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.

Ma question est pour la députée de Newmarket–Aurora.

Madam Speaker, I was pleased to recently visit Hawkesbury and District General Hospital together with the parliamentary assistant to the Minister of Health. Hawkesbury General Hospital is such a great example of a provider that provides services in French. From the moment that patients enter the hospital, we see the signage in the French language and the idea of an active offer is fully implemented there.

I was also pleased to see the government support the expansion and renovation of this hospital with millions of dollars of infrastructure funding in 2022. We were able to visit this beautiful new hospital. I wanted to ask the parliamentary assistant if she can comment on why it’s important that we continue supporting hospital infrastructure projects, but specifically the ones that are servicing our francophone community?

It is now time for questions and answers.

I feel like I’ve just gone through a very painful commercial, because what the government is saying happened in committee is quite different, Madam Speaker—and I have it here in Hansard. Those delegations warned that the legislation “could fatally undermine the public health care system.” That’s a quote. Despite the PC government’s characterizations that we’re fearmongering, in fact proponents of the legislation told the committee the issues raised are legitimate and called on the government to be careful and take steps to avoid or mitigate them.

Even John Yip, who the member quoted, said, “We are aware of the concerns that the bill may widen the health care access gap. We share this concern.”

The radiologists said that investor-driven companies to own for-profit surgical clinics is a bad idea—from Hansard. Then he went on to say, “If you have non-physician owners, they’re going to poach health care workers from the hospital, because their interest is not” in the hospital or the health care system.

We moved amendments to make Bill 60 fairer. Why is this government so determined to undermine public health care in the province of Ontario?

Thank you to the member for Markham–Thornhill for his question. Madam Speaker, our government has launched the largest health care recruiting and training initiative in this province’s history. As I spoke about in my speech, we are building on the over 12,000 new nurses that have registered in this province since last year, and our government is also investing in a range of other initiatives. That also includes the “learn and stay” grant, which has been hugely successful, and that’s why we have expanded it to not just nurses but to paramedics as well as medical technologists and medical sciences. So all in all, what I’d say to the member for Thornhill—on top of that, our government announced that we are breaking down registration barriers so that more health care professionals can come and work in this great province.

This is probably going to be a first time for me here, but I want to take a moment to actually thank the government for finally listening to one part of this bill that I agree with, which is recognizing international professionals, internationally trained health care workers.

We’re not all there yet with this bill, and I know there are other portions, other bills that have been brought forward, but I remember coming to this House in 2018, for the first time, and bringing this up and then bringing my private member’s bill. To finally see the government take on pieces that I have recommended, pieces that the Ontario NDP has recommended be put in legislation, makes a lot of difference to a lot of Ontarians who are internationally trained who can contribute to our health care system.

So I want to thank the government for doing that, but I think we have a long way to go to make sure that we’re recruiting them properly and retaining them, because that process has been undermined and this bill does not do justice to that. I hope that the government will listen and actually allow for that to happen as well. I’d be happy to hear from any of the members.

There is absolutely no doubt that this bill is the beginning of throwing open the door to private, for-profit investor-owned corporations into our public health care system. This is the beginning; let’s make no mistake. And we already have evidence from the Auditor General that these private, for-profit health care facilities are not regulated. There’s no oversight. In fact, the Auditor General said, “More specifically, there’s a higher risk that privately owned organizations may prioritize profits by charging patients for add-ons, and those charges would not be adequately monitored and scrutinized by the ministry.”

So my question to you is—you say that you can guarantee people won’t be overcharged, you can guarantee that they won’t be put to the bottom of a wait-list because of not agreeing to sign up for the add-ons by these private clinics, but you have absolutely no government mechanism to oversee them. What do you say to the Auditor General’s questions about this lack of oversight that you’ve done nothing to address?

Thank you to my colleagues the PAs from Newmarket–Aurora and Eglinton–Lawrence for that wonderful presentation. Our government has for the first time opened the door for foreign-trained nurses and foreign-trained doctors. It was a firewall for the last decades and decades, and we lost so much human intellectual capital and talent which left the province for south of the border for so many decades, including my sister. She was a foreign-trained doctor. She couldn’t get into the system; five years full-time studying, came to U of T, this building, and she couldn’t get into the system 21 years ago. So she left the country and she went to America, along with hundreds and hundreds of doctors who have left.

For the first time, our government is opening the door for foreign-trained credentials, and I have to thank and commend the minister, our Premier and the PAs.

Can the members tell this House, what is the government doing to expand our health care human resources and ensure health care workers aren’t moving out of the province and out of the hospitals?

Thank you very much for the question from the member for Hamilton West–Ancaster–Dundas. In fact, I would think the members opposite would be supporting Bill 60, because for 30 years in this province, we’ve had something like 900 independent health facilities, and what Bill 60 does is integrate those 900 independent health facilities—which, by the way, have been renewed licences for 30 years under every government of every political stripe in this province. But this piece of legislation actually integrates those formerly—after we pass Bill 60, hopefully—independent health facilities into integrated surgical community centres, which will be integrated with our health care system.

But what are we doing to make sure people are not having to worry about oversight, etc.? We’re making people post uninsured charges online and in person so a discussion can happen ahead of time; a process for responding to complaints; patients can’t be denied treatment if they don’t purchase uninsured services; and the Patient Ombudsman—

Further questions?

Third reading debate deemed adjourned.

Report continues in volume B.

Speaker, if you seek it, you will find unanimous consent to see the clock at 6.