SoVote

Decentralized Democracy

Ontario Assembly

43rd Parl. 1st Sess.
August 24, 2022 09:00AM
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  • Aug/24/22 4:30:00 p.m.
  • Re: Bill 7 

They don’t like being faced with the truth.

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  • Aug/24/22 4:30:00 p.m.
  • Re: Bill 7 

Point of order, Speaker.

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  • Aug/24/22 4:30:00 p.m.
  • Re: Bill 7 

Order, the member from Renfrew. Thank you.

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  • Aug/24/22 4:40:00 p.m.
  • Re: Bill 7 

Thank you, Speaker, and thank you to the member opposite for her contribution to the debate. The members opposite, as a whole, have been saying to this government, “Do something about crowded emergency rooms and closing emergency rooms,” and yet when we added 3,500 new hospital beds, they opposed that. Then, when we said we were going to add another 3,000 hospital beds, they opposed that.

What I’d like to know is just how you expect people to be able to get into the hospitals if nobody is leaving the hospitals and you don’t want us to build any more beds.

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  • Aug/24/22 4:40:00 p.m.
  • Re: Bill 7 

I have a minute left, so I’ll make the most of it.

As I was saying, seniors in this province deserve dignity and they deserve respect. What this bill will do—again, it’s this “just trust us” approach with a government that has given us and Ontarians absolutely no reason to trust them. It’s going to target the most vulnerable among us.

I would urge the government once again to expand the opportunity for these folks to come and speak to you. Reach out to those people who are going to be most impacted. Listen to what they have to say. Do something to actually improve working conditions and pay for nurses and other front-line health care workers, because that will do more than anything that this bill will accomplish.

We have a responsibility to make sure that we don’t divide our most vulnerable residents from their families and from the care they deserve. I would encourage the government to take a second look and do something more positive with the opportunity they have here.

I spent two minutes talking about home care because that’s what seniors want: They would like to stay in their home, at least in my community, and I think, from speaking to seniors, across this province. So I would urge the member opposite to take a moment to really read this legislation and consider what’s not said here and what’s going to be determined in regulations because I think that is what is concerning to most Ontarians.

It’s a low bar to say that the only thing that this government has put in this legislation that they’re preventing is the actual physical restraint of individuals. But, unfortunately, it is a low bar, because what we think is going to happen is that people will be coerced using other means.

Our health care workers—the same people this government and these members stood up and proclaimed were heroes during the pandemic—have been hit hard with an arbitrary wage cap, while the cost of living is increasing for them, they’re living with PTSD from the experience of COVID, for goodness’ sake, and they’re overwhelmed, overworked.

We have a staffing crisis. If this government wants to actually do something to deal with the crisis in our hospitals right now, they would be addressing that. Repeal Bill 124.

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  • Aug/24/22 4:40:00 p.m.
  • Re: Bill 7 

I want to thank the member from Davenport for her passionate speech and for sharing with us exactly what many seniors in our province have gone through throughout the past couple of years, as well as the reality that we’ve had in this province and the deterioration in our long-term-care sector.

One of the things we’re noticing—and it’s clear from the member from Eglinton–Lawrence’s question—is that this bill doesn’t actually address the crisis we’re facing in long-term care or in health care in general. Rather, it’s just something they have put forward which takes away consent, takes away patients’ rights.

One of the things I think is important to highlight is that clearing ALC beds will not actually free up nurses or doctors. I would like the member to maybe add a little bit on why this government might be doing this. Does it actually do anything for our health care crisis or what’s happening in long-term care?

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  • Aug/24/22 4:40:00 p.m.
  • Re: Bill 7 

Ancaster–Dundas.

Why would this government treat our seniors so cruelly after all they have been through?

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  • Aug/24/22 4:40:00 p.m.
  • Re: Bill 7 

I think we can allow it to continue.

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  • Aug/24/22 4:40:00 p.m.
  • Re: Bill 7 

I’m sitting here very disappointed with what I have been hearing for the whole afternoon. I was hoping that the House leader would just call it off because we are not really debating.

This is an important bill, the More Beds, Better Care Act. I’m sitting here waiting for the debate, waiting for some good answers from the opposition. But from what I’m hearing, they are not focusing on the bill. We care for the seniors, but they’re talking about something else. Rather than focusing on long-term care, they’re talking about community care—which we care so much about and we definitely will want to work on that. That is not what we are debating and what we are discussing today.

The other thing too is, I’ve heard all the members giving different kinds of information that, “This is incorrect. This is incorrect.” They keep on bringing it back. That is not right—

Interjections.

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  • Aug/24/22 4:40:00 p.m.
  • Re: Bill 7 

Thank you. Pursuant to standing order 50(c), I’m required to interrupt the proceedings and announce that there have been six and a half hours of debate on the motion for second reading of this bill. This debate will therefore be deemed adjourned unless the government House leader directs the debate to continue.

I’ll remind the members that we’re in this debate. Can we just keep the room respectful and keep chatter down, please?

Response?

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  • Aug/24/22 4:50:00 p.m.
  • Re: Bill 7 

I really wish the member from Davenport had shown the same passion for the last 15 years when they were playing friendly matches with the Liberal government. They did nothing to improve the quality of health care and long-term care when they had the opportunity, for the last 15 years.

There’s no government in the history of this province that has invested more in health care and long-term care, Madam Speaker—unprecedented investments. If I talk about my community of Brampton, we got two new long-term-care homes, the long-term-care homes that community was demanding for many, many years: culture-based long-term-care homes. And who delivered this? This government delivered those long-term-care homes. So we are the government that will leave no stone unturned when it comes to improving the quality of health care and quality of long-term care.

My question to the member opposite is: Why, when given the opportunity to support this commitment, did the member opposite vote against it?

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  • Aug/24/22 4:50:00 p.m.
  • Re: Bill 7 

Thank you very much, Madam Speaker. I will say it’s an absolute pleasure to see you in the chair, and congratulations on your nomination as Acting Speaker.

This is exciting for me. It’s my first time to get up in the 43rd Parliament and take part in debate. It’s been, dare we say, an interesting afternoon here in the Ontario Legislature. I just want to congratulate everybody. Welcome back. To the folks who were re-elected multiple times here to this place, congratulations. And of course, to all the new members that are here—including yourself, Madam Speaker—welcome to the people’s House. I think it’s very important that we remember, truly, that it is the people’s House and that we really do try to work together and address concerns and all try to make the place we call home, the beautiful province of Ontario, a better place.

While we may not always agree, we can discuss our differences of opinion peacefully, and at the end of the day, we can go home safe to our families. I think that is something we often take for granted here in the province of Ontario.

Speaking of families, I want to thank my family for their support. I know that a few of them are actually watching right now, so: Hi, everyone back at home.

I look forward to, like I said, getting to know a lot more about your families, especially the new members here.

Interjection.

Let’s get into a bit of the reason we’re here today. I think, obviously, it’s important. I want to highlight a few things. I’m working on the kinder, gentler Mike Harris. I know it’s strange for a lot of people in this Legislature to hear those words come out of my mouth.

Interjection.

But I think today may not be the day for that, based on some of the conversation that I’ve heard. I want to spend a little portion of my remarks here highlighting, quite frankly, the lack of progress that the previous NDP-backed Liberal governments have done, and really, a lot of the different recommendations that have been brought forward that they have consistently ignored and have not acted upon. To contrast this, I’ll mention some of the ways our government is taking action to improve long-term care and health care overall across the province of Ontario.

Bill 7, of course, is the subject of the day, but legislation does not exist in a vacuum, Madam Speaker. We must note the context in which any piece of legislation exists, of course the broader history of the issues it seeks to address, and what other actions the government is taking to address the matter at hand.

It’s important to note that the More Beds, Better Care Act is one part of our plan to improve outcomes for patients and their families across this province. Our government has introduced its Plan to Stay Open: Health System Stability and Recovery, a five-point plan to provide the best care possible to patients and residents while ensuring the resources and supports are in place to keep the province and economy open. I think that’s very important, given what has happened over the last couple of years, Madam Speaker. The plan further bolsters Ontario’s health care workforce, expands innovative models of care and ensures hospital beds are there for patients when they need them. Finally, I will discuss what our government is doing specifically in my riding to improve long-term care.

Before we get into the nuts and bolts of this bill, I want to discuss some of the history behind this issue and how we got here. Unfortunately, we can look back several years and see warning signs that were ignored by the previous Liberal government. I would love to see them stand up and refute any of this in questions and comments today. I think it’s really important that they participate in debate here as well.

Let’s go back, roughly—well, here, let’s see—seven years ago. In 2015, Donna Rubin, the CEO of the Ontario Association of Non-Profit Homes and Services for Seniors, gave the following reaction to the Wynne Liberal government’s budget’s failure to increase the hours of care residents received: “Clearly, long-term care was far from a priority in this budget. It’s particularly disheartening because this is by no means a new need. This is the same target recommended in the government-commissioned Sharkey report”—which we’re going to refer to a couple of times here—“on long-term care” that goes back as far as 2008, “and that same report recommended that 4.0 hours of care be achieved by 2012.” Just to remind everybody, it’s now 2022. The target was right then and there, and it still applies.

Prior to our government’s investment to increase direct care, residents were receiving an average of two hours and 45 minutes of direct care from registered nurses, registered practical nurses and personal support workers. Direct care is hands-on care that includes personal care, such as helping with eating, bathing and dressing, as well as other important tasks like helping residents move around, maybe getting to the bathroom, and of course providing much-needed medication. Our government is investing $4.9 billion—I’ll say it again: $4.9 billion—over the next four years to increase direct resident care to an average of four hours a day by 2024-25 through the hiring of more than 27,000 new health professionals.

This year, our plan will see an investment of $673 million to provide three hours and 15 minutes of care per resident per day. In 2023-24, it will increase to $1.25 billion to increase that time of care to three hours and 42 minutes. And then, finally, by 2024-25, our plan will see an investment of $1.82 billion to bring direct care up to that standard of four hours a day that for so long, since 2008, has been recommended and still was not provided. This is actually, I think, really interesting too: Ontario is the first jurisdiction in Canada to commit to this standard-of-care legislation.

Speaker, you may have heard members on this side of the House refer to the Sharkey report before, which I previously mentioned. This report was commissioned by then-Premier Dalton McGuinty and his government. It included recommendations to boost standards of care to four hours per resident by 2012, and here we are in 2022. Obviously they did not get this done by 2012, nor did they get it done during the next decade—decade—that they were in power, which is truly shameful. The Liberals were well aware of these issues since 2008, and they were consistently ignored by the then McGuinty and Wynne governments.

In 2007, a Toronto Star article said the following: “Ontario needs minimum standards of care in nursing homes that give seniors the ‘dignity and respect’ they deserve.” That is a quote, if you can believe it, by then-Premier Dalton McGuinty. Then they were in power for another decade, and still did nothing. They did nothing about it. It certainly sounds good, but like I said, what actually happened: They didn’t introduce a single bill to legislate the standard of care during the next decade that they were in power.

Speaker, let’s go back a little bit further. A former Kitchener–Waterloo MPP and health minister, Elizabeth Witmer, took the McGuinty government to task over long-term care back in 2006. In this very Legislature, the former member called on the Liberals to address what she called “a growing crisis” in the lack of long-term-care beds. That member also highlighted another critical issue that the Minister of Long-Term Care was seeking to alleviate in this bill, and that is the pressure placed on hospitals by the lack of long-term-care beds. To put things in perspective, 2006 was the year a very new website called YouTube rose to popularity. I know that the member across the way, from Brampton, is very excited to hear what comes next. I’m not even sure—was he born at that point?

I want to quote Ms. Witmer here, because I think it’s very important:

“This shortage of beds is not only affecting the people waiting, but it is drastically affecting other areas of the health care system, especially hospitals, where many beds are filled with patients waiting for a bed in a long-term-care home. As a result, surgeries are being postponed or even cancelled and patients are waiting hours or days in emergency rooms because there is no bed for them in the hospital”—which, sadly, over the next decade, again, the Liberals ignored.

More than a decade later, hospitals in Ontario were still struggling to provide beds for incoming patients, due to the backlog of patients waiting for more appropriate long-term care. I’m going to read one more quote from the former member from Kitchener–Waterloo, and I would like to include just a quick snippet about the—at the time former Premier—everyone likes to bring him up, so we should bring him up again; I think he did a pretty good job—Mike Harris.

I think this is critical, and we mentioned this a little bit earlier. It’s critical to understand the parallel between the Bob Rae government, the then Conservative government, and then what happened with the Liberals and now what we see with this Conservative government. Quoting Elizabeth Witmer:

“It was our government”—this is speaking of the Conservative Harris government—“that added 20,000 long-term-care beds to the system because the Liberals and the NDP hadn’t built any”—Madam Speaker, zero. “It was our government that invested $1.2 billion in community care services and long-term-care beds.” So it is, unfortunately, a sad reality that the Liberal government failed to listen to countless calls for action to build enough long-term-care beds and raise the standard of care for Ontario’s aging population.

On this side of the House, we can stand behind our track record of getting it done after years of inaction of the Liberals and the NDP. We cleaned up the mess that was left by the Bob Rae government, and we will clean up the mess that was left for us by the McGuinty-Wynne Liberals.

Now, Speaker, we have heard speculation from the opposition about what this bill could mean for residents and their families. I would like to take a moment to address those questions. Here is a headline from an article that was on the front page of the Waterloo Chronicle’s website just yesterday: “No Ontario Hospital Patients Will Be Moved to Nursing Homes Without Consent, Long-Term Care Minister Says.”

This was the headline in the newspaper. I think it’s very, very important, because the opposition keeps bringing these things up when, quite frankly, the minister has been very clear. He is also quoted as saying, “It simply does not work unless we involve the families, unless we involve the patients ... it is the patients who will have the opportunity to grant final consent.” The article goes on to describe the backlog of senior patients in hospitals awaiting nursing home beds as a long-standing problem in Ontario known as the alternative-level-of-care beds—of course, ALC beds.

In fact, the article links to a Toronto Star story from 2017 with this headline: “Surge in Patients Forces Ontario Hospitals to Put Beds in ‘Unconventional Spaces.’” This article does a good job of explaining the issue that the bill seeks to alleviate. I’m just going to quote a little bit more from that article: “When ALC patients can’t be discharged, there are fewer beds available for those admitted to hospital from the emergency department. That makes for a particularly bad combination when there is a big influx of patients on that end....”

Keep in mind that this article, again, was written in 2017. A responsible government would have taken the appropriate steps to address this issue immediately. Instead, once again, Madam Speaker, the problem was ignored, leaving our health care system more vulnerable as we entered the pandemic in 2020.

We cannot and will not—I repeat, will not—make the mistakes of previous governments. That is why our government brought the House back this summer to make real progress on a problem that has existed for many years. With Bill 7, hospital discharge planners and long-term-care placement coordinators will be encouraged to engage with patients or substitute decision-makers to explain that a patient no longer requires hospital care and benefits from transitioning to a long-term-care home. Patients will only be admitted to a home that meets their care needs and is within a defined geographic distance from their preferred location and proximity to family, friends and loved ones.

In response to this bill, opposition members have raised concerns about the capacity of long-term-care homes. One would hope that those members will support us as we increase funding to long-term care to boost capacity by hiring more staff and building more beds. As we boost capacity we will be able to get more patients into the long-term care that they deserve instead of waiting sometimes several months in hospital beds.

The Minister of Long-Term Care has said that this will only work by involving patients and families. Not only will patients and families be involved in this process; long-term-care homes themselves will get a say as well. Bill 7 states that a licensee of a long-term-care home “must ... approve the ALC patient for admission as a resident of the home after reviewing the assessments and information provided by the placement co-ordinator, unless a condition for not approving the admission listed in subsection 51(7) is met.”

A subsection of the Providing More Care, Protecting Seniors and Building More Beds Act states that homes “shall approve the applicant’s admission to the home unless,

“(a) the home lacks the physical facilities necessary to meet the applicant’s care requirements;

“(b) the staff of the home lack the nursing expertise necessary to meet the applicant’s care requirements.”

So to make it clear, long-term-care homes will not be forced to accept patients if they cannot meet their individual care needs. I think that is another very important part of the bill that has been overlooked. Like I said, we’ll do this responsibly, with input from patients and their families, as well as medical experts, to deliver the care that seniors deserve, while ensuring there is space in our hospitals when it is needed. Ultimately, it will be the patients and their families who get to make the final decision.

Previously, patients would give their homes of preference to their health care providers, and they would simply wait for a space to open up in their specific preferred home, and would stay in hospital during that time. If spaces opened up in homes that were not on their list, the patient would continue to be in the hospital without being made aware of alternative options.

What we are proposing is to keep that work and that conversation going. We want to ensure that everyone has the option on the table, for patients waiting for more appropriate care. While they wait for their first-choice home to become available, why not let our patients know about other available spaces that they can receive care in until their preferred space becomes available? Again, the patient will remain in hospital if they refuse to be moved to an alternative space. This is simply about providing more options for patients while they wait for their preferred space to become available. If they would prefer to stay in hospital and wait for their top choice, they can. But they will be given every opportunity to move to an alternate space while they wait. Keeping that conversation going will lead to better outcomes for seniors all across Ontario.

Speaker, I’ll tell you, I’m proud to be part of a government that is improving care for our seniors by hiring more staff, delivering more beds and providing better care for the people of Kitchener–Conestoga. We are building 176 new beds and redeveloping 48 beds in Elmira. Derbecker’s Heritage House in St. Jacobs will receive 56 new and 72 redeveloped beds. Also in St. Jacobs, this means 160 brand new beds at a brand new peopleCare facility. In Kitchener, we’re building 80 new beds and redeveloping 240 beds at Forest Heights. Finally, in New Hamburg, Tri-County Mennonite Homes’ Nithview Community will receive 95 new beds and 97 redeveloped beds. And that is just in my riding alone. We are building more beds and providing better long-term care right across Waterloo region and, quite frankly, the entire province.

We’re hiring more nurses, more personal support workers and doctors. We’re building the first new medical school in Ontario in over 30 years, in Brampton, to train more doctors here at home. These are all key components of our plan to stabilize Ontario’s health care system, not just now but into the future.

As actions of this plan are implemented in the coming weeks and months, Ontarians can expect to see faster access to health care, including lower wait times in emergency departments, lower wait times for surgical procedures and more care options right there in their communities. The More Beds, Better Care Act is one component of our plan to address issues that have been developing for many years across the health care sector. We owe it to our seniors to provide appropriate care instead of leaving them in hospitals for months on end.

Our hard-working hospital staff do incredible work, from custodial staff to nurses to doctors, but a hospital is no place to live. For too long, a lack of capacity in Ontario’s long-term-care sector has placed an undue burden not only on our hospital system but also the patients waiting for appropriate care beds to become available.

As I have explained today, we inherited a system from the previous government that was aware of this issue but did nothing about it for decades, as our population ages. Ontarians have sent us back to this people’s House with a clear mandate and an even clearer mission, and I am happy to be able to stand up here and get it done for the people of Ontario.

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  • Aug/24/22 4:50:00 p.m.
  • Re: Bill 7 

Thank you so much to the member from Scarborough Southwest for that excellent question, and thank you for all you do for your community as well. I’m always hearing about the extraordinary work you’re doing there to serve folks from your community, many of whom are, I know, coming to you with the same issues and concerns about this legislation, about their family members, about the state of our health care system and long-term care. As you mentioned, one of the real issues here is the protection of patient rights.

But why is this government doing this? To save the for-profit long-term-care industry from financial ruin. That’s why they’re doing it. That would be my assumption. Again, I won’t, I can’t speak for them, but if you look at what’s going on in the industry right now—

Interjection: That’s imputing motive.

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  • Aug/24/22 4:50:00 p.m.
  • Re: Bill 7 

That is imputing—

Interjections.

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  • Aug/24/22 5:10:00 p.m.
  • Re: Bill 7 

Thank you to the member from Spadina–Fort York for the question. Listen, it’s important if we’re going to look back in history to understand that it’s really great that maybe the NDP government—and I will say again, the one and only time there has been an NDP government here in the province of Ontario—put those things into place, but quite frankly, they contributed to the problem that we have now. They developed no new spaces, and it has put us into a position where the Conservative government that followed that up had to scramble and try and do what they could to move that forward, in building 27,000 new beds and contributing $1.2 billion. At the time, that, quite frankly—and it still is a lot of money. So for that member to get up and say that we should be taking lessons from the NDP—I just don’t think it’s the case.

Interjection: What was that called?

Thank you very much to the member for raising that, because I think it is very important for people to understand, and, well, as we’ve seen, the caucus keeps shrinking on the other side of the House.

We need to build more long-term-care beds here in the province of Ontario. We also need to be able to free up as much space in our hospitals as possible, especially when we look at what—

Interjections.

If you’ll let me continue, when we look at we look at what’s happening across the province, we still have an opportunity to really bolster what we’re doing with our health care system. If we continue down the same path that we’ve continued down for the last 20-plus years, we’re going to end up having the same results. We need to be innovative. We need to make sure that we’re doing the best that we can for the people of Ontario, and this Doug Ford government will continue to do that every single day.

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  • Aug/24/22 5:10:00 p.m.
  • Re: Bill 7 

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

I just want to comment on the remarks from my friend from Kitchener–Conestoga—very thoughtful remarks, looking back into history.

We’ve just heard a member of the NDP talk about the legacy, from his eyes, on what the one NDP government was able to accomplish. But I know that the member from Kitchener–Conestoga would probably have his own version of the legacy that the NDP government of Bob Rae left on our province. I was just wondering maybe if he’d be interested in enlightening us with the real story behind Bob Rae and that government and the mess that they left for the Premier to fix back in those days.

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  • Aug/24/22 5:10:00 p.m.
  • Re: Bill 7 

Question?

The member from Davenport—thank you.

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  • Aug/24/22 5:10:00 p.m.
  • Re: Bill 7 

I appreciate the comments from the member for Kitchener–Conestoga. But his history is selective, because the NDP government—the last time we were in power, we actually brought in a seniors’ bill of rights, we brought in mandated residents’ councils in all long-term-care homes to represent the rights of residents, and we also mandated hours of care and also inspections. The Conservative government that came in in 1995 stripped all of that away, including the seniors’ bill of rights.

This bill goes even further. This bill is about “without consent.” It uses the term “without consent” six times, and it has a list. Some 20% of the text of this bill is a list of 13 items or things that this government is empowering people to do without the consent of the resident seniors. So will this member admit that his government is not at all interested in protecting the rights of seniors in long-term-care homes?

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  • Aug/24/22 5:10:00 p.m.
  • Re: Bill 7 

I’ve been listening to the member from Kitchener–Conestoga’s comments. The member wants the official opposition to support this legislation. Earlier today, the interim leader of the official opposition asked the Minister of Long-Term Care in this place if he would ban hospitals from billing for hospital beds for people who continue to stay there. And the member opposite talked about if people prefer to stay, they won’t—the long-term-care minister refused to answer that question. It was very notable.

Afterwards, in scrums—and I want to just share this with everybody here, because it’s coming out in the news reports as we sit here—the minister has been quoted as saying now, “If they refuse to move into their home of preferred choice, then yes, absolutely,” the hospital will charge them, “because we need those spaces for patients who need acute care.” The Minister of Long-Term Care has confirmed that those patients will be billed if they don’t take the spaces that are immediately offered to them. I’d like to know the member’s response. Please, give me a reason to support this terrible piece of legislation.

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