After some continued requests, the Minister of Housing (Mr. Bennett) was purporting to tell this House how many units had been approved for Ontario and for Metro Toronto under the Ontario rental construction loan program. He stated figures of 609 for Toronto, 895 for North York and 1,861 for Scarborough.
What the minister has done in his statement has been, I think, misleading, although perhaps inadvertently so. He says that for Ontario, 11,993 units were approved and 3,074 were committed. By the word “committed” he means what most people would mean by fully approved: namely, approved to the point where they have actually had mortgage funds from the program committed to them.
If he had continued his statement accurately he would not just have said there were 609 units approved in Toronto; he would have said what Mr. Haley of the Ontario Mortgage Corporation has told us today: that in terms of full approval -- that is, approval to the point where money has been committed -- whereas 3,000 units have been fully approved and had money committed in the rest of Ontario, zero units have in fact been approved to the point of full commitment in Metropolitan Toronto.
I would have thought an honest, straightforward answer to that when the question was first raised by the member for Parkdale (Mr. Ruprecht) would have been much better than the cat-and-mouse game we have had to play in this House to get that answer, which still was not forthcoming from the minister.
Hon. Mr. Bennett: Mr. Speaker, in reply to the question of privilege, or whatever it happens to come under, I said very clearly in this House yesterday, and I repeat, that the total number of units approved by the Ontario Mortgage Corporation under the Ontario rental construction loan program have been approved in full by OMC. The Leader of the Opposition’s people were in touch with OMC this morning and the same message was given to them as I am giving now.
I have said in this House before, and I repeat, that after we give the approval, which makes it a financially viable program, they then have to secure building permits. Indeed, they have to secure a commitment by the private lending institutions for the money they require in the private mortgage market field. That is the difference between what we call approved by Ontario Mortgage Corporation and the completely committed, which means they have secured a building permit, financing in the outside market and are prepared to go into the ground.
In discussing this yesterday with several who have made applications under the rental construction loan program, they reviewed the latest amendment to the program. One in particular, Mastercraft Construction, which is developing in both Mississauga and Scarborough, will be under way within the next two to three weeks. Officials of the firm think it will have its permits from the municipality to commence construction. It will then appear in the committed program; it is now in the approved program.
Mr. Smith: Mr. Speaker, a separate point of order: I think I have made my point on the other one. It concerns yesterday’s statement by the Minister of Consumer and Commercial Relations (Mr. Walker) regarding initiatives to improve the ministry’s licensing and monitoring procedures. You will recall the statement, Mr. Speaker.
It is my understanding that, according to the rules of the House, a statement of this kind outlining new ministerial policy must be accompanied by a compendium of background information presumably indicating what the previous policy had been, the reasons for the change and things of that kind.
It is especially relevant in this case because the so-called initiatives to improve the licensing and monitoring procedures are so basic and so germane to the exercise of the licensing and monitoring function that I am alarmed to think what the previous policy of the ministry was.
I note the minister stated, “Mortgage broker registrants are now subject to extensive individual scrutiny, including credit and police checks and search of executions.” Without a compendium, we are left to wonder whether our licensed mortgage brokers operating in this province were licensed without something as basic as checking to see whether they had absconded with other people’s money in the past.
Similarly he said: “We have created a special joint investigation approach between the financial institutions and business practices divisions. They work with the Ontario Securities Commission. Members of this team are specially trained and tackle problem situations as a single team, with impressive results since its inception.” Again, without a compendium, are we to believe that one arm of the ministry did not bother to communicate with another arm of the ministry to see whether people dealing with the public’s money were already found to be fraudulent or guilty of a shady practice in the past?
I do not want to use the time of the House unnecessarily, but he says, “Ministry officials liaise more frequently with police forces at all levels across the province and beyond.” He says this contact has “increased dramatically.” Are we to believe this did not happen before or that the dramatic increase may be from one contact to two -- a 100 per cent increase or something of this kind?
We need a compendium because he says, “The ministry maintains a list of individuals who have been under investigation by our officials or who have been disciplined by the Ontario Securities Commission, the financial institutions division or the business practices division.” How could it be conceivable that such a list was not kept in the past? People will wonder how safe any investment is today if the ministry has been operating without even those basic, rudimentary practices in place.
Without a compendium, we are asked to believe that new initiatives have occurred which are so basic and fundamental that one could hardly imagine the ministry could have gone on without them in the past. I would ask you, Mr. Speaker, to consider whether such a compendium will be forthcoming as to past practice in the ministry.
Mr. McGuigan: Mr. Speaker, I rise to inform the members of the death of Jack Spence who was the member for Kent-Elgin from 1955 to 1977. He was a friend of all members of the House and he was known for his humour, his wise counsel and his dedication to public service.
Mr. MacDonald: Mr. Speaker, as a fellow member of the class of 1955 that came in with Jack Spence, and on behalf of our group, I want to express our sadness at Jack’s passing and to express our condolences to all members of the family. Jack was a very earthy, friendly sort of fellow with whom everybody had direct human relationships, and he was the kind of person who brought honour and warmth to this House. I would like to join with the honourable member for Kent-Elgin in our expression of sympathy.
Hon. Mr. Henderson: Mr. Speaker, I would like to associate myself with the former speakers in recognizing the death of our friend, Jack Spence. I had the pleasure of working with Jack Spence on many committees and I had the pleasure of working with him in the neighbouring riding. Jack Spence was recognized in this House and across Ontario as an individual who wanted to help people, who did help people, and who spent most of his life helping people. His death will sadden many people.
Mr. Speaker: Thank you, Mr. Henderson. Before routine proceedings I would ask all members of the assembly to join me in welcoming Mr. Yaroslav Stetzko, former head of the Ukrainian provisional government.
Hon. Mr. Henderson: Mr. Speaker, I am pleased today to announce the details of my ministry’s fruit and vegetable storage construction and packing equipment assistance program. As members all know, it is part of the government’s Board of Industrial Leadership and Development program announced by the Premier (Mr. Davis) in late January. The storage program was created to further the production and marketing of Ontario-grown fruits and vegetables.
The program will encourage the construction of new fruit and vegetable storage space as well as the modernization of existing facilities. This will increase Ontario’s ability to supply quality fruits and vegetables over an extended marketing season. It will also assist in the construction and modernization of packing facilities to supply markets with high-quality, Ontario-grown produce.
The government of Ontario has allocated $20 million to this program over the next five years. Fruit and vegetable growers and packers may apply for the grants. This includes individual producers, partnerships, corporations, producer groups, co-operatives and food processors who meet the program’s standards. Qualified applicants are eligible for a grant of one third of the total capital costs up to a maximum grant of $85,000 for one or more approved projects during the five-year period of the program.
Projects with a capital cost of $255,000 or less will be approved by my ministry. Storage projects with a total capital cost of more than $255,000 will also require the approval of the Board of Industrial Leadership and Development. The level of grant assistance for these projects will be determined by BILD. The total program will be administered by my ministry.
Projects with a capital cost of less than $3,000 and those which receive any other form of government aid from either the province or the federal government will not be eligible for assistance under this program. Further information on the program and application forms will be available through my ministry’s county and district offices in mid-July.
Mr. Laughren: Mr. Speaker, on a point of privilege: I missed a little bit of what the minister said. Is he telling us that the deceit is now going to end and that Timmins is going to get a food terminal?
Hon. Mr. Timbrell: Mr. Speaker, the honourable members are aware that arbitration awards have recently been handed down for two groups of hospital employees: those represented by the Service Employees International Union and those represented by the Canadian Union of Public Employees. The CUPE award is retroactive to September 29, 1980, while the SEIU award is effective April 1, 1981.
The settlements will require additional funding to be provided by the Ministry of Health to assist hospitals in financing the impact the employee awards will have on them. To give an indication of the extent of this impact I need only remind this House that staff salaries and wages comprise about 80 per cent of a typical hospital budget.
So as to allow hospitals to handle known and anticipated awards the Ministry of Health will be adjusting hospital budgets both for 1980-81 retroactively and for 1981-82. These adjustments are also designed to reflect other inflationary pressures which hospitals may be experiencing.
For the fiscal year 1980-81, the ministry will be adding $37 million to hospital budgets. The details will be released within the next week to individual hospitals. In addition, the ministry will be increasing the present hospital budget guidelines by a further two percentage points in 1981-82, which will adjust to an average of 12.1 per cent overall.
In total, the ministry will be increasing the cash flow to the hospitals by $118 million this year. This figure covers the two fiscal years, both the retroactive funds for the 1980-81 fiscal year, resulting in an adjustment in the operating base, plus a further increase of two percentage points in 1981-82.
I would assure the honourable members the government is committed to maintaining our excellent hospital system. These adjustments should permit the hospitals to meet their salary settlements and maintain their existing operations.
Hon. Mr. Walker: Mr. Speaker, I am pleased to announce that the Ontario Securities Commission, in co-operation with the Toronto Stock Exchange, has developed legislation that revises the Toronto Stock Exchange Act and will incorporate the Toronto Futures Exchange.
It will not be possible to introduce and have passed the Toronto Stock Exchange Act, 1981, and the Toronto Futures Exchange Act, 1981, before the recess, but it is important to distribute their contents as widely as possible during the summer in order that all interested parties can contribute their input. Within the next two weeks the Ontario Securities Commission will be printing the draft bills in their weekly bulletin which has very widespread coverage. Comments are invited and should be directed to their offices.
The Toronto Stock Exchange Act, 1981, would replace an act passed by the Legislature in 1968. In the years since that act came into force there have been further developments in corporate and securities legislation not reflected in the original act. It is now time to bring the act up to date to match the realities of the 1980s.
1. The board of governors of the Toronto Stock Exchange will be authorized to delegate its investigative and disciplinary functions to one or more committees established by the board and to individual persons.
7. Where in the public interest an order is made restricting or suspending the privileges of a member before a hearing is held, a hearing must be held within 15 days of the making of the order, otherwise the restriction or suspension expires 15 days after the making of the order.
The board of governors of the Toronto Futures Exchange will consist of 11 members: five will be elected by members of the futures exchange, three will be elected by the Toronto Stock Exchange, two will be public directors and one will be president.
Under the new act the board of governors will have the authority to pass bylaws and will have the power to discipline its members or to delegate its disciplinary power to a committee established by the board.
The act provides that the futures exchange may hold property without the limitations contained in the Corporations Act, and will allow meetings of the board and its committees to be held by conference telephone, electronic or other communications facilities.
I mentioned earlier that the Toronto Stock Exchange Act is being brought up to date to match the realities of the 1980s, and the same philosophy is behind the Toronto Futures Exchange Act. The latter will create for the first time in Ontario a separate and distinct commodity futures exchange similar to commodity exchanges in the United States and elsewhere in the world.
The act will bring commodity dealers who are not members of the Toronto Stock Exchange within the self-regulatory framework of the futures exchange, and will allow an added measure of customer protection through a contingency fund to be established.
Hon. Mr. Elgie: Mr. Speaker, yesterday when I introduced amendments to the Workmen’s Compensation Act adjusting benefit levels I advised the House I would be tabling a white paper on workers’ compensation in Ontario. Copies of the paper have now been filed with the Clerk and are in the members’ boxes.
As I said yesterday, the paper results from a comprehensive review of the existing Workmen’s Compensation Act and its administration by Professor Paul Weiler, whose report entitled Reshaping Workers’ Compensation in Ontario was tabled last November.
The white paper outlines 21 major recommendations, both substantive and procedural. Each of the recommendations is followed by a concrete illustration showing its practical effect. In addition, the paper contains a completely revised act embodying all the new recommendations as well as cost estimates prepared by the board’s actuary and verified by a firm of actuarial consultants.
As I state in the preface of the white paper, I would like to proceed with the enactment of new legislation along the lines set out in the draft bill contained in the white paper unless I receive strongly-supported reasons for modifications in the approach we are taking. The white paper will be distributed to all persons and organizations known to have an interest in this important topic. I have requested that written comments he provided to me by August 31, 1981.
The significance and far-reaching effect of the proposals contained in the white paper and in the draft bill cannot he overemphasized. I therefore look forward to receiving full and carefully considered responses from members opposite and from the community at large.
Mr. Smith: Mr. Speaker, I have a question for the Minister of Health. The minister will be aware that our health critic, the member for London North (Mr. Van Horne), and a member of our staff along with certain members of the press were able to come face to face with some of the rather deplorable housing conditions facing ex-psychiatric patients in Metropolitan Toronto.
The recently completed but still secret study on the problem of housing ex-psychiatric patients in Ontario prepared by Community Resources Consultants of Toronto lays the blame for the problem squarely on the member’s ministry. It concludes, “The major problem arises from the inadequate funding base of the adult community mental health program, and the adult community mental health program is the only source of substantial and sustained funding which exists at the present time.”
Will the minister tell us whether he intends now to commit funds to provide the necessary alternative community housing for these unfortunate people? Will the minister accept the opinions expressed in this secret report, and recognize that simply clearing psychiatric patients off custodial wards is not doing them any favour if they end up having to live in dingy, filthy basements somewhere without adequate care? Will the ministry accept its responsibility and provide proper housing for former psychiatric patients, at least in Metro?
In recent months we have had a number of discussions with representatives of the city and Metro councils, including a recent meeting about 10 days ago with the chairman of Metro and representatives of the social services committee of Metro council, several of them being aldermen in the city of Toronto. In the course of these discussions, I think everyone acknowledged a number of boarding homes have been closing. This is due to a variety of factors, one being increased inspection, surveillance and enforcement of the legal requirements of the Public Health Act and another being the current real estate market.
One might say on the one hand that is good because the power that has been there for years in the Public Health Act is being utilized to meet problems as they arise. On the other hand the effect of that seems to be, in many cases, the operators are closing those boarding houses and thereby reducing the options for some people. That is creating a problem in the availability of housing for discharged patients, for whom the more traditional alternatives of housing that anybody else might turn to are not appropriate.
What we have agreed -- I have discussed this with my colleague the Minister of Housing (Mr. Bennett) -- is that we will work with them at identifying the extent of the problem and also work on solutions to it. At no time in my discussions with representatives of Metropolitan Toronto or the city has there been the suggestion that the community mental health funds, which are for aftercare and preventive programs, should be devoted to housing.
I do not recall at any point in the discussions any suggestion that those funds should be devoted to that. We acknowledged, as we did in the past with respect to the developmentally handicapped and the disabled, there may be a need for some housing programs and my colleague has indicated his willingness to work on identifying the extent of the problems and coming up with some solutions.
Mr. Smith: By way of supplementary, Mr. Speaker: I would draw the attention of the minister to the fact that the report I mentioned is not the same report as the one he is referring to. This one is called Funding Options for Alternative Community Housing for Psychiatric Patients in Ontario. It says clearly on page four -- it is by Community Resources Consultants, a private group that was hired by the ministry -- “The adult community mental health program is the only source of substantial and sustained funding which exists at the present time.” Whether Metro is asking that those funds be used or not is immaterial. This group of consultants has found that happens to be the only source of funding that exists; if the ministry has another source, that is great.
I ask the minister, if he has not seen this report -- he says he has not seen it and I believe him -- if he will undertake to look at it? At the same time, would he check into reports we have received indicating that members of his staff have met this month with the consultants who did this study, and have directed the authors to rewrite it, to launder the report, to remove those aspects that were critical of the Ministry of Health?
Hon. Mr. Timbrell: Mr. Speaker, I do not believe I have seen it. I am certainly familiar with this other report, also prepared by the Community Resources Consultants, but that is where I am having some difficulty. This after-care review also touched on housing, also dealt with the Clarke Institute of Psychiatry, the Toronto General Hospital and Queen Street; that is why I am having some difficulty understanding what that is, or whether it is one person’s views or not.
Hon. Mr. Timbrell: The member made the insinuations. We do not operate under the Napoleonic Code here, we operate under the British judicial system and one’s innocence is maintained until proven guilty.
Mr. McClellan: Supplementary: If we can get off the red herring and back to the problem, my understanding is that the Community Resources Consultants study identified very clearly that the problem consists of chronic mental health patients who are living in inadequate housing accommodation outside of institutions.
My question is very simple: Does the minister continue to pretend that this is not a problem, that there are not a lot of chronic mental health patients living in totally inadequate housing? Does he continue to pretend that he, as Minister of Health, has no responsibility for providing housing programs for this particularly unfortunate group of people?
Hon. Mr. Timbrell: Mr. Speaker, I am not and I do not think I ever have said there is no problem. The member will recall that on a number of occasions I have written to the municipalities emphasizing the authority that exists under present legislation to license at the municipal level, to inspect and to close if necessary. In fact, in a way we were discussing this in standing committee on social development a few days ago when we were talking about the extent of the power of a medical officer of health to close a facility that is unhealthy.
Acknowledging that, at the present time, the result of that law being enforced in Metro, plus apparently the real estate market making a sale of the premises more attractive than meeting the requirements laid down by the municipal inspectors for some operators, there is a growing problem. I acknowledge that. That is why we have been in discussion with the Metro people and have indicated that we are prepared to work with them to identify the extent of the problem and try to come up with some solutions.
Mr. Van Horne: Mr. Speaker, I am not sure we had a direct answer as to which of the ministries has the responsibility for monitoring the boarding homes. Would this minister take it upon himself to accept that responsibility through the office of his new executive co-ordinator, Dr. Gilbert Heseltine, and ask him to take the mandate, run with it, and see that these unfortunate people do not have to sit in the middle of a wilderness? One ministry washes its hands and says, “No, it is not my responsibility; it is the other’s.” Will he assign the responsibility to him and see that the job is done?
Hon. Mr. Timbrell: Mr. Speaker, our responsibilities in the Ministry of Health have to do with the care of the individual. If that person is in need of continuing care but not institutional care, they may be in the homes for special care program or one or two other alternatives, where they are legally still patients and receiving care.
Hon. Mr. Timbrell: If the honourable member does not want to hear what I am saying I think others do. When the member talks about boarding homes, whether the residents are former psychiatric patients or whether they are people who have never seen the inside of any kind of facility, the inspection and licensing of boarding homes is a municipal responsibility.
I do not for a moment reject the fact that we have a responsibility to assure that the availability of community mental health programs will either back up treatment programs relayed through the private practitioners or outpatient facilities of psychiatric facilities, or serve as preventive programs. I point out to the member that, if he compares our spending on community and mental health programs in the last couple of years, he will see that it has more than doubled.
Apart from the niggardly aspect of it, will the minister consider for a moment two groups of citizens? Will he consider, on the one hand, the 52,000 seniors who are earning as total income in each case more than $20,000 a year? There are 52,000 of those people getting more than $20,000 a year. Will he consider, on the other hand, the thousands and thousands of households trying to raise a family on less than $20,000 a year? Will he explain to me why it is that the families earning less than $20,000 a year in hundreds of thousands of instances will receive zero from this, whereas the seniors earning more than $20,000 a year will each receive $60? How can that be considered fair?
Really, any program that a government can come forward with very seldom will be perceived as the end-all to serve everybody’s needs. The particular program announced by the Treasurer (Mr. F. S. Miller) some days ago was designed to fit in and take care of the needs of two parts of our population, one being seniors. I acknowledge, as I mentioned yesterday, that partly for administrative reasons it was easier, if you will, not to set up a new system but to tag on to existing programs so that we could pass through to seniors, to the full extent, the $60, $40 or $20, as the case may be, over the next three years.
In so doing -- there is no doubt about it -- some seniors will receive that rebate, as they do with the property tax rebate and as they do with the sales tax rebate, who in a straight economic sense perhaps do not require those funds.
But I feel, as does this government, two things: First, we want to make the programs that we provide in this province easy and very accessible to all seniors without undue complications; second, we feel that the seniors in this province have contributed to the growth of Ontario and do not have to come forward to justify why they should or should not receive and participate in a certain program.
Now the other end of the scale: There is no doubt that with the credit program as it has been announced -- in other words, the 60 per cent less one per cent of taxable income to the principal taxpayer -- there will be people earning, to use the illustration of the Leader of the Opposition, and receiving less, based on the incomes they receive, than some seniors would. But again, as we indicated and as the Treasurer enunciated some days ago, this particular program was designed to get to those who needed it most.
It is not the be-all and end-all program, and I suggest that if the Leader of the Opposition has any further concerns he should pick up the phone to some of his own federal representatives and ask them to follow the lead taken by Ontario and join us.
Mr. Smith: Since the minister admits that there will be 52,000 seniors making more than $20,000 who will receive the $60, whereas there will be thousands of families of working people earning less than $20,000 and who will get nothing, and since he claims the reason for that is that they did not wish to add administrative costs or to add on a new system, how does he justify that in the face of the fact that before the last election his ministry did not hesitate to add $3 million in administrative costs alone so that the tax grants to seniors could come by way of a cheque from Ontario rather than by way of a rebate with the income tax rebates from Ottawa?
In particular, apart from all of the politics here, will the minister please consider amending this program to permit some assistance to go to working people with children? I ask him to consider that his plan is likely to help seniors, obviously, and single-parent families and singles living alone; that is the target, the very impoverished. But will the minister consider the possibility of expanding the plan slightly to help working people who actually have children and are earning low wages, less than $20,000 a year, and trying to raise a family on that?
Hon. Mr. Ashe: First of all, I did not acknowledge that the figure of 52,000 was accurate or inaccurate. I acknowledged that no doubt there are a number in that income category as referred to by the leader of the official opposition. It may or may not be the right number; I do not have those figures handy at this time.
As for amending the program, the Leader of the Opposition knows the Treasurer sets the policy on this program and we in the Ministry of Revenue implement that program. If he would look closely at the program that has been outlined, he would see that some of the concerns he has just brought forward are already acknowledged within it -- granted, not to the degree that he may perceive; in other words, somebody getting --
In any event, the program as it has been enunciated recognizes taxable income by the principal earner in the family. It still recognizes whomever that may be. Similarly, as for property tax credits -- and again we are doing it all through the same form -- I suggest that there may be particular and different burdens on a household whether they have zero children, or one, two, three, four, five. I suggest to members that our tax system as it is now designed recognizes, at least to some degree, those differences and we are tying into that accordingly.
Mr. R. F. Johnston: Mr. Speaker, the minister admits that this is not the be-all and end-all of legislation. Is it now his policy to bring in half-hearted and half-baked legislation when it is absolutely unnecessary and when in terms of these senior citizens the money is not going to be available until next spring? Would it not be a lot better to come back with comprehensive and well-thought-out legislation this fall if the money is not going to be available until next spring? Why come up with something half-baked now?
Hon. Mr. Ashe: Mr. Speaker, the member opposite can put any classification on the program that he so chooses. Needless to say, we do not agree with his particular interpretation that it is a half-baked program at all. It is a well-thought-out program that has been implemented. It recognizes and was designed to offset heating costs in the next heating season, which for most people in this climate takes place starting this fall and going through to next spring. That is when the grants or the credits, as the case may be, will be recognized by the respective group of taxpayers.
Mr. Peterson: Mr. Speaker, recognizing that the Treasurer through his program last year saddled the Minister of Revenue’s ministry with $3 million extra in overhead to administer and dispense the various cheques that he does, does the minister not feel it would be fair to go back to the tax credit system, assisting those people on an income-tested basis, those most in need, and distributing this money on that basis, as well as the $3 million in overhead his ministry is consuming right now?
Hon. Mr. Ashe: Mr. Speaker, I would not recommend that to the Treasurer of Ontario, because I do not agree. It would be a step backwards. What we are doing now is making funds available to the seniors of this province without them having to wait till they file their income tax returns in the spring of the year. In many cases these are people who would not under any other circumstances be obliged to file an income tax statement. We are delivering to them funds at the time that they need them. I think that is a step forward, and to go back to what the honourable member suggested would be a step backwards.
Can the minister explain why the government has once again rejected the principle of compensating injured workers against the force of inflation and why the increases in benefits being proposed in legislation this week will leave those workers at least 3.6 per cent further behind inflation just over the course of the last couple of years?
Given the fact that the cabinet has not been prepared even to propose to the Legislature that workers be compensated for inflation, how is it that the government believes it should be entrusted to make further adjustments to WCB benefits by regulation without even coming for reference to the House?
Hon. Mr. Elgie: Mr. Speaker, first of all and with respect, I submit that the member had better go back and read the consumer price index. It has been the custom during ad hoc amendments to increase them by the amount of the previous year’s average consumer price index, or by two years, as we did the time before. If he goes back to the tables, he will find the cost of living price index increase on average in 1979 was nine and in 1980 was 10. That is exactly in line with the cost of living increases.
Mr. Cassidy: With respect, the rate of inflation as measured by the consumer price index has been a 23.5 per cent increase over the two years since the last adjustment in July 1979. If stacked together, the increases that are being proposed by the government now will give workers who already have inadequate incomes an increase of 19.9 per cent, which means they will lose a further 3.6 per cent in purchasing power.
The minister surely is aware of the fact that workers who had a pension granted in 1971 have lost 39 per cent of their purchasing power over the course of the last decade, and that is even after counting the increase being proposed now. Why does the government always seek to make injured workers its whipping boys when it is fighting the battle of inflation?
Hon. Mr. Elgie: I do not know about other members, but I get a little sick of hearing that kind of stuff. The member knows very well that, in the introduction to the Weiler report, Professor Weiler said, “In view of the major reforms I am recommending here, I do not feel I should introduce any further interim amendments.” But this government said that two years will have gone by, as of July 1, since workers have had an increase.
I gave an undertaking in December 1979 that if there were a prolonged delay I would introduce amendments. I have done that. Whether the member likes it or not, if he looks back in history he will see that the increases have been obtained in exactly the same way as they were in other years in relation to the consumer price index for 1979 and for 1980. That is exactly how it has always been done.
Mr. Mancini: Supplementary, Mr. Speaker: The Minister of Labour is aware that injured workers have absolutely no defence against the ravages of inflation; they cannot defend themselves in any way whatsoever against inflation. It is totally up to the government, through the legislation it can introduce, to protect injured workers and to help maintain some part of their standard of living. Why does the minister not grant them the exact amount of the increase in the consumer price index so they can try to support themselves and their families adequately in the best way they can?
Hon. Mr. Elgie: -- but he will know that today we tabled a white paper, which recommends major areas of reform. In the interim, my review of it and our efforts to convert it to statutory language indicate to me that it clearly needs thorough consideration by other people before we proceed with it. There have been increases made that are exactly in line with the cost of living index. I do not understand where this is coming from. They had better read the cost of living index again.
Mr. McClellan: Supplementary, Mr. Speaker: The minister seems confused. Has the minister not read the section on page 68 of the Weiler report, Reshaping Workers’ Compensation in Ontario, where Mr. Paul Weiler says: “In the five years from 1975 to 1979, inflation adjustments have totalled 37 per cent, while the consumer price index increased by a total of 45 per cent”?
Has the minister conveniently forgotten that little ripoff of injured workers, and can he explain why this present set of rate increases has not taken into account the ravages of inflation as measured by the consumer price index? Does the minister just want to nickel and dime injured workers again?
Hon. Mr. Elgie: Mr. Speaker, the member for Bellwoods is reading selectively. If he wants to read the Weiler report into the record, he should read out the inequities that occur with regard to what Mr. Weiler perceives as payment when there has not been any income loss as opposed to those situations where there may not have been enough awarded in the past. What I am saying is that for the past two years --
Hon. Mr. Elgie: If the member does not understand that report, then it is a good thing we are delaying it so he does get a chance to read it. That is exactly why I am tabling a white paper, because even the member seems to have some misunderstandings about it.
Hon. Mr. Elgie: Clearly, anybody who understands the process of ad hoc adjustments we have gone through understands the difficulties with them and understands that the amendment I introduced yesterday covered the last two years and follows the cost of living index.
Mr. Laughren: Mr. Speaker, on a point of privilege: I believe my privileges as a member have been abused, and indeed the privileges of all the members in the opposition in this chamber have been abused, because of a lie contained in the white paper on the Workers’ Compensation Act at page 28. There is no better term to describe it.
On page 28, in discussing the erosion of workers’ permanent pensions because of inflation, the report declares, “Given the crowded Legislative agenda each year, however, and the time-consuming debate about proper benefit levels, such increases have been sporadic.”
I suggest to you, Mr. Speaker, that the fact injured workers have not received adequate increases in permanent pensions is not because of the crowded agenda and not because of the debate carried on by members of the opposition, but rather because the government simply refused to bring in adequate increases. To attempt to blame the opposition members for the way injured workers have been nickled and dimed in Ontario is a blatant lie.
Mr. Cassidy: Mr. Speaker, I have a new question for the Minister of Industry and Tourism which arises out of his claim that I was distorting the record when we exchanged a few views over the question of creation of jobs in the automobile industry last Friday. The minister said, “Until the leader of the third party is able to say the information we provided about Atlas and Linamar is something we made up -- that it is fiction -- he has no case.”
My question to the minister is this: Is the minister not aware that in the case of Atlas Hoist and Body, which has received a $300,000 employment development fund grant in Cornwall and for which the minister has been claiming an increase of 130 new jobs from the 55 jobs that were there in 1978, there are only 59 workers there today, and we have it from both the union and the management of that company that there is a very strong chance that, far from creating 130 new jobs, the company may find itself compelled to close in Ontario?
Hon. Mr. Grossman: Mr. Speaker, the member of course has not indicated, first, that last year Atlas had 20 employees and this year they have tripled that number to 60. Second, they expect to have 130 workers by 1983 if conditions warrant that. If they are able because of market to meet that target, then all of our numbers will he in place.
Hon. Mr. Grossman: Just settle down. The member for Hamilton West (Mr. Smith) should take it easy. He was not here last night. The member for London Centre (Mr. Peterson) was over here trying to get votes on this side last night. At least I work my own side.
Hon. Mr. Grossman: I say to the leader of the third party, if he will stop shaking his head, the fact of the matter is that in the case of Atlas they are having problems with market, there is no question about it. If they find that they are unable to meet their commitments under the employment development fund contract which we require from firms -- they have to make hard, firm commitments to this government -- then they will not be able to provide that number of jobs and the government will recover its money. Those conversations are already under way with Atlas.
Just so we will understand, this government said that, to date, projects announced or undertaken in those 24 months amounted to about 25,000 new jobs over that time frame. The announced projects included Atlas. Atlas, as is the case with some other of those 73 firms, may find that they are unable to go ahead and may return the EDF money.
If the member is asking me whether all those figures will turn out four years from today to total exactly 25,300 and whatever it was, the answer is no. Some of those firms will create more jobs, since our contracts negotiate minimum numbers; others will not be able to create enough, and those that have EDF grants will return their money. All the member opposite is able to do as of today is say that perhaps 130 of those 25,300 jobs may not turn up in 1983. That is the entire point he is making.
Mr. Cassidy: Since it appears now that the BILD program should be renamed the IF program, because nothing will happen unless a whole lot of conditions are met, and if those conditions are met and the 4,500 jobs the minister has talked about in the auto parts industry will not be created, will the minister withdraw the allegation he made that I was distorting the facts, when it is clear that a fact is not a fact when it comes from the public relations puffery issued by his ministry?
Is the minister now also prepared to agree with this party that PR puffery from the Ministry of Industry and Tourism is not enough, that it is not enough to have indiscriminate handing out of grants under the BILD program or the employment development fund to turn the auto parts industry around, and that it is about time we created a crown corporation for the auto parts industry -- let us call it Auto-Canada, the way we suggested during the course of the election campaign -- and gave a mandate to Auto-Canada to redress the parts imbalance in our trade with the United States and get this province moving in terms of auto parts production and jobs?
I have to say to the leader of the third party that in Toronto last week we had the major auto parts show in the world. I thought it was interesting. If any of the Windsor members of the member’s party had taken a few minutes -- instead of writing open letters to the minister; or on Fridays, when the Canadian Broadcasting Corporation people from Windsor are in town, rising on a point of privilege -- if they had thought it might be worth while to see what is happening in the auto industry, they could have driven the 10 blocks to the Coliseum and visited the major auto show in the world, and they would have found --
Mr. Samis: Supplementary, Mr. Speaker: Returning to the case of Atlas, is the minister aware that the union has been told the work force probably will be reduced to 15 by September and that the company is actively seeking a customer to take over the plant lock, stock and barrel? Will he table the details of the agreement with the House?
Hon. Mr. Grossman: First, I will be pleased to give the honourable member all the details we can of the Atlas agreement. Second, if those eventualities occur, this government, unlike the things the third party predicted when we entered the employment development fund program, will recover all of the moneys promised to Atlas.
Third, may I say to the member that in point of fact, if his leader wants to play this game of pointing out the half a dozen firms out of 73 which will not meet their projections, I will come tomorrow, or however many days we have left, and rise during statements by the ministry and indicate the number of firms that are going to far exceed the projected numbers.
Mr. Cooke: Mr. Speaker, I rise on a point of privilege. I wish to point out to the Minister of Industry and Tourism that I did go to the Societé internationale de transportation et vehicules trade show last week with my leader. I spent a few hours there.
He might be interested to know that when I was contacted by my local newspaper I said it was a step in the right direction. This government does not know how to attack the structural problems, but the trade show was a good idea and I congratulate the minister for getting it off the ground.
Mr. Haggerty: Mr. Speaker, I want to direct a question to the Premier. Are the Premier, the Minister of the Environment (Mr. Norton), the Minister of Consumer and Commercial Relations (Mr. Walker) and the office of the fire marshal aware of the continuing threat of another explosion caused by gasoline spillage which could destroy the town of Fort Erie?
I had the opportunity of visiting the site last night. The contractor had excavated a deep hole in the ground, some 13 feet deep by 20 feet long, and it was being used as a catchbasin to drain off liquid fluid. I have a bottle here containing that liquid fluid.
Mr. Haggerty: The members may be smiling over on that side, but a serious problem happened on June 15 when two buildings blew up in the town of Fort Erie and some persons were injured and hospitalized as a result of that incident. I suggest to the minister, before he allows Robo Self Service Gas Bar to continue to be open for business, as has been permitted by the different ministry staffs over there, that he put a stop to it now, because this bottle is highly explosive.
Mr. Haggerty: Under certain atmospheric conditions this becomes very volatile. I suggest that the Premier should sniff it. He should not drink it or put his pipe close to it, because he is liable to take off and we might have another election.
I am not personally aware of it, although I think I did overhear -- I could be wrong -- a conversation with the Minister of Energy (Mr. Welch) some two days ago. Is that correct? Is that what the member was talking about here?
Hon. Mr. Davis: I assume the member has advised the Minister of Energy and is pursuing it with him and with other ministries. I do not think the member brought it to my attention; so I am not particularly aware of it, although I do listen in on other conversations when they are that close at hand. I know the minister will pursue it with the member, representing his constituents.
Mr. Haggerty: This is a serious matter. I request the government ministries responsible to stop the opening of this gas bar. Under certain atmospheric conditions, vapour from those fumes will saturate the ground and leak into the sewer system again and the town will take off.
Hon. Mr. Davis: If the member wanted to take it seriously, which I think he should, he might have done something other than this little performance. I did overhear what he was saying to the Minister of Energy, and I know he takes it seriously, but he does not make his point in the House. Why does he not ask the Minister of Consumer and Commercial Relations? He might just have an answer for the member.
Mr. Haggerty: I drew it to the attention of the Minister of Energy some time in May. Representatives of the Ministry of Consumer and Commercial Relations, the Ministry of the Environment and the Ministry of Energy were present. What more can a person do?
Hon. Mr. Davis: I think it was some two days ago that I overheard the conversation -- it may have been last Friday, but it has been within the last three or four days. All I am saying to the member is simply to ask the Minister of Consumer and Commercial Relations.
Mr. Martel: Mr. Speaker, I have a question for the Minister of Labour. The minister is aware that National Steel closed its doors in 1979 as part of a temporary layoff. On January 19, 1981, the company advised the United Steelworkers of America that it was going to be a permanent shutdown. Will those 225 employees who qualify now be eligible for severance pay?
Mr. Martel: Let me reiterate my question. The union was advised on January 19, 1981, that the closure was to become permanent. Therefore, will these workers be entitled to benefits? What assurance can the minister give us that they will get those benefits?
Can the Solicitor General confirm to the House what he expressed to me yesterday, that although he was quite concerned about bringing the police complaints bill for third reading and ultimate passage and he felt it was important in relation to the social problems in Toronto this summer, he is content to leave the public hearing process until late this fall?
Hon. Mr. McMurtry: As far as the bill itself is concerned, it is scheduled for second reading later today. Originally, we had hoped we might be able to have the standing committee on administration of justice review the bill and hear submissions from the public in September. We now hear that because of previous scheduling that will not be possible.
Yesterday, I shared with the member what had been communicated to me by the Metropolitan Toronto council, particularly the Metro chairman and the chairman of the Metropolitan Toronto Police Commission. They said if the bill were to pass second reading they might establish some sort of skeleton operation modelled on the bill over the summer, which of course would not have the authority the Legislature will provide to this complaints commissioner and his office staff should the legislation pass. It might give an opportunity for various citizens’ groups to assess the effectiveness of the individuals given the responsibility to process these complaints, and it might help clarify some of the issues before the justice committee hearings and before third reading. This is basically what we discussed, and I am happy to share it with the House.
Mr. Elston: Supplementary, Mr. Speaker: I wonder if the minister appreciates in the interim, while this skeleton operation is being put forward by the Metro Toronto council or whoever -- or even on behalf of members of his ministry -- that the citizens who are making complaints about police matters in Metropolitan Toronto will then have to be sure their problems are properly processed. They will have to be sure they go not only to the skeleton project but also to the procedure now in effect.
They may also have to take matters to legal redress in the courts to ensure they will be dealt with fairly. Does the minister not see a danger in putting the skeleton project in place when the Legislature has not sanctioned it and the people who are performing will not have the sanctions available to them when the legislation is finally passed?
Hon. Mr. McMurtry: There is perhaps a basic misunderstanding by the honourable member about the role of the board of police commissioners and Metropolitan council. We are not in the position, short of legislation, to dictate to Metropolitan Toronto how it wants to deal with its citizens’ complaints against the police. If Metropolitan Toronto wishes to make some changes over the summer that might be along the lines of the principle of this legislation, we certainly should not discourage it from so doing because it can do that with or without legislation.
As I indicated to the member, it seems to me it is probably something that should be encouraged because it is within its authority in any event. This might give citizens’ groups an opportunity to assess the new system, at least to that limited extent, pending the passage of any legislation by this Legislature. I have to remind the honourable member the basic responsibility with respect to processing citizens’ complaints against the police lies with the individual board of police commissioners. It is not up to us to play the role of Big Brother and say, “You should or should not try this.” That is up to the board --
Mr. Smith: Mr. Speaker, the Solicitor General must understand the problems inherent in having Metro Toronto, under his encouragement, go ahead with a pilot project of the pilot project the Solicitor General has put before the House. Surely if there is such a rush that Metro Toronto cannot even wait for the legislation to come through this House -- if the matter is so urgent it now has to set in force a group of people to pretend to do what this legislation presumably might accomplish in the future -- why has he not spoken to the chief government whip and arranged for the justice committee to deal with this matter before now; and certainly, why not in July and August?
If the urgency is such, surely, instead of encouraging Metro to set up a pilot project of the pilot project, it would be much wiser for the minister to encourage his members to get this matter heard with some dispatch and not wait until October. Either there is a rush or there is not. If there is a rush, let us do it quickly and hear it in July. If there is no rush should he not be discouraging this skeleton project, this attempt to do without legislation what many people feel would be wrong even with legislation?
Hon. Mr. McMurtry: Mr. Speaker, I am sure the Metropolitan Toronto council and the local police commission will make the right decision, preferably without any advice from the leader of the official opposition because I am sure if they paid any attention to him about anything they undertook it could only create problems. They do not need any advice from the member. It is as simple as that.
Mr. Cooke: Mr. Speaker, I have a question for the Minister of Labour with regard to the situation involving the Windsor Bumper Division of Gulf and Western. I am sure he is aware it has now been settled and the plant will not close.
I would like to ask the minister’s opinion of the behaviour of that company when in the last week it announced the plant closure twice, obviously as a blackmail tactic with the union. Also, when they negotiate with their American workers in Michigan they say, “If you take larger cuts in your cost-of-living allowance than the Canadian workers, you get the work.” They say the same thing to the Canadian workers. Does the minister approve of that kind of blackmail behaviour on the part of a multinational?
Hon. Mr. Elgie: No, we are on his side for leader now. Will the member for Scarborough West (Mr. R. F. Johnston) relax? We like him better. He can say nice things. The member for Scarborough West is never nice. But I know the member wanted to congratulate Mr. H. R. Illing, director of mediation services, for the wonderful job he did yesterday.
Hon. Mr. Elgie: No, I do not choose to get into the business of criticizing one side or the other. Each party has a right under the Labour Relations Act to take any claim regarding unfair labour practices to the Ontario Labour Relations Board. I do not propose to get into that game.
Ms. Copps: Supplementary, Mr. Speaker: In the same vein, I think the type of attitude exhibited in Windsor is the same type of attitude one sees in the white paper on the Workmen’s Compensation Act. On page 14 it states, “If the worker is unemployed because he and his fellow employees have gone out on strike --”
Mr. Mackenzie: Supplementary, Mr. Speaker: I would like to draw the Minister of Labour’s attention to remarks he made in the House about the unfortunate activities of the workers in taking over or attempting to take over part of that plant. I suggest that, given the obvious blackmail that company used, the settlement may have been more a result of those workers being willing to take over that plant than the initiatives his ministry took.
Hon. Mr. Elgie: Mr. Speaker, I am not going to get into the business of who did what. I think the member for Hamilton East knows full well the role that every party played. I have made it very clear what my views are about the sit-in or occupation of that plant. He knows I do not think that was an appropriate act or an act that brought credit on the trade union movement.
Mr. Eves: Mr. Speaker, I have a question for the Minister of the Environment. In view of the fact there was a derailment of a Canadian National train last evening in the village of Sundridge and in view of the fact that several of the cars that were derailed contained petroleum products, at least two of which exploded and burned, can the minister advise me what action his ministry is taking with respect to this matter?
Hon. Mr. Norton: Mr. Speaker, I can indicate at least on a preliminary basis what action has been taken by the staff of the ministry. As of the time of coming into the House today, I was not able to get a complete update because staff are still on site in Sundridge, I expect even at the present time.
Upon receipt of word of the derailment last night, the staff of the ministry responded immediately. They went to the site and have been there since in an attempt to determine what remedial action may have to be taken.
I would suggest that a number of steps have already been taken by the CN in terms of diking, for example, to prevent any of the fuels from entering the lake which is nearby. It is anticipated that soil removal will have to occur by way of cleanup and CN has assumed responsibility for that. Obviously an appropriate disposal site will have to be found for the soil which was contaminated by the fuels.
At the present time the best information I have is that there were no injuries and there is no ongoing hazard to human health, but there is the problem of the contaminated soil. When I receive further reports from the staff in the field, I will bring the honourable members up to date.
Mr. Peterson: Mr. Speaker, I have a question for the Minister of Consumer and Commercial Relations. I would like to ask him, in his capacity as chief regulator of corporations and also the person in charge of the Ontario Securities Commission, can he please tell this House the result of his investigation into the Med-Lon and Arcturus small business development corporations?
Has the minister had consultations with his colleague the Minister of Revenue (Mr. Ashe)? Does the Minister of Consumer and Commercial Relations know what is going on there? Is there any chance of recovery of the $2.5 million worth of taxpayers’ money in those companies by way of grants through the small business development corporations? How many assets have been found there, and what is the status?
In so far as the Ontario Securities Commission’s investigations have been involved, they are continuing and ongoing and presumably those will be dealt with -- the appropriate saying would be in the fullness of time.
Relative to the trust company itself, we are involved as a ministry in respect of the Loan and Trust Corporations Act, and our financial institutions people have been in there. There is no problem at all from that place. I am told they are as safe as 1,000 churches in terms of their capacity to deal with matters.
With respect to the two companies and whether or not the taxpayers’ moneys will be coming back, I think there is every good reason to believe that resolution of the problem will be favourable to the province.
Is the minister telling me that Ontario is going to press ahead right now to try to collect the $2.5 million that was given by way of grants to those investors in the small business development corporation? How much of that money is still trusteed? Will he have to proceed against the individuals? What exactly are his plans?
Under the Small Business Development Corporations Act, in fact under the Corporations Tax Act, there are many pieces of information that are considered confidential that I cannot disclose to the honourable member, or to this Legislature, at this time. I can tell him that negotiations have been carrying on between the inspector appointed by the shareholders of the small business development corporations and the trust companies. It is anticipated --
There will quite possibly be a resolution of this unfortunate situation in the very near future. I think it is fair to say there could very well be some financial losses involved. I am not trying to belittle that. As far as our participation under the Small Business Development Corporations Act is concerned, we are involved in the process and no final decisions or disposition has been made of either the funds that have been paid out or the funds that are still held under trust.
Mr. Van Horne: Mr. Speaker, I would like to direct a supplementary to the Minister of Revenue. Has Ontario lost that $2 million, or whatever the sum is, or is it the trust company? The rumour around the community is that the investors are going to end up settling for somewhere near 35 cents on the dollar. We just heard the Minister of Consumer and Commercial Affairs say everything was safe as a church. There seems to be some contradiction in these two statements.
Hon. Mr. Ashe: I do not think there is. The answer given by my colleague was that the trust company was, to use his words, as safe as a church. I do not think he intimated there would not be some financial losses involved and neither did I. They could very well be financial losses spread among not only the shareholders and the trust company, but also, indirectly, the province. Even that is not a fair conclusion because the Small Business Development Corporations Act was designed and set up to encourage people to get involved and make investments in small business.
We have always been abundantly clear that we were not intending to get involved in the management of small businesses and, generally speaking, these investments are speculative in nature. That is the reason behind the 30 per cent tax grant or tax credit, as the case may be. There is no doubt that, when people put up money, there is the opportunity for gain, but there is also the opportunity for loss. The 30 per cent enticement to generate more funds for the benefit of small business recognizes that kind of an investment and that kind of a possibility of loss and/or gain.
Mr. Swart: Mr. Speaker, I want to raise a question of privilege which I think is being seriously restricted. This is not new to the back-benchers in this House, and was raised at the beginning of the question period by my colleague the member for Downsview (Mr. Di Santo). I raise it now not just because today happens to be his birthday but because -- with that kind of applause I would like to inform everybody here it is my birthday too --
Mr. Swart: Mr. Speaker, the restriction of the back-benchers’ privileges to getting very few questions during the question period is serious and must be corrected. On at least one or two days they got no questions at all.
Please hear me out on this question of privilege. Section 27(e) of the standing orders states, “In putting an oral question, no argument or opinion is to be offered, nor any facts stated, except so far as may be necessary to explain the same; and in answering any such question the member is not to debate the matter to which it refers.”
I suggest the problem here is that the ministers in replying go on at great length -- in fact, they make statements and reply to every interjection. I humbly suggest that although you told my colleague to speak to the House leader of his party you have a responsibility to see the answers are shortened and that the backbenchers get more questions in.
Mr. Speaker: Order. Thank you. That is not really a point of privilege. However, it is a problem with which I have some sympathy. The problem quite simply is, and I say this respectfully, that all members on all sides of the House are guilty of taking too much time both in asking questions and in answering questions.
Having said that, I received a plaintive plea this afternoon, and it says quite clearly: “Mr. Speaker, please restrain the leaders and the ministers. Stop the supplementaries. Protect the back-benchers.”
Mr. Mancini: On a point of privilege, Mr. Speaker, concerning question period: It is my view that this session of the Legislature and the question period procedure that we have used has unfairly given the New Democratic Party more questions than they justly deserve. There is no way they should be allowed --
Hon. Mr. Wells moved that the standing committee on social development be authorized to sit following routine proceedings on Friday, June 26, 1981, to consider the annual report of the Minister of Health for 1979-80.
I think I have been more than patient with the House leader (Mr. Wells) and the government in terms of my question, which was originally placed on the Order Paper on May 19, 1981, dealing with public opinion polls and their tabling in the Legislature and the fact I maintain that since they are taken with taxpayers’ money they should be made public.
Mr. Speaker, you will recall I mentioned this three or four days ago and the government House leader sort of waved his hand and said, “It is still about the middle of June.” I know the flexibility of the government House leader but I think that even his flexibility would really not stretch to the last week in June. I wonder if we can be assured that not only my question, number 92, that has been on the Order Paper since May, but others on the Order Paper for this length of time will be answered.
Hon. Mr. Wells: Mr. Speaker, we will be glad to look into that. It is my impression that we are going to be around here for a few weeks yet, so I do not see any problem. I suggest to the member that we said we would get the answer around the middle of June and June is not over yet.
Mr. Martel: Mr. Speaker, the purpose of the bill is to authorize the apportionment of school rates between public and separate schools in the case of a mixed marriage, where the husband and wife own or lease rateable property jointly. It is time we got rid of this inequity with respect to women in this province.
Mr. Samis: Mr. Speaker, despite the comments, the purpose of this bill is to prohibit the possession and sale of wild animals that are not native to Canada. Zoos, research facilities and humane society shelters are exempt from the prohibition.
That further to the sequence and hours of estimates, as printed on today’s Notice Paper, the following transfers be made: in standing committee on general government, there be added Government Services, four hours; Housing, 10 hours; Treasury and Economics, 13 hours; Transportation and Communications, 12 hours; in standing committee on social development, there be added Labour, 20 hours; also, in committee of supply, Northern Affairs be changed to 10 hours.
Mr. Nixon: Mr. Speaker, we do this every time. Normally the minister gets up and has a few words to say, so I do not think it is really fair to rush through the “Carried” business. If he does not want to speak, our critic would like to speak without having to have it presented to him that somehow or other he was not on his feet fast enough. This is an important bill. There is going to be an important debate. Let us get on with it.
Mr. Van Horne: Mr. Speaker, on a point of personal privilege: If we get into some kind of dispute because I am in error, I would like to point out that at the precise moment you stood and uttered those few words, I had delivered to me -- I would have to assume from the minister -- information pertaining to that bill.
Hon. Mr. Timbrell: Last week, Mr. Speaker, members will recall that I introduced this amendment to the Public Hospitals Act. I would like to provide the honourable members with a brief background on the necessity for the bill.
Over the years, the public of Ontario has been very well served by our public hospitals and by the voluntary boards which are responsible for their operations. For a number of historical reasons, there are wide variations in the makeup of the boards, their corporate structures and their methods of functioning. In some cases, boards are elected by a broadly based community membership. Others have evolved from municipal or civic sponsorships. Still others are owned and operated by charitable organizations with internal corporate boards and sometimes with outside advisory councils. This is certainly true of some of the hospitals sponsored by religious orders.
Hon. Mr. Timbrell: Mr. Speaker, we in Ontario have seen this variety as desirable in that it draws solid support and involvement from people with diverse interests and associations. The record of public service from so many hospital trustees is one of the strengths of our system.
In the early days, many of these boards actually raised funds and built the hospitals with little or no government assistance. However, in more recent years, almost all hospitals have become public institutions, receiving almost complete operating funding and the majority of capital funding from the provincial government.
Since the general public, in addition to funding our network of 231 public hospitals, is wholly dependent on these same hospitals for the provision of quality health care, it is clear that there must be a mechanism to ensure ultimate responsibility and accountability to the public, both for quality and value for money. This, then, is the central issue of this legislation and this is an element that, because of the historical development of our system, is lacking. It is a gap in existing legislation which, with hindsight, we should have remedied before this. Five years ago, His Honour Judge Waisberg, in reviewing the problems which had developed up to that time at the Laurentian Hospital in Sudbury, recommended this kind of reform.
In our present situation as regards the report on the Toronto East General and Orthopaedic Hospital Incorporated, it has been made clear by the authors that the existing powers of intervention which they had as inspectors would be wholly inadequate to assure the public that the very serious problems relating to the structure, the functions and the operations of the administration are remedied. They also concluded that the hospital was unable to correct its problems without outside help. They therefore recommended, and I quote from the report:
“We therefore recommend that appropriate legislation be put in place so that steps can be taken to assist hospitals who find themselves in such a situation.” I emphasize “hospitals,” not just the Toronto East General Hospital. “It is further our opinion that such legislation will not, if used properly, detract from the principle of local autonomy but will assist in coping with situations which, if left unresolved, will or could seriously affect the quality of patient care provided by the hospitals.”
I believe members will agree it is a cause for grave concern that there is no provision for public intervention to protect the general public interest and to ensure the continued provision of quality patient care and sound administration. A number of other provinces have legislation that is somewhat more rigorous than that proposed, namely the suspension or even the dismissal of the board in question. We evaluated those pieces of legislation in other provinces and we chose to opt for what we believe to be a more moderate and yet effective remedy, modelled on the well-established concept that has been part of the Ontario municipal legislation for many years, indeed many decades.
This will keep the board in place, but will establish a supervisor with powers to be exercised on a gradual basis. His first responsibility will be to provide advice and guidance. Second, he will have the power to review and approve acts of the board. Finally, if the board fails to act on his advice, he has the necessary power to ensure compliance. This design then will enable a supervisor to assist and strengthen the management of the hospital while keeping the board functioning. The objective of the supervisor will be to establish the necessary procedures, policies and practices to ensure the effective functioning of the hospital and then to withdraw as soon as possible.
It is not the desire nor is it the purpose of the Ministry of Health, which I represent, to get into the business of directly operating public hospitals. It is my hope and firm belief that this procedure will be the rare exception rather than the rule. Yet the amendment is necessary to ensure that, in the event of serious problems, the public interest can be safeguarded and that ultimately public responsibility and accountability can and will be maintained.
In the exercise of legislation, a report of an inspector under the Public Hospitals Act will first be required. In the case of serious problems that could lead to the appointment of a supervisor under the act, it will be our policy to draw upon experienced and knowledgeable people from outside the Ministry of Health to fill the role of supervisor. While they will be appointed by order in council, they will not be permanent civil servants. This has been a point of concern to representatives of the hospital and medical associations to whom I have spoken, that they not be permanent civil servants who in their view -- and they may well be right -- would have a certain lack of objectivity or could not bring to such a position the necessary complete objectivity.
This will ensure there is no suggestion of bias in the proceedings and will, I trust, allay any fears that might exist to the effect that the government might assume excessive power over hospitals in an unfair way. We fully recognize the concern expressed by hospitals and physicians that such power to appoint supervisors should be exercised with care and sensitivity. In that regard, my critics have had delivered to them copies of some amendments to this amendment that I will propose once we get into committee and that I fully intend will address these very same concerns to which I have just referred.
The purpose of the amendments will be threefold. The first is housekeeping in nature and makes it clear that this bill does pertain to the Toronto East General Hospital. The second ensures that the report of the investigator or investigators will be delivered to the chairman of the board. It was not clear in the --
Mr. Van Horne: Mr. Speaker, on the question raised on this side of the floor, it came through to me -- and I am sure to my colleague from the third party -- that this would apply specifically to the Toronto East General Hospital. I believe that is what the minister said or certainly what he implied.
Hon. Mr. Timbrell: The purpose of it is to make clear that this amendment to the Public Hospitals Act applies to the Toronto East General Hospital. It has to do with the relationship of the timing of the appointment of a supervisor and the legislative authority for that, with the timing and the legislative authority for the original appointment of the inspectors, to make it clear the two mesh.
Going on from there, the purpose of the additional amendments which I had sent to members are, as I started to say, first, to make it clear a copy of the report of the investigation will be delivered to the chairman of the board of the hospital. There was some concern the amendment as printed in Bill 113 did not ensure officials of the hospital would have access to the report and therefore be able to comment on it and offer suggestions.
The third of the three amendments ensures that 30 days will have elapsed between the point the report is completed and the earliest point at which the Lieutenant Governor in Council can consider the appointment of a supervisor.
This arises from discussions I have had with members opposite as well as with a number of people representing themselves or professional organizations outside the Legislature who are concerned. There is a general concern about the potential for abuse of this authority.
I have submitted to them that by ensuring this 30-day -- call it what one will, I will call it a cooling-off period -- there will be full opportunity for the board of the hospital, the medical staff, various other professional groups in the employ of the hospital, the community, members of the Legislature, whoever is interested in the case in question, to make their representations, to state their cases and to try to prevail on the minister to consider the exercise of other alternatives than the appointment of a supervisor.
Therefore, the earliest point at which I or any of my successors could possibly go to cabinet and seek the appointment of a supervisor would be 30 days after the completion of the report. This is an effective check or balance in the system to ensure everyone will have --
Hon. Mr. Timbrell: For whomever. These concerns have been expressed to me. Neither I nor my administration in the Ministry of Health would abuse the authority this legislation conveys on us. I felt it was important we show even more tangibly we are prepared to ensure there will be time for discussion and the presentation of alternatives before this authority would even be considered. When we get to committee, I will be proposing those three amendments.
I thank the member for Bellwoods (Mr. McClellan) for sending me a copy of what he is going to propose as well. My decision to propose these amendments was in no small way based on discussions with the two opposition critics who may oppose the bill and may have other amendments to propose. I have tried to understand and acknowledge their concerns in this amendment I am proposing.
Further, we wish to assure everyone we are prepared to consult with the Ontario Hospital Association and the Ontario Medical Association about the best course of action in any future situation where the implementation of an investigator’s report is being considered. That again underscores the reasons for at least two of the three amendments I intend to move in committee.
In conclusion, the issue here is one of ensuring public responsibility and accountability for extremely important and critically essential public institutions. So I ask for the support of all members of this House in approving the Public Hospitals Amendment Act and the amendments I will move in committee under Bill 113.
Mr. Van Horne: Mr. Speaker, it is with some mixed emotion that I speak to this bill because I know there is a change in the way hospital boards have to act now as compared with the responsibility they had before government was quite so involved with the overall health care service in our province. If one does not acknowledge that their view has to change with changing times, then I think one has a very narrow view.
I say that from one stance or view of this particular legislation and yet, at the same time, I have to say that what is being suggested here is so broad that it really presents problems to me. Although again I see some need, I see on the other hand that what is being provided to accommodate this need is a lot more than should exist.
I think I can build a case for what I say if I take a look at the past history, as did the minister, with a view to seeing how important voluntary boards are to the health care system in this province.
It has been said by many who visit our province, and certainly by us here in Ontario, that we are blessed with the best health care system in the entire western hemisphere, if not in the world. I think we in Ontario take considerable pride in that system, but we cannot forget that system developed through, at least in part, the efforts of a lot of people out there in the community who worked as volunteer members on boards having nothing more or less in mind than good health care service.
Some of those people who have been involved with hospitals for many years have spoken to me in this last week expressing dismay that Bill 113 erodes this process I am speaking so highly of, this voluntary service process. It detracts from local autonomy. I have had people ask me what incentive there is to serve if they are going to be completely and totally overseen by government.
The minister was careful to point out that the supervisor would not necessarily be a permanent civil servant, but I would have to submit to him that whether he is or is not a permanent civil servant, or a person seconded into the ministry for the period of time, as we are obviously going to have with the Toronto East General Hospital supervisor being seconded out of Mount Sinai, that person does take on the role of government, be he a permanent civil servant or someone who is there on an interim basis. So that concern of government being too involved I think is an honest concern.
We cannot forget that we are seeing erosion. One has to ask why such a drastic step is necessary, given the glowing comments of praise and commendation passed on to volunteer boards and health councils in the last few years. When we look through some of the speeches and comments made by the minister, I do not think there is any question but that he is very proud of what he calls this series of partnerships, this effective work within the community. I am quoting now from some of his statements just within the last two years. I do not want to go into all of the details because I am sure I could keep the House going for at least another day if I repeated all of the glowing comments that he made about the wonderful work done by these volunteer boards.
Even the people who wrote the report on the Toronto East General Hospital say to us on page 63, as they were summing up their efforts: “The review committee strongly supports the principle of local autonomy in the operation of Ontario public hospitals. The hospital system in this province is considered to be one of the best in the world, and has reached its present level of excellence because of the joint efforts of local hospital boards and the provincial government working together as partners. It is our firm conviction that this relationship should continue and that nothing should be done to detract from the role of the local hospital board in the administration of their hospitals.”
“However, there may be situations where problems associated with a hospital are of such overwhelming magnitude that the resolution of them requires intervention, in the public interest, by the provincial authority to solve the problem.”
We do not dispute that, but we are suggesting that to have this piece of all-encompassing, ombudsman legislation is much more than is needed. The minister -- and I am paraphrasing, and I may be taking one or two words slightly off the theme that he was addressing -- indicated that this would be used only in the rare exceptional case. If that is true, why does he need such an omnibus bill? Why could this bill simply not address itself to the Toronto East General and Orthopaedic Hospital?
If I can take the liberty, as the minister did, to make reference to amendments, we are having amendments prepared, to send him a copy and to send my friends from the third party a copy in a very few minutes, which suggest that this bill be amended to address itself simply and singularly to that particular hospital. If it is needed again for another hospital -- and our rationale, I think, is quite reasonable and quite understandable -- then a similar bill can be brought in.
There is no particular magic with this, but we feel this type of amendment would achieve the goal that has been there for some time -- not just our goal but the ministry’s goal -- to recognize this local autonomy, and not, as with this piece of legislation, to walk in and wipe it out of every one of our 231 hospitals here in Ontario. That is essentially what this does. It does not address itself just to the one hospital; it wipes out the local autonomy, the feeling of satisfaction that people get from doing their bit to help their community. It just wipes that out of those other 200-odd hospitals in our province.
That kind of legislation is far too broad, and it is a form of legislation we simply cannot accept. Therefore, we too will be suggesting an amendment, the amendment being that Bill 113 be addressed singularly to Toronto East General and Orthopaedic Hospital.
When I say this I have to make reference to concerned groups, again as the minister did, in regard to this legislation. I am going to take the liberty of making reference to the Hospital Council of Metropolitan Toronto and the second page of a letter of concern that they sent to the minister dated June 18. It says in part that the Hospital Council of Metropolitan Toronto “believes in the role of the trustee and strongly endorses the voluntary support so generously given by the business and community leaders of Metropolitan Toronto.” I do not think it is suggesting that it fully endorses Bill 113.
Let me quote further from a letter that we received this afternoon from the Ontario Medical Association, which says in part that that association “is opposed to the passage of Bill 113. The association contends that the passage of the bill would seriously undermine the historic autonomy of community-based boards or corporations of hospitals which have served the people of Ontario so long and so well.”
I said at the outset that one has to keep one’s eye on changing times. I agree with the minister that there is a problem at that particular hospital that is redressed through this legislation. But, again, we cannot support this ombudsman type of legislation addressing itself to potentially every hospital in the province with no recourse through this particular chamber for people such as those in the Ontario Medical Association or in the Ontario Hospital Association to have the opportunity to express their concerns.
The minister made reference to the situation that concerned all of us regarding the Laurentian Hospital in Sudbury a few years ago. The specific reference was to Judge Waisberg’s report, the public inquiry into Laurentian Hospital, Sudbury. I think it is interesting to note when one looks through the recommendations of that report -- it is a very big document, which I have in front of me; it is more than 230 pages long -- that he makes reference to problems such as this and states: “The Ministry of Health should be given the legal power to intervene in, or temporarily take over the management of, public hospital corporations which are persistently in fiscal difficulties.”
The implication is that he is not giving the government a broad brush but he is saying it should be there for cases in which it is needed. That is the thrust of the recommendation we are making. There are problems that come up from time to time in hospitals. I do not think anyone can deny that; we are not trying to deny it.
The legislation we have in front of us now could have come along and accommodated the problem in Sudbury. Here we are five or six years down the line; the same thing could have been brought in to accommodate the problem that we have in Toronto East General.
By the way, maybe we should take a moment to look at the problems that existed at that hospital and see how they were investigated by the government. The government simply took what it had -- that is, the existing legislation -- and applied the power of that legislation to appoint the three gentlemen who wrote that report. While we are at it, I have to make a reference to the gentlemen, one of whom is from my community, London, Ontario, Mr. Pat Blewett. The other two gentlemen I do not know, but I am sure Mr. Clark from Windsor and Dr. Wadsworth from Vancouver are also commendable men. They are very talented and did a good job.
The point is that there was no particular action required within this assembly to put them to the task. The existing legislation was adequate. They were able to go in. They were able to take a look at things. Now they have drawn to the attention of the ministry not only what they consider to be the problems but also some solutions, and what they are suggesting directs itself again to that hospital.
It might well be a good exercise for us to consider some alternatives that would come out of this. I may have lost the page here, but there is a reference to the ombudsman approach within the health delivery system. If the minister put his mind to it, I think that would be a much better way of accommodating problems within hospitals and hospital boards than to come up again with the legislation we have in Bill 113.
When we look at the legislation, the bill as it stands in front of us, there are questions that come to mind. The first question is when the Lieutenant Governor in Council may appoint one or more investigators; that is the trigger, the thing that gets this whole process rolling. On what evidence -- and this is the concern that some people have in the Ontario Hospital Association and the Ontario Medical Association -- and how frivolously might this be applied?
Certainly the minister, who I think has the regard and respect of a fair number of people in the health delivery system across the province, has to wonder what happens when the day comes and he moves on to that big chariot, the Big Blue Machine driver’s wheel. If he is going to aspire to be the leader, or if he is going to be moved to another ministry -- the rumours are rampant, and he knows it; there is considerable discussion around the back rooms of this place about which ministry the Minister of Health is going to -- if he moves on, what happens? How frivolously might this particular legislation be applied?
We have another concern, the provision of the supervisor. I think the minister indicated that the supervisor would be withdrawn as soon as possible. But there is a bit of vagueness there that concerns me and tells me that, even though we hear that this legislation was written before the report came out -- that is a nasty thing to say, and the minister is shaking his head -- somewhere along the way people had to have some inkling of this kind of legislation, whether all the t’s were crossed and the i’s dotted.
The question still comes, for how long will the supervisor be provided? Beyond that, what about the board that has to take this supervisor? It is told simply that it is its duty to receive the advice, that is it. The supervisor says what he or she feels has to be said, and the board has no choice. Again, they talk about local autonomy and then move in a supervisor who can tell the rest of the board exactly what to do. The members of the board must receive that advice. What is left? They might as well pack their bags and go home.
I will conclude by saying that we cannot support the legislation as it exists. We feel it should be amended and, of course, amendments can only be made when the bill is referred to committee. It is our hope to see it go to committee, to have considerable further discussion and to see the amendments accepted as we present them.
I made the suggestion a few moments ago that the ombudsman theme is one the minister might consider. All of us concerned with the health system here in Ontario are very much aware of the recent series in one of the major newspapers here in Toronto concerning the overall hospital care system in Ontario. It suggests that for months questions have arisen about the quality and availability of health care here in Ontario.
Doctors and hospital administrators frequently say the Ontario government has cut back so severely on hospital budgets that hospitals cannot buy or replace equipment they need. They have to reduce non-nursing or nonmedical staff in some instances. All kinds of questions were raised in our minds by that series of articles, questions we have raised in this chamber and in the estimates rooms on occasion for the last few years.
The newspaper that carried that series, the Toronto Star, ended up by editorializing and suggesting there is a way of accommodating these concerns. We empathize with the minister, who must feel on occasion like a punching bag when he comes out of cabinet meetings, having been attacked by his colleagues when it comes time to share the dollar pie they have to share. The health service system here in Ontario takes the lion’s share of that, and he is being harassed from the other side by the various demands from hospitals and from other areas for the moneys that he has to distribute.
We know there is a problem there, but he alone is not able to answer those problems. Quite candidly, I am not sure his administrative staff can. As dedicated as they are, I have to be a little concerned about their singular ability to see their way out of the many tunnels they fall into each day.
The editorial concludes with the suggestion that there should be an investigation of the highest order. That investigation, of course, would be a royal commission. It may be time to urge the minister to take that kind of approach to redressing the various problems that we have in our health care delivery here in Ontario. It may well be that kind of approach would provide answers for us that would give us something to build on through the 1980s and 1990s and remove us from the situation we are in right now, which seems to be a situation where we are governing by crisis. We seem to go from crisis to crisis. This legislation may well not be necessary and may not have been necessary had we used the tool of the royal commission.
Let me conclude by saying that although we are cognizant of problems the ministry has to face, we are also very concerned that local autonomy not be hammered into the graveyard with omnibus legislation that eats away at that local autonomy. Let this bill address itself singularly to Toronto East General. The hospitals in this province of ours are generally very well looked after by their voluntary boards and other boards. If there is another problem that we see in a year, two years or three, we can deal with it through another piece of legislation.
Mr. McClellan: Mr. Speaker, first I want to set out our own position on Bill 113. The New Democratic Party intends to oppose the bill on second reading, and we will move an amendment when the bill goes into committee of the whole House. The purpose of that amendment would be to restrict the application of the bill specifically to Toronto East General Hospital.
We do not believe the government should be given the power to place any hospital in Ontario under trusteeship through blanket or omnibus legislation. Our position is that if it is shown there are problems of such severity in an individual hospital that they require the emergency step of imposing trusteeship, then the minister must approach the Legislature on each and every specific instance and ask for that power and try to justify it.
We are not going to give this minister or any other minister that kind of blanket power. Let us not kid ourselves about the nature of the power we are talking about. I do not have the minister’s statement in front of me, and I will not say he soft-pedalled the strength of the powers that are vested in him and the government under Bill 113; but, in the way he expressed himself, I think he softened them a little bit in his description of them.
It is absolute power the minister is asking for. He is asking for the power to appoint a supervisor, who is a trustee. The supervisor will have the power to require the board to have each and every one of its actions approved by the supervisor before it becomes valid. No act of the board of the hospital is valid unless approved in writing by the hospital supervisor, period. That is trusteeship. There is no other way of describing it.
The supervisor can require the hospital board to do any act that a public hospital is empowered to do under the Public Hospitals Act and regulations. That is complete trusteeship. The Ontario Medical Association, in its letter of June 25, refers to the bill as vesting “dictatorial power in government.”
Let us not have any misunderstanding about the nature of the power the minister is asking for: it is complete power over the running of a hospital, to be exercised by an agent of the minister, called the hospital supervisor, to be appointed by the Lieutenant Governor in Council.
Not to belabour the point, we are not going to give the government that power on a blanket basis. If they want it -- and I think the minister and the government should understand this -- they should approach the Legislature each and every time they need this kind of power.
The second thing I want to address in my second reading remarks is the question of the problems at the Toronto East General Hospital and the cause of some of those problems. The question remains begged as to which problems the minister intends to address through Bill 113 and which problems he intends to continue to ignore. I hope the minister does not expect any of us to believe that all the problems at Toronto East General are attributable to the board of directors, because that is not a fair thing to say. Many of the problems lie on the doorstep of the Minister of Health himself.
Mr. McClellan: I have read the report many times. I do not need any gratuitous comments from the minister to read the report. I will be happy to read the report again. I find it a very good report, and I will read it again, but I have read it carefully.
I read the section dealing with the emergency department at the Toronto East General. I read that the emergency department is closed from time to time because it becomes too busy. I read that the emergency department is overcrowded. I read that in the emergency department there is a long wait on too many occasions when patients are waiting for admission to active treatment beds. I read that the emergency department is too small and the physical facilities are inadequate.
I read all that in the report. I read as well that there are 130 patients at Toronto East General Hospital at any given time who require long-term institutional care but who are in active treatment beds. Who is responsible for that? Not the board of directors of Toronto East General Hospital, but the Minister of Health.
How many times has the need for chronic care beds in Metropolitan Toronto and throughout the province been brought to the Minister of Health’s attention? How many times has the minister promised to increase the ratio of chronic care beds in relation to active treatment beds? A thousand times? How many false and broken promises have been made by the Minister of Health?
Mr. McClellan: I recall the minister promised in 1980 that in excess of 3,000 chronic-care beds would be opened; I do not have the exact figure, but I can look it up in the files. That was in response to a written question on the Notice Paper: for 1980, open and planned, in excess of 3,000 beds.
Hon. Mr. Timbrell: Mr. Speaker, on a point of order: If the member will take the time to look at the question as asked and answered, he will see it talks about beds open and planned; it did not refer just to 1980. With respect, the honourable member is mistaken.
Mr. McClellan: No, the honourable member is not mistaken. The question was tabled in the House on December 12, 1980. The question read, “Will the Minister of Health indicate the total number of active treatment beds by individual county?” He refused to answer that.
Mr. McClellan: It is broken out the way the minister wants to break it out. He has two systems of breaking it out: before an election and after an election. Before the election, the count is significantly higher than it turns out to be after the election.
Mr. McClellan: Leaving aside the question of open and planned, let us go back to March 31, 1979, to hospital and extended care beds -- and that is the number of beds as at March 31, 1979. That is not open and planned; that is open. As of March 31, 1979, the number of chronic care beds was 10,820. Two years later, the number of chronic care beds as of March 31, 1981, was 9,859. What a marvellous accomplishment!
Mr. McClellan: I am just using the minister’s figures from his annual report and answers to questions tabled in the House. I thought a hospital bed was a hospital bed, and I thought a chronic care hospital bed was a chronic care hospital bed. Obviously they are not. I await the minister’s fun with figures. He promised it a week and a half ago, and his minions have still not been able to unscramble the stew.
Mr. McClellan: The point is that the Ministry of Health has been told and warned time and time again that there is a critical shortage of chronic care beds, that it is causing terrible problems in our hospitals and that it is resulting in backups, closures, overcrowding and long waits in emergency departments. We have the example of the Toronto East General Hospital before us today.
In September 1980, the report of the long-term care needs committee of the Hospital Council of Metropolitan Toronto cited an immediate need, as of 1980, for 2,070 extra long-term care beds in Metropolitan Toronto alone. Some of us remember what the Minister of Health said when that report was made public. He denied that was a statement of current need, despite the fact that it was clearly set out in the report that the figure of 2,070 was the need as of 1980 and was responsible for a terrible backlog and jamup within the hospital system.
The minister tried to weasel out and said, “No, that is a five-year need forecast.” It is not. There is no way one can read that report and come to the conclusion that the authors were talking about a five-year need. They were talking about the need for 2,070 beds as of 1980, and they had additional bed needs identified to cover the period to 1985.
The minister pretends there is no problem. He tries to pass the buck on to a hospital that obviously has serious management problems. He passes the buck on to that hospital to try to cover up his own failures as Minister of Health.
He is not going to improve things by continuing to pretend there are no problems or that he has done things he has not done; that he has opened chronic care beds he has not opened; that problems do not exist that obviously do exist; and that reports do not say there is an urgent need for X beds when they do say that.
How does he serve his office by that kind of performance? It is beyond belief that this kind of performance, which has so consistently characterized his tenure in office, is going to lead to anything but the problems identified in the report on the Toronto East General Hospital.
There are problems that will not go away by the imposition of a trustee on the Toronto East General Hospital. That is not going to solve the problems the minister has created by the failure to build sufficient chronic care beds.
Mr. McClellan: I am sure there is only one point on the face of this earth on which I agree with the Minister of Health, and that was just it. But I still support the member for Parkdale (Mr. Ruprecht) as leader of the Liberal Party. I want to make that absolutely clear.
Mr. McClellan: On Bill 113: The Hospital Council of Metropolitan Toronto in a letter to the minister dated June 18, 1981, has simply restated in a very concise and clear way the point I have been trying to make, perhaps somewhat discursively. I quote the second numbered point in that letter:
“As far back as 1975, and as recently as October 1980, this council noted a substantial need for more long-term care beds in Metropolitan Toronto and identified the need for a further comprehensive study. While your ministry may question the total number of beds required, the need remains critical.”
“In November 1980, a request was made to your ministry for funds to conduct a study to plan the development of a co-ordinated emergency services network in Metropolitan Toronto, which would involve classifying the capabilities of emergency departments and developing an emergency medical services communications system. To date, our proposal has not been acknowledged.”
The proposal has not even been acknowledged, as of June 18. I am sure the minister will whip out his letter of acknowledgement, which will be dated subsequent to June 18, or perhaps even backdated. But the reality is --
Mr. McClellan: I know he will. He does not vary his shtick at all. He waits until problems have become crises, until the correspondence is public, and then he initiates some kind of token response. That is simply not good enough.
The problems in the emergency department at Toronto East General are not unique to that hospital. We have tried to make that point over the last couple of weeks. Those problems characterize a number of hospitals in Metropolitan Toronto and throughout the province. They are caused by the same set of factors I have been talking about, which the Minister of Health has refused to deal with. He hopes people will be distracted from them by this imposition of a trusteeship.
There are obviously other problems at the Toronto East General and Orthopaedic Hospital that speak to very bad management, and I do not want to minimize these. There are very, very serious problems at the East General, and I am not denying that. That is evident from the report. There is evidence of poor management in the blood bank, evidence -- and I think this is of most personal concern -- of what the authors of the report refer to as “poor nursing care.”
To read that section on nursing care is to wonder what is really happening in that hospital. I do not think there is anything in the report that is as upsetting as allegations of what is basically cruel and callous treatment of patients. That in itself, I think, would partially or almost completely justify the kind of severe measure this bill represents.
Third, there is obviously a serious problem within the medical care staff with respect to communications with patients. The problem identified as a not infrequent problem was that people had enormous difficulty at this hospital in getting clear information about the medical condition of their relatives who were patients. From that problem flowed the recommendation for an ombudsman.
Again I do not know what happened to the recommendation for an ombudsman. That is not dealt with in this bill. I think it is an idea that has a lot of merit. I would like to hear the minister comment on it and tell us whether it is part of the program of the hospital supervisor for the Toronto East General and Orthopaedic Hospital that some of the specific recommendations in the report will be implemented.
For example, the ombudsman: Is it the intention that the supervisor will establish an ombudsman function at that hospital? For example, the ambulatory care unit to ease some of the pressure on the emergency department: Is it the intention that the ministry will make that service available? Perhaps the minister would be so kind as to go through, at least in an illustrative way, some of the principal recommendations of the report, the specific recommendations designed to alleviate specific problems, and tell us whether the hospital supervisor will have a mandate to make sure those services and programs are actually put into place.
The final point I want to deal with is the question of the board of directors and the allegations of conflict of interest. The report itself, I think it is fair to say, is rather ambiguous in dealing with the problems of conflict of interest.
For example, the matter of the chairman of the board who was also supplying food services to the hospital: The report, as I understand it, indicated under the rubric of conflict of interest -- I believe that is how they dealt with the issue -- that this did not really represent a conflict of interest; they said rather that, on balance, the hospital benefited from the relationship more, perhaps, than the chairman of the board.
I do not think that is a very healthy situation. I suspect the minister agrees with me. I do not want to make any allegations with respect to the financial aspect of that relationship, but a conflict of interest is a conflict of interest. There should be provisions in the bylaws of any public institution that prevent the members of a board of a public corporation from engaging in financial or business transactions with the agency on whose board they sit. I think that should be a simple law, quite frankly.
It is a very unhealthy situation where people can sit on the board of a public hospital and boast that their firm has been supplying food to this hospital for 50 years or that they are providing a first-class banking system and therefore, because they are such great bankers, they have a right to sit on the board of directors. This lowers the standards of public morality in this province when that kind of clear confusion with respect to what represents a conflict of interest is allowed to perpetuate itself and justify itself without any real reprimand and obviously with no sanction.
There were allegations in the report that involved conflict of interest of a number of board members -- nepotism in the allocation of jobs, and one instance of the use of a medical photography department for a private photography business. Because of the number of allegations, I would have thought there would have been something in this bill that would have toughened up the bylaw section of the Public Hospitals Act. I thought there would have been something that would have required members of a board of directors to abstain on matters in which they had a direct interest and prevent members of the board from continuing to serve on a board where there is a clear financial or business relationship with that philanthropic corporation, in this case hospitals.
I would be interested to hear some response on that from the Minister of Health. I think that is an important defect in the legislation and I am curious to know whether the minister intends to deal with that simply by the program or actions of the hospital supervisor requiring the Toronto East General to change its bylaws, as I suspect. Will the minister tell us whether he would not agree it might make more sense to change the Public Hospitals Act to make sure hospital bylaws are required to have a clear conflict of interest provision? He should also set that out in the regulation.
Ultimately, the issue comes down to one of trust, I think, and I regret to have to say it but I don’t think we trust this government with the kinds of powers that Bill 113 would vest in it. As far as we are concerned the relationship between the government and the hospitals it funds leaves a lot to he desired.
My colleague from Renfrew North (Mr. Conway) can testify to this. We have gone through the experience many times of talking to hospital administrators and having them tell us their problems in confidence, only to find that when they come to testify before the standing committee on social development they are very reluctant to repeat what they said in confidence.
I refer to an editorial in the Toronto Star dated June 13, 1981. This editorial was written at the conclusion of a series of feature articles the Toronto Star did on the problems in the health care system. The editorial begins: “Ontario hospitals say their negotiations for funds with the health minister are a matter of constant dispute, but many hospital administrators say giving the Star details of these conflicts could bring reprisals.”
So several hospital officials agreed to give the Star a composite picture of their problems. That is a pretty sad commentary on the relationship between the Ontario Ministry of Health and our public hospitals. They are afraid to speak openly and candidly for fear of reprisals and I think we have seen in the past some evidence of the heaviness of those reprisals.
We would be afraid -- I will express this fear very bluntly and very directly -- that if a government had this kind of power to put a hospital into trusteeship there would be nothing to stop the government from successfully completing the kind of campaign for hospital closure that it undertook in the mid-1970s. That kind of pressure upon hospitals would give the government complete leverage to impose its will, at will, on hospitals. We feel no hospital would have the independent capacity to speak out against a planned health rationalization program for a particular district, that the Minister of Health, in this legislation, has the power to exercise this kind of clout to strip them of every vestige of independent decision-making and to impose his own agent upon them.
The minister can frown and shake his head and say, “No, this is not what we are contemplating”; and maybe it is not what the incumbent is contemplating, but I do not think any government asks its Legislature to give, at these times, omnibus power with no evidence that it is required under a specific instance referenced in an investigative report. For that reason and the reasons I have set out we do not intend to support the bill on second reading.
Mr. Gordon: Mr. Speaker, the point of particular interest I would like to underscore for the honourable members on the other side is that the need for reform similar to the Public Hospitals Amendment Act was clearly identified fully five years ago in a review of Laurentian Hospital in my riding of Sudbury. As the minister has so well stated, the absence of this amendment is a gap in legislation that could have and should have been remedied before now. Nevertheless, I would like to offer some brief thoughts of my own on what the minister has said about our health system.
There is no doubt it was, and still is, able to operate with a minimum of government supervision. The ministry provides only a limited number of services directly. Instead, we believe strongly in the principle of local autonomy and responsibility for the delivery of services. Our job in government is the ultimate responsibility to ensure the health care system runs smoothly, that certain standards of care are maintained at as reasonable a cost as possible. We feel the provision of health care services remains, on balance, the most effective that can be found anywhere.
Notwithstanding all this, the ministry has been very conscious of the fact that we, through the present Public Hospitals Act, have lacked the ability to act with authority in the event of extraordinary circumstances. We have seen this inability to move swiftly when it may be absolutely required as a deficiency in the act. Given the high standards maintained in our system, we have never felt the pressing need to rectify this deficiency.
However, when the problems at Toronto East General Hospital became known to us, and subsequently the report was released, the Minister of Health and the Deputy Minister of Health concluded that the ministry’s assistance would be appropriate. The inspectors of the East General report were asked by the minister if the hospital was able to correct its problems without outside help. They said no.
The honourable members heard the minister quote from the inspectors’ report in which they recommend that appropriate legislation should be put in place so that steps could be taken to assist hospitals in the event of such extreme situations. This led to the decision to introduce the Public Hospitals Amendment Act, to enable government action where the quality of management, or the quality of patient care, is in jeopardy.
The members have had the opportunity to read the Toronto East General report and will have noted the major problems as long-standing, unsound management practices, ineffectiveness of the board of governors in its actions and the absence of definitive operational policies, particularly in the emergency and blood bank departments. These factors led to a gradual decline in hospital staff morale and the problems by staff in the care of patients. These matters accounted for our deepest concern, that of patient safety.
As serious as the ministry feels this is, however, we have identified certain criteria which must be established before the Lieutenant Governor in Council would be allowed to act on our proposed legislation. There would first have to be a special investigation to look at the quality of the hospital administration and the care and treatment of patients in the hospitals. Depending on the findings of the investigator’s report on these subjects, the government could appoint a provincial hospital supervisor or supervisors.
I would remind this House that the Legislatures in Alberta, British Columbia and Quebec now have legislation to employ in emergency circumstances. In Ontario, there are a number of instances where even other ministries of the government, as well as other levels of government, may take action to remedy problems in a variety of organizations. Ontario has lagged behind compared with other provinces in the enactment of emergency health legislation.
As the minister told the media last week, the real test of this proposed bill is going to be the frequency of its use. We anticipate it will be very rare and only when clear grounds, as with the Toronto East General Hospital, are established.
If this ministry is ultimately responsible for the funding and quality of the health system, it is clearly an abdication of that trust not to have provision for emergencies as they arise, no matter how infrequently. The present Public Hospitals Act allows us to do no more than identify problem areas through the appointment of inspectors. It does not enable us to take action.
The proposed Public Hospitals Amendment Act would give power to ministry-appointed supervisors, but even then only on a graduated basis. Initially, the supervisor would offer advice and guidance to the board and to the administrator of the specific hospital. Should they fail to heed his advice, only then can he act on their behalf.
During his term, no action of the hospital board would be considered valid without the written approval of the appointee who would also have complete access to all records and documents. He would be accountable for his actions at all times to the minister who may ask the supervisor to report as often as he feels it is necessary.
We feel the approach of this legislation would enable the government to give expert assistance to board members without those board members losing enthusiasm for or dedication to their tasks or, most important, losing the confidence the community has placed in them.
There has been some concern we could have proceeded in a different way in resolving the situation. Given the Toronto East General’s affair, it is apparent hospitals may not always be able to solve their problems internally. Also, given the inadequacy of our current legislation in covering this contingency, the government has concluded the only really effective approach is to proceed with this proposed bill. In our view it is wise to have the option available to permit the government to move fairly quickly as is required from time to time.
We recognize the concerns expressed by hospitals and physicians that the new powers to appoint supervisors should be exercised with great care and sensitivity -- something which members over there are perhaps not familiar with. We hasten to assure them we are prepared to consult with the Ontario Hospital Association and the Ontario Medical Association about the best course of action in any such future situation. Quite clearly, the minister’s remarks about amendments to his bill go further to assure input from all interested parties.
Mr. Speaker, the central point we wish to impress upon you and the honourable members, if I might sum up, is that we must have the tools to do the job. The present Public Hospitals Act will not allow the government to be of sufficient help when our help will be most required. This amendment will also not permit us to snoop or swoop in arbitrarily either; I have spoken of the criteria that must be in place before we act.
This amendment will, however, free us to move towards resolving nasty difficulties in our system. I have said we are responsible for the health system of this province and will continue to be responsible for it. We recognize our responsibilities and we need the power to exercise this responsibility and no more.
On behalf of this government, I would ask for the support of all members in this chamber in approving the Public Hospitals Amendment Act for second reading in the interest of the public’s safety and wellbeing that we have been elected to ensure.
Mr. Laughren: Mr. Speaker, I rise on a point of information. I wonder if you would allow me to ask the member for Sudbury if he will promise to heap this praise on his colleague when he returns to Sudbury.
Mr. Conway: Mr. Speaker, I am pleased and interested to rise and participate in what I believe to be an extremely important debate about what I believe to be a very radical piece of legislation -- legislation that is radically bad and radically wrong. I find it interesting to listen to the Minister of Health and his parliamentary assistant’s remarks on behalf of the government.
I do not know what Hansard will show about the comments of the member for Sudbury, but if he said in his remarks, or as an aside to the member for Nickel Belt, that the current legislation does not provide sufficient snoop and swoop sanction and latitude then he spoke to a far greater reality about Bill 113 than he might at first understand.
Like every other member who has participated in the debate this afternoon I appreciate fully the difficulties as set out by the report of inspectors Clark, Wadsworth and Blewett on the situation at the Toronto East General and Orthopaedic Hospital. There can be no doubt in anyone’s mind that, as the member for Bellwoods and others signalled in their remarks, there is a very serious problem at that hospital which that report outlines at great length. I have not heard a scintilla of commentary from anyone in this chamber this afternoon which would make me believe any honourable member here wishes to stand in the way of appropriate redress to the specific problem at that institution.
I certainly want to associate myself entirely with the position that we must, as a Legislature, respond as specifically and as sensitively as we can to the problems at the Toronto East General Hospital. The member for Bellwoods cited a couple of things from the report and I wanted to go over one that he touched on very briefly that had to do with nursing care. I would like to read from pages 15 and 16 of the report of the inspectors, because like the member for Bellwoods I was concerned and very upset to think that in the Ontario of 1981 we could have inspectors report to us that a health care delivery system might involve the following:
“Many complaints of inadequate nursing care were made to the review committee. We have identified instances of poor nursing care. Complaints regarding rough and unsympathetic treatment were received and some complaints of medication errors were reported. There also have been reports of inappropriate behaviour by nurses, such as taking insufficient care of a paralyzed or unconscious patient, laughing at a patient’s misfortune and turning off a patient’s call light.
“These shortcomings in nursing care and decorum seem particularly to affect those areas of the hospital where large numbers of elderly patients are treated. We have been unable to substantiate many of the allegations about inadequate nursing care, but the large number of complaints of a similar nature causes us to believe there is some substance to the allegations. The majority of the complaints reflect attitudinal problems; however, understaffing, poor physical facilities and inadequate equipment may also be contributory factors.”
How many times have members of this assembly, particularly those who served in the minority parliaments from 1975 through 1981, sat and listened to specific complaints from hospitals across the province about the impact at the ward level of years of significant cutbacks by this government as far as nursing care and related areas are concerned?
I learned a long time ago that the numbers from the minister and the Ministry of Health are nothing but an elaborate scam that I would not spend two moments concerning myself with. I regret to have to say that. I have long since abandoned any seriousness in analysing or accepting what is offered to me by that ministry.
It was remembered here this afternoon that this is very much a matter of trust. In so far as this ministry is concerned it has unfortunately lost some of the capital of trust it once had. Some of us believed what we were told by this minister’s predecessor when he went out armed with what were apparently watertight regression analyses for the closure of public hospitals in Ontario five or six years ago. We saw what that case really involved. We were told on the one hand there was every good health care reason why Doctors Hospital should be closed. As I have said in this House before, the former Minister of Health (Mr. F. S. Miller) told us why that hospital should close, and the former Minister of Consumer and Commercial Relations (Mr. Grossman) came along months later and told us why it should remain open.
Whom are we to believe? What was the trust in that transaction? Some of us will always remember the famous day in the committee, looking at the Ontario health insurance plan premium increase, and the numbers of people on partial-premium assistance in the province. We talked about this the other day. On the one hand we were told the numbers were not fewer than 60,000. A short-time representative of this same government stood in that place and said, “The number is, I think, something in the order of 586.” Those numbers were recommended to our attention --
For the edification of the new member for Lakeshore (Mr. Kolyn) -- who ought to know something about the ravages of this government’s health care policy with respect to his own community -- when I look at the report of the inspectors and see their references as to how government cutbacks and insufficient funding for proper levels of nursing care have potentially impacted upon --
Mr. Conway: I will tell the minister. They say, “Understaffing, poor physical facilities and inadequate equipment may also be contributory factors.” I am very likely to believe the reference, however oblique it might be.
Mr. Conway: What about inadequate equipment? We sat in the select committee and listened ad nauseam to very distinguished members of the community who were telling us just what was happening as a result of the government’s formula for new plant and equipment in this very city. I heard representatives from outstanding teaching hospitals talk about the pressures under which they were finding themselves and how it was that as a result of this government’s underfunding they were not able to renew plant and equipment to the levels that were expected and suggested.
Mr. Conway: I want to say, like the member for Bellwoods (Mr. McClellan), that the Minister of Health must bear a very significant part of the responsibility for the debacle reported in this particular inspector’s report, for the years of constant underfunding that have led to these kinds of conditions. I am particularly anxious to put that on the record, because certainly it runs throughout this particular report.
Mr. Conway: My anxiety does show; indeed it does. We saw the promise of 1975-76. Anybody who went through the Doctors Hospital situation will agree with me that when this government set out to undertake health care planning initiatives in the 1970s they had only one main objective, and that was to reduce their overall budgetary expenditures. Constraint and restraint were the order of the day.
I want to take this opportunity to say this report is the product of years of insensitive underfunding by the Minister of Health, the very man who stood here in his place but three years ago, when inflation was running at something in the order of nine per cent, and told the people at the Toronto East General and Orthopaedic Hospital and others that they would get 4.5 per cent. Now they have this incredibly cynical budgetary process where they underfund knowingly --
Mr. Conway: Indeed we are, Mr. Speaker. It is my contention that what has led us to this radical piece of legislation is the significant and insensitive underfunding by this government, through the Ministry of Health, of the public hospital sector.
I listened with great interest to the Minister of Health both today and in his statement of June 15. I want to read a few paragraphs from the minister’s statement to the House on Monday, June 15. I am going to read two paragraphs of that particular statement:
“Although the report has just been received, members of the committee were sufficiently concerned with what they were finding to alert both the administration of the hospital and my senior staff to specific issues so that critical problems could be addressed in an ongoing way. At the same time, they shared with the ministry the limitation of the Public Hospitals Act to deal decisively with inadequacies such as those found at East General. In these cases, the government must be able to intervene in the interests of the broader public whom we all serve.
“The change we are recommending to the legislation is based on provisions that most other provinces already have to deal with problems of this same sort.” I found it very interesting that the impression is being created that there are not extant in the legislation as it now reads, opportunities for the government to deal with the broader public interest. I know the minister has been petitioned by the very distinguished leadership of the Ontario Hospital Association, the equally distinguished leadership of the Ontario Medical Association, and others about their reading of what might be already in place to deal with the broader public interest as it is defined.
I wonder why we have not heard anything from either the minister or his parliamentary assistant about section 9(11), of the Public Hospitals Act which says, and I quote: “Notwithstanding the Corporations Act, upon the recommendation of the minister, the Lieutenant Governor in Council may appoint one or more provincial hospital representatives to the board of a hospital for a term of office of not more than three years and such provincial hospital representatives shall have all the rights and responsibilities of elected directors.”
Again, section 15 reads, “The minister may designate one or more officers of the ministry to be inspectors for the purposes of this act and the regulations.” Looking at the regulations, section 10 reads: “An inspector may administer and enforce this act and the regulations in a hospital; inspect and inquire with respect to the premises, management and operation of a hospital; require the superintendent, a member of the medical staff, or a hospital employee to furnish any information in his possession or under his control, and to make returns, reports and statements in writing, relating to the hospital but only for the purpose of the act and this regulation; examine and audit all hospital books, accounts and records; and investigate and require information from a person in possession of information in respect of any hospital matter or financial condition of a patient.”
It seems to me there are already in the Public Hospitals Act provisions that allow the Minister of Health an opportunity to intervene in the broader public interest, if that is his determination. I wonder why we have not heard from the member for Don Mills, the Minister of Health, why those provisions already in the act are so hopelessly unable to deal with the problems at hand. The impression has been left that we have a serious problem at East General, and friends, we have no choice, the only choice we have is Bill 113.
I have a feeling that the minister is already thinking about the speech he might give if members of the opposition should stand in their places and reject this legislation, which both he and his parliamentary assistant have suggested is fair and reasonable. I can almost imagine how the Minister of Health might go forward in the way of the Minister of Housing (Mr. Bennett), talking about how the obstructionist opposition was prepared to endorse the status quo at East General and how Bill 113 is the only fair and reasonable response to those problems which, surely he will say, all reasonable, concerned and conscientious members of the community will want resolved.
If it is the case -- and I have not yet heard from the Minister of Health, the member for Nipissing (Mr. Harris), the member for Sudbury (Mr. Gordon) or others how the provisions in the Public Hospitals Act I just cited are wholly inadequate to deal with the problem. It may be they are, but I want to hear from the minister -- who nods his head in the affirmative, suggesting they are inadequate -- how they are so inadequate. I am prepared to listen to that argument. Assuming he has a compelling argument, then the question remains: Why do we need an omnibus bill to deal with the specific, if serious and immediate, problem at Toronto East General?
On first principles, it is clear to me at least that the specific problem at that hospital ought to require a specific legislative redress. I endorse wholeheartedly what has been said by the members for London North (Mr. Van Horne) and Bellwoods when they strongly recommended to the minister that he draw back from the radicalism of Bill 113 and make the bill specific to that hospital, at least until such time as he and his ministry, or a commission of inquiry with a mandate to inquire into the state of affairs in our public hospital sector or some other group, shows cause as to how and why we need this kind of omnibus legislation.
If they can do this, it might well be we would send Messrs. Clark, Wadsworth and Blewett out with a mandate to generalize their concern for all public hospitals. They might report back and give us the kind of information that would entirely justify the minister’s point in Bill 113. But it is absolutely wrong for the minister to proceed with this kind of omnibus general legislation on the basis of a specific problem at a specific hospital.
Some of us will also recall an article which appeared in a national newspaper about a week ago indicating, according to one of the commissioners, Dr. Wadsworth, that the bill was in the mill a long time before this report was finalized. How I can imagine that.
I have a suspicion that maybe even before the current Minister of Health there were circumstances whereby, well before 1978 when he took over the ministry, Bill 113 was sitting in the minister’s top drawer -- whoever the minister involved might have been; the current member for Muskoka (Mr. F. S. Miller), Mr. Potter or Mr. Lawrence -- just waiting for the appropriate time.
A minority government never provided the appropriate environment for this kind of Draconian measure. The moment a majority government returns and a report on a specific hospital is brought forward, we get Bill 113.
I had to believe that when I saw those comments in the Globe and Mail the other day about how the bill seemed to have been ready well in advance of the report being written and there was a feeling this legislation was all set and ready to go.
I have listened to both the Minister of Health and his parliamentary assistant say, and I know the member for Bellwoods and others heard them repeat: “We want to put on the record now that while this is a generalized approach to a specific problem, we want to assure all the members, from Carleton East through to St. George, that it is our firm belief it will be a very rare exception as opposed to a general rule. We do not expect this legislation to have to be applied often.”
I have to say to my friends the members for Don Mills and Sudbury that if they are to be believed in those remarks they should be as good as their commitment, have the presence of mind to acknowledge the likely rarity of this sordid intervention and make their intervention specific on individual case studies with individual bills.
I do not know how, on the one hand, they can say they expect the number of times this amendment under Bill 113 will have to be applied to be rare almost to the point of nonexistence and, on the other hand, justify so repugnant a principle as is contained within it now in the absence of any evidence beyond this report and the Laurentian Hospital report of some five years ago.
Those are the only two hospital reports I heard cited. If the minister has more evidence, he must bring it forward and then we will have an opportunity to see just how many cases there might be. I have to wonder if there are other cases because it seems to me every additional case that is found is another nail in the coffin of mismanagement of the public hospital sector as a result of their underfunding in this province. If they want general legislation, they should produce the evidence to indicate that it is necessary. As long as they come forward with a specific report about a specific hospital and say the legislation will be rarely implemented, how dare they insult our intelligence by asking us to endorse this kind of radical intervention?
Mr. Conway: -- even though many have not spoken -- that it represents an attack on the volunteer sector, particularly those hundreds, if not thousands, of Ontarians who serve in a volunteer capacity on boards of directors in Algoma-Manitoulin, in Mount Forest, in Queensway-Carleton and in a lot of other very fine institutions. I know the very distinguished member for Carleton (Mr. Mitchell) would agree with me when I say that the people who serve on the board of Queensway-Carleton are very fine distinguished members of the community, whom his friend and colleague the Minister of Health has abused in the most direct way with this attack on their standing. How anybody, serving on a public hospital board, would continue with this kind of trusteeship hanging over their heads, is to me quite incomprehensible.
If I were at home in Pembroke, sitting on the board at the Pembroke Civic or General, I would resign as a matter of principle and as a matter of honour if this bill passed. I feel it quite seriously and I mean this most seriously: under the conditions of this legislation I would resign.
I want to reopen the opportunity, because it may be there; the minister may have an awful lot more he wants to tell us. I am prepared in all good conscience to listen. If he has the evidence, let him bring it forward and I will sit until it is all disposed of. I like to believe that I am not known for participating in unfair hearings around this place. If he has a case to be made, then I am most anxious to hear it. I am sure hospital board members in Little Current and in Brockville and in North Bay would agree with me that if there is a widespread problem, let it be brought forward and we must deal with it. In the absence of that evidence, how can he expect me, as a member of a board, to stand in my place and allow this trusteeship to be foisted over my head.
Mr. Conway: The member for Beaches-Woodbine reminds me that I promised to be rather succinct, and I am certainly anxious to do so, but I must say that when I heard the minister days ago introduce his bill and his statement, I was fully expecting to pick up the bill and find it really a matter of housekeeping that we could get on with in the space of very little time.
When I read it I found that this was not at all a bill for Toronto East General; and then I started to get calls from people in the know, people on those hospital boards and in the medical community and other health care people and they all had the very same impression, so I felt it just wasn’t my own perhaps cynical, sinister, naysaying oppositionist bent of mind, and there were a lot of other people out there who felt that this was a serious intervention. Let me, just for the record, quote from an editorial in a very distinguished daily paper in the province, the St. Catharines Standard, from Thursday, June 18. I want this to be read carefully for my friends on the government benches.
I do not really see this as a party question, but as a serious matter for our public hospital sector. I want my friends opposite to listen to what the St. Catharines Standard has to say. The last time I checked this was one of the most illustrious supporters editorially of the government of Ontario and the party that runs it that is to be found anywhere in this great province.
Headlined “Unneeded and Dangerous,” the editorial in the St. Catharines Standard, Thursday, June 18, 1981, says: “It will be a dangerous move if the Ontario government empowers itself to move in on any hospital any time it chooses, to take charge when it deems such control to be, as the vague phrase puts it, in the best interests of the public. The legislation introduced Monday and expected to be passed later this month, is to be used against Toronto East General and Orthopaedic Hospital, Health Minister Dennis Timbrell said.
“Despite Mr. Timbrell’s assurance that the legislation would be used very, very infrequently, we wonder. To rely on the government’s wise, paternal concern in determining the best interest of the public, affords no guarantee. It appears there is no right of appeal.
“Such an autocratic move against a private business would likely provoke public outcry. Of course, the government has the right, even the responsibility to ensure that hospitals are properly run and that the $8 million a day for health care across the province is well spent.
“But why this extraordinary new measure? The government already has all the power it needs. If there is a suspicion that a hospital is badly run the health ministry can send in inspectors, cut funds and restrict activities. Indeed, considering these powers, how did the Toronto East General get into such bad shape?”
Let me say I agree with this editorial to this degree: This is an extraordinary radical piece of legislation, which the evidence in front of us does not warrant. It is incumbent upon the Minister of Health to produce the evidence to get that general mandate for this kind of omnibus legislation.
I believe there is a firmly developed and firmly held view within the Ministry of Health -- the senior mandarins nicely arrayed across the pine panels under the press gallery. I happen to believe that this bill represents a well thought out effort by the central government at Queen’s Park to get a major new power of intervention for direct budgetary control of the public hospital sector in this province.
I think that is what the principle of Bill 113 is really intended to get at. This is the perception in the community as well -- that it is just another effort by the Hepburn Block to spread its fiscally and financially sensitive tentacles out into the communities, whether they be Brampton, Brantford, Kenora, Timmins, or Toronto East General, and to gather control of those institutions so that the restraint ethic, the constraint obsession that has so often hounded, and on occasion nearly ruined the putative Premier from Don Mills, will in fact become the order of the day.
Mr. Conway: How many times, Mr. Speaker, have I heard the super secretary for social development, the Minister of Education (Miss Stephenson), the Minister of Environment (Mr. Norton), yes, even the very distinguished first minister, talk to us about the reverential attitude they hold towards the voluntary sector in this province? Sometimes some of us think the Minister of Health plans to do an awful lot in the future on the basis and on the strength of his well-developed connections with the voluntary sector that he is so anxious to abuse in this particular bill.
I find it, in this respect, a bill that is contradictory and hypocritical. I know that members of this government and others close to the government have drawn to this minister’s attention just how wrong and wrong-headed Bill 113 is. Certainly, I want to say I find it as offensive and as radical a piece of legislation as I have seen in five and a half years here. I will resist it with perhaps more enthusiasm than the lateness of the session would otherwise require or demand or invite.
In conclusion, if the minister has the evidence, if he can produce a compelling case for me and other members who are genuinely concerned about why an omnibus response to a specific problem at a Toronto hospital is needed, then we are quite prepared to give him a full and fair hearing. But for him to proceed otherwise in an arrogant, authoritarian and almost groundless fashion is, I submit, an abuse of this House and something that will invite a reaction that I do not think will provide effective redress for the serious, specific problem at the Toronto East General.
This bill is another of those bills being brought in during this session as an indication of what the members opposite appear to think majority government is all about. It is legislation transferring power from the Legislature into the hands of the executive council. It is not unique. We have had several other bills doing the same thing, by increasing the power of regulation and the power of the cabinet. It is legislation dealing the Legislature out of policy making in this field.
This kind of legislation, once it is in, is very difficult to change, because none of the decisions which will be made under it come back to the House. It is legislation which, in my opinion, is on the road to dictatorship, and it is the role of the opposition to expose it to the public, to let it know what is actually happening in this kind of legislation and, if possible, to limit the power of such legislation by the power of public opinion. But the government, of course, is aware of what it is doing and is trying to restrict the role of the opposition in this way by slipping in such aggrandizement of its powers at the end of the spring session, insisting that it must be passed before the spring session is over, giving no opportunity for public hearings or for referring it out to a committee.
I think the public should be aware that this kind of legislation is not the kind we should be expecting from a majority government; that the Legislature is here to decide policy and to put limits on the power of the executive council.
This bill has a special genesis in the allegations of mismanagement and mistakes that were made about the Toronto East General Hospital. I have a very special interest in it because of the fact that a majority of my constituents consider the Toronto East General Hospital as their principal hospital. A large number of the minister’s constituents also use this hospital.
In the past two or three years I have heard a great many complaints about the situation at the hospital. I have heard about the jammed emergency department, the bed shortage, the unopened beds in the new wing because of a nursing shortage. I have heard about the deterioration in morale and in patient care. I have heard about the deterioration in the quality of meals.
I know that this deterioration stems from the lack of budget funding by the ministry and from the fact that the staff has been reduced below the level where adequate patient care can be given and is both overworked and grossly underpaid -- to the extent that some of the staff took the unusual step of going on strike illegally to try to alert the public to the fact that they were grossly underpaid, falling behind in the cost of living and had no recourse such as most other employees have to rectify this through collective bargaining procedures with the full right to strike.
I even decided that I should find out whether the complaints were justified. I made an appointment with the administrator of the hospital and the medical director in February and spent a considerable time with them. At the end of the interview I understood their problems in greater depth, but I realized that most of them stemmed from the lack of funding and lack of policies of the Ministry of Health itself at the provincial level.
The report that we have received from the three members of the inquiry does confirm most of the complaints I have heard. It is an alarming report. It might have been even more comprehensive if the inquiry commissioners had acceded to my request that the hearings should be open to the public and that there should be an opportunity to cross-examine some of the people who appeared before them.
I will say that the inquiry did listen to anybody who either telephoned them or wrote to them, and they did make it clear that they were willing to hear from anybody. But that is not the same as public hearings in that the public does not know what other people are saying and does not have the opportunity to question some of the people who are appearing.
The report certainly identified the problems that have been mentioned by all the speakers and that I have mentioned too, namely, the overcrowding of the emergency ward; the bed shortage, which led to the actual closing of the emergency ward to new calls or new patients being brought in on certain nights; the fact that a fifth of the beds are occupied by chronic care patients who should be in other facilities, though there is no place for them to go; the fact that the hospital lacks an adequate intensive care unit and cardiac unit for very ill patients who come in through the emergency ward; the fact that there is understaffing because of a nursing shortage; the fact that some beds have not been able to open; the fact that there is low morale; and the fact that there have been mistakes.
However, the inquiry report does not identify the real culprit for these conditions. If one looks at the inspectors’ terms of reference, one can understand why they did not. Their terms of reference were limited. They were asked to inquire into the allegations made in the media about the quality of medical care. They were asked to consider the policy of the hospital on the release of medical information and to review any relevant administrative practices or procedures.
That is all. They were not asked to say whether the hospital had been underfunded or understaffed as a result of the ministry’s grants being below the inflation rate. They were not asked to consider why there was a nursing shortage or, if there was one, who was responsible.
But we know the situation at the Toronto East General Hospital stems mainly from the policies of this government. The 130 beds for chronic care have not been emptied so they can be used for active treatment. There is no adequate place in the east end and no definite plans to get those 130 beds emptied. There are no capital funds for streamlining and reorganizing the emergency service, one of the busiest in the whole province. It needs spinoff facilities for some of the crisis care cases that come in, and it needs a new intensive care unit.
They are not able to keep equipment up to date. They have no computerized axial tomography scanner because of lack of funds. The nursing shortage, we know, can be laid at the door of the Ministry of Colleges and Universities, which cut back on nursing training in the community colleges a while ago because it thought there was a surplus. Its forecasting was very bad and we now have a serious shortage.
We know the bed shortage stems from unrealistic bed targets set for a busy hospital of this type, because 50 per cent of its patients are over 65, which means in many cases they have multi-illnesses; they need more care than the average patient under that age.
There is a high maternity rate in the hospital, something over seven babies a day. There is a special orthopaedic section. There is a crisis and drug centre. All these require more, not fewer, beds. These targets set by the minister are completely unrealistic. There is also the question of cutbacks in patients’ service and in food because budgets have been below the inflation rate.
Finally, the shortcomings of the management in the hospital stem from the ministry’s failure to deal with the whole question of how hospital boards should be constituted and monitored. We have the situation of public hospitals being run by private self-perpetuating boards, often chosen on a very undemocratic basis.
For example, in the Toronto East General Hospital there are 171 people in the voting category who are able to vote for the board, but to be able to vote one has to ante up $100. How many of the ordinary patients in that hospital or their families can ante up $100 to vote on the hospital board?
Even more undemocratic is the fact that if one can ante up 20 times $100, one gets 20 votes. Whatever number of $100 up to 20, one gets that number of votes. As a result, for the 171 members of the corporation there were 911 votes on the choice of the board of directors, but almost 800 of those votes were cast by 101 corporations that were able to ante up certain funds for the corporation.
About three years ago, in a green paper on health delivery, the New Democratic Party outlined a possible alternative model for the administration and delivery of hospital services. Included in that paper was a suggestion for hospital boards. We felt that all health care delivery should be by district and community health and social service boards, which would combine all the services of that nature and would involve direct user and worker participation on those boards and would cause the abolition of the self-perpetuating hospital boards. Two thirds of the community board would be elected from the community and one third from health workers. This is the sort of model the minister should be looking at as a possible alternative.
Certainly, the report indicates that the self- perpetuating board at the Toronto East General Hospital was not delivering the best kind of administration. In fact, when we have a board that does not advertise when its meetings are held and whether they are open, the public has no opportunity for input. When a situation like that occurs, we are bound to have charges of nepotism, conflict of interest and such things as the inquiry found in some cases.
I recognize that a great many people who serve on hospital boards throughout this province are very dedicated people who often give their time as a community service with little or no remuneration. However, when the system under which they work is closed, the public has no way of knowing how they are handling their stewardship and they have no means of replacing them if they think they are not handling them adequately.
I think the minister should bear most of the blame for the situation at the Toronto East General Hospital. I think he should be condemned for letting the situation go on for so long. He should be condemned for letting so many of his constituents suffer the trauma of spending several days in a 10-bed observation area before beds could be found for them in the active treatment units of the hospital. The minister may say he lacked the authority to intervene, but presumably he did not lack the authority to correct the conditions I have mentioned.
The alarming items in the report of the inquiry and the serious state the ministry has allowed to develop at the Toronto East General Hospital are such that I believe there is justification at this time for putting a government administrator in that hospital until some of the problems are solved. However, even a super administrator will not be able to solve them unless the ministry itself acts in many of the areas I have mentioned which are preventing the hospital from solving its problems.
I accept that as a necessity at this time, but I do not accept the principle that the minister should have power to take over any hospital on his own assessment of the situation. It seems to me that under this legislation he could possibly close it down, because the administrator has the power to do anything the board of the hospital can do. Presumably a hospital can wind itself up.
In addition, if we do appoint an administrator just for this hospital, there should be limits on the secrecy in which he can operate. Any reports that the minister requests from him should be open to the public, and there should be an opportunity for public monitoring and input on his operation and on the remedies he proposes.
For the reason that we do not think this kind of general and sweeping legislation should be permitted, we are going to oppose the bill. It is dangerous legislation, giving the executive council far too much power over every hospital in this province. We feel very strongly that this is the kind of legislation the public must be aware is a danger to their freedoms and they must put pressure on the minister to withdraw it and bring in a bill that will solve the one problem we are facing at the moment and not give this kind of sweeping power to the minister.
Hon. Mr. Timbrell: Mr. Speaker, in the few minutes that remain I want to respond to some of the points raised by the members opposite. Let me say at the outset that I recognize how intensely some people hold the views they do about this legislation.
Hon. Mr. Timbrell: It was with those views and concerns in mind, and recognizing the concerns for local autonomy about which I have some equally strong feelings, that I indicated when we get to committee certain amendments will be put forward that will maintain that balance.
It strikes me as somewhat ironic that in all the time I have been minister I have heard repeatedly from across the floor and other quarters statements and various speeches that attempt to attribute to me and to the Ministry of Health all the ills and all the problems of the health care system, at no point ever acknowledging that the minister or the ministry might do something right.
Hon. Mr. Timbrell: I am observing the tone and contents of the remarks from over there from time to time. They want to heap that total accountability on the minister and the ministry, but they do not want to give the minister and the ministry, when there are extraordinary circumstances --
Hon. Mr. Timbrell: Let me come to that, Mr. Speaker. It was suggested by the former Health critic of the Liberal Party that all one has to do is stack the board. That is as good as the BC system, which we examined and rejected, which is to simply dissolve the board --
Hon. Mr. Timbrell: I do not think we could have put together a more impartial, capable group of people than the three we did to examine the problems at the East General. In their report and, a few days before the report was delivered, in the verbal briefing I had from the chairman, based on whose advice and only after whose advice this bill was drawn, they highlighted for me not only problems there but also the fact that the balance is not complete; that, as in the case of municipalities, there should be the authority to go further and to assist in exceptional instances and circumstances.
With respect, I submit that a number of people, and perhaps some opposite, are looking at this authority in a punitive sense. It is submitted to this House for consideration with a view to correcting problems, not to punishing. I submit that it is an inconsistency to demand total accountability of the ministry and yet not to give the ministry the authority in the legislation --
There were a number of other points I wanted to comment on. I guess the most significant is that, when I had my verbal briefing prior to the completion of the written report, the most significant question I put to the chairman of the review was, “Can this hospital clean up the mess itself?” He said, “No.” My second question was: “Do you have the authority to assist in cleaning up the mess?” He said, “No.” Thence came the recommendation which, I submit, is a rounding out, a balancing of --
Hon. Mr. Timbrell: Mr. Speaker, the honourable member quoted an editorial from St. Catharines that said something to the effect that any time it chooses the government may do X, Y or Z. The fact is it will not be any time the government chooses. There are a great many safeguards built into the system to ensure that we do not trample on local autonomy, that we do not abuse authority, but to also ensure accountability in the system.
Andrewes, Ashe, Baetz, Barlow, Bennett, Bernier, Brandt, Cousens, Cureatz, Davis, Dean, Drea, Eaton, Elgie, Eves, Fish, Gillies, Gordon, Gregory, Grossman, Harris, Henderson, Hennessy, Hodgson, Johnson, J. M., Jones, Kells, Kerr, Kolyn, Lane, Leluk, MacQuarrie, McCaffrey, McCague, McLean, McMurtry. McNeil, Mitchell;
Norton, Piché, Pope, Ramsay, Robinson, Rotenberg, Runciman, Scrivener, Sheppard, Snow, Stephenson, B. M., Sterling, Stevenson, K. R., Taylor, G. W., Taylor, J. A., Timbrell, Treleaven, Walker, Watson, Welch, Wells, Williams, Wiseman.
Bradley, Breaugh, Breithaupt, Bryden, Charlton, Conway, Cooke, Copps, Cunningham, Di Santo, Eakins, Edighoffer, Epp, Grande, Haggerty, Johnston, R. F., Laughren, MacDonald, Mackenzie, Mancini, Martel, McClellan, McEwen, McGuigan, McKessock, Newman, Nixon;
Mr. Van Horne: Mr. Speaker, aside from the things that happen in this House from time to time in our disagreeing with each other, the fact is that when two or three people speak at one time the acoustics are so lousy that we simply cannot hear in the back rows. I am sorry if I did speak contrary to the minister’s motion, but we simply cannot hear.
Tonight, immediately after the supper recess, we will begin the budget bills still remaining, which are second reading of Bills 73, 78 and 77. That will be followed by second reading of Bills 85 and 67. Tomorrow morning, after question period, we will do all the third readings on the Order Paper, followed by second reading of Bill 92, and then any second readings required of bills that were on the list tonight and not completed. That will be followed by all those bills that are in committee of the whole House as listed on the Order Paper.