Point of order.

Good afternoon, Madam Speaker. I’ll begin by making a confession: It was hard to keep my lunch down while listening to the comments from the member for Hastings–Lennox and Addington. He completely ignored the substance of this legislation, and it was rich hearing those comments from a government that has been forced to walk back nearly every major piece of policy that it has put forward, whether it’s the greenbelt, development charges, urban boundary expansion—and all of that within the context of a government that is so preoccupied with talking about the gravy train that it has become the gravy train, and even that in the midst of an RCMP criminal investigation so dire that it has required the appointment of a special prosecutor.

But now I’d like to talk about something that can actually bring a smile to our faces, and that is Bill 184. I want to acknowledge that Bill 184 is an ambitious and important piece of legislation, and for that I want to acknowledge the hard-working, dynamic and relentless member for Scarborough–Guildwood, who is bringing this forward to represent not just her constituents but hard-working Ontarians province-wide, and even—nay, especially—in rural, remote and northern areas.

I want to touch on a few things that this bill will accomplish, if passed. It enhances integration between bike-share services and public transit, and it does so through fare integration, so that people can take advantage of options that are cheaper, healthier and more environmentally friendly. Along the way, it does this and promotes the uptake of public transit by making it easier for people to get to and from bus and train stations, because that is often the biggest barrier to uptake for public transit.

The bill also does a fabulous job of beginning to address the affordability crisis in housing in Ontario. Specifically, it ensures that at least 20% of housing units on provincial land sold to developers are mandated to be affordable. This is crucial because, historically, valuable land that is near transit lines, such as the space near 8 Dawes Road in Beaches–East York, steps from the Danforth GO and Main subway stations, has been sold under this government without any requirements for affordable housing. This kind of lack of oversight has previously allowed private interests to maximize profits while leaving some of our most vulnerable people in this province behind.

If passed, this bill would ensure that, moving forward, developments—such as those at the West Don Lands, East Harbour, Thorncliffe Park and along the new Ontario Line—incorporate essential affordable housing that benefits all Ontarians and all those people living in those communities. We are in the midst of an affordability crisis, Madam Speaker, and this legislation is a critical step to showing that finally someone in this province is ready to take this seriously.

The bill also seeks to establish mandatory, enhanced maintenance standards for Highways 11, 17 and 69. This will ensure rigorous snow and ice removal within hours of weather events as well as timely pothole repairs. These will not only ensure that we maintain our infrastructure but guarantee the safety and efficiency of our transportation systems.

Now, I have spent many years travelling and working in the north. I have seen the consequences of inadequate highway maintenance. When snow and ice is not removed in time, it puts people at risk in the following ways: It increases the risk of accidents; it slows emergency response times; it prevents people from accessing vital services, such as hospitals and fire departments; and when the road conditions are poor, it cripples transportation and, in particular, trucks that are vital for delivering things important for our economy.

In conclusion, Madam Speaker, Bill 184 addresses critical gaps in our transportation and housing policies. It ensures that our infrastructure serves the economic and social well-being of our province. It secures the livelihood of our communities and it maintains the integrity of our environment.

I urge all members of this House to support this legislation for the future of our great province of Ontario. Thank you for allowing me this opportunity—

Interjections.

It’s a pleasure to rise in the chamber today to speak on an issue of paramount importance to people in Ontario, to patients in Ontario and especially the northern and rural communities in our province.

I speak today, of course, as the member of provincial Parliament for Don Valley East, but also has an emergency and family physician that has worked throughout the province, and in particular, for a large part of my career, in northern, rural and remote Ontario. I can say first-hand, from having helped my patients, helped to navigate them through this process, I can speak to the urgent and pressing need for us to look at how we can improve it, because if we don’t, it will, unfortunately, impact clinical care and patient outcomes.

I want to start by outlining the five principles of medicare: comprehensiveness, universal, portable, publicly administered and accessible. It doesn’t matter if we have the best health care in the world in Toronto or in Ottawa; if you live in Moose Factory and can’t access it, we are not honouring the spirit of the Canada Health Act—frankly, the letter of the law, of the Canada Health Act—until we make sure that health care in our province is accessible.

What we know right now, based upon the Auditor General’s report on northern hospitals just released about two and a half months ago, on December 6, 2023: There is a significant imbalance in health care access between the north and the south. Not only that, the Auditor General identified that that significant imbalance is only expected to accelerate because of worsening staffing shortages. And yet, even going beyond that, the pressing need to address the Northern Health Travel Grant is only more relevant as we face in our province an affordability crisis, as we face a government that has introduced repeated waves of legislation that will centralize a variety of government services, including, under Bill 60, health care services that will drain surgeries and health care access from rural communities into urban communities.

And then, of course—and very relevant to something that just happened—as we see the growing spectre of climate change, that will make it more difficult for people to travel. We just learned a week or two ago that a number of northern communities declared a state of emergency because their ice roads are melting. When I worked in Moose Factory, those ice roads were a vital pipeline for patients to be able to come down to Moose Factory and continue their travel onto other places. For all of these reasons, we can expect that the travel, which is already expensive, will only become more expensive.

The people of our great north are not an afterthought. They have value. They contribute immensely to our history, our culture, our heritage and our province’s prosperity, and they need to be treated as such. When they can’t get access to the health care that they need, this is what happens: They don’t apply for the grants, because they don’t believe that they’re going to get it, and their health suffers. They apply and they’re denied, so their health suffers. Or they apply, they’re denied, and they appeal, and eventually, they’re approved, but in the process, their health suffers. Their health outcomes go down, and it ultimately becomes more expensive for all of us.

What the member from Algoma–Manitoulin has proposed is very fair. There is no reason that anyone could possibly disagree with this. He’s not saying, by some edict, let’s give everyone $10,000 or $100,000—no. He’s saying, let’s strike a committee that will look at the challenges that northern communities and northern patients face right now and look at ways, through those consultations, to improve the Northern Health Travel Grant. For a government that says that it is for the people, there could be no better suggestion for how to improve that health travel grant than by speaking to the people.

We have a grant that is well-intentioned. I can tell you from my own clinical experience working with a large number of patients throughout northern Ontario that the grant isn’t meeting their needs. We have a very reasonable proposal to show the patients of northern Ontario and rural Ontario that they are not an afterthought. I hope everyone can support this.

I’m pleased to rise this afternoon in support of the bill by the member for Niagara Falls. I would like to say at the outset that I cannot imagine a better champion for this cause, because the member unquestionably has a moustache for Movember.

But prostate cancer is not a joke. It’s a really big deal. It is the fourth most common cause of cancer in Canada, and it impacts one in nine men. It kills men, and it cannot be ignored.

I’ll touch briefly on the risk factors because I will come back to them momentarily. Those risk factors include increased age, certain ethnicities like African Americans or people from Black communities, smoking and family history.

In the vast majority of cases, prostate cancer is asymptomatic. Less commonly, men may present with lower urinary tract symptoms—difficulty urinating, blood in their urine—and sometimes it is discovered when, sadly, the cancer is already metastatic; in other words, it has already spread.

This debate is important just for the very fact that it raises awareness about prostate cancer. This discussion is really important, and it is really important that all men have a discussion with their doctor about prostate cancer and their individual risk. So I’m glad that we’re talking about this today.

Now, at the risk of being a little bit too graphic, I will touch on a little bit about how we detect prostate cancer, because ultimately, the decisions that we make will be consequences that men across this province have to face. In order to detect prostate cancer before it develops symptoms, there are two ways: a digital rectal exam which involves a physician taking a gloved finger and inserting it into a man’s rectum to palpate their prostate; the other way is a blood test.

Now, I do want to be clear. There is what we call equipoise and a divergence of opinion about how to screen and test for prostate cancer. The reason is that there isn’t a perfect screening test. In fact, there rarely is a perfect screening test for anything. There are what we call false positives with the PSA test—that is, the blood test. There are also false negatives with the rectal exam. But it is largely accepted that men should have a discussion with their health care provider about their individual risk for prostate cancer and decide together, based on their individual risk and their risk tolerance, about whether they should get a test.

In my own clinical practice, when I’ve had that discussion with male patients, many men have decided that it is the right thing for them to do to get screened for prostate cancer. I know that plays out in clinics across our province. But health care is more difficult to access: Fewer people have access to a trusted family doctor, and those that do may have difficulty seeing them in person. So for those who even have an appetite for getting tested with a digital rectal exam, it may not be possible at all. The PSA test may, by default, be their only option.

Certain marginalized populations are especially vulnerable and have a decreased ability to be able to pay for that test. I mentioned the risk factors for prostate cancer: men who are either from Black communities or African American, who are disproportionately represented in less affluent communities, are the ones who are more likely to have prostate cancer and less likely to be able to afford the test. In my work with Indigenous communities—another community that is going to be less likely to be able to pay for a test—I’ve treated patients who were sodomized. Again, forgive me for being graphic, but they were sodomized. A digital rectal exam is a no-go for those individuals and it would have to be a PSA test.

And so I want to reiterate that we don’t have a perfect test for screening for prostate cancer. We rarely have perfect screening tests. But men should have the choice, based upon their own values and their risk tolerance, which is in compliance with professional recommendations. They should have the opportunity to discuss with their doctor and seek out screening for prostate cancer if they so choose. For many men the best way to do that, they will decide, is with the PSA test. It should be covered so that they can get the care they need.