Mr. Speaker, today I want to highlight a major concern in my riding of Don Valley East. For so many of my constituents, increased violence in schools, places of worship and public transit has become a reality of daily life, and people are worried about their personal and family safety.

When people fall through the cracks, one of the stops is often public transit. We need to create a safety net that catches them before they get there.

This is about getting vulnerable people the supports that they need. We know that anyone can turn to violence and that anyone can commit a crime, but we also know that building a stronger network of support systems will reduce the risk for everyone.

During the pandemic, as an emergency physician, I saw how rates of child abuse and domestic violence increased because people were stressed to their limits by cost of living, by isolation, by fear, by other things. Worsening access to health care has also meant that people can’t get the mental health and addictions supports that they need.

Mr. Speaker, this government can’t keep pushing public safety onto the municipalities. While there may be some superficial promises in the budget to address social well-being, we all know what a promise from this government is worth. It’s time for this government to stop talking and start delivering.

This means getting serious about tackling hatred in our communities, defending against Islamophobia, anti-Semitism and racism in all its forms. And it means tackling gun violence by getting weapons off the street and especially out of the hands of youth.

This government—this province—has an obligation to keep the people of Ontario safe, and we must hold them to it.

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.