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.

Mr. Speaker, for the Premier: 60 seconds isn’t enough time to list this government’s failures in health care, but let’s give it a try. What if I told you emergency room wait times are the worst they’ve ever been, and ER closures have become the norm? That’s because we’re losing family doctors faster than we’re gaining them, and thousands of patients are losing primary care overnight.

On top of that, Bill 124 has shattered our workforce for nothing—you sure got that done—and there’s still no health care worker retention plan, so now temporary staffing agencies have stepped in and are burning a hole in our hospitals and long-term-care homes. But the Premier says, “Just let it burn.” As a result, hospital debts are ballooning, and they’re being forced to rely on high-interest loans because this government does not have their back. And now, desperate patients are being forced to turn to private for-profit clinics that are overcharging elderly patients while this government turns a blind eye.

Mr. Speaker, why should this government trust any of the Premier’s promises when all he has to show for his efforts is this long list of health care woes?

The government loves to brag about all the money it spent on health care, but what does it have to show for it? You wouldn’t see me bragging about spending millions of dollars on a car that doesn’t start. This government has created a problem that it cannot fix.

Through you, Mr. Speaker, to all Ontarians: They’re not thinking about your future; they’re thinking about their future. They don’t care about bringing your emergency room wait times down, and they don’t care about emergency room closures. They don’t care about keeping your family doctor or your nurse practitioner. They don’t care about anything unless someone is making a profit, whether it’s temporary nursing agencies, private for-profit clinics, developers drooling over the greenbelt, private companies like Staples, Shoppers Drug Mart and Loblaws. This government will always lead with greed.

Mr. Speaker, when will this government realize they could give the people of Ontario so much more if they would only focus on people, not profits?

None of these things have done anything to keep ERs closed and have ignored entirely the root causes of what we’re facing, because right now patients cannot get access to primary care. They can’t get access to family doctors and family health teams. When they try to get out to nurse practitioners, many of them can only be accessed by paying $400 mandatory subscription fees.

This is about doing things like dropping the appeal of Bill 124 and putting in the work to retain health care workers with proper wages, benefits and mental health supports. This means regulating temporary nursing agencies. It means investing the billions of dollars this government is instead stashing away in contingency funds. We cannot afford to fail on this.

In September, three teens were stabbed at a house party in the middle the night. Rushed to the nearest emergency department, they found that it was closed. In the last month, there was a 10-day period where the emergency department in Chesley, Ontario, was open for only 10 hours.

What does the Minister of Health say to the people Ontario who live with the anxiety of not having an emergency room open in their times of crisis?

As is so typical of this government, there are lots of promises but nothing to back up the words with action. For example, there is a proposal to offer mammograms to women below 50, but there is no funding for that. You cannot perform mammograms unless there is funding for more staff, for more infrastructure, for more technical fees. So I find it audacious, preposterous, that this government can grandstand as though they’re actually going to help patients, when they say the words but don’t back it up with the dollars or the action to actually deliver on their promises. That is a very consistent pattern, time and time again.

But what’s even more outrageous is the fact that we have an opioid crisis, an addiction crisis across our province. We have a mental health road map that has been bandied about for the last five years that needs to see massive and sustained improvements and increases, especially increases in funding, especially as it relates to delivering those services in rural and remote parts of Ontario.

So I want to reiterate: There is this road map to mental health or mental wellness, but so much more needs to be done. I look forward to working with the Associate Minister of Mental Health and Addictions to push the government to address that in greater detail.

My friends in the government across, the members across: I would suggest, do a little bit of self-reflection and have some self-awareness before choosing your words. This is preposterous.

Good morning, Speaker. Thank you for acknowledging me. I’d like to welcome to the chamber today the Medical Laboratory Professionals’ Association of Ontario, as well as the Ontario Association of Medical Radiation Sciences, and thank them all for their incredible services to patients and health care in our province

That’s not what stakeholder after stakeholder after stakeholder said during public hearings. What this bill actually allows is the simplest surgeries to be done for the highest price. They will be funded by our tax dollars—and it is the shareholders who will be laughing all the way to the bank. Meanwhile, patients will be left with lighter wallets since this government refused to put protections against upselling and up-charging in place. They refused. I find that strange, when the Premier insists patients will never pay with their credit card even though they already are.

So the bottom line is, this government isn’t about protecting patients; they aren’t about protecting our public health care system. All they are doing is protecting shareholders. They’re letting private for-profit companies have unfettered access to the demand that exists in our health care system.

So, Mr. Speaker, why won’t the Premier recognize the need to clear the surgical backlog and protect patients, as well as our public health care system, at the same time?

On behalf of patients across Ontario, I wish to welcome Natalie Mehra from the Ontario Health Coalition, Michael Hurley from the Canadian Union of Public Employees, Erin Ariss from the Ontario Nurses’ Association—and a special welcome to every single person in this chamber here today who is showing their opposition to Bill 60.

The bill proclaims the third week of June in each year as Health Professionals’ Week. It honours the service and sacrifice of all health care workers, including the contributions of over 200 health professionals who work in direct patient contact and also behind the scenes to ensure patients in Ontario get the exceptional care they need.

“To the Legislative Assembly of Ontario:

“Whereas a basic principle of health care is that it must be patient-centred instead of profit-centred; and

“Whereas the introduction of profit in health care has consistently led to poorer health outcomes in Canada and around the world; and

“Whereas the introduction of profits and privatized health care creates a division between those who can afford it and those who cannot;

“We, the undersigned, call upon the Legislative Assembly of Ontario to enact the following measures:

“(1) Recommit to honouring and defending the Canada Health Act;

“(2) Guarantee that health care in Ontario will not be privatized;

“(3) Ensure that in every case, health care system decisions are patient-centred and not profit-centred;

“(4) Commit to solve the challenges in our health care system through public and not-for-profit initiatives.”

I support this petition. I am signing it and am pleased to hand it to page Yusuf.

This summer, Ontarians told us that the health care system was in crisis, but the Premier and Minister of Health were nowhere to be found for six weeks.

Then, in August, the CEO of Ontario Health went on record admitting that the health care system was under tremendous strain.

Despite this, we kept hearing from the government that patients were getting care in the time that they needed even though they weren’t. This month, I discovered leaked Ontario Health data revealing that for the month of August, ER wait times, lengths of stay, ambulance off-load times, and time to in-patient bed were the worst that they have ever been, going all the way back to 2008. The health care system took a nosedive in the last 12 months alone.

Yesterday, the member for Eglinton–Lawrence quoted Dr. Ronald Cohn to justify her position that our health care system has adequate capacity, yet Dr. Cohn’s quote was incomplete. In the same article she referenced, he conceded that, faced with mounting patient volumes, “I am worried about how much more we can do.”

Will the Minister of Health explain why, in each of these examples, the government’s position has disagreed with the positions of their own sources?

The plan that she references, a Plan to Stay Open, is the most unambitiously titled plan, I think, in history. It’s a plan to stay open; it’s not a plan to deliver great patient care. It’s a plan to merely stay open, and it’s already failing on that mandate.

Anyway, I would like to expand on the Ontario Health data I revealed on October 12, which for the first time revealed the incredibly bleak and deteriorating state of our health care system. The people of Ontario used to get weekly updates from the Chief Medical Officer of Health. They used to have transparent access to Ontario’s science table.

Now the only way to get real data portraying our health care system is to get leaked information from the courage of people who are willing to share documents. I’m hearing now from health care workers that there is deafening silence from the Ministry of Health, and also that this weekend there were multiple GTA emergency departments on redirect because they were full.

Will the Minister of Health or her designate explain why this government refuses to be accountable to the people of Ontario about the state of our health care system?

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

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

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

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

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

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

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

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

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

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

Mr. Speaker, Bill 7 is flawed at its core because it violates patient rights. True patient consent must pass three tests: (1) The patient must be capable; (2) they must be fully informed; and (3) they must give their consent voluntarily and freely.

When it comes to transmitting confidential health information and authorizing admission to a long-term-care home, Bill 7 doesn’t even pretend to ask for patient consent. It’s not required. And after all that, if a patient is given space in a faraway, culturally inappropriate long-term-care home, although patients don’t have to say yes, there’s a steep cost to saying no.

To quote the Minister of Long-Term Care on August 24, “Are there instances where the hospital will be charging? Absolutely, if someone refuses to move into a home.”

Will the Minister of Long-Term Care explain why he is choosing to entirely circumvent informed patient consent and instead violate patient autonomy?

Additionally, while I agree that patients need and deserve to be in long-term-care homes, it should be under their own terms and under their own circumstances, not by violating their rights in the process.

You know, this bill is actually so bad, so unethical and so immoral that it actually apologizes for itself. It says, “Despite subsection 3(2), this section ... shall not be interpreted or construed as being inconsistent with the residents’ bill of rights,” even though it does. It fails to pass the three tests of patient consent, it fails to protect patients’ confidential health information and it fails to respect patients’ express wishes.

So I ask again: Will the minister withdraw his bill and instead focus on the root causes of our ALC crisis, such as the mass exodus of health care workers created by Bill 124 in the last four years?

Interjection.

I sincerely appreciate the question from the minister, and I’ll begin by saying as a physician that every member has a right to patient-physician confidentiality. I admire you for acknowledging me publicly, but it is my pleasure to serve both in a political capacity and, of course, if my services are ever required, in a clinical capacity as well.

One of the things that I hope to bring forward as a physician in this Legislature is the fact that I have a unique privilege: When serving in the emergency department, my patients tell me things that they don’t necessarily feel comfortable sharing with other people, because of stigma, because of things that have happened to them in the past. I hope that when I rise in this chamber, I can amplify those voices and tell those stories, and I would humbly ask if you would join me in listening, in helping me to amplify those voices as well, so that we can fight for every single person in this province, not just the ones who can be the most vocal. For me, that is one thing I would hope for.

A close friend of mine shared with me an account just last week of a young woman who had passed out, and so she came to the emergency department. It costs hundreds, if not thousands, of dollars just to register someone in the emergency department, to ensure that it’s adequately staffed and to pay for the services that are provided. Ultimately, after the consultation was complete, the reason that she had passed out was because she hadn’t been able to eat that morning. She couldn’t afford to do it.

Stories like this remind me that up-front investment in things like—sir, you spoke about food insecurity earlier. Investments in things like housing, in food, in making sure that disabled people can access the services that they need, can have profound and massive impacts on their long-term quality of—