It’s always an honour to be able to stand in this House and debate the issues of the day and today Bill 69, An Act to amend various Acts with respect to infrastructure. This bill talks about consolidation of real estate holdings of the province and about a change to the Environmental Assessment Act.

Many of you may know, and for those of you who didn’t, you’re going to find out: I’m actually here because of the Environmental Assessment Act. I have an interest in the Environmental Assessment Act because we fought a large issue in my part of the world and it was fully approved under the Environmental Assessment Act. The local people didn’t believe that it was fairly approved, accurately approved. We continued to fight it and this Legislature passed a law stopping that project. But in that process, I was personally sued by the proponent of the project—and I don’t blame the proponent, actually. The Adams Mine Lake Act stopped the project, but I almost lost my farm because it didn’t do anything about the SLAPP suit.

I was approached by the New Democratic Party to run in a provincial election to bring focus on that issue. I ran in that provincial election for the one goal, to bring focus to that lawsuit, to hopefully get rid of it, and however that happened, three days before the writ dropped, the company dropped the lawsuit.

I didn’t win that election. We came within 634 votes, I believe, of taking out a very popular cabinet minister, a very good MPP: Mr. David Ramsay. And Mr. David Ramsay announced his retirement and we came so close that I thought, “You know what? If I don’t try again, I might never know if I can do this job.” And I’m still trying to figure that out.

That’s how I got here. So my ears always perk up when I hear about the Environmental Assessment Act and when I hear words like, “We have the strongest Environmental Assessment Act in the province, in the world.” I always, “Okay, but.” No one wants red tape, but we do want regulations that actually work.

We’re currently dealing in my riding with an issue that has to do with the Environmental Assessment Act. I’ve brought this issue up several times in the Legislature. I’m going to bring it up again today.

I give credit where credit is due: The Minister of the Environment, Conservation and Parks has looked into this issue. We don’t agree on exactly everything that’s wrong, but he did take the time—I would say he’s knee-deep in this issue.

Okay, everyone in my part of the world knows that was a dairy farm. They milked 100 cows there. Some of the buildings are still there and the lagoon is still there. So we asked about the well and we were told there was no well, even though the site was approved. It was engineered and approved. All the boxes were clicked.

Now, everyone knew there was a well there, but the consultation process—under the rules, the way I understand them, everyone within 500 metres of the site has to be notified. The two places that were notified had a personal relationship with the person applying for the business and there was no other notification, except on the Environmental Registry. If there is no public notification, how do you actually get the right information?

The site was approved, there was sewage being dumped into it, and everyone except the MOE knew there was an abandoned well on that property—everyone. Yet all the boxes were clicked. We kept pushing and at some point the MOE realized, yes, there is an abandoned well. It has never been decommissioned and we’re going to have to look into that. Then the MOE kicked into gear.

Again, I’m not blaming the ministry for this. There’s something wrong with the process, because the purpose of consultation is to find the most information that you can. When everyone around the neighbourhood knew there was a well there, but no one in the neighbourhood knew that that construction site—they saw there were backhoes building something, but they didn’t know it was going to be a human storage lagoon. And when we, including myself, went to the MOE we were told, “No, no, no, you’re wrong. This is a new site.” No, no, no.

Then, when they did acknowledge there was a well there, it became apparent that part of the concrete from the original farm was in the storage lagoon. And anyone who knows anything about farms—there’s all kinds of pipes under concrete. All of a sudden, it was then an emergency because that well could be connected to that lagoon underneath that concrete, and the concrete was in the plans of the structure. So they told me, “No, this is not an old dairy lagoon,” but the legacy concrete from the farm was in the plans.

So something is wrong with the system. I’m not blaming anyone within the ministry, but the consultation sucked because it didn’t do its job. Now we are still wondering about other legacy infrastructure underneath the ground at that site, because in the clay belt in Timiskaming, we’ve got 100 feet of clay and it’s very impervious. It’s great for earth and lagoons. But that farm has been there for a long time, so for the last 100 years, those farmers have been doing everything they can to drain that impervious clay. So all around that site, there could be random tiles, systematic tiles, pipes—we don’t know what they did in the last 100 years, and we don’t see there’s been any account for it.

So when people tell me that we’ve got the best environmental assessment system in the country, I question it, because 20 years ago, when we brought up issues on Adams mine, we were told, “Oh, no, no, no. You’re wrong.” And now, 20 years later, on a smaller project, we got the same answer: “No, no, no. That’s not right.” And again, we had to push to make them acknowledge there was a well.

There’s something wrong with our system, and changing these periods isn’t going to make it better.

So are we.

I’m wondering if I could beg the indulgence of the House. On March 1, 1958, my parents were married. Yesterday marked the 65th wedding anniversary for Len and Gwen Glover, and I’m wondering if I could have a round of applause from the members of the House. Thank you.

Applause.

The presentation was extremely helpful. I wanted to share with you an experience I’ve had at city council where I’ve seen different types of environmental assessments placed before different Ministers of the Environment in different administrations and, depending on the type of assessment and what the cities were oftentimes asking for, you would get different speeds of response. For example, assessments around bike lanes or perhaps sidewalk widening and inclusion of bike lanes and road narrowing—it takes a long time for any Minister of the Environment to come out and approve it. Assessments with respect to urban sprawl that may have impact on endangered species or perhaps has impacts on flood protection, sometimes that happens a little quicker.

But in this legislation, the schedule allows the minister to use discretion on whether or not she then waives the 30-day notice, but there’s no prescription to what would lead them to that decision. Does that trouble the member of the House?

Thank you, Speaker, and thank you to our member for, once again, a passionate presentation.

I want to reiterate in this House that it was the Conservative government that slashed the Environmental Commissioner of Ontario’s office. To me, that really does demonstrate a lack of sincerity with regard to our environment.

So the environmental assessment period—I understand the government wants to waive the 30 days, which takes away an opportunity for folks to speak up and share their concerns. Learning about the bill and chatting with some folks, I understand that issues near and dear to Indigenous community members may be missed if those comments aren’t listened to by the government.

Communities that are concerned with environmental racism, with gentrification, with overdevelopment pushing them out will not be heard by the government with that 30-day waiver.

I’m wondering if the member can share with us what they feel is the purpose. What is the purpose of removing that 30-day opportunity to hear from our communities? How are community members to trust what this government has to say if they are removing an opportunity for transparency and accountability, if they’re removing the voice of the community members impacted by these environmental assessments?

I always enjoy our conversations, both here and outside of here, with the member from Timiskaming-Cochrane. In fact, as I look around the room this afternoon, I am so pleased to know that everyone I see in here is in here for the right reasons, and that’s because they care about their communities deeply. That kind of goes against the grain of what you read in the media today, actually, about how all politicians are liars and in it for bags of money and things like that. But I appreciate knowing that I have colleagues on the opposite of the side of the House—even though we’re on the same side of the House—who feel the same way about their communities as I do.

My question is—continuous improvement. What I see in this bill is a small step on the path—a thousand miles starts with one step—of continuous improvement. I was just wondering if the member could say that looking for continuous improvement in the actions that we take as government is a good thing and that we should continue to do so?

What I don’t see is a connection between the amount of time that EA consultation took and the fact it wasn’t done correctly, from what you said. I don’t know if changing the time frame on that would have had a negative impact on that so much. So I was curious what his link is between his presentation and what we’re trying to do to speed things up as far as timing goes. I mean, if the process isn’t done right, it’s not done right regardless of the time, and so I was wondering if he could connect those dots here in debate.

Questions to the member for Timiskaming-Cochrane?

I move that, in the opinion of the House, the government of Ontario should follow the lead of eight other Canadian provinces and ensure PSA testing is an eligible procedure under OHIP for individuals referred by their health care provider.

However, before I begin my speech today, I want to take some time to thank the Canadian Cancer Society for all their hard work and their advocacy on this issue. I’d also like to thank Anthony Henry, who is here in the gallery. Thanks for coming. I really appreciate it. Anthony is someone who has not only been greatly impacted by prostate cancer, but he’s also an activist. He works every day to educate Black men about prostate cancer, the increased risk to them and the importance of screening. He works through the Walnut Foundation and the Canadian Cancer Society and is helping to save lives. Thank you for that. I’m proud to share your story today and I thank you for being here.

Mr. Speaker, today isn’t a day to sit back and discuss stats and numbers on the problems of prostate cancer. It’s a day to face the human side of this health issue. In 2022, nearly 1,800 people were projected to die from prostate cancer in this province. That number is way too high. That means that five men are going to die today from prostate cancer. If we, as legislators, can reduce that number by even one by passing this motion, our work is worthwhile, because, at the end of the day, that one life was somebody’s father, grandfather, son or partner. It was a person in this world who was valued, and they did not deserve to have their life cut short.

Right now in the province of Ontario, the PSA tests are not fully covered. Quite frankly, that’s a shame. These simple blood tests are a key screening tool for early detection of prostate cancer. This is also very important. Eight other provinces in Canada cover the test. They saw the importance of it. It removes the barriers for early detection and saves lives. It’s time that Ontario follows their lead.

Mr. Speaker, before I get into the details on how important this test is and the real life consequences that exist when we continue to put up barriers for testing, I want to talk about the history of how this motion came to be. It was in 2018. I was knocking on doors in Fort Erie—many of us do that during campaigns. A number of men at the door stopped me and asked why the test wasn’t covered. They asked why the PSA test wasn’t covered, forcing them to pay nearly $50 out of their pocket, which they couldn’t afford. I was actually stumped. I honestly never realized such an important, vital test wasn’t fully covered by our health insurance in Ontario. It felt wrong.

So after the campaign, my staff and I dug into the issue. We worked with Prostate Cancer Canada, now part of the Canadian Cancer Society, and learned about the lack of coverage and the importance of this test. I felt it was important that we acted, and the more we looked into it, the more we recognized how much prostate cancer has affected the lives of people around us, because it’s not just the man or somebody who has a prostate who ends up suffering, it’s the family.

Two of my staff out of the three staff I have, fathers, have survived prostate cancer, both thanks to early detection from PSA tests. My father-in-law also had prostate cancer. My good friend Larry Gibson told me he was diagnosed with prostate cancer because of a PSA test and that early detection saved his life. That experience inspired Larry. He thought everyone should have access to the PSA test, so Larry started a golf tournament at the club he owns to raise money. Each year, we participate in the tournament and Larry uses those funds to pay for PSA tests for those who can’t afford it.

Anthony from Walnut Foundation also works in a similar way to take down barriers to testing by paying for men’s PSA tests. Thank you for doing that. It’s so important. That shouldn’t be the case. We shouldn’t have to run golf tournaments to cover the costs of a test that should be part of our universal health care system.

Mr. Speaker, the time to act is now. One in eight men will be diagnosed with prostate cancer in their lifetime. That would be over 10,000 in Ontario last year. For many, this is a terrifying reality. To be diagnosed with cancer is life-altering. It changes your entire world and your family’s.

But if detected early—and this is important—the survival rate is impressive. Nearly 100% of people diagnosed early will survive at least five years or more. Early detection is the key. The survival rate for those diagnosed late with advanced prostate cancer is 29%. What you would prefer for your father or your grandfather: 100% or 29%? I think it’s a fair question.

For those worried about the cost, it’s extremely low. I know my Conservative colleagues like to whittle away at our public services and reduce costs, but including this test would cost as little as $3 million annually and save close to $60 million in the health care system. Think about that. If the PSA test is insured—and this is really interesting—the lab will pay the bill of the Ministry of Health. They bill them just $9.50 per test. But if it’s uninsured and the patient goes, he must pay between $35 and $57 out of pocket, depending on the test. Think about that for a second. Can we afford this?

Considering you have held back billions in spending, I hope you can find it in your heart to approve such a limited expense which literally saves lives in this province. But at the end of the day, that shouldn’t matter. We have the ability to fundamentally alter the health outcome of people in this province. It’s an opportunity to allow people more time with those they love. How could any government say no to that? The evidence is clear on early detection. We can’t continue to ignore it. The costs and stats on survival rates are important, but there’s a real human side to this cancer.

I’d also like to take some time today to discuss the story of someone who is living with prostate cancer and how important a PSA test is to them. First off, I can’t thank him enough for coming, and I’m so grateful for everything that you do to bring awareness to testing of prostate cancer and the importance of early detection. I mentioned him already, but today in the gallery is Anthony Henry, who has dedicated many hours of his life for something so important. So thank you.

Mr. Speaker, Anthony, unfortunately, has a significant family history of prostate cancer. His father didn’t receive a PSA test, and he passed away from stage four prostate cancer at the age of 68. Anthony’s brothers and uncles have both been impacted by prostate cancer.

Because of the family history and the experience with his father, Anthony began getting regular PSA tests when he turned 40—and the age is important. In 2015, his PSA levels jumped significantly, and he had a biopsy. Unfortunately, that biopsy found that he did indeed have prostate cancer. In the case of Anthony, early detection—he was advised to watch and have active surveillance. The message that Anthony wants to provide to men, especially those with a family history of prostate cancer: Talk to your health provider and get a PSA test. Stay on top of your health. It could save your life.

But we as government need to remove barriers for getting that test. There should be no deterrent to taking care of your own health. It should be a joint decision with your doctor. It’s that simple.

It’s important that we also recognize the equality issue we have with prostate cancer. There is data and background that show Black men of African or Caribbean background have a much higher chance of getting prostate cancer. Statistics show that Black men of African or Caribbean background have almost double the risk of developing prostate cancer compared to non-Black men. They’re also more likely to have prostate tumours that grow and spread quickly and are 2.2 times more likely to die from prostate cancer compared to other men.

Even with this information alone, we should be pushing to include PSA testing coverage based on shared decisions with your physician when we know there are higher risks in certain groups.

I understand that the federal clinical guidelines do not recommend screening with PSA tests for those with moderate risk. But those guidelines need updating, as they do not meet the needs of high-risk men. The Canadian Cancer Society recommended men and their health care providers make a joint decision on whether to undergo PSA testing after discussing the benefits and limitations of testing, personal values, preference and individual risk. There are numerous international health care organizations that share this shared decision. Research has been conducted since federal guidelines were introduced in 2014—10 years ago.

Mr. Speaker, together we can do something meaningful for the people of the province of Ontario. We can reduce one more barrier and potentially save lives. I truly hope for support from all parties on this motion and together we can work together to better health outcomes for all. Thank you very much. I appreciate it.

Next question?

Ms. Surma has moved second reading of Bill 69, An Act to amend various Acts with respect to infrastructure.

Is it the pleasure of the House that the motion carry? I heard some noes.

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.

A recorded vote being required, it will be deferred until the next instance of deferred votes.

Second reading vote deferred.

Thank you. That’s actually a very good question. The minister, as part of the minister’s duty, has discretion on many issues, but there should be some kind of parameter on what that discretion is, because this government has—and I’m just using this government; we have vast disagreements in principle on the greenbelt and on some other things, and we would question some of the minister’s discretion.

Ministers need to have the ability to make decisions, but the decisions need to be encompassed in something that people have faith in. If you have good regulations and effective regulations—the idea is not to slow things down; if people have faith in the process, it should speed it up. When people don’t have faith, that’s when they start putting spokes in the wheels, even maybe if the wheels should be turning. People need to have faith, and every time that they see something that’s just, you know—you lose faith in the system. You lose faith in the system.

Speaker, I think if you’ll seek it, you’ll find unanimous consent to see the clock at 6.

My thanks to the member for Timiskaming–Cochrane for his participation this afternoon. I appreciated hearing from him with regard to some of the impetus behind his involvement in provincial politics. It’s always important to remember those anchoring moments and why we got involved.

I thought he spoke very well about some of his particular concerns or perspectives around different aspects of the legislation. I don’t think we would have some of the same experience or perspective on it.

I’m wondering if you could speak a little about the real estate management aspect of the legislation. I think it is an important part of it. I think having that management in place is key, so for the last 30 seconds, over to you to speak about the real estate part.

I want to thank the member from Niagara Falls for bringing forward this motion again. I think I was here the last time he brought it forward, and I know he’s very committed on this issue. I also want to thank Mr. Anthony Henry, the guest who is in the gallery here, for all the hard work that he’s doing to educate people, particularly in the Black community, about prostate cancer.

Cancers touch all of us. I can disclose that there’s prostate cancer in my family as well, so I certainly empathize with people wanting to make sure that we do everything we can to support people with cancers here in Ontario.

Our government invests in cancer care through Ontario Health, who is our adviser on cancer and renal systems; it was the former Cancer Care Ontario. We flow about $2 billion to hospitals to support direct patient care every year. Through Ontario Health, several screening programs are available with the goal of finding cancer earlier, leading to better health outcomes for patients.

Ontario’s cancer screening programs detect pre-cancerous changes or cancer at an early stage when there is a better chance of treating it successfully. Screening is for people who do not have any cancer symptoms, and I certainly encourage Ontarians to speak to their physicians or any primary care provider to discuss their care plan.

Ontario Health oversees Ontario’s overall cancer strategy, including critical programs and services such as:

—cancer surgery, chemotherapy and radiation therapy;

—Ontario’s cancer screening programs, such as the Ontario breast cancer screening program, ColonCancerCheck, Ontario cervical cancer screening program and the Ontario lung cancer screening program;

—the Ontario Renal Network, which manages dialysis services for the province; and

—tracking performance to ensure constant improvements in cancer, chronic kidney disease and access to care.

Speaker, I’m proud to say that, given the success of Ontario’s cancer strategy, cancer incidence rates have been stable since 2001 and mortality has been declining since 1983. But of course, there is still more to be done.

Cancer screening and associated diagnostic services are delivered in Ontario through primary care, through hospitals, independent health facilities and other health care providers practising outside of hospitals, like community-based colonoscopists—have to get the emphasis on the right syllable with that one.

Last month, our government introduced Your Health: A Plan for Connected and Convenient Care. The plan focuses on providing people with a better health care experience by connecting them to more convenient care options close to home while shortening wait times for key services across the province and growing the health care workforce for years to come.

One of the key initiatives includes expanding access to integrated community health services centres, where cancer screening and associated diagnostic services are delivered in Ontario. We are increasing access to surgeries and procedures, such as MRIs and CT scans, cataract surgeries, orthopedics, colonoscopies and endoscopies.

In addition to shortening wait times, providing these publicly funded services through community surgical and diagnostic centres will allow hospitals to focus their efforts and resources on more complex and high-risk surgeries. We’re also investing more than $18 million in existing centres to cover care for thousands of patients, including more than 49,000 hours of MRI and CT scans, 4,800 more cataract surgeries, 900 other ophthalmological surgeries, 1,000 minimally-invasive gynecological surgeries and 2,845 plastic surgeries.

For over 30 years, community surgical and diagnostic centres have been partners in Ontario’s health care system. Like hospitals, community surgical diagnostic centres are held accountable to the highest quality standards, the standards that Ontarians deserve and expect across the health care system. To further support integration, quality and funding accountability, oversight of community surgical centres will transition to Ontario Health. This improved integration into our broader health care system will allow Ontario Health to continue to track available community surgical capacity, assess regional needs and respond more quickly across the province and within the regions where there are gaps and patient need exists. Our government is clear: Ontarians will continue to use their OHIP card and never their credit card.

Based on clinical guidelines established by the Canadian Task Force on Preventive Health Care—which the member referenced—currently the province, through OHIP, funds the prostate-specific antigen, or PSA, test for men under these circumstances: men who are receiving treatment for prostate cancer; men who are being followed after treatment for prostate cancer; and, finally, men who are suspected of having prostate cancer because of a family history—like Anthony—and/or the results of a physical exam with their provider. I should note that Ontario’s policy in this area is akin to that of British Columbia, Alberta, New Brunswick and Quebec. Prince Edward Island only covers PSA testing as a screening tool after the age of 50, but patients must still speak with a health care provider about tests.

Most international and national guidelines and recommendations—including those by the Canadian Task Force on Preventive Health Care, the United States Preventive Services Task Force, and the American College of Physicians—recommend against screening for prostate cancer using the PSA test due to the lack of evidence to suggest a universal benefit to screening. Should these recommendations from the experts be updated, Ontario will, of course, review eligibility in consultations with our clinical partners at Ontario Health. Ontarians who are concerned about their risk of prostate cancer—and Anthony probably talks to many people who would fall in that category—should reach out to their primary care provider about test eligibility and have that discussion with them.

Our government also supports cancer care through the Ontario Public Drug Programs; approximately $1.7 billion was invested last year in cancer drug expenditures. I would like to highlight in this House that take-home cancer drugs are funded through the Ontario Drug Benefit Program and make up about 58% of the Ministry of Health’s total expenditure for cancer drugs.

All of these services are priorities highlighted in our Ontario Cancer Plan 5, a strategic five-year guide for improving the cancer system in Ontario that was launched by our government, with the support of Ontario Health, in 2019. The scope of the work in this plan includes all stages of the cancer care treatment journey from diagnosis through to recovery.

I’d like to close by thanking the member for bringing forward this important motion—it’s important to talk about prostate cancer and raise awareness, as Anthony Henry is doing in his community; certainly, it’s good for all of us to raise awareness about it in ours—and giving me the opportunity to speak about some of the investments the government is making in the cancer system and the reason for our decisions. As always, Ontarians who are concerned about their risk of prostate cancer or any other cancer should speak with their primary care provider. Ontarians can also connect to Health811, formerly Health Care Connect, to find available primary care services in their area.

Further debate?

Further debate?

Just before I started, I want to express to anyone watching or to those who aren’t familiar with the government’s Bill 60, the profitization and privatization of health care, which the member from Eglinton–Lawrence spoke so proudly of: Make no mistake, the excess service that this bill claims to provide Ontarians is only provided to those who have the pockets, the money, the finances to purchase. It’s very, very problematic when procedures that should be covered and are covered by your OHIP are all of a sudden being covered by credit cards, courtesy of Bill 60. I just wanted to clear that up so that folks got the reality check of what Bill 60 is.

Anyone with a prostate can get prostate cancer, and this includes cisgender men, trans women and nonbinary people. I wholeheartedly support this motion, and I’m calling on the Ford government to follow the lead of eight other provinces and fully cover the prostate-specific antigen PSA test under OHIP when prescribed by a doctor.

I must also note that this motion, put forth by our outstanding member from Niagara Falls, is a fiscally responsible piece of legislation that calls for investing now to help save lives, as opposed to not covering the PSA test, which has been known to act as a deterrent for those who may have limited financial means. A cost for diagnostic tests will deter people from seeking answers early, and with prostate cancer, early detection is key. If prostate cancer is left undiagnosed and unchecked, the cost to our health care system would be tenfold. As the saying goes, prevention is better—or, I might add, cheaper—than the cure.

The cost of a test should never be a prohibitive factor, especially for groups in society who have felt the disproportionate impact of health inequities. This is especially true for many Black men, who are disproportionately impacted by prostate cancer. Black men, as we have heard, have almost double the risk of developing prostate cancer compared to non-Black men. They’re also more likely to have prostate tumours that grow and spread quickly. Black men are also more likely to die from prostate cancer compared to other men.

I want to read into the Hansard a quote from Mr. Ken Noel, the president of the Walnut Foundation: “Prostate cancer disproportionately impacts Black men in this province, according to a recent study co-authored by the Walnut Foundation and published in the Canadian Medical Association open journal. The Walnut Foundation, a prostate cancer awareness and support non-profit organization targeting the Black community, encourages Black men to be more involved in their personal health, get the facts, ‘know your numbers’ and that ‘early detection saves lives.’ However, men are thwarted by having to pay for a simple blood test in Ontario. We need to minimize barriers to early diagnosis and getting the PSA test funded by OHIP will improve outcomes for those most impacted by this disease. Remember Black men are 76% more likely to be diagnosed and 2.2 times more likely to die from prostate cancer.”

The name of that study, and I would encourage everyone to read it—it is a study that was led by Dr. Aisha Lofters. It is titled Prostate Cancer Incidence among Immigrant Men in Ontario, Canada: A Population-Based Retrospective Cohort Study.

I of course also want to give a shout-out to Mr. Henry as well. Thank you for your leadership and your advocacy—and your research, at that.

The Walnut Foundation’s annual Walk the Path Walkathon to help raise awareness about prostate cancer is taking place on June 3 this year. I also want to give a shout-out to Ivan Dawns, who has been named the honorary campaign chairperson of this year’s walk. Ivan Dawns is the first Black union representative with the International Union of Painters and Allied Trades, and recently received the Ontario Black History Society Dr. Anderson Abbott Award for his leadership and advocacy. Dr. Abbott, born in 1837 in Toronto, Upper Canada, was Canada’s first Canadian-born Black person to be licensed as a doctor.

The Ontario NDP has long called for the collection of race-based socio-demographic data in health to prevent worse health outcomes for racialized Ontarians. If we see where the disparities are, we can address health inequities through a full systems approach. According to the Black Health Alliance, “Although there are some conditions that are inherited at greater rates in some ethnic groups, such as sickle cell disease”—which we’ve also raised legislation for in this House—“the majority of chronic illnesses have many different contributing factors including—social determinants of health such as access to health care, support networks, education and stress.”

Lastly, “One ongoing stressor is anti-Black racism, which we believe is a major contributing factor to many of the disparities in health that Black people experience.” Experiencing everyday systemic and even internalized racism intersecting with class or socio-economic barriers and disparities, according to evidence-based research, has been shown to worsen illness and health outcomes for many within Black, Indigenous and racialized communities.

I couldn’t support the member for Niagara Falls’ legislation more, and I hope that this government passes it and saves lives.

I’m pleased to rise this afternoon in support of the bill by the member for Niagara Falls. I would like to say at the outset that I cannot imagine a better champion for this cause, because the member unquestionably has a moustache for Movember.

But prostate cancer is not a joke. It’s a really big deal. It is the fourth most common cause of cancer in Canada, and it impacts one in nine men. It kills men, and it cannot be ignored.

I’ll touch briefly on the risk factors because I will come back to them momentarily. Those risk factors include increased age, certain ethnicities like African Americans or people from Black communities, smoking and family history.

In the vast majority of cases, prostate cancer is asymptomatic. Less commonly, men may present with lower urinary tract symptoms—difficulty urinating, blood in their urine—and sometimes it is discovered when, sadly, the cancer is already metastatic; in other words, it has already spread.

This debate is important just for the very fact that it raises awareness about prostate cancer. This discussion is really important, and it is really important that all men have a discussion with their doctor about prostate cancer and their individual risk. So I’m glad that we’re talking about this today.

Now, at the risk of being a little bit too graphic, I will touch on a little bit about how we detect prostate cancer, because ultimately, the decisions that we make will be consequences that men across this province have to face. In order to detect prostate cancer before it develops symptoms, there are two ways: a digital rectal exam which involves a physician taking a gloved finger and inserting it into a man’s rectum to palpate their prostate; the other way is a blood test.

Now, I do want to be clear. There is what we call equipoise and a divergence of opinion about how to screen and test for prostate cancer. The reason is that there isn’t a perfect screening test. In fact, there rarely is a perfect screening test for anything. There are what we call false positives with the PSA test—that is, the blood test. There are also false negatives with the rectal exam. But it is largely accepted that men should have a discussion with their health care provider about their individual risk for prostate cancer and decide together, based on their individual risk and their risk tolerance, about whether they should get a test.

In my own clinical practice, when I’ve had that discussion with male patients, many men have decided that it is the right thing for them to do to get screened for prostate cancer. I know that plays out in clinics across our province. But health care is more difficult to access: Fewer people have access to a trusted family doctor, and those that do may have difficulty seeing them in person. So for those who even have an appetite for getting tested with a digital rectal exam, it may not be possible at all. The PSA test may, by default, be their only option.

Certain marginalized populations are especially vulnerable and have a decreased ability to be able to pay for that test. I mentioned the risk factors for prostate cancer: men who are either from Black communities or African American, who are disproportionately represented in less affluent communities, are the ones who are more likely to have prostate cancer and less likely to be able to afford the test. In my work with Indigenous communities—another community that is going to be less likely to be able to pay for a test—I’ve treated patients who were sodomized. Again, forgive me for being graphic, but they were sodomized. A digital rectal exam is a no-go for those individuals and it would have to be a PSA test.

And so I want to reiterate that we don’t have a perfect test for screening for prostate cancer. We rarely have perfect screening tests. But men should have the choice, based upon their own values and their risk tolerance, which is in compliance with professional recommendations. They should have the opportunity to discuss with their doctor and seek out screening for prostate cancer if they so choose. For many men the best way to do that, they will decide, is with the PSA test. It should be covered so that they can get the care they need.

Further debate?

I really want to thank the member from Niagara Falls for bringing forward this motion. I want to thank Anthony Henry for your advocacy and for being here, and the Canadian Cancer Society. Today, the motion from the member for Niagara Falls is to ask that OHIP cover PSA testing, which is a prostate screening test, in all cases, because right now some men, when they go to get a PSA blood test to see if they’ve got prostate cancer, have to pay for it, and that’s absolutely inexcusable.

I was listening to the deputy to the Minister of Health’s comments earlier in regard to this motion. She recited this line that the government always recites: “You’re going to pay for your health care with your OHIP card, not your credit card.” And yet, the very motion that she was speaking about is a case where Ontarian men have to pay for their health care with their credit card and can’t pay for it with their OHIP card. If you actually pass this motion today and make it into law, then Ontarians won’t have to pay for PSA testing with their credit card; they will be able to pay for it with their OHIP card. I just can’t believe that the deputy to the minister actually recited that line in the context of this motion that we’ve got here.

The other thing about this is that prostate cancer is the most commonly diagnosed cancer among men: One in eight men in Canada will be diagnosed with prostate cancer in their lifetime. It disproportionately affects Black, Indigenous and people of colour, and there are higher rates of prostate cancer among men of African and Caribbean ancestry. There is racial inequality in access to health care in this country, that’s something that we have to acknowledge. This motion today would actually help to address some of that racial inequality in access to health care.

Right now, OHIP pays for a PSA test—this is a prostate-specific antigen test; it measures to see if those antigens are in your blood, which could indicate that you’ve got prostate cancer—only if your physician suspects prostate cancer, if you’ve been diagnosed or if you are being treated for prostate cancer. Well, this is too late. The idea of cancer screening is that an ounce of prevention is worth a pound of cure. You want early detection of cancer.

That’s what this motion is about. It’s about making sure that everybody, regardless of their ability to pay, can access a PSA test, so that they can get the earliest detection of prostate cancer and have the likely best health outcomes. So I don’t know why it sounded like, from the deputy to the minister, the government is not going to be supporting this motion. I think that’s really shameful. It just shows that when the government says you’re going to pay for your health care with your OHIP card, not your credit card, you’re not telling the truth, because this is a case right here where you have the chance to fix—