My question is to the Premier. Last November, 25 hospital CEOs in northern Ontario wrote a joint letter to your government about the precarious financial situation that they are in. In the letter, they outlined the fact that hospitals in northern Ontario have been directed by your minister to avoid closures of emergency departments, support surgical recovery and avoid reductions of hospital services. At the same time, they are expected to cope with the financial pressures of private agency staffing, the impacts of Bill 124, infrastructure costs and inflation, as well as the discontinuation of the locum incentive program on March 31.

Despite these pressures being communicated to the ministry, northern hospitals have received no funding to support their work, pushing many of our northern hospitals to the brink of having to consider drastic measures to continue to operate. Premier, why has your government ignored the request of northern hospitals and allowed them to reach this crisis point?

Northern hospitals are approaching a crisis that will impact services and will mean emergency closures, services suspended and potentially complete hospital closures. The situation is especially dire in small communities, where they deal with more complex delivery of care, work with fewer resources and are often the end-all and be-all of health care for a very large area.

Northern hospitals are poised for catastrophe. This crisis is real. Premier, these hospitals raised this alarm months ago. What are you waiting for?

It’s always a joy to stand in my place and speak on behalf of the good people of Algoma–Manitoulin, particularly when I have to—not have to—but I’ve always been one to stand in my place in this House and give credit where credit is due, whether it’s from the opposition, whether it’s from government individuals, whether it’s from independent members, community leaders, municipalities. I think that’s a task that we have as representatives of our constituents.

And I want to give a really good, big shout-out to the community of Hornepayne, particularly, the public works manager there, Duane Gaudreau, along with Her Worship Cheryl Fort, Gail Jaremy and Jennifer Hill, who work extremely hard. And what came out of this is their community was challenged with some infrastructure challenges, particularly a very large water leak. And it took them a very long time in order to get someone to actually address and recognize the permits that were required in order to permit them to move ahead with the work. It was well over 30 days that we waited for it. And it’s through their work we managed to get it resolved.

There were some people in the community that had to be relocated. Some of them ended up in hotel rooms. Unfortunately, some of them suffer from big hardships. However, the leadership of this community came to the table and reached out to the Association of Municipalities of Ontario, the Federation of Northern Ontario Municipalities, Rural Ontario Municipal Association, Northwestern Ontario Municipal Association, the Algoma District Municipal Association—all of them, along with FONOM—worked together in order to bring some suggestions to this government and this government acted on it. And I want give credit where credit is due, and again, for their leadership and tenacity for bringing these issues forward and the community of Hornepayne for really taking the lead on this issue and being a champion to getting this legislation brought forward.

And I know, initially, the member—his riding escapes me; the member was a PA at that point in time—from Sarnia–Lambton. I want to give him a shout-out as well for having listened to the community and those individuals who brought that issue forward and bringing it as a PA in order to have the legislation that we have in front of us here today and being an instrument of change as well. So I always give credit where credit is due. Shout-out to you, Hornepayne.

You know what? I want to thank the member for asking that question, because part of the consultation that did happen within the government—there were some strong suggestions that were provided by many of those municipal leaders, and particularly the community of Hornepayne. One of those is to actually “set up a system where local contractors can respond to locate requests”—that was one—“Hydro One to consider completing the locates in house”—instead of contracting it out to other firms.

The other two were, “Ontario One Call to employ a better complaint process, one which elicits results and has a mandatory response time”—because that was one of the issues that we’re having: these extensive waiting periods in order to get the locates done. And the other one, which I thought was really important, is, “Open up a second call centre in the north” to remove the barriers that divide all the requests that are being done.

These were constructive suggestions that were given to the government. It’s nice to see that some of them were implemented and some of them were moved upon. But again, there are very big challenges in northern Ontario. The stress that was being put by the many associations in northern Ontario is, recognize the geographical challenges that we have in northern Ontario by providing us with a second locate office.

Again, I give credit where credit is due. We needed something to change. This is a step. Let’s see if the work that needs to be done now is actually going to materialize positively so that the economies of communities aren’t affected, the complaints of individuals are addressed, people are not put in undue hardship, are not moved out of their homes—

I will be speaking about the Northern Health Travel Grant and its importance to residents, but first, I would like to paint a picture of the realities that hospitals, individuals, organizations and service providers are facing in northern Ontario.

Just recently—actually, this morning, during question period—I put a question to the government in regard to the need for action from this government for funding for northern hospitals. The Ministry of Health has directed northern hospitals to keep services open at any cost and to implement millions of dollars in initiatives without upfront funding. This includes millions of capital and staffing dollars spent on Meditech Expanse that hospitals paid out of their own budgets. Twenty-four hospitals are expecting year-end deficits totalling more than $74 million, which includes $43 million in agency staffing costs. Twelve hospitals are projecting deficits greater than 10%.

Emergency department closures are becoming the norm. Lines of credit are being used in order to meet payroll and responsibilities by hospitals. Hospitals are looking at their providers’ bills and invoices at the end of the month, making a determination as to which ones they’re going to be paying. Cash advances are becoming more increasingly difficult to obtain, because financial institutions are losing trust that the government will get money to hospitals in time.

Speaker, there’s more. I also spoke this morning in regard to the Auditor General’s annual report. The report found that ER wait times remain too long, lack of nursing staff to quickly triage patients leads to longer delays, lack of primary care has created backlogs in ERs. Two hundred unplanned ER closures at 23 hospitals were recorded between 2022 and 2023, largely due to staffing issues. Without locum coverage, this would have expanded to 600 closures. Northern hospitals are increasingly reliant on agency nursing, costing up to three times more for hospitals to deliver services. Numerous patients are waiting for long-term care and home care services, taking up hospital beds. The ministry does not have a strategy for ER closures or for northern Ontario health care issues. The locum incentive program ends on March 31, with nothing coming from this government in regard to the challenges that will present to the hospitals.

There are approximately 10,000 de-rostered patients in Algoma as of last July, in 2023. Recently, another 10,000 are without a family doctor in Sault Ste. Marie. In the Sudbury/Espanola/Manitoulin/Elliot Lake area, 13,000 are without a family doctor. That’s the reality of what we’re facing in many communities across northern Ontario.

Now I want to get back to the importance of what the travel grant does and how it helps people in northern Ontario. Briefly, for background for any of the members—because I was surprised; I’m a little bit lonely in my corner here today, but many of the members were actually not aware of what the Northern Health Travel Grant Program does for northerners. The Northern Health Travel Grant was established in 1980 to aid patients who live in northern Ontario and who must travel for specialized medical treatment or diagnostics. It reimburses patients based on the distance they travel to their appointment and for overnight accommodation.

Doing this is necessary to ensure that people living in northern Ontario can get the care they need without financial barriers in access to health care. It’s necessary because we face different realities in northern Ontario when it comes to health care. Most of our specialized treatment and diagnostic services are in large urban centres. For ridings like mine, where it is almost entirely small, rural communities, patients must travel large distances to get to their appointments. Depending on the time of year, you might have to get to the city your appointment is in the day before to make sure you can get there on time. You travel on northern roads, and our roads close very often due to poor winter road maintenance, or you may have to stay there overnight afterwards.

All these costs add up, so on top of the stress and hardship of your treatment, you must also add the burden of travel and all the associated costs. That makes the Northern Health Travel Grant essential to people in my riding and across northern Ontario. It takes away the added stress of, “How am I going to get to or from my appointments that are hundreds of kilometres away from my home?”

However, my office has been hearing for years that the grant is not keeping up with the cost of travel in northern Ontario. Not only that, the policies and requirements to get the reimbursement are painfully complicated and slow. I want to take a couple of minutes to read into the record some of the words that constituents have shared with me in regard to how the travel grant challenges have affected them.

Roxanne Goulet, who is a nurse on Manitoulin Island, wrote to my office saying, “Living in rural northern Ontario has presented many challenges for our family members across specialized health care and diagnostics. We are required to travel the minimum of three and a half hours, round trip, weather depending, to access necessary medical treatment only available at the larger Sudbury city hospital site.

“In addition to the distance travelled, there are also extensive wait times, parking fees and sometimes overnight accommodation requirements. The increased fuel prices have surpassed any cost benefit the Northern Health Travel Grant Program allows for, leaving me out of pocket. The onerous wait times of three-plus months for the processing of a grant adds to the impact of one’s monthly budget and all other living expenses.”

Here’s another one from Richard and Jane Gulka from Manitouwadge: “Richard required medical treatment at a facility in Mississauga, five days a week for approximately two hours daily, which left him extremely tired and weak for several hours. We submitted a claim for one round trip by automobile, accommodation for the duration of the six weeks and two trips by Uber to Sunnybrook Hospital in Toronto.

“My husband has been dealing with an illness for three years, necessitating diagnosis, treatment and follow-up care out of our community. Richard is physically tired, emotionally drained, and we are both extremely stressed. Our initial submission for a round trip was $863.46 and accommodation of $3,995, and the total reimbursement was $1,413.46. He was denied the outstanding balance because we didn’t fit the program protocol of returning home, 12 hours away, on days of non-treatment.”

Florie Maeck from North Bay: “I live in North Bay, Ontario, and I have to travel to Sudbury every few months to see an ophthalmologist and every three months to see a physiatrist who holds Botox injection clinics for movement disorders. I receive $60 from the Northern Health Travel Grant service for these visits. There have been a couple of visits where I have received nothing, and there is no response from the travel grant agency when you try to address the issue. I must rely on a family member to take me. This grant money does not cover a tank of gas to and from these appointments. We seldom eat. I cannot afford a meal for two of us. Forty-one cents per kilometre does not cut it anymore.”

Marina Verdonk from Sault Ste. Marie: “I had to stay at a hotel for three nights in Toronto, and even at the hotel’s medical rate, the cost was $500. The Northern Health Travel Grant only covers $250. I had to fly last minute to Toronto at a cost of $851.17 and was reimbursed $533 to cover my flight. Meals are not covered in any way, and with the cost of eating out or even ordering in, even one meal can cost you $20 to $30. I’ve even resorted to taking coupons with me to eat at McDonald’s in Toronto. Any taxi, from and to the airport, to the hospital or from the hotel, is not taken into consideration. Since I have to travel every three weeks and it takes about eight weeks to obtain a reimbursement, I’m having difficulties making ends meet.”

The last one that I have here is from Marguerite Collin, from Sudbury: “I appreciate you answering me. I am currently travelling to Barrie for nerve block injections for chronic migraines, upper back pain and neck. I am going to the Simcoe pain clinic because the Sudbury chronic pain clinic is a three-year wait for the same treatment. Originally, my rheumatologist in Barrie referred me there because of the wait times in Sudbury. Because she is not a northern doctor, they denied the travel grant. I got my GP in Sudbury to refer me to the Simcoe plain clinic, so now they are denying me only because the doctor is a GP. I work with the city of Greater Sudbury and most recently had to take a leave of absence due to my stress and migraines of this. I am unsure if I will be able to even travel next week because of the money it’s costing me. My family of five is really suffering financially.”

Speaker, there are endless stories that I could bring to the floor of the Legislature. What I’m asking this government to consider is establishing a table where we can bring individuals and have a discussion and make recommendations in order to improve the Northern Health Travel Grant.

In my supplementary, I will be touching on a group that I just met this afternoon, which I hadn’t heard of. Only just recently, through a CBC article, I’ve heard of Hope Air. I will be talking about them in the additional time that I’m provided.

This is long overdue—long overdue. The last substantive change that has happened to the Northern Health Travel Grant was back in 2017. I think this is something that we can all agree upon: that care, regardless of where you are in this province, should be something that is provided. There should be no barriers to getting individuals to the care that they need. We pride ourselves on the health care system that we have, and we need to share that pride with those that are being affected and those that absolutely need the care that is needed.

So again, I am proud to present this bill here to the floor, and I look forward to the many discussions and points that I look to hear from the government, the opposition and some of my independent colleagues.

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

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

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

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

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

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