SoVote

Decentralized Democracy

Ontario Assembly

43rd Parl. 1st Sess.
February 28, 2023 09:00AM
  • Feb/28/23 9:20:00 a.m.
  • Re: Bill 60 

The member raises a great point. This is crisis-by-design. The minister, back in the day, spilled the beans that it was happening when she wasn’t supposed to. Comms tried to cover it up and to fix that issue. But here we are, seeing exactly what she had said years ago with the for-profit system that is going to siphon our precious health care dollars that could be paying for those surgeries, that could be paying for those kids’ critical needs and nurses at home instead of having moms struggling, not being able to go to work, instead of 12,000 kids on wait-lists for surgeries. All of those things could have been paid for instead of investing into a for-profit system helping those investors get money back when they shouldn’t even be in there in the first place.

This bill will do nothing to correct that. It is going to be the same number of nurses, the same number of doctors. You’re just splitting them in half.

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  • Feb/28/23 9:20:00 a.m.
  • Re: Bill 60 

Further questions?

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  • Feb/28/23 9:20:00 a.m.
  • Re: Bill 60 

I appreciate the opportunity to interact with the member from Hamilton Mountain. She always brings such clarity to the opposition position on an issue, and that’s what I was hoping to ask her.

Yesterday morning, during question period, we had a very interesting question from one of the opposition members stating that the operating rooms in many hospitals were operating overcapacity. And then yesterday afternoon, we were debating a motion from the opposition stating that the hospitals were under capacity. So I was wondering if the member could help clarify exactly what the position of the opposition is on this issue.

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  • Feb/28/23 9:30:00 a.m.
  • Re: Bill 60 

Thank you, Speaker. You had me fooled there for a second.

I have to say to the House that one of the things I appreciate most about being a member of this government is that we refuse to accept the status quo, and what’s so interesting is that all we hear from the opposition is that they tell us that we must continue to invest in the status quo.

Travelling around with the minister in my riding and seeing the incredible work we’re doing in training new people to go into the health care field in different directions than we ever have before and seeing the success of those programs like the Learn and Stay program is so exciting to me. I’m just wondering if she could expand on that further, on what it means in the health care system that we are looking at different options. Ontario is a land of innovators and to see innovation bear fruit in the health care system is really exciting for me, and I’m wondering what that means for her.

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  • Feb/28/23 9:30:00 a.m.
  • Re: Bill 60 

When it comes to our health, the status quo is no longer acceptable. Can the member tell this House what our government is doing to protect Ontarians from extra billing?

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  • Feb/28/23 9:30:00 a.m.
  • Re: Bill 60 

Thank you to the member for that question. Having supports in the north is very important, and in underserved areas. That’s why, with the new Learn and Stay grant, we’ve seen those areas specifically identified not just for nursing, but for lab technologists, for paramedicine.

With the work that we’ve been doing to ensure that there are more doctors, this is the first time in 10 years that we’ve seen a seat expansion for doctors: 160 undergraduate spaces and 295 postgraduate spaces. This was not done under the Liberal government. It was this government that came in and said, “We need to ensure that people have access to doctors.”

I can tell you that in my own area, I’ve talked to families who are experiencing not having a local doctor, but accessing the work at some of our community care clinics through our local health teams and the resources and supports that are served there. So we do recognize the need for more doctors in the north, but also in rural and underserved areas across this province.

The status quo is not working. We need to do better for the people of Ontario. Before COVID, we were working hard, and COVID just expedited that as well, but the investments are being made. We’re here to support all Ontarians and ensure that you’re going to the doctor or a hospital and using your OHIP card and not a credit card.

I just have a note from my staff that says that as of 9 a.m. today, the Ontario Learn and Stay Grant website has had over 405,000 visits, so the word is getting out there. It’s to support northern and rural communities, the ones you’re talking about, that we’re encouraging students and paying for their education to get them to learn in those communities and make that commitment of staying for two years, because if you’re staying there for two years, you’re starting to set down roots. You are becoming familiar with the community and maybe meeting someone there and staying in that area.

But the supports that we’re giving to ensure that more nurses, paramedics, lab technologists—we’re also working with the Northern Ontario School of Medicine to ensure there are more doctors in the north as well, so that everyone has access to quality care.

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  • Feb/28/23 9:30:00 a.m.
  • Re: Bill 60 

Meegwetch for the presentation. I know that in far northern Ontario—sometimes I refer to it as the other Ontario because we’re treated differently because of who we are and where we live. In the north, it’s not a health care system, it’s not a health system; it’s a sickness system. It’s a sickness system because you don’t get access to health services until you are sick. For example, Ornge is our ambulance.

When you have a community of 1,000 people, you have five days of physician services per month, which is only—five days and two days are travel days, so that’s three days per month. Like, the needless deaths, the unnecessary suffering: That is our status quo. Status quo is construed as normal and acceptable. That would not be acceptable anywhere else in Ontario, anywhere else in Canada. How will this bill help First Nations and northern Ontario, for example, Fort Severn?

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  • Feb/28/23 9:30:00 a.m.
  • Re: Bill 60 

My thanks to the member for her presentation. At the beginning of her comments, she noted that a lot of what is driving this is concern that services be made available to people who are in remote locations who may not be close to major medical centres.

I just want to note that last year, the payments to doctors for doing remote and virtual consultations were cut dramatically, so that many doctors have now abandoned that. Talking to my friends from the north, their experience has been that those arrangements allowed people for the first time, for many of them, in their lives to access a doctor quickly. Why did you cut that support for virtual consultations while you are espousing support for greater access to medical help?

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  • Feb/28/23 9:30:00 a.m.
  • Re: Bill 60 

It’s now time for questions.

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  • Feb/28/23 9:40:00 a.m.
  • Re: Bill 60 

Thank you.

Further questions?

Further debate?

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  • Feb/28/23 9:40:00 a.m.
  • Re: Bill 60 

Thank you to the member for that question. It’s always a privilege to tour your riding and meet with the schools in your areas as well. I think you can see my excitement about the Ontario Learn and Stay Grant, as well as the Premier’s and the Minister of Health’s, but the excitement for students who are looking to go into that field. Imagine considering nursing and to find out that you could have your education paid for if you were open to living in a different area, spending two years there. Like I said, it’s likely that you spend some time there, you start to love that community and hopefully stay in that area.

But looking at how you ensure that we have more nurses and doctors, it’s innovative programs like this, and I think—this is just the beginning of this program. We announced last March, we’ve already expanded it. It was nursing in the beginning; now we’ve expanded to lab technologists and paramedics. I think there’s so much more we can look at doing as this progresses, but we’re already seeing that there’s a huge interest in the program so there will be more to come on that and I think great opportunities to look at other communities—

We are making investments into our hospitals, our long-term-care centres. Under this government, we saw the increase of care to clients in long-term care up to four hours. We’ve also seen the investments, the 60,000 new long-term-care spaces. I’ve seen the investments in long-term-care homes in my area as well, which I know we’re all very excited about, to ensure that seniors have access to long-term care in their communities.

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  • Feb/28/23 9:40:00 a.m.
  • Re: Bill 60 

Thank you to the member opposite for your comments this morning. Our public health care system in Canada is one of our biggest competitive advantages. When companies are deciding whether to locate in the States or in Canada, they look at our public health care system and they say it’s a far better system, it’s a far less expensive system. A previous Conservative government converted our long-term-care homes from public not-for-profits into private for-profits, and then the Armed Forces report during the pandemic showed what a travesty that was, how people were dying of thirst because there was nobody there to give them a glass of water.

Why is this government converting our public not-for-profit health care system into a private for-profit system that will prioritize profit over the care that people receive?

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  • Feb/28/23 9:40:00 a.m.
  • Re: Bill 60 

It’s with regret today that I rise to speak to Bill 60, the government’s plan to introduce two-tier health care in Ontario. Public health care is a key component of our identity in Canada. Unlike our neighbours to the south, we made a decision that we weren’t going to let wealth determine people’s access to vital health care. We created a public medicare system that ensures everyone is able to get the health care they need, when they need it, without any question of how much money they have. People don’t have to go deeply into debt or sell off homes or businesses just because a family member got sick. People without money don’t need to worry that people with more money are going to come along and bump them out of the way. Access to health care is based on the urgency of your condition instead of your bank account.

Conservatives have never liked this system. They’ve always hated the fact that you can’t buy your way to the front of the line, and we know there have always been many people lobbying them, salivating over the opportunity to make a lot of money off of people in need. So, over the past four years, they’ve been hard at work generating a crisis.

Admittedly, the past Liberal government wasn’t great at managing health care either. They cut and underfunded until people were being treated in hallways—hallway medicine, everyone called it. But, under this Premier, we’ve gone from hallway medicine to no medicine. Emergency rooms are closed, so people can’t even get into the hallways. We’ve got beds and operating rooms that are empty despite the demand for health care, the long wait-lists, because we don’t have nurses and health care workers to staff them.

I guess it’s “mission accomplished” for the Premier and for the private, for-profit health care industry that has been lobbying him so hard for the past few years. Now that he has made the crisis so bad that nurses are leaving the profession in droves, now that people are waiting 12 hours at the emergency room, now that the wait-lists for surgeries are so long, the Premier has decided that this is the moment to really stick the knife in public health care and introduce two-tier health care in Ontario.

Make no mistake: This is deliberate. This government has set up public health care to fail so they could replace it with a for-profit model to line the pockets of their wealthy friends. And it is Ontarians—as always, with this government—that will pay the price, that will have to pull out their credit cards to pay for health care at these private facilities, that will wait even longer for health care in our public system as they bleed even more health care workers out of our hospitals, that will have to pay the taxes that are going into the pockets of private shareholders instead of to strengthening and expanding our public health care system.

This is part of a pattern with this government. Whether it’s the development of the greenbelt, the refusal to invest in public education or the destruction of public health care, we see this government constantly make decisions that don’t help people with the very real challenges that they face every day but somehow manage to make a bunch of friends and lobbyists around the Premier a lot of money.

We’ve seen this pattern with health care throughout this government’s time in office and throughout the pandemic. They took away public oversight of home care, leaving people vulnerable to the whims of for-profit companies. They granted licences to for-profit long-term-care providers that had hugely disproportionate death rates and they took away the rights of family members to sue. They contracted out PCR COVID testing to for-profit companies, leading to Ontarians having to pay $200 out of pocket to be tested because publicly accessible tests were so tightly rationed—unless you happened to attend a private school. And they’ve been expanding private clinics.

This most recent bill is not the innovative, bold or creative solution to surgical backlogs the health minister has claimed it is. It is the oldest trick in this government’s book: Put further pressure on an already struggling sector and offer privatization as the only way out.

If this government really wanted to address the current concerns in the health care sector, they would actually listen to nurses and health care workers about why they are leaving the health care sector and stop their appeal to try to save Bill 124, a bill that the courts found unconstitutional, a bill that nurses and health care workers have told this government they found profoundly disrespectful—humiliating, even—at a moment when they were working so incredibly hard throughout the pandemic, with their wages capped well below the rate of inflation.

I was at the pre-budget hearing in Ottawa, where nurses said that they were leaving the profession because of Bill 124 and that they found Bill 124 profoundly humiliating. Instead of listening to them, government members of the committee got into arguments with them. Nurses were literally telling them, “We’re leaving because of Bill 124,” and the government was saying, “No, that’s definitely not it.” How profoundly disrespectful is that?

What’s even more disrespectful is that government members tried to claim that it wasn’t Bill 124 that’s causing the shortage, because other jurisdictions also have a shortage of health care workers. Well, if other jurisdictions also have a shortage of health care workers, then how foolish is it to cap the wages of our health care workers and drive them away when there are job opportunities in other provinces?

If the government actually wanted to improve health care, they would focus on recruiting, retaining and returning nurses to our health care system—and personal support workers and other health care workers—providing them with better pay, better working conditions and the respect they deserve.

The government could work on licensing tens of thousands of internationally educated nurses and doctors already in Ontario, who are waiting years and paying thousands to have their credentials certified. The government could also fund hospitals across the province so that they have enough staff on every shift and on every ward, so that rooms don’t sit empty due to understaffing.

Make no mistake: The bottleneck for the surgical wait-list in Ontario is not due to a lack of operating space, it is due to a lack of staff for these operating rooms. Operating rooms are sitting empty because hospitals don’t have the resources to staff the ORs they already have. And now this government is trying to create a parallel system which will pull more staff out of our publicly funded system.

This move is also going to cost our health care system more. Services in private clinics receive more money than our public hospitals do for the same service, meaning that when private facilities perform surgeries, Ontario tax dollars will be going right into the pockets of shareholders that have invested in these facilities. The government’s actions will lead to investors making large profits off the backs of sick Ontarians.

Meanwhile, our hospitals depend on economies of scale to be able to fund more complex surgeries. So when we pull services out of the hospital, we leave the hospital trying to provide the more complex surgeries and the people with complications requiring longer surgeries, but we’re paying the hospitals less money than the private facilities are getting for simple surgeries, so we’re actually making it harder for the hospitals to pay the cost of these surgeries.

And while these clinics are able to charge our health care system more for the services they provide, they can also charge extra fees directly to the patients who are being sent there by this government. These fees take the form of consulting fees or membership fees that patients are made to cover in order to receive the health care they desperately need. We also know that many patients are upsold by doctors keen to make a profit.

But it’s not just people who are getting surgeries or procedures at private clinics who will be paying a price for this government’s policies; patients using the public system will also pay a price. They’re already paying a price now for Bill 124, with 12-hour wait times or longer at emergency rooms.

The Ottawa Hospital has had many times over the past year where they have been short as many as 800 nurses. They’ve had to get creative, and these absences are filled with unregulated, unlicensed care providers, not trained, professional registered nurses. In January, the Ottawa Hospital lost more nurses than they were able to recruit. While this is happening, this government has chosen to suppress nurses’ wages, ignore their concerns and undervalue their profession, while people are working in unbelievable conditions.

Here’s why this really matters, Speaker: There’s not a magical pool of nurses and health care workers that we just haven’t tapped yet who are suddenly going to appear and fill these positions in private health care facilities. These nurses and health care workers are going to come from our public system. And when we’re capping their wages in the public system, when we are putting them into unsustainable and dangerous working conditions, when nurses are already leaving to work at Costco because it’s less stressful, then why wouldn’t they leave to take a job at a private facility that only works weekdays from 9 to 5 and doesn’t have a wage cap?

This move is only going to pull more nurses and health care workers out of our system, leaving public health care in an even more precarious state, lengthening wait times for everyone, and the minister’s toothless staffing plan requirement isn’t going to address that, as we’ve already seen at the Riverside hospital in Ottawa, because that’s not a magic wand that can miraculously create more health care workers.

Ontario’s public health care system needs fixing. It absolutely needs fixing, but by allowing for-profit companies to offer health care services that were originally done by the public sector, this government is instead ensuring that sooner or later, those with more money will have access to better health care faster than other Ontarians, and this is unacceptable.

And so, Speaker, here we see another pattern emerging: Ontario residents are demanding better, health care workers are demanding better, but instead of listening to them, working with them and investing in the system, the government is enriching some private, for-profit corporations that lobbied really hard. Shame on them.

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  • Feb/28/23 9:50:00 a.m.
  • Re: Bill 60 

I want to commend my colleague for her very astute remarks about this bill.

I wanted to highlight a model that exists in my community in London. The London Health Sciences Centre has created the first-of-its-kind, stand-alone, self-contained, ambulatory surgery centre to allow people to get less complex minor surgeries performed there. It has demonstrated its effectiveness. The cost for surgeries is way down. It is a model of how we can deal with the backlog in hips, knees and cataracts surgeries under a public system, with oversight from the hospital.

I wondered if the member has any thoughts on why the government didn’t just expand this model across the province to ensure that people have access to publicly funded and publicly delivered surgical care.

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  • Feb/28/23 9:50:00 a.m.
  • Re: Bill 60 

Questions? I recognize the member for Sarnia–Lambton.

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  • Feb/28/23 9:50:00 a.m.
  • Re: Bill 60 

Thanks to the member for Sarnia–Lambton for the question.

The crisis that this government has created in health care extends to all parts of our health care system. We have incredibly underfunded community health centres that haven’t seen an increase in their base funding. We have family physicians who are leaving the practice mid-career because they just can’t take the workload anymore and are struggling with burnout. We have health care workers and nurses who are leaving the profession. We absolutely need to improve conditions for all workers across this system.

Expanding the number of doctors who are working in family health teams could be part of the solution, but we need to make sure that this continues to be part of the public health care system and we are not directing the funds that should be going to health care into the pockets of investors instead.

This is part of another pattern that we see from this government. Our public health care system, as you say, is absolutely a competitive advantage. So is our publicly funded education system, and we also see the government making decisions there that are undermining the quality and the strength of our public education system.

We’ve seen in the United States what happens when public systems are allowed to erode—kids are no longer getting health care, they’re no longer getting a decent education—and what that does to a country, what that does to an economy. The only explanation when we see these kinds of examples around us is that this government is more motivated by ideology than by the actual needs and concerns of Ontarians and by the evidence that exists around us about what practices would actually support Ontarians in getting the health care and education they need.

I listed the solutions in my remarks. We had a two-hour debate yesterday on the solutions. I suggest that the member consult Hansard if he didn’t hear my remarks clearly, but the answer is to invest in our public health care system and stop driving our nurses and health care workers away from it.

I know the community service agencies in my riding that provide preventative health care that keep people from getting sick and from ending up in the hospital are desperately underfunded. I know the Queensway Carleton Hospital is asking for an urgent care centre in Ottawa, which would keep people from needing to go to the ER for conditions that can’t be dealt with in their family doctors’ office but don’t need the emergency room.

We know there are models for stand-alone surgical facilities like the one you described, and instead of looking at any of these solutions and investing in the solutions that we have in our public health care system, this government is bound and determined to go down the road of putting profits in the pockets of private investors, and the only answer can be that those investors lobbied them really, really hard.

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  • Feb/28/23 9:50:00 a.m.
  • Re: Bill 60 

I thank the member from Ottawa West–Nepean for her discussion this morning, but it left me curious. Obviously the opposition has to oppose what we’re doing, and it sounds like they’ll be voting against this piece of legislation also—

So I was wondering if the member—because I know she has experience working on different sides of the House in different places—has any ideas on how we could actually improve this legislation or what we could do to improve the health care system in Ontario, other than just continuing to maintain the status quo, which is what I’ve heard so far.

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  • Feb/28/23 9:50:00 a.m.
  • Re: Bill 60 

One hundred per cent.

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  • Feb/28/23 9:50:00 a.m.
  • Re: Bill 60 

Thank you, Madam Speaker. It’s good to see you in the chair.

Thank you to the member for Ottawa West–Nepean for that presentation this morning. One thing I don’t think has been touched on in the debate that I’ve heard so far is that Bill 60 talks about expanding the number of physicians who can join a family health team. I’d like to know the member’s position on that, if she supports expanding access to family health teams with more doctors.

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  • Feb/28/23 9:50:00 a.m.
  • Re: Bill 60 

Thank you to the member from Ottawa West–Nepean for the question. I’m going to ask the same question I asked the member from the government side.

Public, not-for-profit health care in Canada is one of our biggest competitive advantages. When companies are deciding whether to locate in the United States or Canada, they look at our public, not-for-profit health care. It’s far cheaper than the system in the United States. It’s far better. We are healthier in Canada because of our system.

A previous Conservative government privatized long-term care. They changed it from public, not-for-profit system to a private, for-profit system. We saw from the Armed Forces report what a travesty that was and how people were dying in just unspeakable conditions.

Why do you think this government is converting our public, not-for-profit health care system in Ontario into a private, for-profit system, instead of just expanding and supporting the public, not-for-profit system?

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