I’m proud to stand in here in support of this very practical motion to provide additional administrative support for doctors so they can focus their time and their talent and their skills on providing patient care. We estimate an investment in administrative support could enable doctors to take on approximately two million more patients. It is a very practical solution that we are presenting today.

In my riding, we have a primary care provider and family doctor shortage.

I recently met with staff and patients from the Taddle Creek Family Health Team. They represent over 25,000 people; they have over 25,000 patients. The doctors told me that they spend easily 20 hours a week on administration, faxing forms, filling in paperwork, referring patients to multiple specialists as there is no centralized wait-list.

The Taddle Creek executive member was telling me that they have many vacant positions that they cannot fill—nurses, pharmacists, social workers. They also told me that people are leaving because they are not paid enough and they can get higher-paying jobs elsewhere. They have made a request to this government to raise wages for staff to comparable wages in the hospital sector, and it was rejected, and as a result, doctors and staff are leaving. This is the family health team that just had one doctor go to a private executive health clinic where it now costs $5,000 a year to access that medical clinic and get basic primary care. That is a shame, and that should not be happening in Ontario today.

When people are left without a family doctor, their health is at risk. Some people will get sicker. Some people will end up in the emergency room. Some people will needlessly die. I do not think this is right.

I believe this government is driving our primary health care system into the ground.

Our health care system depends on people having a primary care provider—it is the backbone—who can perform physicals, prescribe medication, do referrals and consistently manage non-urgent and preventive care.

Residents should not have to go down to the emergency room to get a prescription for antibiotics because there is nowhere else for them to go. That is happening in University–Rosedale today. It is a shame.

We are calling on this government to fix the family doctor shortage and the primary care crisis because everyone in Ontario should have access to good primary care that works for them, regardless of their age or ethnicity, or where they live, or their income.

We have presented a practical solution today to provide additional administrative support to doctors so they can expand the number of patients they can see and do the job that they do well to more people.

I am urging this government to support our motion today and fix our primary care provider shortage.

Most people listen to their doctors. People trust their advice and do what they are told that they need to do. That said, that is not happening when it comes to this government and sound medical advice. This government hasn’t been listening to doctors, which is why we are here today debating a practical solution proposed by the Ontario NDP to help more doctors to see more patients.

The lines for walk-in clinics start well before they open and wrap around buildings. People need care, but they can’t find it. Nicole in Oshawa has a family doctor in Scarborough, but she can’t get off that roster to free up space for a local patient, because then she won’t have a doctor. Frank moved here from out of province and hops from clinic to clinic to get important prescriptions renewed. Newcomers and new neighbours try to figure out waiting rooms without English or a primary care provider. Folks need access to medical care, and they need family doctors.

The Oshawa Clinic is moving to Whitby imminently, and we don’t know what will become of their patients if they can’t travel and follow them.

Some 2.3 million Ontarians do not have a family doctor. The NDP has a solution that will get people access to the doctors we have today by freeing them up to see additional patients. Doctors are tied up with paperwork and are unable to see as many patients as they otherwise could if they had support with the workload. We have listened to our doctors, and we’re proposing that the province hire staff support to free up family doctors, and we’re proposing that the province hire staff soon. We could take an additional estimated two million more patients—the doctors can handle up to two million additional patients if we did something now. This still won’t solve all the ills of the system. We need more doctors in the system and more doctors to go into family medicine. We still need family doctors in communities where there aren’t any. But where there are doctors, we want them to be able to work to their full capacity.

Hire staff support to handle the paperwork, so doctors can handle the patient work. There is no time to waste, because as we know, an ounce of prevention is a worth a pound of cure. We want a healthier system so we can have healthier communities. We need to do something today to support the family doctors of tomorrow.

Today, we can support this motion to ensure more patients have access to the doctors we currently have. This motion is just what the doctor ordered, and I hope this government will follow good advice.

Further debate?

I’m proud to rise today to speak in support of this motion to address the doctor shortage crisis in Ontario by providing more administrative support, freeing up Ontario’s doctors to take on tens of thousands more patients.

Currently, 73,000 people in the Niagara region do not have a family doctor, a sharp increase from 53,000 in 2023. This is not sustainable. What’s worse, this number is expected to explode to over 140,000 in Niagara by 2026. Welland has around four family physicians per 10,000 people, the lowest ratio in the region. Port Colborne has a population of about 20,000; roughly 10,000—half of them—are without a family doctor and rely on the urgent care centre, which is slated to close, as their primary point of health care.

Dr. Ahmed, a family physician from Niagara, spoke with the media recently and said, “I looked at the numbers ... and I was saddened but not shocked.” Several factors are driving the increasing shortage, she said, and they include an increased administrative burden “that has been foisted upon us by the powers that be,” as well as compensation that is not keeping up with inflation, “so physicians are struggling to keep their doors open.” Ahmed said family doctors spend an average of 19 hours per week, more than two full days’ work, in Niagara on administrative work.

Speaker, this government should support our common-sense motion to invest in administrative staff and integrated care options, which would unlock more time for doctors to care for thousands of patients in Niagara and across Ontario who are desperate for a family doctor right now.

I rise to support our motion to free up doctors from their administrative burdens. It’s an important opportunity.

In the north, where I live, accessing primary health care, or accessing any health care whatsoever, is often a challenge—we are at about 45,000 people in Thunder Bay who don’t have access to primary health care.

We know that the Ontario Medical Association named administrative support as one of their key asks, so we think that needs to happen.

Now, nurse practitioners: I want to talk a little bit about that, because the NDP actually started them, and they’ve been a fantastic model of team-based work. The problem is, there aren’t enough positions for nurse practitioners, and they’re leaving the province, they’re going to the United States, or, in some cases, they’re joining for-profit clinics, which is exactly what has happened in Thunder Bay. The moment Bill 60 dropped, we got a for-profit clinic. It started at $100, now it’s $200, now it’s $400 a year.

I’ve just heard from health care teams in the region, and they’re saying they’re much worse off than they were two years ago. The OMA also notes that patients in the north experience persistent inequities in the care they receive and in their health outcomes.

Then we have the Northern Health Travel Grant, which this government voted against. All we were asking for was a review, and yet the member from Kenora, the member from Thunder Bay–Atikokan, along with the rest of the government, voted against it. Where’s the money? Well, we know that the cataract clinic in Kingston is getting 56% more than public clinics for the same work.

I’d just like to close by reading something here. Krystal Shapland said that she was initially seeing a nurse practitioner but had to stop once the practice started charging fees higher than she could afford. She now has been diagnosed with cancer and is only able to go to walk-in clinics because she can’t afford to pay for the for-profit clinic that’s now available. She says she believes the government is deliberately underfunding primary care and feels all but the healthiest patients will become casualties of a failing primary care system.

To close, I don’t know that everybody knows, but the ask from health services across the province was $700 million; the government gave out $90 million. There’s a lot of money that’s going into private health care. If it wasn’t going there, it could be going to support publicly funded primary health care that we need right now.

This government is bankrupting our hospitals and they’re creating a crisis in our public health care system in order to privatize it. If you want to see a health care professional in Ontario, well, you can see a nurse practitioner at the South Keys Health Center in Ottawa and just pay $400 for the first visit. Or you can go online to Maple, a virtual care app that charges $70 for a visit.

This government is undermining our public health care system and creating a two-tier system, and the victims of this are the 2.3 million Ontarians who do not have a family doctor. That number is growing; by 2026, it will be four million patients who do not have a family doctor.

This government refuses to take simple measures so, today, our leader Marit Stiles has proposed a simple solution to address some of this problem. I’ve met with family physicians, I’ve met with medical students, and they say the reason that people don’t want to go into family practice is because they end up spending 20 hours a week—40% of their work time—filling out paperwork.

The solution proposed by Marit Stiles that we’ll be voting on today and which the government has said that they’re going to be voting against is simply to hire administrators to do the paperwork so that doctors can see patients. This simple solution would free up the equivalent of adding an additional 2,000 doctors to our system.

In my riding of Spadina–Fort York, we’ve lost two walk-in clinics and seven doctors in Chinatown, and thousands and thousands of patients are affected. I’ll give you just a couple of examples:

Ye is an elderly woman in the riding. She was dizzy and could not sleep for four days, so she went to a pharmacy and asked for meds, but there were no more refills. Then she went to the emergency. She waited in emergency room for seven hours, but she couldn’t get the prescription because she doesn’t speak English.

Amanjeev, another resident, says, “I have experienced US health care, and there is nothing amazing about it. Public health is needed to make sure there is equitable health care access for everyone. And funding this public health care system means that nurses and doctors who got into this profession to help actually” can do it without burning out.

The simple solution that we are proposing today and that I’m asking the government to support is to hire administrators so that family physicians can see patients.

I’m very proud to rise in support of the opposition motion brought forward by NDP leader Marit Stiles. The fact is there are 2.2 million people in Ontario who do not have family doctors; about 32,000 where I live.

The Ontario College of Family Physicians talks about an exodus of physicians from family medicine. Some are retiring in their seventies and eighties, some are dying because of their age, but many of them are leaving the practice, and they’re predicting about 65% will leave in the next five years.

The Ontario Medical Association, when they were in Queen’s Park meeting with all of us from all parties, very clearly said that physicians who are in family practice are telling students, “Don’t get into this field. The administrative burden is too much. It is too much.” Some 2.2 million Ontarians without a family doctor—these doctors are spending 19 hours a week doing paperwork. You think of a 40-hour work week, that’s half your work week doing paperwork.

How do you solve this? You follow up what we’re doing in this opposition day motion. You provide more people doing administration work to help the doctors. It gets them out of the backrooms and the offices where they’re typing and working on forms that are mandatory, and doing actual medical work. The result of that is equal to 2,000 new doctors—2,000 new doctors out of thin air. That’s two million more patients being seen. Perhaps when you do that, when you make it a job people would like to do, to actually do medical work, people who are in the medical field will want to become family practitioners as well.

This is an amazing idea, a great idea, a supportable idea. We look forward to the Conservatives joining us for many more of our good ideas.

We here in the official opposition NDP believe everyone deserves a family doctor. We believe the people in Kiiwetinoong deserve a family doctor. Les gens à Hearst méritent un médecin.

The 2.3 million people in Ontario who are being denied access to the basic right of primary health care—they deserve a family physician.

There has been a 66% increase in the number of children and teens with no family doctor, and that’s shocking. Sixty thousand people in Hamilton right now have no family doctor, and that number is scheduled to double in two years.

I’d like to talk about a constituent, Kathy Archer, who shared her heartbreaking story. She’s a senior living in Hamilton who hasn’t had a family physician in over five years. She has multiple chronic conditions, and she said, without a family physician, “I’m begging for help ... I don’t want to die.”

Without a family physician, people miss out on life-saving preventive screenings to catch deadly cancers early. Undiagnosed heart diseases like Afib—we know that they go unchecked. Some 300,000 people right now are on a waiting list for a mammogram. I would just like to say, I welcomed grandchild number eight, and I can’t imagine, without access—

Interjection.

Access to primary care is the bedrock of our health care, but as we have been describing here, it’s in crisis. If you listened to the government side, you would think everything is fine and rosy. But here we listen to people, and we know that people are struggling without access to family doctors.

What we are proposing here today is a very clear, very practical solution that this government could pass, and you could implement that today. We are proposing that you invest in administrative staff so that we can unlock more time for doctors to take on an additional two million patients.

Instead of rereading endless talking points, we call on this government to act with urgency. Pass this motion and save lives. Pass this motion and end the pain and suffering of so many that don’t have access to doctors—2.3 million Ontarians. Pass this motion and join us in saying that everyone in Ontario deserves a family doctor.

Thank you so much to my colleagues from the official opposition. Our proposal is the equivalent of introducing 2,000 new doctors in the province of Ontario tomorrow to see two million more patients. What could possibly be wrong with this?

Listening to the government members opposite address this motion, I felt a little bit like Alice down the rabbit hole. But there’s no waking up from this nightmare. We’ve listened to Liberal and Conservative governments over so many years—the last 20, 30 years—with half measures and cuts. Let’s just call the Liberal and Conservative governments Tweedledee and Tweedledum for the purposes of this argument. Nothing has been adequate and the writing has been on the wall all of that time.

Six years into this government’s mandate I would urge them to do something for the people of Ontario, listen to the 2.2 million Ontarians who do not have a family doctor, listen to the voices of Ontarians who are saying, “Please, do something right now.” We are serving you up a solution. You are not approaching this with the urgency that it requires.

If this motion were to pass—and we are forcing a vote on this this afternoon—again, 2,000 more doctors—the equivalent—two million more Ontarians could actually see primary care delivered immediately. It would relieve the administrative burden on family physicians. It will get patients the access they need and then relieve the pressure on our emergency rooms. You have a choice to make. Make the right one today. Vote in favour of this motion.

Further debate.

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

All those opposed will please say “nay.”

In my opinion, the nays have it.

Call in the members. This is a 10-minute bell.

The division bells rang from 1518 to 1528.

Ms. Stiles has moved opposition day number 2.

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

Motion negatived.

Resuming the debate adjourned on March 18, 2024, on the motion for third reading of the following bill:

Bill 149, An Act to amend various statutes with respect to employment and labour and other matters / Projet de loi 149, Loi modifiant diverses lois en ce qui concerne l’emploi, le travail et d’autres questions.

The ayes are 33; the nays are 69.

Further debate?

I’m pleased today to be able to speak to Bill 149, the Working for Workers Four Act. I’ll get into it a bit later, but Working for Workers Four Act is like most movie sequels: By the time they get to the fourth sequel, you realize that they’re losing the plot.

Here’s what’s good in the bill: There are good little snippets and scenes, and one of them is—okay, well, they’re making sure that the pay periods for digital workers are regular and that they’re regulated. That’s a good thing. The problem is we’re not really addressing the problems that face gig workers. I said earlier today in questions, deliveries and transporting people, like a taxi does, are not new jobs. It’s just that corporations have found a different way to employ people on contract so they’re kind of contract employees.

So here’s the thing: If we think it’s just going to be deliveries and taxis, transporting people, it’s not. The way our economy is changing is going to create more opportunities for people to take advantage of people, and that’s the thing that we need to address. That’s what’s missing in this bill. That’s what I mean when I say I think it’s lost the plot.

You go to the second part of the bill, where they are looking at the Employment Standards Act. Including the trial period as a pay period for workers is a good thing to do, no question—long overdue. It should have been done a long time ago.

Banning advertising of a Canadian requirement is a good thing.

Ensuring that employees aren’t penalized for dine-and-dash or gas-and-dash, or for customers that take advantage of service employees by not paying the bill: That’s a good thing. That’s a good reason to support this bill.

The tipping stuff is good as well, too. What I would like to see—and it’s not in this act—is that it’s not just enough to retain this and to post it for employees, but it’s also important that customers know. How many of us go almost everywhere now and we get asked for a tip electronically? I tip because I think it’s the right thing to do, but we don’t know—and maybe this isn’t a labour thing—it’s probably not; it should be a consumer thing. How come we don’t know where that tip goes? It will be a challenge to enforce this. I think if employers had to post the tipping policy where people were making tips, that would be a good thing—again, maybe not necessarily a labour thing, but it would be a good consumer thing that would help employees.

Now, on pay transparency: We did have a Pay Transparency Act here in Ontario. It was passed in 2018. It should have been enacted in November 2018, but the government put an indeterminate pause on that. They’re never going to enact it—it’s not going to happen—and the measures that are included here are not nearly what’s needed to ensure gender pay equity. We heard the member from Sudbury talking about that this morning. Even some people looked at the bill in 2018 and said it could have been stronger. That’s something that should be in the plot. That’s something we’ve been talking about for a long time, for decades, here in Ontario, and we can’t seem to get there. Why is that?

Now, the fair access to regulated professions and compulsory trades: I think that’s the thing in this bill that’s most compelling to me. It gives me more of a reason to vote for the bill. It’s a good thing. It has been something that, again, for decades and decades and decades, we’ve been trying to work with regulated professions to make sure that people would have access; that the people who come to this country and were trained somewhere else and have skills—that their skills would be recognized and somehow we would, if we needed to, help them upgrade those skills, not just because we should do it, but just because it’s the right thing to do. It’s the human thing to do. It’s morally the right thing to do. Somebody else paid to make sure that person got those skills—somewhere else, another jurisdiction. It’s just good economic sense to do it, and that’s why I think this is another measure that’s going to help this. It’s something that governments of all stripes have struggled with for decades, so I want to congratulate the minister on this being put in the bill.

The WSIB changes, especially with regard to presumption for esophageal cancers: again, a good thing. The question that did come up at committee, and I think it’s fair, is that wildland firefighters are not included. Why is that? Why is there a difference? The interesting thing is, wildland firefighters are not organized, generally, and they earn between $16 to $19 an hour. So they’re taking a risk that’s maybe the same, maybe greater, but it’s in the same ballpark; they’re getting paid less, and we’re not covering them. Why is that? I hope, in the questions and answers, that somebody can explain to me why we’re not doing that, why there’s a hesitation, why they need to wait longer. It would only be fair.

We have workplace safety insurance in this province to make sure that people’s backs are covered. Some good things have happened with it in terms of managing the risk and making sure that premiums recognized the risk in the work. There’s a lot of good work that has been done over the last number of years, but the piece that’s missing is that we haven’t expanded coverage. We should actually be trying to get more people covered. That’s what insurance companies do. But this is a different kind of insurance company. It’s the people’s insurance company, for the people, and employers pay into it and governments of all stripes have maintained workplace safety insurance. We should be trying to make sure that more people are covered, and that’s why the wildland firefighters should be covered. They don’t make a lot of money. They take a lot of risks. I would hope that will come up in the questions and answers, sometime in this debate, because I really don’t understand why not.

I mentioned this this morning, as well: I have a private member’s bill, and I’ve talked to the minister about this and I’ve talked to the previous minister, and they were both very positive about it. It’s a bill that ensures that people doing the same job and taking the same risks should have the same coverage, even if their employer is different. Many of you may not know, but if you work in a retirement home, whether you work as a PSW or another worker in that home, the work is very similar in terms of risk profile for people who are working in long-term care. Well, people who are working in long-term care are covered by WSIB. They’re covered. That’s the law. It’s a schedule 1 employer.

But at some point, retirement homes were no longer a schedule 1 employer. Although you’ve got the same number of people, the same kind of work and the same kind of risks, they don’t have to be covered. It’s optional. Here’s the problem: Most insurance will cover you for your job, that one job that you have. Many workers in retirement homes have three different jobs. If they’re covered by WSIB and they get injured, they get paid for all their jobs. If they get injured at one of the retirement homes they work at, they get paid for that one job and not the other two. That’s not fair. People taking the same risks with the same people doing the same things should not be covered differently because their employer is different. They should not be excluded because their employer is different. It’s about the work; it’s about the risks that they take. That’s what insurance is all about, and I’m encouraged by the fact that both ministers have said to me that it’s something that they’re looking at.

We have to do it for many of these workers—these PSWs and developmental service workers—because it applies to them too. If you are in a group home, that’s a contract—you don’t have to be covered. But if you are in a provincial youth offender facility or a provincial facility that provides assistance to the developmentally disabled, you’re covered. It’s not fair that these people aren’t covered. Most of these workers are women, racialized, working three jobs. They’ve been working for a long time. They’re afraid to report injuries, because they can’t lose the income. They work with injuries because they won’t get covered for the other two jobs. They take big risks. There are people taking exactly the same risks that are working for a different employer—the province of Ontario or a long-term-care corporation—and they’re covered. They have to be covered.

So I’m going to support this bill; there are good things in it. But when it comes to WSIB, I think we need to get back to the plot—and that’s where we have an insurance program, so that workers will be protected in the event that they become injured at work, and so that their families will be taken care of. We’re taking really good care of some people—and some, not at all. I think that’s the thing that I would like to see in the Working for Workers Act 5—that we look towards coverage for wildland firefighters, that we look towards coverage for PSWs and developmental service workers who aren’t covered right now just simply because they’ve got the wrong employer.

In closing, to reiterate, I think when we get to the Working for Workers Act 5, there are some things we need to address, like expanding coverage of WSIB for workers who aren’t covered, who should be covered, making sure that when it comes to the gender pay gap that we actually put some measures in that are going to make sure that we address that.

We have a bill that’s still sitting on the books, not enacted, and the government can choose to enact it. It can choose to take some of the measures, add more measures—I think that’s a fair and reasonable expectation to have of the kind of things that we need to do to actually work for workers.

I thank you for your time.

How come you didn’t do it when you were in office?

Questions?

My thanks to the member for Ottawa South for his participation today in debate.

I’m glad to hear that the member is going to be supporting this legislation. He’s correct that this is an iterative process. I for one have no doubt that we will see a Working for Workers Act 5 come at some point in this chamber, and I think that does speak to our commitment to that iterative process of getting ideas. I know, under the leadership of the minister and the Premier—they’ve shown a willingness to listen to those ideas.

I know that the member opposite, as we are now in government, has served in government as well. I’m wondering if he ever brought forward the idea of super-indexing WSIB benefits when he was serving in government. I know it’s something that we’ve heard a lot of support for. It’s something that I know, hearing from those who are living with the—

I want to go back to the issue of pay transparency and pay equity. They were coming up on the anniversary of Equal Pay Day, April 16—and that day represents how far into the next year women have to work to earn what the average man earns in the previous year. So we have a long way to go when it comes to closing the gender gap, and this bill does not help in any way.

In fact, I would like to say that the Equal Pay Coalition had this to say at committee—and you were at committee: “Bill 149 does not advance these protections” for women. “It leaves women vulnerable to employers lowballing their pay while the fig leaf of Bill 149 shields their actual discriminatory pay practices from view.”

So I also would like to know why this government has not enacted the legislation or why this government thinks that women don’t see that this is simply just fluff when it comes to their real need to increase their real earnings to put real food on the table for their real children in this province.

I would hope that maybe I’ll get an explanation of super-indexing and why we need it. Why is it something that’s undefined about—“We’ll give more than the cost of living.” I think it’s because we’re having a debate of what the cost of living is. There’s a dispute between a couple of parties as to what WSIB should be paying out. That’s probably what it is. I’m not saying it’s a bad thing, but I’m saying it’s oversold. I think what’s happening now is, it has become oversold. And what we really should be focusing on is expanding coverage—wildland firefighters, PSWs, DSWs. I brought that forward with the bill with regard to PSWs and DSWs. I’ve done it five times—five times—and debated it twice. I did it while we were in government, and I’m just going to continue to push it because I think it’s the right thing to do and we need to do it.

Next question?