On a point of order: Speaker, if you seek it, you will find unanimous consent to see the clock at 6.

Further debate?

I would like to thank the member from Algoma–Manitoulin for this bill. It’s a very important bill, and it certainly matters to people in Thunder Bay–Superior North, where I am. I think the problems with the inadequacy of the Northern Health Travel Grant keep the people in my office very, very busy.

The amount for kilometres is 41 cents a kilometre. It hasn’t been adjusted since 2007. I think the hotel amount was adjusted in 2017, but there are very few places—I believe the hotel amount is a $100 a night but only to a maximum of $500. We know it costs an awful lot more than that to stay in a hotel these days.

I’ve got a few specific examples. For seniors in Greenstone—Greenstone is 250 kilometres, I think, from Thunder Bay, and the cost of travelling to Thunder Bay for seniors is something that they worry about quite a bit.

I was actually just up in Greenstone and met with a group of seniors, and the Northern Health Travel Grant was the top of the list for their concerns. People can take a van from Greenstone or from Geraldton to Thunder Bay for $350, but the Northern Health Travel Grant only covers $184, not including hotel accommodation. Imagine if you have to travel regularly to Thunder Bay for dialysis; the cost is going to be in the thousands of dollars. In fact, a couple from Kenora—this was an issue a few months ago—had to stay in Thunder Bay over an extended period of time. Well, it was cheaper to actually rent an apartment than stay in a hotel, but it still cost them $9,000 to cover their dialysis treatments.

I recently heard from a constituent in my riding who is now out $20,000 because they had to travel from Thunder Bay to Toronto for a kidney transplant at the Toronto General Hospital. This required staying in a hotel from November 21 until checkout on January 6. They’re actually only eligible for $555 for accommodations. Then, there was of course the travel and so on, which was very high, partly because of the medical condition and having to sit in first class and so on to accommodate that condition.

The thing is that we are supposed to have equal access to the health care that we need where we live, and if we have to travel to get it, then the support needs to be there so that we can have equitable access to health care. The set-up of the Northern Health Travel Grant doesn’t meet those needs at this time, so I think the recommendation to have a table to actually really work out what’s going on and how people can be supported is important. I support the motion, and I would like to pass things over to my colleague from Sudbury to add.

I want to thank the member from Algoma–Manitoulin for bringing forward this bill. I had asked a question about the Northern Health Travel Grant last spring, and I had more phone calls and emails to my office through the spring and the summer about this than any other issue that I brought up that I can think of.

The core issue, really, here is that when you are travelling from northern Ontario—my riding, often—to Toronto, you’re compensated 41 cents a kilometre, but you’re not paid for the first 100 kilometres that you travel. We know the cost of gas and maintenance on vehicles as well. It really doesn’t add up for people. As well, the hotel costs are capped at $100 a night; we can’t find a hotel for $100 a night. Those of us who travel long distances and have residence here know how expensive it is to live in Toronto, and anyone who is coming to Toronto for all the amazing tourist attractions they have or for work knows how expensive lodging is.

I want to share a couple of validators for this. I think it’s important to talk about why this is important, so I’ll tell you about a woman from my riding who had to travel to Toronto for knee surgery. What’s interesting, Speaker, is depending how many of the validators you talk to, you’ll see many of them didn’t want me to use their name, because they feel like—they’re embarrassed. They feel like it’s a poverty issue and they feel stigmatized because they don’t have access to health care. So, I’m going to call this woman “Betty.” She had come down to Toronto for knee surgery. Betty made the trip down to Toronto. She had the surgery, then she applied for the grant and was denied.

Here’s what happened: Betty doesn’t have a credit card. Her husband has a credit card, so her husband paid for everything on credit card. Her husband came with her to take care of her on this trip for the knee surgery. When she filled out the form, she was told to put her name on the forms because she had the surgery. Betty can prove that they’re married and Betty can prove that her husband came with her, but she was still denied.

And here’s the kicker for them: They’re out-of-pocket for all of those expenses—expenses that people who are in the area and can travel to a Toronto hospital, because of where they were born or where they moved and lived, wouldn’t be out of. But the kicker for her is that she asked why she was denied and what was happening, and it took 12 weeks to get a response—12 weeks of trying to figure out what happened to the money and why it wasn’t reimbursed.

I want to talk about Stephan and Denise. Now, Stephan and Denise—I actually asked a question about them last spring. I want to read what Denise wrote to me, outside of the question, because I had to really shorten it for the question. Denise wrote and she said that her husband is required to see a specialized neurologist in Toronto. The current reimbursement for two nights’ accommodation is $100 per night. When you look at hotel rooms in Toronto, on average, the cost of the rooms starts at about $500 a night. Even the hospital rates have doubled. Two years ago, the hospital rate at the DoubleTree hotel was $129. So even two years ago, you paid 30 bucks out of your own pocket. Now, it’s up to $250. Mileage is also an issue. Compensation is limited at 41 cents per kilometre, and the first 100 kilometres is deducted from being compensated.

“We’re both seniors. We both live on a fixed income.” This is the issue that we’re seeing. The system is designed so that you pay up front, but if you’re on a fixed income, like many seniors are—and many seniors have those co-morbidities, need more care. When you’re on a fixed income and you can’t afford to pay up front, if you don’t have a credit card, you’re very limited. You don’t have that equity of access when it comes to health care.

The next person I’m going to talk about I’m going to call Bev. She asked me as well not to use her name. Bev had to travel to Toronto for cancer treatments. It was complex, and she had to do various diagnoses. Bev has cancer, and her husband has taken a leave from work to care for her, so there’s no income coming in from her husband. There’s just Bev’s income, and she has CPP. Between her and her husband, their income is $1,100 per month to make ends meet.

Bev’s oncologist is in Toronto. He’s one of only two in the province that specializes in this type of surgery. Absolutely, congratulations to our province for having specialized health care available. What we’re talking about is having people able to access it in the north. So Bev had to come down, see her oncologist in-person. She couldn’t travel alone. She would have to be in Toronto for three days for tests and the appointment. Bev and her husband had no funds to pay for the hotels. They had no funds to buy food. They had no funds to put gas in their car. They had $1,100 a month at the time.

Bev told me—and this is one of the reasons that she asked me not to use her name—they didn’t even have food in their house at this time. Bev’s doctor offered discount options for accommodations, but because Bev didn’t have the money up front to pay for it, she was out of luck. Because the Northern Health Travel Grant is a system where you pay up front and then you’re reimbursed, Bev and her husband are out of luck.

The question is, if you can’t pay up front, if you can’t afford the wait to reimburse—we know there are a lot of people living hand to mouth. We know that every year since 2018, the number of full-time working people accessing food banks—that number continues to grow. We know there are the working poor out there. The working poor also get sick. The working poor also need specialized treatment in health care, and they deserve to have that access to health care.

It’s about equity of care. People shouldn’t have to go without care because they don’t have the funds up front to travel where health care is. The member for Algoma–Manitoulin is talking about a simple solution of putting our heads together and figuring out where this is broken and fixing it. I believe the Conservative side—I’m a critic; it’s in my title. But I believe the Conservative side wants to address this. I believe they want people in the north to have access to health care. They have members in the north. They wouldn’t want to vote against those members and the access that they have.

With the limited time I have left, I’m going to talk about a gentleman who also asked me not to share his name because he was embarrassed at the situation he was in. I’m going to call him Gary. So Gary had to receive hyperbaric oxygen therapy, and this is a treatment that has to get done daily over the course of several weeks. This is covered by OHIP, but the facilities don’t exist in Sudbury. So Gary’s specialist, who was in Sudbury, referred the treatment to Toronto, and Gary travelled and stayed in Toronto for several weeks. But his Northern Health Travel Grant was denied.

We helped Gary with his appeal. We started helping him in March 2021. The good news is that it was eventually resolved in his favour, but I want to remind you of the people who don’t have the money up front or how tight finances are. And each and every one of us can relate to this, either personally or members of our family or close friends of ours who feel that squeeze, the affordability squeeze that so many people are feeling.

The bad news is, even though it was resolved in his favour, it took more than a year. We started in March 2021, and it ended in March 2022 for him to be reimbursed—more than a year of paying out of pocket for several weeks of accommodations, food and travel. I don’t know who could weather that storm. You’re trying to recover from an injury. You’re trying to recover from illness. You’re getting treatment. The mental stress of not knowing how you’re going to pay your bills or if you’ll be reimbursed is unbelievable, unfathomable.

I know that this is a good bill. I want to congratulate again the member from Algoma–Manitoulin for bringing this forward. This is a common-sense solution to something. I’m sure there was a time when this worked. Nothing is ever perfect, but I’m sure there was a time where this was more effective. Time has moved on. Costs have moved on. We haven’t kept pace with it. This is a good opportunity to recognize how important the people of Ontario are and how we can really help them.

The final example—I have about a minute—is Stephen. Stephen is actually his real name. He’s on a fixed income. He applied for the Northern Health Travel Grant. Typically, you’re reimbursed in about four to six weeks; it’s been more than three months. He hasn’t received anything. He called the Northern Health Travel Grant office to find out what was going on. They said they have a backlog and that processing his claim will take longer than the six weeks it normally takes, but they couldn’t give him a date when.

This is a broken system, Speaker. We need to address it. The member for Algoma–Manitoulin has a very simple solution, about putting our heads together, working together, which I think the people of Ontario want us to do, where we can address this, fix this and make health care better for people across northern Ontario.

Further debate?

It’s a pleasure to stand in the House today and take part in the debate about Bill 13, the Northern Health Travel Grant Advisory Committee Act. Frankly, it’s nice to hear that there’s a Liberal member who has accepted that the north is not just a no man’s land that people shouldn’t pay attention to, that it’s important, so it was nice to hear that from the member opposite.

This proposed legislation seeks to establish yet another advisory committee to have further discussions, while our government is taking decisive action to improve the health care system for northern families. That’s what we’re focused on for families in the north and for families across Ontario. We know that patients can’t afford delays or more talk or endless committees and that it’s time to get it done for families in northern Ontario and across Ontario, and that’s exactly what we’re doing, while ensuring that all of our health care initiatives are actually delivering care to patients. That’s what we’re here for. While the opposition and independent members continue to be all talk or all about talk, our government is busy getting it done.

Speaker, many residents of northern Ontario live in communities that have less than 2,500 people, are dispersed across a vast geographical area in our province and may need to travel longer distances to access specific types of health care services. The province currently provides eligible patients with financial assistance, helping defray medical-related travel costs that residents of northern Ontario incur to access certain health care services. This financial assistance is based on travel that is required to access a medical specialist or ministry-funded health-care-facility-based procedures when they are not available in their local communities within a radius of 100 kilometres.

Speaker, the Northern Health Travel Grant is an important element in the delivery of equitable health care services to northern Ontario residents. In 2022-23, the Ministry of Health reviewed more than 178,000 applications for financial assistance, with the ministry providing almost $45 million in financial travel assistance to more than 66,000 residents of northern Ontario. In 2023-24, the ministry’s funding allocation for the Northern Health Travel Grant Program is more than $48 million, and the ministry regularly reviews its programs, processes and procedures to support ongoing quality improvement and support a sustainable system for the future.

The ministry has enhanced the accommodation allowance and has established payment delivery through electronic bank deposits, providing more convenience for residents, and the program’s call desk works with applicants who submit incomplete applications to help them with missing information. We have streamlined the administrative process for ODSP clients, and work continues to improve the program, including developing an online application program for applicants. Additionally, the program has a medical appeals committee through which external and independent medical advisers review appeals and claims with exceptional medical circumstances.

Speaker, our government is making health care more connected and more convenient, and providing Ontarians with a better health care experience at every stage of life, no matter where they live in the province. We continue working hard to implement our plan to improve access to health care in northern communities by supporting medical education in the north and training more physicians to work in northern communities.

The Northern Ontario School of Medicine is being provided with additional medical resident training positions to ensure an ongoing supply of physicians in the north. The Northern and Rural Recruitment and Retention Initiative helps patients receive primary and specialist care closer to home, offering assistance to close to 130 communities, providing financial recruitment incentives to an eligible family physician or medical specialist who establishes a full-time practice in an eligible community.

Through the Community Commitment Program for Nurses, between 2022 and 2024, over 650 of the nurses placed with employers in need have been hired in northern Ontario, and in northern communities, the Emergency Department Locum Program has provided supports to eligible hospitals to assist with 24/7 emergency department services. The Emergency Department Peer-to-Peer Program is also supporting emergency department physicians in northern, rural and remote communities through access to immediate, on-demand and real-time coaching and support via virtual channels from experienced physician peers.

The government is also reviewing and expanding Ornge air ambulance’s fixed-wing fleet from eight to 12, with a new state-of-the-art aircraft, as well as a new larger Sudbury air base to house the additional four aircraft, ensuring it can continue to provide safe, consistent air ambulance services, which are especially important for northern communities.

We’ve invested in annual operational funding for new MRI machines in northern, rural and smaller communities, and our government made changes to allow pharmacists to treat and prescribe medications for 19 common medical ailments, including UTIs, pink eye, cold sores and acne, for example. More than 700,000 assessments have taken place over the last year, with 94% of Ontario pharmacies participating in this initiative, including many across northern Ontario.

These are just a few examples of how our government is actually taking action to provide more connected and convenient care and supporting the health care needs of people in northern Ontario.

We know that there are different health care challenges in various parts of the province and understand how important it is to have a regional voice on these matters. Ontario Health regions will continue to work and consult with local communities, and our government will continue to listen—and I must say, we have listened here today to what our colleagues have shared with us today. We want to work closely with those on the front lines of our health care system, as well: our doctors, nurses and other care providers. This is an essential part in determining how best to provide care and meet the local health care needs of northern families where and when they need it.

Further debate?

I appreciate the opportunity to participate in this debate. To my colleague the member for Eglinton–Lawrence: I’d like to thank her for her remarks, as she has discussed how our government is prioritizing health care in northern Ontario by continuing to take bold action.

Our government does recognize the residents of northern Ontario and what they face with some unique health care realities. That is why we continue to provide financial assistance that is dedicated to northern Ontario residents. We are taking action for northern families instead of just talking or outright ignoring the needs of the north, as previous governments have done.

I would like to further speak about how our government is strengthening health care for northern Ontario residents and helping address their health needs. Effective, integrated models of care, as exemplified by the Ontario health teams, are critical to providing more convenient and connected health services in northern communities.

In July of last year, our government approved three more Ontario health teams in northern Ontario: the Équipe Santé Ontario Cochrane District Ontario Health Team, as well as the Elliot Lake Ontario health team, both serving Greater Sudbury, Sudbury East, Espanola, Manitoulin, Elliot Lake and surrounding areas, and the Timiskaming area Ontario health team, serving the Timiskaming district and surrounding region.

Last month, our government took another important step forward to strengthen local services in the north with the approval of the West Parry Sound Ontario Health Team, which marked a significant milestone of achieving full provincial Ontario health team coverage, with a total of 58 Ontario health teams operating in every corner of this great province.

These Ontario health teams bring together a wide variety of health care providers from across health and community sectors, including primary care, hospitals, home and community care, and mental health and addiction services, to better serve patients. Working together, these teams break down barriers, connecting people to care by ensuring a seamless transition from one provider to another, with one patient record and one care plan being shared between the providers.

We’re supporting Ontario health teams to take the next step to ensuring better coordinated care by moving the responsibility of connecting people to home care services to Ontario health teams. This is starting in 2025.

Mental health and addiction challenges are also an additional key issue facing our communities. Our government continues to make important investments, making it easier and faster for Ontarians, including in the north, to connect to high-quality and evidence-based mental health and addictions services and supports. This includes establishing eight new youth wellness hubs over this past year, with 22 hubs launched since 2020, with several of these hubs supporting young people in northern communities like Sault Ste. Marie, Kenora, Sudbury and Timmins.

We’ve significantly expanded the Ontario Structured Psychotherapy Program, including through providers in Sudbury and Thunder Bay, to provide more convenient mental health care. Through the Addictions Recovery Fund, 53% of the new addictions beds will be located in northern communities, supporting the creation of 204 addictions beds in northern Ontario.

Speaker, I’d also like to talk to the latest announcement, with the $110-million investment for inter-professional primary care teams that we announced earlier this month. Northern Ontario residents will further benefit from expanded timely access to primary care. Specifically, in northern Ontario, nearly $6 million of this investment will serve more than 37,000 net new patients.

I just want to talk to some of the applicants and the locations, given the members from the north here described these areas: in Moosonee and James Bay coast, Weeneebayko Area Health Authority; in Sudbury District, French River, the Centre de santé Univi Health Centre; in Manitoulin Island, Northeastern Manitoulin FHT, Manitoulin Central FHT, Municipality of Assiginack FHT; as well as in Wawa, the Wawa Family Health Team; in Timmins as well as Chapleau—many of these areas.

Speaker, we know that people stay healthier for longer with this primary care service and with faster diagnosis and treatment as well as more consistent support managing their day-to-day health, while relieving pressures on emergency departments and walk-in clinics. We will continue to work—

I want to thank the members from Eglinton–Lawrence and Newmarket–Aurora. I wasn’t surprised with the responses that I got from the government. Unfortunately, you didn’t listen to the picture that I painted of the realities of what’s happening with our health care system in northern Ontario, and that’s too bad.

The member for Don Valley and the member for Thunder Bay, thank you for your comments. To the member from Sudbury, you’re absolutely right; it is about equity of care.

I want to read the mandate here in the short amount of time that I have. The mandate is “to make recommendations for improving the facilitation of reasonable access to health” care “services for people in northern Ontario by means of reasonable, realistic and efficient reimbursement for travel costs.” It’s not just the reimbursement; it’s also the delivery of these services.

What the member from Newmarket–Aurora just spoke about with the enhancement to the family health teams—we welcome that, but it doesn’t require a travel grant. This is the problem. If we look at the reimbursement in the delivery of the Northern Health Travel Grant, there are things that we want to change.

I’ll give you a perfect example: On the delivery, if you look at a community like Espanola or White River, they’re just on the outside of that 100-kilometre diameter. If you live in White River, God forbid if you look at the price of gas. If you have to drive to Wawa to meet up with a specialist there, you need that travel grant, but guess what? You’re not going to get it. Because if you’re in White River or in Espanola, and you have to travel to Sudbury or Sault Ste. Marie, you won’t get it; you don’t qualify.

These are the types of discussions that we need to have, where we can bring the health care professionals, bring the service providers to start talking about what we need to do as far as improving the delivery and the equity of care. I touched a little bit on let’s bring Hope Air as well, as far as how we can make them a partner in providing the care that we need and getting people to timely specialist appointments. This is something simple—

Further debate?

Back to the member for a two-minute response.

The time provided for private members’ public business has expired.

Mr. Mantha has moved second reading of Bill 13, An Act to enact the Northern Health Travel Grant Advisory Committee Act, 2022. Is it the pleasure of the House that the motion carry? I heard a no.

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

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

In my opinion, the nays have it.

A recorded vote being required, it will be deferred until the next instance of deferred votes.

Second reading vote deferred.

The House adjourned at 1521.