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—

I’ll withdraw.

This is a case right here where Ontarians are being asked to pay for their health care with their credit card, and the government could change that by passing this motion today.

Thank you to the member from Niagara Falls. Thank you to Anthony. Thank you to the Canadian Cancer Society for being here to support this motion today.

Thank you very much, and I want to thank my colleagues, at least most of them, who spoke. I’d like to thank the Canadian Cancer Society for being here and Anthony.

I’m going to go over the stats again because obviously somebody is missing a message here. In 2022, last year, 1,800 people were projected to die from prostate cancer. That means five men—I’m looking at my brothers who are in this room—five men are going to die today. One in eight will be diagnosed with prostate cancer, 10,000 in Ontario last year. If you’re diagnosed early, 100%—100%—will live at least five years or longer, but if you’re diagnosed at stage 4 or later, guess what happens? That goes down to 29%; 29%—they’re going to die. That’s our dads, our brothers. They don’t need to die.

We know some people can’t afford to get the test. That’s what this is about. I’m saying to you, guys—I’m begging you. I’ve done this three or four times now. There’s no need for men to die. If you have a prostate, you can get prostate cancer and you can die.

I’m going to give you a quick example. I know I’ve only got 30 seconds left. I’m going to talk about Larry Gibson. He owns the Fort Erie Golf Club, a small golf course in Fort Erie. He was 48 years old. He went to the doctor; he got the test done. He could afford to pay for it. You know what? He had prostate cancer. He’s alive today. I think he’s 67 years old. He gets to enjoy his family. He’s getting to enjoy his grandkids. The smile on Larry’s face every day, how he enjoys life because he’s still here—if he didn’t get that test, he’d be dead.

How can anybody in this House not support having this covered by OHIP to save men’s lives here, to save our dads’ lives, to save our grandparents’ lives? I’m sorry. I get emotional because I’ve seen the people that have died from prostate cancer and the suffering they went through.

My time is up. I appreciate you giving me an extra minute.

I would also like to start by thanking the member for Niagara for bringing this motion forward and the Canadian Cancer Society and those who have been active on this issue.

Speaker, many people have talked about cost and cost savings, and those are all legitimate concerns that should be taken into account. But I want to say that if my colleague’s motion results in a reduction in the number of people who show up in the radiation treatment waiting room at Princess Margaret hospital, if my colleague’s motion results in a reduction in the number of people who spend time in chemotherapy rooms in hospitals in Kingston, Ottawa, London, Windsor, Timmins, then that motion will have saved quite a few lives and served the people of this province well.

All of us, through our families and our networks of friends, know people who have suffered with cancer and, unfortunately, died of cancer. We’ve been to the funerals. We’ve seen people wither. We know that, in this society, even $35 or $50, which is not a huge amount if you’re an MPP, is a substantial chunk of cash, and when it comes to a question of giving people a chance at surviving a cancer that can be quite effective when not caught early, I don’t quite understand why there needs to be a debate, quite honestly.

I think the member for Niagara put it quite powerfully: We have to look after ourselves, our brothers and our sisters. We don’t want to put them through this. We don’t want to spend time with them in palliative care because we don’t want them to be there because of this. I urge the government to support this motion. Thank you.