Questions?

That was a very long question, and I have a very short answer. We have pledged to work for workers. We’re getting it done. We’ll continue to get it done, with or without the support of the official opposition.

Thank you very much, Speaker. It’s a pleasure to see you in the chair; it’s the first time.

It is always an honour to rise in this House to represent and speak on behalf of the good people of my riding, Hamilton West–Ancaster–Dundas. This Bill 60 and the changes that this government is making to our public health care system are of significant concern to the people in my riding. They call to share their hopes and their dreams and—I’ve been hearing so much from my constituents—to ask the question: Why is this government rushing to dismantle our public health care system, our publicly delivered, world-class health care system that has been the envy of the world?

As has been said here, health care is in crisis. We acknowledge that; we recognize it’s in a crisis, but it’s this government’s job to fix that crisis with the solutions they already have before them, not in fact to make it worse. For example, in Hamilton, we have world-class health care facilities. We have Hamilton Health Sciences, we have McMaster Children’s Hospital and we have St. Joseph’s. These are world-class hospitals that are struggling under the underfunding, the lack of funding, the lack of supports they need to be able to continue to deliver the health care the people of Hamilton need. It’s been said many, many times here that the solutions—in fact, it’s been said that you’ve manufactured this crisis, taken hallway health care that was a legacy of the Liberals and doubled down by making it worse by underfunding health care, and by introducing Bill 124, that has created and exacerbated a health care human resource crisis.

It’s a mystery to me why this government would, rather than the easy solutions which are to fund the health care hospitals we have, these world-class hospitals, cut them off and let them have to put people on wait-lists for surgery. Why you wouldn’t make sure they have the adequate funding? Why you wouldn’t make sure that the money you have in contingency funds and $12 billion of unspent money could be going right now to address wait-lists? Why are you not doing that? Why is that not your first choice?

Why are there 12,000 children on a surgery wait-list in the province of Ontario when you could start to address that by making sure these closed operating suites, these unused facilities are open again so that people could start getting the procedures and the surgeries they need to save lives, relieve pain and suffering and the fears of parents who are hoping that their children would get the care they deserve under this government?

I also wonder why you continue to disrespect health care workers, nurses and PSWs and refuse to repeal Bill 124. You continue to underpay them in a time when they are burnt out, stressed and doing the best they can in a system that you have destabilized further. Why are you taking nurses and PSWs back to court on Bill 124 when it’s been shown that this is an unconstitutional bill? Why is that not your first act?

The question really stands: Why are you rushing, rather than looking at the solutions that are before you? Why is your first act, the thing you’re putting all your effort into, to introduce profits into the health care system? It’s been called the profitization of our health care system, and it’s hard to describe it as anything other than that.

We have talked in this House about the proud history of the NDP and Tommy Douglas and our medicare system. All of you know, and all of you have been hearing from your constituents, that that is the pride of Ontario. That’s one of the things we’re so proud of: that people can get access to the health care and the emergency care they need, despite their ability to pay, anywhere in this province. To now go down the road of a two-tier health care system is exactly the wrong, wrong direction and nobody, if they understood what you are doing, would support this. I can only imagine that you are also hearing from your constituents that this is not what they expected and this is not where they want to see you going with their precious health care system.

Rather than taking the steps that you know will help to relieve the burden and will help to improve our publicly delivered health care system, you’re still rushing to introduce privatization without learning the lessons of the past. In this bill, there are absolutely no protections for patients seeking care in private, for-profit, corporatized facilities. It’s not in the bill. All you have to do is to look at the evidence that comes from what already exists in private, independent health facilities.

The report from the Auditor General is invaluable, and I wonder whether the opposite members, the MPPs or the ministers, have taken into account the findings of this value-for-money audit that the Auditor General has put out, because the warnings are there. The recommendations to protect patients both financially and health outcomes are in this report, but nothing has been put into this bill to address that.

Let me just point out some of the highlights—not really highlights; some of the actual dire warnings or recommendations that come from this report that should have been included in this bill but are not there.

I’m just going to start by—it’s interesting reading if you take the time to look at it, but really, the Auditor General said that there is “inadequate and inconsistent monitoring of the quality of outpatient surgeries.” No one is monitoring the results, the outcome of how people fare after they have surgeries or procedures in these independent health care facilities. There’s inadequate monitoring.

There’s also “no regular review and monitoring of funding and billings for outpatient surgeries.” So it’s all fine and dandy for you to say that people won’t have to pay extra—it’s absolutely not the truth, because in Ontario, people already pay extra for these procedures. They pay dearly for these procedures.

In fact, the Auditor General goes on to say that there’s absolutely “no provincial oversight to protect patients against inappropriate charges.” The ministry has not sufficiently reviewed “unusual billing patterns or trends to identify possible issues, such as inappropriate billings or inappropriate rendering of services.” These are the findings that the Auditor General did in 2021, and these problems still exist and are only going to be exacerbated by this bill.

I think the overall conclusion of the Auditor General that speaks to the two protections that people should expect from a government—to protect them financially and to protect their health outcomes—when they’re being driven by this government to private, for-profit clinics, the Auditor General says, clearly, “The ministry does not have a centralized way to measure and report on surgical quality and outcomes for all surgeries being performed in Ontario.” That’s shocking. There’s no oversight in place, and this bill does not put any in place.

The Auditor General also goes on to say that “We found that some patients could be given misleading information as part of sales practices to make a profit.” So the warning is here. This is already happening. The quality of people’s outcomes are not being monitored, and the fact they’re being charged inappropriately and overcharged for fees is not at all being addressed by this government. I would be curious to know what the government is doing to address these recommendations and these findings from the Auditor General.

The Auditor General’s work is invaluable to all of us in this House to do our work. Her work is stellar, and her work is invaluable. She’s an independent officer of this Legislature, and we should be listening to this and using this to make our bills better and to improve our bills. She said, mincing no words, that “the ministry is putting patients at greater financial risk by allowing additional private organizations to provide publicly funded surgeries while also being allowed to charge patients directly for additional uninsured services to make a profit without appropriate oversight mechanisms in place.”

There it is. It’s happening already in this province. You’re putting a bill forward that’s going to double down on this and that has not in any way addressed those concerns.

My question to the government would be, what happens if something goes wrong in one of these private clinics? What is the procedure when there are complications or urgent issues that arise? How will this impact our emergency rooms that are already closing? Have you considered any of this? Because it’s not in the bill, and in the debate that I’ve heard, you don’t address any of the concerns that people have.

So I would just say, despite the despair that we feel that this government is not protecting people when they need health care in this province—that in fact, you’re protecting profits over patients—I just have to end with a quote from Tommy Douglas, because it is the anniversary of his passing. Despite the despair that we feel, I think Tommy’s words would be, "Courage, my friends; ’tis not too late to build a better world.” That’s what we should be aspiring to, not a downward spiral to privatization and lack of services for the people of the province of Ontario.

I find it interesting in the House this afternoon—especially since we were just debating putting together this big piece of land for, potentially, a new automotive manufacturing plant—to hear from the opposition that they actually want to set the price of vehicles that an auto manufacturer can charge. I find that amusing.

But I know for the member, who had to have life-saving surgery himself and has been quite open about that in the House, that wait times are very, very important. They’re very personal to him.

I was wondering if he could speak a little bit more about how important it will be for everyone in Ontario to be able to get the health care that they need, faster and more effectively, when they need it, and to be able to pay for that with their health card.

Before I continue, I also want to remind members: We do not refer to other members by their name and we do not make reference to whether a member is or is not in the House or in the chamber.

Further questions.

Mr. Fedeli has moved third reading of Bill 63, An Act respecting the adjustment of the boundary between the City of St. Thomas and the Municipality of Central Elgin.

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

Be it resolved that the bill do now pass and be entitled as in the motion.

Third reading agreed to.

Resuming the debate adjourned on February 28, 2023, on the motion for second reading of the following bill:

Bill 60, An Act to amend and enact various Acts with respect to the health system / Projet de loi 60, Loi visant à modifier et à édicter diverses lois en ce qui concerne le système de santé.

Thank you very much, Speaker. Thank you to the member opposite as well.

I was reading in Hansard yesterday that the member for Nickel Belt was talking about how, in Health Sciences North in Sudbury, we have 17 surgical units available. Only 14 of those are open; typically, they don’t even run the entire year because they run out of government funding.

I’m curious to understand why the Conservative government thinks that’s a better solution than providing the funding to operate these existing, publicly structured, already-built hospital surgical rooms; that funding them at a lower cost doesn’t make sense, but funding a private clinic where there’s a profit margin that will cost more, ultimately—it’s through the OHIP card, but it still costs the only taxpayer we have. There’s only one taxpayer; we’ll pay more, all of us, as taxpayers. Why is that a better solution than actually funding the hospitals that exist, that could be doing the work with the equipment in facilities that we already have?

Thank you to the member across for his comments. I wanted to just dig a little bit deeper. I think it’s important for to us recognize that there is a description of the annexed area that’s described in the bill, in the schedule, but we have learned that the Minister of Municipal Affairs and Housing can oftentimes prescribe a different outcome.

I just want to make sure that the area described, the annexed area in the bill, in the schedule, is going to be exactly what is going to be prescribed by the Minister of Municipal Affairs and Housing afterwards.

I want to thank the member for Durham for educating us on not just the work that’s required for a mega-site, but the preparation. The member discussed the competition, with close to 40 US jurisdictions offering mega-site programs. With this in mind, the government needs to grow the economy and invest in the future, because if we don’t, somebody else will.

Speaker, can the member talk about this challenge for large-scale projects and how this legislation, if passed, will attract investment in Ontario that will have otherwise gone elsewhere?

I’m glad I have this opportunity because, as the member was speaking this morning, all I kept thinking in my mind is I want him to think of this scenario. He comes from Ford; he’s an autoworker. If he has the ability to buy and pay for a car at, say, $10,000—just to make it easy—under the public system, and then he has that exact same vehicle that he can get that’s privately done at $15,000, which one is he going to do? It is a perfect example of for-profit in our health care system compared to public.

I would love to hear from the member: Is he going to buy the $10,000 public vehicle or the $15,000 private vehicle?

I want to thank the member for that question. In health care, we want our patients to get the service they need, as quick as they can. If you have to wait for 18 months to have a surgery and I can get it done in four months and pay with my OHIP card, that’s what I’m going to do. I want to get it done quickly and have the care to take care of me and be able to get back on my feet and get back to work. So that’s what I would do.

If we can move the non-invasive surgeries out of the hospital so we can do the heart valve surgeries and the cancer surgeries in the hospital, that would save a lot of lives in the province of Ontario. I think that’s the way—

My goal is to get surgeries done. We have a 200,000-surgery backlog due to COVID. We have to get these surgeries done so we can get these people up and running quicker.

Time for questions and answers.

I recognize the member for Mississauga-Lakeshore.

Thank you, Madam Speaker, and I thank the member for her debate today.

I just want to ask the member a few questions. I hope that she can answer them.

Do you go to LifeLabs and do you use LifeLabs? It’s a private organization where you pay with your OHIP card. And if you do have a family doctor, which most of us do have, it is another private organization where you pay with your OHIP card. So are you against family doctors and LifeLabs? Do you want us to put them back into the hospital?

As well, the late Jack Layton, rest his soul, used Shouldice Hospital to have his hernia repaired. Do you agree with what Jack Layton did?

Well, that was a multi-pronged question that went in all directions, but I would take from it that you’re asking me if I think that it’s okay, because I am forced to go to a privatized LifeLabs, a privatized diagnostic clinic, that I agree that the Liberals began the privatization of health care? No, I don’t think that makes any sense at all. I don’t agree with that.

Do I support family doctors? Of course I support family doctors. I want to give a shout-out to my doctor, Dr. Nathanson, who has been looking after me and my family and all my brothers and sisters for many, many years. Absolutely we support the idea that people should have access to health care, publicly delivered, publicly funded.

Yes, the Auditor General, particularly when it comes to cataract surgery, identified in this report that people were being overcharged for specialty lenses, that the surgeon said, “I only work with that kind of lens,” that they paid the money and afterward didn’t realize that it was optional. There were pressure sales tactics to spend extra money for something that should have been covered under the public dime, so it’s absolutely happening already.

I think what’s really important to note is that we’ve had the warning from this government and that they’re not being heeded. This is only going to continue, so people that are already stretched thin and are seeking care in their most vulnerable moments will be pressured into spending money that they don’t have and they don’t need to spend.

We think that the whole idea of dental care is something that people should be able to have covered. People go to emergency rooms—I think one in five visits to the emergency rooms are for pain in people’s teeth. That is a waste of a service when we could be covering dental practice in a publicly funded system.

And eye care: Eye care is very, very expensive for families that can’t afford the tests for their young children. They can’t afford the glasses. We should be bringing that into a public system to allow people, from head to toe, to have the kinds of supports they need to keep themselves healthy.

Interjection: Your constituents will thank you.

Further questions?

Further debate?

I was intrigued by the comments from the member from Hamilton West–Ancaster–Dundas. I’m an optometrist. I have a small-town private clinic. I sell some of my patients glasses and/or contact lenses. Using her logic, because I support my family that way and I bill OHIP, it sounds like she’s intimating that I’m somehow gouging people. I would just like her to give clarity to optometrists across the entire province of Ontario who operate their own private clinics, billing OHIP and also selling people optical goods, whether they’re good people or bad people, from her logic.

It’s great to stand and talk to this bill.

One of the things that we were first electing on in 2018 was reducing hallway health care. Obviously, with COVID, there were some changes that had to happen, some things that we had to do differently. Let’s be honest, there were 214 countries dealing with it, and they all had to do things in a different way.

Now that we’re transitioning out of COVID—it’s not the pandemic; it’s become more of an endemic—we can get back to dealing with some of the challenges that we had. But COVID did do something that created a negative for us, as well, and that was to increase the backlog of surgeries. One of the things that we did earlier on was to increase funding to hospitals, to their operating rooms, to try to clear up some of that backlog. I’m going to give you some statistics on it, and I’m kind of averaging and rounding it—not giving the total number, but an average of what they were. Roughly 260,000 surgeries is what we had as the backlog; prior to COVID, we had a backlog of about 200,000. We’ve brought that back down to about 200,000. It has taken almost three years to bring that down. So about 20,000 extra per year is what we can handle under the current system. That means it would take a decade to clear the backlog that we currently have under status quo. I’m not a rocket scientist, but I can look at it and say that 10 years is not realistic—status quo cannot remain.

I’ve heard some of the opposition members talking about this, and they’ve thrown these scare tactics out—“Oh, my goodness, the sky is going to fall if the ophthalmologist who does the surgery in the hospital does that same surgery someplace other than the hospital.” What we’ve heard from ophthalmologists is that they can do more surgeries in the same length of time if they’re not using the hospital operating room. We’ve heard the opposition say, “Well, they’re only going to do the easy surgeries.” Yes, that is correct. They are only going to do the surgeries that do not require hospitalization after surgery.

If you think of it from a common-sense approach—common sense doesn’t seem to be something that I’m hearing an awful lot from the opposition on this—would you want to have a surgery outside of the hospital if you were going to have to be hospitalized directly after the surgery? The answer to that would be a resounding no. But, if you’re going to have a surgery that’s going to take roughly 20 minutes, and 15 minutes after the surgery you’re in a condition that you could go home, wouldn’t you prefer that? Wouldn’t you rather come to the clinic, have your surgery fairly quickly, go through the appropriate processes to make sure there aren’t any side effects, and then go home? Or would you rather go into the hospital; spend some time waiting, prepping; go into the surgery room; leave the surgery room or the operating room; and follow the hospital’s protocol, which is probably closer to an hour? You’re going to spend roughly a three-hour time frame for a 35-minute process that wouldn’t be at the hospital. To me, it makes logical sense. If I only have to spend 35 minutes someplace to accomplish exactly the same thing, I’m going to want to do that. And if I only have to spend 35 minutes instead of three hours, wouldn’t that tell you that more surgeries could actually be completed?

It seems like this is something that’s a stretch for the opposition, and I truly do not understand why, because the same doctor who would operate on you in the hospital is the doctor who’s going to operate on you in the clinic. They’ve said things like, “Oh, my goodness, it’s going to cost millions of dollars more to do that.” The doctor gets paid the same, whether they’re in the hospital or their clinic for the surgery portion of it. And then they say things like, “Oh, my goodness, you’re doing this instead of doing it in the hospital. We should be opening it up so it can be done in the hospital.” Obviously, they have not read the legislation or, conveniently, they skipped over parts of the legislation, because nowhere in the legislation does it say the hospital can’t apply for this. Nowhere does it say, if a hospital has extra capacity and wants to do it and has the staffing to do it, they can apply for this and do it—nor does it say that they can’t; the reality is, they can.

I then turn to my opposition friends and say, what’s the issue? If the hospital can do it and the hospital says, “We can do it,” and the hospital applies to do it, they get approved to do it. But if the hospital says, “Right now, we’re at capacity and we can’t,” or “We have some higher-risk surgeries that we need to get completed, so we would like to have some of those low-risk things moved out so that we can have the capacity to do things like a valve replacement surgery”—as one of our colleagues has had done to him. Or perhaps they’re looking at it and saying, “Our backlog for cancer surgery is too long. We could do more cancer surgeries if we take these non-invasive, non-medically critical surgeries and move them out.” Wouldn’t that be something to which the average person would say, “This is a good idea”? Those who need medical intervention, those who need to have hospitalization after their surgery, those who have those critical illnesses that are more complex that should be done in a hospital will have faster access to it. Don’t you think the average person is going to say, “That’s a good idea”?

Now the sky is going to fall because your OHIP card is going to be used to pay for this someplace else—because that doctor who is doing the surgery in the hospital suddenly is an evil person for doing that same operation someplace else and getting paid by OHIP. Where they were getting paid by OHIP to do it over here, it’s evil for them to get paid by OHIP to do it over here—and if we only kept status quo, nobody would be evil. Of course, our backlog would take a decade to get cleaned up. I’ve had a number of people reach out to my office and say that’s just not acceptable. They want service.

I find it so ironic that the opposition members stood up last term and presented all kinds of petitions to save eye care, because those evil optometrists, as my seatmate described, who get paid by OHIP to do eye exams, were selling glasses to those people or selling contacts to those people—we can’t trust those doctors because they’re getting paid by OHIP and they’re selling something as well. Perhaps what we should have been doing is having petitions by the opposition saying, “Optometrists should never be able to sell glasses to people because OHIP is going to fund them to do the eye exam, and they should only ever do eye exams, and we should have glasses sold someplace else because they can’t be in the same building as each other, because that would be evil if we were to do something like that.”

The logic the opposition has put forward just doesn’t make any sense. At the end of the day, you’re getting the care you need, when you need it, where you need it, and you’re paying for it with your OHIP card.

With that, Speaker, I move that the question now be put.

Thank you to our member for that wonderful presentation. The government seems to think that privatization of health care gives Ontarians choices. But really, it gives choice to those who have the deep pockets to be able to take advantage of private care. I’m wondering if the member can express how this broadens the gap between the haves and have-nots in terms of access to health care, where it seems that the healthy and the wealthy are at the front of the line. They’re at the top. But where are those who don’t have? Where are they?

I have here a long list of people who have already been extra-billed substantial amounts of money for various surgeries in for-profit clinics: $8,435, plus $150 for a checkup, for cataract surgery, upsold; in Lindsay, $5,300, private cataract clinic, upsold—this already happened in 2019—a private eye clinic, another one, $58,000.

I wonder if the member from Ancaster—

Interjection.

Thank you for the member opposite’s presentation. When it comes to your health, the status quo is no longer acceptable. Our government is taking bold action to eliminate surgery backlogs and reduce wait times for publicly funded surgeries and procedures. By boosting this availability of publicly funded health services in Ontario, our government is ensuring Ontarians currently waiting for specialized surgery will have great access to the world-class care they need when they need it.

My question is simple. Will the member of the opposition support their constituents by supporting this bill to ensure that Ontarians are not waiting too long for surgeries and procedures?