinks it's all right that the federal government will pass laws, that they will pass regulations about the governance of the Canada Health Act. The federal government will pass these regulations; they will say how it's going to be run, but they will not come to the table. If you're going to pass the rules, you have to be a player.

Of course, we can question why the Prime Minister doesn't want to come to the table. Is it because he hasn't had any ownership, he doesn't want any ownership in the health care question? He doesn't want his government to be held accountable for the problems in the health care field? Why is that? Is it possible that he's looking at an election and he knows that the health care question is the number one priority of people in Canada today-not just in Ontario but in the whole country? Yes, I think that could be a reason. I'm speculating, mind you, but yes.

I'm embarrassed, as a Canadian citizen, to have a Prime Minister who lacks leadership in this area, the most important issue facing Canadians today. Yes, prior to the budget we did ask the federal government to come to the table with tax reductions. Yes, we did, as did the people around this country. They wanted tax reductions because they knew that would boost the economy. They knew that. But the people of this country also wanted more money from the federal government in health care. What did the federal government do? In the discussions leading up to the budget in February, what did they do? They started talking about a national child care program-and I'm not going to criticize a child care program; I won't do that. However, they were floating this trial balloon that they didn't know the cost of. On one hand they would say it was $14 billion a year; on another hand they would say it's $20 billion a year. Then it was $12 billion a year. They had all kinds of money to consider for a national child care program, but all they could cough up for health care was $2.5 billion. They have shortchanged the provinces by $6.2 billion from 1994-95. Sure, they gave us back $2 billion in the last fiscal year and all of the money we're getting in the province of Ontario is going to go into health care over a three-year period, as was promised. It will all be going back into health care. But the provinces of Canada are still shortchanged $4.2 billion by the federal government, which claims it's doing everything it can for health care.

What is the province doing for health care? We have announced $1.2 billion in the last two years for long-term care, to create 20,000 additional long-term-care spaces. Now, of that, 6,700 have been awarded and there will be additional ones awarded in the near future. Long-term-care beds hadn't been announced in 10 years prior to our government announcing them. The federal government says, "Oh yeah, we have to have more long-term care facilities." Then how about some contribution for it?

We've established 43 community care access centres in the last four years across the province to allow services to be delivered closer to home for Ontario citizens.

Home care: The federal government talks about home care. I don't see any strategy from the federal government. However, the Ontario Ministry of Health is currently spending $1.5 billion annually on home care and community care services. From 1994-95 to the current fiscal year, 1999-2000, funding for community services increased by 49%. In-home services funding increased by 56%. We provide the most generous level of home care in Canada, at $115 per capita.

Two years ago, the Ministry of Health and Long-Term Care began investing over half a billion dollars over a six-year period to expand and enhance community services. These in-home community services consist of in-home nursing, therapy, homemaking, supportive housing, attendant outreach and services for individuals with physical disabilities.

We aren't the only province doing it. We are taking credit for the investments we've made in Ontario, but other provinces are also making investments. Some of the provinces are really suffering. We've increased spending by $3.5 billion in health care in four years. Other provinces have increased their investments as well, but they don't have the economy that we have in Ontario. As a result, they are strapped financially. We are fortunate in this province. We are making the investments and we will make a further 20% in investments over and above the present level over the next four years.

Yes, we can stand here and look for congratulations or we can indulge in some self-congratulation, but that's not what we're all about. We want to manage the health care system to the benefit of the average Ontario citizen. The federal government wants to take credit, but they won't put any strategy into it and they won't put any money into it.

Mr Rick Bartolucci (Sudbury): Wayne, do you have a plan?

Mr Wettlaufer: It's very interesting over here. They member from Sudbury asks, do we have a plan? What is the federal government's plan? We have asked the federal government to come forward with a plan, we have asked the federal government to come forward with money, and the federal government can't come forward at all. It's pretty evident, with the money that has been going into the Ontario drug benefit, into long-term care, into MRIs around this province, into cancer care, into cardiac care, facilities which weren't provided by those other governments, that we do have a plan.

I just want to talk about the Ontario drug benefit for a moment, if I may. The Ontario drug benefit covers the cost of over 3,100 prescription drugs. In the last four years since we came to power initially in 1995, 1,018 products have been added to the Ontario drug benefit. Now, $1.6 billion is what the Ontario drug benefit is costing Ontarians, and it covers 2.2 million seniors and social assistance recipients. In 1998-99, 44 million prescriptions were filled. I want to repeat that: 44 million prescriptions were filled.

We also have the Trillium drug program, as you're aware. It's a unique program. It's for those who are not otherwise eligible for the Ontario drug benefit and still have high drug costs. Approximately 100,000 Ontarians who need expensive drugs to treat various serious illnesses-nothing major: cancer, HIV, cystic fibrosis-receive benefits under this program. Expenditures for the Trillium drug program for 1998-99 totalled $45.5 million, an increase of over $10 million in one year.

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These are the things this government is doing for the people of Ontario. We ask the federal government what it's doing for the people of Ontario. I'm looking to hear. I realize there may be a federal election in another six months or a year or eighteen months, as soon as the Prime Minister is sure that he doesn't have to take ownership for the health care issue. He wants to appear to be the saviour of the health care system. Anybody who admits to having cut the heart out of the health care system can hardly be called a saviour.

I'd like to quote what Jean Chrétien said, if I can find the quote.

Mr Bartolucci: Make it up.

Mr Wettlaufer: No, I'm not going to make it up. I never do that. I will quote something else, though.

" Only the federal government continues to use `tax points' and cash in describing its programs. This makes the numbers look bigger." That was by Mike McCracken in "Contra-cyclical Fiscal Policy: Is It Dead?" That was in the Monthly Economic Review, volume XVI, number 12, July 30, 1998.

I'm sure the people of Ontario have heard a lot in newspapers lately and on TV and on the radio. The federal government, Jean Chrétien, is talking a lot about tax points. He's saying: "Oh, the provinces are doing so much better now because of all these tax points. Look at the tax points today compared to what they were in 1985 or 1977." Forget the tax points. They've cut $4.2 billion. Mike McCracken says that only the federal government combines the two in their discussions.

This is another quote: "The federal government has no control over the use of these tax points, nor do they constitute an expenditure or revenue item in the federal budget. They do, however, provide a convenient shield"-a convenient shield-"for the federal government to reduce its cash outlays while claiming that overall entitlements are only frozen or marginally increasing. For these reasons, the forum considers the inclusion of tax points in the federal contribution to be confusing and unhelpful." That was the National Forum on Health, Maintaining a National Health Care System: a Question of Principle(s) ... and Money, in February 1996.

Only the Prime Minister could confuse things. But at the same time he said, and he was quoted in the Toronto Star as having said, on October 27, 1996, "We needed to squeeze [medicare] in order to save it." That's what Jean Chrétien said.

What did Allan Rock say? Allan Rock, in his speech to the 130th annual meeting of the Canadian Medical Association in Victoria, BC, August 20, 1997, said: "But I am part of the problem, not the solution. It was my government that diminished the size of transfer payments." That's the federal health minister, Allan Rock.

All we're asking, not just in Ontario but in all the provinces, is for the federal government to come back to the table. Please be a player, for the benefit of the citizens of this country. Is that so difficult? That's what this resolution addresses. The third party recognizes this. But the Liberals, because they're the official opposition, who don't even play the role of an official opposition, are opposing it because they are Liberals, and I presume because their federal cousins who govern this country are also Liberals.

The Speaker: Further debate?

Ms Caroline Di Cocco (Sarnia-Lambton): I'm pleased to have this opportunity to speak on Mr Harris's motion. I'm also pleased that you have officially declared that we're not rookies any more.

I want to start off by suggesting, first of all, that we stop the blaming and we start taking responsibility. It's time that the Harris Tories show good leadership and for once take responsibility and stop blaming others.

I picked up a book called Moral Leadership: Facing Canada's Leadership Crisis, by Robert Evans. He articulates this trend of what he calls "a culture of blame avoidance now rampant." The Harris Tories are at the leading edge of this culture of blame.

Today I met with Lawrence and Kay Greenaway, the founders of the Breast Cancer Society of Canada. What they told me was quite disturbing. Of the 273 mammography machines in Ontario, 60% are not accredited. Considering that early detection is crucial to successful treatment, I cannot believe that 60% of the machines are not subject to quality control. Who's responsible to regulate mandatory accreditation for these machines that can detect breast cancer? Let's remember that this disease took 2,100 lives last year in this province. The Greenaways have done their part. They take responsibility. They raised millions of dollars for research. Not only do the Harris Conservatives not take responsibility, but Minister Witmer will not even meet with the founders of the Breast Cancer Society of Canada.

One of the things I've always heard from my parents is that if we don't have our health, we have nothing. Taking care of our health is more important than money, no question. I add to this: If we do not have a good health care system, what good are tax cuts?

Mr Harris's resolution denouncing and blaming the federal government for the crisis in health care has been preceded by a taxpayer-funded advertising campaign. I have watched with interest the involvement of the Harris neo-Conservatives in the federal arena of the renamed Reform Party, now known as the Canadian Alliance. Concurrently, there have been advertisements denouncing the federal government and distorting the facts about the complex matter of cash and tax transfers. This leads me to wonder if the blaming game and costly taxpayer-paid partisan advertising is a less than discreet attempt by the Tories to play politics in the big arena at the federal level. They're using health care as their weapon. That is what you're using. Dalton McGuinty and the provincial Liberal caucus believe that partisan advertising should be banned.

The Harris government has continually extolled the virtues of tax cuts. Again last week I heard from the members that the Conservatives have cut taxes 99 times. I wonder if there is a direct connection between continued tax cuts and continued funding constraints to the various sectors of health, education and the environment, and to social, cultural and heritage programs. Now we hear this loud complaining that there's no additional funding, yet the province is losing $4 billion to $5 billion in tax revenues. I recall Harris justifying these tax cuts somewhere as an indirect way to provide better health care, so less personal income tax revenues to the province will add up somehow to more money for health care. Go figure.

1940

Although the budget rhetoric is going to include things such as health and education and strong and secure communities, the focus on tax cuts will force a reduction of the government's role in health and education and community support programs. This is at a time when there needs to be significant reinvestment in these services because of the cuts during deficit years.

The government has indicated it intends to aggressively restrict expenditures in education, community and social services, and support for municipalities. A key tool in this policy is the government's decision to essentially pre-spend much of the fiscal dividend on tax cuts. So they don't have the money to put into these social programs.

The people of Ontario are beginning to realize that there is a significant price we all pay in both the quality of life for all Ontarians and the basic civility in Ontario society. This has been a Harris revolution, with many victims and casualties. We brag to the world about our quality of life while the Harris government moves to undermine the very things that contribute so much to our quality of life.

The province has the responsibility for health care. You know it; I know it; the people of Ontario know it. When you choose, and the Harris Tories choose, not to take responsibility, you play the blaming game: Attack the teachers, blame the school boards, blame welfare recipients, blame past governments, blame the federal government.

From very early on in my life, I was taught to take responsibility for my actions and for my decisions. This is considered a mature approach in our everyday lives, in carrying out our daily jobs, and is the basis of credible, responsible decision-making. So why has the Harris government been playing the blaming game for so long? Is the Harris government not responsible for the consequences of decisions made in this House? But I forgot-I think I've heard numerous times that they are not a government. They must have said it over and over again. I don't understand what they're here for, because they're not a government.

Interjection: They're here to fix government.

Ms Di Cocco: That's right. They're here to fix government, but they're not government.

Minister Witmer stated just last week that the Harris Tories have maintained a quality health care system. I have to add, there was a feature article in the London Free Press by Mary Jane Egan on February 5 of this year. The headline stated, "Hemorrhaging Health Care," and right underneath that headline it said, "A highly skilled London eye surgeon pulling up stakes for the United States is only one symptom of a health care system losing doctors faster than they can be replaced." This headline must be fiction because, according to Minister Witmer, the Tories have maintained a quality health care system.

Dr Probst, a 34-year-old ophthalmologist, moved his practice to Michigan on March 1 of this year, and I'll quote what he said: "Hospitals in London and across Ontario have been forced to cut operating time for eye surgery in half because they can't afford to cover the procedures." But according to Minister Witmer, they have maintained a quality health care system.

I have a letter from the Ivey Institute of Ophthalmology in London, Ontario, to a patient in Sarnia, dated this February 10, that the funding situation in London is extremely tight and that level 2 care for patients from Lambton county depletes the funding for patients who reside in Middlesex county. But again, let's remember that Minister Witmer says the Harris Tories have maintained a quality health care system.

I'll give you one other example within a 100-kilometre radius, that of an ophthalmologist who shut his doors in October in Lambton county because Minister Witmer's ministry changed the geographic boundaries and disallowed his exemption of OHIP funding caps for underserviced areas.

I handed in a petition with about 4,000 signatures of people affected by not having their cataracts, glaucoma and other eye conditions looked after in a timely fashion. But all these people must be wrong because-I'll say it again-Minister Witmer said the Harris Tories have maintained a quality health care system. I have received hundreds of letters, phone calls and e-mails on this and other health matters, yet the Harris government chooses not to address it.

Why did the Harris government make such drastic cuts to hospitals? You have not reformed health care. Instead, you've cut hospital beds and restructured hospitals. Dr Sinclair, head of the Health Services Restructuring Commission, is on record as saying that hospital restructuring has put the cart before the horse.

Interjections.

The Speaker: Would the member take her seat. Order. The member has the floor.

Would the member continue, please.

Ms Di Cocco: Thank you, Speaker. The Ontario Health Services Restructuring Commission held its first meeting on April 24, 1996. At that meeting-and it's in the documents-an agreement was reached on the following approach to fulfilling the Health Services Restructuring Commission's mandate: acceptance of the prime mandate of the HSRC to facilitate hospital restructuring. The HSRC would have preferred, however, to deal initially with restructuring of the primary care and community service systems as the first order of business rather than beginning with the task of restructuring hospitals. In other words, it would have made more sense to begin restructuring or creation of a genuine health services system at its front end rather than with the institutions of last resort. Again, you can read it in the report from the HSRC.

1950

When banks changed, they put in automated tellers before they shut their branches. However, the Harris Tories have not done this. They closed beds, they restructured, before they had a viable contingency plan in place.

The government likes to pretend that federal contributions toward health spending continue to decline in Ontario. I have some other figures. In fact, last year the federal contribution to health care spending grew faster than the provincial increase, and I'll show you why: 55% of the $1.647-billion increase in provincial spending was the result of $945 million in additional federal entitlement, while provincial funding was just $702 million. The source is the 1999-2000 provincial budget papers. For every additional federal dollar, Ontario kicked in just another 80 cents. The province drew only $755 million of its share of the $1.3 billion available from the federal government. The balance is sitting in a bank account earning interest. An additional $190 million in federal funding came from changes to the CHST formula.

We on this side of the House want a commitment from the Harris government that any additional federal funding for health goes specifically to health care. Additional health spending should not be diverted for further tax cuts or other spending priorities, but instead should be used for real improvements in health care. Improvements, however, do not seem to be a priority for this government. If they were, cancer patients awaiting health care wouldn't be forced to go out of the country for care.

How much longer can health care in this province be eroded beyond the point of repair? To lay blame solely at the federal level, in my estimation, is highly irresponsible.

I would like to review some of the actions of this government since 1995. They set out on a path of restructuring, of creating a crisis, of cutting and cutting. Of course, we keep hearing about the tax cut agenda. Health care has not been high on the Conservative agenda, and we all know that. What has actually happened is that restructuring of hospitals has been done backwards.

The way it was explained to me by Dr Sinclair is that the first point of contact in the health care system is a family physician. It is from this primary point of contact that people are cared for. They are sent for tests, referred to specialists, and, the last point of care, sent to hospital. Now we have a system that has been broken. It's in crisis. Since 1995, the Conservatives, as we all remember, have fired 10,000 nurses, have been restructuring, have been closing hospitals, have been cutting hospital beds.

What is poor management of the Harris government is that there's no plan to fix it, nor was there a thoughtful approach to change. What is worse is that the Harris Tories do not take responsibility for the consequences of their decisions. The Harris government is good at blaming others, and you're spending million of dollars on a TV advertising campaign to blame the federal government about health care. Would this money not have better served the province of Ontario if it had been invested into health care?

I would like to put on record the deliberation from the hospital restructuring commission. They said that the role and responsibility of the provincial government-it is on page 165 of the document-is to retain authority for overall policy, to provide leadership and high-level direction to the health system, and to be ultimately accountable for the provision and management of health services.

The provincial government has the constitutional responsibility for the provision and management of health care services, and must therefore retain accountability for its handling of this portfolio, regardless of whether it manages directly or creates and delegates this responsibility to others.

This motion that Mr Harris put out is an abdication of this responsibility as a government. The contrast to the hospital and health care crisis is strong economic growth in this province. If we have such a healthy economy, why does it not translate to a better health care system in this province? The Harris neo-Conservatives are destroying the social fabric, and we know it.

Mr Steve Gilchrist (Scarborough East): And now for something completely different. I would like to start with a couple of quick quotes. "It is a fact that during our first mandate, this government reduced transfer payments to the provinces." That was the Liberal 1997 red book. Jean Chrétien, our Prime Minister, said in the Toronto Star on October 27, 1996, "We needed to squeeze [medicare] in order to save it." Our current health minister, Allan Rock, in a speech to the 130th annual meeting of the Canadian Medical Association on August 20, 1997, said: "I am part of the problem, not the solution. It was my government that diminished the size of transfer payments."

Hon John R. Baird (Minister of Community and Social Services, minister responsible for francophone affairs): Who said that?

Mr Gilchrist: That was Allan Rock, the federal health minister.

Before the most recent federal election, the federal Liberal government, as most parties do, commissioned extensive public surveys. They went to Angus Reid and Angus Reid came back and told them, before the budget and before the election, that health care is the number one concern in the minds of Canadians. They were told that it mattered far more than tax cuts; it mattered far more than any spending issue; it mattered far more than any of the boondoggles that they were otherwise involved in. Despite that, the most recent federal budget had a grand total of 2% of new spending in health. So we have a bit of a contradiction. On the one hand the federal Liberals join with us in saying that there is a crisis in funding, but when they had an opportunity to stand up and be accountable, they chose to look elsewhere. It is indeed regrettable and I think it compounds a very fundamental problem on the part of the federal Liberal government, and I regret to say, perhaps some of their colleagues in this Legislature: They're not prepared to recognize their responsibility in this, the most important category of government spending.

You've heard before in this debate that the original premise behind the Canada Health Act was that the province and the federal government would share responsibility, and that was quite appropriate given that health was a defined provincial role. So for the federal government to intervene in any way, to have a say, to engineer a countrywide common health strategy, it was appropriate for the province to say, "If you want to have say, you have to be part of the pay." In fact, to their credit, in those early years the federal government did pony up 50% of the cost of the health care systems all across Canada. Today, their percentage has shrunk to an almost insignificant 11%. They would argue, by throwing issues such as tax points back on the table-a red herring if there ever was one because tax points haven't changed in over 25 years. But if you throw that back on the table, they say: "Guess what? We're really not ripping you off by paying only 11%. We're ripping you off by paying 34%." And what a compelling argument that is. They are still, by their own words, one-third below the standard that was the overriding premise behind the creation of the act in the first place, behind the creation of the partnership between the provinces and the federal government. We do not want to believe that the federal government really pays that little heed to health care issues across this country, but I'm afraid their budget would suggest otherwise, and that's the current federal Liberal government.

During the mid-1990s they made a very historic decision. They decided to make the biggest cuts to health care in the history of this country. Today, the annual base funding for the federal program that supports health care is still $4.2 billion lower than the day the Liberal government was elected-$4.2 billion. Contrast that with the cost of any number of the initiatives that our government has undertaken and you would see just how far our share of that $4.2 billion would go.

When you talk about a large metropolitan hospital taking approximately $100 million to operate, if Ontario was just getting its fair share of that $4.2 billion, we would be running another 18 hospitals, large metropolitan hospitals. Put another way, countless numbers of new dialysis machines, dozens of new MRI machines, any category you care to mention, this province would have infinitely greater ability to meet the increasing needs and demands of an aging population, to embrace new technology, to guarantee that even in the most remote parts of this province we offer the same quality of health care that we take for granted down here in Toronto.

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We don't have that ability, despite the fact that since we were elected in 1995 the provincial health budget has gone from $17.6 billion to $20.6 billion. We have committed an additional $3 billion at the same time our share of those federal funds, $1.7 billion, was removed by the federal Liberal government.

In very real terms, it can be said that we've made up $4.7 billion worth of maintenance or increased funding to health care, a staggering percentage of the money that's being spent in this province today. Where is that money going? Let's talk about a number of the initiatives this province has committed to: a primary care network, a new way of providing medical care-we've got pilot projects in four different locations since 1998, and three more were added in September 1999; ways of making sure that family doctors are available on a seven-day-a-week, 24-hour-a-day model; guaranteeing that family doctors will participate by tying themselves individually to patients so that they have a far greater awareness of the needs of individual patients, but the patients, in turn, are guaranteed greater access. I didn't see my federal counterpart at any of the announcements that were made in connection with that program.

We have the Ontario drug benefit plan. The ODB is the largest pharmaceutical plan in the country. It covers the cost of over 3,100 prescription drugs; 1,018 products have been added to that list since our government took office in 1995. It's a $1.6-billion program that covers 2.2 million seniors and social assistance recipients, and last year, 44 million prescriptions were filled.

We also have the Trillium drug program. It's quite unique because it's for those who don't qualify for the ODB and who have high drug costs. Approximately 100,000 Ontarians who need expensive drugs to treat serious illnesses like cancer, HIV and cystic fibrosis have their drugs paid for by this program. Expenditures under that program cost $45.5 million last year.

Our third drug plan, the special drugs program, covers the full cost of certain expensive outpatient drugs, such as specific drugs for AIDS, organ transplants, cystic fibrosis, schizophrenia and thalassemia. The program provides funding to over 12,000 beneficiaries at a cost of approximately $92 million annually.

Again, I don't recall seeing our federal brethren standing up and taking any share of the responsibility for those programs or their expansions.

We've heard the federal Minister of Health suggest that we need to look at expansions in home care. That's very interesting, perhaps, if you live in one of the eight provinces that don't already have a generous home care program. Ontario has by far the most generous program. We currently spend $1.5 billion annually on home care and community care services. Since we were elected, the funding for community services has increased by 49% and in-home services have increased by 56%. We're providing $115 per capita. The next highest province is Manitoba at $97.62. The other eight provinces are barely on the map.

Beginning in 1998-99, the Ministry of Health and Long-Term Care was also investing $550 million over six years to expand and enhance community services, such as in-home nursing, therapy and homemaking, supportive housing, attendant outreach and services for individuals with physical disabilities. I didn't see any federal MPs at that announcement in 1998-99.

Community care access centres: In 1996, this government established 43 CCACs all across the province, with a view of providing support to Ontario residents who seek community-based, long-term health care. This guaranteed that services would be delivered closer to home for all Ontario citizens.

In 1999-2000, the ministry is providing CCACs with a total of $53 million in additional permanent annual funding to provide additional nursing, homemaking and therapy services. Not to be repetitive, no federal member was there to pony up their share of that funding increase.

And perhaps the most important initiative the government has undertaken: In April 1998, the government announced the largest ever expansion of health services in Ontario. We're going to be investing $1.2 billion to improve long-term-care facilities and community programs. No new long-term-care beds had been built in this province in the previous 10 years despite an obvious aging of our society. Our commitment would add 6,700 new beds back in December 1998, and in addition to adding the equivalent of 175 new nursing homes, we're also rebuilding and renovating 100 older facilities so that they'll comply with today's new standards to promote a better quality of life for all residents. I'm pleased to say that the Metro Toronto Legion Village in my riding has been a beneficiary of just such a renovation. The veterans who live in that building, I can tell you, have benefited tremendously by the increased size of the rooms, the increased commitment to providing the technology and the equipment that only a fully funded health care system can provide.

I could go on at great length about the other initiatives, but I don't think too well of it because in every case it ends with the same punch line: There is no federal involvement. At the same time as they come out with the flowery phrases, as they come to more and more meetings and suggest that we need more and more studies, we have recognized the need for increased funding, we have come up with the dollars for the long-suffering taxpayers in this province, and we have been able to balance the tax revenue to commit that extra $3 billion and make up the $1.7 billion that the federal government had cut.

When we launched our advertisements calling on the federal government to meet their responsibility, to review what they had planned in their budget and, in fact, before passing any budget bill, to guarantee that they came up with the dollars that they really should be contributing, not just to this province but to all the provinces, the Ontario long-term care association issued a statement. They said, "The association and its members are supportive of the message contained in the public awareness campaign launched today by the provincial government to address the issue," the issue of the underfunding, to put pressure to restore the $4.2 billion and to educate Ontarians, and indeed Canadians, as to what was happening to federal health care funding since the Chrétien government was elected.

We've got to condemn the most recent statement by a spokesman for the federal finance minister, who implied that increasing health funding was a waste of money. We had the recent meeting just a couple of weeks ago, where our Minister of Health and the other provincial ministers met with Allan Rock, the federal health minister. Mr Rock didn't come to the meeting with a commitment to provide stable long-term funding, and while that was perhaps a disappointment to some, it was hardly surprising.

Mr Rock was told about all the initiatives Ontario and other provinces have committed to. He was told how generous our home care program is. He was told how generous our drug plan is. At the end of the meeting, Mr Rock came out and told the press that he found that whole meeting very enlightening, to which the press response was, "You didn't know all of these things already?" His comeback was, "Well, yes, I guess I did." Once again, we had just another stalling tactic, just another sham, where the federal government, under the guise of listening to Ontarians and other Canadians, had really done nothing more than stall another few weeks until the next election.

I don't think the people in this province are going to have the wool pulled over their eyes any longer. The reality is, even with their announced increases in health care funding, it will take until the year 2002-03 for the federal government to catch up to the actual out-of-pocket spending that they were making in 1995. While that sounds very well and good, the reality is there will be 2.3 million more Canadians by the year 2003 than there were eight years previous, 2.3 million Canadians in an aging population who need increasing amounts of health care, who need increasing allocations for drug plans and for home care. To simply catch up to where they were in 1995 is not good enough. They must meet their responsibility. They must come forward and recommit to a 50-50 funding relationship. Anything less than that is a betrayal of Tommy Douglas, a betrayal of all of those who originally crafted medicare.

2010

Mr Bisson: You said "Tommy Douglas" and didn't faint.

Mr Gilchrist: I did say "Tommy Douglas." I'll give credit where it's due, to my honourable colleague.

The reality is, all of those people who in the early years truly believed that there was a partnership being formed between the provinces and the federal government have been betrayed by the actions of the federal government since then.

The Prime Minister was quoted in February as saying that the total value in cash and tax points is now slightly higher than the $28 billion when the Liberals took office in 1993. But here are the facts: Between 1994-95 and 1998-99, the federal government cut the annual CHST cash entitlements by $6.2 billion, or 33%. Since then, the federal government restored only $2 billion of those cuts in its budget last year. Clearly that still leaves a funding gap of $4.2 billion. The inclusion of tax points distorts the facts. Let's compare apples to apples. The fact is the federal government provided provinces $18.7 billion in cash in 1994, not tax points, not tax room, but simple, old-fashioned Canadian dollars. Today we want the same amount of CHST cash.

Federal myths: The finance department itself proclaimed these tax points to be part of its contribution, but this was always a gross misrepresentation. A transfer is money that the federal government provides to the provinces out of its taxes, not the provinces' taxes. With the replacement of EPF by the CHST, even the finance department has had to give up pretending otherwise. It's a shame that the health minister and the Prime Minister won't even follow their own bureaucrats in honestly recounting their shortfall. The federal contribution, even by their own admission, in 1997 had dropped to 15%, and as I said earlier, today it's down to 11%.

What matters is federal cash contributions dedicated to health, not other cash payments to provinces such as equalization, nor the artificial notions of entitlements and tax transfers. This is from the National Forum on Health back in February 1996, "However, the federal government has no control over the use of these tax points, nor do they constitute an expenditure or revenue item in the federal budget." I guess we can take credit for the fact that, having raised this issue some months ago and having now turned the heat up through the advertisements we've been running to raise awareness all across Ontario of what has really happened to health care funding, the last-gasp, desperate measure of the federal government was to come up with this concept of tax points as their salvation, as their way of saving face. It's not going to fly. The bottom line is the bottom line.

Our government recognizes the importance of health care. Every budget has seen increasing amounts of money dedicated to important health care initiatives such as the ones I recounted earlier. That's no less true in our most recent budget, where we've committed to another $2-billion increase, the largest increase by any province in the history of Canada. There is no doubt, though, that if both levels of government were paying their fair share even more could be done for the people of this province who need cancer care, who need cardiac care, who need very expensive services for any number of ailments.

The reality, as we look at our local hospitals, is that we see new dialysis wards, we see new expansions in cardiac care. We've seen a vast expansion in expenditures on cancer care. We've seen more money go into hiring nurses, more money into emergency rooms, more money for hospital renovation. But the fact of the matter is, we still have a long way to go, and only with the federal money can we make that last step.

I don't think there's much more to be said, except another quote from Allan Rock: "I will not stand here and tell you the cuts in transfer payments we made were insignificant. They were not. And I won't tell you that they have not had an impact. They have."

This resolution begs a very simple response from all members in this House. If they care about their commitment to defend the interests of the people who elected them, they should put aside their party membership, put aside their allegiance in the back rooms and guarantee that it's a common commitment to the federal government to restore full funding for health care in the province of Ontario.

Mr Bruce Crozier (Essex): I'm pleased to join this debate on the resolution and the amendments thereto. Throughout the debate in the last few days, our constituents at home have heard a lot of references to the transfer payments and to EPFs, which is established programs financing. They've heard a lot said about the CHST, which is the Canada health and social transfer. I just wanted to add to the comments of my colleague who spoke just a moment ago and give a little bit of history. I'm not going to get into the numbers, because I think the numbers have been convoluted by practically every speaker who has preceded me, but certainly not by my friend from Renfrew-Nipissing-Pembroke earlier today; he told it as it is. I want to give you a little bit of history on what is commonly known as the Canada health and social transfer.

Part of those transfers are referred to as tax points. The tax point transfer system was established by the Federal-Provincial Fiscal Arrangement Act in 1977. Other federal-provincial fiscal arrangements actually predate the legislation, and these include some of the following:

In 1958, under the Hospital Insurance and Diagnostic Services Act, the federal government provided the provinces with 25% of their per capita costs and 25% of the national per capita costs times their population.

In 1965, the Established Programs (Interim Arrangements) Act, permitted opting out by the provinces with compensation, and only Quebec chose to do so.

In 1966, the Canada assistance plan, commonly referred to as CAP, initiated a 50-50 shared-cost program for various social purposes.

In 1967, the post-secondary education cost sharing agreement, PSE, between the federal and provincial governments: Cost sharing was 50% of the operating costs or a specific per capita amount if a province so desired.

In 1968, the Medical Care Act came into force, and by 1972 all the provinces had signed on. Ottawa paid 50% of the national average cost that was distributed to the provinces on an equal per capita basis.

In 1972, the federal government capped the growth in the post-secondary education contributions at 15% per annum.

In 1975-76, as part of its anti-inflation program, the federal government introduced a series of restraints on medical payments to the provinces.

Established programs financing: In 1977, following the passage of the Federal-Provincial Fiscal Arrangements Act-and I emphasize that these are federal-provincial agreements-the federal government gave up a share of its income tax revenues to the provinces. In place of the cash payments formerly made to finance the federal share of three established cost-sharing programs-hospital insurance, medicare and post-secondary education-Ottawa transferred to the provinces an additional 9.143 personal income tax points, in addition to the existing 4.357 points that it had surrendered previously and the 1 point of corporation income tax, for a total of 13.5 points.

The previous speaker to me, from Scarborough, said there had not been any change, but obviously in 1977 there was. These tax points were incorporated into provincial tax regimes and were equalized via the formula of equalization like other provincial revenue. These equalized transfers were notional; there were no actual transfers of cash. But the only thing we hear of in the Legislature is transfers of cash.

2020

It's interesting to me that it was only three or four months ago, in the fall of last year, that all we heard from the provincial government was, "The federal government should look at tax breaks, tax reductions." I didn't hear anything from them last fall about the fact that any kind of change should be made in the cash transfers or the tax point transfers to provincial governments specifically for health care. Now that the federal government has brought forth a budget that not only introduced tax reduction but increased the amount that is paid for health care throughout Canada, we hear that lonely voice in the woods saying, "What we need is more money."

When I came to this Legislature in 1993, I recall that Mike Harris, as leader of the third party, sat down here just a few desks away, and all he could say to the government of the day was, "You don't have a revenue problem; you have a spending problem." What does Mike Harris want now? He wants more money. He just wants more money. He keeps saying, "Give me more money." I would say to the Premier that he should think back to when he said, "The government doesn't have a revenue problem; it has a spending problem."

Ms Mushinski: He's not saying that. He's saying, "Give it back."

Mr Crozier: He certainly isn't saying that today. His tune has changed completely, because now he's the government. That's the point I am trying to make: It depends on what time it is and what he is talking about as to whether he wants more money or tax cuts. We've seen what tax cuts do to us. We've seen where he has given money to the rich and taken from those who don't have it. Part of the result of doing that is the fact that health care has suffered.

There has been a cash floor established throughout this time, and I, like many others, hope the federal government will pay its fair share. I encourage the federal government to pay its fair share. Certainly I am part of that Liberal-they are my Liberal colleagues. This discussion has gone on not only at the federal level, as far as the Liberal Party or the Liberal government is concerned; it goes on every day in our caucus. We too are concerned about health care in Ontario.

But we are not the only ones concerned. I have even heard the Premier and others on the other side say, "We are delivering more and better health care than we have ever delivered in history." Let me tell you what Henry from Bell River says when he calls my office. I assume that all members of this Legislature get calls that are similar to mine. This constituent's wife called the office. They have received notice from their doctor that he is retiring and giving up his practice. He doesn't have any other doctor coming in to take over his patients. "They're left out on the sidewalk," in the words of Henry's wife. "How can the government allow them to do this?"

We explained that we're aware of the lack of physicians in our area. I live in an under-serviced area. But does this government give more to education to open up more medical spaces? We suggested that at least a 15% increase should be available for educational medical spaces in this province. But is the government doing this? Their answer to that is: "We'll simply increase tuition fees. In fact, in some professions we'll deregulate the tuition fees."

The option my constituents see they have is that they are to call the Essex county medical association and be referred to a doctor. The problem is that most, if not all, the doctors in our area aren't taking on new patients. So they have to use a walk-in clinic, several of which are in the county, but most are in the city of Windsor. This is a very serious concern for these constituents, and they say in conclusion: "This government is terrible. Who voted them in anyway?" Well, I'm not sure who did.

I have another memo from Nick, who lives in Emeryville. He called and spoke to us about the sorry state of our health care system. What I want to point out is that it is the province that is responsible for the delivery of health care, as was pointed out by my colleague from Sarnia in the health care restructuring commission's report. It's the province's responsibility. Here again, I wonder what it is the Premier means when he says: "In all areas of the government, we have to do more with less." I'm not suggesting that we should do more with less when it comes to health care, but I haven't heard that the Premier has differentiated between doing more for less in health care and doing more for less in any other area of government services.

This constituent is so beside himself that he feels they should privatize health care, that he would be willing to pay the cost of his vaccination. That isn't what health care is all about, nor is it what health care has been all about in Ontario or in Canada. We feel that there should be health care that's comprehensive, universal, has portability, has public administration and, most of all, is accessible. In other words, we agree with the Canada Health Act.

I have another one, from Marilyn in Lakeshore township, who called to complain about health care. Frankly, I have files at home that are full of these kinds of comments. She has been ill for 10 months, diagnosed with six different ailments. She has a breathing problem; went to the ER and was sent home. She has been sent from doctor to doctor; sometimes she has to wait two or three months for a doctor. She feels she's getting an expensive runaround.

That brings to our mind that there should be primary health care reform. She shouldn't have to go from doctor to doctor. She shouldn't have to go find a doctor who will treat the ailments she has-at great cost, by the way, to our health care system. It seems nobody knows for certain what is wrong.

I think that's a very important statement she has made. We've been debating this resolution for two or three days and we're going to go on, I suspect, at some length. She says, "Nobody knows for certain what is wrong." I suspect that's what all of us are trying to find the answer to: What's wrong? She has pain in the larynx and throat area. The specialist has sent her back to the original respirologist and she now has a two-month wait to see him. She has also been told that her problem may be psychological.

Can you imagine? This woman wants to know what's wrong with her. She's batted from one doctor to another in our health care system, at great cost, but she really doesn't know whether anybody knows for certain what's wrong. Frankly, in that case, I gave her the Minister of Health's address and hoped that she would write to Minister Witmer and see what her response might be.

I have Doreen, from LaSalle, who called and said that they just moved from Toronto. Her husband has a job in the area, and the problem is she can't get a doctor in LaSalle or in the city or in the county to take them as new patients. They have a five-month-old who obviously needs care. They've called the medical society to get a list of doctors. There was only one accepting new patients, and the first appointment available was in July. I received this message and had this conversation with this constituent in early April.

She goes on to say that this is not acceptable to them. The baby needs her shots and can't go without a doctor. She and her husband could get by with visiting a walk-in clinic, but not the baby. Again, the only answer that we can give to them is that they should call the local medical society and hope that someone would be able to answer their needs.

2030

A little bit more of the history of medical care in our area: In the early to mid-1960s, Hopewell Hospital had been operating for years in our community. Had it not been for the Rotary Club some years before, a community the size of Leamington, where I live, might not even have had a hospital. But thank goodness the Rotary Club of the day took that obligation and we had our own hospital. It just so happens, by coincidence of the change in riding boundaries, that there isn't a hospital in the riding of Essex. We rely on the Leamington District Memorial Hospital, we rely on Windsor Regional Hospital, we rely on Windsor Hotel-Dieu Grace and, to some extent, up in the northeast part of the county they rely on the Chatham-Kent Health Alliance hospital.

It doesn't matter that I don't have a hospital right within my riding. The important thing is that we have access to hospitals, that we have access to that medical care. What have we found? Those hospitals in our area are running near-deficits or are in fact running deficits. Some of them have to dip into their savings, if you like, into their trust money in order to make their hospitals function. I repeat that it's the responsibility of the province to carry out the delivery of health care in our area.

Earlier today my colleague from Renfrew, I believe during his address, mentioned ambulance service. One of the things I can't understand, although I think I know the motive behind it, is that ambulance service is now a municipal responsibility. Ambulance service is, for many of our constituents, the very first contact they have with our health care system, and what has happened? The province has downloaded it on to the municipalities. We've heard a lot said in this Legislature in the last couple of days blaming someone else, someone else calling the kettle black. Well, I suggest that when it comes to ambulance service, that's an integral part of our health care system, and yet I think this provincial government has to take responsibility for having downloaded that on to the municipalities.

Fortunately I know the resilience, the dedication and the understanding of the people in my constituency. I know that even though the county has now been given responsibility for the operation of ambulances in our area, it will be a first-class ambulance service. But that doesn't take away from the fact that this government has abdicated its responsibility for one of the very first contact points that all of our constituents have with our health care system.

I think it's a shame that we have two levels of government, the province and the federal government, who are now using what could be valuable health care money to throw stones at each other. How many of us heard that people in glass houses shouldn't throw stones? In this case, I think neither the provincial government nor the federal government should throw stones at each other. They both live in glass houses.

Do you know that we live in the most prosperous times we've ever seen? There is more tax revenue; there is more money. We're told that people are earning more than they've ever earned before. Yet with all this prosperity, and with all the sincerity that we have in this Legislature, we have a health care system that's going down and down and isn't serving its constituents. Shame on all of us. When I look back to my municipal background, I think consensus is what we should be looking for. Let's stop the bickering. Let's stop the waste of advertising money when it could be used on health care and get together on this.

Mr Bisson: I appreciate having the opportunity to participate in this debate. I want to say at the outset that I am going to support this motion because my view has always been the same. In the time from 1990 to 1995, when we were the government, the federal government of the day, both the government of Brian Mulroney and the government of Jean Chrétien later, after 1993, exercised what is the most massive downloading of services and of costs on to the provinces that we've seen in the history of this province. At a time that this country was going through the worst recession we had seen since the 1930s, first the Mulroney government and then the Chrétien government started the process of offloading to the provinces their responsibility when it came to paying for a number of services in this great nation, and health care was but one of them.

I remember that before I came to this place in 1990 the federal government's share of health care costs in Ontario was 50 cents on the dollar. We find ourselves today in a situation where, depending on whose figures you listen to and who you want to believe, it is anywhere from nine to 11 cents. So I agree with the motion put forward by the Conservative government. I believed, when our government tried to go after the federal government in 1992-93 and onwards to get our fair share of transfers for health care dollars and education dollars, that that government was downloading on us and making it very unfair for Ontario to be able to deal adequately with health care needs in this province.

I remember, however, what the then leader of the third party and all of the members of his caucus, the now Minister of Labour and others members of his caucus, had to say about the Rae government when we were proposing that the federal government should engage in discussion with Ontario to give what was our fair share when it came to health care dollars. I'll read from the Hansard of May 11, 1994, what Mike Harris had to say at the time: "When I hear other provinces coming to the federal government, which is $40 billion in deficit, and whining that we need more money, particularly Ontario, this province whose taxpayers pay the bulk of the federal taxes"-you know, blah, blah, blah, nothing but whining.

I want to know what happened to Mike Harris and I want to know what happened to all the Conservative backbenchers and now cabinet ministers who changed their attitudes from 1994 to today. The Rae government reached across the House to the Liberal opposition and then third party Tories to say: "We don't want to engage in a political debate about what's happening in regard to how the federal government is transferring their responsibilities on to us. Work with us in order to get the dollars that we justly deserve in Ontario." The response we got from Mike Harris at the time was, "Quit your whining." I remember that well.

Now something has happened. They've been converted on the way to government. They walk that road and all of a sudden they've changed their minds. I'll tell you what has happened. It's a real simple thing. It's called politics. This government has read the pulse of what's happening in this nation. People across this country are worried about what's happening to our public system of health care. They worry that it's being underfunded and that the system is starting to show some cracks through it.

Members here have talked about different instances that we've seen in our own constituencies where people are not able to get services. We're seeing in this province, probably in the next federal election, that the number one issue coming up this fall, if there's a federal election, is going to be health care. This provincial Tory government, for political reasons having nothing to do, I would argue, with the idea of trying to get Ontario's fair share, is now whining at the public trough, trying to figure out a way to get into the political debate in order to get the dollars to Ontario that it richly deserves.

2040

I say to the Conservative government, if it wasn't good enough for you in 1993-94, I wonder how much sincerity you have in your debate today. I tell you, I have a bit of a hard time standing in this Legislature, or sitting in this Legislature earlier, and listening to some of the comments of the members from across the way complaining about what the federal government has done to the province of Ontario. I agree with you: We've been downloaded. But for you guys all of a sudden to change your tune for political reasons runs not only thin for members of the assembly who have been here for a while, but, I would arguem for the public of Ontario. People in my riding, and I would argue people from other ridings, because nowadays as members we get e-mails from all across the province and from all across the country-in fact, I got an e-mail from somebody in Ireland today on an issue of transportation in Ontario. People from across this country and this province are saying: "We are worried about what's happening to public health care. We worry that both the federal and provincial governments of all stripes are challenging our system of health care to the point that it's starting to break down."

I say we have some choices. Ontario and Canada are at a crossroads when it comes to decisions we have to make about health care. We can basically go two ways: We can follow Mike Harris and Ralph Klein and we can start going the way of private health care, because I'll say to the members of this House, as I will say outside of this House, that this government's agenda, along with Ralph Klein's, is to privatize health care at a slow, creeping crawl. That's what the agenda is. You don't care how much money the feds put into it, because at the end of the day your agenda is to make this system for-profit.

I'm not old enough to remember what health care was like before the 1960s. I was born at the end of the 1950s, in 1957. But I do know well enough from the stories I've heard growing up as a young boy in northern Ontario, and eventually a younger man, the stories that my parents and our neighbours went through when they didn't have money to access health care services. We used to have a bit of a joke at home. My grandfather, who died of an aneurysm, tried to go to the hospital for services and died because he couldn't get services at the hospital. A little bit of the story that we had inside the household, because he didn't have the money to pay for health care, was that the only health care service pépère had was a high-speed rosary, because that was all we could get. Pray to God that we were healthy enough to live and that our illness would eventually go away, because we didn't have the money to pay; neither did most people in this province.

You only have to look at the United States to see what's happening. Depending on who you believe, literally millions of people, 50 million people, are without health care coverage in the United States. Even those people who have health insurance plans, like my Aunt Lola, who lives in Philadelphia, have to worry, "Is my plan going to cover me when I get sick?" In her particular case, her husband has to keep on working past age 65 only to be able to keep his health coverage, because the plan they would get through the state is not sufficient to cover their health care needs. And they're well-to-do. My uncle and aunt worked all their lives, they put a couple of bucks away, but they face the prospect of losing their life savings over illness, because both of them now are over age 65 and are starting to have some problems as they get older. My uncle Tom has to work because his health care coverage that the state pays is insufficient to cover what their health care needs will be. In fact, I am told by people I talk to from the States, New Jersey and other places, that often where you think you've got health care coverage, if you get too sick and start to tax the system, they just yank your services away.

I say this government's got choices to make, as all governments have choices to make. This government can choose to keep on playing politics with health care, say one thing publicly: "Oh, my Lord, the government's got to give us more money. They've dumped on us"-we know that's happened-or they can decide to try to do something in order to strengthen our health care system.

I will argue that's what we did. That's a choice we made when we were government. Back in the early 1990s, when we were in the midst of the worst recession in the history of this province since the Great Depression of the 1930s, our government made investments in health care that in the end were long-term investments into our health care system to make sure we were able to respond to needs. We were the government that introduced Cancer Care Ontario, not the Conservative government of today. We were the government that introduced a northern residency program, where we trained doctors in northern Ontario by allowing them to do their residency through the northeastern and the northwestern part of this province. I would argue that 75% of the people who go through that program stay in northern Ontario to practise health care. The continuation of that obviously would be a medical school, something that we've always put forward.

We were the government, the Bob Rae government, that introduced MRIs to many of the communities across Ontario: Timmins, just to name one. That was one of the initiatives our government put forward. This government gets up at great length and talks about the investments they've made in health care. My Lord, for five years they've been running on NDP accomplishments, not on their own record. If they had to run on the health care record of the Tory government, it would be what? Making hospital reform a priority before doing primary health care reform. How stupid can you be? Even Duncan Sinclair, the guy who headed their darn hospital restructuring committee, said: "You guys are going at this backwards. You shouldn't be trying to restructure hospitals until you've done primary health care reform." He said that at the beginning of his work and he's now said it at the end, something we in the NDP have been saying since the beginning, something we had started to do when we were the government.

We were the government that introduced and passed the Regulated Health Professions Act to allow health care professionals to work in the system and take some of the burden off the doctors. I would argue it doesn't only take the burden off; midwives, nurse practitioners and various other health care professionals are a more effective and efficient way of providing services to patients, within both the hospital sector and the community sector.

We were the government that introduced long-term-care reform in Ontario by creating a multi-service agency approach. This government's accomplishment wasn't to do something about trying to improve community long-term care; it was about privatizing. You scrapped the MSAs that we as a government had put in place and now you've introduced CCACs, community care access centres, that basically are a vehicle for privatization.

I look at the community of Timmins. For 75 years, the Canadian Red Cross provided health care services in their homes to people in our community with health care and nursing needs. After 75 years of service, the Mike Harris government's approach is: "Let's get rid of them. We don't want them. God forbid that a not-for-profit organization is involved in health care. I believe in private health care."

We now have Olsten, as do most of the communities across this province. That's a choice that this government is making. They are saying they want us to go the way of private health care. The reality is, it's not only bad for health care but it's bad for business as well, because in the end it's much more expensive to deliver health care services by way of a private system than by way of a public system.

This government can talk the line it wants when it comes to getting its fair share from the federal Liberals. We know what the Liberals did. We can sit here and argue. Look at their last budget. For every dollar they gave in tax cuts, they gave two cents to health care. So we know where their priority is. Let's stop this arguing and ping-pong, throwing back and forth, trying to say, "It's your fault; give me more," and let's try to find some way to work together on all sides of this House to come up with real reforms in health care that will move the yardsticks further ahead so that we strengthen our health care system.

The total hypocrisy of this thing is, remember the ads the Conservative government ran when it came to them beseeching the federal government prior to the last budget to give tax cuts? They said the number one priority of the Chrétien Liberals should be to give tax cuts. That's what Mr Mulroney-Mr Harris wanted. Well, Mulroney was even further left than Harris, I would argue, but that's another story. They spent public dollars on advertising and they lobbied the federal government to get the Chrétien government to move on tax cuts. Well, you know what? You got it. The Chrétien government said, "All right, we'll give you tax cuts."

Now they've got the nerve to sit here and whine and say, "We don't have enough money for health care." No wonder. Give your head a shake. It's a choice. Either we socialize the cost of medicine, and that means taxes, or we allow the private sector to deliver it, and then we pay out of our pockets every time we're sick. It's a very simple equation. You can't have it both ways. You can't come into this Legislature on the one hand and preach the virtue of tax cuts and wonder why you're getting cut by the federal government when it comes to health care transfers to Ontario. The Chrétien government made the same decision you did, which is to give tax cuts. For those people on the right-and I would argue some on the left-who think tax cuts are more important than health care, you got your way. You made your bed and now you've got to lie in it. But I would argue that's wrong.

I think tax cuts in the right, proper time make sense if you can afford it, but certainly not when we're in a situation, as we are in Ontario, where we're still running a deficit and have been for the last five years, and certainly not when it comes to a choice of a tax cut in my pocket versus health care.

I hope this doesn't happen to anybody, but if we end up in a private health care system, it will be real simple. You know that little nest egg you're building by way of your mutual funds and that money you're socking away in GICs for a rainy day? Better not have a heart attack or, God forbid, better not get cancer or some other fairly serious disease, because it will be gone.

2050

I've got to tell you a story. My Uncle Conrad died seven or eight years ago, my godfather, a devout Conservative who believed in everything this government is talking about. When he got ill was when he reformed, and he reformed to the NDP, thank God. There's hope for everybody, I think. The point is my uncle, only when he was sick, realized how important it was to have a system of public health care, because up to then he made the same arguments you make: "Why should my tax dollars pay for somebody else's illness because they didn't take care of themselves. They smoked too much. They ate too much. They didn't exercise enough. Why should my tax dollars pay?"

We used to argue, my uncle and I, jokingly, because I loved him a lot and I'm sure he loved me too. I'd say: "Uncle, you never know. Public health care is about making sure that all people get services when they're in need." It was when my uncle got cancer and a heart attack and a whole bunch of other things that he finally, all of a sudden, realized that yes, health care is important. At least my Aunt Odette doesn't have to worry today about having spent the whole amount of money they had gathered through their lives, working hard in a small business they ran, to spend for his health care needs. He passed away and it was a traumatic thing for the whole family. They were like a partnership, the two of them. But at least, because they didn't have to pay health care dollars out of their pocket, she is able to live with some dignity in her retirement. Imagine what would have happened if we had been in the private system. They would have been wiped out. It would have been as simple as that.

What I say to this government is very simple: You have choices. You have choices about how to invest in health care and what to do to make the system better. Yes, I agree, we need to go after the federal government to try to get our transfers back. I wouldn't argue that for one second, but there's a lot of hypocrisy here in light of the fact that the government here has asked the government in Ottawa for tax cuts, got them, and now they're wondering why they're not getting more health care dollars.

At the same time, I've got to say this to the same Mike Harris government that argues: "We've been downloaded on. How unfair for an upper level of government to download on us. Please, help us." Remember the municipalities over here? The municipalities have been downloaded on since 1995 when you guys took power. Just in health care, public health has gone to the municipalities. They don't have the capacity to fund it. As a matter of fact, where I live, some communities are saying, "Jeez, we want to have more control about what happens in public health, because that's a large expenditure item in our budget and we're going to do something about getting these guys under control when it comes to spending." You know what that means. It means to say they're going to get rid of services. Why? Because Mike Harris downloaded that responsibility and that cost on to municipalities.

Interjection: Revenue neutral.

Mr Bisson: Revenue neutral it wasn't.

Public ambulances? The same idea. They're in the process of transferring all the ambulances to the municipalities. The list goes on.

They also have a bill that I understand they'd like to bring forward which will make it even easier than it was under Bill 26-remember the omnibus bill?-to privatize municipal nursing homes, another way in which they're going to allow municipalities basically to get rid of and send into the private sector municipal homes for the aged. I hope it doesn't happen in my community, because I understand, as do most politicians, most members of the Legislature, that municipal nursing homes are among the best in the province, Golden Manor, to name one.

I say to the government that you have some choices. You have the choice to say, "Yes, we will work with you as the third party," to do what we can in order to assist you to get fair dollars from the federal government. But we don't want to engage in the politics that you're playing by placing huge ads, spending millions of dollars, trying to build this political campaign to be seen as the saviours of health care when we know, quite frankly, you're chameleons when it comes to this particular issue. You're much of a different colour.

The other thing is that you have to make some choices about where you spend health care dollars. I would argue that a tax cut is not the priority in Ontario as far as I'm concerned. The priority is in making sure that we have dollars for health care and education, those programs that we need to make our communities whole and strong. The types of investments we have to make start, I would argue, with primary health care reform, to look at what we do there, in order to find efficiencies by providing the opportunity for other health care professionals to practise within the system. We need to take a look at ways of putting doctors on salary so that we're able to take some of the load off the doctors, transfer some of the responsibility on to other health care professionals and look at ways that we can create community health care initiatives such as community health clinics across Ontario. I would argue that we need to look at those things before we start engaging in the politics that you're engaging in.

With that, Mr Speaker, I would like to thank you for the opportunity to rise in this debate.

The Acting Speaker (Mr Michael A. Brown): Further debate?

Mr Carl DeFaria (Mississauga East): I'm pleased to rise today to join in this debate. I have listened to all sides on this debate, and I am quite surprised at the official opposition. I'm not sure whether the official opposition is against the resolution that we are passing just because it involves the federal Liberal government. Actually, I don't know which part of the resolution they are against. The resolution, in part, reads as follows:

" Be it resolved that the Legislative Assembly of the province of Ontario:

" (a) Condemns the government of Canada for cutting, by $4.2 billion annually, base payments under the federal program that supports health care, the CHST, while provincial governments have increased health spending."

I don't know why the official opposition would be against this resolution. It's clear that the federal government has been cutting the transfer payments on health care, and it's clear that the provincial government has increased its funding in health care.

The second portion of the resolution reads as follows:

" ... that the Legislative Assembly of the province of Ontario:

" (b) Urges the government of Canada to repudiate the statement attributed to a spokesperson for the federal finance minister, the Honourable Paul Martin, that increasing health funding would be `just shovelling money into a hole that's going to open right back up again.'"

The message that we get from our constituents is clear, that health care is the most important service that is provided in Ontario. It's clear that there has been a cut in funding, and it's clear that there is a need for further funding. For a spokesperson for the federal finance minister to make such a statement is completely irresponsible.

The third portion of the resolution reads as follows:

" (c) Urges the government of Canada immediately to restore permanently the health funding that it has cut and to assume its fair share of increased ongoing funding to meet the health needs of our country's aging and growing population."

I can't see anyone in this House being against this resolution, because it's obvious that there is a responsibility both on the federal government and on the provincial government to ensure that the funding for health care is sustainable funding.

It's clear that it's not just a problem in Ontario. The opposition party may blame the government of Mike Harris for Ontario, but what about the governments of other provinces? What about provinces such as British Columbia which has a health care crisis, and it's not a Conservative government? What about the province of Newfoundland that has a Liberal government? All these provinces that have different parties in government have crises in health care, so it's obviously a national crisis and not a crisis that was brought upon Ontario by the government of Mike Harris.

The last portion of the resolution reads as follows:

" (d) Reminds the federal Minister of Health, the Honourable Allan Rock, that the sincerity of his commitment to medicare and the principles of the Canada Health Act would be best demonstrated not by idle rhetoric and vague words but by restoring the health funding he has cut."

All these components of this resolution proposed by the Premier are so clear and to the point that I don't understand why the provincial Liberals would not stand up and support it so that we can, as a province, give a message to the federal government that it's not acceptable that the federal government continue to cut funding on health care when it's clear from the people of Ontario and the people of Canada that health care is so important and is in such dire straits that it needs to be propped up and services need to be restored.

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It becomes more confusing when some members on the other side-I think I heard the member for Sarnia-Lambton indicate that health is a provincial jurisdiction, that it is the role only of the provinces to provide for health care and that the federal government has no role in health care. I would ask the member then, why did the federal government pass the Canada Health Act? If they don't have constitutional jurisdiction, why would they pass a federal act dealing with health care? Why would we have a Minister of Health in the federal government if they have no jurisdiction over health care?

The problem that these statements make is that it brings confusion to the minds of Ontarians who are looking for governments to work together, who are looking for governments to provide service in health care that is acceptable, standards that are excellent. I was hoping this House would unanimously support this resolution to give the clear message to the federal government that we are united in Ontario and that we want to ameliorate the situation in Ontario.

Ontario is very disappointed that the Prime Minister refused to meet with the premiers to discuss the long-term sustainability of the health care system. In order to ensure the sustainability of the health care system, the federal government must restore the $4.2 billion that it has cut annually from transfers to the provinces and provide an appropriate escalator to help cover increasing costs.

Our province has been leading, and our leadership on health care reform is very clear. It has increased health care funding from $17.4 billion in 1995-96 to $20.8 billion in 1999-2000. In contrast, in 1999-2000, Ontario will receive $1.7 billion less from Ottawa under the Canada health care transfer than it received in 1994-95.

Ontario has a plan to reform health care. Ontario established the Health Services Restructuring Commission to review the hospital system to better deal with patients because we are trying to do better with less money. Even though we have put so much money into the system, we realize that we also have to streamline and make the system more efficient.

We have increased spending on home care 43% since 1995. In fact, the province's home care program is already the most generous in Canada.

Ontario is committed to the reform of primary health care to improve patient access to doctors across the province 24 hours a day, every day of the week, every week of the month and every month of the year.

The federal government claims that their funding of health care is adequate. They provide today only 11% of the total funding in health care. This is clearly a reduction from the 50-50 agreement that was originally put into the health care system when it was founded. The government of Canada keeps playing with these numbers, sometimes saying, "Well, no, it's more than 11%; it's 28%, it's 33%." That is just not acceptable to Ontarians and to Canadians.

I will be supporting this resolution, and I ask the members across the floor to join us in supporting this resolution because it's very important that the message we give to the federal government in health care is a very clear and united-front type of message. That's what Ontarians expect of us. The bulk of our calls and the bulk of our complaints and people contacting us indicate that they want us to ensure that there is funding there for health care and that health care is protected. All sides here have indicated that health care is important. Now is the time to get united and give a clear message to the federal government that we want the funding restored.

Mr David Young (Willowdale): I'm pleased to be able to join this debate and I'm certainly very pleased that the Legislature is sitting into the evening hours to discuss this very important issue. I'm sure all the members here feel likewise.

It's important and it's an urgent issue because, as we have heard earlier this day, Ottawa cut $6.2 billion from the CHST between the fiscal year 1994-95 and 1998-99. That's a 33% cut. It's a cut that the residents of this province are experiencing each and every day in very real terms. Ottawa did in fact restore $2 billion, only $2 billion, in 1999-2000. As I'm sure you have figured, that leaves a $4.2-billion deficit or cut. Ontario's share of that is $1.7 billion, a great deal of money. Not only has the province of Ontario, Mike Harris's government, made up that shortfall, but they have increased spending by a further $3 billion.

By and large, the system is working. Our health care system is there when the residents of Ontario need it. That is not to say that we cannot do better; that is not to say that we will not do better. We must do better. But it must be recalled that for most Ontarians, the health care system is there.

This past weekend within my own family we had occasion to test that principle, and I'm pleased to say that it did in fact work. My wife's grandmother, who lives on her own and has been very little burden to the health care system, who is approaching her 95th birthday, had occasion to attend at one of the emergency departments just outside of the riding of Willowdale. She was triaged by a nurse and assessed within 15 minutes, and within a further 15 minutes was assessed by a physician. This was on a Sunday in the springtime. The system worked for her, and I'm pleased to say that.

With that in mind, you may wonder aloud why there is this ad campaign underway that is costing Ontarians a significant amount of money, let there be no mistake: $3 million emanating from the province, and an unidentified number that the federal government is spending. By the way, I want to say aloud on this occasion that I'm very disappointed that the federal government has not come forward and been forthright about the amount they are spending on the ads we read in the paper. We did in fact indicate that $3 million is the figure that is being spent, and certainly it would be incumbent upon our federal counterpart to do the same thing.

Why, then, are we spending this relatively significant amount of money? The answer is because we must. The answer is because it is an investment in the future of all Ontarians. If we are to look at that figure, a figure that in and of itself seems rather substantial-$3 million from the province alone; an unknown amount from the federal government-that comes to about 50 cents a person in this province. What we are hoping to get back, what we are hoping to receive with that investment, is about $155 a person, so an investment of 50 cents to recover $155 a person from the federal government. Indeed, it is true that for a family of four, the total investment is in the neighbourhood of about $2, the cost of a token on the TTC. The return would be $620 to that family if the Liberals in Ottawa would come forward and live up to their commitment.

What is that commitment? It's a commitment they made in 1969 or thereabouts to be an equal partner, to equally apportion health care expenses in this country. It's a commitment they made not only to this province, Ontario, but a commitment they made to every province and to every Canadian. We all know that when it comes to the federal government, a promise made is a-well, how about that GST?

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We are talking about a national issue. We are not alone in our fight with Ottawa. Every province, whether it is governed today by an NDP government or whether it's governed by Mr Tobin in Newfoundland, a former federal Liberal cabinet minister, or the Parti Québécois, they all say the same thing. They all say that the federal government has not lived up to its commitment. They all are struggling to reform their respective health care systems to cope with the devastating federal cuts and the increased demand that we are experiencing.

Let me pause for a moment to talk about that increased demand. It is very serious. One need not be a demographer to realize just how serious it is. If we look at spending today, we realize that almost 50% of the funds spent in this province on health care, almost 50% of the $20-plus billion, is spent on approximately 12.6% of the population. We are all familiar with the fact that the baby boom generation is maturing and aging and that it will not be long until they are over 65. That's the 12.6% today that is utilizing approximately 50% of our health care system. What will be the situation we will have to deal with, and we must deal with, when that group is over 65? Clearly, in order to properly reform this system, it has to be properly funded, and in order to properly fund it, the federal Liberal cousins of the members opposite must live up to their commitments.

I look over to the NDP ranks. Perhaps I should put my glasses on to do that. I hope the NDP friends across the way will see reason, just as their cousins in Saskatchewan and their cousins in Manitoba and their cousins in British Columbia have. Surely we don't have their governing parties in those provinces coming forward to blame health care problems on some phantom conspiracy. No, they don't do that. They have to pay bills and they have budgets to table. In NDP-led provinces across this country, the governments realize that the most urgent problem facing us today is the federal government's unwillingness to do its part.

We have heard back from the federal government, through their ads and through their health minister and the Prime Minister, that in fact they have paid somewhat more. They've done so through cash transfers and points, and so on. I think it's important to look at the facts. I've looked at the federal budget, Budget 2000, and I'd refer you to page 66, table 3.6, and page 129. It says in there: "Only CHST cash transfers are included by the federal government in its list of federal program spending. The CHST tax transfer is not included as federal spending." Very telling indeed. "The revenue from the CHST tax transfer is not included by the federal government in its list of federal revenue." The reference for that is page 60, table 3.5, of the federal budget plan, the very same one.

It's also interesting to consider some comments made by representatives of the federal government. Mr Rock, when he addressed the Canadian Medical Association, said rather clearly and acknowledged in a very forthright manner that the cuts made by the federal government were significant. He said, on August 20, 1997: "But I am part of the problem, not the solution. It was my government that diminished the size of transfer payments." He said, on the same day to the same audience, "I will not stand here and tell you that the cuts in transfer payments we made were insignificant." I'm still quoting: "They were not and I won't tell you that they have not had an impact. They have."

As soon as one leaves the partisan dialogue that seems to emanate from the members opposite and looks at the facts and considers this in an objective manner, one realizes that the federal government's activity, or inactivity, in this area is nothing short of scandalous.

Mr Michael Gravelle (Thunder Bay-Superior North): I'm happy to join the debate tonight, to wrap it up, in fact. Just to make a quick reference, if I may, to the previous member's comments, certainly the member for Mississauga East spoke in terms of governments working together, and I think that's exactly what we think needs to happen, rather than the politicization of this whole process, which has become so horrendous and offensive.

The member for Willowdale talked about meeting commitments. We all know that the responsibilities this government has ignored and dropped the ball on in so many areas are something people do not find acceptable as well.

There are a few things we know for sure. I think I can speak on behalf of my constituents of the Thunder Bay-Superior North riding with some accuracy by saying that people do not like the fact that the provincial government is spending $3 million, and for that matter the federal government is spending substantial amounts of money as well, on an advertising campaign basically each battling the other. I can tell you as a member from northern Ontario that those of us who are terribly frightened by the extraordinary extra costs we pay for health care, in terms of our travel under the northern health travel grant, would give an arm and a leg to have some of that $3 million. The people who are running the eating disorders clinic at St Joseph's Hospital out of their own operating funds, who are asking for half a million dollars to truly try to make this program something that can really work in northern, northeastern and northwestern Ontario, would be absolutely thrilled with that half a million dollars. So it's quite horrendous to see this kind of money being spent in this fashion.

People do not like to see bickering and politics being played in this fashion. What they really expect is for governments to work together, to literally recognize that we have a very serious problem here. It's not a political issue that should be bandied about for your perceived benefit, to try to place blame one way or the other.

It's very difficult when the province won't even take responsibility for the decisions it has made that have damaged our health care system so horrendously over these past five years. I believe the federal government must contribute more money through transfer payments. I've said it publicly before and I'll say it again; there's no question about that. But for this government to remove itself from its responsibilities in terms of the deterioration in the health care system is quite frankly shameful, it's dishonest and it's cruel.

Mr Crozier: And it's whining.

Mr Gravelle: And it certainly is whining as well.

Let's begin with the reason all this started back in 1995 when this government was first elected. The decision was: "We are going to make tax cuts our big priority. How are we going to pay for that? We're going to pay for that by going after the health care system." One of the first things you did was to remove $800 million from our hospitals. You made a huge decision to remove $800 million from our hospitals. You laid off 10,000 nurses. You left us with emergency rooms that were clogged, where people could not receive the service. You made that decision to pay for your damn tax cuts. There's a time and a place, but in 1995 that's what you did. You made a mistake, you know you made a mistake, but now you're trying to shift the blame to the federal government.

The fact is, you can't keep passing the buck; you can't. This is a government that literally received a big chunk of change last year and hasn't even spent the money. Again, we would love to have that money in our health care system.

Interjection.

Mr Gravelle: You haven't, and you know you haven't.

Let's talk about the decisions that have left people in this province without any confidence any longer that health care is important to the Mike Harris government. This is really what this debate should be about. Ultimately it ends up being an excuse to further privatize our health care system. We've watched what you've done. You want to privatize our roads, you want to privatize our jails, you're moving to privatize our education system and now you want to privatize our health care system. You're saying you're being forced to do it. We've watched what has happened here, and people aren't being fooled by it. There's no question about it.

Again, just speaking as a northerner, I can only tell you how absolutely frustrating it is to watch what happens to my constituents when they are so desperately in need of health care. Like everyone else in this Legislature, including the government members, and certainly my colleagues, we know what it's like. In my riding, thousands of people do not have a family doctor, do not have a family physician. We know what happens when they call our office because they can't receive the care they're supposed to get in our hospitals. We know that people are being removed from hospitals sicker and quicker, and into a system that you like to talk about as being in place, that wasn't in place. You simply didn't have the system in place. You know you made an absolutely huge mistake, and that's been a disaster. People are frightened and people are very concerned. To simply try and shift the blame when you should be bloody well working with the federal government, recognizing that indeed it's a partnership-quite frankly, there's been a long history in our country where that's taken place. You choose to simply make it into a political football. It's truly irresponsible, and it's not what people expect. I think they do expect you to work with them.

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If I may speak as the member for Thunder Bay-Superior North, I know what it's like for people in Nipigon, Red Rock, Schreiber, Terrace Bay, Marathon, Geraldton, Longlac, Nakina, Beardmore and Jellicoe, all the communities, and certainly my community of Thunder Bay, when they have a member of their family who is very sick, who cannot receive health care in Thunder Bay, cannot receive health care in their own community hospitals, and they have to go down to Toronto and are paying thousands upon thousands of dollars continually because that's all they can get. There's a northern health travel grant in place that does not remotely adequately meet the needs of those people, yet we've seen this government actually take the amount of money they put into that from $13 million to $7 million. Again, you should put the money back into that system.

We see those extraordinary frustrations. We recognize that you sit here every day and try and build this into a political issue that I don't believe the people of this province accept or buy at all. You've got to understand that your job is to try and work to improve our health care system and take responsibility for the decisions you've made to destroy our health care system. I notice you are no longer heckling. I think you recognize that we're right when we remind you of your own responsibilities. There's no question there's a shared responsibility and it's got to remain that kind of responsibility, but you can't simply walk away from it yourselves because your priorities are somewhere else.

You talk about doing more for less. In the health care system, I'm not sure we can do it that way. We need real changes in our health care system. The answer was not to simply destroy our hospital-based system before you had a community care system in place. You know that you can't simply talk in terms of all the things you say you're going to do if you're not going to really put the money in. You can't talk about the money that you need when you aren't even spending the money you have and when you've got your priorities all wrong. It's incredibly upsetting.

We've looked at our mental health system, which I think is in a terrible state, and the closure of our psychiatric facilities. I know the Lakehead Psychiatric Hospital is still scheduled to close. But before you did that, what did you do? You removed hundreds of beds, and we do not have nearly enough psychiatrists. What you've done ultimately is that you've put people who need mental health services and help in our jails. They're ending up in our jails because the services aren't there. I'll be honest with you: The changes to the Mental Health Act concern me as well. When we start talking about community treatment orders, one of the worries I have is, what will we do if there's no place for them to go? What if the community supports aren't in place? The answer is not to put them into jails, but you have done that as well.

You made some decisions in terms of saving money. You're going to cut beds. We've lost a lot of the services that are supposed to be there. You made those decisions quite deliberately to simply pay for your tax cut, and I don't think people accept it.

If I may, before my time runs out, I want to make very specific reference to the eating disorders clinic at St Joseph's Hospital. This is an extraordinary service. I will recognize and acknowledge that not everybody understands the value or the importance of this particular program. The fact is that eating disorders have the highest mortality rate of any sort of psychiatric disorder-it's something people don't realize-either through suicide or simply the disease itself actually killing people. It's incredibly important.

We've been fighting for over 10 years now in Thunder Bay to try and get support from the province to properly fund this program. We've had excuse upon excuse. We've had campaigns. We've had petitions. We've had extraordinary letters. We had a press conference a month or so ago with Dr Geoff Davis, the chief of staff, and Dr Ron Davis, the psychiatrist in charge of the program, and the wonderful staff there, begging the province to do something. We've written letters upon letters to the minister asking for help. We're looking for about $500,000. We got an answer back from the Minister of Health, and I will read part of it, which is quite astonishing: "The majority of funding allocated to eating disorder treatment in the last few years has been allocated to increase specialized treatment services for adolescents with eating disorders in parts of the province where the need is greatest."

In other words, "You're not getting it, because we don't think the need is that important in Thunder Bay or northwestern Ontario." It's another one of the examples of why we feel so frustrated and so upset. The same situation exists in Sudbury, by the way. They're also desperately trying to get that kind of help. They have chosen to fund other parts of the province. They told us they were going to provide the funds basically as a result of mental health restructuring. To some degree we accepted that, at least recognized there was a certain consistency to that when we were first given that answer, but then we discovered that there was funding being given to various parts of the province, clearly where they think the need is the greatest.

So when we listen to this government talk about priorities and where they think the need is the greatest, those of us in northern Ontario, for a variety of reasons, feel as if we're sometimes pretty much left out of the loop, and we sure don't think that's right. I believe it's my obligation as a representative from Thunder Bay-Superior North, and I know you feel the same way, to fight on behalf of our constituents to recognize that we get the same treatment.

It's astonishing to go and talk to people who are either suffering from an eating disorder or have family members who are suffering from a disorder and to really understand the impact this has, to recognize you have St Joseph's care group, which is concerned enough to take funding out of their own operating budget in order to maintain the program at the level they are, but to have the province come back and tell us that they do not think it's necessary or worthy of funding because they don't think the need is there, when indeed we can prove that it is there-tragedies are happening. It's completely frustrating to be a part of that.

There's issue upon issue where that happened. To have to stand up here and spend our time in debate, which is the simple politics of a blame game, I know, and I think everybody in this Legislature knows, that is not what the people of this province want to be talking about. They want to find some solutions. They recognize that there's a need for some solutions, and it certainly isn't going to be simply by pointing fingers. We will not stand for that. I will not stand for that as a member of provincial Parliament. I intend to fight for what I believe my constituents need and deserve, and I will continue to do that as long as I can stand here and get an opportunity to speak. We have to continue to deal with the reality that these are complex issues, there's no question about it. Health care reform itself is complex, but it's not going to be solved by simply finger-pointing, by saying we cannot carry on, by threats of privatization, because that is one of the fears that we have.

The threat of privatization is indeed the road down which this government seems to want to go. We have seen example upon example that when the government has chosen to privatize, the costs have increased. But it's an ideological bent we're on. It's more difficult to get them to listen and to understand. We've even proven, example upon example, where this privatization has cost more. We've seen more and more delisting of services. We've seen more and more examples of that happening. So it's very important to us that we continue to fight this fight. I hope I get another opportunity to continue my remarks at the next stage.

The Acting Speaker: It being 9:30 of the clock, this House stands adjourned until 1:30 of the clock tomorrow.

The House adjourned at 2129.

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Hansard, April 11, 2000

HEALTH CARE FUNDING

Resuming the debate adjourned on April 10, 2000, on the amendment to the amendment to the motion by Mr Harris relating to health care funding.

Mr Michael Gravelle (Thunder Bay-Superior North): I'm pleased to have the opportunity of completing my remarks from last night relating to the Premier's resolution on health care funding and the amendments to that resolution that have been put forward by both the Liberal and the NDP caucuses.

What strikes me most clearly about this debate is that the Premier and this government seem more concerned with attaching political blame related to our health care crisis than they do to working towards a real solution. Both the provincial and the federal governments' decision to spend millions of dollars of taxpayers' money on nasty advertising campaigns, blaming each other for the declining standards of our health care system, deserves, I believe, our condemnation. Surely those millions could be better spent on opening hospital beds, providing speedier access to an MRI or hiring some much-needed nurses.

I believe I speak for the constituents of my Thunder Bay-Superior North riding when I say that the people of this province expect their senior levels of government to work together to repair our seriously damaged health care system, and not to frustrate all of us by playing this mindless and counterproductive blame game.

Having said that, I believe, as do my colleagues on this side of the House, that the government of Canada should immediately restore on a permanent basis the health funding it has cut in the past, and indeed must assume its fair share of increased ongoing funding to meet the health care needs of our country's aging and growing population.

But it must also be said that while the federal government must be a fair partner in this process, there is much about Mr Harris's resolution that smacks of nothing more than politics at its worst, and that is not what is needed now. After all, it has clearly been decisions made by the Mike Harris government, decisions they have even acknowledged to be wrong, that have left us in the mess we are in today. And let's not forget that these decisions were made to finance a tax cut rather than to deal with a shortage of transfer payments from the federal government.

As you know, Mr Speaker, one of the first decisions made by the Mike Harris government was to cut hospital funding by some $800 million. I'm glad to see agreement on the other side of the House. This withdrawal of financial support was the key to all that followed: massive cutbacks in hospital beds, the layoff of 10,000 nurses, backed-up emergency rooms and people being removed from hospitals sicker and quicker. Remember, this is also the government that forcibly closed hospitals all across the province, this done by a Premier who said during the 1995 election campaign, "It is not my plan to close hospitals."

All this moved towards something I think we all are very concerned about: a frightening move towards two-tier health care as this system became increasingly privatized and we lurched towards American-style health care.

But what's important to say here is that this was not an accident. It was all part of a deliberate decision by the Mike Harris government to change the way we delivered health care. So when we all hear the Premier telling the federal government or telling anyone that they may be forced to privatize more of our health care system unless more funds are transferred from the federal government, I almost choke on the absurdity of that statement. After all, this is a government whose ideology is grounded on the belief that privatization is the answer to all our problems. Whether it's toll roads or the maintenance of those roads or our jail system or our health care system, they believe privatization is the way to go, even when the evidence is overwhelmingly out there that privatization is certainly going to cost more and is not providing the service to the people that they expect and deserve from their government.

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Let's also not forget that this is a government that did not even spend all the health care funds that the federal government sent them last year. Instead, they played a shell game with our health care dollars while people could not get a hospital bed, and vital programs such as the eating disorders program at St Joseph's Care Group in Thunder Bay remained unfunded and unsupported by the province.

If I may speak, in the few remaining moments of time that I have, as a northerner, as a representative of Thunder Bay-Superior North, a vast riding where health care is clearly the number one issue, every day, like all my colleagues, I hear many horror stories of a health care system that's gone amok. There are so many areas I would like to discuss, but I won't have time. But I think it's important for me to say that there is perhaps no issue which upsets my constituents more than the fact that the northern health travel grant, put in place by a Liberal government in 1987, no longer remotely meets the needs of the people who must travel outside their communities for specialized medical care. While this government refuses to review the adequacy of the travel grant program and in fact is spending $6 million a year less than they did five years ago on this program-

Mr Alvin Curling (Scarborough-Rouge River): Shame.

Mr Gravelle: It is a shame. People are spending thousands of dollars of their own hard-earned money to seek medical care elsewhere. In the meantime, this government has made a decision to pay the full cost of cancer patients who reside in southern Ontario, because of the mess they made of that system, to receive treatment in northwestern Ontario, at the cancer centre in Thunder Bay. While we feel for these people very strongly, the government is truly being unfair. While northerners are being treated as second-class citizens by the province, people from other parts of the province are having their travel, accommodation and meal costs looked after by the government. This is nothing more than discrimination. It's an issue that all of us in the north find unacceptable and will continue to fight.

I cannot tell you the number of people I've spoken to whose lives have been altered in such a dramatic fashion as a result of the fact that they must seek medical help elsewhere. If the government will acknowledge that indeed there is help that is required, they have to acknowledge that this program no longer meets those needs. It is something we want to continue to fight for.

If I may, in my last moments as well, I'd like to make reference to the eating disorders program at St Joseph's Care Group, an extraordinarily important program funded out of the operating funds of the hospital. They fund eating disorder programs in other parts of the province but will not do it in Thunder Bay, in northwestern Ontario. We think that is just dreadful as well and we will continue to fight to get them to understand that that is needed.

The Speaker (Hon Gary Carr): Further debate?

Mr Ted Chudleigh (Halton): Let me just say how disappointed Ontarians are that the Prime Minister just recently has refused to meet with the premiers of the provinces to discuss what is perhaps the most difficult and impending problem that Canadians face across this entire country-not just in this province but across the entire country. The Prime Minister of this country, the leader of this country, has refused to meet with the premiers to discuss this in very real terms.

Mr Marcel Beaubien (Lambton-Kent-Middlesex): Why is that?

Mr Chudleigh: "Why is that?" asks my friend from Petrolia. He comes from a riding which surrounds Petrolia-it's basically Petrolia, isn't it?

Mr Beaubien: Well, Lambton-Kent-Middlesex.

Mr Chudleigh: He asks, "Why is that?" I suspect it's because they have nothing to bring to the table. They have no ideas. They are devoid of ideas. They have nothing to bring to the table and they are afraid of coming to the table to be embarrassed, so they have refused this meeting.

Ontario, on the other hand, has had a great deal of leadership in the health care area across Canada. In 1995, when we were elected, our health budget, as the opposition has heard, was approximately $17.4 billion. In the intervening five years or so, that budget has increased to $20.8 billion, while at the same time Ottawa has withdrawn $1.7 billion of their share of that funding. So not only did we have to increase the budget to $20.8 billion, but we had to make up that $1.7 billion that Ottawa refused to contribute to Ontario's health care system. So, yes, we are looking for help from Ottawa, for their fair share.

Where at one time they funded practically 50% of the health care system in Ontario, today that ratio has dropped to 11%. Out of every dollar that goes into health care in Ontario, rather than Ottawa spending their fair share of 50%, they are instead spending 11 cents, while Ontario is contributing 89 cents of every dollar going into health care, certainly a far cry from what the Canada Health Act envisioned as a sharing of the health care dollars between Ontario and Ottawa. The federal Liberals have clawed back much of that money out of the Canada health and social transfer programs, leaving Ontario in a deficit position as far as that health care budget is concerned.

The Ontario government has been working hard over the past five years on reforms and innovations to the health care system as we implement our vision for health care. We have a health care action plan to allow us to accomplish this. Now the feds are just trying to join the race and they're running hard in order to get to the start of the parade, a parade that already started without them.

Primary care reform is not new to Ontario, and it is important to emphasize this fact in the Legislature today. Ontario is a leader in primary care reform, and we have been working since 1995 in partnership with the Ontario Medical Association on primary care initiatives. The government of Ontario has consistently stated that it is committed to the idea of primary care and will continue to move ahead with its implementation. However, unlike Dalton McGuinty's Liberals over there, we are doing it in partnership with doctors, not at odds with doctors.

Mr Beaubien: We believe in co-operation.

Mr Chudleigh: We believe in co-operation. Absolutely.

The federal government has talked about pharmacare programs and drug programs. They have talked about it; Ontario has done something about it.

The federal Liberal government has often spoken about the need to establish a national pharmacare program; indeed, it was an election commitment by the federal government. Unfortunately, since the election we haven't heard another word about it. In its five years of governance, this government-I can remember many times in this House thinking, as the minister made an announcement during routine proceedings, "There is another promise that we made during the election, another promise kept." Unfortunately, that doesn't happen when you get just a short distance away from here to Ottawa. There the reverse is true: Election promises are seldom kept.

However, we have not waited for the federal leadership to act. The government of Ontario has been working for a number of years reforming and enhancing Ontario's drug programs. It is important to provide information on the work done on this program to remind both the House and the federal government that this government has an action plan for health care and for implementing this plan today. Costs in this area are rising fast, and with the growing and aging population, this growth and expense will only increase. It is time for the federal government to assume their fair share of these costs.

In Ontario we have three stages of drug programs. Ontario's drug programs include the Ontario drug benefit program, the Trillium drug plan and the special drugs program. The Ontario drug benefit program is the largest plan, and it covers over 3,100 prescription drugs. Since our government took office in 1995, 1,018 products have been added to the ODB, providing new and innovative drugs that will help people live with their diseases or recover from them. The $1.6-billion program covers about 2.2 million seniors and social assistance recipients in Ontario. There were 44 million prescriptions written under this program in 1998-99.

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The Trillium drug program is a very unique program. The Trillium drug program is for those who are not otherwise eligible for the Ontario drug benefit program but who may have very high drug costs. Approximately 100,000 Ontarians who need expensive drugs to treat serious illnesses like cancer, HIV and cystic fibrosis have their drugs paid for through this program. Expenditures for the Trillium drug program for 1998-99 totalled $45.5 million, up from $35 million the year before.

The special drugs program covers the full cost of certain expensive outpatient drugs such as special drugs for AIDS, organ transplants, cystic fibrosis, schizophrenia and thalassemia. The program provides funding for over 12,000 beneficiaries, at a cost of approximately $92 million annually.

Extensive reform and innovation is being demonstrated by the government of Ontario in the area of drug programs. If the federal government has any ideas about health care reform, we look forward with anticipation to hearing about those reforms, but we have heard nothing new to date from the federal Liberal government. The federal Liberal government must immediately restore the $4.2 billion in the Canada health and social transfer funding for health care that it slashed so that we can use that funding to support our important health care innovations.

The government of Ontario recognized upon taking office in 1995 that we have a rapidly aging population and that it was important to plan now for that future. If anyone had the opportunity to read the book Boom, Bust and Echo by David Foot, it points out very clearly what is going to happen to the Canadian health program if you don't take major steps today to put that program, that whole health care system, into a mode that will support huge numbers of people as that boom, bust and echo begins to happen in Ontario.

The Minister of Health, on behalf of the government of Ontario, provided Allan Rock, the federal Minister of Health, with information last week on what we are doing in the areas of home care and long-term-care needs and asked him for any comments and suggestions about our programs. Again, I'm afraid I have to report that at this point in time we have heard nothing, not one word, from Minister Rock. If the federal government supports home care and long-term care for some of our most vulnerable citizens, it should restore the $4.2 billion in CHST health funding it cut from the provinces that could be used to support important programs such as these.

Home care: Ontario has one of the most generous home care programs in Canada. The Ministry of Health currently spends about $1.5 billion annually on home care and community care services. From 1994-95 to 1999-2000, funding for community services increased by 49% and in-home services funding increased by 56%. Ontario provides the most generous levels of home care services in Canada-$115 per capita. The next closest is Manitoba at $97 per capita.

Community care access centres: In 1996, this government established 43 community care access centres across the province, offering support to Ontario residents who seek community based long-term health care. This allows services to be delivered closer to home for Ontario citizens. CCACs coordinate access to homemaking, nursing, therapy and other services to people at home, as well as providing long-term-care facility placements and vital information to caregivers about the services and support available to their family and friends.

In April 1998, this government announced the largest-ever expansion in health care services to Ontario. The government will be investing $1.2 billion to improve long-term-care facilities and community programs. No new long-term-care beds had been built in this province for over a decade, while the senior population had been growing. By adding these new beds, our government will ensure that necessary long-term-care facilities and services will be in place to meet the demands that the future will place on us. This program will create more than 20,000 new long-term-care beds in the province and will add to that number the renovation of a further 13,000 beds.

In the area of mental health, our extensive mental health reforms include leading a consultative review on mental health reform in Ontario, which was led by Dan Newman, the new Minister of the Environment. He began a mental health law education project to inform Ontarians, especially professionals, about their rights and responsibilities under existing mental health legislation. We developed a provincial forensic policy and opened 446 new forensic beds across the province. We initiated a review of the Mental Health Act and related legislation to ensure that the mental health service delivery system is accessible, accountable, cost-efficient and promotes public safety.

It's a pleasure to stand here and talk about the accomplishments that we have made here in Ontario and how much greater those accomplishments could be if the federal government would re-establish the $4.2 billion they took out of Ontarians' pockets with their cuts to health care. Perhaps one of the most telling comments that I see in these notes is a quote from Allan Rock in a speech that he made on August 20, 1997:

" I will not stand here and tell you that the cuts in transfer payments we made were insignificant. They were not. And I won't tell you that they have not had an impact. They have."

Mr Rock fixed the problem.

Mr Garfield Dunlop (Simcoe North): It's a pleasure today to speak on the Premier's resolution that "Condemns the government of Canada for cutting, by $4.2 billion annually, base payments under the federal program that supports health care"-the Canada health and social transfer-"while provincial governments have increased health spending."

Since 1994-95, the federal government has cut $4.2 billion from health care transfer payments to the provinces, and over the same period Ontario has increased health care spending by over $3 billion here in Ontario. It is clear that the federal Liberals are responsible for the largest health funding cut in Canadian history. In the last budget, the federal Liberals had a chance to rectify their problems by restoring the funding. They had a surplus, but failed to inject more money into our health care system. In short, the federal government has failed to live up to its commitments to the people of Ontario. Once again, the federal government has failed to recognize the needs of the growing and aging population in Ontario. The $2.5 billion in one-time funding in the last budget is clearly not enough.

I'd like to take a bit of time from this debate to boast a little bit about the hospitals and the health care services that we have in my riding of Simcoe North. They rank as some of the best in our province.

Yearly, hospitals around the province are evaluated in four general areas, and Soldiers' Memorial Hospital in Orillia is the only hospital in Ontario rated above average two years in a row for the amount of staff time devoted to patients. As well, the hospital is a recipient of the National Quality Institute's Canada Award for Excellence: Quality-Health Care, "for a strong and ongoing commitment to continuously improving the patient experience and responding to the changing needs of the community." As well, I should point out that currently in our hospital, at the Orillia Soldiers, we're trying to put our final plans together to get approval for a major redevelopment project.

In the western part of my riding, the Penetanguishene General Hospital and the Huronia District Hospital saw the inefficiencies in their two hospitals long before the restructuring commission and decided to form an alliance to eliminate those inefficiencies and reinvest those dollars back into the health care system of the area. This is one of the most important elements of health care system reform, health care providers working together to improve a system. That is what these two hospitals have done in Midland and Penetang, and I commend them and their staff for those efforts.

In February, I had the honour of taking part in the opening of a new kidney dialysis unit at the Penetanguishene General Hospital. This temporary service will give local dialysis patients in the western part of the riding three-times-a-week access to local treatment. These services will ensure that some of north Simcoe's patients do not have to drive to Orillia, which will relieve pressure on the Orillia Regional Dialysis Centre at Soldiers' Memorial Hospital. I'm proud to represent this hard-working, determined team of health care professionals.

According to the Health Services Restructuring Commission, which was created by this government to look at ways of reforming our health care system, a plan was created for the hospitals in our province to become more efficient and more effective. The HSRC also urged the government to approve more long-term-care beds for our seniors.

I'd like to inform this House that construction is taking place in both Orillia and Midland for the creation of more long-term-care beds, as outlined in our government's health action plan. At the new Village of Leacock Point Health Care Centre in Orillia, we are building 68 new long-term-care beds and that construction is just beginning now. At St Andrew's Centennial Manor in Midland, about 100 long-term-care beds are being created for the fine people of Simcoe North. This is a redevelopment project.

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Since the Harris government was elected, 533 new long-term-care beds have been allocated to Simcoe county. This fits in quite nicely with the two manors, the Georgian Manor and the Trillium Manor in my riding that are operated by the county of Simcoe.

The provincial government has also committed to update 303 long-term-care beds in Simcoe county alone. Provincially, this government has committed to creating over 20,000 new long-term-care beds, which will improve access to community based services for an additional 100,000 Ontarians. I am proud to be part of a government that understands the long-term-care needs not only of my riding, but of my county and my province.

While hospital reforms creating new long-term-care beds are important, giving Ontarians access to a doctor is one of the foundations of our health care system. That is why our government introduced primary care networks in 1998. Primary care networks are made up of family doctors joining together in their communities to provide easier access to health services and better coordination of health information through computers. The networks will help reduce waste and duplication in the health care system.

Health service is of higher quality because there is better communication about the patient's health. The family doctor, nurse or health care professional that the patient deals with will keep his family doctor informed about his or her own health care problem.

I would like to encourage the federal government to take a look at how we are providing ambulance services in Simcoe county based on a 50-50 agreement between the province and the county. I guess I should explain, for the benefit of the federal government, the province agrees to pay half of the cost of ambulance services while the county agrees to pay the other half. Wouldn't it be nice if the federal government paid at least a quarter of the health care funding to the province instead of the 11% that we are receiving now?

The federal government likes to make an argument that they did not cut health care funding, but one only has to look at their election platform of 1997 where they admit that they cut health care funding despite this phony tax point argument, an argument, I might add, that has been called meaningless, according to CIBC Wood Gundy economist Jeffrey Rubin. I quote from the Liberal campaign book, "It is a fact that, during our first mandate, this government reduced transfer payments to the provinces." Where do these transfer payments go, you might be asking? Into health care, into the hospitals, nursing homes, health units and the providers of this service in Ontario.

While federal Minister Rock talks about improving access to doctors, Ontario is doing it. Rock talks about expanding home care and community care; Ontario is doing it. Rock talks about health care reform; Ontario is doing it. I would like to thank Mr Rock for admitting the mistakes of the past, but I would encourage them to correct them. The citizens of Canada and the province of Ontario expect and deserve more from their federal government.

Mr Rick Bartolucci (Sudbury): Thank you for allowing me the privilege to offer a few comments with regard to this motion.

Because there is an amendment to the amendment of the main motion, the people of Ontario should know that under the rules we will be able to debate the amendment to the amendment and then the amendment and then finally the motion, so every member in this House will have ample opportunity to put their point of view forward. The only thing that could ever stop that would be of course if the government invoked closure on their own motion. I would hope that the government wouldn't do that, which would allow every member in this House-103 members-to ensure that their points of view are made clearly, succinctly, and certainly with the best interests of their constituents in mind.

First of all, I'd like to talk a little bit about the Lankin amendment. In general, the Lankin amendment simply states that we have to ensure that we're opposed to privatization in our health care system; that we are opposed to two-tier medicine in this province. Certainly I'll be supporting this type of motion because I see what is happening in Ralph Klein's Alberta. We all know that we don't want that to happen in Ontario, so the safeguard here is if we support the Lankin amendment. It's not very complicated. It casts no blame. It just ensures that two-tier medicine won't come to Ontario.

Our Liberal amendment lays blame in both places, both at the federal government and at the foot of the provincial government. I'm in agreement with that because I've long argued, over the course of the last five years now, that we were making fundamental mistakes in health care in the province of Ontario.

Speaker, you will know that I get up here quite often and rant and rave and sometimes, hopefully, make salient points to ensure the government is held accountable for what I see are weaknesses in their plan to implement restructuring of health care services in Ontario. So I have no problem supporting the amendment by the Liberal Party. It doesn't cast blame; it ensures that both people, both governments, do their job.

I have some concerns with the main motion because the main motion is nothing more than trying to lay blame as opposed to doing something very constructive. I'm reminded of a television show, and I know it's a little bit corny to draw this analogy but the reality is there. There is a very popular television show, probably about six months old now, hosted by Regis Philbin called Who Wants to be a Millionaire? Mike Harris has been hosting a show for the last five years as well. The name of his show is Who Wants to Take the Blame? When the government created a crisis in education, Mike Harris was the first one to say, "Let's cast blame on the trustees, you know, those overpaid trustees, the ones who do nothing for education." When that didn't work any more, he said, "Let's blame the school boards." When that didn't work any more, he said, "Let's blame the parents." When that didn't fly, he said, "Let's blame the students." That went over like a lead balloon, so he found the group he wanted to blame and said, "Let's blame the teachers." The reality is that in Ontario the way we've avoided a crisis in education is because of the dedication and the support our teachers have given to our students.

Let's move on and talk a little bit about fuel prices. You remember that this past year, the summer in particular, Mike Harris was quick, when the truckers decided it was time they took action, to say, "It's the truckers' fault, they haven't negotiated good contracts," or, "It's the oil companies' fault, they're ripping off the consumers," or, "It's the consumers' fault because they're driving too much." The reality is that constitutionally and legislatively the only one who can accept blame for rising gas prices is the Premier, Mike Harris.

Let's talk a little bit about social services costs for only a second. Who did he blame then? Well, it was the pregnant mothers on welfare. They drank too much beer. That's why social services costs were escalating. Let's lay the blame there because it's a popular thing to do. When it wasn't popular any more, he moved away from it.

Finally we come to health care. Four years ago Mike Harris said: "It's the nurses' fault. It's the doctors' fault. It's the hospital administrator's fault. It's the board's fault." We have a crisis in our health care system. We have to repair this crisis. We need restructuring in the system.

He blamed all the partners in education. He established a commission to go about the province and restructure. That commission has issued its final report. It lists seven recommendations with regard to system building. If time permits in this 20 minutes, I will deal with a few of those; if not, I will deal with them in the next 20 minutes I have; if I can't deal with them then, we'll deal with them in the final 20 minutes I have with regard to the way the amendment to the amendment and the amendment and the main motion are debated.

The people in my community know clearly where I stand. They told me clearly about five months ago: "Rick, we agree that the government moved too quickly. We agree, as the new health minister, Elizabeth Witmer, said, `We don't have a vision for health care.'"

They agreed with her then and they agree with her now when she has to stand up in the House and say, "There is no plan for health care." They agree with all that, but you know what they don't agree with? They do not agree with the government casting blame on the federal government. They don't agree with everyone around here blaming everybody else for the problems we have. And so, my community said: "It's time we stop fighting over health care. It's time we started fighting for health care."

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My community agrees with my leader that it's time we put away the sword. It's time we put away the guns. It's time we put away the rhetoric. It's time that we come together to find the solutions to the problems we have in health care in the province of Ontario, because we, as members of provincial Parliament, are mandated to find those solutions.

Is the federal government a player in all of this? There is no question the federal government is a player. They have a part to play in it. In fact, they have a very important part to play in it. We expect that they will live up to that part, and we want the 103 MPs in the province of Ontario to fight at the federal level to ensure that the commitment, the obligations and the responsibilities of the federal government are lived up to.

The reality is that we can no longer do what we've been doing for too long. We can no longer yell across the way to each other, calling each other names, saying, "You're to blame," "I'm to blame," "He's to blame," "She's to blame." No more. It's not going to fly with the public any longer. Not only my constituents, but I guarantee every constituent in the province of Ontario has said: "I've had it. I want my elected people to come together to work for a better health care system, to stop fighting over health care and start fighting together for health care to solve the problems we have."

My community is a very progressive community. It's not waiting for governments to come together. It's not waiting for the name-calling to cease. My community has decided, "If there's a job to do, we'll do it." But there are some limitations that my community has to face, and I want to outline a few of those to you and to the House.

To do that, I have to spend a very short time going back in history to the restructuring report and the direction it took. Certainly it wasn't the direction that the community wanted, but we've already had that argument so I'm not going to revisit that argument. But it did leave us with two of our three acute care hospitals closing. It did decrease the number of acute care beds. It did decrease the number of transitional care beds. It did decrease the funding in our main hospital, in the other hospitals that we're going to close. It did mean that nurses were laid off or fired. It did mean that one emergency room was closed and that there were longer waits in the one emergency room we had left. It meant all of those things. But we've already had that argument.

The direction from the Health Services Restructuring Commission was that we were going to enhance the facility we already had and the government would pay its fair share. Well, it took a while for my community to heal, to come to the realization that that's the direction we're going to take, but we did that. When we were fighting the last election, we weren't fighting it over the direction of the Health Services Restructuring Commission so much; we were fighting it over, how are we going to be able to build this direction that the Health Services Restructuring Commission has mandated?

The burden on my community is enormous. Later in this talk I will try to outline some of the problems we have in our community, but for the next few minutes I want to tell you what our community did. Our community said: "All right. It's time that we put the war of words to bed. It's time that we establish an approach we're going to use to ensure that we have world-class health facilities at the end of the process." So a group of very dedicated, hard-working volunteers came together, and they did what the federal government couldn't do, they did what the provincial government couldn't do: They brought every partner to the table and they said: "If we all work together we can resolve the problem. If we all show we have a direction, governments will listen."

Under the very capable leadership of Gerry Lougheed Jr, who has decided to chair this campaign-and the campaign is called the Heart and Soul Campaign, because in essence health care is really the heart and soul of our community, in the present and for the future. So he brought together a wonderful group of individuals dedicated to the community and the region of Sudbury and northeastern Ontario.

I think of Joe Drago, for example, a retired high school teacher and principal, one who devoted his entire life to education and the betterment of students. He came; he decided that it was important that he become involved in it. I think of Jim Corless, a hard-working member of the community. Remember-I'm glad I'm given this particular 20 minutes during National Volunteer Week, because these people are all volunteers. They don't get paid anything for this. They're just sold on our community and they want what's best for our community and they're tired of the in-fighting they see among governments and within government.

I think of Mac Sinclair-Speaker, you know Mac Sinclair well-a hard-working individual who gives of his time at the Centre for Life, our new YMCA, who believes that health care is important in our community. Maureen Lacroix and Jackie Thoms, both hard-working people, both feel they have something to offer and they want to do it, with or without the help of government. They're assisted very capably by staff such as Judy Robertson, Allan Katz, Michelle Liebrock, and certainly hospital administrators or health care administrators such as Sister Bonnie MacLellan, who came down from Thunder Bay and helped at our new St Joseph's health care facility, and Dr Randy Bisset, who is world renowned with regard to the way he administers our regional cancer centre, and certainly very dedicated individuals like Dave McNeil from the Sudbury Regional Hospital, who's trying to put all the numbers together to make the numbers work.

They decided that we have to establish the plan. They went before regional council and they explained their plan and it was a beautiful plan. The place was filled. Regional council chambers were filled with people who were pointed in the right direction: the fruition of the dream, the completion of the plan, always with excellent health care facilities as the final target. Regional council was very supportive, but there was a part they had some trouble with.

They believe, as I believe, that the provincial government has an obligation to fund our health care facilities to a greater extent. They're not blaming the provincial government, nor are they blaming the federal government. They are simply saying: "Let's lay all the cards on the table. Let's look closely. Let's look at our facilities, our hospital." A very high percentage of cases that come to that hospital are not from Sudbury, because we're a northeastern referral centre. A large percentage of our cancer cases are from across northern Ontario, in some instances from across Ontario.

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The provincial government is going to be asked to come to the table with some more money. We're not coming down. My community-it's political representatives led by regional chair Frank Mazzuca-but certainly we'll be supported; and I'm sure Sudbury Mayor Jim Gordon will be taking a lead in this because he was very vocal. He was not throwing stones at the government. Nobody around that regional council table was throwing stones. They wanted, though, a greater commitment on the part of the government of Ontario, Mike Harris's government, to come to the table.

Hopefully before the end of April, this committee of politicians, community volunteers and community leaders will be coming to Toronto and they'll be meeting with the health minister. Councillor Doug Craig will be explaining some of the factors that she may not be aware of with regard to what our catchment area is. Certainly Jim Gordon, the mayor of the city, will be meeting with Jim Wilson. He will be asking that the minister look at the potential for a broadening of our economic base through a donation from the provincial government in that particular area. Austin Davey, I'm sure, will be dealing with Minister of Northern Development and Mines Tim Hudak. At no time will they be throwing stones. At no time will they be casting blame. The only thing they will be asking is that you understand that our community cannot sustain a $45-million community campaign. It is virtually impossible for us in our community, given the economic factors surrounding a resource-based economy, given our population, given the present employment situation we have in Sudbury and in our region, to sustain a $45-million community campaign. So our local politicians and our community leaders will be coming to Toronto and all they will be asking for is a fair deal.

I've only got 48 seconds left, but I'd like the House to know that in my next 20 minutes, whenever that may be-and I hope the government doesn't invoke closure-I'll be talking a little bit about some of the horror stories that have evolved through the restructuring process, and how they could have avoided it, and the concerns we have with physician shortages. But finally, as my time winds down, I want to say that I am totally in support of the Heart and Soul Campaign of our community. I'm proud of that team and my community for taking a proactive approach, a very positive approach to solving the problems we have with our health care facilities in the city and region of Sudbury.

Mr David Christopherson (Hamilton West): I appreciate the opportunity to speak to this resolution. Obviously, one of the things that I want to do in the time that is afforded me is to not only discuss the macro issues, as many of my colleagues have, but to also speak to the implications in our communities and the impact on individual citizens and our families in terms of what all these cuts and the squabbling between the different levels of government are causing on the streets of communities in Hamilton.

I find it a bit hypocritical that the Harris government now wants to make health care funding the absolute number one priority. Nothing else matters. This is the top priority, and yet just a couple of months ago the federal government announced they were introducing their budget and the Ontario PCs ran ads effectively lobbying the government, trying to generate public support to put pressure on the federal government to take a certain course of action.

Given what's happening here today with this resolution, listening to the Premier speak, listening to Health Minister Witmer speak, you would think that when you checked back you would find that the ads they had taken out were indeed urging the federal government to make health care funding an absolute priority in terms of where the federal government ought to place the surplus funds they now find themselves in possession of. But, like many things with this government, what you'd expect, what they say and what the reality is are entirely different. They did not run ads urging the federal government to make up the money they've cut in transfer payments for our health care system. No. Their top priority was more tax cuts. That was the priority.

I want to say to the federal Liberals that, much to their everlasting shame, they succumbed to that pressure. I see one of the cabinet ministers across the way giving the thumbs-up. They love these tax cuts. Do you know why? Because they don't need to worry about what happens if we go to a privatized system and you only manage to get what you really need by coughing up the money. Why? Because they've already got lots of money, and with the tax cuts they've given, these folks have got even more money. Unfortunately-and the minister and his colleagues fail to take this into account-the vast, overwhelming majority of Ontarians don't have that kind of money. The only way the majority of Ontarians are going to have the health care system we need is to provide it through a public system.

When the federal government brought down their budget, for every dollar they gave for tax cuts, they put two cents in health care. Talk about putting in your two cents' worth. That's how much of a priority it was for both these governments. Both of them are listening to the cries for tax cuts above and beyond the critical need they now say consumes them in terms of making sure they receive adequate funding from the federal government to provide Ontarians with the health care system they deserve. What hypocrisy, and then to spend these past few months between the federal health minister and the provincial health minister squabbling back and forth.

It's our sense in the NDP caucus that, at the end of the day, what people are looking for is some kind of solution. I know the government will say, "Just support our resolution; there's the solution." At the end of the day, who is not going to be in favour of providing sufficient funds from the feds to the province for health care? But it is so filled with hypocrisy.

When I talk about taking the macro and then talk about what's happening in communities, you know I cannot deal with the issue of health care without talking about what's happening in my own home town of Hamilton. Because of the money that this government has cut from hospitals-yes, the overall health budget is up, but then so is the demand on the health care system, so are the number of people demanding services, the type of services being required as a result of our generation getting older. Of course there is going to be an increase, but when you look at it on a per capita basis, we're behind, overall, in health care.

In the hospital sector, they cut out $800 million. In terms of the Hamilton Health Sciences Corp, we're looking at the Henderson site being basically demolished and the cancer care centre moving away from there, at a cost of $100 million, by the way, a brand new building that was just opened a few years ago at a cost of over $40 million. We still haven't figured out how that lunacy is supposed to make any sense. Out of the Hamilton Health Sciences Corp budget, they've been facing a total of over $40 million in operating grants in terms of the funding they get from the provincial government. And what is the deficit that's caused the government to go upside down and twirl all around and now come in and bring in a supervisor? What has caused all of this? A $40-million deficit. Well, let's see now: $40 million cut from the budget by the provincial government and a $40-million deficit. I wonder how that happened. Yet the minister insists on standing up and saying that there have been no cuts. She's actually in Hansard saying there have been no cuts. The fact of the matter is that there have been cuts. That's why I've always maintained that looking at these two numbers is so important. Give or take $1 million or $2 million, it's $40 million on each side of the ledger.

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I and my fellow area MPPs meet on a regular basis with the board of the Hamilton Health Sciences Corp. They've been telling us for some time that because of the cuts-and other things, but definitely because of the cuts-they're running deficits. But they said they were going to make sure that the health care needs of our citizens in Hamilton were the first and top priority-not some hypocritical, "This is our priority," like the government saying, "Health care is a top priority," when what they're really pushing is tax cuts. This board said, "Our priority is the health care needs of the community."

What did the PricewaterhouseCoopers report come out with in regard to that? Well, somehow this is meant to be a criticism, but it sure isn't, as someone who represents tens of thousands of Hamiltonians. Listen to this, page 32 of the PricewaterhouseCoopers report: "This is reflected in the board placing a higher priority on meeting the needs of patients who request HHSC's services versus fiscal accountability and solvency of HHSC."

I realize that you cannot say money doesn't matter, but you also can't have it both ways. If your revenue is being cut and you have not only the same service demands on your hospital but increasing demands, you have to make one of two choices. You'll either run a deficit and provide the service and work out with the government and the proper officials later how you manage this fiscal issue, which, by the way, was caused by their cuts in the first place, or you say to Hamiltonians when they bring a sick child to the emergency ward: "Sorry. You're the point where we have to cut off today, because we don't have enough money to pay for servicing your child in terms of their immediate health care needs."

This board-rightfully, in my opinion, and I was proud to stand behind the board up until the recent announcement about what they were going to do with Henderson. I was proud to stand behind them when they said that the health care needs of those Hamiltonians who are at the doorstep of a hospital will be first. That's not a criticism. That's the way it ought to be. In fact, that's what this government says they do. They say that dollars don't matter, it's the health care that matters, that they'll make sure there is enough money to meet the need. That's exactly what this board did, and now they're being criticized for it.

The point was even made twice. On page 42 of the review it says, "Interviews conducted with senior managers reveal the following key issues," and the fourth bullet point is, "Community needs clearly outweigh the responsibility for fiscal accountability when the senior team is making decisions." Well, as long as the senior level of government is cutting funding, this had better be their decision, this had better be their policy, because I can't imagine anybody in this place of any political stripe saying that it's OK not to provide hospital services that are needed because there's not enough money.

The dangerous game that's going on here-and this is where the federal Liberals have got to start paying a lot more attention to the implications of the positioning they're taking vis-à-vis the provincial ministers of health. By ensuring that provincial governments are not receiving their fair share and what they need to provide health care services, you give the Kleins of this country a green light. It also probably feeds the belief of quite a number across the way on the government benches that privatized health care is OK. I would assume that if money is not a problem, maybe it is OK, but it's sure not OK for the average person.

I don't really understand how it's supposed to save us money if the government, through the Minister of Labour, when he says that he cares about workers, making sure they get fair pay for work and fair benefits and a safe workplace-how it makes any sense that privatizing something is going to save us money in the general public. It's another one of those, "You can't have it both ways." If you privatize it and it's going to cost people less, then where are the savings coming from? Nothing magical happens when it goes from public control to private control. There's no magic transformation there.

Thanks to this government, in many cases collective agreements go into the wastebasket. You put that legislation in place so that if something is privatized there's no collective agreement. What does that mean? It means they can pay whatever wages they want. So they're going to pay nurses a lot less, they're going to pay support staff a lot less, they're going to pay the ambulance drivers a whole lot less. That's how they're going to save money. How does that help my community in Hamilton if you take a few thousand people who are earning at least a half-decent wage and cut their incomes by 20%, 30%, 40%, 50%, which means there's that much less money in our local economy? How is that supposed to help us?

The other way you make profit, after you've done your damage to wages and benefits, is that you provide less service. Yes, that will save money, but then we're back to the same old dilemma: You're saving money but at the expense of the health care service.

If we hearken back to the wisdom of John Snobelen, the then Minister of Education, who said to that room full of Ministry of Education bureaucrats, "What we need to do is create a crisis"-I'm paraphrasing-"to justify the action we're going to take," that is what I fear is going on. At the end of the day they'll try to convince Hamiltonians and others across Ontario that because there's this huge problem they need to do something and that something is, "At least let's talk about privatized health care." They create the crisis.

That's what they've done at Henderson. Would we still have fiscal challenges? Yes. Would we still have major staff challenges in terms of doctor shortages? Yes. Would we still have a problem in terms of ensuring that there are alternative levels of care beds, meaning long-term-care beds, to move people out of hospitals into these beds so you can free up those acute care beds for others who need them? Yes, those are still problems. But those problems have to be dealt with by the provincial government. Henderson hospital doesn't decide what the policy is around providing doctors for our communities and they aren't the ones who are designing a long-term-care system, which they're also privatizing. So at every front where we look at why the Henderson crisis is in front of us, it all comes back to this government.

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Yet this Minister of Health continues to stand up and say, "No, there have been no cuts, and this is all about bad management." Has the management at Henderson been perfect? No. Has the management anywhere on this planet been perfect? I think not.

Now we've got the sight of the minister, as if she had no involvement in anything to do with Henderson, standing back and saying, "I'm going to send in a supervisor because you folks are all irresponsible and can't be trusted to do the right thing."

The reality is that the entire operational review and the recovery plan, which this government still refuses to table, had as full participants senior ministry officials from the Ministry of Health. In the absence of any kind of guarantee that bringing in a supervisor or an overseer so that Henderson emergency and the cancer care centre next to it will stay open, it's meaningless. It doesn't mean anything, other than one does get to the conclusion that you've obviously gotten into a process to buy some time. What's going to happen during that time? There'll be a by-election. That's what's going on.

The minister, in her own news release, said-and I'm down to my last two minutes-"It is unacceptable that Hamilton Health Science Corp's proposed recovery plan did not take into consideration the needs of the residents on the Hamilton Mountain and surrounding communities." The Ministry of Health was a part of putting together that recovery plan. They were involved in every step of the development of that recovery plan and that's why she won't table it, because then she has to either lie or fess up that she was a part of it.

Hon David Turnbull (Minister of Transportation): David, can you speak up a bit?

Mr Christopherson: You tell me to speak up. Do you know what? We're a little tired that no matter what we do, your government won't listen. So at the very least, you're going to have to listen.

But the fact of the matter is that this minister and her officials are a part of that plan and that she said it's unacceptable that there's not consideration for the community. The only thing we've been concerned about at this stage, because it's the only thing that's been in the bull's eye, is Henderson; ergo, the minister ought to announce that Henderson's going to be saved and that's why the supervisor's being brought in. That's not what's happening.

The board of the Hamilton Health Sciences Corp, for all the challenges they face, have done the best they can. I think they made an absolutely critical strategic error in saying they're going to close the Henderson, or do anything else for that matter, in advance of the operational review and the recovery plan being tabled, which would mean that the ministry would have to say whether they're onside or not. It would be hard to be offside when you were a part of developing it.

But for all of that, they are good people who have done the best they can and they don't deserve to be treated this way. They've been hung out to dry, just like the broader community has been hung out to dry. If we don't get this funding issue resolved, privatization is what's coming next. When that happens, just look down the road five, 10, 15 years: The Hendersons of our communities will be privately owned.

Mr R. Gary Stewart (Peterborough): It's my pleasure to speak to the Premier's resolution on health care. It's interesting to note that the number one priority with our government is health care and it's the only thing that is the same for everybody in this province. I feel very disappointed that the federal government does not believe that health care should be a priority as well.

As I listened to the opposition members in this House, they seemed to be standing in their places and not suggesting that we try to get the fair funding from the federal government that this province deserves, and not only this province but all of them in Canada. I ask the members of the opposition, are they more interested in protecting their Liberal cousins in Ottawa or are they more interested in protecting the people of Ontario and indeed the people they represent?

I could use a whole bunch of clichés here today, like "Talk versus action," and "Put your money where your mouth is," and "Facts, not fallacy," but I won't use those because I have no intention of blaming anybody. What I am trying to suggest is that there were a great number of dollars, to the tune of $4.6 billion, taken out of transfers by the federal government of this country that I believe should be put back into our health care system, and I believe most other Ontarians believe the same thing. For that reason I find it very difficult to listen to the rhetoric, or whatever you wish to call it, from across the House of those who don't want to protect health care for the people of this province.

Now let's talk about priorities. Let's talk about protecting health care for Ontarians. As a government, and I include all sides, we must ensure that all Ontarians can continue to depend on a health care system that is accessible, affordable, accountable and sustainable in the long term, and that seems to be one of our problems. I can't understand why past governments did not plan in the long term for health care. I don't know about you folks, but I have got a little bit older. I suggest to you that 10 or 15 years ago, when the opposition was in power, they must have had a moment when they did not think anybody was ever going to get older. We didn't have to plan for long-term health care.

Our health care system in this province and throughout Canada, you know and I know, faces many challenges. But at the same time we also have many opportunities, and we should not forget that. We should work in co-operation with all levels of government, with all parties, void of political bias, to make sure that health care will be sustainable in this province.

On the medical front, there are several revolutions going on simultaneously: in new technology, new equipment, new treatment and, of course, new drug therapy. This includes everything from multiple organ transplants and new treatments for cancer to less invasive cardiac surgery. In my riding alone, we've been very, very fortunate to obtain some of this new technology. For 15 years Peterborough had tried to get a dialysis unit. Within six months of our government getting elected and getting into place, we had a dialysis unit in the city of Peterborough. Our government reacted. Since then we have obtained a cardiac care unit, which will open later on this month. They had been trying for 12 years to get that. Also the MRI, which is also coming to Peterborough, they had been trying for some eight to 10 years to get that particular unit.

If you look at the types of reform and the things that our government has done in the last five years, I think it's a tremendous record and it's a tremendous indication of the type of priority that we hold for health care. For example, last year we expanded the number of breast screening sites in Ontario to 48, an increase of 12 sites in just one year. We have invested an additional $155 million into cancer care since 1995. Unfortunately, in this province we have a very aging population; also, the incidence of cancer continues to grow at about 3% per year. We have done some of these things, albeit we have a long way to go, in spite of the cutbacks of the federal government.

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As I mentioned, new technologies and new treatments are very exciting, but when you combine them with the increasing demands of our growing and aging population, they raise some larger questions of accessibility and affordability. As I mentioned, between 1995 and 1998 the demand for dialysis grew by 30%. There has also been a major increase in the last couple of years in cardiac surgery and cardiac management.

One of the reasons I have mentioned some of these things is that we listen to what's coming out of the federal Minister of Health's mouth, suggesting that the provinces-not only Ontario but the provinces across this great country-have to start looking at reform. Reform has been an ongoing thing, certainly in this province, for the last four years.

As I said, we have major changes. The demographics are changing. We've got to prepare for that type of future, and it appears without a great deal of additional help from the federal government. In 11 years, for instance, the post-war baby boom generation will be reaching the age of 65. Thus, the demand for health services will only continue to increase, and again, it appears without additional help from the federal government.

What will that mean for health care costs? Let me put it in perspective for you. Today we are spending $20.6 billion. Half of that money is being spent on 12.6% of our population, and that is people over 65 years of age. So I think you can appreciate that our growing and aging population will bring tremendous financial challenges to the health care system in the years to come, not only in our province but every province across this great country.

Again, I have to emphasize that the federal government has got to realize that they have got to be part of the solution in health care funding.

It's interesting to note that the Ontario Hospital Association recently noted in their pre-budget brief, and I quote: "Today the Internet is accelerating the globalization of health care services and exposing the public to new options for diagnostics and patient care. The public will expect to have access to modern medical equipment or treatments that are saving people's lives in other jurisdictions. Customers' needs and expectations will increase."

I hope the federal government realizes that is a thing that is definitely going to happen in the future. We're not asking for more or less than what we deserve; we are asking to get what we need and what is fair to us.

If you notice, it's not only Ontario and Canada that have a health care problem. A number of months ago I had the opportunity, over a couple of weeks of holidays, to read a lot of newspapers. Health care is a problem all over the world and we have to be prepared to solve it. We, at all levels of government, have to be prepared to be part of the solution.

I can assure you that Ontarians are concerned-certainly they are in my riding-about the future of our health care system. They want to know that the system will be there for them and for their families if they need it. They want to be assured they will have access to new treatment, new services and new drugs.

The people of Ontario also know that our health care system is a tremendous asset. It is a competitive advantage that contributes much to the strength of our economy. Ontarians want that asset protected. They want their health system to be sustainable, accessible and affordable in the long term.

The system we inherited in 1995 had for too long seen the hospital bed as the answer to everyone's needs, even though today more than 70% of surgery occurs as day surgery. Unfortunately, community based initiatives such as services and long-term-care beds had not been addressed until our government got into power. Certainly, when we announced 20,000 new long-term-care beds in 1998, there had been no construction of any long-term-care beds in the previous 10 years.

Mr Rock says, "You should start reforming the health care system." Ladies and gentlemen, Mr Rock should listen and see what the people of all provinces have been doing in health care across this great country.

I suggest to you that this government has put those reforms in place. Piece by piece, step by step, we have put in place the necessary elements of a modern health care system in response to the needs of our population, and yes, we've got a way to go, but we'll continue moving forward.

One of the reforms that has happened is we're shifting the focus from sickness to wellness, as we must if we are to sustain our health system. We're promoting injury prevention and health promotion. We're investing in early intervention for children and their families through programs such as our pre-school speech and language programs, our Healthy Babies, Healthy Children program, all of these reforms at major cost, major increase to this province. We are doing it in spite of cutbacks from the federal government. As I mentioned, we want no more, nor do we want any less.

Because we restructured the hospital system, we have been able to make major reinvestments in our hospital facilities and in long-term care. There's presently $1.2 billion worth of hospital construction underway and we plan to spend another $2 billion to meet the needs.

That brings me to a health care problem and a hospital problem that we have in the riding of Peterborough. We have a new name for our hospital. It's called the Peterborough Regional Hospital, from the old name of Civic Hospital. We have a new name, but we need a new hospital. Why? Because our hospital has had very little refurbishment since 1947-a little bit in 1962 and a little bit more in 1988. Our inpatient rooms are too small to appropriately accommodate modern medical equipment. We use the old crank beds because the rooms are not big enough for electric beds. We have to use those crank beds getting patients from one floor to the other because the elevators are not big enough to take the new beds. If a person has a cast on one's leg and has to use a wheelchair but also has to use the washroom, they must leave the door open in that washroom. Because of their leg, there's not enough room to go to the bathroom.

That's the type of hospital we have at Peterborough. We need a change. We need a new one. We don't have sufficient space for nurses and doctors in the wards. We have a $250,000 piece of equipment that sits outside our operating room which gets banged constantly by gurneys and beds because there is no room for it to be put any place. But we cannot get this type of new hospital or improved health care unless we have a commitment from the federal government to put the dollars they've stolen out of this province back into the system.

We have established that it's about a 70-30 split. As you may or may not know, it used to be a 50-50 split between the community and the province. When we got in to form the government it was changed to 70-30. I commend the people of Peterborough and area because they are ready to put up their 30%. The county, the city councils and the community have approved that there will be a levy put on their property tax on a yearly basis for the next 25 years. We're committed, and I suggest to you that the federal government better soon get committed to enhancing health care in this province.

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Fortunately for this province, we have a strong and growing economy. We also have a strong Premier. We have a strong and caring health minister. The reason I make the comment about a strong Premier is the fact that Premier Mike Harris has led the charge towards Mr Rock, to somehow convince this individual that the dollars they have taken out have to be put back in.

We have been able to increase our health care spending from $17.4 billion in 1995 to $20.8 billion today in spite of the cutbacks of the transfers from the federal government. Why have we been able to do it? Because we have a thriving economy that has seen the creation of 665,000 net new jobs since 1995. The tax cut is working.

However, while we have increased health care funding, as I said, the federal health cuts have cost Ontarians $2.8 billion since 1993. Our taxpayers have had to make up the difference in order to protect and preserve health care in this province. Moreover, we have committed to spending another 20% over the next four years, to an unprecedented $22.7 billion.

I want you to think for just a moment about those transfer payment cuts and the impact they have had not only on Ontarians but on all Canadians. In simple terms, since 1993, Ottawa has been forcing Ontarians to pay a major part of their health care bill twice. The people of this province paid their taxes to Ottawa, but unfortunately Ottawa did not return all of the health care money. Then, as a result of those federal cuts to health care, those same Ontario taxpayers have had to pay-

Mr Richard Patten (Ottawa Centre): On a point of order, Mr Speaker: The member across continues to make disparaging comments about my community, Ottawa. It is not Ottawa. I believe he's talking about the federal government-

The Acting Speaker (Mr Michael A. Brown): That's not a point of order. The member for Peterborough.

Mr Stewart: Ottawa did not return all of the health care money and, as I say, Ontario taxpayers have had to pay twice, because they've had to pay again for the needed services that could be provided for people in this province.

I suggest to all members of this House, and indeed the member from Ottawa, that we go out of our way to make sure that Allan Rock, the federal minister, and the federal government put the transfer dollars back into health care as quickly as possible.

Mrs Marie Bountrogianni (Hamilton Mountain): It's a privilege to speak on any debate with respect to health care, particularly since these past two months have been very significant ones for health care in my community in Hamilton. My colleague from Hamilton West talked about the Henderson hospital situation, and I want to give the House some background because you'll be hearing quite a bit about this in the future.

Yesterday, the minister took a very severe step in recommending a supervisor go into the corporation. There's a 14-day waiting period and if this indeed occurs, I believe it's only the third or fourth time in this province's history that this has happened.

One of the promises the minister has made is a promise of consultation with the community and with the various stakeholders, and I do hope that occurs. Indeed, there has been in the last three months an informal consultation process, and I'd like to summarize some of that consultation and have it on the record, both for the minister and for the opposition.

In 1996, the Health Services Restructuring Commission came to Hamilton-Wentworth and recommended that the corporation's three acute care sites remain open. They reviewed the demographics, they reviewed the need, and the commission recommended that the three acute care sites remain open. Indeed, in 1992, a cancer centre was built at a cost of $41 million beside one of those acute care hospitals, the Henderson, precisely because it was to remain an acute care hospital. This state-of-the-art centre, at $41 million, needs an acute care hospital and indeed will move if the acute care hospital is downgraded, as was proposed by the corporation. In fact, there was an expansion to occur, and that is on hold until all of this is resolved. This has caused a lot of insecurity among cancer patients and physicians, adding to an already untenable position with respect to attracting physicians to the area. According to the corporation, we are short about 80 physicians in the Hamilton-Wentworth area.

The proposal to downgrade the Henderson from acute care to urgent care is unacceptable for many reasons. One, it is the only acute care hospital on Hamilton Mountain. For those who aren't aware of the geography of the Hamilton region, it truly is an escarpment and it's truly difficult to get down the escarpment when the weather is bad. As well, during certain traffic periods the traffic goes only one way up on some of the major routes.

One of the areas of waste, according to the operational review, is the fact that long-term-care patients take up acute care beds. That's true. They take up these beds for months and months when really they should be for patients who need them for a few days or weeks. In 1998 we were promised almost 1,300 long-term-care beds or alternative care beds, and we're still waiting for those. The funding has been approved; they still haven't been built.

I understand that these things take time; I was on a hospital board once before. This isn't a criticism, but it is a reality. These beds take time to be built. Therefore, to close down 95 acute care beds, as was proposed by the operational review, before the long-term-care beds are built would be disastrous. We already have long waiting lists for long-term care and home care. We understand that those patients belong in different settings, but until those settings are built, it would make an already bad situation untenable.

I have here a letter dated April 6 from the director of the cancer centre, Dr George Browman, referring to the possible downgrading of the Henderson hospital, to the staff of the corporation. I'll just read a couple of sentences of his letter:

" It is Cancer Care Ontario's position that a cancer centre must be affiliated with and located in close relation to an acute care hospital with a full range of in-patient services. This principle has been applied in all recent decisions around the location and building of cancer centres throughout the province. We have been given a strong direct indication that the Ontario Ministry of Health and Long-Term Care shares this position as a matter of policy."

Therefore, if the acute care centre is downgraded to urgent care, this $41-million centre will have to move. Not only will that $41 million be thrown out the window, $41 million of taxpayers' money, but estimates of moving the centre are anywhere from $50 million to $80 million. That's $130 million. The savings of the downgrading of the ER is $2 million. It just doesn't make any sense, not from a clinical point of view and not from an economic point of view.

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There are also legal implications to downgrading the only acute care hospital on Hamilton Mountain. I have a letter-again I will only read a couple of sentences from it-from the Canadian Medical Protective Association. It is in response to a letter from the physicians in Hamilton about this very issue, about transporting critically ill patients to a hospital down in the city from the Henderson if the urgent care isn't sufficient. That letter states:

" We have concerns about issues regarding transfer of critically ill patients and the inability to provide ventrolatory support. In addition, full cardiac support when necessary, including inotropic support and invasive monitoring, should be potentially available when medically necessary."

This is the critical point here: "There isn't any reliable method that can be used to scientifically, medically screen out patients prior to surgery to put patients into true high-risk and true low-risk groups. That is the problem with urgent care versus acute care, and the relationship between that and surgery. As such, the idea of splitting patients between sites is unacceptable to us. In addition, we would feel that it is unacceptable to us to consider that our current quality and standards of care could be compromised by the changes proposed." This is from the chief of surgery from McMaster University to the Canadian Medical Protective Association.

The response was: "Patients should be informed, perhaps as part of their pre-operative consent, of the potential risks for being transferred to another hospital in the unusual event that they develop unexpected post-operative complications." In other words, after an operation, you need an emergency room, you need acute care facilities.

The letter finishes from this Canadian Medical Protective Association: "Clearly, an investigation would have to follow any difficulty in accessing critical care beds in a timely fashion in the event of a demand for such services. It may be necessary to even transfer patients to Toronto if closer intensive care unit beds are unavailable."

Is that what we've come to, transferring critically ill patients to Toronto because there aren't enough beds? Yet another reason why we need an acute care centre hospital on the mountain.

With respect to consultation, we've had nothing but consultation in the last two months, albeit informal. We've had over a thousand e-mails. We had a town hall meeting March 9, where 1,200 people were able to stay; hundreds more were turned away because of fire regulations. During that town hall meeting, people made presentations, stakeholder groups made presentations. That document has been given to the Minister of Health. I urge her to read it carefully. There are some very good proposals there to this overwhelming challenge in Hamilton-Wentworth.

We have 75,000 signatures-that must be a record of some sort, 75,000 signatures in less than a month-saying this is not appropriate. Although the majority of the signatures are from Hamilton Mountain, they also extended outwards because the acute care hospital on Hamilton Mountain also services other parts of the region: Glanbrook, Stoney Creek, Ancaster, Dundas.

As part of one of our events at the town hall meeting, physicians gave a proposal. Ambulance care managers said that it was inappropriate to transport patients. Also, it came to light that this would be an extra cost for the region of about $700,000, the extra ambulance driving and transporting patients from the Henderson to the other sites. From a selfish point of view as a representative of Hamilton Mountain, it didn't make sense to us politically to have three acute care centres in the city and none on the mountain, which is the fastest-growing part of the region. We are expanding the south mountain exponentially. The airport, as you may have heard, will also be expanding, meaning more expansion, more business, but also, unfortunately, more accidents, therefore increasing the need for that acute care centre.

But I want to be clear: I'm not advocating that any of our emergency rooms be closed. I'm just talking from Hamilton Mountain's point of view, or as one of the media in Hamilton likes to say, "If you're from another planet and travelling above Hamilton, does it make sense not to have one on the mountain and to have three downtown?"

Having said that, even with three downtown and one now on the mountain, four, Hamilton hospitals have also been hit by the emergency room crunch gripping Ontario. During the month of December, Hamilton's ERs were on critical care bypass 19% of the time, which means that 19% of the time they had to refuse even the most critical of patients. Although these are the formal statistics, I happen to know that sometimes they take these critical patients even if they are on critical bypass, because they're professional, they're caring, and they know that but by the grace of God go they, and they do take care of these patients but under amazing conditions.

During the first week of January, which of course is heart attack season and accident season, it's not uncommon to have an increase, but it was 49% of the time that Hamilton's ERs were on critical care bypass. An obvious question is, why are we speaking about closing any of our emergency rooms? That is a question that was asked and answered by this government's health care commission, hospital commission, in 1996, and the conclusion was, no, none of the emergency rooms should close.

We have a physician shortage crisis in this country. Hamilton isn't any exception. This whole insecurity is making it even worse. Who in their right mind would want to transfer to hospitals when they're in this crisis? The doctors who are there are committed. They want to stay there. We do need to do something very quickly. It's heartening to hear that there is this task force, but we would like an update very quickly on what is happening, just to give us some hope that progress has been made on recruiting doctors. All levels of government were short-sighted 10 years ago when they reduced the medical spaces in medical schools.

Perhaps some of the short-term solutions that the minister was alluding to might have something to do with opening up, albeit on a short-term, extra spaces so that within three to four years we have more doctors. Maybe she was alluding to a better relationship with the federal government where some of the immigration policies can be looked at, because I'm sure we all know of people who are driving cabs out there, who really should be in operating rooms. I do hope and encourage that this enhancement of the relationship between the provincial and federal government be improved. We need to work together. It's health care we're talking about.

Being the critic for colleges and universities, I can't help but use this as a pitch to re-look at the deregulated tuition fees. It's up to $12,000 a year now to study medicine. One of the arguments is that they'll make a lot of money when they finish and therefore they'll be able to afford to pay down the loan. That's true for those who can get there. For those who are very smart, in their 90s but can't get there because of financial difficulties-they can't get the loans; they don't have the kind of family backup where they can even get the loan-that is another barrier. I would hope that both levels of government will look at that.

When I read through the operational review of the Price Waterhouse company, the funding issues were staggering. The challenges are staggering in my community with respect to our hospitals. I do hope, whatever happens, that we work together to solve this problem in a non-partisan way. Whether a supervisor is appointed or not, whether in the next two weeks ultimate solutions are discussed or not, my community will always have my support and my voice on this issue.

I would like to spend the last five minutes of my time to speak about another issue that my colleague from Sarnia-Lambton brought to this House's attention last week. This issue is extremely important to me, not only as a member of provincial Parliament, but as a mother of a girl, as a daughter of an aging mother and as a woman myself. I didn't know-and I have been in the health care and education fields for 17 years-for example, that in Canada there isn't any mandatory accreditation of mammography, of mammograms. In other words, when women go-and it's a very stressful test-to see if potentially they have breast cancer or not, these units may not necessarily be checked by an inspector basically.

I'd like to give a little background, if I may. Breast cancer is the most common form of cancer diagnosed in Canadian women. One out of every nine Canadian women will develop breast cancer during her lifetime. One out of every 25 women will die from this disease. In fact, in Canada, we are second in the world with respect to fatalities to breast cancer in women. It was estimated that in 1996, there were approximately 18,600 new cases and 5,300 deaths attributed to breast cancer.

At present, the only proven strategy to reduce deaths caused by breast cancer is early detection and mammography. Mammography is a very important tool in early detection. Not only is it used to screen women in the absence of disease symptoms, but it is also used to diagnose the disease. In Canada, breast cancer screening occurs in provincial organized breast cancer screening programs, private clinics and hospital-based mammography clinics. Analysis of the health survey results indicates that nearly 60% of women over 35 had a screening mammogram in the last two years. This is equivalent to 1.5 million mammograms annually. However, most of these machines are not accredited, and we don't know when we go which ones are or are not. There isn't even a posting that says, "This machine isn't accredited," or one that says it is.

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This was a problem in the United States seven years ago. They did a survey and they found out that a large percentage of their machines were simply not giving valid tests and therefore could be giving either false negatives or false positives, both very scary. A false positive is also scary. Being told you have cancer when in fact you don't is actually, in my mind, a crime to that family.

Other provinces have made accreditation mandatory-not as many as should, but Alberta has and so has Quebec; we haven't here in Ontario. Again I encourage both levels of government to get together on this issue. It's one that affects 51% of the population.

I'll give you an example of how staggering the statistics are. Only 35% of mammography facilities in Canada have joined the voluntary accreditation program, and 40% of these units are accredited in Ontario; in other words, 60% in Ontario aren't.

The act in the US seven years ago mandated accreditation of these units. Why did they do that? When they surveyed their facilities, 90% of the images did pass today's image quality criteria but 50% had quality control problems with film processing and handling that could affect diagnoses; in other words, half of them. If we transfer that statistic to here in Canada, we're in trouble. This is something that can be fixed. It's not one of those insurmountable health challenges that we're all faced with.

The Radiation Protection Bureau brought together all the key stakeholders for a consultation on the issue and made recommendations to the Minister of Health at the federal level. I do hope the Minister of Health at the provincial level heeds these recommendations as well. We need public information and education. I, for one, when I go for my next test, will ask, "Is this machine accredited or not?"

Research and professional training: This is a lecture in itself, but most of our doctor training does not include training in cancer. Research should be done within one organization seen as the knowledge centre. A critical mass evolves when you do research in one centre and when the funding is focused in one centre.

We met yesterday, with the health critic and with my colleague from Sarnia-Lambton, Mr Greenaway, the president and CEO of the Breast Cancer Society. This gentleman and his wife lost their daughter to cancer at the age of 38, years ago, and since then have committed their lives to raising funds, millions of dollars, for breast cancer. They are on a mission to have Canadian mammograms accredited across the country. I support them. I ask for this side of the House to support them and to support the minister at both levels.

Mr Joseph N. Tascona (Barrie-Simcoe-Bradford): I am very pleased to join in the debate on this resolution. I can frankly say that, with respect to health care reform, this government has taken leadership. It's not about dollars and cents. It's about having a plan with respect to reforming health care.

Ontario is a leader in health care. It increased health care funding from $17.4 billion in 1995-96 to $20.8 billion in 1999-2000. In contrast, in 1999-2000, Ontario will receive $1.7 billion less from Ottawa under the CHST than it received in 1994-95. This resolution condemns the government of Canada for cutting by $4.2 billion the annual base payments under the federal program that supports health care.

At this time I want to talk about our plan for reforming health care. What it has been, as we've established, is that the federal government instead of spending their fair share, which is 50%, is actually spending only 11 cents on the dollar with respect to health care in this province. That's not the fair deal that was set out to provide Canadians and Ontarians with health care that meets their needs. There have been many provincial reform initiatives, and I'll just name of few: primary care reform, pharmacare programs, home care, long-term care, mental health and the restructuring of our hospital system. So when you hear the federal government say, "You're not going to get any money unless you have a plan," it's very difficult to take the federal government seriously and to think that they understand the situation. We do have a plan and we're implementing that plan. We're implementing that plan notwithstanding that the federal government has cut their transfers significantly and at the same time haven't come up with any initiatives of their own.

Interjections.

Mr Tascona: Listening across to the other side, the provincial Liberals have done nothing with respect to this issue, no initiatives, but we have marched on.

As I said, it's not just dollars. Let's just look at my area, Barrie-Simcoe-Bradford, as you appropriately said, Mr Speaker, one of the fastest growing areas in this province. Actually it's made up of the city of Barrie, the town of Innisfil and the town of Bradford-West Gwillimbury. I may add that the city of Barrie is the fastest growing city in this province. We're very privileged to have a brand new hospital as of 1996 and to have the tremendous growth that we're seeing with respect to new people coming into our area and coming from all parts of the province. Because of the economic growth in our area and with the aging of our population, our hospital needs to expand, even though we got a brand new hospital in 1996. What's great about the restructuring that's been happening in this province is that it has resulted in my constituents not having to go to Toronto for services they would normally have to go there for. I'll name just a couple: breast screening for cancer, MRI technology and kidney dialysis-significant reinvestments for my area because my constituents don't have to go down to Toronto to get that treatment.

We're looking also to try to get a regional cancer care clinic, which would allow us to have state-of-the-art service to treat cancer victims and they wouldn't have to go down to Toronto to get the services they need. That's something we're working on. It's a five-year plan and it's something that this government has taken seriously. There have been other communities-for example, Kitchener-Waterloo-that have regional cancer care clinics. Certainly that's very important to them in providing the services they need to provide to cancer care victims in their area.

Also what's important to know is that there's tremendous investment in the health care of our community; for example, the Barrie Community Health Care clinic which has opened up downtown in the city of Barrie. It is a tremendous reinvestment, a much larger facility and more accessible for people. It's a part of our community health initiative in terms of educating the public about the health care services that it can provide and about their health, but also providing much-needed services to the community at large. Also, the community care access centre which started up under this government's initiative is serving our constituents well in terms of their transition into and out of hospital. That's another program we have implemented and it has done very well in Simcoe county.

1700

I'm very pleased to announce that in the next couple of weeks we're going to be seeing a seven-day emergency care clinic that will be set up in the south end of the city of Barrie which is going to service my constituents for emergency care services. It's state of the art and it's going to be, from what I understand, the second of this type of clinic that there is in the province, and it's much needed. It will allow people to go to that clinic rather than have to go to the RVH emergency clinic. It will be staffed by the same doctors and medical staff who treat people at the Royal Victoria Hospital.

That is tremendous news because of the tremendous size of Barrie, but it will also serve people from the town of Innisfil. Speaking of that, we also have, as a part of my riding that serves my constituents in the town of Innisfil and the town of Bradford-West Gwillimbury, a tremendous investment in York County Hospital. The province has committed in excess of $60 million towards the expansion of York County Hospital, another fast-growing area that needs the services, with investment in their birthing units and in catheterization. It has become the regional centre for the area of York region and Simcoe county. We've been very blessed with respect to the investments that have been made at York County Hospital. It will allow my constituents not to have to go to the city of Toronto to get their medical services in those specialized areas.

The investments that have taken place have been in the millions and millions of dollars in restructuring of services. That's something that is long overdue in terms of moving health care services to the people who need them and to where they live. That is tremendous news.

In our area, as I said, with the tremendous growth, it's certainly going to place even more pressure on the services we need brought here. We have a temporary kidney dialysis clinic. That's going to be made permanent, I understand, this year and provide even more service with respect to kidney dialysis patients. I just want to say this: This government has invested in health care, it's invested in the services that are needed in this province, and that's what health care restructuring is about.

There are some other areas I want to comment on as we deal with this resolution. It's not a situation, as the federal government's finance minister likes to say, of shovelling money into a bottomless pit. We're talking about health care. Health care is very important to Canadians and it's very important to Ontarians. It's a situation of there being a plan, which is in place, and for the money that is needed-not 11 cents on the dollar, which the federal government provides, but full and equal partnership that has to be played out by the federal government.

With respect to the primary care network, the Ontario government has been working hard for the past five years on reforms and innovations to the health system as we implement our vision for health care. The health action plan has been extended to primary care reform, and we have to recognize that here today. Ontario is a leader in primary care reform. We've been working in partnership with the Ontario Medical Association since 1995 on primary care initiatives. The Ministry of Health and Long-Term Care and the Ontario Medical Association first introduced primary care networks in four Ontario communities-Hamilton, Paris, Chatham and the Kingston area-in May 1998. In September 1999, primary care networks were introduced in three more communities: Ottawa, Parry Sound and Thunder Bay.

What are primary care networks? Primary care networks are made up of family doctors joining together in their communities to provide easier access to health care services and better coordination of health information through computers. The networks will help reduce waste and duplication in the health system. About 200 family doctors will participate in the primary care network pilot projects across seven communities, and nearly 400,000 Ontarians could eventually join or enrol with their family doctors as part of this new service model, which will provide 24-hour, seven-day access to care.

How it works is that patients agree that their family doctor and their doctor's primary care network will look after their primary health needs. Illness prevention, health education, diagnosis and treatment are all part of what family doctors do to provide their patients with health care. Primary care also includes family doctors making referrals to specialists. Referrals can also be made to another of the network's doctors who may have more expertise about the patient's condition. That's a tremendous initiative. It's something that is needed in this province.

I also want to comment on the pharmacare programs. We have not waited for the federal government to act in this area. The government of Ontario has been working for a number of years reforming and enhancing Ontario drug programs. For example, Ontario's drug programs consist of three different plans tailored to different needs of the population: the Ontario drug benefit plan, the Trillium drug plan and the special drugs program.

The Ontario drug benefit plan is the largest, and covers the cost of over 3,100 prescription drugs. Some 1,018 products have been added to the Ontario drug plan since our government took office in 1995. The $1.6-billion program covers about 2.2 million seniors and social assistance recipients. Forty-four million prescriptions were filled in 1998-99.

The government has a unique program, the Trillium drug program, for those who are not otherwise eligible for the Ontario drug plan and who have high drug costs. Approximately 100,000 Ontarians who need expensive drugs to treat serious illnesses like cancer, HIV and cystic fibrosis have their drugs paid for through this program. Expenditures for the Trillim drug program for 1998-99 totalled $45.5 million, up from $35 million the year before.

There is also a special drugs program which covers the full cost of certain expensive outpatient drugs such as specific drugs for AIDS, organ transplants, cystic fibrosis, schizophrenia and thalassemia. The program provides funding to over 12,000 beneficiaries at a cost of approximately $92 million annually. So that is another one of our initiatives.

We're looking forward to more investment, more expansion of the programs with respect to home care and also with respect to long-term care. That is especially important to my area, the riding of Barrie-Simcoe-Bradford, because of the tremendous growth, the number of seniors who are moving to my area and the fact that there is a shortage in the city of Barrie with respect to long-term-care programs. That initiative, which was announced by the minister, is something we're looking forward to. The number of beds is 544 long-term-care beds. In the first go-round, the city of Barrie was given a little bit more than half of the 150 long-term-care beds. The second phase of it, I understand, will deal with 225 more long-term-care beds. When you're dealing with fast-growing areas and the initiatives that have been taken by this government, they have to be directed toward the services that are in need. As the MPP for the area, I put my focus on services that have to be there, like breast cancer screening for women, MRI technology, state-of-the-art technology that could only be gotten by my constituents in terms of advanced X-rays. The type of technology that is needed to be able to diagnose the most serious of illnesses is at RVH and also at York County Hospital. Kidney dialysis is something that has been wanted by my constituents for many years. Those initiatives are examples.

Cancer care is something we're going to be working hard on. A regional cancer care clinic for RVH is much needed. Certainly, because of the population dynamics of Simcoe county, RVH is ideally suited to be the regional cancer care clinic. With the growing population, I find many of my constituents who unfortunately are stricken with cancer have to go down to Sunnybrook hospital and get treatment, and go back and forth on the highway-a very difficult situation. When it gets fatal and they're in RVH, then the issue becomes whether they should be moving from RVH down to Sunnybrook hospital to get more treatment.

I'm in full endorsement of this resolution that has been put forth by the Premier. I believe in it 100%.

By my account, 12 hours and 45 minutes have now been spent on the debate surrounding this resolution. We have spent five sessional days debating this resolution. In comparison to debate on many other items, this is a significant amount of time. For example, the budget debate-

Interjections.

The Acting Speaker: Order. I cannot hear the member. Could we be quiet so that I can hear the member for Barrie-Simcoe-Bradford.

Mr Tascona: The members have debated this resolution long enough, and it is time we sent a strong message to the federal government. That is why I move that this question be now put.

The Acting Speaker: Mr Tascona has moved that the question be now put. Is it the pleasure of the House that the motion carry?

All those in favour will say "aye."

All those opposed will say "nay."

In my opinion, the ayes have it.

Call in the members. It will be a 30-minute bell.

The division bells rang from 1714 to 1744.

The Acting Speaker: Order. Will members take their seats, please.

Mr Tascona has moved that the question now be put. All those in favour will stand.

Ayes Arnott, Ted

Baird, John R.

Beaubien, Marcel

Chudleigh, Ted

Clement, Tony

Coburn, Brian

Cunningham, Dianne

DeFaria, Carl

Dunlop, Garfield

Ecker, Janet

Elliott, Brenda

Eves, Ernie L.

Galt, Doug

Gilchrist, Steve

Gill, Raminder Guzzo, Garry J.

Hardeman, Ernie

Harris, Michael D.

Johns, Helen

Kells, Morley

Klees, Frank

Maves, Bart

Mazzilli, Frank

Molinari, Tina R.

Munro, Julia

Murdoch, Bill

Mushinski, Marilyn

Newman, Dan

O'Toole, John

Palladini, Al Runciman, Robert W.

Sampson, Rob

Spina, Joseph

Sterling, Norman W.

Stewart, R. Gary

Stockwell, Chris

Tascona, Joseph N.

Tilson, David

Turnbull, David

Wettlaufer, Wayne

Wilson, Jim

Witmer, Elizabeth

Wood, Bob

Young, David

The Acting Speaker: All those opposed will stand one at a time.

Nays

Agostino, Dominic

Bartolucci, Rick

Bountrogianni, Marie

Boyer, Claudette

Bryant, Michael

Churley, Marilyn

Conway, Sean G.

Cordiano, Joseph

Curling, Alvin

Dombrowsky, Leona Gerretsen, John

Gravelle, Michael

Hampton, Howard

Kennedy, Gerard

Kormos, Peter

Kwinter, Monte

Lalonde, Jean-Marc

Lankin, Frances

Levac, David Marchese, Rosario

Martel, Shelley

McLeod, Lyn

Patten, Richard

Peters, Steve

Phillips, Gerry

Pupatello, Sandra

Ramsay, David

Smitherman, George Clerk of the House (Mr Claude L. DesRosiers): The ayes are 44; the nays are 28.

The Acting Speaker: I declare the motion carried.

Mrs Lyn McLeod (Thunder Bay-Atikokan): On a point of order, Mr Speaker: I understand that the government's notice of closure has now cut off debate on the government's motion that was considered their priority before the House. I accept the vote that has just been taken, but I do ask to understand now what will happen to amendments. I have placed an amendment, as the New Democratic Party has. The amendment is considered to be in order and germane to the motion. In our view it would have made the motion considerably more balanced, because it would have recognized the Harris government's responsibility for the funding of health care. I'm asking whether or not the government's closure motion has now precluded having the government vote in support of their own extension of funding to health care.

The Acting Speaker: I would bring the member's attention to standing order 47, which spells it out quite clearly. I will just read the last sentence: "If a motion for closure is resolved in the affirmative, the original question shall be put forthwith and decided without amendment or debate."

The motion that the question be now put having passed, the next question is therefore on the main motion.

On April 4, Mr Harris moved:

" That the Legislative Assembly of the province of Ontario:

" (a) Condemns the government of Canada for cutting, by $4.2 billion annually, base payments under the federal program that supports health care, the CHST, while provincial governments have increased health spending;

" (b) Urges the government of Canada to repudiate the statement attributed to a spokesperson for the federal finance minister, the Honourable Paul Martin, that increasing health funding would be `just shovelling money into a hole that's going to open right back up again';

" (c) Urges the government of Canada immediately to restore permanently the health funding that it has cut, and to assume its fair share of increased, ongoing funding to meet the health needs of our country's aging and growing population; and

" (d) Reminds the federal health minister, the Honourable Allan Rock, that the sincerity of his commitment to medicare and the principles of the Canada Health Act would be best demonstrated not by idle rhetoric and vague words, but by restoring the health funding he has cut."

All those in favour of the motion will please say "aye."

All those opposed will please say "nay."

In my opinion, the ayes have it.

Call in the members.

Pursuant to standing order 28, the government has requested a deferred vote. The vote will take place during deferred votes in routine proceedings.

===============================================================

April 12, 2000

DEFERRED VOTES

HEALTH CARE FUNDING

The Speaker (Hon Gary Carr): We now have a deferred vote on the motion by Mr Harris relating to health care funding. Call in the members; this will be a five-minute bell.

The division bells rang from 1349 to 1354.

The Speaker: All those in favour of the motion will please rise one at a time and be recognized by the Clerk.

Ayes

Arnott, Ted

Baird, John R.

Barrett, Toby

Beaubien, Marcel

Chudleigh, Ted

Churley, Marilyn

Clark, Brad

Clement, Tony

Coburn, Brian

Cunningham, Dianne

Dunlop, Garfield

Ecker, Janet

Eves, Ernie L.

Flaherty, Jim

Galt, Doug

Gilchrist, Steve

Gill, Raminder

Guzzo, Garry J.

Hampton, Howard Hardeman, Ernie

Harris, Michael D.

Hastings, John

Hodgson, Chris

Hudak, Tim

Jackson, Cameron

Johns, Helen

Kells, Morley

Klees, Frank

Kormos, Peter

Lankin, Frances

Marchese, Rosario

Martel, Shelley

Martin, Tony

Martiniuk, Gerry

Mazzilli, Frank

Molinari, Tina R.

Munro, Julia

Murdoch, Bill Mushinski, Marilyn

Newman, Dan

O'Toole, John

Palladini, Al

Runciman, Robert W.

Sampson, Rob

Snobelen, John

Spina, Joseph

Sterling, Norman W.

Stewart, R. Gary

Stockwell, Chris

Tascona, Joseph N.

Tilson, David

Tsubouchi, David H.

Turnbull, David

Wettlaufer, Wayne

Wilson, Jim

Wood, Bob

Young, David

The Speaker: All those opposed to the motion will please rise and be recognized by the Clerk.

Nays

Agostino, Dominic

Bartolucci, Rick

Bountrogianni, Marie

Boyer, Claudette

Bryant, Michael

Caplan, David

Colle, Mike

Conway, Sean G.

Curling, Alvin Di Cocco, Caroline

Dombrowsky, Leona

Gerretsen, John

Gravelle, Michael

Kennedy, Gerard

Kwinter, Monte

Lalonde, Jean-Marc

Levac, David

McGuinty, Dalton McLeod, Lyn

Parsons, Ernie

Patten, Richard

Peters, Steve

Phillips, Gerry

Ramsay, David

Smitherman, George