I very much appreciated listening to the member from Windsor–Tecumseh and his remarks, and reflecting on the fact that he used to be, as I think I heard him say, a drainage superintendent in Windsor. That’s a very practical position, and, frankly, someone we really need in this building, and perhaps even in this Legislature sometimes.

I was interested in the comprehensiveness of this bill—energy, colleges and universities, mining, natural resources, infrastructure, transportation, so many ministries impacted directly. I wonder if the member can further reflect on, from his past experience in a very practical role, other practical benefits he sees from this bill going forward.

I also want to thank the member for his contribution to the debate as well. Actually, I want to follow up on the question that my colleague on this side of the House from Toronto Centre asked; I know that the member from Windsor–Tecumseh may not have had enough time to answer.

We have a lot of businesses that are in debt right now across this province, and because of the red tape created by your government, unfortunately a lot of these businesses did not qualify, or even after qualifying, did not receive the funds that they truly needed to just stay afloat.

What would you do to change that, and how come there is nothing in this bill to support those?

Further questions?

I appreciate the question from the member from Bruce–Grey–Owen Sound. I didn’t have enough time to mention it, but it actually is a nice full-circle moment. Back when I was in engineering school, in solid waste management, we had a class detailing the Blue Box Program and the issue with the refillable bottles and how troublesome that was, and that was in the early 2000s. Now, as part of the regulations affiliated with this bill, the government of Ontario is actually addressing them, getting rid of these regulations that were no longer relevant. They weren’t relevant in 1999.

I just brought up the article that was cited. I believe it was in the environmental science management journal, and I’ll quote—actually, another interesting part is the author of that report was Dev Tyagi, who I used to report to at work. He was in Toronto at the time and he eventually made it to Windsor.

That’s one other example of a practical implication that I have seen, in the Blue Box Program, and I’m looking forward to seeing many more of the options in this bill implemented for municipalities and corporations and persons to come.

Yes, we went through a pandemic, and, yes, you have to set limits as to what programs can do and cannot do, but this is a permanent, ongoing cost savings for all kinds of organizations, and that’s why this is worth implementing because, going forward, it reduces those costs, and that means that property owners, business owners, Ontarians do not have to lie awake at night thinking, “How am I going to address this?” Their costs are coming down thanks to the measures in this bill.

Bill 91 addresses red tape and regulations. In listening to the member, I was really focused on the priorities of the government, what areas you chose to bring in regulations. Because right now, the province of Ontario is making sure that ODSP clients have to weigh in every month to a MyBenefits app or to their worker to confirm that they’re still in Ontario. This seems onerous. It doesn’t seem necessary. You know what? It seems like red tape.

What does the member say to the government when they’re picking and choosing which areas to reduce red tape in or to actually just double down on regulatory burdens?

Thank you to the member for Toronto Centre for her presentation. I’m sure the member for Toronto Centre would agree that modernizing agency governance and clarifying rules for Ontario’s public appointees is an important thing that we do. What this Bill 91 is proposing is changing clarification rules for public appointees to align agencies and government best practices. What we want to do is ensure that we’re making it easier and more attractive to serve on their boards. This is specific to the Ministry of Tourism, Culture and Sport.

Based on the member’s presentation, I would have to assume she would be fully supportive of this proposal for Bill 91.

I would remind the member her comments should reflect the bill that is before us today to debate.

Thank you to the member opposite for her submissions. I know that the member opposite represents the riding of Toronto Centre, and I know lots of people who live in the riding of Toronto Centre, lots of people there who run businesses and own businesses.

I wanted to ask the member opposite if she didn’t think that there are a lot of great things in our red tape reduction package this year, the Less Red Tape, Stronger Economy Act, that will help the businesses in the member’s riding and those constituents who I’m sure want her to represent them today.

Thank you to the member for your contributions today. My question is this: This government pretends to be preoccupying itself with reducing red tape, building a stronger economy, but the truth is we have so many Indigenous people who are living without clean water.

If we were going to build a stronger economy, why is it, do you think, that racialized people, Indigenous people and the concerns of queer people are not properly reflected in bills like this? What do you think we need to be adding?

Referred to Standing Committee on Justice Policy.

It’s my pleasure to rise in the Legislature today to speak to Bill 60 as parliamentary assistant to the Minister of Health. I would like to note that I will be sharing my time today with the member for Eglinton–Lawrence, my fellow parliamentary assistant.

Madame la Présidente, la principale promesse que nous faisons à chaque personne en Ontario est la suivante : vous serez aiguillé vers les soins dont vous avez besoin au moment où vous en avez besoin, qu’il s’agisse d’une visite imprévue à la salle d’urgence à 3 h du matin avec votre enfant ou bien d’un bilan régulier chez votre médecin de famille; que votre mère vieillissante ait besoin de plus de soutien pour continuer à vivre dans la maison familiale qu’elle aime, ou que vous ayez besoin d’une chirurgie de la cataracte pour régler un problème qui vous ennuie depuis des années; que vous viviez dans une grande ville, ou bien dans une petite ville, ou bien un lieu éloigné dans le Nord.

Votre santé : Plan pour des soins interconnectés et commodes place les gens au coeur du processus, en ajoutant et en élargissant les services de santé près de leur domicile.

Nous adoptons des mesures pour renforcer tous les aspects des soins de santé, particulièrement aux endroits où vous y accédez le plus souvent—dans les salles d’urgence des hôpitaux, dans les installations en milieu communautaire comme les pharmacies et les cabinets médicaux, dans les foyers de soins de longue durée et grâce aux soins prodigués, à votre domicile.

Nous savons que nous ne pouvons pas y arriver seuls. C’est pourquoi nous embauchons et formons davantage de médecins, de personnel infirmier, de préposés aux services de soutien à la personne et plus encore afin de nous aider à concrétiser cette promesse.

Ce plan à long terme est axé autour de trois piliers : premier, les bons soins au bon endroit; deuxième, un accès plus rapide aux soins; et troisième, d’engager davantage de travailleurs de santé. En nous concentrant à améliorer les expériences en matière de soins de santé de la population ontarienne et à faire croître notre main-d’oeuvre de la santé, nous améliorerons la qualité de la prestation des soins de santé dans l’ensemble de la province pour les années à venir.

Certains de ces changements surviendront immédiatement alors que nous prenons des mesures pour régler les problèmes urgents. D’autres changements nécessiteront du temps. Ils seront déployés progressivement au cours des mois et des années à venir alors que nous formons et diplômons de nouveaux travailleurs de la santé et construisons de nouveaux hôpitaux, centres chirurgicaux et de diagnostics en milieu communautaire et foyers de soins de longue durée, et prodiguons des soins à l’aide de nouvelles façons innovantes.

Mais au fil du temps, vous verrez et ressentirez de véritables améliorations dans les soins que vous recevez, alors que nous érigeons un meilleur système de santé pour l’avenir. Vous aurez plus de renseignements et de meilleurs outils pour prendre les bonnes décisions concernant votre santé.

Vous serez en mesure de prendre des rendez-vous en ligne ou de participer à un rendez-vous de façon virtuelle. Il deviendra plus rapide et plus facile pour vous d’obtenir les services de santé dont vous avez besoin dans votre collectivité ou à domicile, peu importe où vous vivez.

Vous serez confrontés à des temps d’attente plus courts pour des services clés—comme les chirurgies, les soins d’urgence et les soutiens en matière de santé mentale et de dépendances.

Vos travailleurs de la santé seront outillés pour travailler ensemble comme équipe pour vous, facilitant votre orientation dans le système de santé à chaque étape de votre vie.

Se fondant sur les meilleures preuves disponibles et sur les réussites obtenues dans d’autres collectivités publiques, l’Ontario agit pour vous aiguiller vers les soins au moment et à l’endroit où vous en avez besoin. Il s’agit de rendre les soins de santé plus commodes. Il s’agit de vous aiguiller vers les soins dont vous avez besoin. Il s’agit de vous et de votre santé.

Madam Speaker, our core promise to every person in Ontario is this: You will be connected to the health care you need, when you need it, whether it’s an unplanned 3 o’clock in the morning trip to the emergency department with your child or a routine checkup with your family doctor; whether your aging mother needs more support to keep living in the family home she loves, or if you need a cataract surgery to fix a problem that’s been bothering you for years; whether you live in a big city, small town or in a remote spot in the north.

Your Health: A Plan for Connected and Convenient Care puts people at its heart by adding and expanding health care services closer to home. We are taking action to strengthen all aspects of health care, particularly where you access it most frequently: in hospital emergency rooms, in community settings like pharmacies and doctors’ offices, in long-term-care homes and through care delivered right in your own home.

Speaker, we know we can’t do it alone. That’s why we’re hiring and training more doctors, nurses and personal support workers to help us deliver on that promise. This long-term plan is built on three pillars: first, the right care in the right place; second, faster access to care; and, third, hiring more health care workers. By focusing on improving the health care experiences of Ontarians and growing our health care workforce, we will improve the quality of health care delivery across the province for years to come.

Some of these changes will happen immediately as we take action to address some pressing issues. Other changes will take some time. They will be phased in over the months and years ahead as we educate and graduate new health care workers; build new hospitals, community surgical and diagnostic centres, and long-term-care homes; and deliver care in new and innovative ways.

But over time, you will see and feel the real improvements in the care you receive as we build a better health care system for the future. You will have more information and better tools to make the right decisions about your health. You will be able to book more appointments online or take an appointment virtually. It will become faster and easier for you to connect to the health care services you need in your community or at home, no matter where you live. You will experience shorter wait times for key services like surgeries, emergency care and supports for mental health and addictions. Your health care workers will be set up to work together as a team for you, making it easier for you to navigate at every stage of your life.

Following the best evidence available and successes of other jurisdictions, Ontario is taking action to connect you to care when and where you need it. It’s about making health care more convenient. It’s about connecting you to the care you need. Speaker, it’s about you and your health.

It has been over a month since we released Your Health: A Plan for Connected and Convenient Care, and we are already seeing results in our health care system across the province. Already, we’ve seen emergency department wait times coming down, and we’ve started to shorten wait times for key surgeries. Nearly 100,000 people have connected to convenient care at the pharmacy for a common ailment.

Through the Your Health plan, our government is taking action to strengthen all aspects of health care, particularly where people access it more frequently, and Bill 60, the Your Health Act, 2023, supports our efforts to do so. The Your Health plan, which is supported by this bill, builds on the significant progress our government has made over the last several years. Since 2018, we have increased health care funding in our province by $14 billion.

We have expanded Ontario’s health workforce with more doctors, nurses and personal support workers. In fact, since 2018, we’ve grown our health care workforce by 60,000 new nurses and 8,000 new physicians. We’ve added more than 3,500 hospital beds across Ontario, including acute, post-acute and critical care beds. We’re building new hospitals in every region of the province, getting shovels in the ground for 50 new major hospital development projects.

Since 2021, we’ve provided funding to support operations of 49 new MRI machines.

We’re adding nearly 60,000 new and upgraded long-term-care beds and investing nearly $5 billion over four years to hire more than 27,000 long-term-care staff, including nurses and personal support workers, and increasing the amount of direct care residents receive.

We continue to make it easier and faster for individuals of all ages to connect to mental health and addictions supports by building on our Roadmap to Wellness.

We have made it more convenient to book or take a health care appointment by launching virtual care options and adding more online appointment booking tools.

Our government is better connecting health care organizations and providers in our communities through Ontario health teams.

Through Bill 60, our first objective is taking steps to help those who want to work in Ontario. There are many health care workers from across the country and across the world who want to work right here in Ontario, and we are making innovative changes to make it easier and faster for them to begin working and providing care to people in Ontario.

With the legislation’s new as-of-right rules, Ontario will become the first province in Canada to allow health care workers who are registered in other provinces and territories to immediately start providing care without having to first register with one of Ontario’s health regulatory colleges.

If passed, Bill 60 would result in amendments to certain health profession acts, which would allow out-of-province registered health professionals to practise immediately in Ontario while waiting for their registration with their respective Ontario health regulatory college—because I think we can all agree here that a doctor from BC shouldn’t face bureaucratic delays to be able to practise in Ontario. This change will help health care workers overcome excessive red tape, something that we’ve just been talking about, that makes it difficult for them to practise in Ontario.

We will also help hospitals and other health organizations temporarily increase staffing when they need to fill vacancies or manage periods of high patient volume, such as during a flu surge. Participants will need to be in good standing with their home regulatory college and have a job offer at a health care facility, like a hospital or a long-term-care home, in Ontario to be eligible. This will allow nurses, paramedics, therapists and other health care professionals to work outside of their regular responsibilities or settings as long as they have the knowledge, skill and judgment to do so. That’s the kind of innovative solutions that will help bring reinforcements to the front lines of our health care system.

We are also continuing to make it easier for internationally trained health care professionals to use their expertise here in Ontario. We are working closely with regulatory colleges to make it easier and faster for qualified health care professionals to work here as well, without facing unnecessary barriers and costs, including requiring colleges to comply with time limits to make registration decisions. These proposed changes are another way we are looking to reduce administrative barriers and help to allow qualified professionals to work in Ontario quickly and efficiently.

Another way we are supporting this is by expanding the Ontario Learn and Stay Grant. We know that there are unique health care challenges in small, rural and remote communities and that recruiting and retaining health care workers in these regions requires a dedicated approach. Last spring, we launched the Ontario Learn and Stay Grant to help these communities build their own health workforces. This program covers the costs of tuition, books and other direct educational costs for post-secondary students who enrol in high-priority programs in more than a dozen growing and underserved communities and commit to work in those communities when they graduate. This year, we are expanding the program beginning in spring 2023, targeting approximately 2,500 eligible post-secondary students who enrol in high-priority programs like nursing, paramedic, and medical laboratory technology or medical laboratory science.

Another aspect of Bill 60 I’d like to highlight is repealing the Independent Health Facilities Act and replacing it with new legislation, the Integrated Community Health Services Centres Act, 2023, to better reflect the settings where care is taking place across the province. The health care landscape has changed significantly since the enactment of the Independent Health Facilities Act in 1990. There is a need for a legislative framework that better responds to current surgical demands in a manner that is integrated within the broader health system, that prioritizes safety and patient needs and better reflects the modern health system landscape and priorities. This proposed change would support the expansion of surgical, procedural and diagnostic services in the community, which is another important part of our plan for convenient and connected care.

We are reducing wait times by increasing access to surgeries and procedures such as MRIs and CT scans, cataract surgeries, orthopedics, colonoscopies and endoscopies. For over 30 years, community surgical and diagnostic centres have been partners with Ontario’s health care system. Like hospitals, community surgical and diagnostic centres are held accountable to the highest quality standards—the standards Ontarians deserve and expect across the health care system.

In committee, Dr. Agarwal commented, “I’ll say that the Ontario Association of Radiologists strongly support the current Bill 60 that’s being proposed and we applaud the government for its innovative approach to solving a very complex problem,” in reference to expanding integrated community health services centres to address the MRI and CT backlog.

To further support integration, quality and funding accountability, oversight of community surgical centres will transition to Ontario Health. This improved integration into the broader health care system will allow Ontario Health to continue to track available community surgical capacity, assess regional needs and respond more quickly across the province and within regions where patient need exists.

We’re also expanding oversight and patient protections when it comes to your health. Integrated community health services centres will now have to post any uninsured charges both online and in person. Every community surgical and diagnostic centre must have a process for receiving and responding to patient complaints. Patients cannot be denied access to treatment if they don’t purchase uninsured services. We’re also expanding the oversight of the Patient Ombudsman to include integrated community health services centres. These safeguards are in place to ensure that no extra charges occur for OHIP-funded procedures.

By further leveraging the support of community surgical and diagnostic centres, we will eliminate surgical backlogs and reduce wait times. We know that lengthy wait times for surgeries are one of the biggest challenges you and your family are facing in Ontario. While Ontario leads the country in the number of people who receive the surgery they need for hip and knee replacements, we still aren’t meeting the right benchmarks. We need to do more.

As a first step, we are tackling the existing backlog for cataract surgeries, which has one of the longest waits for procedures in the province. Four existing community-based centres, located in Windsor, Kitchener-Waterloo and Ottawa, have been identified as successful applicants to a recent call for applications. These centres will be able to support an additional 14,000 publicly funded cataract surgeries every year. These additional volumes make up to 25% of the province’s current cataract wait-list, which will help significantly reduce the number of people waiting outside appropriate wait-times for this surgery.

We are also investing more than $18 million in existing centres to cover care for thousands of patients, including more than 49,000 hours of MRI and CT, 4,800 cataract surgeries, 900 other ophthalmic surgeries, 1,000 minimally invasive gynecological surgeries and 2,845 plastic surgeries. And I would like to emphasize that this is all publicly funded: The costs of receiving these insured services in community surgical and diagnostic centres is covered by an Ontario health card, never by your credit card.

As the government significantly expands the number of surgeries being done through community surgical and diagnostic centres, it will do so with measures in place to protect the stability of staffing at public hospitals, including requiring new facilities to provide detailed staffing plans as part of their application and requiring a number of physicians at these centres to have active privileges at their local hospital. Further, Ontario Health will ensure that these centres are included in regional health system planning.

Funding agreements with new community surgical and diagnostic centres will require these facilities to work with local public hospitals to ensure health system integration and linkages, including connection and reporting into the province’s wait times information system and participation in regional central intakes, where available. Community surgical and diagnostic centres will also coordinate with local public hospitals to accept patients that are being referred, ensuring people get the surgery they need as quickly as possible.

In addition to shortening wait-times, providing these publicly funded services through community surgical and diagnostic centres will allow for hospitals to focus their efforts and resources on the more complex and high-risk surgeries. This is another way our government is making it easier for people to connect to care and access publicly funded services in more locations. Because we all know, the sooner you have access to the care you need, the better the outcomes.

Long wait times take a toll on people’s physical and mental health, creating more anxiety and stress. We have all seen our loved ones struggle because the wait for the knee or cataract surgery is way too many months long. Delays and complications in care only add to the toll of dealing with health issues. For health care to help, it needs to happen in a timely manner. And that is the primary reason we are investing to expand surgeries across the province, so that you and your family can have faster access to care.

The final aspect of Bill 60 is to enhance privacy obligations related to certain health administrative data through proposed amendments to the Freedom of Information and Protection of Privacy Act. These proposed amendments will benefit patients by supporting improvements to the health care system through linking de-identified data while enhancing privacy protection, transparency and accountability for entities that collect, use and disclose government data. The Information and Privacy Commissioner, which provides oversight to ensure compliance with the proper handling of data, has collaborated in the development of the proposed approach.

But we know that none of this would be possible without the dedication of our world-class health human resources here in Ontario. Ontario has one of the most dedicated and highly trained health workforces in the world. They step up, day in and day out, to keep you and our communities across this province safe and healthy. We’ve made significant progress recently to increase the number of health workers available to provide you care and support. Together, we’ve come so far. Over 60,000 new nurses and nearly 8,000 new doctors have registered to work in Ontario. In fact, last year was a record-breaking year for new nurses in Ontario, with over 12,000 new nurses registered and ready to work, and another 30,000 nurses studying at a college or university, providing a pipeline of talent and reinforcements.

But we know we need to do far more, and we are doing more. Hiring more health care professionals is the most effective step to ensure you and your family are able to see a health care provider where and when you need to. Well-trained and well-supported doctors, nurses, personal support workers and more are the people you rely on when you need care. This year, we’re training more health professionals than ever before, with 455 new spots for physicians in training, 52 new physician assistant training spots, 150 new nurse practitioner spots, 1,500 additional nursing spots and 24,000 personal support workers in training by the end of 2023.

And we’re investing to reduce fees for nurses who are ready and available to resume or begin practising in Ontario for retired and internationally educated nurses; $15 million will temporarily cover the cost of examination, application and registration fees for internationally trained and retired nurses, saving them up to $1,500 each. This will help up to 5,000 internationally educated nurses and up to 3,000 retired nurses begin working sooner to strengthen our front lines.

Part of the investment will also be used to develop a centralized site for all internationally educated health professionals to streamline their access to supports such as education, registration and employment in their profession or an alternative career. This initiative will make it easier for internationally trained health professionals to navigate the system and get the support they need on their path to getting licensed to practise in Ontario.

To continue to support our health system, we will scale up the Enhanced Extern Program and Supervised Practice Experience Partnership program for an additional year. Since January 2022, more than 2,000 internationally educated nurses have been enrolled through the Supervised Practice Experience Partnership program, and over 1,300 of them are already fully registered. We are providing additional funding to hire over 3,100 internationally educated nurses to work under the supervision of regulated health professionals in order to give them an opportunity to meet the experience requirements and language proficiency requirements they need to become fully licensed to work in Ontario.

New funding will be extended to the home and community care sector to extend the reach of the program this year. This investment also expands the Enhanced Extern Program for an additional year.

Last year, this program helped hire up to 5,000 qualified nursing, medical, respiratory therapy, paramedic, physiotherapy, occupational therapy students and internationally educated nurses to work in hospitals across this great province.

Increased funding for both the Supervised Practice Experience Partnership and Enhanced Extern Program will also allow hospitals to continue to hire more preceptors, mentors and coordinators to work with students and internationally educated nurses.

With that, Madam Speaker, I will turn things over to the member from Eglinton–Lawrence to say a little more about Bill 60 and what we heard at the committee on social policy.

Thank you so much to the member from Waterloo for her question. That’s a really important issue that you raise. There are so many different areas where Ontarians are facing regulatory burdens, including the ODSP recipients. We know that social assistance recipients really need to see that basic rate increased—doubled, I would argue—and then index it to the rate of inflation.

I would argue that the ODSP and Ontario Works recipients are unduly punished with regulation. They are unduly punished every single month to just resubmit and requalify for what is a basic Ontario service that they do deserve and that they already have qualified once to meet, but they have to go back every month to do it. If you want to reduce red tape, reduce the red tape for them.

There are Ontarians right now who are trying desperately to hold on to the employment contracts and the contracts that they have with different venues because they can’t get to work safely or they’re being stalked or being doxxed. That is something that is specifically affecting the LGBT community, plus the audiences, plus the businesses that are hosting them. They are not even specifically LGBT, all of them. Some of them are Kelseys and Boston Pizzas. They would like to book the drag performers. They can’t do it because there isn’t any protection for them in Ontario right now.

Thank you very much to my colleague across the aisle for her presentation to the House. You particularly made mention about the 2SLGBTQI+ community here in Ontario and how this doesn’t support them. Madam Speaker, I’d like to submit to the member opposite that this is our 10th red tape reduction bill, and new job numbers are out today where Ontario is leading the country in job growth and economic growth. I would ask that in those particularly 21,000 job numbers, do you not see how that does help our 2SLGBTQI+ community and racialized Ontarians?

Further questions?

Further debate. Further debate?

Mr. Gill has moved second reading of Bill 91, An Act to enact two Acts, amend various Acts and revoke various regulations.

Is it the pleasure of the House that the motion carry? In my opinion, the ayes have it.

I declare the motion carried.

Second reading agreed to.

Ms. Williams, on behalf of Ms. Jones, moved third reading of the following bill:

Bill 60, An Act to amend and enact various Acts with respect to the health system / Projet de loi 60, Loi visant à modifier et à édicter diverses lois en ce qui concerne le système de santé.

It’s a very quick question. To the member opposite: I’m just reading through the Financial Accountability Office report for labour stats in the last couple of years, and Ontario’s economy posted the largest job gain in the history of the province over the last two years, and that’s continuing now. It’s based on all groups and genders. We’re continuing that with this bill, Madam Speaker. I wanted to ask the member: Does not this tangible support of job growth in Ontario support the work we’re doing and look forward to continuing with this bill?

I’d like to thank my colleague from Toronto Centre for their presentation. This bill includes measures from the pandemic time that are going to be continued. One of the things the official opposition would like to see is the continuation of the paid sick days program. In fact, we think that every worker in this province should have at least 10 paid sick days. I was wondering if the member could comment on why it is so important that workers have access to paid sick days.

I recognize the member for Eglinton–Lawrence.

It’s my pleasure to rise in the House today to speak to Bill 60, and I’d like to thank my fellow parliamentary assistant, the member for Newmarket–Aurora, for leading off the debate and for a great speech, which I think went over a lot of the important ground on Bill 60.

As a member of the Standing Committee on Social Policy, I’m here to confirm that the committee heard from over 40 presenters who provided their feedback on Bill 60 over the course of three days of public hearings. We heard from Dr. John Yip, president and CEO of SE Health, who said, “Based on SE Health’s knowledge of the national landscape, I’m here to say that Bill 60 is a good start in eliminating Ontario’s surgical backlogs. We are pleased to see this government introduce significant changes to our system that will better serve Ontarians within a publicly funded system. Overall, this bill sets up a good framework to create a system of surgical care that is patient-centred and promotes patient choice.”

The president of the Ontario Medical Association, Dr. Rose Zacharias said, “We support Bill 60 and its feature to move lower acuity surgeries and procedures out of hospitals. This is an important step in reducing wait times....

“I think what we want to emphasize is that every medical necessary service would be covered by OHIP and no one would be paying out of pocket to jump first in line.”

And Dr. Agarwal, a radiologist who currently runs a clinic with other radiologists, shared with the committee this: “I come to you today in support of Bill 60 as it applies to diagnostic imaging and moving CT and MRI” scans “from our public hospitals into outpatient centres. I believe that this proposal, if implemented correctly, will decrease our wait-lists, increase access to these important medical examinations, and alleviate the bottleneck that has been crippling our health care system.

“Just a little bit of background: MRI and CT scans, when they’re ordered by your physicians, should be completed within 28 days. What we see in Ontario is that these scans are completed between three months and 12 months later.” That’s what Dr. Agarwal said.

And Speaker, that is exactly why our government is supporting moving forward with Bill 60 so we can clear the backlog and ensure that patients in Ontario are getting the care they need when they need it.

Since the beginning of the pandemic, our government has invested almost a billion dollars—$880 million specifically—in surgical recovery funding for our hospitals to increase surgical hours and address procedures that were delayed as a result of COVID-19, and $300 million of that almost a billion dollars was invested this year.

As a next step, our government is making it faster and easier for people to access the surgeries and the procedures they need by better integrating and using community surgical and diagnostic centres to increase capacity and complete more publicly funded services.

Increasing community capacity will target patients who have been waiting the longest amount of time for treatment and expand available options to receive safe, quality care. This means that there will be shorter wait times for common but vital surgeries such as cataracts and hip and knee replacements, and you can expect shorter wait times for diagnostic services such as MRI and CT scans.

This is important: In committee, Dr. Agarwal shared that “Everyone knows someone who’s waiting for diagnostic imaging. This is a fact. It’s a sad fact in Ontario and in Canada, but it is a fact. If we are able to diagnose diseases earlier, patients will do better. It’s not just their outcomes, but we’re going to save the system money and we’re going to decrease patient anxiety.

“I used to do a lot of breast imaging, and I would tell you, the amount of anxiety that exists when you read a mammogram and you call someone—we read mammograms, and say we’re suspicious of something. The way that breast imaging is set up is that we have to be ultra careful, so the majority of the time, when we’re calling women back, it’s for something that’s benign, but women don’t know that.

“I’ve seen this in my own family members. I’ve seen this in my relatives. I’ve seen this in my patients. There’s a lot of anxiety, and now if you’re waiting a week, two weeks, for your next test, that’s a terrible two weeks. We just don’t need to have that. We’re one of the richest countries in the world, and we can do better.” So said Dr. Agarwal, and we agree.

That’s exactly why we’re moving ahead with this legislation to improve access to MRI and CT across the province.

In addition to shortening wait times, providing these publicly funded services through community surgical and diagnostic centres will allow hospitals to focus their efforts and resources on more complex and high-risk surgeries.

Dr. Andy Smith, CEO of Sunnybrook Health Sciences, was at the committee and shared, “With regard to surgery and imaging capacity: We need to improve access to surgical care, now.

“One approach that is enabled in Your Health Act is support to partner with community surgical centres, which I’ll call CSCs. We are encouraged by this opportunity because of the successes we have observed already to this point with CSCs.

“We have had success in delivering cataract surgery at Kensington Eye Institute and endoscopy services at many community centres for many years. Additionally, we have developed coordinated partnerships with community diagnostic centres to support patients with faster testing for cardiac diagnoses, for example.

“Most recently, we have had success with delivering increased volumes of specialized ear surgery for patients who can’t hear properly. Our team at Sunnybrook is world-class resourced for state-of-the-art surgery to restore hearing. But, as the pandemic receded, we found ourselves with a greater than two-year wait-list and inability to get surgery done fast enough at Sunnybrook because of the multiple competing demands for operating room resources.

“Think of this situation from a patient perspective. Imagine a frail older person living alone with minimal family support. Imagine now that they cannot hear. That robs the person of the ability to listen to CBC on the radio or to watch a favourite TV show. Deafness erodes quality of life unbearably.

“The care team that such people need is available. We needed to find ways to expand access immediately, if not sooner. Together with superb physician leadership, we developed a partnership with a community surgical centre, engaged government support and have been able to develop a sustained approach to getting care to the people and shrinking that wait-list.” That was the CEO of Sunnybrook, Andy Smith.

Speaker, the Ontario Medical Association agreed, saying “If we were to roll it all up, we’re really quite aligned, principally, with what the government is intending to do on behalf of our families, our neighbours and our communities to improve access to procedures that they ought not to be waiting six months, 12 months or two years, in some cases” for. That’s exactly what we’re doing by investing more than $18 million in existing centres to cover care for thousands of patients, including more than 49,000 hours of MRI and CT scans, 4,800 cataract surgeries, 900 other ophthalmic surgeries, 1,000 minimally invasive gynecological surgeries and 2,845 plastic surgeries.

Surgical wait times and wait-lists have returned to pre-pandemic levels but more needs to be done. As our government has said before, when it comes to your health, the status quo is no longer acceptable. Our government is taking bold action to eliminate surgical backlogs and reduce wait times for publicly funded surgeries and procedures. And as always, services will continue to be conducted at no cost to the patient with their Ontario health card.

Another important initiative we’re tackling is the existing backlog for cataract surgeries, which has one of the longest waits for procedures in Ontario. In February, we issued four new licences to health centres in Windsor, Kitchener-Waterloo and Ottawa to support an additional 14,000 publicly funded cataract surgeries annually. These additional volumes make up to 25% of the province’s current cataract wait-list, which will help significantly reduce the surgical backlog.

Beyond all the work that our government is doing to address the surgical backlog, we’re also building up our health care system for the future. One of the key investments we’re making to achieve this is expanding access to primary care. When people have health care available in their own communities and in ways that are convenient for them, they’re more likely to seek and receive the treatment they need when they need it and stay healthier. Delivering convenient care to people in their communities will help keep Ontario healthier by ensuring illnesses are diagnosed earlier, starting treatment as soon as possible and keeping emergency room wait times down for when you and your family need urgent care.

Ontario leads the country in the number of people who benefit from a long-term and stable relationship with a family doctor or primary care provider. Over 90% of Ontarians have a regular health care provider. But we can do more, and we will do more. That’s why we’re increasing training opportunities at the same time as expanding team models of primary care across the province of Ontario. Work is already under way to train the next generation of doctors, nurses, personal support workers and other health professionals in this province. We’re expanding training spots to more health professionals in Ontario every year with 455 new spots for physicians in training, 52 new spots for physician assistant training spots, 150 new nurse practitioner spots, 1,500 additional nursing spots and 24,000 personal support workers in training by the end of 2023.

As Dr. Smith, CEO of Sunnybrook, agreed, “With health human resources, we have terrific health care professionals and teams” here “in Ontario. But their numbers are diminished, and they are tired as we advance through the post-pandemic period. This challenge must be faced with energy, resolve and innovation. Recruitment, retention and expanded training opportunities are an important part of the solution. There has been a real can-do attitude about this in recent months and years, and together with government, looking at lots of different aspects to enhance collaboration. All of the solutions are essential. No one (solution) is going to get us to where we need to be.” And that’s the quote from the CEO of Sunnybrook, Dr. Andy Smith.

Speaker, by adding new health human resources to Ontario’s workforce, more team-based care will be made available to Ontarians.

When family physicians work in a team model alongside other family physicians, nurses, dietitians, social workers, pharmacists and other health care providers and professionals to deliver programs and services, you get better continuity of care and more access to after-hours care which may be more convenient for you.

We are increasing the number of spots for physicians to join a team model of care through the expansion of existing family health organizations and allowing new ones to form. This will add up to 1,200 physicians in this model over the next two years, starting with an additional 720 spots for physicians interested in joining the family health organization model in 2022-23 and 480 spots for those interested in joining in 2023-24.

I just want to take a moment to say, Madam Speaker, that I had the opportunity to visit the North York Family Health Team recently and had a great tour of their facility, talked to the doctors there, and they’re very excited about the future and about having more doctors join this model and other health providers join this model. It’s partly in our Your Health plan with this announcement of expanded family health teams and family health organizations, but also we have Ontario health teams, which we’ve been working on since very early on when we were elected, and those Ontario health teams are now—54 of them covering 99% of the province, and the next stage in their development is integration of primary care.

I was talking with the doctors at the North York Family Health Team, and one of them is very actively involved in integrating primary care into their Ontario health team. And of course it’s easier to integrate the family health teams and the family health organizations, because they’re already organized in team-based models, but we want to get all of the primary care practitioners into these team models to work together in their Ontario health team so they’ll be able to work as a more integrated, coordinated team.

Team models of primary care have demonstrated how bringing health care providers together as one team can improve the patient experience in how people access care. They’re required to provide comprehensive primary care services, extend evening and weekend hours of practice and provide more weekend coverage so you can access a family physician when you need one—and it’s a great model.

Ontario’s population is expected to increase by almost 15% over the next 10 years, Madam Speaker. The population of seniors in Ontario aged 75 and older is expected to increase by 49.3%, from 1.2 million to 1.8 million, over the same 10-year period. By contrast, Ontario’s 65-plus seniors population will increase from 2.5 million in 2019 to 4.6 million by 2046. So the population over 65 in Ontario will make up 23% of all Ontarians by 2046. With this and all of the immigrants that we’re bringing into Ontario, we know that we need to continue to grow our health care workforce to meet the needs of our growing population.

These are all very important aspects of our development in health care. I think we also mentioned, as part of our plan for convenient and connected care, that we’re working on centralized wait-list management, and the government is investing in digital tools to enhance coordination of surgical services between hospitals to enable better patient flow through the implementation of a centralized wait-list management program which is being rolled out province-wide for the first time in Ontario’s history. This is really important to make our surgical and diagnostic clinics coordinated and integrated with our hospitals, but it’s also really important to make sure that the care is there when we need it, and it can be referred as needed. So I’m very excited about that investment.

We’re investing $30 million into centralized wait-list management, and investments in this are providing funding for regionally led projects across the province that support more equitable distribution of surgical cases and reductions in patient wait times, as well as investments for the development of the technical infrastructure at Ontario Health which is required to support centralized wait-list management at the provincial level. That’s another important part of what the government is doing to make sure that we have a connected system.

All of these initiatives—Ontario health teams, family health teams, family health organizations—the expansions of all of those are going to help make our system function better and help people stay well and stay out of hospital as much as possible, making sure a hospital is available when they need it without a huge amount of waiting in the emergency rooms. We want to make sure people can get in and get the care they need when they get there.

In closing, I wanted to share another quote from the committee, from the evidence of Mr. David Graham, who is the president and CEO of the Scarborough Health Network. From his evidence at the committee, let me just share this quote with the Legislature today: “For those of you who may not know, SHN has three hospitals across Scarborough serving an identified catchment area of over 830,000 individuals. In a typical day, we treat 500 patients in our three emergency departments, 800 participants and patients in our in-patient units and 1,300 patients in our outpatient clinics. We perform over 900 diagnostic imaging tests and 140 surgeries.

“We also have one of the largest orthopedic and eye programs in the region. SHN’s eye program is designated as a regional centre of excellence and consists of 10 full-time ophthalmologists covering pediatric, retina, glaucoma, corneal and cataract procedures. In 2022, the eye program finished 5,700 quality-based procedures, plus an additional 1,000 cases on the provincial waiting list, totalling 6,600 cases in 2022. We are extremely proud of our surgical programs and the work they are doing to not only lower the wait times in Scarborough, but across the region.

“However, we know that any wait is” too long “for someone who requires surgery. Every surgery is an urgent surgery when you or your loved one is the one waiting. I welcome the opportunity to work with our government, Ministry of Health and Ontario Health partners to integrate community surgical centres and diagnostic centres into the broader publicly funded and publicly administered health system and establish new partnerships between SHN and community-based surgical clinics to help ensure equitable and accessible publicly funded surgical care for patients.”

That is the quote from David Graham, who is the president and CEO of the Scarborough Health Network. He said that at his presentation at committee.

Speaker, this plan, and our significant investments in our health care system, will incorporate lessons learned from COVID-19 and ensure that we are prepared and equipped to meet the health care needs of Ontarians for years to come. All of the investments we’re making are critical. No one solution, as Dr. Andy Smith said, is going to solve the problem. We need to work on all fronts to make sure that we are providing care to people when and where they need it.

We’re excited to work with our partners, and I’ve read to you a number of quotations from those partners of what can be done to fix the system and how people are looking forward to being able to treat people and give them access to the treatments they need—the diagnostic imaging, the scans, the surgeries—as quickly as possible. And we’re really excited to move forward with this next step.

If we pass Bill 60, we believe that we’re going to be able to improve patient access to care and make it much more timely for people. After all, we think that is extremely important, as Dr. Agarwal said in the quotes that I read earlier. The anxiety of waiting for the results of your test, the anxiety of waiting for treatment when you’re sick is not good for anybody. We want to make sure people get the care they need as quickly as possible—good, quality care through our publicly funded health care system.

Thank you to the member from Mississauga Centre for the question. Yes, we visited Hawkesbury, and I have to say it was an amazing hospital. Yes, they just underwent all these renovations. Our francophone community in this area actually represents over 60% of people who only speak French, so it is critical that we have those health care services and the health care professionals who can speak en français and provide that service to our francophone community.

In addition, I have to say that this hospital is looking for further expansion, and we are looking to support them in their endeavours to support their community members tout en français.