It really gives me great pleasure to welcome into the gallery here in the chamber former MP Peggy Nash and the Toronto Metropolitan University Women in the House program participants. It’s great to see you here.

This visit and this program are organized by former MP Peggy Nash, Dr. Tracey Raney and Zaima Aurony. Thank you so much for being with us here today.

This is already happening in private clinics and the government is working to expand it. What does the Premier have to say to these patients?

Thank you to the member opposite for the question. I think the question proves why you should vote for Bill 60. Bill 60 is going to make sure that these protections are in place for patients. Honestly, Ontarians will never have to pay under a Doug Ford government for services that are OHIP-insured. That’s what we’ve committed to. Ontarians will have these services and we’ll be continuing to fund one of the largest publicly funded health care systems in the world—$77.5 billion this year alone. That’s an additional $14 billion invested in health care spending since 2018.

We’re working with all of our partners to identify innovative solutions, such as these clinics, to expand access. Because that’s what this is about: making sure that people get timely access to care when they need it.

So the Premier is gouging patients, just more transparently. That’s what I got from that answer. Speaker, the Premier owes these patients and all of us an explanation. I have so many examples right here, which I will share with the Premier.

Back to the Premier: For-profit health care, like the kind that is being pushed by this government, requires a return on investment. That money is going to come from two places: extra charges to the public system that we’re all going to pay for, and upselling directly to patients at a time when they’re at their most vulnerable, while the cost of everything just keeps going up.

Why is this government opening the door to new fees and charges on people who are just looking to get the medical care that they deserve?

To the Premier again: Why is there no commitment to transparent public oversight authority in your legislation?

Ontarians cherish our greenbelt. We know that paving it over and paving over our vital farmlands and wetlands is going to hurt our province and its people for generations.

Instead of protecting it, this government has opened the floodgates for their well-connected personal friends. In fact, nine of the developers who benefit from the greenbelt land swap are top PC donors. Some even attended the Premier’s family festivities.

Did the Premier, his ministers or their staff tell developers about their intention to open up the greenbelt before their public announcement?

Interjections.

But now, thanks to the Premier’s actions, more land speculators are circling like vultures. One of the new requests to develop the greenbelt is linked to a former staffer of the Premier turned lobbyist.

How naive does the Premier think Ontarians are? Exactly what price did this government put on the greenbelt?

My question is for the Premier. Hamilton Health Sciences has 270 patients waiting in hospital who cannot be discharged because they are waiting for alternative kinds of care, such as long-term or home care. This has gotten so bad that Hamilton hospitals have resorted to keeping these patients in a satellite health facility. Clearly, Bill 7 and its promise to free up bed space by sending seniors up to 70 kilometres away is not working for Hamilton.

It has been four years of empty promises from this government. Will the Premier commit to repealing Bill 7 and finally focus on providing the funding our health care system needs?

These problems are getting worse, not better. Why is the Premier sitting on $3.5 billion in contingency funds instead of ensuring we have a strong health care system that people can rely on?

It’s a pleasure to rise today to respond to this opposition day motion and highlight some of the many investments and new programs our government is making to clear the surgical backlog and improve the patient experience across the province.

Honestly, Madam Speaker, the Leader of the Opposition said, “if only Ontario’s ORs are allowed to operate at full capacity”—well, I can tell you, they are allowed to operate at full capacity. She said that by prioritizing hospital ORs, we’ll be reducing wait times right now. Well, since the beginning of the pandemic, our government has been investing in prioritizing hospital ORs. We’ve invested $880 million in surgical recovery funding, almost a billion dollars, for our hospitals to increase—that’s just for them to increase; that’s in addition to the other funds they get—surgical hours and address procedures that were delayed as a result of the COVID-19 pandemic. That money is to fund more surgeries and diagnostics at hospitals, including opening more operating rooms, more for longer hours, and more on evenings and weekends, when possible.

But hospitals are independent corporations that make their own decisions about how best to use their resources. The government does not dictate how many ORs they open at any particular time on any particular day. That is up to the hospital to decide and to make sure they have the staffing in place to do so.

Although we have put in an extra billion dollars—almost $880 million—so far we haven’t got the backlog cleared. The money has gone some way to clear the backlog, but our government knows that people like Nathan, who was mentioned, are still waiting way too long. We don’t want Nathan to have to suffer, or to wait, or to have five rescheduled surgeries. We don’t think that’s appropriate, and that is why we’re taking more steps. We added an additional $330 million for the hospital surgery backlog this year, for hospital operating rooms.

Unfortunately, we’ve done what the Leader of the Opposition suggests, by prioritizing hospitals and giving them a lot of extra money, but there are limits to what hospitals can do with those resources. They can do as much as they can, and that’s what they’re doing.

But Nathan shouldn’t have to wait, so our government is taking that next step. The next step is making it faster and easier for people to access surgeries and procedures they need, by better integrating and using community and diagnostic centres to increase capacity and to complete more publicly funded services—and these, increasing community capacity, target patients who will have been waiting the longest amount of time for their treatment, and expand available options to receive safe and quality care. This will mean shorter wait times for common but vital surgeries such as cataract and hip and knee surgery—eventually; that will be in 2024—and you can expect, people of Ontario, shorter wait times for diagnostic services, as well, such as MRIs and CT scans. We’re starting by tackling the existing backlog for cataract surgeries, which has one of the longest wait times for procedures.

Just let me take a moment to digress a bit, because the Leader of the Opposition had some story about saving money and said that cataract surgeries cost an OHIP fee of $500 in a hospital, whereas at a for-profit clinic they cost $605. I wrote down what she said. The fact is that a clinic will get a fee that includes a facility fee—that’s maybe the $605, assuming those numbers are accurate; I’ll give her the benefit of the doubt—but the hospital doesn’t just get the $500 OHIP fee. The OHIP fee goes to the doctor performing the surgery, but the hospital gets hospital funding, infrastructure renewal funding, nursing funding and a whole bunch of other funding, and believe me, the clinics don’t get that. They just get the $605 mentioned by the member opposite. So it’s very misleading, I would say, to say that one kind of person is getting more than the other. That is not the way it is. The fee is a $500 OHIP fee plus a facility fee in a clinic.

The other thing I want to point out is that the member said that more than a third of operating rooms in Ontario public hospitals do not meet the 90% target for operating room use. I think she pulled this from a December 2021 report of the Auditor General, so I think that might be dated. However, if we’re going to pull from that report, let me just add this quote from the Auditor General’s December 2021 report: “Studies have shown that outpatient surgeries can be performed more efficiently and cost-effectively when performed in an ambulatory setting. As well, because these ambulatory settings often specialize in a handful of types of surgeries, more can typically be done in a day as compared to the number that are performed in a general hospital setting. For example, a 2014 study released in Health Affairs (a peer-reviewed journal on health policy and research) found that procedures done in ambulatory surgery centres took about 31.8 minutes (25%) less time than those in hospitals. Estimated cost savings ranged from approximately $363–$1,000 per outpatient case, depending on the surgery.” That’s the quote from the same Auditor General’s report that my friend opposite has quoted from. Clearly. there’s a difference of view there.

Madam Speaker, as I said, we’re targeting shorter wait times for common but vital surgeries such as cataracts, hip and knee replacements so the people of Ontario can expect shorter wait times for those things and for diagnostic services such as MRI and CT scans, because this government thinks they’re waiting too long. And we’ve started by tackling the backlog for cataract surgeries—as I’ve said, one of the longest waits for procedures. This past month, 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. As I said the other day when I was quoting the member from Thunder Bay–Superior North, people are delighted to not have to wait so long to get their surgeries. They’re very excited to be able to get on with their lives. These additional volumes make up 25% of the province’s current cataract wait-list, and this will significantly reduce the surgical backlog.

In addition to shortening 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 such as Nathan’s surgery. He’ll be able to get in sooner as a result.

We’re also investing more than $18 million in existing centres to cover care for thousands of patients, including 49,000 hours of MRI and CT scans, 4,800 cataract surgeries, 900 ophthalmic procedures of other varieties, 1,000 minimally invasive gynecological surgeries, and 2,845 plastic surgeries. As a result, surgical wait-lists will return to pre-pandemic levels, it is anticipated, by March 2023. And as always, these services will continue to be provided at no cost to the patient, with their Ontario health card.

Beyond all the work 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 that we’re making is to achieve this through the expansion of access to primary care. When people have health care available in their communities and in ways that are convenient for them, they’re much 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 Ontario stay healthier by diagnosing illnesses earlier, starting treatments as soon as possible, and keeping emergency wait times down when you and your family need urgent care.

Ontario leads the country in the number of people who benefit already from a long-term, stable relationship with a family doctor or primary care provider. Over 90% of Ontarians has 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 care 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.

This is all very good news for Ontarians. 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 physicians, nurses, dietitians, social workers, pharmacists and other health care professionals to deliver programs and services, you get better continuity of care and more access to after-hours care.

We’re 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 joining our family health organization model in 2022-23 and 480 spots in 2023-24. These family health organizations will be required to provide comprehensive primary care services, extend evening and weekend hours of practice, and provide more weekend coverage so people can access a family physician when they need it.

Team models of primary care have demonstrated how bringing health care providers together as one team can improve the patient experience and how people access care.

Speaker, another way that we are building on this is through the development of Ontario health teams. Teams of primary care providers, regardless of model, will be central to all Ontario health teams across the province.

Finally, I want to highlight the important work that our government is doing to develop a 10-year capacity plan for health human resources. Last fall, we began our work to develop an Integrated Capacity and Health Human Resources Plan for Ontario. We’re analyzing current gaps in our system, anticipating needs over the next 10 years, and determining solutions to addressing growing health care demands. The plan will focus on how to meet this demand through investment, health human resources and innovative solutions.

This year, we’re building on this work and shifting our focus to working directly with leaders in our health system on a workforce plan that includes where to prioritize current and future resources, addressing and minimizing system gaps, and building a strong health system for the long term. The plan will also look at specific strategies for increasing the number of health care professionals, starting with physician assistants, nurse practitioners, registered nurses, registered practical nurses and medical laboratory technologists, and will also look at the retention of our health workforce through incentives, leveraging programs like our Learn and Stay program as well.

We have more positions open, which was pointed out by the member opposite, but that’s because we are hiring more health care professionals than ever before. That’s what Ontarians want. They want to have more health care professionals delivering more health care as soon as possible.

We will ensure that we have a greater understanding of each community and their local needs and that we have a plan to recruit and retain the health care workers needed, including our family doctors, nurses, specialists and other health providers, in every region of the province. We will begin by prioritizing the areas most in need, like rural and remote communities, where we know gaps already exist.

Ontario’s population is projected to increase by almost 15% over the next 10 years—and this really addresses the comments about how somehow we’ve decided to make a crisis. I don’t think that’s true at all. What I think is that demographics are here, and demographics have a certain reality, and we need to pay attention to those. Ontario’s population is expected to increase by almost 15% over the next 10 years. That alone places significant demands on our health care system. But on top of that significant population growth, much like other OECD countries, we have an aging population. It is well known that we use much more health care resources as we age, and certainly within the last 10 years of life—it generally is considered to be responsible for some 90% of the health resources that we use in our lifetime.

The Conference Board of Canada recently noted that population aging alone will drive 20% of all health-corresponding increases in the coming decade. The population which is age 65-plus is the fastest-growing segment of the population, and especially the group over 85. That population, the group over 85, will increase by 141% between 2022 and 2042. By contrast, the population of seniors aged 75 and older is expected to increase by 49.3%, from 1.2 million to 1.8 million, over the next 10 years. By contrast, the Ontario population of 65-plus will increase from 2.5 million in 2019 to 4.6 million in 2046. It will make up 23% of all Ontarians by that point. That would be one out of four—seniors, people over the age of 65—in Ontario if that comes to pass.

We need to continue to grow our health care workforce to meet the demands of our growing and our aging population. This plan that we have and our significant investments in our health care system will incorporate the lessons we’ve learned from COVID-19 and ensure we are prepared and equipped to meet the health care needs of Ontarians for years to come.

Thank you again for the opportunity to speak, Madam Speaker, to this opposition day motion. I’m confident that the government has a plan, and I think it’s very important that we make sure there is access to surgeries for people like Nathan who are waiting too long.

I want to start by thanking all the members of the official opposition here, in the NDP, for their very strong and effective arguments for why this government, the members opposite, should support this important motion. I’m very proud to sit here with all of you and to have your support.

Speaker, we heard this afternoon that the option is there—the option is, fully fund and fully utilize our public operating rooms, fully fund and support our staff to expand the number of shifts in the public system, keeping our nurses here in Ontario rather than having them become, as I’ve mentioned before here, Ontario’s greatest export right now. All of that is there. The option is there. But what is missing is the political will to get it done. This is about choice. This government has chosen not to spend money on public health care. They’ve chosen to create a crisis, and as the member from Waterloo said, they have, in fact, squirrelled away billions and billions of health care dollars rather than spend them to fix the crisis. This crisis could be fixed today. This problem could be solved today if this government chose to put patients ahead of profits, if they chose to put patients and public health care ahead of their political ideology. We could do better. We could serve the people of this province well. And we wouldn’t have people waiting for surgeries, looking to the private health care system now for solutions.

I hope I can count on the government to support this motion.

I rise today to share the story of London West constituent Cathy Melo. Cathy has been waiting since 2019 for a knee replacement. She lives with a tremendous amount of pain. She can hardly walk. She’s unable to work. She contacted my office and told me that she has been put on strong painkillers, but she feels very uncomfortable taking opioids for the long-term basis. She’s seriously considering asking for assisted suicide if she doesn’t soon get relief from pain. She asked me about accessing knee surgery at the Nazem Kadri centre for ambulatory care, which is operated by London Health Sciences Centre. This is a model that solves the crisis that we are finding here in this province with people like Cathy, who are unable to get access to the surgeries they need.

The Nazem Kadri centre is a publicly delivered facility that operates under the auspices of the hospital. It has all the hospital safeguards and oversight in place. It opened in early 2020. It has performed 4,000 procedures—the first of its kind in Ontario. It currently has two operating rooms. It is in negotiations with the province to expand to six operating rooms so that they can do more of these procedures and they can expand from very low-complexity, minor procedures for foot and ankle into those hip and knee replacements that are so terribly backlogged in Ontario.

Instead of approving the funding for the Nazem Kadri centre to expand their ORs, this government is looking to shift public dollars to private, investor-owned corporations where shareholders will make the profits—and patients won’t get the relief that they need.

Speaker, investments in facilities like the Nazem Kadri centre actually save public dollars. There has been an evaluation done that says the costs of traditional operating rooms are about $469 per patient; in an ambulatory care centre like Nazem Kadri, under the London Health Sciences Centre, the costs are $172 per patient. So the province could invest in ambulatory care centres like Nazem Kadri at hospitals across the province, and they would save dollars on operating costs, and they would improve patient care.

The other findings that have come out of the Nazem Kadri centre are that patients spend less time in post-op recovery. There is better planning in those operating rooms, because they know the time that each procedure is going to require, so they are able to go through 10 to 15 procedures methodically each day in each of the two ORs.

That is the kind of solution that would really make a difference for people in this province like Cathy, who are struggling with the terrible pain of hip and knee replacements and are unable to get access to the surgeries they need.

That is the investment that this province should be looking at. That is why they should be supporting our motion today that calls on the government to fund and fully utilize public operating rooms instead of moving to further privatize hospital operating room services.

It’s an honour to rise and participate in the debate on Bill 60. Let’s be clear: Ontario’s health care system is in crisis and it’s only gotten worse under the current government, starving our public health care system of the resources it needs, bringing it to the point of collapse.

An FAO report just last year confirmed that since 2008, Ontario has had the lowest per capita funding for health care of any province in the country. Health spending in Ontario is 10% lower than the Canadian average, and this has had disastrous consequences. Patients are waiting far too long for critical surgeries. Emergency rooms are understaffed and sometimes being closed. Existing surgical clinics are being underutilized due to staff shortages. Nurses are overworked, underpaid and experiencing tough working conditions. The government’s Bill 124, which restrains their wages, has only made the situation worse.

That’s exactly why health advocates, experts and front-line workers have been emphatic in their appeal to this government to not appeal the ruling on Bill 124 and to make strategic investments in primary health care, home and community care, mental health services and in addressing the health human resource crisis that we’re facing.

Instead, this government has continued to ignore the experts and is instead scheming up a plan to expand private, for-profit health care clinics, draining staff and financial resources from our public health care system. Bill 60 will force Ontarians to pay more for less care. Every precious public health dollar should go to patient care, not shareholder-driven profits.

To make matters worse, there are no clear protections for patients being pressured for upselling of services in Bill 60. The Auditor General’s report has already showed the problems that exist in this regard. This bill has no clear oversight provisions in place to protect people and the public.

There are better and more effective ways to address Ontario’s health care crisis. It’s time for this government to start listening to what the nurses and the experts are saying. Make the investments needed to bring Ontario’s per capita funding of health care at least up to the Canadian average and ensure that every dollar spent in this province is focused on patient care, not shareholder profits.

I would suggest to the member: Listen to what nurses are saying. Listen to what front-line health care workers are saying, who are overworked, underpaid and dealing with tough working conditions. End the government’s appeal of Bill 124, so we can actually negotiate fair compensation, fair benefits and better working conditions for nurses. That’s how we can stop draining staff from our public health care system.

And if you’re going to set up community surgery facilities, make them non-profit and connected to a hospital, where you don’t see staff being drained away from our publicly funded, publicly delivered health care system.

Let’s spend our money, the precious health dollars we have, on actually utilizing the infrastructure we already have in place.

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—