I must say that I stand in front of you, Speaker, with very mixed emotions this morning. Part of me is really angry that this bill is going through. Part of me is really anxious; I have anxiety about this bill going through.

You see, Speaker, Bill 60 is laser-focused, very powerful, and it serves one purpose. The purpose is to bring in investor-owned corporations to provide what forever has been provided by our not-for-profit hospitals. Why am I so anxious and angry about this? Because we are being witness, all 124 of us, to the destruction of medicare, a program that defines us as Canadians, as Ontarians, where we know that the care we need will be based on our needs, not on our ability to pay. Once Bill 60 becomes reality in Ontario, all of this will change, Speaker, and it will change for the worse.

You see, health care is a relationship that happens between somebody who needs care and the health care providers who provide that care. There is a very strong trust relationship that needs to take place between those two human beings in order for quality care to take place. Often, your health care providers—your nurses, your physician, your physiotherapist—will ask you to do things that you don’t really want to do, will ask you to do things that could be painful in the short term but are aimed at improving your health in the long term. All of this can take place because there’s trust.

This trust relationship will change forever once there is a for-profit motive in there. You see, Speaker, what we have right now in Ontario are publicly owned facilities. If you think of a community health centre or a public health unit, those are publicly owned facilities. They provide care; they are not-for-profit.

We have privately owned, not-for-profit facilities. Most hospitals in Ontario are set out under this model.

Then, a lot of people know the physician-owned small business. Most physicians are a small business. They provide care, but because you have this caring relationship between the owner of the small business—the physician—and its patients, the system works.

What we don’t have very much of at all in Ontario, but what Bill 60 will bring us, is what we call investor-owned corporations. So, a corporation will invest to build a surgical suite. Those are not cheap, Speaker. We are talking investing millions of dollars to build a surgical suite so that hip and knee surgeries can take place in that surgical suite. The only reason those investors are investing those millions of dollars in surgical suites is not because they want your knee pain to go away; it’s because they want to make money. And this changes everything.

We are all human beings. When you will be asked to do something by an investor-owned corporation that owns the surgical suite, you will start to double-guess yourself: “Are they asking me to do this because they’ll make more money? Or are they asking me to do this because it’s good for me?” And the minute this doubt comes into our minds—because we are all human beings, when we don’t know, we always imagine the worst; this is the way human beings think—then the opportunity to have top-quality care goes out the window, not to mention everything else that could go wrong.

So, am I against community-based surgical suites? Absolutely not. I mean, look at what Sunnybrook has done. They have built in the community an OR suite that provides hip and knee surgeries. They are able to do those surgeries 30% faster and 40% cheaper than in their hospital. They provide outpatient care, that is, you come in in the morning, you have your surgery, you go out at night—no need for a hospital admission. They do the same type of surgery in the hospitals. It’s more expensive and a little bit more timely, but I’ll come back to that.

The difference here is that it is owned by a not-for-profit hospital. It is staffed by physicians who work not only in the community-based surgical suite; they also work in the hospital. Because sometimes, although you will try to select, and there are selection criteria that we use—most hospitals use a set of four. They are new criteria. You can divide them in nine, but I won’t go into the details. You select patients who you think are able to have the surgery done in the morning or afternoon and go home at night.

But for anybody who has worked in health care, there’s the theory and then there’s the practice. Somebody who you thought would do really, really good suddenly codes on the OR table and needs to be admitted into the hospital.

At Sunnybrook, there’s no issue. The surgeon who was there when things went wrong will follow you back into the hospital. You will be transferred to the hospital, admitted and looked after. Everything goes smoothly.

The people who work in the community-based surgical suites run by the hospital are the same OR nurses and technicians who work in the hospital also. They see not only the cases that are deemed lower-risk that can be done on an outpatient basis; they also work in the hospital and see people with complex, multiple co-morbidity factors who still need the surgery but it becomes a whole lot more complicated because of their health status.

Not all of us have the same health status. Many people have multiple chronic diseases that make it harder to provide what would be qualified as a simple surgery. It’s not that simple, depending on who you’re providing that to.

This model I fully support. You can look at what London has done. My colleague right here could tell you a whole lot more about it, being from London himself. London bought a building across the street from the hospital, set it up as a community-based outpatient surgical centre and operates it pretty much the same way. They operate it where if it’s somebody that they feel can have their surgery and be discharged the same day, they will be cared for in the outpatient surgical suite that it owns. But again, it is owned by a not-for-profit hospital. It is staffed by people who handle both: the people who are healthy enough to be seen and discharged the same day as well as the people with the multiple co-morbidities, who need to be seen in the hospital.

If something goes wrong—we always hope it doesn’t; I don’t wish harm upon anybody, but it happens—the continuity of care is there. The same surgeon who looked after you when things went wrong will continue to look after you to make sure that you get back to health and back to the outcomes that were expected out of that surgery—same thing with the rest of the surgical team that provided you with that care. That makes a whole lot of difference.

You all know that many hospitals right now have hundreds of vacancies on their websites. Go on the Ottawa Hospital: The last thing I counted was over 575 vacancies. Go on any hospital in Toronto, London, Sudbury—it doesn’t matter where you go, there are multiple vacancies.

When you have those investor-owned corporations investing millions of dollars to build those surgical suites because they want to make money, then there’s a good chance that they will take even more of those exhausted, overworked, overstressed hospital workers and bring them into those investor-owned surgical suites.

Why, Speaker? Well when you work in a hospital, a hospital runs 24/7. They run on evening shifts and on night shifts. They run on the weekends. They run on the statutory holidays. It doesn’t matter that it is Christmas and it’s your son’s—none of that matters. You work in a hospital, you will be scheduled and you will have to work shift work: weekends, night shifts, statutory holidays.

You go work in an investor-owned surgical suite that exists to make money, you don’t have to provide care 24/7. You will get a Monday-to-Friday job, 9 to 5.

Think about it, Speaker. You have a choice to work in a hospital, where the cases are more complex, require a whole lot more thinking and care, and things don’t always go well. You have to work day shifts, afternoon shifts, night shifts. You have to work Saturday, Sunday, statutory holidays. Or you can work Monday to Friday, 9 to 5, looking after the healthy and the wealthy in an investor-owned corporate surgical suite.

We’re all human beings. People like to be home with their kids at night. People like to have the weekends off to enjoy their lives and their friends. People like to be home on Christmas morning or Eid or whatever other holidays that you celebrate with your families and friends. It is a whole lot more difficult to do this when you work in a hospital than when you work in an investor-owned corporation whose sole, number one priority is to make money.

This is what is about to change in Ontario. Ontario has over 700 independent health facilities. That’s how we call them right now; they’ll be changing the name apparently. Most of the independent health facilities that we have are X-ray—quite a few sleep labs. You will remember the audit that the Auditor General has done that showed that the sleep labs in our hospitals work pretty good. You have sleep apnea or something, you will be tested in the sleep lab in the hospital and be treated.

But the ones that are owned and run in the community, the ones that are privately owned—the Auditor General showed us that a physician who owned a sleep lab referred every single one of his patients to the sleep lab and most of them twice. There were no valid medical reasons for every single patient of a physician to be sent to a sleep lab, except that he owned it and makes more money when there are more patients coming through. I could go on about the oversight of the private clinics, and I will in a few minutes, but it’s pretty weak, Speaker.

We already know that in the 700 or so independent health facilities that exist in Ontario, the great majority, 98% of them, are for-profit, that whenever there is an opportunity to make more money, they take it.

When we look at who is waiting to build those surgical suites, I could name a few. Clearpoint Health Network certainly cannot wait for Bill 60 to pass. They already have spotted out a few places in Toronto where they want to set up those for-profit surgical suites, because they know that they will make money.

But I want you to look at some of the side-effects of this. The first one is the draining of staff away from our not-for-profit hospitals who look after everyone, no matter your complexity, no matter how many co-morbidities you have. Some of those staff will go to the for-profit surgical suites.

I’ve already said why: We are human beings. They’re offering you a Monday-to-Friday, 9-to-5 job, probably will pay more, and you don’t have to do night shifts anymore. You don’t have to look after the complex cases anymore. It’s a money-making proposition that very many people will be interested in.

You have to look at what that will mean. Does that mean that the 575 vacancies in the Ottawa Hospital will stay there or grow? Does that mean that the vacancies in London Health Sciences or UHN—University Health Network—or Health Sciences North, or in Sault Ste. Marie, will grow bigger?

Many of those specialists—the anaesthetists, the orthopaedic surgeons etc.—who will be needed to do those surgeries right now volunteer to do locums in northern Ontario. That is, all hip and knee surgeries are based on a quota. It’s called paid-per-procedure—whatever; it doesn’t matter—every hospital gets allocated a certain number of hips and knees. So the surgeons divide them amongst themselves—I’ll make this up: “You are given 230 hip and knee surgeries for the year.” Once the 230 surgeries are done, there is no more money to do hip and knee surgeries. You’re done.

Many of those surgeons then volunteer to come to northern Ontario. They do what we call locum. I can tell you right now that in Sault Ste. Marie, the Sault Area Hospital has lost their anaesthetist, the locum that used to come up. Why? Because they are working with some companies down south who are getting ready to set up those for-profit surgical suites. Once the private surgical suites are there and the government is giving them plenty of cases to keep them busy, then the surgeons, the anaesthetists who used to come to northern Ontario to do locum, because their share had been used, won’t be coming to northern Ontario. Every single hospital in northern Ontario works really hard—time, effort and energy—to recruit and retain health specialists to staff our hospitals. All of this will become really hard, Speaker. All of this will become harder, because once they have used their—I made up the 230; some of them have 500, some of them have 100; it all varies—paper procedure number of cases in their hospital, they don’t need to come to northern Ontario anymore. They can just go to the investor-owned corporations that operate the surgical suites and they can do all of the surgeries that they want because the government is very generous.

We have seen what has just happened with cataract surgeries, where the three for-profit corporations were given thousands more payments for cataract surgery. But I can tell you that in Sudbury the hospital does very few cataract surgeries in March because the payments go from April 1 to March 31. They don’t follow January 1. They go April 1 to March 31. So once the money is gone, then nothing happens until April 1, till the money starts to flow again. But not for the for-profit. They were given thousands of cataract surgery money to do the exact same thing that could have been done in our hospital, but that money was not available to our hospital. It was only available to the for-profit corporations.

Those are decisions that this government is making because they are laser-focused on bringing forward private investor-owned corporations to Ontario. Don’t get me wrong, there are many, many wealthy corporations that just can’t wait, but I’m trying to explain to all of us the impact it will have.

We have First Nations people from Kitchenuhmaykoosib Inninuwug and all through Treaty 7 that are at Queen’s Park right now. Bringing health care services to fly-in, remote First Nations is not easy. Recruitment of staff is something that is really, really demanding, difficult but important.

We are just making that job 10 times more difficult than it was before, because the pool of locums—that is the term that we use for people who work in Ontario, usually in southern Ontario, and come to northern Ontario. They will come for a week at a time or two weeks at a time. Some nurses come for months at a time. They come and work in northern Ontario and then they go back to their day job in southern Ontario.

We call those locums. They are paid to do locum services. But once the demand comes from the investor-owned corporations for those same people with the same skills to stay down south, then we know that there will be an impact on all of the good people who have flown in from Treaty 7 right now who are at Queen’s Park and who want equity of access to health care services.

Will we be doing double lung transplants at Kitchenuhmaykoosib Inninuwug? No. But do they deserve to have access to primary care? Do they deserve to have equitable access to our health care system? Yes, absolutely. But none of that is possible if there are no health care workers, if there are no physicians, if there are no nurses, if there are no physiotherapists, occupational therapists, speech language pathologists, audiologists. The list goes on. This worries me.

Then, we have to talk about—I’ll stick with my example: The Ministry of Health allocated 150,000 cataract surgeries to the for-profit cataract provider. They are paying them $605 per surgery. I’m strong in math; that’s a $90-million industry just for cataract surgery that has been done. You can all see that if the government just created a $90-million industry just for the cataract surgeries that they have recently allocated to the for-profit, it could motivate people to go into this industry. Speaker, $90 million is a fair chunk of change, if you ask me—a whole lot of money that the government is willing to spend.

The government doesn’t spend that amount of money when the cataract surgery is done in a hospital. A hospital that wants to build a surgical suite will have to raise money, so they will have to collect donations from a ton of people. The good people of Ontario have always supported our hospitals, so they were able to put in place infrastructure to do cataract surgery or hip and knee surgery or buy a new MRI. In my community, a PET scanner took a very long time to raise the money. Thank you so much to Sam Brumo’s family for leading that money-raising adventure, I will call it. It was tough.

But the for-profits don’t have to do any of that. The for-profits get paid by the government what is called a fee for using their infrastructure. The hospital doesn’t get that. The hospital has to fundraise. The hospital has to find donations. But if you are a for-profit, you get paid. You get reimbursed for the infrastructure that we are using.

You see the difference, Speaker? The hospital has to fundraise to purchase a new MRI. The for-profit puts the money upfront, and then the government pays them back a facility fee every single time somebody uses that infrastructure. That infrastructure will be paid for by taxpayers many times over, because this is where a lot of their profit will come from. But a hospital doesn’t have access to any of this. A hospital—a not-for-profit hospital—has to fundraise to do the same thing.

The same goes on for any other surgery. A hip surgery costs, in general in Ontario, $12,223. Try to find a corporate, investor-owned corporation that will do a hip surgery for $12,000. It is impossible. You are looking at double that; $25,000 at the minimum. Why, Speaker? Why is it that we don’t give our hospitals the money they need to do more hips and knees?

I can tell you that at Health Sciences North, the hospital in Sudbury, the hospital built 17 brand new ORs when the new tower was built, but it’s only funded for 14 of them. So you have state-of-the-art technology sitting there that has never opened, never been used. Do we need the for-profit corporations to build more infrastructure, to build more surgical suites? Absolutely not. We have them sitting empty in every single one of our hospitals. Every hospital that provides surgery in Ontario has downtime. The Auditor General went through and did her analysis and showed that the vast majority of them do surgeries from 7 until 4. They don’t do surgeries at night. There are days that they don’t do surgeries at all. There are weekends where they don’t do surgeries at all; that it sits empty. Why? Because they don’t have the money. Remember, paid per procedure. Once the number of procedures that the government has paid for ends, it ends. Yet the for-profits got more. Why weren’t those surgeries sent?

I would say, within the health care sector, everybody agrees that if you—you as in the government—were to pay to keep existing OR infrastructure that we already own, that we’ve already paid for, that are in our hospitals, operating an average of two hours more a day, the wait-lists would go away. Let that sink in. We have 200,000 people right now in Ontario waiting for surgery. They’re waiting in pain; sometimes they’re waiting a really long time to get the surgeries they need. If the government were to fund the existing infrastructure to stay open two hours a day more, we would get rid of the wait times.

Do we really need those investor-owned corporations? The answer is clear: We do not. We have the infrastructure that is needed to provide the surgical, the diagnostic imaging that needs to happen. What we haven’t got is a government willing to fund the not-for-profit hospitals. The number of companies lining up to make a profit is kind of sickening. But that’s not all. They’re not only there to make money. Not only do they make money on the infrastructure fees that they’re allowed to charge, that hospitals are not allowed to charge, but most of them make money because there’s a greater risk to patient safety. Why? Because they will hire people—first of all, a lower number of staff to do the same procedures than what you would see in a hospital, and second, the qualifications of those staff won’t be the same.

First, they only take the healthy and the wealthy. If you have diabetes, if you have a heart condition, or God forbid, you have a mental health or an addiction problem? Forget it. The investor-owned surgical suites, those corporations don’t want to have anything to do with you because you may actually require care: “Go to the hospital; they will look after you.” They want the healthy and the wealthy.

If you are fortunate enough to have passed the bar of being healthy and wealthy enough to go in the for-profits, the risks are real. The risk to patient safety is real; it has been well documented. We can look—not only the risk of harm—that is, the surgery does not turn out—but the risk of death is also very real. Why? Because the number of staff and the people who are there do not have the skills.

This brings me to schedule 2 of the bill, which will allow physicians and nurses who are not members of the college of nurses and who are not members of the College of Physicians and Surgeons of Ontario to call themselves physicians or call themselves nurses. Right now in Ontario, if somebody calls themself a nurse, you know for a fact that she is registered with the College of Nurses of Ontario. She has the training, the skills and the ongoing ability to be able to provide nursing care. But with schedule 2, Ontario will allow people who are not registered with the College of Nurses of Ontario—who have not been checked for the education they received, the training they know or the skills they know—to call themselves nurses. I will go out on a limb but I feel pretty secure that not too many hospitals will hire those, but the investor-owned corporations, who run those surgical suites, will be more than happy to hire them. Why? Because they will pay them less. Why? Because they will make more money off the back of paying their employees less. This is part of how they make money.

But how they make most of their money is by upselling, that is, to offer people a service that is “not covered by OHIP.” I put it in quotes because there is sometimes a very, very narrow definition as to what is covered by OHIP and what is not.

Again, remember, Speaker, I opened up talking about trust. In order for you to receive quality care, you need to have trust in the providers in front of you. When the provider in front of you, who is about to put a laser to your eye, tells you that he prefers to use this lens and this lens is not covered by OHIP, and this lens costs sometimes $500, sometimes $1,200, sometimes $2,000, who are you to argue? He prefers to use that lens. He’s about to put a laser to my eye. Do I really want to argue and say, “I would prefer you use the one that’s covered by OHIP”? Who the hell would have a conversation like that? It does not happen. The power imbalance between the health professional, who knows what they are doing, and the patient who needs care makes that kind of conversation absolutely impossible. But it happens; it happens every day.

I am sure all of us have had conversations with some of our constituents who come to see us with bills and say, “You know, it cost me $2,500 to have my cataract surgery. I don’t really have the money to pay for that $2,500, but there must be a government program to help with this. It’s a surgery. Surgeries are covered in Ontario.” Then you have to explain to them that, no, they don’t.

In my neck of the woods, cataract surgery can be done in a hospital or in the ophthalmologist’s private clinic. The wait-list at the hospital is very long. Remember, those 1,500 cataract procedures that went to the for-profit company? None of them came up north. None of them came to Health Sciences North, so the number of cataract surgeries is very limited. There’s a long wait-list. But you can go to the ophthalmologist and have the same surgery done, except that in his office, he only does certain procedures that are not covered by OHIP. So now you have a choice. You can be given a fixed date to have your cataract surgery done. You will have to pay for a lens that is not covered by OHIP, for a measurement that is not covered by OHIP, but you’ll get it done within a couple of weeks. Or you can be put on the hospital wait-list, where you have a good chance of having your surgical date bumped down the road and not knowing when it will happen for months and months.

I live in northern Ontario. There is no public transit where I live. You need to have a driver’s licence and you need to drive, or you need to have somebody to drive you.

So you have an opportunity to keep your driver’s licence and have the surgery done on a fixed time frame if you buy a service that is not covered by OHIP. Or you can lose your driver’s licence because your vision has deteriorated and have a date in the future at a hospital to have a surgery covered by OHIP, and we don’t really know when that surgery is going to take place. What do you figure people will do?

I had a lady who shared this exact story that I just told you. Here is where it gets interesting: “If I had it performed in the office, I would be scheduled for a committed date and time frame. My other option was in the hospital, but I had to be aware that my appointment could be rescheduled due to hospital surgical rooms becoming unavailable. As we would be travelling, we would have no idea of rescheduling until we travelled the three hours”—because in northern Ontario the distances are long—“plus the cost of a stay overnight, unable to cancel our room because it is no longer needed. Having to take time off work was also a factor in considering. We were offered ... lenses at an increased price of $2,300 per eye, a firm date and a set operation time versus a soft hospital date and a government-supplied lens that had to be replaced within a shorter period of time. Any time you have a surgery that is a risk to failure, so everything had to be factored in.”

Then she went on to share with me the choices that she had to make regarding the lens that she wanted, and one part that was interesting was the method of payments. She could pay with cash, debit, bank draft, Visa or Mastercard. If she chose to pay with the first three methods—cash, debit or bank draft—it was free, but if she used her Visa or Mastercard, because she didn’t happen to have $2,300 hanging around, then she was charged an extra $25 for using a credit card.

All of this is happening right here, right now in Ontario, and all of this is about to increase exponentially.

I wanted to share some of those examples regarding cataract surgery because this is where most of the private surgical suites exist right now, but under Bill 60, expect many, many more. Those are not going to be available for people in northern and rural Ontario. Those are going to be in big centres where there is a lot of money to be made.

I want to share the story of a woman in Ottawa diagnosed with breast cancer and needing to have surgery done. She went to the Ottawa Hospital and was told of the long, long wait-list to have cancer surgery done. The Ottawa Hospital does not meet the deadline set for quality care—it only meets the deadline set for quality care in 13% of the cases, and 87% of these women do not get their breast cancer surgery done in a time that is safe for them to do so. So she decided to have the same procedure done at a private clinic, paying $50,000 to have that done. But you see, Speaker, there were other hospitals within Ottawa, within the same radius of driving from Ottawa to Montreal, where she had the surgery done, or driving from Ottawa to Kingston or to other hospitals, that had much shorter wait-lists, well within the recommended guidelines, that would have been completely free. But she didn’t know about that. She did not know about that because Ontario does not have a common wait-time strategy.

We do measure. We know the wait times for each and every one of the surgeons, for each and every one of the surgeries. It is being measured, but it is not being shared. So her family physician—he or she, I have no idea—did what he or she does: He referred her to an oncologist who he knew was a good surgical oncologist to follow her for her breast cancer, not knowing that this oncologist’s wait time is way beyond what is recommended and not knowing that at another hospital, there was another surgical oncologist who could have done the same procedures, paid for by OHIP, in an acceptable amount of time.

There are still women in Ottawa right now who have seen the long wait-lists, who have seen that if you go to the Montreal investor-owned clinic, you can have the procedures done in the right amount of time. I don’t blame them. You are faced with a cancer diagnosis. You are told that you need to have the surgery done. You are told that, to maximize your health and life, you need to have it done within a certain amount of time, but that the surgeon that you’ve been referred to has no hope of seeing you, so they look elsewhere.

Why is it that Ontario has not put a centralized wait time so everybody can go online and see this? British Columbia did it. Other provinces have done it. We have the information. We don’t make that information available or accessible. Why not? Why not? These women in Ottawa who are being diagnosed with sometimes stage 3 or stage 4 breast cancer, who need surgery in a very short period of time, would like to know that there is another surgeon who provides this service not far from where they live.

In British Columbia, the statistics are clear: Of all of the surgeries—because they have them all public; you can go on their website right now and see how long you would wait for this surgeon or that surgeon, for the same surgery—50% of the people selected surgeons that they knew and that they liked, 23% of the people selected the first available surgeon, and the rest of them selected the surgeon that was closest to their home. There’s nothing wrong with that. It certainly did not hurt the health care system in any way, shape or form, but it sure helped redistribute the workload among specialists who could provide that surgery.

I can tell the women in Ottawa that there are hospitals and there are surgeons that have way shorter wait-lists. Unfortunately, the government of Ontario won’t make that information available to you, but we should. Right now you will have to pick up the phone and wait on the line—because doctors’ offices always take a long time to pick up—to ask every single surgeon who is qualified to do that surgery how long their wait-list is. Really, Speaker? This is 2023? We would rather have a woman worried about her life paying $50,000 for a private surgery than make that information that we already collect available to her? What kind of government does that? Who does that? This is part of the anger and anxiety that I talked about when I started my speech. I don’t understand the decisions that are made.

A single wait-list would go a long way. In British Columbia, you click on the surgery you need, you say the geographical area you’re interested in, and you see how long it is. I can just about guarantee you that this woman in Ottawa, had she had this information available to her—she didn’t choose to go to Montreal because she wanted to support the private, for-profit corporations there; she went to Montreal because she wanted care in a timely basis. Care in a timely basis was available to her in Ontario, but she had no way to access that information. All of this could change.

I see that I only have 14 minutes left.

You can see that this bill is really focused. It really targets one thing: make it easier for investor-owned corporations to make money off the backs of sick people.

When Bill 60 came to committee, we had many, many people who wanted to present. The opportunity to present was quite limited, but some people managed to come and talk to us. Many more sent us comments in writing. They all wanted change, from the Ontario Health Coalition, who made very good comments that they wanted that gone, to Dr. Agarwal—I hope I pronounced his name properly—who made it clear that if we’re going to go down this path, it has to be physician-owned, because a physician is bound by the College of Physicians and Surgeons of Ontario which will look at what the physicians are doing to make sure that they always put the good of their patients at the forefront.

We had the Health Profession Regulators of Ontario who came to us. The Health Profession Regulators of Ontario are 27 colleges for health professionals existing in Ontario. Everybody who wants to practise in Ontario has to belong to a college. This has been there for one reason. Every college, the College of Physicians and Surgeons, the College of Nurses, the College of Physiotherapists—they exist for one reason: It’s to protect the public.

The Health Profession Regulators of Ontario, which represents all 27 colleges, came to do a deputation and made it clear that they don’t agree with schedule 2, where people who are not registered with their college would be allowed to work in Ontario. They said if we’re going to allow a nurse from Alberta or British Columbia to come and work in Ontario, give them a time frame where they have to register with the college in Ontario so that the college in Ontario can check that they are in good standing. They came and they gave us how long it takes for a nurse, a dental surgeon, a pharmacist, a massage therapist—they went through the whole line. The longest it takes if you come to Ontario—we’ll say you’re a physician. You’re a physician or a nurse in British Columbia or Alberta. You want to come and work in Ontario. If you give the college in Ontario the permission to connect with the college in the province where you are registered now, the longest it would take them is less than two weeks to do. Where it takes longer is when the person does not grant the permission to connect with the college where they are registered now.

The Health Profession Regulators of Ontario made it really clear that they are worried that the people who do not give the college in Ontario the right to connect with the college in the province where they are working right now—it’s because they’re in trouble with their college. They have done something that is being investigated by the college. They’re in trouble. They are at risk of losing their licence in their province of origin, and they are coming to Ontario because in Ontario you won’t have to be a member of the college of physicians, surgeons, nurses, physiotherapists—you name it. You will be allowed to call yourself a physician, to call yourself a nurse and not be a member of the college.

They are really worried. I tried—our entire team tried—really hard to make amendments to that part of the bill. First, I put in, “Let’s give them four weeks.” Then I put in another amendment: “Let’s give them two months.” Then another amendment: “Let’s give them three months to register.” The government voted all of that down. So right now, we have no deadline for those nurses, physicians, physios, OTs, speech pathologists—you name it—who come from other provinces to work in Ontario before they need to join the college. You will remember, the health colleges exist for one reason: to protect the public. And they do a good job of it. They are worried, and so am I.

Many others came to present. Kevin Smith, the president and chief executive officer of University Health Network, came and talked to us. The Ontario Nurses’ Association came and talked to us. The Ontario Association of Clinic Endoscopists came and talked to us—many more; the Toronto Centre for Medical Imaging.

Kevin Smith is the president of the University Health Network, a not-for-profit hospital. I can tell you that anybody from hospitals who came to talk to us all said the same thing: There has to be a strong link between the community outpatient surgery that everybody supports and the local hospital, because we all know that some patients will need care. Not every surgery goes according to plan. Some of them will need to be admitted into a hospital. You have to make sure that it is a surgeon who has working privileges in a hospital. Otherwise, who will admit that patient? You will send him in the middle of a surgery through EMS into the waiting room of an emergency room? This is a recipe for disaster. It’s a nightmare.

The physicians who will work in community clinics need to have privileges in a hospital. Hospital CEO after hospital CEO came and told us that, how important it is. They talked about the model that already exists, the model that they would love to have if only the money was available for an amount of time that makes it feasible. To be told in January that you could open up a surgical centre and the money will run out on March 31 is not a recipe for success. We don’t put those tight deadlines on the for-profit health care providers, but we put them on our hospitals. This is the narrative of this government, who wants investor-owned corporations to own hospital suites, to own surgical suites.

The list went on. We had the Toronto Centre for Medical Imaging that came. Not only will we have investor-owned corporations to do surgeries, they will also do medical imaging. The same thing is there: They need to be connected to our hospitals. You don’t go have an MRI done or a CAT scan or a PET scan done because all is well. Your physician sends you for diagnostic imaging because something is not right with you and follow-up will need to be there, and they need to be connected.

The NDP put forward 74 recommendations. Those 74 recommendations were all based on a body of evidence that was either presented to us or that was submitted to us—as in, all of us, because through Bill 60, we all got a chance to see them. All 74 of those recommendations were voted down, but I thought that I would share some of them with you.

From the Indigenous Primary Health Care Council that came to see us, they talked very clearly about how the danger of the poor access to care for Indigenous people right here, right now in Ontario is going to get worse once those investor-owned private clinics are up and running. They know full well that none of them are going to set up shop in a remote First Nation. Their access to care will diminish.

The definition of what they call an integrated community health service, which is a private, for-profit, investor-owned surgical suite—well, I can tell you that the Association of Family Health Teams, the association of family physicians, the Alliance for Healthier Communities, the Indigenous Primary Health Care Council, the Nurse Practitioner-Led Clinic Association and a long list of other ones asked that they be not-for-profit and that they be linked to an existing not-for-profit hospital. The Canadian Doctors for Medicare; the Canadian Federation of University Women of Ontario; the OMA, the Ontario Medical Association, all talked about the importance of having physician-owned—if you’re going to go down the private, don’t let the investor-owned corporations own those facilities, because we all know—the body of evidence from across the world is very clear—there will be extra fees, which means barriers to care for a lot of people. There will be more mortality and poor care, and there will be more people waiting in our not-for-profit system because of it.

The system will be licensed through a person within the ministry, so if there is a request or proposal, the association of family physicians, the Alliance for Healthier Communities, the Indigenous Primary Health Care Council, the Nurse Practitioner-Led Clinic Association all want to have quality advisers. If we are going to have community-based surgical suites, you need to develop a program to make sure that there’s accountability for the quality of the care that is provided.

I see that I’ve run out of time.

I want each and every one of you to realize that medicare is a program that you, your family, your neighbours, your friends have counted on for—most of us, for our entire lives. It was brought forward in the early 1960s. Medicare guarantees that the care you receive is based on needs, not on ability to pay. Bill 60 will change all of this for the worse, and forever. Once investor-owned corporations start to do outpatient surgeries, we will never be able to go back. They will charge extra fees. They all do. There are a ton of loopholes that allow them to do this. These extra fees will mean that some people will decide not to have their surgery because they can’t afford the extra fees.

Those clinics will mean that a lot of health care professionals who will be working there won’t be working in our hospitals. The crisis we have at Sault Area Hospital right now, who cannot have an anaesthetist, you will see it throughout. Sault Ste. Marie is not the only one; Manitoulin Health Centre has the same, every hospital in the north. All of those recruitment issues in northern and rural Ontario will get worse. The wait time for each and every one of us who needs care based on needs, not on ability to pay, will get worse.

Vote down Bill 60. You have an opportunity to save medicare. Don’t let it go by.

We already have. I have the Kensington Eye Institute not-for-profit. I have Dr. Sorgini. They already post their charges, and the charges vary quite a bit from one to the next. What costs $200 at Kensington costs $250 with Dr. Sorgini, and the list goes on.

It’s not because the extra fees are being posted that the relationship between the person who provides the care and the person who receives the care changes. The health providers have all the power. If, in order to have the surgery done on a fixed date, you need to buy one of those products, you will, because you don’t want to lose your driver’s licence. You don’t want to have to travel three times to Sudbury to have your surgery cancelled.

No, I will never support extra fees. Hospitals don’t charge extra fees. Care is based on need, not ability to pay.

Those people—you go on the website; they are here to lobby the government. They are lobbying me also, so I have no doubt that they are lobbying the government, and the government is listening. There are a lot of people closely tied to the Conservative government who stand to benefit by millions of dollars once Bill 60 goes forward, on the backs of sick people.

The body of evidence throughout the world is very strong and solid. I would encourage the member to read from Canadian physicians for medicare. They have a four-page—so it’s very easy to read. I can guarantee you that bringing in for-profit does not decrease wait times. It’s the opposite, because the for-profit only can make profit out of the healthy and the wealthy. As soon as you have a comorbidity—remember when we debated about chronic diseases? Most people over 45 have a chronic condition, which means that they will not qualify for healthy and wealthy, where you make a lot of money. They will still be on the wait-list for a hospital, and those wait-lists will grow exponentially. Do you think that 200,000 Ontarians waiting for care is long? Wait to see what happens once the for-profits come in. Go have a look at what happened in Australia. Go have a look at what happened in the UK when the Conservative government did the exact same thing you’re doing now. Their wait-lists grew. Many of them are backtracking right now.

There are a ton of investor-owned corporations who know that there are enough loopholes to be able to make millions, hundreds of millions, if not billions of dollars off the backs of sick people in Ontario. They are the ones lobbying for Bill 60 to go through. They are the ones who will benefit from Bill 60, and they are the ones that have the ears of this Conservative government. They are willing to listen to them at the expense of destroying a program that defines us, where care is based on need, not ability to pay.

Ma question est pour le premier ministre. We heard what happened at Minden hospital. Now let’s go to Carleton Place hospital, where the local hospital was forced to close its emergency department overnight because there weren’t enough staff to keep it open. A week before, it was its sister hospital that was closed overnight due to staff shortages—its third closure in as many months.

Ontario had exactly one—one—unplanned emergency room closure in the last 15 years, but in the last year alone we’ve now had 160—160—emergency room closures in a single year. This isn’t normal, Speaker, and we should not pretend that it is. What new measure will the Premier take today to stop the closure of emergency rooms across our province?

A hundred and sixty emergency room closures in one year under this minister’s watch.

Let’s go to Chesley. In Chesley right now, if a child requires care on a Saturday, they are out of luck. Their local emergency room is now closed evenings and weekends due to staff shortages. People there are worried that this is a sign that the end is near for this hospital. The member from Bruce–Grey–Owen Sound said that he wants Chesley hospital to return to full service. But after 10 years on the job, it does not look good, Speaker. Would the Premier agree the people of Chesley deserve a full-time emergency room? What will the government do to keep the emergency rooms open in our province?

J’aimerais remercier Erick Brunet de Blezard Valley dans mon comté pour cette pétition.

« Soutenez le système d’éducation francophone en Ontario. »

« Attendu que les enfants francophones ont un droit constitutionnel à une éducation de haute qualité, financée par les fonds publics, dans leur propre langue;

« Attendu que l’augmentation des inscriptions dans le système d’éducation en langue française signifie que plus de 1 000 nouveaux enseignants et enseignantes de langue française sont nécessaires chaque année pour les cinq prochaines années;

« Attendu que les changements apportés au modèle de financement du gouvernement provincial pour la formation des enseignantes et enseignants de langue française signifient que l’Ontario n’en forme que 500 par an;

« Attendu que le nombre de personnes qui enseignent sans certification complète dans le système d’éducation en langue française a augmenté de plus de 450 % au cours de la dernière décennie; »

Ils et elles demandent « à l’Assemblée législative de l’Ontario de fournir immédiatement le financement demandé par le rapport du groupe de travail sur la pénurie des enseignantes et des enseignants dans le système d’éducation en langue française de l’Ontario et de travailler avec des partenaires pour mettre pleinement en oeuvre les recommandations. »

J’appuie cette pétition, monsieur le Président. Je vais la signer et je demande à Nicholas de l’amener à la table des greffiers.

Your phone?

If we see cows outside in the winter, are they safe?

I would like to ask my colleague a question about when the provincial animal welfare service drives around in northern Ontario in the middle of a snowstorm, and it’s minus 30, and sees animals outside. Am I the only one who thinks that those cows should be inside in the middle of the winter when it’s cold?

If the inspector doesn’t know any better—I listened to your speech—what will happen to all of the dairy farmers who safely let their animals go outside if the inspector is like me and didn’t know that cows could go outside in the winter?

The title of the bill is “strengthening safety.” I can tell you that for the people I represent, whether it is in French River, Markstay-Warren, St. Charles, Killarney, Britt-Byng Inlet, as well as the First Nations of Dokis and Henvey Inlet, they all depend on the OPP detachment in Noëlville. The OPP detachment in Noëlville is in great danger of being closed under your government any day now. It makes the people of all of those communities very nervous.

How can you reassure them that when you bring forward bills that talk about strengthening safety—they all feel that having a detachment where the OPP officers who work there know them, have patrolled the area, brings higher safety. You talk about strengthening safety. How do you link that up with closing a detachment in a rural northern area?