Unfortunately, I was not here to be able to hear the members speak to this portion of the debate. But on this side of the House, we have real questions and concerns about this bill. So a question that I asked to the minister yesterday, I will put back to the members who did have the opportunity to speak to this bill yesterday.

We’re greatly concerned about patients being charged when they refuse to leave the hospital and go to long-term care or to be sent home. This is something that I know I’ve heard in my office for years has been happening. This bill will definitely seem to seal the deal to allow hospitals to charge an uninsured amount to patients. Could the member answer what his government is doing to ensure that that does not happen to patients going forward?

What I said in my question is that, for years, patients have been charged and threatened to be charged—so that is existing legislation. Where in this bill does it protect patients going forward? The hospitals are going to have the ability to move ahead, to push people out of hospital into long-term care, particularly when they’re not wanting to be there. And if they’re refusing to do so, what is going to happen? Did the government think to put a protection in this bill to make sure that patients wouldn’t be charged any further?

I would appreciate a reasonable answer from this member instead of just throwing stones back on this side. Let’s talk—

Good morning. Let us pray.

Prayers.

Resuming the debate adjourned on August 23, 2022, on the motion for second reading of the following bill:

Bill 7, An Act to amend the Fixing Long-Term Care Act, 2021 with respect to patients requiring an alternate level of care and other matters and to make a consequential amendment to the Health Care Consent Act, 1996 / Projet de loi 7, Loi modifiant la Loi de 2021 sur le redressement des soins de longue durée en ce qui concerne les patients ayant besoin d’un niveau de soins différent et d’autres questions et apportant une modification corrélative à la Loi de 1996 sur le consentement aux soins de santé.

The member for Hamilton Mountain.

It was interesting to hear the member for Niagara Falls talk about reading the bill, colleagues. He started off last week saying that we were going to move people into ward rooms. That was not correct. Then he switched it over to, we’re going to be moving people without their consent. That was incorrect. Then he said that hospitals were going to be discharging people again and moving them hundreds of miles away. That was incorrect.

Now they’ve trotted out a policy that has existed in the province of Ontario since 1979—and one of the previous governments to actually increase that rate was the Bob Rae government, the NDP government. The reason I think the member is having trouble finding that in this bill is because it’s actually not in the bill.

More importantly, I wonder if the member could expand on his earlier comment about how a policy like this, working with patients, actually improves the quality of care, to get the service where it is best for the patient, as opposed to what the NDP thinks.

I really want to thank the minister for that question.

I think we all should really thank the minister for the outstanding work that he has been doing on this file. When you look at the work that’s being done in reducing wait-lists and ensuring that patients—

Interjections.

It really is unfortunate that the members opposite don’t want to listen and they don’t want to read and they don’t want to understand that the work we are doing has helped so many people in our province. One only need look at the makeup of this room after June 2, 2022, and it’s evident that we are helping so many in our communities across all of Ontario, and the people of this province are seeing the results, are appreciating that response and responding in turn.

I look forward to being able to speak a little further in the next opportunity here about the outstanding work that we are doing.

We know that under this Conservative watch, close to 5,000 seniors—parents, grandparents, mothers-in-law, fathers-in-law—died in long-term care. Most died in for-profit homes. Forty seniors died just in the last two weeks alone. Knowing this, do you feel it’s okay to give medical information of patients, seniors, to long-term-care providers without consent?

I want to thank the member for her address this morning.

I’ve been here for nearly 19 years, and this is probably the most egregious example of NDP fearmongering since I’ve been here.

Since I’ve been here, ALC patients have been a huge problem in this province. We’ve got our vulnerable seniors in a place where they shouldn’t be, but no capacity was built in long-term-care homes to accommodate those seniors who would be best cared for in a long-term-care home.

This government has acted expeditiously and quickly, since the election, to bring in the proper legislation so we can actually move those patients to a home—

Interjections.

And now we have the NDP inventing all kinds of voodoo scenarios that do not exist.

So I do ask the member, could you please stick to what the bill actually says? No one will be going to a home that they’re not consenting to. Stop with the fearmongering—

I don’t think there’s any question that hospitals, alternate-level-of-care beds, are not the greatest place for people to be, but neither is a long-term-care home that is not of the patient’s choosing—a long-term-care home that likely has availability because no one wants to go there. We all know of those long-term-care homes that became notorious during COVID-19 because of their abject failure to protect the residents who lived in those homes.

Unless this bill is accompanied by a huge effort to improve PSW wages, to make those jobs good jobs, to improve supports for seniors in long-term-care homes, moving vulnerable people from one situation of crisis in a hospital to another situation of crisis in a long-term-care home will do nothing to solve the problem.

Clearly, I do not think it is okay to allow the provision of personal health information to any entity without the consent of the person whose information is being shared.

I did want to comment on the fact that private sector long-term-care homes are very likely to be the biggest beneficiaries of this bill, because many of the long-term-care homes that have the shortest waiting lists, that will be able to accommodate these alternate-level-of-care patients, are those private sector homes that other people don’t want to go to. They are the homes that were exposed as having the worst protections in place for seniors during COVID-19.

Yesterday, the Toronto Star editorial board wrote in support of Bill 7:

“Earlier this year, the Ontario Hospital Association estimated there were 5,800 patients waiting in hospital beds for what is known as ‘alternate levels of care.’

“The consequences of such hospital stays ripple through the system and impact others seeking care. With beds occupied, other patients can’t be admitted and emergency rooms back up.”

“Hospitals are not the ideal location for such patients. They don’t require the intensive medical care hospitals are meant to provide. Nor do they receive the variety of supportive programs offered at long-term-care facilities designed specifically for seniors.”

I’d like to give the member an opportunity to comment on the Toronto Star editorial.

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?

It’s great to be able to take part in debate here today and in questions and comments.

While I do have a great working relationship with the member from Guelph, I do have a few concerns with what he has brought up here today, when we talk about this bill going to committee or some of the different provisions of the bill.

Again, as part of the kinder, gentler Mike Harris that we’re all experiencing here in the 43rd Parliament, I want to give the member an opportunity to share some solutions, rather than just trying to carve up the problems. Let’s hear some solutions. What can we do to get ALC patients out of hospital? How can we move forward with making sure that those people are still looked after in the way they need to be here in Ontario?

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.

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.

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.

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.

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—

The changes that we are making in the more beds, more choice act are very clear: We are trying to ensure that people can get into long-term-care homes where the quality of care is better for them, full stop. I don’t think anybody disagrees that when somebody is in hospital and they’ve been discharged from the hospital, the better quality of care for them—where we can give them better services, where they can be closer to their family—is in a long-term-care home.

The member opposite references a tool that has been in the tool box for hospitals since 1979.

Ultimately, what we are trying to do, the changes we are suggesting and, hopefully, that this Legislature will pass will help us deal with the challenges of acute care; will help residents, like the one she is talking about, get a better quality of care in homes and communities close to their homes, while leaving them on the waiting list for their preferred choice. Doctors agree with this; hospital administrators agree with this, and I hope the opposition does—

What are we actually trying to do? What we’re trying to do is give people who are in acute care in hospitals who are waiting for long-term-care beds more options. We know—experts agree, doctors agree, hospital administrators agree—that the best place for somebody who’s waiting for a long-term-care bed is in a long-term-care home. It is about providing better services, better quality of services for a person waiting for long-term care. That is why we are providing for additional resources so that somebody doesn’t have to be transported back and forth, whether they need kidney dialysis—Behavioural Supports Ontario is getting more resources.

I hope the opposition will join with us, help us. Ontario’s long-term-care system can be part of the solution of the acute-care problem in this province that has existed for decades. Join with us, because it’s better for the patients and it’s better for—

As part of the delegations at the Association of Municipalities of Ontario meetings last week, I actually met with the Guelph-Wellington organization to talk very specifically about their paramedic service.

There is no doubt that our paramedics are doing exceptional work in community, which is why we have announced, as part of our investments, to expand the community paramedics program, because we see it as an opportunity for, first and foremost, making sure that people get the care they need in their own homes, when it is appropriate. Frankly, it also allows us to ensure that when those paramedics get those emergency calls and need the ambulances, they are available to ensure that they get to the emergency departments quickly and get that service.

The hugely successful 911 models of care: Patients are being diverted from emergency departments through these models and receive the care they need 17 times faster. The satisfaction rate is in the 90s. And 94% of the individuals who are served through these models of care are not, in fact, going to emergency.

These innovations are working. These opportunities to work with all partners, again, whether they’re in hospital, long-term care, in community or through our paramedics, are making our system smoother and better.

We have, of course, as a government, already added 400 additional physicians who are working in remote and northern communities and ensuring that they have the coverage they need.

We have launched a new provincial emergency department program. It’s a peer-to-peer program that provides additional on-demand, real-time support and coaching from experienced emergency physicians to aid in the management of patients presenting to rural emergency departments.

If the member opposite has an innovation or an idea that he would like to bring forward, I am happy to look at and review those.

Those expansions are exactly what we are looking for and we are funding through historic announcements that we’ve been making at AMO and across Ontario.

I was working as recently as yesterday with the federal, provincial and territorial ministers to make sure that what we do across Canada is helping everyone.

And we’re going to work with our federal government to make sure that we expedite the process for foreign-trained, professionally educated individuals to practise in the province of Ontario.

Back to the Premier: This issue is not unique to Guelph. In London, OPSEU 147 reports that 30% of paramedics are looking to leave the field as soon as possible. They face dangerous understaffing and ever-increasing hospital off-load delays, and they run out of ambulances every day.

Communities across Ontario are worried, terrified, about not having access to emergency medical services. ERs are flooded with patients. So why is this government taking resources away from our public hospitals?

My question is to the Premier.

Charles de Lint is a famous writer back in Ottawa. MaryAnn, Charles’s partner, was his first reader, his editor and his business manager. She has always been there offering Charles crucial support. But MaryAnn has been in the hospital since September 6, 2021. She contracted a rare disease and is now intubated, living on a ventilator, and has very limited movement. In order to make a full recovery, MaryAnn will need more therapy and more time in the hospital—more than our system at the moment can provide. So her family and friends have launched a GoFundMe in the hopes of raising money for her long-term medical care.

Can the Premier guarantee that MaryAnn and her family will never be billed for her hospital bed? Or will GoFundMe campaigns become the norm for rare disease patients in Ontario?

Charles and MaryAnn are incredible artists. Both of them have given this province gift after gift after gift. But they can’t afford the private treatments that MaryAnn needs right now; frankly, in Canada, you shouldn’t have to. Their friends have launched a GoFundMe campaign.

Is that what Ontario has become for patients with rare diseases? Has our Ministry of Health become a ministry of fend-for-yourself?

I’d like to thank the member for her presentation. As you’ve heard throughout this debate, New Democrats are quite concerned about fees being charged to patients who are not able to leave the hospital, who are refusing to take the transfer into long-term care. It’s something that’s been happening historically, as we know, but the government did nothing to reverse that, and yet is putting more pressure on people to have to move to a long-term care that is not of their consent.

Has the member heard from her constituents in this regard, because it clearly is a big deal throughout all of our constituency offices and has been for some time. How would she deal with that when it comes to her office and her constituents?