Ontario Hansard - 03-June2004
HEALTH SERVICES / SERVICES DE SANTÉ

Ms Laurie Scott (Haliburton-Victoria-Brock): My question is for the Minister of Health and Long-Term Care. Like most members of the Legislature, I've been hearing from my constituents about your government's budget and the impact it's going to have on them and their families. Although people are concerned with many aspects of the budget, the biggest issue I'm hearing about, and the most vocally, is the decision to delist health care services. This decision will have a direct impact on the residents of my riding, and they have been very clear about their lack of support for this measure. I will ask the minister: Will you please reconsider your decision to delist chiropractic, optometry and physiotherapy services?

Hon George Smitherman (Minister of Health and Long-Term Care): By now I know the member has had a chance to hear, on a few cases, that we recognize the difficulty of this decision, and, frankly, the response is understandable and predictable. But the fact of the matter remains that as a government we face the challenge of adequately funding medically necessary services, and that's what we've done in our budget.

In a statement earlier in the House, this member was very keen to acknowledge, as an example, that her community desires to have community health centres. I'm proud to say that as a result of the prioritization in this budget, there is $111 million for new primary care initiatives, including $14 million targeted specifically at community health centres.

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That is but one of five very specific and distinct examples of the kind of move forward that we're able to make, bringing more care down to the community level. Our family health team proposal provides the opportunity for health care providers to come together and offer an array of services that meet the needs of those populations. That means that if those populations dictate that optometry, physiotherapy or chiropractic are their priorities, they'll be able to work those into their family health teams.

Ms Scott: I appreciate the member's commitment to community health and to increasing the full-time nurses, but I'm asking a question. This is an increased tax. Ordinary people in my riding are going to have to cope with additional fees, and not just the taxes you're increasing under the health care premiums, but also paying for chiropractors.

I've been in a profession --

Hon Greg Sorbara (Minister of Finance): Laurie, that's just not true.

Ms Scott: It is true. I've been in a profession, in nursing, which is very strenuous and rigorous -- it's called a nurse's back. I'm just telling you about having professions.

I have the luxury of having a job that has benefits. Many people in my riding don't have that luxury. They're self-employed business people and farmers. They work in strenuous jobs and they need chiropractic services. They don't have those benefit plans. You've already tried to find ways of increasing hydro rates, the cost of health care premiums, and water regulations in the Nutrient Management Act. Would you please reconsider the delisting of chiropractic, optometry and physiotherapy services?

Hon Mr Smitherman: In her question, the honourable member speaks quite a lot about chiropractic. I think it's important to say that the maximum benefit that the OHIP system has been able to provide for chiropractic is but a subsidy for those people who require those services: a maximum of $150 a year. We look at the aggregate impact of $150 a year and we come up with $100 million.

The result is clear that, faced with other priorities which are desperate for resources -- including primary care; home care, which we all acknowledge is under pressure; long-term care, around which until a few months ago, people were more prone to use the word "crisis"; with respect to the lack of quality and capacity in our public health system; and, seriously, about the lack of funding over time for community mental health and addictions -- we are faced with difficult priorities.

We made choices and we stand by those choices, not because we're proud that we had to make them, but we're proud that we've made the right choices. We're building a health care system that will be to the benefit of the people of Ontario and that will ensure sustainability of medicare for future generations. That's the challenge we face --

The Speaker (Hon Alvin Curling): Thank you. New question.

M. Gilles Bisson (Timmins-Baie James): Ma question est au premier ministre. Demain à Kapuskasing, je vais avoir l'opportunité de rencontrer les oculistes, les physiothérapeutes et les chiropraticiens de Hearst et de Kapuskasing, qui sont très en colère, avec leurs patients, que votre gouvernement ait retiré du formulaire médical l'habilité de payer ces spécialistes. Monsieur le premier ministre, la question est très simple : qu'est-ce qu'on dit demain à ces gens-là faisant affaire avec vos actions? Êtes-vous préparé à renverser la décision?

L'hon. Dalton McGuinty (premier ministre, ministre des Affaires intergouvernementales): Au ministre de la Santé.

Hon George Smitherman (Minister of Health and Long-Term Care): I apologize to the member that I'm unable to answer his question in the language it was asked in. I'm a slow learner on that point.

Interjection.

Hon Mr Smitherman: Marilyn, I gave you a chance to be magnanimous; I knew you couldn't do it.

I want to say, in response to the very serious question by the honourable member, I think I've had a chance by now to outline the position that our government takes. We recognize that these are difficult choices. On the issue of physiotherapy, let me be very, very clear. There is no impact on physiotherapy in the 2004-05 fiscal year, meaning that until March 31, 2005, there will be no change or implication about the way we fund physiotherapy in our province. Hospitals will continue to provide those services where they're currently doing so. We'll be working to re-profile that money in a fashion that assures the most equitable distribution possible of those precious resources.

What does that mean? If you're in a long-term-care facility, your access to physiotherapy is going to be enhanced. If you're receiving supports for home care, we're going to make additional resources available to expand our physiotherapy capacities in home care. For anyone who has a need for physiotherapy, for a medically necessary service related, as an example, to a disability or an illness, we're going to continue to be able to offer support for those people.

What you see is an attempt to make a difficult decision, but making sure that we offer prioritization to those most vulnerable in our society. I'm proud of the efforts that we've made.

M. Bisson: Monsieur le ministre, je ne comprends pas comment votre ministre de la Santé peut être fier d'une décision qui, franchement, n'est pas supportée par les spécialistes et non supportée par la population. La réalité est que la plupart du monde, les gens à Kapuskasing, à Hearst et à travers la province, qui ont besoin de ces services ne sont pas dans des institutions dont vous parlez. C'est du monde qui demeure dans la communauté et qui n'ont pas d'autre choix. S'ils ne sont pas capables de rentrer voir leur spécialiste, payé à travers le système de santé, ils n'auront pas d'option.

Donc, je vous demande très clairement : on se rencontre avec ces gens demain. Ils sont en colère. Ils viennent nous dire avec colère que le problème va être que beaucoup de monde à Kapuskasing, à Hearst et à travers la province va être sans services une fois que cette décision sera mise en place. Je vous demande encore, êtes-vous préparé à renverser votre décision, oui ou non?

Hon Mr Smitherman: I think the honourable member makes points about the challenges we face around health care delivery in remote areas of our province, and especially in northern Ontario. But the fact remains that these services will be enhanced in the areas we've mentioned. I think the member asked at the beginning of his question, in the face of this concern expressed by people, how could we continue with the decision? Frankly speaking, because we're charged with difficult decisions, and this is one of those difficult decisions. The fact of the matter remains that on a priority basis, we've determined that investments in primary care reform to give people access to a doctor in the first place, our additional supports for public health to provide immunization and make sure we're able to deal with any infectious disease outbreak, our capacity to enhance home care overall -- and I could go on -- dictated that we had to make some priorities and make difficult choices. While I recognize that concern is expressed related to those, I think the trade-offs we had to make were the appropriate ones.