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?

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—

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.

Again to the Premier: The government is giving itself the power to sign people up to long-term-care homes they don’t want to go to. If they refuse, they could be slapped with a huge tab, like Jon Suter and his family.

To prevent seniors from being coerced into long-term-care homes against their will, will this government ban billing for hospital beds?

Dr. Vivian Stamatopoulos says she’s already hearing from families being threatened with high fees for their hospital stay.

Jane Meadus, a lawyer for the Advocacy Centre for the Elderly, says they get hundreds of these calls from families.

The government’s new legislation lets them send your information to a care home without your consent. They can sign you up for that care home without your consent. If you refuse to go, they have the power to use massive bed bills to force Grandma to get in that cab.

I ask again, will this government ban billing for hospital beds?

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—

That question is completely contrary to the question he just asked before.

What he is admitting, and what his party is admitting, is that there has been a tool in the tool box for decades in this province.

But what he doesn’t want to talk about is the fact that, because of the investments that we have made in long-term care, the investments that this Premier and this government and this cabinet and this caucus have made in every part of this province, we are able to be part of a solution to the acute-care bed shortage that has existed in this province for decades. We are talking about making 2,500 additional beds available. We are talking about better quality of care for people who are actually waiting for long-term care. Experts agree, doctors agree, hospital administrators agree that the best place for you to get the care you need if you’re waiting for a long-term-care bed is in a long-term-care home. That’s why we are providing millions of dollars in support to make the system even better. They voted against all of that. But we will not stop improving the system.

Thank you for that question. I will say I don’t think the long-term care in my riding is very pretty. I think they could have done a lot better with regard to the outside creation of that building. But we do have an additional 320 beds for our Lakeridge Gardens long-term care. We have both private and semi-private rooms that are very important to members within my community, to be able to have what is no longer ward-type settings with four beds in a room. We have had a really good response to it in my riding. The people in Ajax are extremely excited about it coming in.

I know we have our Bomb Girl. I spoke about her before. She’s 100 years old and she couldn’t wait to get her room in that long-term care. We have done everything with regard to getting her in and settled.

It has been a very impactful piece in our community, to have that long-term care. We’ve also had investments to redevelop other beds within Ajax as well. It’s been fantastic having that built and it has made a really big impact within our community.

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?

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.

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.

Again to the member: One of the things that we saw during the previous 15 years was that no beds were built across the province of Ontario—some 611—with the support of the NDP. How has that contributed to the challenges that we’re facing in acute care in the province of Ontario?

That’s a great question. I think that’s really what the crux of this bill does. When we look at what’s happened over the last couple of years with the COVID-19 pandemic, it’s really, really highlighted some of the issues that we have in our health care system here in the province of Ontario. And a lot of that revolves around alternate-level-of care, or ALC, beds. We need to be able to make sure that people that are using those beds and taking up those spaces are there for the right reasons. If there’s an opportunity to make sure, or allow, those people to move out into a long-term-care home—or perhaps it could be community care. It could be all kinds of things, colleagues. We’ve made some significant investments into the broader health care system. We’ve got a great program working with paramedics in Waterloo region.

Thank you to the Minister of Health and thank you to the Minister of Long-Term Care for really taking the bull by the horns and making sure that we’re able to bolster a very strained health care system here in the province of Ontario.

Again, thank you to the Minister of Long-Term Care for really realizing that there is work that can be done, and I’m very excited to see these things go forward.

Thank you, Speaker, and congratulations on your appointment to the chair.

I just want to thank my colleague from Kitchener–Conestoga for those wise words that we heard today, going back in time. We all have parents who are aging, or are at the age that our parents are aging, and you want to make sure that they have that care as they grow older and they have a place to go that is secure, that is safe. Because it’s about compassion, as we’ve said. We want to take care of our seniors and we want to make sure that they’re looked after. So I thank them.

But I want to thank the Minister of Long-Term Care for the 256 brand new beds that we’re getting in Etobicoke–Lakeshore. I know that the member for Kitchener–Conestoga mentioned the new long-term-care beds in his community, and I know, all across this province, we have all received long-term-care beds under the Doug Ford government, not under the previous government, propped up by the NDP. Zero beds were put in Etobicoke–Lakeshore. Zero beds were put in Etobicoke altogether. Very few beds were built across this province. It’s this government that got it done.

My question to the member of Kitchener–Conestoga is, how will Bill 7 play a role in supporting Ontario’s broader health care plan?

I want to thank the member for her question, because it allows me to share another bit that I didn’t have enough time to, which is that when we talk about freeing up beds, when we talk about freeing about the ability for staffing, when we talk about clearing ALC beds, this legislation actually does not free up nurses and specialized staff.

We need to talk a little bit about the types of alternate care and, when people in the hospital are in this situation, what kind of care they receive. In long-term-care homes, for example, will that actually allow for nurses and PSWs to be freed up?

And the fact that we need thousands—Speaker, thousands—of PSWs and nurses: One of the things that we could have done is to allow for internationally trained professionals and so many others who want to be nurses and PSWs in this province to become certified, and allow them to be paid better. Repeal Bill 124, so that we can retain and recruit more health care workers in our province.

If we walk back a little bit and actually talk about what happens when someone ends up in the hospital—first, no one ever wants to go to a hospital. You’re not going to a fancy hotel to stay. Let’s be clear; let’s be honest: You’re ill. You’re not well.

I have so many seniors and I know so many people who don’t want to go to the hospital even when they’re not well, especially in the crisis that we’re facing right now. So the fact that these people, when they refuse, for example, to go to the designated long-term-care home—if they refuse, then they will be charged. There is a financial hammer on this, and that means that people will feel that financial coercion in order to go to that long-term-care home.

So one of the things I would urge this member, as well as all the other members in the government—if you really care about Scarborough, show us. Come to Scarborough and provide the funding that we need, because our hospitals are some of the oldest hospitals in the province.

I will not be heckled about that.

Our hospitals are some of the oldest hospitals. They need to be repaired.

Interjections.

There are a lot of things that we can anticipate happening. There are a lot of advocates across the province who have been really worried about this.

I think this will answer your question. One of the quotes that I can share is from the Advocacy Centre for the Elderly. This is what they said: “We oppose today’s proposed amendments to the FLTCA revoking the right of seniors in hospital to consent to LTC which will result in them being moved far from supportive family & community, again attempting to ‘fix’ health care to the detriment of seniors. #RightsDontAge.”

Speaker, that’s what will end up happening. So many people will lose their support, will lose their community and their family because they will be forced to go to a home that may not be up to par with what they need or the care that’s necessary. Most of the beds that are empty and people don’t want to go to them—it’s because they don’t have that quality that’s necessary.