Nobody believes it anymore.

It was Mike Harris who also opened the door to privatization of our long-term-care homes. More than 50% of every long-term-care bed in Ontario is privatized. What does that mean? That means that shareholders make millions of dollars on the backs of frail, elderly people. We have just gone through a pandemic. Would anybody in this House believe that the private long-term-care homes do things better, faster, cheaper than the not-for-profit, than the homes for the aged? Nobody believes that.

The statistics are there; the statistics speak for themselves: There were twice as many deaths in private for-profit long-term-care homes during COVID than there were in not-for-profit. There were three times as many deaths in private for-profit long-term-care homes than there were in homes for the aged, which are managed by municipalities. Those sad statistics speak for themselves. The quality of care is directly linked to the fact that they are not-for-profit, that every dollar that they get goes to the bedside, as opposed to the $300 million that was paid by the biggest chain of long-term-care homes in the first three months of the pandemic. In the first three months of the pandemic, they got $280 million in government subsidies to help them face the pandemic, and they paid their shareholders $300 million during that same period of time. That’s not quality care. That is the private sector gouging frail, elderly people.

What we have here with the More Beds, Better Care Act—the idea behind more beds is good. The idea behind better care is good. To take away your right to consent so that you can take someone out of a hospital and put them in a long-term-care home not of their choosing? That’s not respect. That’s not right. Whether you are frail and elderly, whether you have cognitive impairment, you are still a human being. There are still people who love you, who care about you, who want to be near you. None of that is taken into account in this bill.

I see that I only have a few minutes.

The bill goes on to say, “Certain limitations apply. The actions cannot be performed without first making reasonable efforts to obtain the patient’s consent.” Again, what is “reasonable effort” is not defined in the bill and could be interpreted in many different ways. When you have an emergency room with 30 patients who need to be admitted and you have no beds and nowhere to place them, the pressure on people to leave the hospital is tremendous.

I want to remind everyone, though, that most people who get admitted through our ERs—our emergency rooms—are really sick. They will need the care of specialist physicians, they will need the care of specialist nurses to be able to regain their health.

Most people who have been labelled as ALC will be put in a part of the hospital that is staffed mainly by PSWs—personal support workers—and registered practical nurses. They are the ones with the right set of skills to meet the needs of the people labelled as ALC, who meet the criteria for ALC. So even if you free up what is called an ALC bed in our hospitals, that certainly does not mean that you will have the right amount of trained nurses in place to take on the extra load or that you will have the right amount of physicians in place to take on the extra load—not to mention the staffing crisis in our long-term-care homes.

No matter where they are, in every part of our province, long-term-care homes are having staffing issues. Many long-term-care homes are not able to take more patients, but remember, the new bill will require the long-term-care home to admit the patient to the home. They won’t have a choice. It is in the bill. They will have to admit them whether they have the staff to do this or not.

The crisis in our long-term-care system has been there for a long time. There are solutions that should be implemented right now. The number one solution that everybody knows would make a huge difference is for this government to mandate a minimum of 70 permanent, full-time jobs, well paid, with benefits, with sick days, with a pension plan and with a workload that a human being can handle. There are thousands of PSWs right now in every part of our province who would love to go back to do what they do well. They are good at taking care of the frail, elderly patients in our long-term-care homes, but if they do this as a part-time job, sitting by the phone, they cannot pay their rent and feed their kids. So they leave the sector so that they can go work at another part-time job that would allow them to pay the rent and feed their kids.

Why don’t we make PSW a career? Why don’t we give them permanent, full-time jobs with decent pay, with benefits, with sick days, and give them the respect that they deserve? These women—because the great majority are women—deserve to be respected. Do that.

Same thing with our hospitals: To free up an ALC bed in a hospital does not mean that we will have the staff to look after whoever gets admitted into that bed, because remember, the person who was there before was cared for by a PSW and an RPN. If you’re admitted through the emergency room, you are sick enough that you will need a physician, an RN and specialized care. Where will those people come from when we see every weekend there are emergency rooms that close, parts of our hospitals that close because we haven’t got enough health human resources?

Why don’t we give those health human resources a little bit of respect? I tabled a bill today that has to do with violence and harassment in the workplace. Why don’t we pass that bill? Because if you have worked really hard for the last two and a half years in health care and you are completely burnt out, and you go to work—and 1 in 2 have an incident of violence or harassment at work—and you are one of the 1 in 2 who gets violence or harassment at work, there’s a good chance you will walk away from a profession that you love and a profession that you are good at. Because in order to care for others, you have to care for yourself. This is where nurses are at.

There are things that you could do right now that would help with the health human resources crisis. Repeal Bill 124. Show respect to our health care workers. Pass the bill from my colleague about internationally trained physicians and nurses. There is lots that can be done. None of that is in that bill.

The bill wants more beds in our hospitals and better care in our long-term-care homes, but all this does is take away the right of people to consent to what is done to them, to consent to share their personal health information. I cannot stand for this and I will never stand for that.

I’m glad that the member opened up saying that we have huge challenges in our health care system. I fully agree with you. We do have huge challenges in our health care system.

The clinical assessment requires access to your personal information. For anybody to do an assessment of you, you have to give consent, but in the bill, the bill takes away the hospital patients’ right to say whether they want this assessment or not. The bill takes that away.

When it comes to sharing personal information, the assessments that are done before you can be transferred are quite thorough. Not only do they look at your activities of daily living, they also look at your cognitive function, they look at all of your sicknesses, they look at all of the medications you take. This is all personal health information that you have to give consent to share. The consent has been taken away in that bill. That personal information will be shared with the long-term-care home without your consent.

If you have cognitive impairment and cannot give consent, the health care system usually goes to the power of attorney, who would give consent on your behalf, but the bill is explicit that both the patients themselves or the power of attorney do not need to give consent. That right is taken away from you. They will do the assessment whether you consent to it or not.

Questions and answers?

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

Meanwhile, the member for Nickel Belt and the NDP appear content to sit back and oppose these actions, or do nothing, much like they were content to sit back and do nothing from 2011 to 2014 and onward to 2018 as the Liberal government, propped up by the NDP for three of those years, built only 611 net new beds while the population of Ontarians aged 75 and older grew by over 176,000.

My question is simply this: Why are the member from Nickel Belt and her colleagues in the official opposition content to sit back and do nothing when action is clearly needed?

A lot of the conversation has been about consent, but I want to raise the issue of informed consent. It’s estimated that up to 90% of people living in long-term-care homes may be facing some sort of cognitive impairment. Do you feel satisfied that this government can ensure that residents in long-term care who are being moved are actually doing so with true informed consent?

Thank you to the member opposite for the description of all the huge challenges this government has inherited and that have been compounded because of COVID-19.

Assessments are required. These aren’t clinical assessments; it’s not the medical record being shared. It’s an assessment to determine the needs in long-term care and whether long-term care is appropriate. Parameters are in place. Consent is required for movement. Proximity to a preferred home is required. Care needs to be met are required, if needed—for example, behavioural supports. And also, they remain in the queue. They maintain their priority for their preferred home.

Why would you leave someone in a hospital setting inappropriate for their care and not move them to a long-term-care home appropriate for their care?

I’d like to commend the member for Nickel Belt for her heart and passion in this debate. But I do believe that the minister provided a suitable response to the premise of the objection expressed.

My question is this—since the beginning of the COVID-19 pandemic, our government’s followed the expert advice of the Chief Medical Officer of Health. That has not changed here. Basically on the advice of Dr. Moore, we are taking immediate action today, just as many of my constituents have been asking for, to further 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, this should free up approximately 300 beds for people on the wait-list to safely move into with the potential of 1,000 more beds available within six months.

Does the member opposite respect the advice of the Chief Medical Officer of Health to follow through with this plan to ensure Ontarians can receive the right care in the right place?

I agree with you that action is needed, and I agree with you that our health care system is under immense pressure. What 90% of the frail, elderly people in Ontario want is that they want to stay home. Support them at home so they don’t end up in our hospitals, they don’t end up ALC and they don’t end up needing a long-term-care home.

How do you do this? You fix our home care system. How do you fix our home care system? You give PSWs permanent, full-time jobs with decent pay, with benefits, with sick days, maybe with a pension plan and a workload that a human being can handle.

There are many, many PSWs who would love to go back and provide home care if they could make a living out of this, but they can’t. There are solutions that exist right here in Ontario with the resources we have, but taking away a person’s ability to consent is not something I can support.

What will happen is clear. A whole bunch of frail, elderly people will be taken from our hospitals and put into a long-term-care home that is not of their choosing. Once they are there, they will not have their circle of care to be there because it will be too far, because it’s not the right language, it’s not the right culture. They will feel abandoned; they will feel disrespected. When you’re frail and elderly enough to qualify for long-term care and you get depressed, things go bad really quickly.

They were about 2,000 beds that were set aside for isolation, so when you get admitted into a long-term-care home, they did not want to take any risks; they put you in isolation for 14 days, so that if you had COVID, you didn’t spread it. Some of those beds will be put back into circulation—300 of them by the end of the summer; that’s what I hear; 1,000 of them this year, depending on how the pandemic goes.

Absolutely, I have no problem with people going to the long-term-care home of their choosing. I have a problem with taking away the right to consent to be assessed and the right to consent to share information. I cannot support anything like that.

Member for Toronto Centre.

My question to our member here is specifically with respect to the comments she raised. Clearly, this plan was being developed even prior to the election, but unfortunately I don’t think we actually heard much about this plan during the election. So I’m just very curious, considering this government’s record, especially when it comes to private long-term-care facilities, contracting out and deregulation, what does this member foresee happening in the future, should the bill go ahead without any substantial amendments or improvements?

I recognize the member from Mississauga Centre.

I thank the member for Mississauga–Lakeshore for sharing his time today. I am very glad that he mentioned the accelerated build on Speakman Drive. This is a project that all six Mississauga MPPs are very proud to support. The member and I are working very hard to ensure that, for the very first time in the region of Peel, there will be some long-term-care beds available to also service our francophone population.

It is indeed an honour to rise today and speak to Bill 7, More Beds, Better Care Act. I would like to take this opportunity to congratulate the Minister of Long-Term Care on the work that he has been doing since taking over this portfolio.

Before I dive into this bill as well as speak to our five-pillar plan to stay open, I would like to lay down some context and highlight some of the tremendous and unprecedented work and investments we have made in long-term care during our first mandate.

The Fixing Long-Term Care Act instilled four hours of direct patient care per resident per day, leading the country in legislating such high standards of care. This is an increase from 2.75 hours, on average, to four hours—an increase of 42%. Conversely, the previous Liberal government increased the direct care to residents by only 21 minutes from 2009 to 2018—an increase of only 12% over nine years, or about two minutes per year. Speaker, two minutes per year. I think you and I can both agree that our residents deserve much better.

We are also hiring 27,000 more health care workers into the system to live up to this four hours of care standard. We will do this over time, of course, in tranches, by investing $270 million last fiscal year, $673 million this fiscal year, $1.25 billion in 2023-24 and $1.82 billion in 2024-25.

We are also offering free education to 16,000 PSWs, who have taken these courses and are starting to enter the workforce currently. We have made the PSW wage increase permanent, from $15 to $18.

We have also committed to building 30,000 long-term-care beds over 10 years through accelerated build projects such as the one on Speakman Drive in Mississauga.

And we have committed ourselves to linguistically and culturally appropriate care, some examples of which include the Muslim Welfare Centre we recently announced with our members in Mississauga, as well as the Coptic home in Mississauga, through Virgin Mary and St. Athanasius church, which will provide for the first time in the history of Ontario long-term-care services available in the Arabic language.

I’m also, of course, very, very proud of our francophone strategy, which we announced last year, which saw 777 new and renovated beds for our Franco-Ontarian population. For the very first time in Ontario, we are building a francophone long-term-care home right here in Toronto, with 256 projected beds. These underserviced and equity-seeking populations will now, for the first time, have access to care, here in Toronto—par et pour les francophones.

An example of this incredible work is the Foyer Richelieu. I had the opportunity, recently, to meet with the mayor of Welland, Frank Campion, to discuss the incredible projects that are happening there under the leadership of Foyer Richelieu and Mr. Sean Keays.

All of these actions taken by our government are not just lip service. Let me speak a little bit about what these actions mean on a practical, human level.

I never had the opportunity to work in long-term care; however, I did work at the Bickle site of the Toronto rehabilitation centre as a nursing student, where the staffing and care models resemble long-term care. Residents were staying there for a prolonged period of time to seek complex continuing care and geriatric rehabilitation and dialysis. A team of nurses, nurse practitioners and PSWs were taking care of residents to overcome challenges of disability, injury, illness or age-related conditions, to live active, healthier and more independent lives. I was happy to be an addition to this team as a nursing student, to help these patients get better, to be able to hopefully transition safely back home from patients to residents.

Due to limited time, I remember rushing with my preceptor through the morning routine, which began at 7:30 a.m. with a report from the night shift, ensuring that all of our patients are bathed, changed, have gone to the bathroom and set up in their chair for breakfast. Next was the race through breakfast. Mrs. Jones needed her toast to be buttered and cut into small pieces, and orange juice to be opened within arm’s reach. Mr. Smith was getting total parenteral nutrition and needed his pump primed and bag hung and run properly. Mrs. Brown needed to be fed under supervision from start to finish to avoid any choking hazards, and so on until all of our patients were fed.

Next came medication time—the dreaded 10 a.m. rush. Racing against the clock, first pulling all of our medications from the med stations for all of our patients at the same time, ensuring no med errors were made, then crushing the pills that needed to be crushed, again for swallowing ease, then pulling our injections like insulin and doing point-of-care sugar tests, and finally making the rounds with all of these medications prepped in our cart, ensuring we administered the right medication to the right patient, at the right time, at the right dose, through the right route. Then came our mobilization activities, which included fitness, rehabilitation, occupational therapy or cognitive activities, getting each patient ready and transferred to the right room. We are now at about 11:30 a.m., and my preceptor and I are sweating from all the running around, without having had the chance to take a coffee break or go to the bathroom or simply to pause and take a breath.

Speaker, why am I painting this picture? Because I strongly believe that had we had, back then, four hours of direct, hands-on care per resident, which would mean more staff—on average 25 more PSWs, 12 more RPNs, or six more RNs per home of 160 residents—we would have had the ability to spend more time with each resident, giving them the dignity and, at the most simple humanistic level, more time to chat about their grandchildren, to bring them their favourite flavour of pudding or take five minutes to play cards or board games. To these seniors, it is the smallest things that make the most difference, like asking them what flavour of pudding they like, and giving them that small level of autonomy to decide for themselves. And I truly and wholeheartedly believe that the Fixing Long-Term Care Act will allow that extra time for health care providers to turn patients to residents and facilities into homes.

Speaker, with my remaining time I would like to address some of the pillars of Bill 7, More Beds, Better Care Act, 2022. The bill, if passed, will enable the transition of patients who no longer require treatment in hospital into long-term care. Currently there are almost 5,000 alternate-level-of-care patients, with about 39% of them waiting for long-term care—5,000 patients, Speaker. That is the equivalent of 11 large community hospitals. This is a staggering number. To ease off the pressures of our emergency rooms and acute care and patient units, and to allow for surgeries to go back to pre-pandemic levels, we simply must make the room. The status quo will simply no longer be acceptable.

You know, Speaker, I’m having trouble understanding the members opposite. On one hand, they are sounding the alarm on the health care crisis with long wait times in the ERs, long wait-lists to access surgeries and diagnostic imaging. But on the other hand, when we bring outside-of-the-box, innovative and very practical solutions to make room for around 2,400 acute care beds, all we hear from the opposition is “no, no and no.”

Speaker, the member from Nickle Belt said that people do not like to be institutionalized, and I could not agree more. Patients do not like to be staying in sterile hospital environments with bells and alarms sounding at all times of day and night. Hospitals have simply not been set up for patients to stay for months at a time—up to two years. Our long-term-care homes provide more home-like environments with the proper social and recreational programming, in addition to the new services like bariatric, behavioural and diagnostic services in long-term care, which our government is funding with an investment of $37 million.

In conclusion, Speaker, these are just some of the actions our government is taking to fix long-term care and build more beds and better care.

I want to thank the member for that question, on the consent issue as well.

Yes, we have to free up these hospital spots right now because we are looking at a flu season that is happening further ahead. But we wouldn’t have to be doing this if, from 2011 to 2018, they had built more long-term-care beds. The previous government only built 611 beds throughout this whole province of Ontario. We’re building 632 just in my riding in one location alone, on an accelerated build.

We have to continue doing this throughout the province of Ontario to help our seniors get into homes where they can get four hours of care and so they can be treated with dignity. That’s what we’re doing as a government here in Ontario.

We have to free up hospital spots as well because we have to do surgeries that have been backlogged for the last couple of years during the pandemic, people who need heart surgeries and stroke treatment as well as ICU treatment. We have to work together with our long-term care and our hospitals to move forward in the province of Ontario.

Thank you to the members across the floor for your comments on this bill. Recently, I had the opportunity to meet with nurses from ONA Local 83 of the Ottawa Hospital and ONA Local 84 of the Queensway Carleton Hospital about the health care crisis in Ottawa. We discussed the fact that there are beds available in Ottawa hospitals even though there are patients waiting in the emergency room.

The Queensway Carleton Hospital is only operating at 60% of its surgical capacity. The issue is not beds; the issue is a lack of nurses available to staff the beds. So I am deeply disappointed to see that the government’s response to the health care crisis is a bill that will not recruit or retain one single additional nurse to our health care system but does show incredible disrespect to seniors and persons living with disability and their right to provide consent regarding their care.

I’m wondering why the government feels that the most appropriate response to our health care crisis is to continue to show disrespect to our hard-working health care workers, while also adding a new level of disrespect—

I want to thank the members from Mississauga–Lakeshore as well as Mississauga Centre for both of your remarks, and also thank the member from Mississauga Centre for her work in the health care sector and the dedication that she has shown, especially during the pandemic, going back to it. It’s incredible.

I do have a few questions. I know that the things you’ve highlighted are what we’re facing in our province right now in our health care sector. My question to the members opposite—and mainly, I guess, this goes to the member for Mississauga–Lakeshore because I want to quote one of the words that he’s pointed out, which was that they will “ensure” that people will, for example, be placed near their homes, and if there is a payment that someone’s asked for, this bill will “ensure” that that’s not the case. But we know that there are a lot of things that are up to the regulations, for example. How will you ensure that they are within the region of their homes or that they are liking the home that they’re placed in? And how will you ensure that there is no extra payment made?

Questions and answers?

This question is for the member for Mississauga–Lakeshore. He talked about ALC patients earlier. Could the member explain what measures will be taken into consideration when proposing appropriate long-term-care homes for ALC patients?

That’s a great question. You’re speaking about British Columbia, Alberta and Nova Scotia. We’re following what they’re doing. As well, British Columbia is under an NDP government, so I don’t really understand why the opposition is against their own friends in British Columbia that are NDP members and they don’t believe in what the NDP are doing in British Columbia. So I think that what we’re doing—we’re taking ideas from the NDP from British Columbia and putting it in to our bill to help our health care system.

Thank you, Speaker. I am remiss in not congratulating you on your appointment, so congratulations.

We know that under the previous Liberal government, the long-term-care sector was badly underdeveloped and neglected. In the third of its terms in office, the NDP propped up that government in that underdeveloped and neglected way—