We’ve heard a lot about Tommy Douglas today and the great work he did in getting the Medical Care Act passed in 1966. I’m sure my friends opposite know that there are four core principles to that policy—before the federal government will entertain any health care transfer. Those four principles are public administration, comprehensiveness, universality and portability.

We know that this government spent $78 billion last year on health care, which was a $14-billion increase from the year before. We also know that in recent discussions with the federal government, they’ve increased that funding over the next 10 years by $8.4 billion.

Will the member opposite agree that the federal government would have ceased the transfers if we were privatizing health care in Canada? Will you admit that this privatization is just a smokescreen that you are proposing to try to somehow discredit the much-needed changes this government is making?

I’d like to thank my colleague from Oshawa for her wonderful presentation.

I want to take you back to March 2022, when Ontario’s former Patient Ombudsman and, at that time, the Conservative health minister, Christine Elliott, almost issued a warning—or, at the very least, let it slip. She stated: “We are ... making sure that we can let independent health facilities operate private hospitals.” Possibly, when they realized how foolish and wrong this was, the minister’s spokespeople said, of privatization, “The use or function of private hospitals and independent health facilities in Ontario is not being expanded or changed.”

Clearly, funding is being cut for publicly delivered health care, as we’ve seen in the FAO’s report—cutting $5 billion—and it’s being put into for-profit health care profiteers’ pockets.

My question to the member is, why did they flip-flop?

As I mentioned earlier, one key component to ensuring the right care in the right place is expanding care at local pharmacies. As of last week, 70,000 assessments were conducted by pharmacists—highly trained, trusted, regulated health professionals across the province.

Will the member opposite support expanding the scope of pharmacists so that constituents in Oshawa and ridings across Ontario can get better access to care closer to home?

I am very proud to stand in this House as a New Democrat and as a provincial member who is excited about having the opportunity to stand on behalf of people when it comes to public education, public health care. I want to strengthen the system we have before us.

Tommy Douglas—his vision was also about pharmacare and dental care. That’s the whole thing—it’s supposed to be about wellness and the idea of prevention and trying to keep people well before they get sick. Economically speaking, that should make sense to Conservatives.

From a human perspective, health and wellness should be based on need, not people’s ability to pay, which is why we’re standing here talking about the importance of protecting medicare from this piece of legislation—and I’m proud to do that work every day.

Anyway, what I will say is that our communities have complex needs, so the fact that folks can go to the pharmacists, who are professionals and are able to deliver important pieces of that care—everyone across communities is glad for that. Who benefits from that beyond the patients and actual folks in the community? I get pretty sticky when it starts to be Mr. Galen Weston, over and over and over. I want health care to be about health care, about caring about health, not just about making folks stupid rich.

I think that when we are focused on patient care, we’re going to be doing the right thing—or, I guess, the left thing. When we’re focused on profit care, I’ve got a problem with that.

I’m going to do the opposite of that: I’m going to talk about why we should not privatize public hospital services, whatever that looks like, whatever they call it, them or the next—well, they won’t be the next. The next government will make the best decisions for Ontarians and their health.

Why we shouldn’t privatize public hospital services, from the Ontario Health Coalition—for-profit clinics and hospitals provide poorer-quality care; they hire less-qualified staff and direct public funds into profits rather than care, as we’ve talked about. It worsens staffing shortages. Private clinics take easier and less complex patients, leaving the more complex folks languishing, and they also charge user fees and extra-bill patients on top of OHIP for medically necessary services.

This is not the direction Ontario should be going. Reverse course, please.

Privatization or profitization, or whatever word this government is going to be comfortable with, is the wrong direction.

When it comes to the lowest per capita funding that we’ve got in Ontario—to the member’s question—there are multiple layers to why, but this government is not making it better. This government has not been investing what it needs to in health care.

The manufactured crisis is your smokescreen. That is this government’s “Hey, look over here. Look how bad things are. We’re going to have to rescue it with this absurd scheme that has been tried, time and time again, and does not bear fruit.” In fact, it will make sure that Ontarians don’t have what they need when they need it. That is the wrong way ahead.

This should not be a plan for just the wealthy. This should be a plan to—

I’m pleased to rise in the chamber today to speak to Bill 60. I’d like to point out, at the outset, that I’ll be sharing my time with the member for Kingston and the Islands—

I’d like to begin this debate by pointing out something that the member from Simcoe–Grey just remarked on, which is that medicare has four principles. That’s not true. Medicare has five principles, and the one that he missed was accessibility. For as long as there are fundamental differences on objective facts like the number of principles that we hold dear in the Canada Health Act, then it is just not credible that this government can be trusted to manage public health care in the first place.

Bill 60 remains the latest in a series of poorly conceived, superficial policies lacking thought, detail or any semblance of understanding about the challenges in our health care system. It continues with a series of failed policies, like the failed effort to increase credentialing of foreign-trained health care workers; the failed effort to regulate temporary for-profit nursing agencies; and the failed effort to reassure us that Ontarians will always pay with their OHIP cards, not their credit cards. We don’t need to look further than virtual primary care to discover that OHIP services are locked up in this province behind paywalls and credit cards already.

As a brief overview—what’s wrong with Bill 60?

(1) It completely misses the point of our health care crisis. Notably, it doesn’t address any of the challenges with our health human resources. It doesn’t address the massive underinvestment in our health care system under the current government.

(2) It only pays lip service to the things that actually matter in our health care system—oversight, protection against upselling and upcharging—but it delivers none of the details and leaves far too much to the regulations.

(3) Finally, I will say that it has failed even before it has passed, because we are seeing for-profit corporatization across our health care system, to the detriment of our patients and having surgeries and procedures addressed in a timely manner.

This government loves to rail against the status quo, without acknowledging that they are the status quo. The moment they took power five years ago, our health care system embarked upon a significant nosedive. They cut hundreds of millions in public health funding. They cut staffing solutions like the practice-ready assessment program for foreign-trained family doctors. And they enacted the unconstitutional and wage-constraining Bill 124, which they continue to support and now appeal in the courts, to the cost of millions of dollars to the citizens of Ontario.

Bill 124 is the rate-limiting step that is preventing us from enhanced performance of our health care system. For those who don’t believe me, I invite you to consider this quote from the Ontario Hospital Association, that very same organization that this government loves to go to when they need quotes to support their policies: “The OHA has consistently advocated that Bill 124 should not be extended nor should additional restrictions be imposed due to its impact on availability of HHR and other impacts on hospital operations.” That’s from their buddy.

It will come as no surprise, then, because they have persisted in defending Bill 124, that Ontario Health data reveals that under the Ford government, our health care system performance has been the worst in this province’s history, ever. To be clear, every year of this government’s so-called leadership has resulted in worse performance than the last.

What I’m here to argue today is that rather than throwing the baby out with the bathwater, what we need to be doing is moving our health care system from neglected under you guys—sorry; neglected by the current government—to protected.

Let’s also not forget that by 2028, this government will have underinvested by over $23 billion, according to the Financial Accountability Officer. I have heard that the government contends they disagree with the FAO, but I will also add that this opinion simply can’t be trusted, considering their own estimates of this province’s deficit swing by billions of dollars every few weeks.

Amidst this comedy of incompetence, we have a murky new bill whose impact really won’t come into focus until it has passed, because so much of the stuff that matters isn’t actually in the bill and is instead left to regulation. Who, for example, will perform the oversight? Is that body external or internal? And without such details, how could we possibly believe that there are credible protections against upselling or overcharging? After all, this government has insisted throughout the entire year that upcharging isn’t actually even a problem, although the Auditor General has said that it is, and instead ignored her recommendations while reassuring us that everything is okay.

Madam Speaker, this bill really could have spent some more time cooking in the oven. For example, in schedule 2, the definition of “nurse” is thrown out the window and is instead replaced with the following: “‘registered nurse’ means a member of the College of Nurses of Ontario who holds a certificate of registration as a registered nurse under the Nursing Act, 1991 or another person prescribed by the regulations....” So the definition is changing, but we have no clue what that definition will be. It is simply left to the regulations. How can we have a discussion about redefining an entire profession without any details about what that will be? The reality is that this is likely an approach to introduce as-of-right legislation, without affording anyone an opportunity in this Legislature to have an actual debate about it.

I’m going to talk very briefly about moving surgeries out of hospitals. There is some precedent that in Canada and around the world, surgeries can be moved out of hospitals, but in order for that to be successful, it has to be done with adequate guardrails. Most importantly, time and time again we have learned that not-for-profit initiatives consistently outperform for-profit ones. This is not an ideological position. Apart from the fact that it has been demonstrated in journal after journal after journal, it is also the position of the Ontario Medical Association. In their report on integrated ambulatory centres in 2022, they made it clear that their position is that such centres should operate on a not-for-profit basis. So they should be not-for-profit, and they must have credible protections against profiteering, upselling and siphoning of health care workers out of the publicly funded system. Bill 60 doesn’t do any of these things, and instead, it leaves massive gaps. Until such gaps are credibly filled, this bill is nothing more than window dressing and does nothing but threaten the quality of health care in this province.

With that, I yield the remainder of my time to the member from Kingston and the Islands.

I want to thank my colleague the member for Don Valley East for serving almost like a one-person opposition on health care. He’s done such a great job to hold this government to account. I’m going to try my best to add a few things to what he said.

What we’re talking about today is establishing something called integrated community health services centres, and what we’re repealing is something called the Independent Health Facilities Act. Now, already this sets off some flags in my head: Why are we changing the name so much? So I decided to compare the two acts a little bit just to see very quickly what the differences might be.

One thing that I found is that both acts rely on a director to grant licences, to look at licence applications, to conduct inspections, to potentially revoke licences if something goes wrong. But I noticed that in the previous act, the director had to be an employee of the health ministry, and in the current act, the director could be anybody. The legislation doesn’t say.

Why is it, Madam Speaker, that the government made this subtle change in the legislation so that they did not have to appoint a director who is an employee of the ministry? They don’t have to appoint a director who’s used to giving fearless advice and loyal implementation. Why is it that they don’t have to appoint a director who is an employee of the ministry and therefore, generally, is non-partisan, is not a big donor or is expecting favours or anything like that? That, to me, is a red flag, and I’d like to understand at the committee stage why the government made this change.

The act is quite long—it’s a lot of pages and it takes a long time to read through. And sometimes little, subtle changes like that, especially when there’s two different acts—one that’s getting repealed and another one that you’re trying to read through as the legislation is being debated—you don’t always see these comparisons. But I would hope that in committee, these little differences are examined. I would very much like to know why this government chose to change the act slightly so that they don’t have to appoint the director—in fact, the most important person, the lynchpin in this whole system, the person who grants licences, reviews licence applications, oversees inspections and potentially revokes licences. Why is the government not committing itself to hiring an employee of the Ministry of Health?

As my colleague said, a lot of the actual plan is going to be in the regulations. This is kind of like asking the people of Ontario to put down a deposit on a house by looking at the sales brochure instead of being able to walk through an open house. That’s what it feels like. If you look at what the considerations are when licence applications are looked at, it doesn’t include what the licensee is going to do in terms of protections from upselling. It doesn’t include what the licensee is going to do to prevent poaching staff from hospitals.

If there are any complaints, what the act says is that the licensee—the operator of the integrated community health service centre—is required to establish a process for complaints, not the system. That strikes me as a little strange, because if we’re going to change the system, it would seem to me that in the first few years, we would want to have a more robust system of hearing complaints from users to make sure things are working, to make sure that there aren’t little adjustments we can make to make sure that the system is serving the people of Ontario properly.

There is no commitment from the government to increase funds to the Patient Ombudsman, but I feel like there needs to be a specialized response to Ontario consumers who are using these new services in integrated community health service centres at least for a few years, to make sure that things are working well.

Thank you. The member from Kingston and the Islands.

Either member could answer this question. I just want to go back a little bit. When the Liberal party was in charge of the government, back in the majority days, Premier Kathleen Wynne’s government was trying to extricate itself from one privatization disaster, even as it sets itself up for another. That’s the Ornge one that they’re referring to. The current disaster of its handling of surgical clinics—Ontarians may recall the government’s decision to expand the scope of private clinics, announced with much fanfare by then health minister Deb Matthews in 2012.

I just need to ask the members a question: Do they support privatization of health care expansion or not?

I appreciate the revised history lesson from our new Liberal colleagues. I can appreciate that they weren’t elected during the 15 years when Liberal governments fired nurses and closed down hospitals, including the Peel Memorial Hospital, which is actually the hospital I was born in, in Brampton—and, actually, I guess the other previous Liberal members in the previous government also voted against rebuilding that hospital in Brampton, to get a second hospital at the site of Peel Memorial. So I can appreciate that these members might—

When we talk about corporate profiteering and privatization—

Questions?

A quick response.

To the member from Don Valley East—interesting presentation, isn’t it? Fifteen years to get absolutely nothing—absolutely nothing.

One of the aspects of our plan supports expanding the number of physicians that can join a family health team. I’m from a region that has a million people. The people that I represent, 149,000 people—this is something they want, this is something I hear at the doors that I knock on, every other weekend.

Can the member for Don Valley East tell me whether he supports increasing access to family health teams?

My question is to the doctor. He said the Ontario Hospital Association has said very clearly to this government that Bill 124 shouldn’t be extended. I think that’s pretty clear.

What I’ve never understood is why a labour minister on that side of the House, who is supposed to be non-partisan, is supporting and continues to support Bill 124. I hope he hears me; I don’t know if he can hear me or not, but I hope he does.

You also said that performance is better in not-for-profit compared to profit. When I look at long-term care, because I’m the critic, 5,400 people died in long-term care; approximately 3,800 of them died in private long-term care.

My question to you is, do you agree that everything should stay not-for-profit?

We stand categorically against Bill 60 and the way in which it gives way to corporatize profiteering in our health care system. There is absolutely no room for that. We have been clear. I campaigned as a Liberal in the last election saying that there is room to move some surgeries out of hospitals in a not-for-profit model with adequate guardrails. That remains our position. To be clear, we are entirely against the profiteering and corporatization being proposed under this legislation.

We’ve seen the corrupting effects of profiteering in our health care system. We’ve seen how Bill 124, for example, has pushed nurses out of public health care. Things like temporary, for-profit nursing agencies, which have proliferated under this government, have subsequently pulled nurses out of public health care.

It’s why, in my unwavering commitment to protect our public health care system, I introduced legislation that will hold these nursing agencies to account, that will commit to and strengthen our publicly funded health care system. It’s what I have done as a physician, it is what I am doing as an opposition critic, and it is what I and the rest of the Liberal caucus will always do.

The member across also made the allegation that nothing happened under the previous 15 years of Liberal government. I would point out that the most immediate five years of performance under this Conservative government have been the worst years in this province’s entire history. I would caution the member about any sort of chest-thumping, given the current state of our health care system.

On repeated occasions, the Minister of Health has been very clear that she didn’t believe that there was a problem in the first place. I recall quite vividly that she cited a 1-800 number, I believe, to anyone who believes that they have been upsold and upcharged, in frank contradiction to what the Auditor General has been telling us.

And so, amidst that backdrop, amidst this problem that we know is objectively a problem, this government now expects us to believe that, coming out of that fantasy land, they can be trusted to protect against upcharging and upselling with this new fallacy of a plan? It simply is not credible.

Thank you for your question.

Report continues in volume B.

I would like to pick up on your information—I thought it was very interesting—about how the director is being appointed and why that difference is there. I would refer back to the Auditor General’s value-for-money audit, and I’m going to quote from that report. She said, “We found that some patients could be given misleading information as part of sales practices to make a profit.

“Several of our findings, such as the underuse of hospital operating rooms, and the lack of ministry oversight ... have been noted in our past value-for-money audits.”

So the Auditor General has identified the lack of oversight, has identified that profiteering is a problem. I would give you an opportunity to comment on it. We haven’t even addressed the Auditor General’s recommendations, and now they’re doubling down on the lack of oversight and profiteering.

I find it interesting hearing the Liberals. But I guess when the Liberals were in power, they didn’t have to worry about health care because they were just driving 300,000 families and businesses out of the province. They didn’t think we had people, because there really wasn’t any jobs for them, so they just assumed there would not be any people so we wouldn’t have to fix health care. But health care does need to be fixed. This government is the government that is fixing health care by looking outside the box and making sure this happens.

My question to the members opposite is: We launched the largest health care recruiting initiative in Ontario’s history; will the member opposite support the future of our publicly funded health care system by supporting this bill?