I agree with you 100% that we have to keep our physicians—have all our health care providers working to full scope and minimize the amount of administration they have to do. Central intake is certainly one of those things. The government is working with the OMA on red tape issues, and that will continue as well. Our Minister of Health has provided funding for interdisciplinary care. There have been proposals received and waiting for approval.

In my riding of Lanark–Frontenac–Kingston, we’ve seen the expansion of the Ottawa Valley Family Health Team from Almonte; it’s now going to be in Carleton Place as well.

Those are great models of care, because they allow the physicians to really scope on doing doctor work and not running a business, not hiring staff, not worrying about whether the hydro bill got paid. The interdisciplinary model, the CHCs, the family health teams, are great models, and the minister has supported that initiative.

The Deputy Premier and Minister of Health.

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

The division bells rang from 1141 to 1146.

On October 25, 2022, Mr. Jones, Chatham-Kent–Leamington, moved private member’s notice of motion number 69.

All those in favour of the motion will please rise one at a time and be recognized by the Clerk.

Motion agreed to.

Deferred vote on the motion for second reading of the following bill:

Bill 38, An Act to establish a framework for the licensing of supportive living accommodation / Projet de loi 38, Loi établissant un cadre pour la délivrance de permis d’exploitation de logements supervisés.

The division bells rang from 1151 to 1152.

All those in favour, please rise and remain standing until recognized by the Clerk.

Second reading negatived.

This petition is entitled “Stop Ford’s Health Care Privatization Plan.

“To the Legislative Assembly of Ontario:

“Whereas Ontarians should get health care based on need—not the size of your wallet;

“Whereas Premier Doug Ford and Health Minister Sylvia Jones say they’re planning to privatize parts of health care;

“Whereas privatization will bleed nurses, doctors and PSWs out of our public hospitals, making the health care crisis worse;

“Whereas privatization always ends with patients getting a bill;

“Therefore we, the undersigned, petition the Legislative Assembly of Ontario to immediately stop all plans to further privatize Ontario’s health care system, and fix the crisis in health care by:

“—repealing Bill 124 and recruiting, retaining and respecting doctors, nurses and PSWs with better pay and better working conditions;

“—licensing tens of thousands of internationally educated nurses and other health care professionals already in Ontario, who wait years and pay thousands to have their credentials certified;

“—making education and training free or low-cost for nurses, doctors and other health care professionals;

“—incentivizing doctors and nurses to choose to live and work in northern Ontario;

“—funding hospitals to have enough nurses on every shift, on every ward.”

I fully support this petition, and will sign it and give it to Margo.

I move that, in the opinion of this House, the government of Ontario should adopt the recommendations of the official opposition report on the Indigenous determinants of health so that Ontario recognizes “Indigeneity” and “colonialism” as overarching and intersectional determinants of health across government ministries.

Speaker, I spoke to the leadership of Muskrat Dam after I announced this motion, and they told me that they need to declare a mental health state of emergency. There is an ongoing public health emergency and social crisis related to mental health and addictions in the 33 First Nations served by the Sioux Lookout First Nations Health Authority, also known as SLFNHA.

On September 5 and 6, 2023, an annual general meeting for SLFNHA chiefs was held. The chiefs in the assembly heard staggering statistics from the preliminary mental health and addictions report. According to data analyses completed by the Institute for Clinical Evaluative Sciences, or ICES, mental health and substance abuse health care utilization rates for Sioux Lookout-area First Nations band members residing on-reserve in any First Nation community in Ontario and off-reserve in Ontario are as follows:

In 2021, Sioux Lookout-area First Nations band members visited the emergency department services for mental health and addictions at a rate 14 times the provincial rate.

In 2021, Sioux Lookout-area First Nations band members visited the emergency department for intentional self-harm or risks of suicide at a rate of 16 times the provincial rate.

In 2021, Sioux Lookout-area First Nations band members were hospitalized for mental health and addictions at a rate six times greater than the provincial rate.

According to data from the Office of the Chief Coroner for Ontario, unnatural death rates in the Sioux Lookout-area First Nations are as follows:

The rate of unnatural death in the Sioux Lookout-area First Nations was 1.6 in 2021, 3.4 times the provincial rate and 2.4 times the national rate.

The rate of death by asphyxia-related suicide in the Sioux Lookout-area First Nations members is 15 times greater than the Canadian rate.

Asphyxia by hanging is a primary cause of unnatural death in the Sioux Lookout-area First Nations. It is determined to be the cause of 38% of all unnatural deaths between 2011-21 and the cause of over 70% of unnatural deaths among children 10 to 19 years of age during the same time period.

I’m just sharing these stats to quantify, you know, the desperate situation that First Nations leadership has to deal with on a daily basis. This crisis is devastating. It takes an enormous toll on their already limited human and financial resources.

The mental health crisis and addictions crisis stems from systematic racism and intergenerational trauma, and the continuing colonial violence embedded in the current federal and provincial health care systems.

The position of the chief states that the Sioux Lookout-area First Nations “will no longer accept processes that are founded on a program-by-program basis, whereby the governments off-load their responsibility while maintaining power and control over our people and organizations” and that those processes must be replaced with a whole-system approach that brings authority back to the First Nations people.

In addition to requiring immediate resources to address the current crisis, the communities served by SLFNHA deserve an equitable and comprehensive public health system to respond to the mental health crisis and other health and public health emergencies. This will allow for control over solutions to ensure that they are delivered in a coordinated, holistic and culturally safe manner to address the social determinants of health and mental health.

We know the health system does not work for Indigenous people. Some people say it’s broken, but it’s not broken. It is working exactly the way it’s designed to, which is to take away the rights of the people through their lands and resources. It is working exactly the way it’s designed to, which is to harm our people.

What I have shared about the public health emergency and social crisis related to mental health and addictions among the Sioux Lookout-area First Nations cannot be denied. It cannot be argued with.

I want to thank some of the advocates working on the front lines of health who see the realities in their work. One of them is Caroline Lidstone-Jones, the chief executive officer of the Indigenous Primary Health Care Council. The IPHCC has dedicated significant time and resources towards engagements focused on development of the more truthful and accurate Indigenous social determinants of health, which include impacts of colonization, impacts of racism, as well as protectant factors such as traditional healing and connection to the land, water, culture and other determinants.

We must ensure that patient-centered services, grounded in equity, are accessible to patients across the province. This motion presents an important and critical step towards recognizing and addressing factors that impact the health and the well-being of Indigenous people in Ontario. If we fail to recognize these determinants, we will fail to address them and ultimately implement solutions that can improve health outcomes and save lives. This government has an opportunity to ensure that this does not happen.

The IPHCC and its network of Indigenous primary health care organization members have developed a provincial Indigenous integrated health hub to ensure that Indigenous peoples are directly involved in the planning, design, delivery and evaluation of health services for Indigenous peoples in Ontario. This work involves collectively advancing Indigenous-led health care solutions across its network of members. This hub also involves working across the broader health system, including the public health units, the mainstream providers to understand and implement more meaningful Indigenous social determinants of health and to introduce accountability measures into the system to ensure Indigenous peoples have equitable access to safe and appropriate health services across the province.

I know that we must look at other provinces such as BC and their First Nations Health Authority, as well as examples within our own backyard such as health system transformation efforts led by the provincial-territorial organizations, Sioux Lookout First Nations Health Authority and the work of Indigenous primary health care organizations, to understand that factors impacting the health and the well-being of First Nations, Inuit and Métis people go beyond the determinants that have been developed through a predominantly Western lens without our input.

Sometimes it’s very difficult to hear stories. We talk about long-term care; our people, our elders have to leave their First Nations, their communities. They’re gone for good, and the only time they come back is when they come back in a box. That’s how colonialism works. And it is my hope that this government—and I trust that this motion will be adopted for further discussion and deliberation, and ultimately implemented across government ministries in Ontario, because the biggest room in the world is the room for improvement. Meegwetch.

It is my honour to stand in support of the member for Kiiwetinoong’s motion to adopt the recommendations of the official opposition’s report on the Indigenous determinants of health. Racism is a structural and social determinant of health. This will unequivocally improve the lives of indigenous peoples and their communities across the province.

As the critic for women’s social and economic opportunity, I want to pay special focus to what this motion means for Indigenous women. In Indigenous cultures, women are held in a special regard in many Indigenous teachings and traditions. For instance, “To the Ojibway, the earth is woman, the mother of the people, and her hair, the sweetgrass, is braided and used in ceremonies. The ... Sioux people of Manitoba and the Dakotas tell how a woman—White Buffalo Calf Woman—brought the pipe to their people. It is through the pipe that prayer is carried by its smoke upwards to the creator in their most sacred ceremonies.”

It was through colonialism that this was gravely disrupted, as we continue to witness today in Ontario, in our communities, and across our nation.

To quote Indigenous author Paula Gunn Allen, “Since the coming of the Anglo-Europeans beginning in the 15th century, the fragile web of identity that long held tribal people secure has gradually been weakened and torn.”

Gender and gender identity have now been listed as social determinants of health in this country, because to identify as a woman is to have barriers placed in front of you from birth because of a sexist world. These are not inevitable, but rather socially constructed. They are also not felt equally, and few are also impacted by the joint forces of colonialism and patriarchy as Indigenous communities are.

We have called on Ontario to recognize gender-based violence as an epidemic. We’ve called on this Conservative government to do so. Our calls are often unheard.

Indigenous women know all too much about gender-based violence, sadly. Indigenous women are at least three times more likely to experience violence, and at least six times more likely to be murdered. While just 4% of the Canadian population identifies as Indigenous and as women, they represent 24% of homicide victims. Many of them are never found, never even looked for, leaving their families shattered and without closure. No day of significance, no database, no event in our communities will bring their sisters, mothers, friends, partners and loved ones home.

We need action, and we demand that action today: action like committing to enacting every one of the missing and murdered Indigenous women and girls report’s 231 individual calls; action like saying yes to my colleague’s motion, a systemic approach to doing better by placing Indigenous self-determination at the centre and by recognizing Indigeneity and colonialism as overarching—I want to say it again—overarching and intersectional determinants of health across government ministries and across every political group. These need to be recognized as the facts that they are.

Thank you, Sol. Thank you for this motion. I support it wholeheartedly.

First of all, I want to commend my colleague from Kiiwetinoong on this acute, efficient and powerful motion. Speaker, there is no other answer to this motion than to support it loudly. There is no way to live in this day and age and not agree that Indigeneity and colonialism are overarching and intersectional determinants of health. Let me tell you how it translates in Mushkegowuk–James Bay.

Ce n’est pas pour rien que je répète très souvent au premier ministre et à son cabinet des ministres de mettre les pieds dans le Nord. Quand on parle du Nord, je vous défie de venir voir les communautés des Premières Nations du Traité 9 sur le bord de la baie James. Vous vous rendriez bien vite compte que de reconnaître le colonialisme et l’indigénéité se fait dans un coup d’oeil.

Speaker, let me give you a few examples of these two factors that can considerably change the quality of health care you receive. We all know about the world-infamous boil water advisories in 23 First Nations territories, with some dating back decades:

—Nibinamik First Nation has had water advisories since 2013: 10 years and still waiting;

—Gull Bay has had their water advisories since 2009: almost 15 years now;

—Sandy Lake First Nation has had their boil-water advisories since 2002: 20 years;

—Neskantaga First Nation has had their water advisories since 1995: 30 years.

It is clear: All the longest-standing water advisories in all of Ontario are on First Nations territories.

Mais je veux vous parler aussi de la dialyse. Quand on parle de la dialyse, nos commettants sont obligés de se déplacer de leurs communautés, soit dans Moose Factory—s’il n’y a pas de place à Moose Factory, ils sont obligés de se déplacer à Kingston. Ils vivent dans des motels pendant des mois. Des motels pendant des mois, c’est inacceptable. On se tanne, nous, dans une semaine ou quelques jours—on est tanné de rester dans des motels. Mais eux, ils sont obligés d’y rester pendant des mois.

We could talk about community isolation, lack of social services and non-recognition of traditional ways of life and cultural health care providers, trauma, industry development in communities that have polluted their environment, and so much more. And there is one thing I also want to talk about: dialysis. A machine costs $84,000. Think about it: $84,000 put in a community and they can stay with their loved ones. And that’s what’s not happening.

We all can think of at least one way to say, “Yes, colonialism is a determinant of health in this province.” I’m truly hoping that this government and all MPPs in this House will rise to support this motion that is in line with the World Health Organization and will finally put in the right tools to address a very important health crisis in Ontario.