SoVote

Decentralized Democracy

Ontario Assembly

43rd Parl. 1st Sess.
August 24, 2022 09:00AM
  • Aug/24/22 9:40:00 a.m.
  • Re: Bill 7 

Thank you to the member opposite for her contributions today.

It’s no secret that the health care system is under immense pressure, and if we do nothing, we could see a shortage of 2,400 hospital beds by the peak of a potential flu or a COVID-19 wave later this year. Our government is seeing this potential wave on the horizon and we’re proposing real steps to address it, to help ensure that our health care system is properly resourced to deliver the care Ontarians need.

Meanwhile, the opposition seems content to sit around and oppose, much like they were content to support the Liberals between 2011 and 2018—propping up that Liberal government when they built only 611 beds for 176,000 new, elderly patients over the age of 75.

My question is really simple: Are you content to sit back, support the status quo and do nothing when action is clearly needed?

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  • Aug/24/22 9:40:00 a.m.
  • Re: Bill 7 

I appreciate the comment from my colleague because he is exactly right. What this bill does is allow a long list of actions that can now be taken without the consent of a patient that will coerce or pressure alternate-level-of-care patients to feel that they have to leave the hospital and move to a long-term-care home, and the only restriction is that they cannot be forcibly handcuffed, physically restrained and physically transferred from the hospital to a long-term-care home.

So I understand why seniors are terrified of this bill, and I understand why experts and advocates also have raised those concerns.

Health care workers are leaving. They’re leaving because of this government’s low-wage suppression policies that are driving them to retire early or leave the province.

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  • Aug/24/22 9:40:00 a.m.
  • Re: Bill 7 

It’s always an honour to rise and participate in the debate—today, on Bill 7 at second reading. For members opposite and for people watching at home: One of the reasons second reading debate happens is so that concerns can be raised and addressed—and amended at committee. Advocates for the elders, seniors, doctors, and health care policy experts have all raised serious concerns about the implications of this bill and the possible unintended consequences.

I understand that we are facing a health care crisis and that that crisis predated the existing government, but it has been made worse by the existing government because of their failure to invest in the people who deliver care. Nurses, front-line health care workers and doctors have all said that wage caps and benefit caps are a significant contributor to the inability to retain nurses and other front-line workers in our health care system. Yet the government—after calls from almost everybody across the province, including the opposition—has failed to say, “Maybe we need to make an adjustment and invest in the people who deliver care.”

One of the concerns that seniors have is the consent provisions in the bill. I’ve heard the argument about, is there consent or is there not consent? Well, I guarantee you, Speaker, that elders deserve clarity around the consent provisions in this bill, because when you combine this bill with legislation that I know has been there since 1979, they could charge elders up to $1,500 a day if they do not consent to being transferred to a long-term-care home they do not want to be in. One of the reasons they may not consent is that they would be a long distance away from their family, which is one of the unintended consequences of this bill. We already have a home care system and a long-term-care system that’s underinvested, understaffed and overwhelmed. Family members play a key role in providing additional care for elders. It will be incredibly difficult if elders feel forced to consent to agree to move a long distance away from family and lose that additional care, which will then put additional pressure on existing staff.

I would say to the official opposition and to the government: Listen to the concerns that people have and amend this bill at committee, because we know that properly placing alternate-level-of-care patients is important to the health care system.

First of all, repeal Bill 124 so nurses and front-line health care workers can negotiate fair wages, fair benefits and better working conditions. Speaker, do you know what it’s like to be overworked in understaffed wards and feeling underappreciated and disrespected by government? Do you know what it’s like to not be able to access mental health benefits, for example, because your benefits are capped, let alone being able to have your wages keep up with inflation?

Second, two years ago, we were asking this government to fast-track the accreditation of internationally trained health care professionals. They are now finally starting to do that. According to the RNA, that was 15,000 to 20,000 nurses or other front-line health care workers who could have been part of the system, taking a burden off the system, if the government had acted on that two years ago.

Speaker, I have more solutions I’d like to offer, but I know my time has run out.

So I encourage the members opposite: Listen to the advocates, listen to the seniors, listen to the health care policy-makers who are putting forward concerns about this bill and address those concerns, because we know that we need a better process for properly and justly placing seniors who have alternate-level-of-care needs.

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  • Aug/24/22 9:40:00 a.m.
  • Re: Bill 7 

That is pathetic.

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  • Aug/24/22 9:40:00 a.m.
  • Re: Bill 7 

Thank you.

The member for London West can reply.

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  • Aug/24/22 9:40:00 a.m.
  • Re: Bill 7 

I’ve always been one to look at legislation—and words are very powerful. I know the member from Guelph talked about consent. If I’m sitting in a long-term-care home or if I’m a family member, I’m looking at this bill and I’m reading the first two sentences—it says, “The bill amends the Fixing Long-Term Care Act, 2021 to add a new provision for patients who occupy a bed in a public hospital and are designated by an attending clinician as requiring an alternate level of care. This new provision authorizes certain actions to be carried out without the consent of these patients.” What else could that possibly mean? It’s removing the consent of individuals. The outcome is what I’m concerned about. When you look at legislation, there are winners and losers. We see who the losers are going to be here.

Who is going to benefit from this legislation? Who is this for? That’s the question that I’m asking the member.

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  • Aug/24/22 9:50:00 a.m.
  • Re: Bill 7 

It is my privilege to rise in the House to speak to the debate on Bill 7, the More Beds, Better Care Act, 2022. This bill, if passed, will make amendments to the Fixing Long-Term Care Act, 2021, as part of our government’s larger Plan to Stay Open: Health System Stability and Recovery. This five-point plan aims to provide the best care possible to patients and residents while ensuring the necessary resources and supports are in place to keep the province and the economy open. The plan further bolsters the Ontario health care workforce, expands innovative models of care, and ensures hospital beds are there for patients when they need them.

As everyone in the chamber knows, health care systems around the world are facing unprecedented challenges lately, and Ontario is no different. In order to address these pressures, make more progress with the surgical backlog, and be properly prepared for a potential winter surge, we need to do more. If we keep the status quo, we could see a 2,400-hospital-bed shortage by the peak of the potential flu and COVID waves later this year.

Over the last few weeks, our government has been actively engaging with front-line partners, hospitals, long-term care, union leadership and the best experts available to identify concrete, actionable solutions to respond to urgent pressures as well as prepare for any potential surge in the winter months. Our government is looking at every possible option as we look for ways to address the challenges facing our hospital capacity, avoid overstraining the health care system, and establish better models of care.

One of the main ways we help with hospital capacity challenges is to ensure that patients are getting an appropriate level of care in an appropriate setting. Across the province, there are many patients whose care needs could be better met elsewhere. These patients are sometimes referred to as alternate-level-of-care patients, or ALC for short. ALC patients in hospital no longer need to be there, and many would have better quality of life in a long-term-care home. At the same time, moving these ALC patients out of hospital and into long-term care frees up much-needed space in hospitals for patients who require hospital treatment.

Our government’s priority is for people to live and receive care where they have the best quality of life, close to their family and loved ones and their community. With this bill, we would add a new provision to the Fixing Long-Term Care Act, 2021, to ease the transfer of patients in ALC into long-term care.

ALC pressures are not unique to Ontario. Several provinces, like BC, Alberta and Nova Scotia, have similar policies which encourage the movement of patients into temporary care settings while they wait for their preferred bed.

In Ontario, there are approximately 1,900 ALC patients on a long-term-care wait-list or in need of long-term care. Some patients can spend up to six months or longer in hospital waiting for a space in their preferred home to open up, even though they no longer need hospital services. When they cannot be discharged, these patients continue to receive care, but in the wrong setting. These patients contribute to backlogs in acute-care services in hospitals because they occupy beds that other patients urgently need.

The More Beds, Better Care Act will enable the movement of these patients to a more appropriate care setting that can better support their quality of life and better meet their needs. ALC patients who are placed in a long-term-care home that was not selected by them will be there temporarily, until they can be placed in their preferred home.

As members in this house surely know, the wait-list for long-term care is sizable, thanks in large part to the neglect of the former Liberal government, who, from 2011 to 2018, only managed to build 611 net new beds across the province—611 net new beds while the population of Ontarians aged 75 and older grew by over 176,000. This blatant neglect of the sector left our government with a wait-list of over 40,000 patients.

Speaker, I am sure you know that our government wasted no time in developing new long-term-care beds. Since 2018, we have invested $6.4 billion into the development of new beds and new homes, and we currently have over 30,000 new and more than 28,000 existing beds to be upgraded in the development pipeline. Despite all of that, we still have a long wait-list for long-term care in Ontario, so I am sure everyone is wondering where we are going to place all of these ALC patients.

Well, as we have done since the beginning of the pandemic, we are working on the advice of the Chief Medical Officer of Health, and we are taking immediate action to increase bed capacity in long-term-care homes by right-sizing the number of COVID-19 isolation beds, based on community demand and COVID-19 risk levels. By the end of the summer, approximately 300 long-term-care beds that were set aside for COVID-19 isolation will be safely available for the people on wait-lists, with a potential of 1,000 more beds available within six months.

I am sure some members in this House are wondering, if we eliminate isolation beds in homes, are we putting long-term-care residents at risk of contracting COVID-19? That is a very good question. Isolation beds were implemented at the onset of the COVID-19 pandemic as a way to protect residents from contracting this highly contagious virus. Since that time, long-term-care homes have implemented enhanced infection prevention and control practices, personal protective equipment is more readily available, and a large majority of residents and staff have been vaccinated. Because of these factors, isolation beds are no longer as necessary as they were in the early days of the pandemic.

Over the course of the last couple of days, I have heard some members of the opposition suggest that the homes that ALC patients would be sent to could be in outbreak, or experiencing staffing shortages. However, I would like to remind those members that, as set out in the Fixing Long-Term Care Act, 2021, long-term care licensees must approve the applicant’s admission to the home unless the home lacks the physical facilities necessary to meet the applicant’s care requirements, or the staff of the home lack the nursing expertise necessary to meet the applicant’s care requirements. In the case of an outbreak, homes must follow guidelines and direction from their local public health unit with respect to any additional measures that may be implemented to reduce the risk of transmission in the home. All this to say, if the home does not have the capacity to take on additional residents, they will not be asked to do so. One thing that we should make clear is that this would not apply to all patients in ALC. It would only apply to ALC patients who have been deemed by a medical professional to no longer need to be in a hospital and who may benefit from receiving care in a long-term-care home instead, but are either waiting for a preferred long-term-care bed or do not consent to apply to a long-term-care home suitable for their needs.

By allowing a placement coordinator to access and authorize an ALC patient admission to a long-term-care home, this amendment, if passed, will allow seniors, their families, caregivers and clinicians to shift the conversation from where a person’s needs can best be met to where a person’s quality of life would be better. The focus should always be on providing the right care in the right place.

Speaker, now I would like to spend a few minutes talking about some of the landmark changes our government has made in long-term care to make sure that seniors receive the care they deserve. When it comes to long-term care, our government saw the status quo that was left behind. We saw a system that had been neglected by the previous Liberal government, with out-of-date homes, understaffing across the sector, and little accountability measures. We knew that we would have to work quickly and that we would need to come up with innovative solutions to accomplish what needed to be done in the sector.

When the Premier promised to build 30,000 net new beds in the province, we acted quickly. In four years, we have had more than 30,000 new beds allocated across the province and another 28,000 existing beds that are being upgraded to modern standards. This means no more four-bed ward rooms with poor ventilation designed to outdated standards.

This includes the brand new 320-bed Lakeridge Gardens home in my riding of Ajax, which was built as part of our accelerated build pilot program. Launched in July 2020, this program uses hospital-owned land and accelerated procurement and construction methods, and aims to deliver new long-term-care beds up to two years quicker than the traditional pilot program. Our government recognized that large urban centres are areas of high service need. The need for additional long-term-care capacity is critical, but it’s often difficult to build due to issues like availability and cost of land. This program leverages the expertise of Infrastructure Ontario to accelerate construction. In addition to the Lakeridge Health home in Ajax, this program will also see the building of two homes with a total of 632 beds in Mississauga by Trillium Health Partners, and another 320-bed home developed by Humber River Hospital in Toronto. This is just one more example of how our government changed the status quo on building long-term-care homes.

For years, the status quo with the Liberal government was reading reports about the need for more staff to deliver more care to residents, and ignoring those reports. From 2009 to 2018, they only managed to increase direct care to residents by 21 minutes. That is a 12% increase over nine years in government, or slightly more than two additional minutes of direct care per resident per year.

Our plan includes a historic investment of $4.9 billion over four years to increase direct care to an average of four hours per resident per day. This plan will require hiring 27,000 support workers and nurses to work in long-term care. But we all know that these highly skilled workers do not just appear. That is why we invested in programs to train these workers. Partnering with our publicly funded colleges, we invested $121 million to accelerate the training of 9,000 PSWs. We invested another $86 million to train up to an additional 8,600 PSWs through private career colleges and district school boards. But we weren’t done there. We invested a further $35 million to increase enrolment in publicly assisted colleges and universities to introduce 2,000 nurses to the health care system.

Training and hiring new staff is one thing, but retaining that staff is a completely different thing altogether. That is why we invested $100 million to add an additional 2,000 nurses to the long-term-care sector by 2024-25 by supporting the training of thousands of support workers and nurses who want to advance their careers in long-term care.

The first program we launched is the Bridging Educational Grant In Nursing—or BEGIN—initiative. Partnered with WeRPN, eligible PSWs will receive $6,000 a year to pursue further education to become registered practical nurses, and eligible registered practical nurses will receive $10,000 a year to become registered nurses.

The second program: We partnered with Colleges Ontario to increase access to nursing programs at publicly assisted colleges through:

—the introduction of hybrid online and in-person models in practical nursing and bachelor of science and nursing programs to provide students with greater flexibility and choice;

—the creation of an additional 500 enrolments in bridging programs for the 2022-23 academic year, designed to give applicants the skills and credentials they need to move to the next stage of their careers; and

—providing up to $6,000 a year in financial support to internationally trained nurses to gain the credentials required to work in Ontario.

Speaker, when it comes to ensuring Ontarians receive the care they require, our government continues to go beyond the status quo and find innovative solutions. That is why we are listening to experts and stakeholders from across the health care and long-term-care sectors. That is why we’re listening to seniors, their families and caregivers. We’re listening to nurses, PSWs and front-line health care workers as we move forward with our plan to fix long-term care. The feedback and insights that we receive from people on the ground in long-term care is invaluable and helps to shape the solutions and direction our government pursues. This will continue to be this government’s approach as we continue to go beyond the status quo to innovate and evolve the long-term-care and health care systems in Ontario.

We all know that this is a critical time for action in Ontario, and I am proud to be part of the government that is taking real steps to fix long-term care and evolve our health care system. With the proposed amendments in the More Beds, Better Care Act, 2022, and our five-point Plan to Stay Open: Health System Stability and Recovery, we are taking actions to solve the challenges and alleviate pressures facing the health care system. I am proud to support this bill, and I hope the members opposite will join us as we ensure that every Ontarian has access to care when and where they need it.

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  • Aug/24/22 9:50:00 a.m.
  • Re: Bill 7 

Thank you to the member opposite.

A recent editorial in the Globe and Mail discussed the government’s five-point Plan to Stay Open. It talked about how acute-care beds are really for acutely ill patients, not those waiting for long-term care. Patients who need long-term care should receive it in a proper setting.

They do something similar in BC, Alberta and Nova Scotia. So, why, when we try to improve the system here so that patients can get into the hospital—

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  • Aug/24/22 9:50:00 a.m.
  • Re: Bill 7 

Six times in this bill we read “without consent.” Mushkegowuk–James Bay has two communities that don’t have long-term-care beds—or hospitals with ALC, I should say. All the long-term-care homes have a two-to-three-year waiting period; the others closest are Cochrane and Timmins—which are an hour and a half away from Timmins, two and a half hours from Hearst. The other ones, we’re going further out—five, six hours—Thunder Bay, and then we have Sudbury. If they have no room there, guess what? Now we’re going to eight, nine hours away.

My question to you is: Without consent, where are you going to send these people, away from their families, when we’re talking about how the closest don’t have room or may be five hours to six hours away?

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  • Aug/24/22 9:50:00 a.m.
  • Re: Bill 7 

I don’t believe the member opposite has actually been attentively listening to my comments. My comments have acknowledged the need to address alternate-level-of-care patients in hospitals.

What I’m asking the government to do is to listen to the experts and address the concerns that elders have about this bill.

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  • Aug/24/22 9:50:00 a.m.
  • Re: Bill 7 

We have time for one quick question.

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  • Aug/24/22 10:10:00 a.m.

Since being elected, I’ve had the opportunity to meet with many community service organizations in my riding of Ottawa West–Nepean. The Caldwell Family Centre, Jewish Family Services, the Carlington Community Health Centre, Meals on Wheels, and Britannia Woods Community House are among the many organizations doing amazing work to support seniors, newcomers, people living with disabilities, and low-income communities. They are all facing a situation where demand for their services is soaring due to the rising cost of living, the challenge of finding affordable housing, and the increasing rate of poverty. The Caldwell Family Centre, for instance, has experienced an almost 200% increase in demand over the past two years. But funding for many of these community organizations has been frozen and is not keeping pace with the demand.

I urge this government to take immediate action to address the affordability crisis, to pass the Rent Stabilization Act, to double Ontario Works and ODSP, to increase the minimum wage, and to support the many community organizations that are providing such vital supports to vulnerable members of our communities.

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  • Aug/24/22 10:10:00 a.m.

I am proud to rise for my first member’s statement since my re-election.

The riding of Humber River–Black Creek is my lifelong home and the place I love the most. I want to once again thank my neighbours, fellow community members, family, friends and all my supporters for putting their trust in me to be their voice in this chamber. Representing my lifelong home is truly my life’s greatest honour.

Speaker, I am joined here today by my wife, Aleksandra, and two sons, four-year-old Aleksandar and one-year-old Ilija. Just as becoming an MPP is my greatest honour, the birth of our two sons is my life’s greatest joy.

My children are here with me every day—maybe not in person, but they are with me in every decision I make here. I ask myself: What kind of a world are we building for them, for all children?

I think of my elderly mother, Aileen, who is watching us from home right now, and ask: Is the system truly there for her when she needs it?

If it is true that this chamber can get heated at times, it is because we are fighting for what matters most: for our own loved ones, our communities, for the future of this province. So despite what it appears at times, we all have a lot in common. We just don’t always agree on the path forward.

To all of my colleagues, regardless of where you sit here: I congratulate you, and I wish you and your loved ones all the best. I look forward to working with you in the years ahead to build an Ontario we can all be proud of.

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  • Aug/24/22 10:10:00 a.m.
  • Re: Bill 7 

I’m pleased to participate in today’s meeting in this session.

Speaker, you will know that, under the previous Liberal government, propped up by the NDP during the period from 2011 to 2018, only 627 beds were built. How many did the region of Durham get? Absolutely zero during that period—shameful.

Can the member from Ajax, who had a great presentation, speak about how long-term-care homes in the region of Durham have the capacity—yes, they do—to accept ALC patients?

Mike, you’re an inspiration for us all. Thank you for your efforts in raising funds and awareness for youth mental health. Residents across Ontario and Canada are absolutely so proud of you.

Speaker and colleagues, please join me in congratulating Mike Shoreman on his historical feat and celebrating this amazing achievement with him, his family and many supporters.

Congratulations, Mike.

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  • Aug/24/22 10:10:00 a.m.

It is my pleasure to rise in the House today and deliver my first members’ statement.

On Friday, August 19, I had the privilege of joining the Juno Beach Centre Association, a non-profit organization that is based in my riding of Burlington. The association owns and operates the Juno Beach Centre in Normandy, France. The JBCA plays a vital role in commemorating Canadians who served during the Second World War.

Last Friday, the Juno Beach Centre Association announced they were the recipient of $119,500 through the Ontario Trillium Foundation’s Resilient Communities Fund. It was an honour to be part of a special funding announcement on the 80th anniversary of Dieppe. This grant has helped the JBCA complete a digital educational resource, Who Tells the Story of Dieppe, focusing on how the soldiers from Ontario and across Canada made the ultimate sacrifice on one of Canada’s darkest days, the Dieppe raid. Congratulations to the Juno Beach Centre Association on receiving this grant, and thank you for educating adults, children and future generations about the role Canada played on the world stage.

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  • Aug/24/22 10:10:00 a.m.
  • Re: Bill 7 

Thank you for that question, to the member across the way.

We have committed to providing our seniors with valuable care, and we know there are special needs that need to be considered within the north.

Under the Fixing Long-Term Care Act, 2021, our government introduced legislation to ensure that all homes can operate so that residents can live with dignity, security, safety and comfort and have their physical, psychological, social, spiritual and cultural needs adequately met.

Let me be clear that the proposed legislation would not force anyone to be relocated without their consent. Instead, these measures are intended to allow hospitals to open a dialogue with residents about the benefits of moving into long-term care when hospitalization is no longer required. For these residents, temporary long-term care is available to provide a better quality of care in a home-like setting where residents will have longer access to social and recreational programming alongside other residents of similar health.

I was very proud when we had our Lakeridge Gardens long-term-care built in our region, the 320 beds that were built—and this was done in less than two years. We have really started addressing those needs.

Within your own riding, member, Glen Hill Terrace had 167 beds built.

It’s no secret that the previous Liberal government severely underfunded the long-term-care sector for years, building a meagre 627 beds between 2011 and 2018.

Fixing these long-standing challenges takes time, but our government has made substantial headway over the past four years. We’re making key investments to hire and retain staff, including an $893-million investment this year to make wage increases permanent for publicly funded support workers and direct support workers. We are also investing $37 million this year to improve the range of care that can be offered to long-term-care residents, which will allow supports like behavioural and dialysis.

Additionally, COVID-19 vaccines have changed the game for our long-term-care homes. Thanks to this, the Chief Medical Officer of Health has advised that 300 long-term-care beds set aside for COVID-19 isolation will be safely available for people on long-term-care wait-lists.

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  • Aug/24/22 10:10:00 a.m.
  • Re: Bill 7 

Questions?

Second reading debate deemed adjourned.

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  • Aug/24/22 10:20:00 a.m.

I would like to take this opportunity to congratulate many organizers and volunteers across the riding of Glengarry–Prescott–Russell for organizing some nice events that took place over the last few weeks.

I had the pleasure of attending the Glengarry Highland Games in the town of Maxville on July 29. It’s a 74-year-old tradition that is always a success.

The town of Russell’s agricultural fair on August 13 and the town of Vankleek Hill’s agricultural fair on August 19 were also successful in hosting many people from the region.

I am looking forward to attending the Riceville Fair this coming weekend, and I’m sure that it will also be a success.

It is nice to see people gathering at social events again.

I would like to thank the provincial government for their financial assistance through the Reconnect Festival and Event Program from the Ministry of Tourism, Culture and Sport.

I would also like to thank the administration of the Glengarry Memorial Hospital in Alexandria for inviting me to their hospital so they could teach me about their operations and their issues. It was very pleasant to meet with the CEO and the chair of the board of directors.

I would also like to thank all the ministers, parliamentary assistants and provincial government staff for participating in the AMO conference last week. It is very important to have a good relationship with all of our 444 municipalities.

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  • Aug/24/22 10:20:00 a.m.

I rise today to pay homage to a true gentleman from my riding. Gidigaa Migiziban has begun his journey to the spirit world. Doug Williams was a much-loved elder, knowledge keeper and former chief of Curve Lake First Nation. In 1972, he was one of the first graduates of Trent University’s newly created Indian and Eskimo studies program. That program would eventually evolve into Trent’s current Indigenous studies.

Doug retained a close relationship with Trent, and would eventually become an associate professor and director of studies in the Indigenous studies PhD program.

But Doug wasn’t just an educator of Indigenous studies; he was also a defender of treaty rights. He was the subject of a court case in the early 1980s that led to a landmark decision on First Nations treaty rights to traditional harvesting. On one particular day, Doug caught more than sixty frogs while waiting for the game warden to come and charge him. When asked why he caught so many, he said that he wanted to make sure it was obvious what he was there to do.

Doug was also an author. His book, Michi Saagiig Nishnaabeg: This is Our Territory, published in 2018, tells the story of his people in Curve Lake. If you have the chance to read it, I highly recommend it. As you read the words, you can actually hear his voice speaking them.

Thank you, Gidigaa, for your teachings, and for sharing your knowledge and wisdom with me.

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