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Decentralized Democracy

Ontario Bill 7

43rd Parl. 1st Sess.
August 31, 2022
  • This is a summary of Bill 7, which is an amendment to the Fixing Long-Term Care Act, 2021 in Ontario. The bill introduces a new provision for patients in public hospitals who are designated as requiring an alternate level of care. This provision allows certain actions to be carried out without the patient's consent, such as determining eligibility for a long-term care home, selecting a home, and authorizing admission. Assessments may also be conducted, and personal health information may be collected, used, and disclosed if necessary. These actions are not subject to certain sections of the Act and are instead regulated separately. Reasonable efforts must be made to obtain consent, and the use of restraints or physical transfer without consent is not authorized. The bill also includes minor amendments to the Act and a consequential amendment to the Health Care Consent Act, 1996. The bill is enacted as Chapter 16 of the Statutes of Ontario, 2022 and is titled the More Beds, Better Care Act, 2022.
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  • Aug/30/22 5:20:00 p.m.
  • Re: Bill 7 

The time for debate has ended.

Pursuant to the order of the House dated August 29, 2022, I am now required to put the question.

Mr. Parsa has moved third reading of Bill 7, An Act to amend the Fixing Long-Term Care Act, 2021 with respect to patients requiring an alternate level of care and other matters and to make a consequential amendment to the Health Care Consent Act, 1996. 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 ayes have it.

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

Third reading vote deferred.

The House adjourned at 1725.

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  • Aug/30/22 5:10:00 p.m.
  • Re: Bill 7 

It’s always an honour to speak in this House—today, more of a tragedy, I think, on Bill 7.

There’s one thing I profoundly disagree with the House leader on: I think every member in this House, regardless of party affiliation, cares about the people of Ontario and wants them to live in an Ontario with the best health care possible, regardless of their age or where they live. He accuses the NDP of fearmongering.

How about we just read the explanatory note into the record? The explanatory note is somewhat different than the picture that the House leader is weaving: “The bill amends the Fixing Long-Term Care Act, 2021, to add a new provision for patients who occupy a bed in a public hospital and are designated by an attending clinician as requiring an alternate level of care. This new provision authorizes certain actions to be carried out without the consent of these patients.” That’s a key point—without the consent.

“The actions include having a placement co-ordinator determine the patient’s eligibility for a long-term-care home, select a home and authorize their admission to the home. They also include having certain persons conduct assessments for the purpose of determining a patient’s eligibility, requiring the licensee to admit the patient to the home when certain conditions have been met....

“Certain limitations apply. The actions cannot be performed without first making reasonable efforts to obtain the patient’s consent.” What is a reasonable effort? “If consent is later provided by an ALC patient, the parts of the process that have been consented to must be conducted in accordance with sections 49 to 54.”

They do stop, however. “The section does not”—where the government stops is—“authorize the use of restraints in order to carry out the actions or the physical transfer of an ALC patient to a long-term-care home without their consent.”

The government House leader talked about his father-in-law, and I respect the government House leader. I disagree with his position, but I respect him. When we had to admit my mom into long-term care, it was the hardest decision of our lives. The families are all—you know, it’s really tough. And it’s really tough for the person. But now on top of everything else they have to face, they have to face this hanging over their heads: that if they don’t make that decision quickly enough, they potentially could go somewhere else.

The government House leader said, “Well, it doesn’t say anywhere how many kilometres.” I agree with that. But it says “in accordance with the geographic prescriptions that are prescribed by the regulations.” Why aren’t they in the bill? Regulations can be changed at any time. Put them in the bill. He accuses us of fearmongering, yet what he claims isn’t in the bill either.

At the most stressful time of a person’s life—we all want our parents, our family members, in the best place possible. And do any of us really want our family members in ALC? No. We want them to get where they can get the best care. And there are places where they can get the best care, but for many of those places there are waiting lists. Now this bill gives the opportunity to say, “Okay, we will give your personal health information to someone that bureaucracy cares about. We will send your personal health information without your consent. We will do many things without your consent. And, oh, the last step, you might have to pay some more money if you want to stay in the hospital, if you don’t like that.” That’s a pretty big hammer at the end of that process.

And you know what? A couple of days ago, I asked a question in the House about someone who was denied a second shower a week through home care. Those are the types of people who end up in ALC. Because I asked that question, do you know what? She got her second shower. But that shouldn’t come into the House. That community care coordinator—how was that decision made?

Now you’re asking people to believe that these decisions will all be made without the person’s consent. That’s a travesty. That is truly a travesty of democracy. A person’s health consent should never, ever be given up. And that’s why we are totally opposed to this bill, because it doesn’t improve people’s health.

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  • Aug/30/22 5:10:00 p.m.
  • Re: Bill 7 

That’s right. Almost every hospital that you see in this province was conceived of, thought of and built by a Conservative government.

And I forgot to mention how medium-sized hospitals—I thank some of the members in some of the smaller jurisdictions, who kept saying, “You know, the Liberals kept starving small and medium-sized hospitals. They kept starving them. They could hardly do anything.” Well, of course, we fixed that funding model too. I forgot to mention that. I almost forgot what I was talking about, because there are just so many good things that are happening.

But what is the bill ostensibly about? It is about looking at somebody who’s in a hospital—Madam Speaker, I’ve actually been there. I’ve been there. I’m not lucky enough to have had a parent, my own parent, that lived long enough to come even close to a long-term-care bed, but I have a father-in-law who did. He was discharged from the Markham-Stouffville alternate-level-of-care centre at the old Humber Valley site—at 400 and Steeles, I think, or something like that.

He didn’t want to go at first. He didn’t want to go. Do you know why he didn’t want to go? It wasn’t because of the distance, but he just thought that that meant too much of a difference, a change for him. You know, “I can’t be on my own anymore and I worry about it.” Once he got there and saw how good the care was in comparison to a hospital, he was grateful for the opportunity that he had to go there. He wasn’t so excited about transitioning out, but we saw what happened. As a family, we saw what happened: He started to do better. He started to thrive. He came back. He came back to the point where he could live on his own again. And I’m glad the member from Niagara Falls is almost finished reading the bill, because he seems to be agreeing with some of this now. He came back. But that’s what we are offering.

The member for Toronto Centre talked about—and I was at the Rekai Centre just a couple of days ago. It is a wonderful place. Not-for-profits are wonderful. Our municipal homes are wonderful. Our for-profit homes are wonderful. What has not always been wonderful is the regulations that they, the Liberals and the NDP, failed to put in place to ensure that the quality of care was equalized among all sectors. We did that. But I was at the Rekai Centre, and she is correct: It’s a great facility. Many members of the LGBT community are now transitioning into that home. It is a home of preferred choice.

But the member talks about how if somebody is in ALC—and if I’m wrong, the member can correct me, if I get it wrong—we won’t be able to address their specific needs. But again, that is incorrect. It’s incorrect. It’s not—I’ll choose my words carefully. It’s incorrect. Why? Because of a couple of things. First of all, nobody can be discharged to a home that doesn’t have the staffing. It’s part of the Fixing Long-Term Care Act. So when they talk about how there are not going to be enough staff, that’s actually incorrect; the law doesn’t allow that to happen.

But part of why we are doing this, part of the rationale for consent, part of the rationale to look at a patient’s needs is so that we know that before we offer a facility that is not a preferred choice, we can ask: “This is what this patient, who is discharged from a hospital, needs. Can you cover this person’s needs?” Whether it is cultural, whether it is, as I’ve said, dialysis, or many of the patients in hospital have dementia, they need specialized care. We can ask, “Can you handle that?” And they will say to us, yes or no. If it’s a no, then we’ll say, “What do you need in order to handle the person we want to send to you for better care?” They may say, in the case of somebody with dementia, “We need additional resources from behavioural services Ontario to ensure that there’s an attendant who can work with the patient.” They may say, “We need a special diet for the patient.” They may say, “We need larger beds for bariatric patients.” They may say, “We need kidney dialysis.” And there’s funding in place to ensure that that happens—funding that doesn’t exist now but that will exist because of this bill. It is matching up the needs of the patient with the resident—the person who will become a resident. So we don’t have to ship people off to get dialysis.

Who would get up in this place and advocate for a system that they know is not in the best interests of the patient?

What we’ve heard from the opposition today is ludicrous—that, somehow, offering a better quality of care to somebody is going to make them give up. My father-in-law didn’t give up because he was asked to go somewhere else. He ended up thriving. And that is what we are trying to accomplish with this bill.

At the same time, it is unacceptable—the member from Niagara Falls talked about how Ontario is a rich province—that if I have to bring my child to an emergency room, or if you have to bring your grandchild, your child, a parent, a loved one, that they have to wait, and that if they need to be put into a hospital, there’s not a bed available. Why? Because we have people there who aren’t being treated in the best possible way. It doesn’t serve the needs of the person who’s waiting. It doesn’t serve the needs of the person who wants or needs a room. And we can do it better.

The worst part is, the NDP are arguing for a reduced level of care. They are arguing to treat our seniors—because that’s what this bill is talking about—like less, that they don’t deserve the same quality of care that somebody else gets. I think that’s wrong. That’s why we’ve made the investments that we’re making. That’s why the bill does what it does. That’s why it makes the extra investments. Their lies, their argument, everything that they say runs counter to what is best for the patient, but what it is best for is the status quo and the people they’re more interested in—because, I would submit to you, Madam Speaker, it’s not the patient who, as my parliamentary assistant said, wants to become a resident, wants to have a home; a patient who will get treatment, who will get care in a long-term-care home while waiting, if they’re asked to move, at the top of the waiting list for their home or preferred choice.

Better care in your community—close to your family, close to your spouse, close to your caregivers, while waiting at the top of the list for your preferred choice. I think it’s a choice that Ontarians understand is in the best interests of the people of the province of Ontario.

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  • Aug/30/22 5:00:00 p.m.
  • Re: Bill 7 

And I appreciate that the member for Niagara Falls is finally reading the bill.

But did they do anything? No.

And now, somehow, they come here, when you have a government that has from day one made enormous investments in health care—we’ve talked about it: a new hospital in Brampton, new hospitals in Niagara. The largest hospital expansion, I think, in Canadian history is in Mississauga. The largest expansion of long-term care in Canadian history—province of Ontario. The largest investment in health care for Ottawa is happening under our government right now. That’s what’s happening in the province of Ontario. We’re hiring thousands of nurses, thousands of PSWs, hundreds of doctors.

They talk about—and I heard the member from Scarborough Southwest talk about, “We’ve got foreign-trained doctors and medical professionals.” Well, we’re actually doing that. We’re doing it, Madam Speaker. It could have been done, but it wasn’t done.

Now, I want to talk—the opposition House leader asked me a question about respite care. She said, “Well, are you going to bring back respite care as part of this?” Well, yes, of course we are. It was part of the news conference.

They say, “You’re going to move people hundreds of miles away.” The announcement talked about what we hoped to accomplish with this program. Yes, there are almost 6,000 people in hospital who should not be there. There are about 2,000 of them who are waiting to be in long-term-care homes, who have applied and want to be in long-term-care homes.

Are there some that should be in home care or would rather home care? Absolutely. Of course there are. That’s why we’re spending $1 billion to improve the system. That’s why I wish they would have voted for it and not against it. They’re going to have another opportunity, though. They voted against the throne speech, but very soon, colleagues, they’re going to get one more chance to vote for home care, a $1-billion investment, and we’ll see how that goes.

The member from London talked about respite care. Colleagues, I’ve talked about this before, when I first spoke. This is the program where you have a loved one and you’re taking care of the loved one at your home. More often than not, it’s an elderly couple: a husband who’s taking care of his spouse and he doesn’t want or she doesn’t want them to be in a long-term-care home, but they need a break. They just need a break. It happens, right? It happens.

The option they have available to them right now is the hospital. That’s the only option they have available to them: the hospital. This bill changes that. This bill reopens the respite care program in the province of Ontario, making available space for about 500 people who are in the hospital right now as ALC patients to come out of that, where they’re not being taken care of, and to get the respite care.

The member from London asked for that to be done. We were already doing it, but the members of the NDP say, “Well, despite the fact that you’re doing it, we can’t vote for it.”

It also said that ward beds, three- and four-bed—and why do I bring up the ward beds, the three- and four-bed rooms? It’s because the member for Niagara Falls, in his speech, talked about how—not even in his speech, in his public Twitter feed—says that we are going to move people into three- and four-bed ward rooms. Now, forget the fact that you can’t do that, but the member spoke about it—

So I’m glad that the member for London screams out that it’s not in the bill. But then I remind the member for London that nor is a $1,500-a-day charge in the bill, nor is sending people 300 kilometres away in the bill, nor is sending somebody 100 kilometres away in the bill.

What the bill ostensibly, though, is about—which they don’t want to talk about, because the NDP and the Liberals together, whether in coalition or separately, like to see chaos, right? They don’t like to see things actually accomplished. It’s not in their interests to do it. It’s about protecting the status quo.

You’ve heard about this a lot. We talk about the status quo a lot. That’s really the essence of the opposition: They are the party of the status quo. That’s what they are. Forget the fact that, to be clear, it was a Progressive Conservative government that brought in socialized medicine in the province of Ontario in the first place, right? It was a Progressive Conservative government that did that.

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  • Aug/30/22 4:50:00 p.m.
  • Re: Bill 7 

I appreciate the opportunity to rise and talk a little bit about this debate about this bill today. There’s been a lot that has been said and a lot that leads me to believe that members have either chosen not to read the bill or have chosen to ignore what’s in the bill and make something out of the bill that is not actually in the bill.

Let’s just hit it head-on, Speaker. We’ve heard many of the members of the opposition talk about—I think the member for Windsor just said we were going to move somebody from Windsor to Timmins. Of course, that’s not in the bill. It’s nowhere in the bill.

And when you ask the members of the opposition, “Show me where in the bill it says that,” they say, “Well, you know, it’s in there. It’s just what’s going to happen. It’s what you’re going to do. You’re just going to do it.” Right?

So that’s what they say: “We’re going to move people 300 kilometres away. This bill says we’re going to move people 300 kilometres away.” The bill not only does not say 300 kilometres away; the bill does not even say a kilometre away. The bill says nothing with respect to where people will be asked to move or how that will happen, but the opposition gets up in the House—and you see the member for Niagara Falls; he’s laughing because he knows. He thinks that he’s got us on it. Look at the way the member for Niagara Falls is laughing, because he thinks, “Oh, look. I know what I said. I said it as though it was real.” He thinks he’s got us on that, right? That’s what the member for Niagara Falls does. He goes to the lowest. He goes to the personal. This is what happens. And he’s agreeing. The member for Niagara Falls is agreeing right now.

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I’d ask a page to bring me a copy of the bill. One of the pages, if they could bring me a copy of the bill, I would appreciate that.

Interjection.

I’d ask one of the pages, if you could come here for me. I would like you to bring that to any member of the opposition—pick any one of them; in fact, why don’t we give it to the opposition House leader? If she wants to get up on a point of order, Madam Speaker, I’d gladly allow that member to get up on a point of order to tell me where in the bill it says that we will be sending people 300 kilometres away, because it won’t be in there. It won’t be in there, Madam Speaker. That’s part of the problem about this debate, isn’t it?

Then you get, “Well, they’re going to be charged $1,500 a day.” I would ask the page, if you would do me a favour—I should have gotten more than one copy—get me another copy of the bill.

Now, we had the new member for Don Valley East, who said, “Let’s not talk about something that’s been on the books since 1979.” Okay, let’s not talk about it, then. All right. Because it’s not in here either, right? It’s been on the books since 1979, but if I could have one of the pages come to me or if one of my colleagues would bring one of these bills over to any member of the opposition—in fact, the deputy leader of the opposition—and if they could find for me in the bill where it suggests that we’re going to be charging people $1,500 a day, I will again cede the floor and listen to the point of order where it says that.

Colleagues, you’ll agree with me that if it’s not in here, then that is not what we are talking about with this, right? So what would be the advantage of somebody to get up here and talk about things that are not in the bill? What would be the advantage? One thing and one thing only: to frighten people. And that, colleagues, is the essence of what the opposition is doing on this.

Now, the Liberals themselves—I’m going to spend a little time on the Liberals. They were in power from 2003 to 2018, 15 very long, difficult, challenging years for the people of the province of Ontario—very, very long. There were a number of Auditor General reports in that time that asked for the then Liberal government to do something about home care, to do something about palliative care, to do something about long-term care, to do something about hospital capacity, but in a subsequent report before they left, the Auditor General highlighted all of the things that they didn’t accomplish. Palliative care, long-term care, home care—not done.

So the new member for Don Valley East, who is a physician, who is a good member—I like him. He’s got a lot to bring to the table here, I think, in this House. He talks about the things—he says there ares a lot of things—I wrote it down. I’ve got to find it, Madam Speaker.

Oh, yes. He talked about things that he thinks aren’t being done. He says it sounds like a trend. He talked about home care, palliative care—it sounds like a trend. Well, we know what the trend was, right? It was 15 years of Liberals doing nothing. And what did we do? The day that we were elected, we began to invest in health care—and not silos in health care, but a health care system that is completely integrated.

Now, this is what they don’t like to talk about. They don’t like to talk about this. We said, “Look, the health care system isn’t working as it is. Once you’re in the system, people have good things to say about it, but getting into the system is a very difficult challenge.” So we brought in Ontario health teams to make it easier for people: a ribbon of care, a blanket of care so that you could have all of your needs met by one person. Whether you needed home care, long-term care, whether you need to be in the hospital or a specialist, you went to one place and you had all of that done for you. You didn’t have to worry about calling this person, that person and all the stress that goes along with it.

So we started the transition to Ontario health teams, and then we said, “What’s next?” Of course, what is next? Long-term care is next, Madam Speaker. Long-term care is next. That’s why we said we’re going to build 30,000 new long-term-care spaces. So the member says it’s a trend, and he’s right. The member for Don Valley East is actually right. It is a trend. Improving health care? Yes, it’s a trend for us to get it done. Improving long-term care? Yes, it’s a trend for us to get it done.

There’s a billion dollars for home care that is on the table, and we will have an opportunity to vote on a billion dollars for added home care very, very soon, but we know how they’re going to vote, right? They’ll vote against it because they voted against the throne speech earlier today which highlighted the investments that we’re making in health care. They already voted against it. This is what the NDP and the Liberals do.

I’m going to take it a bit further. The member for Don Valley East then again said, “Well, it’s $1,500. It’s coercion.” I’m sure his colleagues in the hospitals that he just worked at would be shocked to hear that they are somehow coercing patients to get a better quality of care. I don’t believe that’s the case, Madam Speaker. I don’t believe that the long-term-care discharge officers in the hospitals are going around rubbing their hands together and saying, “Oh, I could get 1,500 bucks from that person.” I don’t think that’s happening. And I don’t think doctors who are looking at patients and saying, “You no longer need to be in a hospital. It is not the best place for you”—I don’t think they’re saying “Oh, well, we’re going to get 1,500 bucks from this person.” I’ve never met a health care official who would say that. And I know that the member for Don Valley East would never, ever do that.

Let’s talk about it. Are there instances when people have been charged for being in a hospital? Absolutely. Of course there are. Are there instances when people should be charged for being in a hospital if they are alternate-level-of-care? Yes, there should be. If the coordinator has offered somebody their preferred home of choice and the person refuses to go to their number one choice, should there be a charge for that? I believe there should be, and I’ve never said anything differently than that. I believe that. And I think most Ontarians would agree with that.

By the same token, they talk about ALC being a current problem. ALC numbers in this province have gone up every single year. Every single year, the amount of people waiting in a hospital to be transferred or cared for in a different environment, in a better environment, has gone up. It has not been dependent on whether there’s a Bill 124. The numbers have gone up and up and up. The difference is that the opposition, the Liberals, when they were in government, did less and less and less.

The NDP dine off of the fact that the people of the province of Ontario have never given them the honour of serving in government but one time. They somehow absolve themselves of the responsibility, from 2011 and 2014—I believe it was 2011 to 2014—when they held the balance of power. For those watching at home who don’t understand what that means, it means that not enough Liberals at that time were elected to govern without the support of another party. We’re seeing the same thing in Ottawa. In 2011—friends, at that time, there were already Auditor General reports with respect to long-term care. There were already thousands of people sitting in hospital beds—alternative-level-of-care—who needed to be treated better somewhere else. Was it a priority for the NDP then? It was not a priority. Did they talk about building long-term-care homes then? They did not. Did they talk about paying PSWs more then? No. Did they talk about bringing them in? Did they talk about the things that the Minister of Colleges and Universities is doing—by adding new medical schools? No. Did they talk about adding beds to our health care system so that we could—they talk about, “Oh, we’ve got the lowest bed-to-person ratio and blah blah blah.” Did they do anything about it? Nothing. It wasn’t a priority for them during that time period. And I’m glad that the member for Niagara Falls agrees with me that they had the opportunity and it wasn’t done.

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  • Aug/30/22 4:40:00 p.m.
  • Re: Bill 7 

Speaker, let’s talk about what this bill really means. It means that we’re giving up on those who took care of us, our seniors, the people with disabilities and the people who are most vulnerable, and the most vulnerable communities that some of my colleagues have pointed out. So in my short time, I just want to point out the fact that, when we’re talking about a health care crisis, this bill is essentially blaming those who are the most vulnerable people in our province.

No one wants ALC patients to end up in hospitals. No one here does. I don’t, and I know ALC patients themselves certainly don’t. Out of the 6,000 patients who need ALC, only about 1,800 are the ones who actually need long-term care. That means we need to build capacity for long-term care. We need to improve long-term care, and we need to make sure that we have things like inspections, things like staffing. What impact will this bill actually have on the crisis that we’re facing in our long-term care or our health care? It does not solve that problem.

The capacity issue that we face in our long-term care: Donna Duncan, the CEO of Ontario Long Term Care Association, said the following in the Toronto Star. She said that the nursing homes themselves actually do not have the capacity to take up the patients who might end up in these homes as a result of this bill because we’re not addressing the fundamental problem, which is staffing, which is the issue of these homes and which is what’s happening in our health care system.

So what we’re asking for is, withdraw Bill 7. All patients have the right to consent, especially our elders. They’re the people who built this province. These are the people who are the most vulnerable and these are the people who should not be blamed for the crisis that many of the past governments—including this government, because they were in power for the past four years—have created, this health care crisis. We really need to do better by everybody, especially those who are waiting for us to make the right decision.

The fact that there are so many advocates across this province talking about this bill and the fact that we did not have committee hearings—and we actually heard from more than, I think, a dozen people who joined our meeting yesterday, which was a mock hearing just so we could get an understanding of what people are saying. We heard from so many people who talked about the fact that we need to withdraw Bill 7. We need to fix the health care crisis, and the way to do that is to retain and recruit staff. We need to make sure we recognize internationally trained professionals who want to contribute to this province. We need to make sure that we actually help the health care system by investing in our health care system, and we need to invest in our home care. That’s where these seniors and these people want to be. They want to be in their homes, with the care they need.

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  • Aug/30/22 4:40:00 p.m.
  • Re: Bill 7 

It’s my honour to be able to rise to speak to this bill. I wish it wasn’t necessary. This bill frankly should never have been tabled in the first place.

I don’t have a lot of time, so I’m just going to highlight some of the key points in the bill that are very concerning, and although the government House leader, who is the part-time Minister of Long-Term Care, tries to gloss over these facts and say that they’re not accurate, the reality is it’s in the bill. We’re reading directly from the bill, and it’s not just us raising these alarm bells about what’s in this bill. There are many other people.

I’m hearing from my constituents who are concerned about this. What this bill does is—and I quote; it’s right in the bill: “The actions listed ... may only be performed without consent if reasonable efforts have been made to obtain consent of the ALC patient or the substitute decision-maker.” But there is nothing that defines what a “reasonable effort” is, or who gets to choose what a “reasonable effort” is to have a conversation and to gain consent. That’s concerning. We’re talking about taking somebody’s right to bodily autonomy away, or their substitute decision-maker, to be able to make those decisions if the patient themselves is not able to.

I’ve heard a great deal of conversation from the government side that is also very alarming. They are weaponizing patients. They are weaponizing seniors and people with disabilities by saying that those people that are in those alternate-level-of-care beds are preventing others from getting care. They’re saying that this person’s care is more important than this person’s care. And if you happen to be one of these people who go into hospital for care and you’re not able to get it because of things like Bill 124 that they brought forward, which is forcing our health care workers, our nurses, out of the system—because we’re short on doctors, because this government is privatizing health care rather than investing in our publicly funded health care system. So if you fall into this category, according to the government, and you go for health care and you don’t get it, it’s this person’s fault who came in for care. It’s their fault. It’s that senior’s fault. It’s that person with a disability’s fault.

And it’s really shameful that that is the narrative that this government is driving instead of taking responsibility for their lack of actions—and I’m getting really tired of the whataboutism. We know what the government before them did, what the Liberals did or didn’t do. But you’ve had over four years to actually do something progressive and invest in the health care system, invest in the long-term-care system, take profit out of care, invest in the front-line workers. You guys brought in Bill 124. It’s not the fault of the folks on this side of the House. So stop with the whataboutism and actually do something to start repairing the system.

But instead of doing that, they’re making it sound like the people that access health care are the problem. It’s their fault. And so what we should be able to do is strip them of their rights, move them into a long-term-care home that they don’t want to go to outside of their community—and there is nothing in this bill that dictates the distance. That’s up to regulation, and that’s important to note because any government, at any time, can change a regulation without it coming before this House—not that this government cares about debate anyways, or public consultation. But that’s important to note. They could change this at any time. So someone in my community, in what I call the deep south of Ontario, could be shipped up to Timmins for care, away from their families, unable to have access to their family caregiver, something this government did during COVID. It locked those family caregivers out.

As others have pointed out, it says, “Interaction with Residents’ Bill of Rights

“(9) Despite subsection 3(2), this section and any regulations made under clause 61(2)(h.1) or (h.2) shall not be interpreted or construed as being inconsistent with the Residents’ Bill of Rights,” which is basically saying that this bill overrides the Residents’ Bill of Rights.

This government is okay with stripping people of their rights. This government is okay with pitting patients against each other. This government is okay with chipping away at our publicly funded health care system and blaming it on others. And they’re okay with taking seniors and people with disabilities and shipping them outside of their communities into for-profit, private homes that many former Conservative Premiers and others are on the boards of, making millions of dollars. They’re okay with that. But instead of standing up and admitting that, they’re dancing around it and they’re defending what’s in here, rather than holding public consultations and hearing from the public.

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  • Aug/30/22 4:20:00 p.m.
  • Re: Bill 7 

I rise today, as many of us have, with a heavy heart, because this is a serious, serious piece of legislation. I know the government House leader has, from what I can tell, about 27 minutes to respond, and respond he will, as he does. But here is my fear, Speaker, through you to the government: I fear what the government House leader and the government is going to tell us is that “Folks here are catastrophizing. This isn’t really a big issue. People’s consent is still upheld.”

Folks over there have consciences—I know they do—so they must believe that. But I want, through you, Speaker, to tell the government what I’m hearing from home, and to be honest and to put my own cards on the table as a representative of my community.

I’m hearing from people at home that if their vulnerable family members are compelled through significant fees, they’re going to resist paying those fees. I’m hearing from staff back home, Speaker, that if they are asked to strap people to a gurney and cart them out against their will, they are going to not be compliant with those orders.

How did we get to here? I want to say very clearly through you to the government, Speaker: I take no pleasure in realizing that if the government passes this piece of legislation, that they will be putting families in that position. They are going to compel them to not pay these fines, because they can’t afford to. And they’re afraid of where their family member will be discharged to. They’re going to compel staff members to resist orders from their hospital directors. This is all avoidable.

As speaker after speaker here has said, massively increase funding to home care, ensure people can be discharged to their homes with adequate PSW care and make sure those PSWs are well-compensated. As the member from Nickel Belt said, problem solved.

Speaker, the person inspiring my words this afternoon in particular is Maria Konopeskas. Maria Konopeskas died in late August of last summer, and she was an ALC patient at the General Hospital, lived with cerebral palsy, taught for decades in our school system, contracted that disability, could no longer work, was on the Ontario Disability Support Program. And she was being asked after a minor surgery—and she couldn’t be released to her own home, said our local LHIN, because there weren’t enough PSWs to support her. So Maria said, “No, I don’t want to go into a long-term-care home. I want to go back to my home. And I want support from PSWs to stay there.” And the LHIN administrator said no.

So she stayed in that hospital, Speaker, and she withered and she deconditioned in front of her own friends’ eyes. I want to quote Alan Thibeau who wrote me this note. He wrote me, the member for Ottawa South and the MPP for Hamilton Centre this note. He said, “I am sending this message to you because you’ve all worked tirelessly to support the rights of disabled citizens. If Maria could speak a final word to each of you, she would extend her sincere thanks to you for all your efforts to help. She would urge you to continue to advocate without ceasing to achieve equal rights for these marginalized Canadian citizens.”

Speaker, in honour of Maria Konopeskas, I’m appealing to you to the government to please pull this legislation off the table, because I can tell the people from home that if you decide not to pay these fees, or as a staff member if you decide not to comply with discharge orders against the will, you will have my support. You can contact our office, and we will be there to support you, because civil disobedience may be the way Bill 7 is stopped.

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  • Aug/30/22 4:20:00 p.m.
  • Re: Bill 7 

Let’s get something out of the way: I don’t want ALC patients to languish in acute care hospitals. It’s not fair to them and it’s certainly not fair to the patients of Ontario. Our seniors deserve to age with dignity in supportive environments of their choosing, but this bill does not accomplish that.

The number of ALC patients in this province has ballooned over the last four years, and now this government is trying to rush things through without addressing the root causes. They could treat health care workers with respect and repeal Bill 124, but they won’t. They could reduce the massive wage differentials between long-term care, home care and acute care hospitals, but they won’t. They could improve conditions in long-term-care homes, implement the recommendations from the long-term-care commission, but they won’t. I guess you’re seeing a trend here, eh? They could prioritize primary care, but they won’t. Instead, they have chosen to make patients victims by forcing them to leave their families and move to distant long-term-care homes.

So, to be clear, I want as many seniors to age with dignity in the place of their choosing as possible, and I want our acute care hospitals to focus on what they do best, which is providing acute and critical care. But this bill is not the way to do it. This bill violates patient autonomy and is coercive.

True patient consent must pass three tests, as I mentioned this morning: The patient must be capable, they must be fully informed and they must give their consent voluntarily and freely. When it comes to the management of personal health information and authorizing admission to long-term care, this bill fails all three tests. Consent is simply not required. It also fails when it comes to transferring patients to long-term care. Again, consent is about enabling patients to make an informed decision that is voluntary and free. It’s not about getting a yes from a patient. It’s not about getting a signature from a patient or their family. And it’s definitely not about holding a gun to a patient’s head and saying, “You don’t have to go to this long-term-care home, but you will have to pay $1,500 a day if you don’t.”

And don’t let references about past bills from 1979 fool anyone into thinking this bill is about the same thing. That one and this one are completely different.

The definition of coercion is “the practice of persuading someone to do things by using force or threats.” The threat of a $1,500-per-day bill sure sounds like coercion to me, especially when it comes to vulnerable patients and their families, especially when there is already a power differential that exists between patients and their health care teams.

With that in mind, it’s actually amusing to think that Bill 7’s short-form rhetorical title is the More Beds, Better Care Act. It should probably be the more people, better care act, because at least that would start solving some of the fundamental staffing issues in long-term-care homes. But this bill has nothing to do with that. The long-form title is actually along the lines of amending the Fixing Long-Term Care Act with respect to patients requiring an alternate level of care and “to make a consequential amendment to the Health Care Consent Act.” The change is consequential, and the major purpose is all about circumventing consent.

The sponsors of this bill know that. That’s why the bill actually says, “Despite subsection 3(2), this section ... shall not be interpreted or construed as being inconsistent with the residents’ bill of rights.” But it is a violation, and it is inconsistent with that bill of rights. And just saying that it isn’t doesn’t make that true.

This bill does not protect confidential patient information, and it fails to pass the three tests of informed patient consent. The worst part is that we couldn’t even invite any lawyers or medical ethicists to explain this to the members across, because they opted to circumvent going to committee—for shame.

There are other major issues with this bill. It can send patients hundreds of kilometres away from their homes, without consideration for their choices or their cultural or social needs. There is no reassurance to patients that their long-term-care homes will be adequately staffed or that they will remain adequately staffed—

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  • Aug/30/22 4:20:00 p.m.
  • Re: Bill 7 

It is an honour to rise today representing the great residents of Toronto Centre and to speak to Bill 7. My colleagues have spoken eloquently to what is wrong with the bill, and I wanted to use my time to provide some additional commentary on it.

First of all, the bill will force our two-spirit, queer and gender-diverse seniors back into the closet by forcing seniors into long-term-care homes that they don’t want to go to. A hospital bed is no one’s choice of where they want to call home, yet this bill does exactly that. It doesn’t even pretend to hide its contempt for patients who have complex reasons for waiting. We understand how complex these choices are in Toronto Centre, especially with our population of aging seniors who are queer.

I hope this government understands that they are pathologizing our beloved queer and trans elders at their peril. My constituents have survived to the point that they are already ready for long-term care because they have had to advocate for themselves to survive homophobic and transphobic institutions. Moving out of the neighbourhood that they know, away from friends and families that they trust can only mean further isolation and fear of rejection.

But don’t take it from me; Arne Stinchcombe, a psychology instructor at the University of Ottawa who researches health and aging, told a TVO news show:

“‘There is evidence suggesting that fears of homophobia and transphobia within formal care prevent health care utilization, timely diagnosis and treatment of major health conditions and treatment adherence among older LGBTQ2+ people’....

“Providing inclusive and safe environments for LGBTQ seniors is ‘essential’....”

Earlier this year, I had the honour of attending the opening of the Rainbow Wing at the Rekai Centre right here in Toronto Centre. It is a brand new facility that was designed specifically for the 2SLGBT seniors’ community. It’s in a non-profit long-term-care facility and was created out of the recognition for the need to create more inclusive spaces for queer elders to thrive. And yet, still, while this is the first dedicated 2SLGBTQ facility in Ontario, even in North America and possibly in the world, the Rainbow Wing has only 25 beds. We clearly have a long way to go.

This government has not announced a single plan to expand 2SLGBTQ long-term care, and they expect queer and trans Ontarians to believe that forcing them great distances away from their chosen families will make their lives better. Speaker, I assure you that it will not.

LeZlie Lee Kam, a queer elder and advocate for inclusive long-term care, told the same TVO journalist, “I want to make sure that if I have to end up in one of those places, it’s going to be queer-friendly.” It has to be affirming.

In the final days, our loved ones are scared. No one should be forced back into the closet, but I’m afraid that by taking the choice away from our seniors, that is exactly what this bill will do.

The second point that I want to touch on is that it matters to Toronto Centre, one of the most diverse ridings in the country, where our seniors go. Our community and city is home to 120 different languages, so our elders need to be close to their families so that they can lean on them for support, especially when they have to translate the complex health care system for them into languages such as Arabic, Bengali, Cantonese, Mandarin, Hindi, Somali, Singhalese, Tamil, Tagalog or Urdu, just to name a few of the languages that we speak.

My grandmother spent her final weeks in a city of Toronto long-term-care home called Fudger House. She actually was able to receive her care in Cantonese as well as Mandarin. She was able to eat culturally appropriate food. I couldn’t imagine better care for my grandmother as she died in the facility that was there, but she was taken care of in the way that she needed. I recognize how fortunate we are now, especially considering what we have in front of us today.

Not allowing seniors to exercise agency in health care during the time in life when people are at their most vulnerable, and most medicated, will make existing racial inequities in health care even worse. This government has no excuse for rushing through a bill that will affect vulnerable and already marginalized communities.

I want to finish by quoting my constituent Cee, who reached out to me to talk about how the government is planning to force people into long-term-care facilities that they don’t want to be in:

“This stuff was going on well before I retired,” but now it’s making it worse. “It demonstrates to me that the political will is lacking” and seniors need help. “Old people aren’t sexy. They cost the system and aren’t looked upon as people who contribute anymore.... They’re going to die anyway ... so why bother making their lives more comfortable?”

Speaker, Bill 7 is redesigning our health care system to take care of corporate shareholders, not people. It doesn’t have to be this way. Privatization is a political choice. I choose people over profits, and I think you should too. Please withdraw Bill 7.

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  • Aug/30/22 4:20:00 p.m.
  • Re: Bill 7 

I rise today with a deep feeling of frustration and disappointment that we’re debating third reading of Bill 7 without having had an opportunity to review this bill at committee, without having public input, and without having the opportunity for amendments. It’s not right for the vulnerable elderly in our province to pay the price for years of underinvestment in our health care system, especially after the last two years. After the last two years, where we’ve seen so many loved ones live in such tragic circumstances in our long-term-care homes, to now tell seniors—frail, elderly people—that we’re going to take away your rights, we’re going to force you to leave hospital without your consent if that’s what government chooses—we don’t have to approach it this way. We can fix the health care system and honour our elders at the same time.

It is true that we need better spaces for people in hospital who are alternate level of care, who would be better cared for at home or in a long-term-care home, but the reality is, if we’re going to provide that care, then we need to invest in that care. We need to invest in a better home and community care system. We need to ensure that we have proper staffing and those staff are paid well and recognized for things like their travel time so the elders who want to be cared for at home—and most would like to be cared for at home—can actually receive that care. We need to invest in better primary care that’s more accessible and available for elders who are being cared for at home. Finally, we need to invest in a long-term-care system that will prioritize care over profits, so that when those elders move to a long-term-care home, it actually is a home, a home that provides the level of care and dignity they deserve.

So, Speaker, how do we accomplish that? Well, you start by investing in the people who actually provide the care: the nurses, the PSWs and the front-line health care workers. For well over two years now those front-line health care workers have been overworked, underpaid and underappreciated. They have been saying over and over again, along with doctors and so many other health care experts, that we need to repeal Bill 124 so they can negotiate fair wages, fair benefits and better working conditions. Why don’t we start with that instead of having the government actually resist paying health care heroes as heroes?

Speaker, long-term-care administrators and advocates are saying, “Hey, we’re understaffed too.” So there could be some major unintended consequences to the provisions of Bill 7, especially if elders are moved far from family, friends and caregivers. I can’t tell you how many caregivers I’ve met in my own riding who spend hours caring for their loved ones. If they live hundreds of kilometres away from those loved ones, it will be incredibly difficult for them to be able to provide that additional care, which will actually put more pressure on our long-term-care system.

Speaker, as we speak, the Premier and the Prime Minister are meeting. We need the federal government to step up with more funding for health care, long-term care, mental health care and the social determinants of health, such as poverty and homelessness, but we also need a provincial government that’s actually going to spend those funds and flow them through to the systems that we need to support in this province, not underspend their health care budget by $1.8 billion, like what happened last year.

I believe there was an opportunity for us, if we could have had an opportunity at committee, to work together across party lines to deliver some solutions that will put seniors first and, unfortunately, Bill 7 as it’s written right now does not accomplish that. I encourage all members from all parties to stand up for the dignity of our elders and vote no on Bill 7.

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