Thank you, Speaker. If you’ll allow me, I would like to say thank you. I was supposed to do my lead on Thursday afternoon. I would like to thank my House leader team, as well as the House leader from the government, for allowing me to postpone my lead to this morning. I attended my nephew’s funeral Thursday afternoon. I was there when my nephew was born. My daughter used to babysit him and his brother. I was there when he graduated. He was a gifted mechanic, a really nice person. He died of a drug overdose at the age of 28, and it was gut-wrenching. I thank you for allowing me time to grieve with my family and attend his funeral. I will change the topic because I may start crying.

Thank you, also, to everybody who reached out and offered me a word of encouragement and support. From both sides of the House, I received them, and it was very much appreciated. Thank you.

Applause.

Home care has seen many changes in the way that it is governed and managed but not so many in the way that it is delivered. The way that it is managed is that there are basically three big groups of people who have needs and can live healthy and productive lives with the help of home care. We will start with the small one.

Some people are born with severe disability or diseases right from birth, whether they need special G-tube feeding to be able to feed themselves or they need help with breathing. Often, those babies becoming kids becoming grown-ups will be sent home with home care. For a lot of people who have severe disability and health needs—as I said, for breathing, for eating etc.—they could be on home care for their entire life. If you have a disability, you may tap into what is called the Passport Program, where you will basically become an employer and hire your own people to come and provide home care to you. Home care can range from helping you get out of bed and into your wheelchair in the morning, transferring to a toilet, showering, preparing meals, eating—all of the activities of daily living. So that’s one part.

The second part, which most adults will know, is post-discharge from hospitals—the ones that are the best known are hip and knee surgeries. I will take them as an example, but there are many others. For hip and knee surgeries, in my day, you used to be admitted to a hospital two or three days before and have the surgery. For a knee, you stayed for a week; for a hip, you stayed at least for 10 days—none of that anymore. All of the assessment is done ahead of time. They show you the exercises that you’ll have to do. They fit you for a walker or crutches, or whatever needs to be done. All of this is done before surgery. More and more, the surgery will be done the same day. The day of the surgery, you will be able to go home—or, at least, the next day or the following day. But the follow-up that used to happen in the hospital still needs to happen. You will have big surgical scars for which you will need a change of bandages. You will still need to be seen by a physiotherapist to make sure that you get your range of motion, you get your balance, you have full extension in your knees, you learn how to go up and down the stairs and how to manage on uneven ground—all of this. More and more of this in our home care is what we call bundled care; that is, you go home and you have a bundle of care where you already know that the nurse will come to see you on this day, this day and this day to change the bandages. The physiotherapist will come to see you to teach you exercises, then on day 5, she’ll start to teach you range of motion so that you get ready for stairs etc. etc. Bundled care happens after surgical or in-patient admission into the hospital.

The third part of home care—and I’m generalizing; there’s way more than that. The third part, I would say, is related to frailty and related to aging. Aging is not a disease. There are many, many elderly people who will live their entire lives never needing home care—but some of us will, and those are usually concentrated on what we call activities of daily living. So they may be able to get out of bed by themselves, but they will need help to go into a tub or a shower. They may be able to do certain things—they’ve had a stroke, and now they need a little bit of help to make sure that they learn to transfer from their bed to a wheelchair, or they learn to stand safely in their home, so you make their homes as safe as possible, to make sure that they continue to be able to walk, maybe with a walker, maybe with a cane, maybe with a quad cane etc.

This type of home care tends to go on for a longer period of time. You will continue to have somebody coming in to help you have a bath. You will continue to have people coming to see you to help you do the transfer, to help you do the toileting, to help you do the feeding and eating and preparing meals and changing the bedsheets and vacuuming. And if you live in my neck of the woods, you may need community care also to shovel the driveway. It just dumped snow in northern Ontario yesterday. The roads were really awful. By the way, where are all the snowplows? I did 450 kilometres, and I saw two snowplows going the opposite way, none in my way. The roads were awful.

Back to home care: So those are the three big parts of home care. Home and community care, way back, used to be delivered mainly by the VO; it was throughout the province. Saint Elizabeth was also very involved. We had the Red Cross. But VON was the biggest one. Basically, when you were discharged from hospital or when your family physician thought that it was not safe for you to be home by yourself, to have a bath by yourself or to transfer, they would send home care. There were no care coordinators or anything like this. It was a referral from your family physicians to home care, and home care was delivered to you. Home care was way closer to primary care at the time, because it was mainly your primary care provider who would make the referral for you to gain access to home care. All of this changed, Speaker, when the Mike Harris government came into power—I think you were there at the time, actually. When Mike Harris came into power, they decided to offer a competitive bidding process for home care rather than having this close-knit referral system from your primary care providers to not-for-profit home care providers that had been there for decades and decades.

In my neck of the woods, it was the VON who had the contract and who provided home care; they were the home care providers. They had nurses there who had done an entire career doing home care. They were really, really good at what they did. Just like anybody else—you work in one sector of health care, you develop best practices, you share them with the rest of your co-workers, and you get pretty good at providing that kind of care because this is what you do as a profession day in and day out.

All of this went out the window when the Mike Harris government decided to make home care “better, faster, cheaper” through the competitive bidding process. Through the competitive bidding process, we saw a whole lot of for-profit companies make bids to offer home care. The for-profit companies’ bids were amazing. They had found a way to clone Mother Teresa. They were going to offer incredibly good home care with knowledgeable people, and they were going to do things better, faster, cheaper. None of that happened—except that the not-for-profits did not win the bids. Most of the bids were won by the for-profit companies, and many not-for-profit home care providers that had been providing really good home care in close relationship to primary care were out of a job.

In my neck of the woods, everybody who used to work home care for VON were let go because VON did not win the contract; it was a for-profit American company that did, so everybody got laid off. The for-profit company tried to rehire some of them. They offered lower pay. They did not offer permanent jobs; they were all part-time. They offered no benefits, no pension, no sick days. And they changed the way they were going to be reimbursed—because in home care, you have to go from one home to the next. In northern Ontario, you drive long distances. In Toronto, you take transit to go from one place to the other. So the way they were going to be reimbursed went down.

What do you think happened to those nurses who had been working in home care all their lives? They said, “I’m not interested in working, standing by a phone”—because back then, it was not an app; it was a phone—“waiting for the phone to ring. I’m not interested in taking a cut in pay. I’m not interested in losing my pension plan. I used to like to have a couple of weeks of paid holidays, and I used to like to have a couple of paid sick days. Why should I do without all of this?” And they went and found work elsewhere. It’s not hard to find jobs when you have a nursing degree. Hospitals wanted them; primary care wanted them; palliative care wanted them—health promotion. It was really easy for them, and it started what we have now—where our home care system cannot recruit and retain a stable workforce.

Remember, I told you how home care was organized. At the end of the day, home care is a home care provider that comes to your home to help you. If you cannot recruit and retain home care providers to come to your home and help you, you cannot have quality home care.

So this is what we have been looking at in Ontario since 1996, when Mike Harris brought in the competitive bidding process, and it has been going downhill. It went downhill under the Liberals, and it’s going further downhill.

The contracts were first awarded by the province. Then, we had the creation of the CCACs, the community care access centres. CCACs would handle all of the home care. We had about 42 of them throughout the province. They were the ones that managed the contracts for home care. The physicians or nurse practitioners or primary care providers did not have direct contact with the home care providers anymore. Through the competitive bidding process, we put in place care coordinators. Care coordinators existed for one reason: to make sure that the limited amount of resources were going to be allocated as appropriately as possible. So we had a system where your family physicians or your nurse practitioners referred to the community care access centre—you couldd also self-refer—and then the care coordinators decide who of the different contractors, that got the different contracts, would provide you the care. We went from 42 community care access centres, CCACs, to 14 community care access centres, because by then, we had 14 LHINs, local health integration networks. The boundaries of the 42 community care access centres were reshaped to fit into the 14 LHINs’ boundaries. So we had 14 CCACs and 14 LHINs that managed the contracts for home care. They also had the care coordinators work for them. The care coordinators could decide how much care you would get. So we went from 42 to 14.

Then, the CCACs disappeared and they got kind of amalgamated with the local health integration networks. There continued to be 14 of them, but the CCACs did not exist anymore—the LHINs.

Then, from the LHINs, we had Home and Community Care Support Services, HCCSS—you learn a lot of alphabet when you work in that kind of program. Home and Community Care Support Services became the agency—14 of them—that would handle home care.

Now, under this new bill—because there have been many, many changes—Home and Community Care Support Services and the LHINs won’t exist anymore. It will be a new agency called Ontario Health atHome. Ontario Health atHome will be one agency province-wide that will then—the bill doesn’t say exactly how that will happen, but it will go into contractual arrangements with the 57 Ontario health teams that we have now in Ontario. If you’re lost in translation, don’t feel bad; we all are.

Ontario health teams are a creation of this government; we have 57 of them in Ontario. They cover almost, geographically—not quite the entire province. They’re all different, no matter where you go. All we know about Ontario health teams is that to be called a health team, you have to have at least three of those five—now six—providers. Hospitals can be a part, long-term-care homes can be a part, primary care can be a part, mental health and addictions can be a part, palliative care can be a part, and now home and community care can be a part. If three partners within those six types of partners in the health care system come together, they can be called an Ontario health team. Not everyone within those health teams are in, so it could very well be that—in my neck of the woods, the francophone community health centre does not want to be part of the family health team, and that’s fine. We still have a family health team that has a hospital—they have a few hospitals, actually: one in Sudbury and one in Espanola. There are a few long-term-care homes that are a part, though not all. There is, I think, one mental health provider that is in, and the rest of them are not. The family health teams went in, but the rest of the other primary care providers did not go in.

Anyway, if you have three of those six different areas of health that get together, you can be called a health team, and 57 health teams have been called throughout our province. But the health teams do not exist in and of themselves, as in, you won’t see them as a transfer payment agency on the list of agencies that the Auditor General reports on. They decide within themselves who will be the lead for the health team.

Well, let’s be serious. The health team that takes in a multi-million dollar hospital or a multi-million dollar long-term-care home—do you really think that a community health centre with a $2.7-million budget would ever be able to manage a health team? No. The big players are the ones who will manage the health teams.

The reluctance of many primary care, community mental health or community care providers to join those groups is that they feel it is hard to put women’s health at the top of the list—it is hard to put mental health; it is even harder to put addiction at the top of the list. Hospitals are well-known and people support them—not so much for other parts of our health care system. Now you’re asking those different health care providers to be within a health team that may not have them as a priority.

So the health teams vary greatly throughout the province. In some parts, they really had to be pushed hard—to say, “You must form a health team,” because the local health providers did not want to do that. As I said, they do not exist as an entity; they exist as a collaborative of good people who want to work together to improve care for the people of Ontario. Sometimes, in some areas, it works better than others—never mind how good or bad, this is where home care will go. It won’t go there initially. Home care should start to go to—I forgot if it’s 10 or 12, Ontario health teams that are a little bit more structured and have been in place a little longer, and they will be the ones that will start providing home and community care.

Those are the two big things that the bill does. It gets rid of the CCACs, LHINs, Home and Community Care Support Services—all of this disappears—and Ontario Health atHome becomes a province-wide agency that will be a sub-agency of Ontario Health. Ontario Health is already there to look after hospitals, long-term-care homes, primary care—a group of different players within the health care system. So Ontario Health atHome is being created; the LHINs and CCACs and Home and Community Care Support Services disappear. That’s one part.

Ontario Health atHome will have a board of directors. All that we know of the board of directors is that they will be appointed by the Ministry of Health. The board will consist of six members appointed by the ministry, and three members appointed by the minister—sorry, not the ministry; the minister—so six members appointed by the minister and up to three members appointed by the minister on the recommendations of Ontario Health.

You can see, Speaker, that the people who came and did deputations—very few of them were able to come and actually do a deputation, because under this government, it’s always the same thing: We have a meeting of the committee. They ask to go into closed session so nobody will know what they say, but they always say the same thing: “We will limit—here’s how many hours of deputations we will allow. It doesn’t matter if we have”—I don’t know if I’m allowed to say how many dozens and hundreds of people applied to do deputations. That doesn’t matter. There will be room for 15 or 18 people to do deputations—and that was it, that was all, on something like home care, that has needed reform for such a long time. Since the Mike Harris era of 1996, we have needed serious reform to improve the quality of our home care system. But no, we went in camera—I won’t tell you exactly what they said, because it was in camera, so I’m not allowed. But I can tell you that we came out of camera with a schedule that said there will be deputations from—

Good morning. Let us pray.

Prayers.

Resuming the debate adjourned on November 23, 2023, on the motion for third 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.

I will. Thank you, Speaker.

Everybody saw the schedule; it was made public. We had about 18 people and providers who had a chance to come and talk to us—they were few and far between, who got the permission to come and talk to us. But many, many more sent us documents in writing, and many of the documents in writing talked about the first point I was talking about, which was the makeup of the board. A lot of people asked, “If you want to provide quality care and Ontario Health atHome is going to be the agency responsible for that, why don’t we make sure that the board reflects what kind of services that they will be providing?”

The big fear is that the big, for-profit home care companies will all be appointed to that board. And then how about giving health care providers a voice? How about giving caregivers a voice? How about giving someone who receives the services a voice on that board? How about people with lived experience? How about making sure that we have geographical representation, regional representation? How about making sure that we have a French-speaking representative on that board, or somebody from multicultural—or even First Nations?

Anyway, I tried many, many amendments to try to make sure that I was reflecting the recommendations that had come to the committee, and they voted that all down.

Other things that people who presented and people who sent written submissions were asking about is that, right now, the boards of the LHINs, or Home and Community Care Support Services, or CCACs, or whatever you want to call them, because people call them very different names—when the boards meet, their agenda is made public. The meetings are public; I have attended some of them. The minutes of those meetings are also made available. They always have a session in camera, and I respect that. They are allowed to go in camera to talk about different things that should not be made public, but the meetings as a whole are public. So the people ask if the LHINs, the CCACs, Home and Community Care Support Services are not going to exist anymore—if they’re going to become Ontario Health atHome. Well, let’s make sure that this level of transparency that we had at the local level is going to be respected.

I put an amendment forward just to make sure that the board’s minutes, once they were approved, would be made available. Let’s make sure that the meetings are open to the public, if people are interested. Let’s make sure that the people, if they’re all going to be based out of Toronto—how about we make sure that they travel and maybe come to the north once in a while, just for fun, just to see where Biscotasing is on the map; maybe some people would like to find that out. But same thing—when I asked that they travel, they voted that down. When I asked that the agenda be made public, that the minutes be made public when they were approved, that people be allowed to attend, they voted all of that down. They were not interested in transparency or in public access whatsoever.

All that the bill says is that the board is required to meet at least four times per year, and quorum requires an equal or greater number of members appointed by the minister than members recommended by Ontario Health. That’s really low comfort for people who, for good reason, are afraid that the people who will be appointed to that board will be the president and CEO of all of the big, for-profit home care companies whose number one goal is to make money for their shareholders, not to provide good home care.

The next series of amendments that we tried to put forward were things as simple as “let’s make sure that the French Language Services Act is actually respected.” You may not know that, Speaker, but the French Language Services Act—the way that it is written, it applies to a transfer payment agency of the government. So the government is covered by the French language act, and so is the transfer payment agency of the Ministry of Health, but the more you go into independent contractors, then the French Language Services Act won’t apply anymore. People are worried, because now it will be Ontario Health atHome that will issue requests for proposals. The requests for proposals will be handled province-wide. When you represent 33 small communities in northern Ontario—what are the chances that the little not-for-profit home care providers that provide services for Alban are going to be able to bid on a province-wide bidding process and win a bid? Let’s just say that it doesn’t look good. If you’re big, like the Bayshores and the CarePartners and the ParaMeds of this world, you won’t have any problems. They will file the requests for proposals and be recognized as home care agencies that the 57 different Ontario health teams will be able to contract out to. But for the French community, this is very worrisome—because the more subcontracts you go, the less the French Language Services Act applies.

If you are a French woman, 95 years old, you are a woman of your time. You probably never went out to work, because at the time you raised your 12 or 14 kids, and that was your priority. All of your family speaks French. You’ve never really learned to speak English because you go to a French church and you go to a French market and you deal with your French kids and grandkids and great-grandkids. All of a sudden, you need home care, and you have no guarantee that the person who will come to give you your bath will be able to speak in your language.

For the francophone community, they wrote—they were not able to come to present because, remember, we only had 18 slots for people to come and present. So they were not able to come and present, but they certainly made their voices heard and said that the French Language Services Act—you have to take that into account; make sure that there’s a member on the board, so that at the level of the board of Ontario Health atHome, you think about the French services act. They voted that down.

I put a motion forward, following the recommendations from the francophone community, that the board appoint at least someone within Ontario Health to be responsible for the French Language Services Act, to be responsible for French services. They voted that down.

Then I put a motion forward to say, “Let’s make sure that the French Language Services Act will apply no matter how many times the contracts are subcontracted”—because it’s not out of the ordinary for Bayshore to subcontract to a physio provider, who will subcontract to the physiotherapists themselves, and the physiotherapist will come to see this 95-year-old French woman and not be able to speak French to her, because that’s the only physio they have and they don’t have to follow the French Language Services Act. They voted that down.

Then we looked at best practices. This is something that happens in health care a lot. If a hospital finds a better way to provide care—I remember the first hospital that started to do pre-assessments for their hips and knees. This became a best practice, and then it got spread to all of the hospitals that do orthopaedic surgery throughout our province. So health care is very much—you find a best practice, you test it, and then you share it with everyone. But that doesn’t happen in home care. Why? Because in home care, we have for-profit companies that see a best practice as a competitive advantage. If we have discovered a best practice in home care, rather than making sure that it is spread throughout the province—they don’t want to spread it with their competitors. They want to keep the best practice to themselves, which is not the way to grow our health care system.

We grow our health care system the more we discover best practices, the more we share them, learn from them and move our health care system as a whole forward to provide better quality care—but not in home care. So I put a motion forward to say that best practices have to be identified and they have to be shared, because we know that it is not happening right now. You guessed it, Speaker: They voted it down.

Then a big one that came from—I forget exactly how many people wrote to us and asked to present, but altogether I would say that, between the presentations and the written submissions, we must have at least 60 of them that had been received by the time the deadline came. Of those 60, 59 asked that we took the for-profit motive out. Do you know the one that did not ask for it? It was Bayshore. But everybody else who came and presented and who wrote talked about, “Let’s take the for-profit out. Let’s focus. If we’re not going to take it out, let’s make sure that if you issue a new request for proposals, take into account the value of not-for-profits. Let’s give priority to not-for-profits.” So I tried to put that in many, many parts of the bill. This is what people are asking for. People make the relationship between the two.

Why is it that home care is not able to recruit and retain a stable workforce? Because they don’t offer good jobs. Why don’t they offer good jobs? Because they exist for one reason: to make money for their shareholders. And how do you make money? By not paying your workers. How do you solve all of the missed appointments—and I will go through a list of examples of people who are being failed by our home care system. It’s easy. Make home care jobs good jobs; make them permanent, full-time, well-paid, with benefits, sick days, a pension plan and a workload that you can handle. And there are lots of people who love to work home care, who are good at providing home care, but right now cannot make ends meet. They cannot pay the rent and feed their kids with the money they get paid in home care. Why? Because home care has been privatized.

We can change all of this. We can make sure that the 30% of the $1.8 billion this province spends in home care does not go to profit and goes to patient care. Patient care is directly related to the person who gives you that care. This is as simple as it is. Home care depends on a home care worker bringing you the care you need. If you’re not able to recruit and retain a stable work force, you are not able to provide quality care. So I put that as an amendment to the bill, and they voted it down.

I also put a part of the bill called, I think, “making home care jobs good jobs.” It was voted out of order, but it’s too bad, because we all know that in order for home and community care to meet the needs of the people who need home care, you need a stable force in home care. There’s no doubt about it. A lot of care that is provided by home care is very personal. You have a stranger coming to your house, and you strip naked in front of that stranger to have a bath. There needs to be a relationship of trust between those two individuals. When every Thursday and every Saturday, a different person you don’t know comes into your house to strip you naked to put you into the tub, after a while, you don’t want home care anymore. Why? Because this is a total lack of respect. Why are we having the lack of respect? Why are we having different people stripping you naked twice a week? Because home care cannot recruit and retain a stable workforce, because they’re more interested in the 30% profit that they will give to their shareholders than providing decent care. Would you want a different stranger giving you a bath? Nobody wants that. We know how to change that. You change this by making home care jobs good jobs. I tabled that in the bill. It was voted down.

Then, after the not-for-profit and the French—I tried many times to get the French back in, and it did not work—we went on to look at the process of awarding the contracts. Ontario Health atHome will be the provincial agency that will issue a request for proposals. We are continuing in Ontario with this competitive bidding process. We already know that the competitive bidding process fails us. It’s not because you’re able to write a good proposal that says, “We will provide home care like Mother Teresa wanted us to provide home care”—because we already know that none of that is true. But there are still some small, not-for-profit home care agencies that exist in different areas of our province that have survived, since the Mike Harris era, the competitive bidding process, mainly because they are the only show in town and the big corporate home care providers don’t want to pay for their staff to travel all the way there.

What’s the chance that they continue to exist? What’s the chance that they continue with this new competitive bidding process that will be province-wide? Because remember, the 42 CCACs that became the 14 CCACs that became the 14 LHINs that became the 14 Home and Community Care Support Services—that was 14 geographical regions that handled their competitive bidding process, that were able to enter into financial arrangements with different care providers. They knew their community better than an agency based out of Toronto—where we’ve tried to say, “Your board of directors should have regional representation,” and they said no. So it could very well be the directors and the CEOs of all of the big, for-profit home care agencies, all based out of Toronto, who decide who will have a contract for Westree, a community they could not even point to on the map because they don’t know where it is. But they will be deciding who gets the contract for that community and who doesn’t.

At least when we had the competitive bidding process and the contract with the 14 agencies, there was a better chance that those 14 agencies knew the different providers and knew the different communities. Nothing wrong against the people from Toronto—they are good people, like there are good people everywhere. But that doesn’t mean that you know the needs and the specificity of the different regions of our province and the different communities. Home care is really delivered at the community level.

We tried to put amendments forward that said, “How about you put that the criteria for the requests for proposals be public, so that at least we could have a say, we could look?” They voted that down.

How about the results of the awarded contracts, so that we would know who was awarded what and have a little bit of information? “No, no. Nobody will know what’s in the contracts.”

There was an interesting amendment that came from the Integrity Commissioner. There’s a part of the bill that gives the minister the right to gain access to personal health information. That’s not something that you see very often, and that’s not something that the Integrity Commissioner takes lightly. Gaining access to aggregate data, yes, absolutely—the Ministry of Health needs to know what kinds of services are being provided, by who, where, when, all of this. No problem with aggregate data going to the ministry, going to Ontario Health, going to Ontario Health atHome—absolutely. But once you get an amendment written by the Integrity Commissioner, who is worried about the powers that the minister is giving himself, or herself, in the case right now, to access patients’ data—I took that quite seriously. He is an independent officer of the Legislature. He knows the integrity act, the PHIPA, and all of the acts that protect personal health information inside and out. This is why he exists. This is what he does for a living. He wrote to us, wrote the actual wording of the amendment that he wanted to make to the bill. I copied and pasted it into an amendment. I let everybody know that this came from the document that the Integrity Commissioner had given to us, at the end of his explanation, as to why he was worried about the access to personal information that was being given in the bill. I explained all of this, and they voted it down.

That worries me. Health care happens between two people. A lot of information is shared with health care providers that is not shared with anybody else. Think about it. There are probably things that you have told your physician or your nurse practitioner or your mental health providers that you have never told anybody else. Nobody else knows that but the person who is there to help you. This is what quality care is based on. You feel free to share things with your health care providers that you would not share with anybody else. But now, every time you have a change in law that allows the minister to gain access to personal health information, there will be people who won’t tell the whole story to their health care providers, because there is information that they don’t want anybody to know. They were willing to share it with their health care providers before, because they knew that—and you could ask, “Don’t put that in my chart. I want you to know, but don’t write it down.” I can tell you, any health care provider will have had that kind of request. They want you to know. They know it is important in the decisions you will make for their care. But they don’t want anybody else to know. The Integrity Commissioner had written an amendment. This amendment also got thrown out—voted down, actually.

I asked for things like: require an audit of the number of hours claimed, the number of employees, the number of clients served, to support standards of care, monitoring and enforcement.

This is a story that a mom allowed me to share, and there are many, many stories like this: Tina is a nurse who works in my riding. She has a very disabled child who is now going to school. He requires G-tube feeding. She was assessed by home care. Home care goes to the school for an hour and a half, sets up his G-tube feeding and makes sure that he’s fed, and then they go on. So she gets an hour and a half of home care during the day for her child to make sure that he gets fed and hydrated—both drinking and eating, through a G-tube. Bayshore happens to have the contract for most of the areas that I serve. Bayshore sends the nurse. The nurse sets up the G-tube feeding and then, 15 minutes later, takes off. But Bayshore gets paid for an hour and a half. This child is supposed to have a nurse with him for an hour and a half. And what ends up happening two or three times a week is, halfway through the feeding, the machine starts to go “beep beep beep” because he moved, because something is not going right. The nurse is gone. And then they phone the mom. The mom has to go to school to reset the G-tube machine, to make sure that her son gets fed. So she put in a complaint and said, “The care coordinator tells you that you have a contract to provide an hour and a half. This is how long it takes to feed my son, to make sure that you set up the machine, then everything is done and disconnected, and all of that. But you only stayed for 15 minutes.” So she puts in a complaint. The care coordinator says, “Yes, you were allowed an hour and a half. This is what’s not happening.” After she started to push—she’s a nurse; she knows how the health care system works—Bayshore said, “Oh, we can’t find anybody to go and feed your son.” So she had to quit her job as a nurse, to be the one who would be there for her son, so that her son would be fed. Her son needs hydration. Some days, he comes home—the hydrations got set up, but they never worked. He comes home and he has never soiled a diaper—it takes hours after he gets home. She starts to hydrate him and feed him. Then, he starts to pee again etc. As a nurse, she knows that means that he hasn’t had anything to drink from 8 o’clock in the morning, when he left for school, until 3:30 in the afternoon, when he came back from school. This is wrong. This is what happens when you have a system that is driven by profit, not by people’s needs.

I have another gentleman—he’s a lower-limb amputee. He’s missing a leg, above the knee, on his left side, and has a serious wound on his right side. We all want to keep both legs, but when you only have one left—he really, really wants to make sure that those wounds on his right legs are well looked after. Same thing: It’s Bayshore that has that contract. They’re supposed to come at 8 o’clock in the morning to change his dressing and come back at 4 o’clock in the afternoon to change his dressing, because this thing leaks and he has had an infection before etc. At 8 o’clock, they’re not there; 9 o’clock, they’re not there. He phones at 9, nobody picks up the phone, and he leaves a message. He phones at 10, nobody picks up, and he leaves a message. He phones at 11, nobody picks up the phone, and he leaves a message. At noon, he got a phone call back from Bayshore to say that somebody will be there at 2. He says, “Somebody will be there at 4. Why would you come and change my dressing at 2? You were supposed to come at 8.” “Oh, are you refusing the visit?” If the patient refuses the visit, Bayshore gets paid, but the patients get no care. He keeps a little log of every time the Bayshore nurse did not come on time or did not come at all. He shares that with me every two weeks. How could that be? He’s an amputee. He has one leg. His right leg has a severe wound. He needs his dressing changed. Everybody agrees to this, but yet, every week, there is a missed appointment. Every week, there is a risk that this wound is going to get infected, because nobody was there to change the dressing; but it doesn’t matter. Bayshore continues to have this contract, they continue to have money every time a nurse doesn’t show up in the morning or in the afternoon, and life goes on.

I also tried to put into this bill some other requests that we received from written submissions and the people who presented that had to do with staffing agencies. More and more people, nurses, who work for home care will work for for-profit providers who subcontract to a staffing agency. Remember, I talked about continuity of care and how you can only have quality care if you have continuity of care. Through for-profit agencies and through staffing agencies, it makes things worse, not better.

I also asked for mandatory reporting—this was ruled out of order—for suspicion of abuse. When you work in home care, you go into people’s homes—often, vulnerable people’s homes. It is pretty easy for the home care worker to see that there’s abuse taking place in that home—either physical abuse or money abuse or mental abuse. They often are the first ones to become aware that abuse is taking place, because the person is mainly homebound and not too many people see them, and their abuser lives with them. Right now, if you report abuse, you have to report it to the police. The police set the bar pretty high to charge against abuse. So what I tried to put forward is the same system that we have for children. Right now, if you are a health care provider—you hold a licence in Ontario—if you suspect abuse, you don’t have to have 100% proof to meet the standard of the police. If you suspect abuse, you have to report it to children’s aid. Children’s aid will go in and do an assessment, and it could very well be that the family needed a little bit of help and a few things needed to be changed in order to make sure that you protect that child. I wanted the same protections to become available to vulnerable people. Not all vulnerable people receive home care, but a lot of vulnerable people receive home care, and a lot of times you have home care providers who are suspicious of abuse. You come to give somebody a bath and they have cigarette butt burns on their back. How do you burn yourself on the back? It’s not obvious, especially if you don’t smoke, but your partner smokes and yells at you quite a bit—but it doesn’t matter if you report that to the police. You don’t have enough proof and evidence for them to charge, but you would have enough proof and evidence for somebody to come and do an assessment and make sure that we protect the vulnerable people. That was also ruled out of order.

I asked for a little bit of training on sexual and gender diversity for home care workers. That was also ruled out of order.

Altogether, the NDP presented 17 different amendments to the bill. Our home care system is broken; it fails more people than it helps every single day. To make Ontario Health atHome is not the solution to the problems that people face on a daily basis with our home care system—but this is what the government has brought forward. We tried to put amendments forward that respond to the actual problems that people face. They voted them all down.

Point of order.

I’m sorry to interrupt the member.

A point of order from the member of from Chatham-Kent–Leamington.

La députée sait que pour offrir les soins en français, on doit avoir du personnel de santé qui parle français. Alors, on a une grande pénurie. C’est pourquoi notre gouvernement a soutenu la création d’un campus francophone du Collège Boréal ici à Toronto, où, pour la première fois, on va avoir les infirmières et infirmiers éduqués en français, ici à Toronto.

Est-ce que la députée soutient ce projet?

Ce projet de loi, s’il est adopté, conférera aux équipes santé Ontario la responsabilité de connecter les gens aux services de soins à domicile à partir de 2025. Aujourd’hui, les équipes santé Ontario sont encouragées à travailler avec leurs membres et les organisations affiliées pour planifier une meilleure prestation des soins. Alors, on aura la Santé à domicile Ontario, qui sera un partenaire clé dans ce travail.

Donc, ma question : je me demande si la députée peut parler d’une partie du projet de loi qu’elle pourrait appuyer.

Je vous remercie, et je vous remercie de la question en français.

Nous avons 57 équipes santé Ontario, et oui, elles vont commencer à être responsables pour les services à domicile dans 10 ou 12 parties de l’Ontario à partir de 2025. De rapprocher les soins primaires des soins à domicile, oui, c’est une excellente, bonne idée. C’est ce qu’on avait avant que le gouvernement de Mike Harris soit au pouvoir. On avait une très bonne relation entre les soins primaires et la santé à domicile. Ça, c’est quelque chose qu’on va toujours appuyer et quelque chose de bien. Le problème, c’est que c’est Ontario à domicile, qui est un organisme provincial, qui va donner les contrats, donc on ne sait vraiment pas qui seront les personnes—

We could pay our PSWs more than $18.50 an hour. We could give all of them a raise with the money that we pay to for-profit companies.

Ça faisait longtemps qu’ils demandaient d’avoir un programme d’infirmières. Qu’ils puissent offrir un programme d’infirmières en français, ça va changer la donne. Quasiment tous les collèges en Ontario—le Collège Boréal, qui est situé à Sudbury—offre le cours d’infirmières en anglais. Le Collège Boréal ne l’offre pas encore, mais va l’offrir l’année prochaine, et, oui, on a très hâte. Je vous garantis qu’il va y avoir beaucoup, beaucoup d’inscriptions. C’est un programme qui est en grande demande, et ce sont des professionnels de la santé qui sont en grande demande.

Oui, c’est quelque chose qu’on attendait depuis longtemps. Je suis certaine que le Collège Boréal va faire un bon travail pour avoir des infirmières francophones qui vont au Collège Boréal, qui graduent en Ontario et qui travaillent en Ontario.

I gave the example of the amputee in my riding who gets called back at noon to say, “We will send you a nurse at 2 o’clock,” when he already has a dressing change scheduled for 4. He says, “Well, don’t bother.” So they say really clearly, “You refuse treatment?” The minute they hear those words, they are allowed to bill for that service, but they don’t have to provide it. Therefore, it does not cost them anything.

In bundled care, it’s the same thing. Bundled care is used mainly for people who get discharged from the hospital. Post-hip and post-knee surgery, you get bundled care, where a nurse will come and change your dressing and a physiotherapist will come and show you your range-of-motion exercises, strengthening exercises, balance, how to do stairs etc. It’s called bundled care. They get the fixed amount to provide what the patient needs, and in that fixed amount there will be five physio visits, 10 nursing visits, 20 PSW visits—I’m making that up. They get paid for that bundled care—they provide half of it, and they still get paid the same amount.

We saw after the Mike Harris government privatized long-term care that conditions for workers and people in long-term care have been disastrous, but enormously profitable to the former Premier himself.

Given the terrible wages and working conditions of PSWs in home care at this time, are you worried that those working conditions and the quality of care will decline even more in order to provide profits to investors?

Questions?

A 30% rate of profit is quite an extraordinary return. Can you talk about how it is that they’re able to secure such a high rate of return on this service?

November is Lung Cancer Awareness Month. Lung cancer is the leading cause of death from cancer in men and women in Ontario. In Canada, 30,000 people are diagnosed each year, making it the most commonly diagnosed cancer type.

November also marks Radon Action Month, yet there is little known about this invisible and odourless radioactive gas that is naturally released from rocks, soil and water. It can get into homes through cracks and holes over time, and breathing in this gas can cause lung cancer. For those who do not smoke, radon gas is the leading cause of lung cancer, responsible for over 3,000 deaths in Canada each year. Home testing kits for radon are inexpensive and can be purchased at your local retailer.

Madam Speaker, our government has already made strides in cancer prevention, such as our initiative to start screening earlier for breast cancer.

I am thankful to the survivors and advocates for their dedication to this cause—including those from the Canadian Cancer Survivor Network, Right2Survive, Lung Cancer Canada, and others—for their continued advocacy on this imperative and deadly issue in Ontario.

I am pleased to rise to speak about the Nova Vita women’s shelter.

Domestic violence is a horrific form of intimate partner violence that affects roughly 100,000 Canadians each year. Domestic violence has devastating effects on a victim’s physical health and mental well-being. Often, the effects of domestic violence can seriously disrupt a victim’s social and economic well-being as well.

That is why the Nova Vita women’s shelter has dedicated itself to fighting to end interpersonal violence and abuse by supporting individuals and families who have experienced domestic violence.

Nova Vita was founded in the Brantford-Brant community in 1982, and it has flourished into a beacon of hope for everyone affected by domestic violence.

In 2003, Nova Vita renovated their emergency shelter, which is open 24/7 and provides a safe place for women and children experiencing abuse or homelessness to eat, sleep and meet with Nova Vita workers for support.

Nova Vita continues to engage in evaluative research of its many programs and services, in partnership with a variety of educational institutions, to ensure that those who rely on their services for support are receiving the highest-quality care.

I am proud to represent a community that takes care of its own.

On behalf of Brantford-Brant, I want to extend my thanks to Nova Vita for protecting the most vulnerable in our community.

Nova Vita, keep up the great work.

We’re very excited, on this side of the House, that the government has signalled they may support a motion by our caucus and the amazing member from St. Catharines to provide full coverage for birth control under OHIP. This could be a game-changer for so many women in Ontario who can’t afford or have easy access to contraception.

Our leader has said, “There’s no doubt that lowering the barriers to accessing contraception can have a huge impact on people’s ability to have control over their family plans and their bodies. It’s long overdue, and it’s just common sense.” I would add that it certainly is worth fighting for—and truly encouraging that the government is considering supporting.

After all, as MPP Stevens has said, “This isn’t just about health; it’s a matter of gender equality.”

Advocates have said that ensuring women don’t have to pay hundreds of dollars a year on birth control will offer more protection for victims of sexual violence, provide women with autonomy over reproductive health, and act as yet another step towards gender equality.

Many people don’t know that “in abusive relationships, violence often escalates during pregnancy,” says Krista MacNeil, the executive director of Victim Services of Durham Region. “The cost of unwanted pregnancies in Canada [is] in excess of $320 million. By contrast, no-cost contraception represents a fraction of that cost and the lives of women are worth this investment.”

Let’s hope that we can work together to expand contraceptive health care for women in the province of Ontario. Let’s get it done.

Thank you to the member from Nickel Belt for her comments.

As we all know, the definition of insanity is doing the same thing over and over again and expecting different results.

We’re bringing a lot of change to our home care sector for the first time in 25 years. As you know, we revisited the legislation. We took off the service maximum, so people can get the amount of home care that they need in their home, and there’s the opportunity for innovation and integrated care in home care for the first time.

In my area, the North Toronto Ontario Health Team has established a neighbourhood care team in a seniors’ housing building offering low-income senior tenants a range of health care services, including regular blood pressure checks, foot care, access to social workers, wellness checks etc.

Can the member opposite not see the importance of innovating and trying to bring new ways of providing home care to our seniors?

Two things: Whenever someone on this side of the House says “innovation,” what you should really hear is “privatization,” because the only innovations they have brought forward for the five and a half years that they have been in power are privatizations of our health care system.

Interjection.

The other is that they have changed it so there are no more set amounts for home care—it used to be like this. We don’t have a set amount anymore. It doesn’t matter, because home care cannot make a deficit. The agency that receives the funds—it used to be home and community care—receives the funds and cannot do a deficit. So from February and March, in my riding, it doesn’t matter how high your needs for home care are; you get two baths a week. That’s it. That’s all. It doesn’t matter that you’re not able to go to the bathroom by yourself, that you’re not able to transfer from your bed. You get two baths a week—because that’s all the money they have left.

In 2022, Chad Bélanger was the victim of a tragic accident while driving between Kapuskasing and Val-Rita on a short work delivery. His vehicle was in a head-on collision with a commercial truck after the truck crossed two solid yellow lines to pass another commercial vehicle going up a hill. He survived, but with extreme pain, bruises on vital organs, including the heart and lungs, a severe concussion, and memory loss from the accident. He had a broken jaw, broken neck, broken ribs. He now lives with anxiety and PTSD.

Currently, there is a grey zone for drivers when it comes to this dangerous manoeuvre. Police officers cannot fine someone for passing on two solid lines; they can only give a slim $85 fine when it is considered unsafe passing. This leaves little room for prevention, and most times it takes an accident to have any consequences from this careless driving.

Speaker, Chad’s Law is a common-sense law. Ontarians wrote to me in complete shock that this was not already illegal, like in all the other provinces in Canada.

As an MPP from northern Ontario, I know all MPPs representing communities from all parties can testify to how dangerous Highways 11 and 17 can be.

Winter is at our door; highways in the north will become more dangerous.

I hope we can all work together, and not wait for another accident, to make passing double lines finally illegal.

On Friday, I joined my colleagues at Peel Regional Police headquarters in Mississauga, where the Premier announced the Preventing Auto Thefts Grant, an $18-million investment over three years to help police services combat auto theft and protect communities, including $900,000 for Peel region.

We know that auto thefts are an increasingly serious problem in Mississauga and across the province. That’s why our government is taking immediate and decisive action to increase safety and security and prevent crime.

Earlier this year, the Solicitor General announced a $51-million investment over three years to fight criminal organizations and put these criminals behind bars.

Although our government is working hard to fight crime, we must be clear: Comprehensive reforms from the federal government are needed to take criminals off the streets and keep them in jails. That’s why this Legislature called on our federal counterparts to implement bail reform. The non-stop game of catch-and-release and the dangerous opposition rhetoric of defunding the police only serves to punish the hard-working, law-abiding residents of Ontario.

We will always continue to support law enforcement officers, such as Peel Regional Police, who are working hard to keep our community safe.

Changes we made earlier this year will provide free tuition at the Ontario Police College and allow up to 550 recruits per cohort—such as the 51 police who graduated in Peel this year.

This government is providing police with the resources and training they need to be successful. We are firmly committed to—

Questions?

Third reading debate deemed adjourned.

In tribute to my predecessor, Percy Hatfield,

A heartwarming story of community generosity shall be revealed.

This weekend over 600 Goodfellows stood at street corners aplenty.

Exchanging Windsor Star newspapers for nickels, toonies and bills of twenty.

In the frigid cold, at Tecumseh and Forest Glade.

I joined the 600 volunteers who encouraged that trade.

For 110 years strong, this tradition has endured,

The gift of monthly food boxes and hampers to the needy is assured.

Thirty-three hundred such hampers are known to be needed.

But in true Windsor-Essex form, we know that this target will be exceeded.

And as this holiday campaign ends, our Goodfellows keep helping the masses

With shoes, boots, breakfasts and bagged lunches for students in classes.

And their food bank on Tuesdays and Fridays helping many families eat

Prices keep on climbing and they struggle to make ends meet.

To the Goodfellows serving us across Windsor and Essex county,

A sincere thank you for filling families’ dinner tables with a generous bounty.