It’s indefensible.

The member from Waterloo is right: This is indefensible.

They now have a criminal investigation at their door. We can’t trust a word they say. They have to show us the papers. They need to open the books, because the people of this province deserve answers. So I ask: Why won’t the Minister of Infrastructure show us the business case that she says showed it was more expensive to renovate the Ontario Science Centre than build a new one at Ontario Place?

Interjection.

Will the Premier and his government leave Ontarians on the hook to pay for something for the next 100 years that they never wanted in the first place? Should the Therme spa fail, what happens then? Can this foreign company do what they want on our public lands? Is this another shady deal that’s tapping into the public coffers of this province to benefit private interests? I’ll tell you, it has all the makings of one.

Speaker, I want to end by saying that the last thing this government needs is another criminal investigation. That’s why we, in the official opposition NDP, are asking this government to just cancel this ridiculous deal; get realistic about revitalizing this important public land, this important waterfront; keep it public; and stop this pattern of handing out secret backroom deals to corporations over the public interest. Will they step out on the right side of governance today and pass our motion?

The Minister of Infrastructure.

All those in favour of the motion, please say “aye.”

All those opposed to the motion, please say “nay.”

In my opinion, the “ayes” have it.

Call in the members. This is a 30-minute bell.

The division bells rang from 1342 to 1412.

Ms. Surma has moved the adjournment of the debate.

All those in favour of the motion, please rise and remain standing to be counted by the Clerks.

All those opposed to the motion, please rise and remain standing to be counted by the Clerks.

Debate adjourned.

Ms. Jones moved second reading of the following bill:

Bill 135, An Act to amend the Connecting Care Act, 2019 with respect to home and community care services and health governance and to make related amendments to other Acts / Projet de loi 135, Loi modifiant la Loi de 2019 pour des soins interconnectés en ce qui concerne les services de soins à domicile et en milieu communautaire et la gouvernance de la santé et apportant des modifications connexes à d’autres lois.

It is indeed my pleasure today to introduce the Convenient Care at Home Act, 2023, and to lead off debate of this important piece of legislation. I will share my time with my colleague the Minister for Seniors and Accessibility, Minister Raymond Cho. The minister responsible for seniors and accessibility will speak about how, if passed, the Convenient Care at Home Act will make it easier for seniors to age in their own homes.

Before I begin, I would like to take this opportunity to thank my two parliamentary assistants: MPP Robin Martin, member for Eglinton–Lawrence, and MPP Dawn Gallagher Murphy, the member for Newmarket–Aurora. Both parliamentary assistants have been tremendous champions in their community and strong advocates for patient-focused health care. I am very appreciative of their support and their ongoing contributions toward building a stronger health care system that centres on the needs of patients and their families.

I would also like to extend my thanks to the entire team at the Ministry of Health. Working together to improve health care for all Ontarians continues to be our shared goal, and I am incredibly grateful for the work that has occurred behind the scenes to get this legislation introduced in the House today.

Lastly, I would also like to extend our deepest thanks to all the providers, health care professionals and volunteers who provide compassionate care for patients, families and loved ones. Our government sincerely appreciates the important work you do and your significant contributions to our health care system and to communities across Ontario.

Indeed, across Ontario, I have had the opportunity to see many examples of world-class health care taking place in communities in every corner of the province, delivered by our incredible health care workers. It’s great to see the ongoing collaboration and partnerships taking place across the health care sector, including in palliative and end-of-life care, but I know that our health care system and health care workers face some significant pressures and too many people face challenges to accessing care close to home. Our government is working hard to address these long-standing challenges, which is why, earlier this year, our government established Your Health: A Plan for Connected and Convenient Care. Your Health is our plan to build a better health care system that puts patients at its heart. It is focused on improving the health care experiences of Ontarians at every stage of life, now and for years to come.

If passed, the Convenient Care at Home Act will support our broader Your Health plan to improve and modernize home and community care services, which are critical to providing patients with the right care in the right place. Speaker, we know people and their families want better and faster access to home care services. Home care plays an important role in the lives of around 700,000 families in our province each and every year. The only thing better than having care close to home is having care in your home.

We’ve heard loud and clear from Ontarians that they want better and faster access to home care services, and our investments will provide them with more choice to connect to convenient care in your own home and in their community, instead of a hospital or a long-term-care home.

Home care addresses the needs of people of all ages, such as people with medically complex needs, physical disabilities and chronic diseases; frail seniors; and others who need services and support to live safely and independently in the community or in their homes. Community care includes services such as personal support, homemaking, meals, transportation, caregiver and respite supports, and other services, and it supports over 800,000 people each and every year. Home and community care helps to keep people healthy and safe, and is an essential component of a connected, convenient and integrated health care system.

Home and community care providers work with primary care, acute care hospitals, mental health and addictions service providers, long-term-care homes and other providers of health and social services to provide appropriate and cost-effective care that meets people’s needs. Home care allows people to return home from the hospital sooner and reduces avoidable hospital readmissions, emergency department visits and unnecessary long-term-care-home placements.

Supporting access to home and community care services helps ensure that Ontarians are receiving the care they need in appropriate settings, such as in their homes, where they would rather be. All Ontarians deserve to be connected to the care they need in ways that are more convenient for them, throughout their life, every step of the way, and our government will continue working to improve patient care and build a more connected and convenient health care system.

Speaker, the proposed legislation being introduced today is another significant step forward in our government’s work to improve and modernize home and community care services and seamlessly connect people to care. The Convenient Care at Home Act would enable the gradual transition of home care to Ontario health teams. By taking on the delivery of home care, we are further developing Ontario health teams to fulfill their mandate to deliver integrated health care services across Ontario.

The first part of this gradual transition—implemented through today’s proposed legislation, if passed—would involve consolidating the province’s 14 regional home and community care support service organizations into a single integrated service organization called Ontario Health atHome, which would work under Ontario Health to support Ontario health teams to provide home care. Upon consolidation, the local health integration networks, or LHINs, would cease to exist.

I want to emphasize that under the proposed Convenient Care at Home Act, all employees of the home and community care support service organizations, including unionized and direct care staff, would transition to Ontario Health atHome. Following the creation of Ontario Health atHome, there would be a gradual transfer of responsibility for providing home care to Ontario health teams, with Ontario Health atHome continuing to provide strong central back-office supports to those teams.

Alongside the consolidation of 14 agencies into one under this proposed legislation, the province would continue to develop, implement and expand new innovative models of care with home care and health service providers, which will serve as a one-stop shop to better support hospital-to-home transitions, as an example, and provide better support for patients and their families. The province will also be updating home care procurement and contracting processes to support quality improvement and support new models of care, with a focus on introducing new performance standards, updating standardized contracts and preserving existing volumes for qualified providers.

Throughout all of these changes—consolidating 14 home care agencies into one, expanding new models of home care and updating home care contractual frameworks—we will continue to focus on maintaining stability and continuity of care for patients and families who need home care, long-term-care-home placements or referral services. I want to be clear that the stability and continuity of care for patients and families is an absolute, key priority during this process, and that means providing stability for important home care workers.

While Home and Community Care Support Services transitions to a new service organization, patients, families and caregivers will continue to access home care in the same way and through the same contacts they have come to know and trust. The new organization that would be created through the consolidation of the 14 regional Home and Community Care Support Services agencies would be a subsidiary of Ontario Health, the agency currently responsible for funding most other health care sector organizations. Ontario Health oversees health care planning and delivery across Ontario, ensuring providers have the tools and information to deliver high-quality care. And Ontario Health supports the integration and coordination of Ontario’s health care system to focus on the needs of patients and their families.

The proposed legislation also amends provisions governing the designation of Ontario health teams, which in the long term will ultimately provide home care as part of their responsibility for locally integrated health care. Ontario health teams are at different stages in their development and in their readiness to provide home care. And as each Ontario health team develops, they will start taking direct responsibility for managing home care delivery, with continuing operational and back office supports from Ontario Health atHome. It is anticipated that the first group of Ontario health teams would start to be designated by the end of 2024, with the first transitions of home care funding and responsibilities to Ontario health teams or their members in early 2025.

Ontario health teams play a key role in connecting all parts of a patient’s care journey. These teams are bringing together different health care providers from across health and community sectors—including, of course, primary care, hospitals, home and community care, long-term care, mental health and addictions, and more—to work as a collaborative team to better coordinate care, share responsibilities and ensure patients experience connected care from their providers.

Ontario health teams are responsible for delivering care for their patients and understanding their health care history while easing their transition from one provider to another, directly connecting them to different types of care and providing 24/7 help in navigating the health care system.

Through the next steps forward in home and community care, we will advance the work of Ontario health teams to seamlessly coordinate services for patients, support Ontarians who rely on these important services, make it easier for people to find and navigate home and community care services, bring decisions closer to the patient and improve the way people receive these services.

We’ve already approved the creation of 57 out of 58 Ontario health teams, entities that will simplify the process of transitioning between health care providers. These teams ensure that every individual’s care is coordinated seamlessly, offering a unified patient record and care plan.

But we are not stopping there. To further support this essential work, the government is investing over $128.2 million to empower each Ontario health team with $2.2 million over three years, helping us to better coordinate your care. Ontario health teams will be a one-stop shop that provide people with easy-to-understand home care plans that let them know the care they are going to receive when and before going home from hospital.

An initial group of 12 Ontario health teams has been chosen to lead the way in delivering home care in their communities starting in 2025. With the support of the Ministry of Health and Ontario Health, these teams will focus on transitioning individuals experiencing chronic diseases from primary care, hospitals, to home and community care with ease. We’ve seen successful examples like the Southlake Regional Health Centre, a pioneer in providing convenient and coordinated transition services. These initiatives ensure that people leaving the hospital have a home care plan in place, granting them peace of mind and a smoother transition.

The proposed changes to modernize home care will also improve the system of care delivery for the many organizations in the sector and thousands of health care workers on the front lines. I again want to acknowledge the countless individuals who work tirelessly every day to care for individuals in our community. They are the true heroes of our health care system, and this legislation is dedicated to making their jobs more manageable and more focused on the well-being of their patients.

Ontario Health atHome care coordinators would be assigned to work within Ontario health teams and other front-line care settings. They would also work alongside care providers like doctors and nurses, and directly with patients while in the hospital or in other care settings to facilitate seamless transitions for people from hospital or primary care to home care services. This change will make it easier for Ontarians to access the home care services they need. Instead of grappling with a complex system or waiting for a phone call, Ontario Health atHome and Ontario health teams will serve as a one-stop shop. This approach is about ensuring that Ontarians have the support they need to age comfortably and gracefully in the place they call home.

Speaker, our government recognizes the incredible dedication of the home and community care workforce and the value of the work they do every day. Across the province, thousands of front-line home and community care workers provide exceptional support to Ontarians, often at a time when they need it most. Home and community care workers play such an important role in many people’s lives, and they make a significant impact in our communities. We are very grateful for their contributions and their service to Ontarians, and our government continues to take action to support them so they can continue to provide essential care and support to the people of Ontario.

Our government also values the important partnerships the province has with many organizations that are involved in providing home and community care. I am very grateful for the input and advice provided by the Minister’s Patient and Family Advisory Council, who have emphasized how vital timely and easily accessible home and community care is to patients and families and the critical role it plays in our health care system. In particular, I want to thank our chair, Betty-Lou Kristy. Betty-Lou Kristy has lived experience as a patient, a caregiver and a bereaved mother, and she helps guide the advisory council to share their perspectives to better improve health care.

The council consists of patient, family, and caregiver representatives who are helping to improve patient care by ensuring that the voices of patients, families and caregivers are central to policy development and decision-making. An essential part of building a world-class health care system is listening to and learning from patient, family and caregiver experiences. Engaging with patients, families and caregivers in health care system design and navigation helps build a more effective and efficient system, resulting in better quality care and better patient outcomes.

I’ve been incredibly honoured to meet with the council on multiple occasions and it is fulfilling to see patient experiences being used as a catalyst for change in our health care system. Engaging the council, and ongoing conversations with organizations and stakeholders, is a key component of the province’s work to modernize home care and gradually bring it into Ontario health teams, as we work towards the shared goal of providing high-quality, connected and convenient care across Ontario.

I am also grateful for the continuing input from Home Care Ontario and the Ontario Community Support Association, whose member organizations, working alongside other provider organizations, deliver home and community care services to so many Ontarians each and every day. We’ve been meeting regularly with service providers at every step in the development and implementation of our home care modernization plans, and we know that the advice we receive from the front-line experts in home and community care will be key in our shared success.

Speaker, I want to highlight that the progress we’ve made is in no small part a testament to the unwavering support, tireless efforts and commitment of our community partners. Their dedication, expertise and passion for the well-being of Ontarians has been instrumental in shaping the proposed Convenient Care at Home Act and I am forever grateful for their input. We are proud to work hand in hand with these exceptional organizations, and we thank them for their unwavering dedication and partnership.

I want to take a few minutes, if I may, to share some of their comments. Deborah Simon, the CEO of the Ontario Community Support Association, says, “Home and community care plays a critical role in the future of a strong Ontario health care system. Legislative changes that strengthen this vital service will be important for supporting client care in an integrated health system.”

Sue VanderBent, the CEO of Home Care Ontario, says, “Ontario must massively expand the size and role of the provincial home and community care system to properly care for a growing and aging population. The legislative changes being introduced today are an important step towards ensuring more Ontarians can get the health care they require in the most appropriate setting—at home.”

Sandra Ketchen, the president and CEO of Spectrum Health Care, said, “Today’s announcement is an important step in modernizing Ontario’s home care system. We look forward to continuing to work together to provide the best possible care to patients, in the comfort of their homes.”

Matt Anderson, the president and CEO of Ontario Health, said, “This ‘connected care’ approach, and the provincial investments to support it, will help transform health care delivery and support the vision of all Ontarians having full access to the care they need, across the spectrum of health care—all working together to deliver integrated care, through their Ontario health team.”

Our government is also building home and community care capacity to help ensure patients are provided with the right care in the right place. We are delivering on our promise to expedite additional funding for our $1-billion investment to stabilize, expand and improve home care services and address worker compensation this year. Furthermore, we are going above and beyond by investing an additional $100 million for community care. This infusion of funds is aimed at stabilizing the delivery of services and addressing workers’ compensation concerns.

These investments aren’t just numbers on a budget sheet; they make a tangible impact on people’s lives. To put it in perspective, in the 2022-23 fiscal, our investments translated into additional volumes of services that included an estimated 930,000 hours of person support services and 120,000 nursing shifts. These numbers represent individuals who received the care they need in the comfort of their home, promoting faster recovery and improved overall health. Our investments are playing a crucial role in helping patients return home after surgeries to recover in a familiar environment. They are ensuring that individuals with complex health conditions receive the comprehensive care they require right in their own homes. This isn’t just about convenience. It’s about providing high-quality care where it matters most.

Moreover, our promise to build home and community care capacity is also integral to ensuring that hospital beds are available for those who need them most. By expanding and improving home care services, we are not only making health care more accessible, but also freeing up critical hospital resources to cater to our most urgent cases.

During my travels across Ontario, I’ve seen many examples of world-class health care, but I’ve also seen that our health care system and health care workers face some significant pressures. These are long-standing challenges that many communities have faced for decades. The status quo is not working. Our government has been unequivocal in our stance: We will not accept the status quo. We are standing up for Ontarians, who rightfully deserve better health care, and we are advancing bold, creative and innovative changes, which is why we are working tirelessly to increase access to service across the health care system. This, indeed, is central to our government’s Your Health plan.

As part of this plan, we are expanding the number of assessments and treatments that pharmacists can provide to Ontarians without the need for a doctor’s appointment. Pharmacies are some of our most accessible access points in our health care system, and I’m proud to say that since our government implemented these changes in January of this year, there have been over 400,000 pharmacist consultations.

Just last week, I heard about a mother who had a son with pink eye, who was able to conveniently go to their local pharmacy and receive an assessment and treatment on the spot. Speaker, that is convenient care close to home.

Additionally, we are increasing our investment in community surgical and diagnostic centres, and we are indeed improving access to MRI and CT scans. This means more people will have quicker access to critical diagnostics and treatments, ultimately enhancing the quality of their health care experience.

We are also investing in health care training and education programs. We’ve provided grants and supports to individuals pursuing careers in health care. Moreover, we are taking steps to break down barriers for internationally educated health care workers and those registered in other Canadian provinces and territories. Our aim is to facilitate their entry into the Ontario health care workforce, ensuring they can start making a difference that much sooner.

Last year was a remarkable year, one for health care in Ontario, as we set a record with nearly 15,000 new nurses registered to work and care for the people of Ontario. We are also building upon this progress with the addition of more than 62,000 new nurses and 8,000 new physicians registered to work in Ontario since 2018, along with the invaluable contribution of thousands of personal support workers. Under the leadership of the Minister of Long-Term Care, Stan Cho, we are leaving no stone unturned. With more than 30,000 net new long-term-care beds and upgrading over 28,000 beds, we are doing everything we can to be better equipped to meet the needs of our aging population. In communities across Ontario, we are getting shovels in the ground, with more than 50 approved hospital development projects that will add thousands of beds to our system.

And our government continues to make it easier and faster for people of all ages to connect to mental health and addiction supports by building on our Roadmap to Wellness, with additional investments and innovative new programs such as more youth wellness hubs and addiction treatment beds.

Patients and health care providers are also being supported by our government’s investment in digital and virtual care, including supporting initiatives such as virtual home and community care, integrated virtual care, remote care management and surgical transitions, and patient portals. And we are expanding access and improving the way people can connect to home and community care services by increasing funding for these services and breaking down long-standing barriers between home care and other parts of the home health care system.

As our population ages, the need for effective and accessible home and community care services becomes even more critical. Over the past decade, we’ve witnessed a 62% increase in the number of patients with complex or high needs. Simultaneously, the proportion of home care clients who are seniors has grown from 54% to now 68% in that same period. These figures underscore the growing importance of providing comprehensive home and community care services.

Looking ahead, the numbers are even more compelling. The senior population aged 65 and over in Ontario is projected to increase significantly from 2.8 million in 2022 to, indeed, 4.4 million by 2046. These projections present both a challenge and an opportunity. We have a responsibility to ensure that all Ontarians, particularly our seniors, receive the care they need and deserve.

The objective is clear: Ontarians should have access to appropriate care in an appropriate setting without being forced to rely on health care settings like hospitals or long-term-care homes, which may not always align with the unique needs of individual patients. It is because of this that we introduced the Convenient Care at Home Act. This act represents our unwavering dedication to providing Ontarians with the right care in the right place, both today and for future generations. By integrating home care through Ontario health teams, we are creating a robust framework that connects home care seamlessly with other types of care at the local level. This is about building a health care system that is not only more connected but also more patient-centered. These changes aim to create a better, more integrated model of home care. They bring decision-making closer to the patient, where it rightfully belongs. It’s about ensuring that our health care services can better align with the unique needs of patients and their families. By strengthening the connection between home care and the broader health care system, we are laying the foundation for a more comprehensive and coordinated approach to health care.

We must remember that the future of health care is not a distant vision; it is a reality that we are working tirelessly to build, now and for future generations.

I encourage everyone in this Legislature to read this legislation carefully and support this important piece of legislation that supports better home and community care for Ontarians.

It is a pleasure for me to share my time with the Minister for Seniors and Accessibility, Minister Raymond Cho, who will speak further about our government’s effort to improve care for seniors in their homes and everyday lives.

Speaker, I think all of us in this chamber have a personal story that we can share or have heard from our constituents about the value and the importance of the transitions that we are making with this legislation, and I hope that we can take those experiences and those stories and translate them into action through supporting this legislation.

I will turn it over to Minister Cho.

The Minister for Seniors and Accessibility, please.

Mr. Speaker, today I’m very proud to rise in our Parliament in support of the Convenient Care at Home Act, 2023. This act, if passed, will continue to do what we said we would do as a government when we were first elected in 2018. When the Premier appointed me as Ontario’s first Minister for Seniors and Accessibility, my goal was and continues to be to have people living in their homes as long as possible in the dignity they deserve.

Whether you’re a Progressive Conservative, NDP, Liberal or Green Party member, regardless of your political stripe, regardless of your religious affiliation or your cultural background, we will all become seniors.

With this act, we are creating a better health care environment for everyone. We are continuing to deliver and expand programs and services for seniors, their families, caregivers and the entire older adult community. We are continuing to increase health care funding to historic levels with this legislation to give people the care in their homes and in their communities that they deserve.

Our government, thanks to the leadership of the Premier along with the hard work of the Deputy Premier and Minister of Health, is seeing real results that are providing the care that people need in their home.

This legislation is the next step in creating a one-stop shop that provides people with easy-to-understand home care plans. This will create Ontario Health atHome, and will do exactly that: This will bring more care to more people in their homes.

I would like to take this opportunity to let you know why this is such a positive step in the right direction. Ontario Health atHome builds on all the great work we are doing to keep our seniors fit, active, healthy, socially connected and close to home in their communities, but more importantly, it addresses the root cause of so many things that cause trouble and challenge seniors, and that root cause is social isolation.

Social isolation is public enemy number one for seniors. Here’s an interesting statistic from research that we have done. Before the global pandemic, our ministry did research and surveyed 8,000 seniors, families and caregivers. We asked how many people wanted to stay in their homes. We found out that 80% of the respondents of this province-wide survey said they felt staying in their home was the most beneficial way to ensure good health and a good life. Now, after the global pandemic, we have found out that 99% of anyone we talk to wants to stay in their home as long as they want to. That is why this act is so important. Madam Speaker, staying in the comfort and familiar surroundings of your own home, no matter where you live in Ontario, creates a sense of stability and security. This act allows people to remain stable and secure, because more health care will now come to them in their home. As a super senior myself, I cannot stress more how important that is. It is key to having a fulfilling life.

I also want to let you know about the leadership of the Premier and hard work of the Minister of Health to address the needs of seniors so that they can continue to live their lives in their homes. Because of the leadership of the very best seniors’ advocate, our Premier, we now have a commitment to the 500 agencies all over Ontario that deliver programs and services on a daily basis to seniors in their homes and in their communities.

The Minister of Health has seen to it that Home and Community Care Support Services is receiving a $1-billion investment to further support our seniors at the local and community level. We now have permanent funding for those 500 agencies all across Ontario to deliver programs and services to our most vulnerable populations, older adults and our senior communities. This did not exist until our government committed this funding. This takes a vision. This takes leadership. That is what our Premier is doing. This shows the hard work and commitment that our Minister of Health is doing. This is our ongoing commitment so people stay connected and get the services and programs they need in their homes. This Premier knows how key it is to make sure that at the local level, people can receive the health and support they need.

This Minister of Health knows that, once passed, this legislation builds on creating a greater health care ecosystem that delivers the needed health-at-home services. Getting the services you need shouldn’t be a chore or a challenge. They should be there when you need them and should be at your fingertips. Ontario Health atHome is another new way that our government is delivering the right health care at the right place and the right time, especially for our seniors.

Another new way our government is getting care into the home is through Ontario’s Seniors Care at Home Tax Credit. Sometimes, seniors may require a range of supports to meet their unique needs and circumstances—attendant care; a medical practitioner, like a nurse or an occupational therapist; dental, vision and hearing care; walking aids; wheelchairs and electric scooters; bathroom aids such as grab bars, grips, rails; oxygen and assisted breathing devices; renovation or construction that improves a person’s mobility within the home. All of these supports are eligible for the Ontario Seniors Care at Home Tax Credit and help seniors continue to live at home in the dignity they deserve.

While we have created new ways to provide health care at home, our government has strengthened and invested in ways to let our seniors stay fit, active, healthy and socially connected in their communities while remaining to live in their homes. Seniors Community Grants are doing just that. This past year, we have increased the funding for Seniors Community Grants to historic levels. This year, we invested $6 million into more than 280 local community projects. These projects are keeping seniors socially connected. They are keeping seniors active. They are providing them with creative and productive ways to continue to contribute to society, to keep in touch with old friends and make new ones. Since 2018, our government has invested over $28 million and funded close to 1,500 projects. And no matter what the Seniors Community Grant, no matter where in the province I have visited, these investments are making a real difference to people’s lives.

Other ways our government is making a real difference is our ongoing commitment to Seniors Active Living Centres—across Ontario, there are 299 Seniors Active Living Centres. This past year, our government, thanks to the leadership of our Premier and the hard work of our Minister of Health, saw Ontario invest over $14 million into Seniors Active Living Centres. And let me tell you, the fun and activity that take place at these centres is money well spent.

Let me give you a couple of examples from this year’s Seniors’ Month that took place in June. I had the honour of travelling to Thunder Bay and Kakabeka Falls. In Thunder Bay, I visited Thunder Bay 55 Plus Centre—and let me tell you, oh my, what a place. It was bursting with services and recreational programs. The seniors there were as active as active could be. I would like to congratulate Thunder Bay 55 Plus Centre for taking very good care of our seniors.

On the same trip, I visited Rural 60 Plus in Kakabeka Falls. What a place. The seniors there were so full of energy. I personally saw at Rural 60 Plus that when people have a purpose, can set their goals, and have a place to achieve those goals, anything is possible. Because, whether you are a senior or not, when we have the ability to come together, to set our goals, and to have an ability to see our goals in action, we have more focus and direction and, as a society, become a better place.

That is what I saw first-hand at Rural 60 Plus in Kakabeka Falls. I met one gentleman; he was 93 and he made me feel like a teenager, and he had more energy than I did. It was explained that a 99-year-old lady travels to play bridge once a week from Thunder Bay.

There is a woodworking workshop, a quilting room, and a room dedicated to the art of working with looms. And if that wasn’t enough, there was an indoor shuffleboard, a lovely library and you could break out into a game of cards anytime you wanted to. And the seniors in Rural 60 Plus were exactly the kind of leaders we know our seniors are here in Ontario. They are resilient. They are resourceful. And most importantly, they are full of life.

But why are these two seniors’ living centres, along with the others all across Ontario, such important parts of our seniors landscape? Because they provide a connection that is close to home, and that is the key. We as a society must understand that for seniors, being close to family, being close to the community and, most importantly, being able to continue to live in your own home is essential. And that is why, Madam Speaker, creating and investing in Ontario Health atHome is so vital for our seniors today, tomorrow and into the future.

Before I conclude, I want to let people know that none of this could be done without the incredible army of volunteers all over Ontario. It is our dedicated volunteers, seniors and not-so-seniors alike that are making sure we stay connected to our health care programs and services. It is also dedicated partners like OACAO and the Ontario Retirement Communities Association, or ORCA, that continue to work with our government to make things better for our seniors each and every day. And for that, as a minister but also as a senior, I am forever grateful. Ontario Health atHome will make it easier for people to find and navigate home care services, giving seniors the ability and the power they need to know the care options available to them, to stay in the comfort of their own home for as long as they wish.

Madam Speaker, I hope that once Ontario Health atHome is up and running, they integrate their services and have their leadership teams connect directly with Seniors Active Living Centres. This will help to create an even more seamless health care ecosystem for seniors.

Another way that Ontario Health atHome can connect with our seniors is through Seniors Active Living Fairs. These fairs also help seniors stay socially connected in their communities and in their homes. These fairs are a marvellous way for seniors to come together, and they have a real purpose. These active living fairs are the information centre for seniors. They are where we can learn about all the incredible services and programs taking place locally, plus it is where we can find out about health care and wellness so we can stay active in our communities and in our homes. These fairs are incredible ways for our government to partner with the Older Adult Centres’ Association of Ontario. The OACAO brings together these local seniors’ events. The seniors’ fairs are ways for our seniors to come together to learn about the programs and services that are available to them in their homes, plus they are also ways to find out all the health care services that are provided locally as well.

I have been to a number of these fairs, and seniors are so happy to be with other seniors. These fairs are full of smiles and laughter, but most importantly, they are an important resource for seniors to stay connected. This is key because, as I have mentioned and will continue to mention, social isolation is public enemy number one for seniors. Seniors need people. People are our energy. To put it simply, we are like that Barbra Streisand song: “People / People who need people / Are the luckiest people in the world.”

We are from a generation where meeting and greeting each other, being with each other, enjoying each other’s company, is the key to a happy and healthy life, and it is we, the seniors, who deserve the dignity and respect to be able to live our lives in our homes. That is why we are growing the seniors’ fairs to close to 90 this year. I would like to someday see each and every municipality have the opportunity to host at least one seniors’ fair.

People are also medicine. Being with people provides stable, strong mental health, and with our focus on having people live in their homes for as long as they wish, that means that their lives will be more fulfilling and more uplifting.

It is we, the seniors, who raised the families, who have worked the jobs. We have built the best country, Canada, and the best province in the world, Ontario. That is why, Madam Speaker, I call on all members of provincial Parliament to say yes and vote for the Convenient Care at Home Act, 2023. This piece of legislation is a continuation of Ontario’s best seniors’ advocate, our Premier.

This act, once passed, builds on the goals and vision of this Premier to let seniors continue to live in their homes. This act, once passed, will continue to provide even more care for seniors, their families, loved ones, caregivers and the entire older adult community.

And remember, no matter your political stripe, whether you are a Progressive Conservative, a Liberal, a member of the NDP or Green Party, that if we are all blessed to live long enough, we all become seniors—some of us even super seniors, like myself. That is why this legislation is so important at this point in Ontario’s health care evolution.

Ontario Health atHome adds to our government’s expanded health care commitment to the entire province, and this will ensure that our seniors can do what I’ve always longed for: to let seniors live at home for as long as they wish, in the dignity they deserve. That is why I am expecting that there will be unanimous support in this provincial Parliament, no matter what the political stripe. It’s so important for all of us to come together in solidarity, as one voice here in Ontario, to pass this act so that seniors can get the health care they deserve.

The Acting Speaker (Ms. Bhutila Karpoche): Questions?

Questions?

Well, I would respectfully say, absolutely, we are expanding the health care workforce. Does the member opposite, who voted against the Learn and Stay program that actually ensures we pay tuition and books for health care workers who are being trained in the province of Ontario—to then use that and practise in areas of highest need—that is the question. As we build our health care workforce, is the member opposite for or against that? Because her voting record would suggest that she is against that.

We need to make sure that we expand the program. The member opposite’s suggestion would actually lead to a shrinking of home care providers and home care access in the province of Ontario. I can’t believe there is anyone in this chamber who believes that we need to shrink home care in the province of Ontario. We need to expand it, which is exactly what we’re doing with this legislation.

The back-office support will be a key piece of this legislation to allow organizations that wish to provide in community the ability to do that and make it consistent, so that we don’t have these examples of “in Ottawa, I get three hours; in Orangeville, I get an hour.” That piece will be able to be consistent when we bring it together under one organization.

Home care is such a key part of the health care system, and where governments past—I’m looking right now at what former Premier Mike Harris did. He went into full private delivery of home care. He said it would make it better, faster, cheaper. None of this, of course, came true.

Our home care system is broken right now. There is no question that it’s broken. We have a labour shortage within that arena; there’s inconsistent care for seniors; and this bill will essentially create an arm’s-length agency to oversee home care, with the board of director members appointed by the government. This is also somewhat problematic, given the appointments that this government has made in the past.

How will this bill prevent private companies from taking over public home care services without governance, without any public accountability structure and without public interest protections?

It was interesting listening to the Minister of Health. I certainly agree with her that the demand for home care is increasing, and the number of people who are not getting the home care they need in Ontario is also increasing, exponentially. Does the minister agree that a lot of this has to do with how health care providers cannot recruit and retain a stable workforce? Because PSWs who work for home care cannot pay their rent and feed their kids. Does the minister agree that if we were to give PSWs permanent, full-time jobs with good pay, benefits, sick days, a bit of a pension plan, the 500 PSWs in my community that are not working could go back to doing what they love to do, what they want to do? Is any of this in the bill, to fix our broken home care system?

My question is for the Minister of Health. I know in my riding we have an unusually large demographic of the retired and seniors. I know that this government has committed $1 billion over three years to enhancing our home care experience.

In her comments today, the minister mentioned an increase of $128 million over the next three years to the Ontario health teams and I’m wondering if she can just explain further to the House how this will impact home care for our residents.

My question is to the minister. I got a letter from Cindy, who is a PSW in my riding. She has written, “I make a top wage of $22.50 after 10 years and we are struggling. With inflation we are having to go to food banks or get second jobs.... We actually hold people’s lives in our hands and enable people to live and die in their own homes but can’t afford to eat or live in our own home. There needs to be wage equity across all health care settings. All PSWs, nurses, etc. should make the same across all sectors. We deserve to be treated with respect for the jobs we do because without us how” do “your parents, grandparents or even yourselves live alone if they need care. Something needs to be done now! We need a living wage to continue in this profession and to be treated with respect, period.”

That’s from Cindy, but I’m sure it could be from any PSW: that they don’t feel respected, that they are overwhelmed and overloaded and driven out of the field.

What is in this bill that I can tell Cindy is going to make her life better?

Thanks for the question. As I mentioned, my ministry did a survey with over 8,000 seniors, their families and their caregivers, before the pandemic outbreak. At the time, the survey results indicated 80% of seniors want to stay in the community, live in their own home as long as they want to. Now, after the pandemic outbreak, every senior—almost 100%, 99% are anxious to stay in their own home and live in their community. This is why this act is so important.

Thank you for the question. I hope that, regardless of your political stripe, you will support this act so that more seniors can stay in their own homes and get the health care services they need.

Very quick question, the member from Mississauga–Lakeshore.

Mississauga Centre.

The minister spoke about the 12 Ontario health teams that have been chosen to work together with the Ministry of Health and Ontario Health to start focusing on a seamless transition for people experiencing chronic disease. Something that I’m very passionate about is people living with dementia, so can the minister explain how this transition and the local navigation services will also help patients living with dementia?

I would start by saying that I am quite happy that we will be talking about home care. As the minister of seniors’ affairs said, things have changed in our province: more and more frail elderly people—more and more people—live at home. They want to continue to live at home. They want to be supported and respected to be able to continue to live a good life in their home, and often this is made possible because they receive home and community care.

So do I want strong and robust home and community care? Absolutely. We all do. We all know people—we’re MPPs; I’m sure that I’m not the only one who receives complaints about home and community care, mainly about home care, pretty much every single day. When people get to my office in the morning, they will play the messages from the night before, and I guarantee you that there will be people calling in because of failures of their home care to support them. They will call my office, and I’m sure they call the offices of every other MPP.

Our home care system is broken. It fails more people than it helps every single day. Why is our home care system broken? Let me bring you back to the Mike Harris era, because before the last Conservative government, our home care system was offered throughout by not-for-profit agencies. In my area, it was the VON. VON had been providing home care for decades. They had staff, they had nurses and PSWs and others who worked for them for a career. They made a career of providing home care. They were really, really good at what they did. They shared best practices throughout the province, because if one thought of a better way to provide care, it was shared throughout. They had meetings together. They really tried to make home and community care as responsive to the patients’ needs as possible, and they were really good at it.

Then came Mike Harris. Mike Harris convinced Ontarians that bringing in a competitive bidding process, bringing in the for-profit companies was going to make home care better, faster and cheaper. That was the logo at the time: “Better, faster, cheaper.”

Let me tell you something, Speaker: We know now, three decades later, that none of that was true. Our home care system is not better, our home care system is not faster, and it certainly is not cheaper. But what has changed, though, is that VON in my community went bankrupt. They put in for the competitive bidding process when that happened. Bayshore won the contract and VON lost. They had to let go of all of those nurses. Those nurses that had 10, 20, 30, 35 years of experience working in home care, dedicated to their patients, dedicated to the profession, lost their jobs.

The American company who won the bid was supposed to do things better, faster, cheaper. You read the proposal. It looks like they were trying to have hundreds of Mother Teresas come and work for them for free, to offer all of those services. It was a beautiful thing to read. None of it was true.

All of those people who worked in home care for their entire life lost their job. Then the American for-profit company came in and offered them a job at less than what they used to make with no guarantee of full-time work, with no pension plan, with no benefits. They were not going to be paid in between patients anymore. VON used to pay them from, “You start in the morning, your first patients—we pay you for the whole shift.” Not anymore: “You are only going to be paid when you provide care.”

In my neck of the woods, they would come and show me, “Look, France, we submitted for over 600 kilometres between patients for the last two weeks.” They don’t get paid for that. Do you know how long it takes to drive 600 kilometres in northern Ontario in my riding? All of those hours they do for free. They get 33 cents for their mileage for that. What do you figure happened? All of those people who were good at what they did and who loved what they did, they had no problem finding jobs elsewhere in the health care system.

We all know that the need for nurses is there. It was there back then. They moved. Since then, the for-profit home care deliverers have not been able to recruit and retain a stable workforce. What does that mean when you cannot recruit and retain a stable workforce? It means that you are not able to provide quality home care. It’s as simple as that.

Think about it: You have a home care worker who is there to give you—in my neck of the woods it doesn’t matter how high your needs are, you get two baths a week. You need somebody to help you with the transfer. You need somebody to help you to eat. You don’t get any of this. Home care gives you two baths a week. Well, two baths a week from different providers every week—it doesn’t take very long that grandpa doesn’t want two baths a week anymore. He doesn’t want to have to strip naked in front of a different stranger every single day because they cannot recruit and retain a stable workforce. This is what our home care system looks like.

We have a bill in front of us that looks at changing home care. I sure hope that we take into account the fact that our home care system is broken. One way to make sure that our for-profit delivery of home care in Ontario—Ontario is the only one, by the way, that has privatized the delivery of their home care system. The home care system in every other province is better than ours. We are at the bottom of the list. We are on another page at the bottom of the list, our home care system is so broken.

My question to the minister is that one way to help right here, right now a home care system, to recruit and retain a stable workforce: Make PSW jobs good jobs in home care. Give them permanent, full-time and well-paid jobs with benefits, a few sick days, maybe a pension plan and a workload that a human being can handle and problem-solve.

We now have hundreds in my community alone. Throughout Ontario, it’s tens of thousands of PSWs, mainly women, who love what they do, who are good at providing home care, who would love to work home care if only it would mean enough money to pay the rent and feed their kids, but it’s not. It doesn’t matter how many hours you work home care, you’re not going to be able to pay rent and feed your kids because, even if you have been there for 20 years, the maximum you can hope for is 22 bucks an hour.

Let that sink in: 22 bucks an hour. You start your shift at 6 a.m. You’re not paid for travelling from one care to the other. You will put in a 10-hour day. You will work from 6 a.m. until 4 in the afternoon but only get paid for six, seven hours, if you’re lucky. For those other three hours that you travel between cases, you can’t. And those are those that are lucky enough to have a car because for many people who make 18, 19, 20 bucks an hour, owning a car, paying for fuel and insurance and everything else is not something they can afford. Those people travel by transit, which means it takes even longer to go from one client to the next, and that travel time, they don’t get paid for it, which means that you put in your 10-hour shift and you’re lucky if you get paid for six, at a maximum of 22 bucks an hour.

Can anybody see where we could easily fix a huge part of our home care system? Now, the first part of the bill is that 14 of what used to be CCACs—care and community, which became the LHINs and became the home care and community support services; it doesn’t matter how you call it—will now be called Ontario Health atHome. So we have 14 of them right now. We will be down to one.

Let me give you an example of what it means once things get centralized to one agency rather than others. We have Ontario Health right now, which is putting out a planned procurement. They have a request for proposals—it’s on their website. Anybody can go and see it; so did I. The request for proposal is, “The scope of the” request for proposal “will include supply, maintenance, delivery, set up and pickup of basic medical equipment in the following categories to support patient receiving care at home”—home care, so:

“—beds (beds, rollators, mattresses...;

“—mobility aids,” such as “walkers, wheelchairs,” canes, “etc.;

“—bath aids,” such as “(commodes, bath seats, etc.); and

“—lifts, slings, transfer devices”—the list goes on.

The RFP goes on to say that they intend to award—resulting from this request for proposals—“to a successful bidder that can service the entire province of Ontario. The term of any recurring contract will be for a period of three (3) years, with an option to extend for up to two (2) additional years.” And the request for proposals goes on—it’s on their website; anybody can read it.

When the minister made her statement today, she made it clear that the same type of request for proposals that is presently on the Ontario Health website will also happen for home care providers. So now think about it: We will have home care providers that are big enough to provide the entire province. No matter where you are, they should be big enough to be able to be a provider for the entire province. You know who can do this, Speaker?

One of the things that you can tell Cindy is, in fact, we’ve done the work on stabilizing the health care workforce. It is absolutely important that whether that PSW is working in a hospital setting or in a home care setting or in a long-term-care home, there is a much more consistent approach in terms of remuneration. We’ve done that, and that has been very welcomed in the sector.

But if we want to talk about affordability, perhaps the member opposite could explain to her constituent Cindy why she supported the carbon tax, in fact making her job that much more expensive as she moves using a vehicle, moving from patient’s to patient’s home. Those are the types of affordability pieces that the member opposite and the party opposite don’t want to talk about. There is a cause and effect when you support the carbon tax that was put on by the federal government, which we oppose, and now we’re seeing the outcome, which is, of course, higher tax, higher inflation.

Nurse Next Door?

Interjection.

You’re funny—big, for-profit home care providers. They are the only ones who will be able to answer that bid. You know what that means for the people of Nickel Belt, the people I represent? That means that there will never be people available.

Don’t take that from me; I will read you some examples of my constituents. I will start with the constituents who just contacted my office on October 5:

“Dear France,

“My mother ... had an assessment from the local LHIN today.” Home and community care keeps changing names. “She previously had a stroke in 2019 and then broke her hip in 2020 and then her back in 2021. She lives alone and was receiving four showers per week (often workers do not show up so it can be less than that in reality) as she tries to do everything else herself. She was visited” by “an assessment officer from the LHIN today and the woman said Mom would be cut back to two showers per week since that is the standard.... Mom then called their office and they said she could continue” to have “four showers per week. Then Mom received a call from the assessment officer who visited her in the morning and the woman told my mom, ‘You were fine with the two showers when I was there with you today.’ My mom was given no choice” so that she could say during the visit. “The woman said she would bring the matter up with her boss about the showers.

“I find it very sad that health care staff would put an elderly person through such” difficulty “when her life is already hard enough as it is. It seems like a power play at my mother’s expense. After a stroke, elderly people cannot handle stress the same as before and are vulnerable. Does the province want elderly people to have to go to long-term-care homes and occupy hospital beds when simple services are not available in their homes? Often workers do not show up or called to cancel in the past, so two showers a week will either be one per week or none” at all. “This is the reality of the system. Mom currently has a pretty stable PSW for her four showers per week but if these are cut back this PSW may have to find other work, and Mom will lose out in the end. Having a stable PSW is so important for things as personal as a shower. We are ... entitled to dignity. I hope you can help with this situation.”

That was one example. I have many, many that I could go through.

Maybe I’ll do another one right now. This is from Lionel Rudd, again from my riding—a very nice man. He says:

“Hi again,

“A follow-up to my previous email.... I was anticipating a call from a Bayshore nurse last evening (Saturday) or at least early this morning (Sunday) when I would be informed as to the time of the nurse’s visit.

“I did not receive any call—so I had to phone Bayshore. I was told that someone would call me at 10 ... no call. After 11:30 a.m. I called Bayshore again and was told eventually that a ‘nurse’ was coming on duty at 3 p.m. who would be able to see me.

“At around 2:15 p.m. I received a call from Bayshore telling me that there was no nurse available to see me today—maybe Monday.

“I was told that I was a level 3 patient ... whatever that might mean except that I was not in a critical condition ... and that I could miss the odd visit! Of course none of this was ever conveyed to me ... I had no idea of the whole set-up. It seems that Bayshore is not at all organized and appears that there is a level of management incompetence.

“It is most troubling that Bayshore did not have the common decency to pick up the phone and at least be honest and straight with me. I sat around for many hours not knowing anything. They appear to have an extremely arrogant attitude and uncaring culture towards at least me. I wonder who else goes through the same kind of dealings with Bayshore.

“Maybe you can raise this issue where it counts—or maybe add it to the pile that you already have.

“Best regards,

“Lionel Rudd”—a resident in my riding.

I wanted to share that with you because he is not—we have complaints like this non-stop. I wanted to make the link between having one care-at-home provider and looking for providers who can service the entire province. I’ll just read into the record and then show you how those two are related:

“Dear France Gélinas,

“I am writing to you because I have a growing concern” with Bayshore “not being provided for days at a time to the French River area.” The French River is an area in the south of my riding. “My husband is terminally ill and requires daily nursing for checkup and drawing up of medication. On”—she gave the date—“at 2:19 p.m. I received a phone message from Bayshore telling me that there was no nurse for the weekend, that they would be doing a virtual visit on the phone. I called back to Bay-shore at 2:29 p.m. and left a message that this was not acceptable as my husband needs meds drawn up daily and I missed the nurse that day as I had to go into Sudbury myself to pick up the meds needed for my husband, which meant the meds were not there when the nurse came on Friday....

“I then called my husband’s caseworker, Linda Emms, at the North East LHIN to report this to her. Linda said she would look into it and then called me back to verify no nurse was coming for the weekend. After I verified once again no nurse she then called Bayshore and told them that this was not acceptable, that my husband had to have daily care. Bayshore assured Linda ... that my husband would have a nurse, but no nurse came that weekend. Our nurse practitioner”—there’s a nurse practitioner who doesn’t work for home care who is in the French River area—“Ann Desrosiers came to the house every day that weekend,” on Friday, Saturday and Sunday.

“I followed up with Linda ... on Monday ... and she said she would file a complaint against Bayshore. Our nurse practitioner, Ann Desrosiers, has had to come to our house several times to draw up meds because” the home care nurse does not “draw up enough or none at all or the meds are not here as we are waiting on the delivery. It’s not just my husband that was without a nurse for the weekend but several others in the French River community that some are even sicker than my husband and they did not have care” at all this weekend.

“I had put this letter away for a while but here we are again ... and my husband has no nurse for the weekend. The nurse from Bayshore came today and drew up a lot of (syringes) meds to last the weekend. She told me no nurse” would be coming this weekend. “I did not receive a phone call out of courtesy from Bayshore as of yet. I have left a message again with my husband’s care coordinator Linda Emms at the North East LHIN but have not heard back from her as of yet. Again not just my terminally ill husband without a nurse for the weekend but several other French River residents that require home care will be without home care as well. If Bayshore has a contract to fulfill they need to fulfill it. Maybe Bayshore should make it mandatory that their staff should have to come to the French River one weekend every other month and maybe then French River will have a nurse every weekend. I have cc’ed our nurse practitioner ... on this.

“With kindness...” and she signed her name. She is from Alban in my riding.

I wanted to share that with you because there are solutions available. There is a little home care provider in the French River called Aide aux Séniors. Aide aux Séniors is a not-for-profit group of health care providers who are more than willing to go and help their neighbours, who are more than willing to provide home care on weekends, on day shift, to people who need it.

But do you really think that the little Aide aux Séniors in Alban in the French River will be able to fill out a request for proposals like you see on the website for Ontario Health? No, there’s absolutely no chance of that, Speaker. The only one who will be able to meet the new requirement that the minister was so proud of saying, “Oh, we will have a centralized procurement process to make sure that everybody is treated the same”—what that means for the people in northern Ontario, what that means for the people that I represent, is that more and more people will never have the home care that they need.

That Bayshore will get those contracts I have no doubt. When it comes to writing up proposals, as I said, it looks like Mother Teresa works for them and will be delivering care to every single home care patient in Ontario. It’s just a beautiful thing to read. But in reality, none of this comes through. In reality, they cannot recruit and retain a stable workforce.

Why can they not recruit and retain a stable workforce? Because they don’t offer good jobs. What do good jobs look like? They look like permanent, full-time jobs, well paid with benefits, sick days, a pension plan and a workload that people can handle.

Do you feel like I’m repeating myself a bit there, Speaker? It’s because I am. We have been saying this for a decade now. For decades, since Mike Harris brought us the privatization of the delivery of our home care system, our home care system has not been able to recruit and retain a stable workforce, because they don’t offer good jobs, and people suffer.

Now, for the few not-for-profit home care deliverers that still exist in parts of the province, because the local CCAC, LHIN, home and community care support services, call it whatever you want—they existed locally. They knew the number of complaints they were getting about the people who get the big contract. Bayshore has a contract in my area. They know how many complaints that they get. They know the areas that they’re not able to support and they go, sometimes, out of contract.

Sometimes they do have a small contract with a not-for-profit agency that will service a little pocket. In Nickel Belt, it’s 33 little communities, none of them big enough to be a city. They don’t have a municipality. They don’t have a mayor. But they have good people who live there, who love where they live, who work there, who age there, who become frail there and who need care.

Does Bayshore have a nurse who goes to Westree, Shining Tree, Biscotasing, Gogama, Mattagami First Nation or Alba? No. Do they have the contract for them? Yes. Do they provide care? No.

Things will get even worse with the change that this bill will bring forward because now it won’t be that you have a contract for the city of Greater Sudbury and the little communities around; you will have to sign a contract that is province-wide. Aide aux Séniors is not going to be able to bid on one of those contracts—and neither are the other little home care providers that exist in my community—to help in those little communities. And what will happen to those good people? The same thing that I just read to you, and I have many, many more.

Before I go on to share more of the problems that we already have, I want to talk a little bit about the second part of the bill that would allow care coordinators to be incorporated into other health care providers. This is such a good idea that it is already happening. If you come to Health Sciences North, the name of our hospital in Sudbury, you will see that we have a health and community support—call them whatever you want—care coordinator who works there. We have very good family health teams called City of Lakes Family Health Teams in Sudbury that have many sites in my riding, one in Lively and one in Val Caron. They also have a care coordinator who is part of that family health team.

Actually, the Ontario Medical Association is at Queen’s Park today. They came with three asks. The first was to ask for integrated primary health care teams. They all want to work in an integrated, interdisciplinary team. That means a community health centre. That means Indigenous primary health care. That means nurse-practitioner-led clinics. That means family health teams. That means a place where a physician is not a fee-for-service solo practitioner anymore. They are supported by nurse practitioners, nurses, dietitians, social workers, physiotherapists, psychotherapists, development workers and health promoters who work as part of a team so that they can focus on being a family physician and have the support of the integrated, multidisciplinary team to work with them. That was their number 1.

Number 2: Decrease the amount of paperwork that they have to do. We still have to go to a family physician three days after we feel better to ask them to sign a sick note; it is a capital waste of resources and we could do away with it. An electronic health record that works would be really good.

Then, number 3 of their recommendations to us is home care. They want a strong and robust home care system that meets the needs of the patients, that meets the needs of the patients where they are. Those care coordinators should be available to most integrated primary care teams, but they are not.

We all know that the government has dedicated $30 million to new integrated primary health care teams. We expect those 17 teams to be announced any time now. Well, Ontario has 15 million people. What do you want 17 teams to do? We need 25 times that amount. In the northeast alone, we could use that $30 million and those 17 teams, never mind the rest of the province.

Just to put an emphasis as to how important home care is, you have a group of physicians represented by their association. The Ontario Medical Association represents 42,000 physicians, and what are they asking us for? They’re asking us to fix home care so that they know that if their patient needs somebody to help them transfer from their bed to their wheelchair, or somebody needs help to transfer into the tub or onto the toilet, or needs help with feeding themselves or changing beds or whatever, the service will be there. This is what their patients want. This is what the OMA and their 42,000 members came to Queen’s Park to tell us, but none of that is in the bill.

The bill talks about basically creating province-wide home care, Ontario Health atHome, and then that would be responsible for procurement of home care services. Let me tell you that the inequality that you see—somebody who gets assessed and scores an 18, 20, 21 or 22 in my riding gets two baths a week. That’s all they have resources for. Somebody in Ottawa who gets assessed for a 21 or 22 will get a whole lot more. They will have one or two hours of home care a day. They will get two or three hours of respite per day for their family caregiver.

It’s not because the people in the north don’t know that the need is there; it’s because there is no money. If you look at the home care and support services, some of those agencies—not on the home care side, but on the support services side—there are still lots of not-for-profit agencies that do that work. They haven’t seen a base budget increase in 12 years. That is when the Liberals were in power. For the last five and a half years that we’ve had a PC government in power—they have not seen a base budget increase for 12 years. Has the demand for their services increased during that period of time? Absolutely. Has the cost of providing those services increased during that period of time? Absolutely. Have they seen any of this actually acted upon by government after government? Absolutely not.

And now we see a bill—there is money in the bill, $122.2 million, that would be to help the teams learn to work together. There’s nothing wrong with helping teams work together, but that doesn’t provide one hour of home care to anybody who needs it. That does not provide one extra bath a week to people who would like to have more than two baths a week, because they know full well that for at least one of those two, the PSW is not going to be able to show up. Having one bath a week—I couldn’t live like that; I can guarantee you that. Why are we asking frail elderly people and people who need home care to live like this? Why aren’t we able to show them respect? Why aren’t we able to meet the needs where they are? This is what people are asking for.

The minister also talks about new models of care. So rather than being paid for—you get 50 bucks to send a PSW for one visit to Mrs. Such-and-Such to do whatever needs to be done—usually a bath—and leave, and Bayshore gets 50 bucks, the PSW gets $8.50, and end of story.

Now there’s what they call care bundles. A lot of people have heard about total knee surgery. A lot of people have heard about total hip replacement, total knee replacement. The care afterward is being standardized. After you have a hip replacement, we know that you will need somebody to come and change your dressing. For a hip replacement, you used to have to stay in the hospital for 10 days, then you stayed in the hospital for seven days, then you stayed in the hospital for four days, then you stayed in the hospital for two days. Now you go home that day—yay! Nobody wants to stay in the hospital. You go home with home care. So we know that you will need somebody to come and change your dressing. We know that you will need access to a physiotherapist so that you regain strength, balance and range of motion. We know that you will need support from a PSW to make sure that you do your transfer in and out of bed, to the toilet, to the bath etc. Now they bundle that care together.

So now Bayshore will get an amount of money to look after you after a total hip replacement or total knee replacement that includes that we will have at least four visits by the nurse, three visits by the physiotherapist and 10 visits by the PSW to look after you as a care bundle after you have your hip replacement. That all makes sense. The first visit, the physio will do the assessment; after the second, we’ll make sure your range of motion is coming; and by the third, make sure the strength and balance is back. The nurse will go make sure that you’ve had the dressing changed, make sure that the staples came out when they were supposed to come out. The PSW will be there to help you with your bath while you have a big bandage on your hip, blah blah blah. It all works—on paper. Bayshore gets paid to do all of that.

How much of that do they deliver? Very little. How many people who were put through the bundle process actually got what the bundle was supposed to include? Very little.

Did you know, Speaker, that 25% of the people who have a hip replacement will never walk again if they don’t have access to physiotherapy? Let that sink in. We do those expensive surgeries so that people can continue to be active, and 25% of them won’t be able to walk again—never mind going up and down the stairs or on an incline or on uneven ground—if they don’t have access to physiotherapy.

But, coming back to Bayshore, who now gets a bundle of money to offer the four visits from the nurses, the three visits from the physio, the 10 visits from the PSW, because this is what you need to make a good recovery from your hip replacement—well, they had one physiotherapist, but she has been on maternity leave for the last two months, with a brand new, very cute little baby, and is not available to work. The nurse never came to change the dressing. The stitches got infected. You had to be admitted back into the hospital and treated because we were afraid you were going to get septic because your stitches were badly infected because the nurse never came to change the bandages. And the PSW did come some of the time. She was not supposed to change the dressing. She ended up lifting the dressing because it didn’t look too good and had been there too long, and she’s the one who said you had to go back to the hospital really quickly. Bayshore got the money for the bundle of care.

This is supposed to be the innovation that comes from this new way of providing home care, but this innovation has already been tried here in Ontario. But because we have for-profit companies who dominate the home care system, the for-profit companies’ number one objective is to make money. They exist to make money for their shareholders—and they do, in the hundreds of millions of dollars for their shareholders, at the expense of not being able to recruit and retain a stable workforce because they don’t provide good enough jobs to allow PSWs to pay their rent and feed their kids.

Interjection: So out of touch.