Transcript: The Agenda's Week in Review | May 10, 2019

Steve stands in the studio. He's slim, clean-shaven, in his fifties, with short curly brown hair. He's wearing a gray suit, blue shirt, and spotted brown tie.
A wall screen behind him reads "The week in review."

Steve says THE AGENDA THIS WEEK
RE-EVALUATED THE USE OF
PRESCRIPTION ANTI-ANXIETY MEDS
KNOWN AS "BENZOS"; LEARNED ABOUT
ELECTRO-CONVULSIVE THERAPY TO
TREAT DEPRESSION; AND CONSIDERED
WAYS TO IMPROVE PHYSICAL
LITERACY IN YOUNG PEOPLE.
THE AGENDA'S WEEK IN REVIEW
BEGINS EXAMINING CLAIMS FOR AND
AGAINST REDUCTIONS IN MUNICIPAL
TRANSFERS.

Music plays as an animated slate reads "The week in review."

Steve sits with a guest in the studio.
A caption reads "Ontario's cuts to public health."

Steve says SHELDON, CAN WE DO
THIS? CAN WE PUT UP THE PIE
CHARTS HERE?
THIS IS WHAT THE TORONTO HEALTH
2019 BUDGET LOOKS LIKE.

A slate appears on screen, with the title "Toronto public health budget 2019."

Two pie charts appear, depicting the previous funding formula, on the left, and the new one, on the right.

Steve reads data from the slate and says
TWO CHARTS.
FOR PEOPLE LISTENING ON PODCAST,
I'LL DESCRIBE THEM HERE.
THE PIE CHART ON THE LEFT WAS
151 MILLION DOLLARS OF PROVINCIAL
FUNDING AND 43 MILLION DOLLARS OF CITY
OF TORONTO FUNDING.
75-25 IN A RATIO.
THE NEW CHARTS THAT THEY'RE
PUTTING FORWARD SAY THAT THE NEW
FUNDING FORMULA HAS THE
PROVINCIAL LOCATION ESSENTIALLY
CUT IN HALF TO 86 MILLION DOLLARS.
THE 43 MILLION DOLLARS FROM THE CITY
STAYS THE SAME.
OF COURSE IT LEAVES A
65 MILLION DOLLAR UNFUNDED OBLIGATION
COMPARED TO THE LAST TIME.
SO FIRST QUESTION IS: DO YOU
DISPUTE ANY OF THESE NUMBERS?

The caption changes to "Robin Martin. PC MPP, Eglington-Lawrence."
Then, it changes again to "Math dispute."

Robin is in her early sixties, with short wavy blond hair. She's wearing glasses, a green blazer over a black blouse, and a beaded necklace.

She says YES.
I DON'T DISPUTE THE EXISTING
NUMBERS, WHAT EXISTS RIGHT NOW,
THE 151 MILLION DOLLARS AND THE
43 MILLION DOLLARS FROM THE CITY, BUT
THE OTHER NUMBERS THE CITY HAS
COME UP WITH WE HAVE DISPUTED
ALL ALONG, WE DON'T AGREE WITH
THOSE NUMBERS AT ALL.
WE'RE TALKING ABOUT A VERY
MODEST REALIGNMENT OF SERVICES
IN PUBLIC HEALTH, AND THE AMOUNT
OF FUNDING THAT WE WOULD BE
GIVING, FOR EXAMPLE, NEXT YEAR
WOULD BE 114 MILLION DOLLARS.

Now music plays as an animated slate reads "The week in review."

Steve says YOU BELIEVE THAT THE
CORRECT NUMBER IS NOT
86 MILLION DOLLARS FROM THE PROVINCE
BUT 114 MILLION DOLLARS?

Robin says YES.

Steve says ALL RIGHT.
WHICH STILL LEAVES TENS OF
MILLIONS OF DOLLARS OF UNFUNDED
AT THE MOMENT OBLIGATIONS;
RIGHT?

Robin says IT'S 33 MILLION DOLLARS AND WE DON'T
CONSIDER THEM UNFUNDED
OBLIGATIONS.
WE'RE ASKING THE CITY TO LOOK AT
THE PROGRAMS, TO PRIORITIZE, AND
TO MAKE THE BEST CHOICES THEY
CAN.
WE'RE ALL WORKING HARD TO GET
THE MAXIMUM VALUE WE CAN FOR
TAXPAYER DOLLARS, ESPECIALLY...
WELL, IN EVERY AREA, ESPECIALLY
IN HEALTH CARE.
IT'S VERY IMPORTANT.
AND, YEAH, WE BELIEVE THAT THEY
CAN FIND SOME EFFICIENCIES AND
MAYBE SOME THINGS THAT WE CAN DO
BETTER AND DELIVER BETTER.

Steve says WHAT IS THE
JUSTIFICATION FROM GOING FROM A
75-25 COST-SHARING ARRANGEMENT
TO A 50-50 COST-SHARING
ARRANGEMENT?

The caption changes to "Robin Martin, @RobinMartinPC."

Robin says WELL, UNDER THE HEALTH
PROTECTION AND PROMOTION ACT,
MUNICIPALITIES ARE RESPONSIBLE
TO PROVIDE PUBLIC HEALTH
SERVICES.
IN THE PAST, IT WAS A 50-50 COST
SHARE ARRANGEMENT.
MORE RECENTLY, THERE HAS BEEN A
75-25 COST SHARE ARRANGEMENT,
BUT WE FEEL THAT IT MAKES SENSE
TO MAKE IT MORE OF A 50-50
ARRANGEMENT GOING FORWARD.
IT'S AN IMPORTANT THING THAT
MUNICIPALITIES HAVE A SAY IN
WHAT THEY'RE PROVIDING WITH THE
SERVICES, AND WE WANT TO MAKE
SURE THAT EVERYBODY IS LOOKING
AT HOW THEY MAXIMIZE HOW TO
SPEND THOSE HEALTH DOLLARS.

The caption changes to "Connect with us: Twitter: @theagenda; Facebook, agendaconnect@tvo.org, Instagram."

Steve says LET'S USE YOUR
NUMBERS JUST FOR ARGUMENT'S
SAKE, 33 MILLION DOLLARS.
YOU KNOW, IT'S... I MEAN, ON AN
11 BILLION DOLLARS BUDGET IN THE CITY
OF TORONTO, IT'S NOT THAT MUCH
MONEY, BUT IT STILL HAS GOT TO
BE FOUND.

says SO IT'S ACTUALLY LESS THAN
ONE-QUARTER OF ONE PERCENT OF
THE CITY OF TORONTO'S BUDGET,
WHICH IS 13.5 BILLION DOLLARS, I
BELIEVE.
SO IT'S A VERY SMALL AMOUNT OF
MONEY.
IT'S .24.
IT'S TWO-ONE THOUSANDTHS OF THE
BUDGET.
SO IT'S A VERY SMALL AMOUNT OF
MONEY...

Steve says IT'S SOMETHING THEY
DIDN'T THINK THEY HAD TO FIND.

Robin says SURE.
BUT WE KNOW THAT THERE ARE LOTS
OF PLACES IN THE BUDGET OF THE
CITY OF TORONTO, LIKE ALL
GOVERNMENTS, YOU KNOW, WHERE
THERE ARE INEFFICIENCIES.

Now music plays as an animated slate reads "The week in review."

Steve sits with four guests.
A caption on screen reads "The cost of Ontario's municipal funding cuts. Downloading by stealth."

Steve says IS IT YOUR VIEW, DEB
HUTTON, TO YOU FIRST, IS IT YOUR
VIEW THAT THESE CUTS WILL HAVE
NO CONSEQUENCES AT ALL?

The caption changes to "Deb Hutton. QP Briefing."

Deb is in her late forties, with short blond hair. She's wearing a gray blazer and a black blouse.

She says I THINK WHERE JOE AND I AGREE
IS ON THE CUTS OR WHAT HE
CONSIDERS TO BE RETROACTIVE
CUTS.
I DO BELIEVE IF THE PROVINCE
CONTINUES DOWN THAT PATH THAT WE
WILL SEE SOME UNINTENDED
CONSEQUENCES BECAUSE I THINK
IT'S DIFFICULT TO MAKE CHANGES
THAT I THINK CAN BE MADE IF YOU
HAVE TO DO IT IN-HOUSE... SORRY,
IN A YEAR, GIVEN THAT THE BUDGET
HAS ALREADY BEEN PASSED.
THAT BEING SAID, WE HAVE A
DOUBLE-DIGIT DEFICIT IN THIS
PROVINCE.
WE HAVE TO TACKLE THAT OR WE END
UP IN A FISCAL AND ECONOMIC
SITUATION THAT'S NOT PALATABLE
IF WE DON'T.

Steve says WHEN YOU SAY DOUBLE
DIGIT, I THINK YOU ACTUALLY MEAN
A NINE-DIGIT.
YOU'RE TALKING NORTH OF
10 BILLION DOLLARS.

Deb says NORTH OF 10 BILLION DOLLARS.
ABSOLUTELY.
I WAS A LITTLE CONFUSED WHEN YOU
LOOKED AT ME.
I ALSO BELIEVE, BY THE WAY, NOT
JUST THAT WE HAVE TO TACKLE THE
DEFICIT, FOR OBVIOUS REASONS,
BUT WE ACTUALLY HAVE SOME
PROGRAM DEFICITS WITHIN HEALTH
AND EDUCATION THAT IF WE DON'T
TAKE SOME OF THE NON-CORE
EXPENSES AWAY, WE'RE NOT GOING
TO BE ABLE TO KEEP PACE WITH THE
NEEDS THAT WE HAVE TODAY, EVEN
AFTER MANY YEARS OF LIBERAL
OVERSPENDING.
YOU WALK INTO ANY SCHOOL TODAY
AND ANY HOSPITAL, AND WE'RE NOT
AT THE LEVEL OF SERVICE THAT WE
SHOULD BE AT GIVEN THE AMOUNT OF
MONEY THAT WE SPENT.

Steve says JOHN, THIS WAS AN
EXERCISE THAT YOU PERFORMED BACK
IN THE DAY, GOING BACK 25 YEARS
NOW, DURING THE MIKE HARRIS
YEARS.
IS IT POSSIBLE TO CUT SPENDING
THIS MUCH WITHOUT RAMIFICATIONS?

The caption changes to "John Snobelen. Former PC Cabinet Minister."

John is in his seventies, clean-shaven and bald. He's wearing a gray suit, blue shirt, and striped burgundy tie.

He says NO, THERE ARE GOING TO BE
RAMIFICATIONS ANY TIME YOU
WITHDRAW FUNDING OR YOU REDUCE
THE RATE OF GROWTH OF FUNDING,
WHICH IS REALLY WHAT WE'RE
TALKING ABOUT.
BUT THE REAL THREAT ON SOCIAL
SERVICES IN THE PROVINCE OF
ONTARIO IS THE GROWING... THE
FASTEST GROWING EXPENDITURE IN
THE PROVINCIAL GOVERNMENT'S
LINE, AND THAT'S INTEREST ON
DEBT, AND EVERY YEAR YOU PUT OFF
CHANGING... MAKING THOSE BUDGET
CHANGES, EVERY MOMENT THAT YOU
PUT OFF, YOU EXACERBATE THAT
GROWING PART OF THE BUDGET
CALLED INTEREST PAYMENTS, AND
THAT REALLY THREATENS HEALTH
CARE, IT REALLY THREATENS
EDUCATION, REALLY THREATENS
SOCIAL SERVICES.
SO SOMEONE NEEDS TO DO SOMETHING
AND THEY NEED TO DO IT NOW.

The caption changes to "The Week in Review. @theagenda. Tvo.org."

Steve says YOU'RE NOT
REPRESENTING YOUR CITY BUT
REPRESENTING LARGE URBAN
CONGLOMERATIONS ACROSS ONTARIO
AND THE MAYORS THAT REPRESENT
THOSE CITIES.
UP UNTIL NOW, YOUR GROUP HAS
HELD ITS FIRE AGAINST THE FORD
GOVERNMENT, BUT NOT NOW.
HOW COME YOU'VE COME OUT NOW
AGAINST?

The caption changes to "Cam Guthrie. Mayor of Guelph."

Cam is in his late forties, clean-shaven, with short brown hair. He's wearing a dark blue suit, white shirt, and gray plaid tie.

He says WELL, MANY MAYORS WERE
REACHING OUT TO ME, AS THE CHAIR
OF THE LARGE URBAN MAYORS CAUCUS
OF ONTARIO, AND THAT'S 28 MAYORS
THAT HAVE A POPULATION OF
120,000 OR MORE, IT REPRESENTS
67 PERCENT OF THE PROVINCE'S
POPULATION.
AND I WAS GETTING CALLS FROM
SEVERAL OF THE MEMBERS SAYING,
YOU KNOW, WE'RE EXPERIENCING
THESE CUTS THAT ARE IN-YEAR THAT
WERE, AFTER WE'VE ALREADY...
MANY CITIES HAVE ALREADY PASSED
THEIR BUDGETS.
WE WERE NEVER CONSULTED.
WE WERE NEVER GIVEN THE
HEADS-UP.
AND THAT FRUSTRATED A LOT OF
MAYORS.
BECAUSE OUR LETTER THAT WE SENT
LAST WEEK WAS QUITE CLEAR.
WE UNDERSTAND THE DEBT.
WE UNDERSTAND THE DEFICIT.
WE UNDERSTAND THAT THINGS ARE
GOING TO NEED TO BE CHANGED.
BUT THE MAYORS ACROSS THE
PROVINCE ARE UNITED IN OUR VOICE
SAYING WE WANT TO WORK WITH YOU
BUT YOU'RE NOT... YOU KNOW,
YOU'RE NOT ON THAT SIDE OF THE
TABLE AT ALL.
AND SO WE REALLY ARE REACHING
OUT TO THE GOVERNMENT TO SAY:
YOU'VE GOT A WILLING PARTNER, A
RESPECTFUL, AUTHENTIC, WILLING
PARTNER ON THIS SIDE OF THE
TABLE.
WE WANT TO PULL A CHAIR UP FOR
YOU ON THIS SIDE.
GIVE US AT LEAST SOME HEADS-UP
AND SOME BREATHING ROOM AND SOME
RUNWAY TO UNDERSTAND THESE TYPES
OF CUTS AND CHANGES THAT YOU'RE
MAKING, AND THEY CAN CALL IT
MODERNIZATION OR CALL IT
SOMETHING ELSE, BUT REALLY AT
THE END OF THE DAY THEY ARE
STRAIGHT-UP CUTS.
AND IT'S OUR CITIZENS THAT ARE
COMING TO US THAT ARE THE EXACT
SAME CITIZENS AND THE PREMIER
REPRESENTS, ALL ONTARIANS, THAT
WE NEED TO BE ABLE TO FIND THOSE
PROGRAMS AND SERVICES THAT ARE
DEARLY NEEDED BY THEM.

Steve says HOW SURPRISED WERE
YOU THAT THEY MADE THIS
ANNOUNCEMENT IN THE MIDDLE OF A
BUDGET YEAR WHERE YOU GUYS HAVE
ALREADY DONE YOUR BOOKKEEPING,
SO TO SPEAK?

Cam says VERY.
WHAT'S FRUSTRATING TO ME AND
OTHERS, MANY OF THE MPPs THAT
ARE THERE COME FROM A MUNICIPAL
BACKGROUND.
SOME OF THEM WERE COUNCILLORS OR
FORMER MAYORS.
THEY KNOW STRAIGHT UP THAT WE
HAVE A DIFFERENT FISCAL YEAR,
AND WE'VE MADE THAT KNOWN TO
THEM EVEN BEFORE THE BUDGET, AND
INSTEAD OF MAKING... YOU KNOW,
RECOGNIZING THOSE DIFFERENCES
BETWEEN THE MUNICIPAL GOVERNMENT
AND THE PROVINCIAL GOVERNMENT,
THEY STILL WENT AHEAD WITH
THESE.
WE FELT IT WAS DONE IN SORT OF A
STEALTH WAY.

Steve says YOU CALLED IT
UNLOADING BY STEALTH.

The caption changes to "Cam Guthrie. LUMCO."

Cam says IT'S NOT COMING DIRECTLY TO
MUNICIPALITIES, TO MAYORS AND
COUNCILS, AND SAYING THIS IS
WHAT'S GOING ON, IT'S GOING
THROUGH AGENCIES, GOING THROUGH
PUBLIC HEALTH OR GOING THROUGH
CONSERVATION AUTHORITIES OR
GOING THROUGH SOCIAL SERVICE
PROVIDERS, THAT HAVE A DIRECT
RELATIONSHIP WITH
MUNICIPALITIES, ESPECIALLY ON A
FUNDING LEVEL, AND AT THE END OF
THE DAY THOSE CUTS AND SERVICE
CHANGES THAT ARE HAPPENING THERE
DIRECTLY FLOW RIGHT BACK UP TO
THE MUNICIPALITY AND WE'RE LEFT
TO TRY TO FIGURE OUT HOW TO DEAL
WITH THAT.

Steve says LET ME FOLLOW UP
WITH JOE CRESSY HERE.
YOU GARNERED QUITE A NUMBER OF
HEADLINES THE LAST WEEK WHEN YOU
CALLED A NEWS CONFERENCE WITH
THE MINISTER OF HEALTH FOR THE
CITY OF TORONTO AND YOU PUT IT
RIGHT OUT THERE, JOE.
YOU SAID BLUNTLY: PEOPLE ARE
GOING TO DIE BECAUSE OF THESE
CUTBACKS.
ARE YOU STANDING BY THAT TODAY?

The caption changes to "Joe Cressy. Toronto Councillor."

Joe is in his forties, clean-shaven, with short blond hair. He's wearing a gray suit, white shirt and burgundy tie.

He says YOU KNOW, I FIRMLY BELIEVE,
STEVE, THAT YOU SHOULD ONLY YELL
FIRE IF THERE IS A FIRE.
AND WHEN YOU CUT PUBLIC HEALTH,
ACCORDING TO THE ONTARIO'S PAST
DOCTOR, DR. DAVID MOWATT, AND TO
OUR CHIEF MEDICAL OFFICER OF
HEALTH, WHEN YOU CUT PUBLIC
HEALTH, PEOPLE WILL DIE.
IT'S NOT RHETORIC.
IT'S SIMPLY A FACT.
AND HERE'S WHY: WHEN PUBLIC
HEALTH WORKS, IT'S INVISIBLE.
THERE HAS NEVER BEEN A
HEADLINE... A CHILD DOESN'T GET
MENINGITIS OR e-COLI OUTBREAK
AVOIDED. WHEN PUBLIC HEALTH
WORKS, IT PREVENTS DISEASES.

The caption changes to "For more on this story visit: tvo.org/theagenda."

Joe continues AND WHAT IS SO UNFORTUNATE HERE,
WHEN WE TALK ABOUT DEBT AND THE
NEED TO TACKLE IT, IS THAT WHEN
YOU INVEST IN PUBLIC HEALTH,
THAT IS THE FISCALLY RESPONSIBLE
PLACE TO INVEST AND IT ACTUALLY
REDUCES HEALTH CARE COSTS.

Now music plays as an animated slate reads "The week in review."

A guest speaks in the studio.
A caption on screen reads "Re-Evaluating youth sport culture. Socialization versus diversification."

The caption changes to "Sean Fitz-Gerald. The Athletic Toronto."

Sean is in his fifties, clean-shaven and bald. He's wearing glasses and a blue sweater.

He says YOU THINK ABOUT THE
REPETITIVE MOVEMENTS OF HOCKEY,
THINK ABOUT GOALIES, LIKE,
13-YEAR-OLD GOALIES WITH THE
HIPS OF PEOPLE MUCH, MUCH OLDER
THAN 13 YEARS OLD AND GETTING
OUT... YES, THERE'S THE
PHYSIOLOGICAL ASPECT OF IT BUT
THE BURNOUT.
THEY HIT BURNOUT WHEN THEY'RE
TEENAGERS BECAUSE IT'S NOT FUN
ANYMORE.
RAY FERRARO IS WORKING FOR TSN
AND HE SAID AS SOON AS HE WAS
DONE, AS SOON AS HIS TEAM WAS
ELIMINATED FROM THE HOCKEY
PLAYOFFS, THE RULE WAS THEY PUT
THE BAG IN THE DARKEST, COLDEST
CORNER OF THE BASEMENT, PICKED
UP THE BASEBALL MITT AND DIDN'T
GO BACK TO THAT BAG UNTIL
SEPTEMBER.
HOCKEY CANADA IS TRYING TO MOVE
TRYOUTS FROM THE SPRING NOW TO
THE FALL.
SO RIGHT NOW A LOT OF TEAMS TRY
OUT FOR THE SPRING.
WHAT THAT DOES, IT TURNS AROUND,
YOU HAVE SPRING HOCKEY, SUMMER
HOCKEY, AND ALL OF A SUDDEN
YOU'RE BACK IN SEPTEMBER.
THEY'RE TRYING TO MOVE TRYOUTS
TO SEPTEMBER IN A BID TO PUSH
THE SEASON BACK SO THAT WHEN
YOUR SEASON IS DONE IN THE
SPRING, YOU'RE FREE FOR THE
SUMMER.
IN THEORY IT WORKS OUT REALLY WELL.

Steve says HOW MUCH, BETH, OF
THIS DO YOU THINK IS PARENTS
LIVING VICARIOUSLY THROUGH THEIR
KIDS AND HOPING FOR THAT BIG
WAYNE SIMMONDS, MATT DUCHENE
PAYDAY.
DO YOU SEE IT?

The caption changes to "Beth McCharles. Ryerson University Athletics."

Beth is in her forties, with long straight blond hair. She's wearing a black blazer and a green shirt.

She says I SEE IT.
I SEE TWO TYPES OF PARENTS THAT
COME TO MY PRACTICE, AND ONE OF
THEM IS, "PLEASE LET THEM JUST
GO TO THE DANCE AND BE REGULAR
PEOPLE," BECAUSE THEY ARE THAT,
YOU KNOW, INTO THEIR SPORT AND
THAT'S ALL THEY WANT TO DO.
SO THEY COME TO ME AND THEY'RE
LIKE, HE OR SHE NEEDS TO BE MORE
WELL-ROUNDED.
LET'S WORK ON THAT.

The caption changes to "The Week in Review. @theagenda. Tvo.org."

Beth continues ON THE FLIPSIDE, IT IS, THIS IS
ALL THEY DO AND I'VE HAD PARENTS
ASK ME TO HELP THEIR KID COME
BACK FROM CONCUSSION WHEN THE
DOCTOR HAS RECOMMENDED THEY NOT
PLAY EVER AGAIN.
I DECLINED.
IT'S NOT PART OF MY VALUES.
BUT THIS IS WHAT WE'RE WORKING
WITH PARENTS.
AND I DO THINK IT REALLY
HAPPENS.
I THINK THE PARENTS LIVE THROUGH
THEIR CHILDREN AND DON'T REALLY
UNDERSTAND THAT AT THE END OF
THE DAY WE NEED TO DEVELOP
WELL-ROUNDED, KIND PEOPLE FOR
THE NEXT GENERATION.

The caption changes to "Patricia Longmuir. Cheo Research Institute."

Patricia is in her early sixties, with chin-length wavy gray hair and bangs. She's wearing a gray pinstripe blazer.

She says BUT I ALSO THINK IT'S OFTEN
THE KIDS THEMSELVES, AT LEAST I
SEE IT... I SEE PARENTS AS WELL,
BUT I ALSO SEE IT IN THE KIDS
THEMSELVES.
IF YOU HAVE A CHILD WHO
NATURALLY HAS A VERY COMPETITIVE
PERSONALITY, THEN THEY WANT TO
BE ON THE "A" TEAM.
THEY NEVER WANT TO PLAY REC.,
YOU KNOW, WHEN THEY PLAY KING OF
THE CASTLE AT RECESS, THEY HAVE
TO BE AT THE TOP OF THE KING OF
THE CASTLE AND THEY JUST
NATURALLY GO THAT WAY.
SO IF YOU TRY TO PUT THEM INTO
ANOTHER SPORT AND GO TO SWIMMING
LESSONS WHERE THEY'RE THE
SLOWEST KID BECAUSE ALL THEY'VE
DONE IS PLAY HOCKEY, THAT
NATURALLY THEY DON'T LIKE IT AND
THEY'RE VERY RESISTANT TO IT A
LOT.
BUT I THINK IT'S REALLY
IMPORTANT TO KEEP THOSE OPTIONS
OPEN BECAUSE OFTEN KIDS DON'T
GET TO TRY VERY MANY DIFFERENT
TYPES OF PHYSICAL ACTIVITY WHEN
THEY'RE CHILDREN.
YOU KNOW, WE HAVE HOCKEY,
SOCCER, BASEBALL.
BUT THINGS LIKE, YOU KNOW,
GYMNASTICS, RHYTHMIC GYMNASTICS
OR FENCING OR SOME OF THE
OTHER... YOU KNOW, WRESTLING.
SOME OF THE OTHER OLYMPIC SPORTS
WHERE YOU CAN SUCCEED AT A VERY
HIGH LEVEL, DON'T REALLY COME
INTO PLAY FOR YOUNG CHILDREN,
AND SO IF THEY HAVE ONLY TRIED
ONE SPORT, THEN THEY REALLY
DON'T HAVE THE BACKGROUND AND
SKILLS TO MOVE INTO THOSE OTHER
TYPES OF SPORTS ONCE THOSE
OPPORTUNITIES BECOME AVAILABLE.

Beth says WHEN YOU'RE WORKING WITH THAT
NATURAL ATHLETE, THAT THAT'S ALL
THEY WANT TO DO, IS AT 15, WHEN
THEY FAIL FOR THE FIRST TIME...

Patricia says IT'S DEVASTATING.

Beth says IT'S DEVASTATING.
AND THEY DON'T HAVE THE TOOLS OR
RESILIENCE TO PUSH THROUGH AND
IT IS STRESS AND ANXIETY AND
IT'S A HUGE THING FOR THESE KIDS
AT 14 TO GO THROUGH.

Steve says THAT'S WHEN YOU COME
IN, RIGHT?

Beth says I DO COME IN.
BUT IF THEY PLAYED IN THE
PLAYGROUND AND HAD RESILIENCE
AND FAILED MORE THERE AND IN
OTHER SPORTS, THEY'D HAVE MORE
TOOLS.

The caption changes to "Sean Fitz-Gerald. Author, 'Before the lights go out.'"

Sean says THIS IS WHERE THE PARENTING COMES IN.
YOU TALK ABOUT CHOICE AND WHAT
KIDS LIKE TO DO.
MY KIDS LIKE ICE CREAM.
THEY WOULD EAT IT ALL THE TIME.
FRANKLY, SO WOULD I, BUT DON'T
TELL THEM THAT.
STOP WATCHING NOW.
AS A PARENT I CAN SAY YOU CAN
HAVE ICE CREAM BUT YOU HAVE TO
EAT YOUR BRUSSELS SPROUTS, FIBRE
AND ALL THAT.
I HATE TO KEEP BLAMING PARENTS.
THEY HAVE TO DRIVE THE BUS.
THEY HAVE TO UNDERSTAND, THE END
RESULT, WHETHER YOU'RE PLAYING
ELITE SOCCER AND MANGLING YOUR
PINKIE FINGER, THE END RESULT
ISN'T GETTING THE SCHOLARSHIP,
IT'S NOT GOING TO THE NHL.
YOU WIN AS A PARENT IF YOUR
CHILD IS OUT OF UNIVERSITY AND
25 YEARS OLD AND SAYS I'M GOING
TO GO AND PLAY BEER LEAGUE
HOCKEY.

The caption changes to "For more on this story visit: tvo.org/theagenda."

Sean continues THEY PICK UP THE LOVE AND
PHYSICAL LITERACY AND THEY PICK
THAT UP FOR LIFE.
YOU'RE HELPING THEM MAKE HEALTHY
LIFESTYLE CHOICES.
THEY'RE GOING TO BE MORE
PHYSICALLY ACTIVE.
THAT'S THE GOLD MEDAL FOR A PARENT.

Now music plays as an animated slate reads "The week in review."

A caption on screen reads "Rethinking anxiety meds."

Steve says LET'S PUT THIS FACT
FILE UP, EVERYBODY, JUST TO GET
A LITTLE BACKGROUND IN PLACE.
SHELDON, IF YOU WOULD, BRING THE
GRAPHIC UP.
HERE WE GO.

A slate appears on screen, with the title "Benzodiazepine use in Canada."

Steve reads data from the slate and says
A REPORT FROM 2017 SHOWED THAT
10 PERCENT... 10 PERCENT OF THE
GENERAL POPULATION TOOK A BENZO
AT SOME POINT IN THE PAST YEAR.
WOMEN ARE ALMOST TWICE AS LIKELY
TO BE PRESCRIBED THESE DRUGS AS
MEN ARE, AND 51 PERCENT OF THE
FATAL OPIOID OVERDOSES IN THIS
PROVINCE INVOLVED BENZOS.
LET'S FIND OUT MORE, FIRST OF
ALL, ABOUT WHAT THEY ACTUALLY
ARE.
ROGER, DO YOU WANT TO GET US
STARTED?
WHAT ARE BENZOS AND WHAT DO THEY
DO.

The caption changes to "Roger McIntyre. University Health Network."
Then, it changes again to "Too many benzos?"

Roger is in his late forties, clean-shaven, with short curly blond hair. He's wearing a black suit and a white shirt.

He says STEVE, YOU'RE RIGHT.
YOU MENTIONED TRANQUILLIZERS.
THESE WERE FIRST ISOLATED BACK
IN 1955.
THEY HAD BEEN FIRST APPROVED IN
THE EARLY '60s FOR THE
TREATMENT OF REALLY A BROAD SET
OF PURPOSES.
THESE PURPOSES INCLUDE ANXIETY,
INSOMNIA, ALCOHOL WITHDRAWAL,
AND (inaudible) DISORDERS.
THE USE OF THESE MEDICATIONS
OVER THE LAST DECADES HAVE WAXED
AND WANED, PEAKING IN THE MID
'70s, COMING DOWN SLIGHTLY IN
THE '80s AND '90s, AND
OBVIOUSLY INCREASING... IN FACT,
IN THE LAST 15 YEARS, WE'VE SEEN
A SIGNIFICANT INCREASE.
YOU CITED THE PERCENTAGE.
THE TRAJECTORY IS GOING UP AND
UP OF PEOPLE WHO ARE BEING
PRESCRIBED THESE MEDICINES.
SECONDLY, THE NUMBER OF PEOPLE
WHO ARE RECEIVING REPEAT
PRESCRIPTIONS IS GOING UP.
AND THIRDLY, WHICH IS VERY
CONCERNING, IS THE NUMBER OF
PEOPLE BEING PRESCRIBED THE
BENZODIAZEPINE WITH ANOTHER
CONTROLLED SUBSTANCE SUCH AS
OPIOIDS HAS ALSO BEEN
INCREASING.
SO TAKEN TOGETHER, THIS IS WHAT
WE CALL PHARMACO EPIDEMIOLOGY
HAS BEEN VERY CONCERNING TO US.

Steve says HOW ADDICTIVE ARE BENZOS?

The caption changes to "Tamina Eapen. The Centre for Addiction and Mental Health."

Tamina is in her thirties, with long curly black hair. She's wearing a black blazer and a black turtleneck.

She says WE KNOW THAT DOPAMINE IS
INCREASED IN THE BRAIN AFTER THE
PROPERTIES OF BENZODIAZEPINES
CAN TAKE PLACE.
LIKE CANNABIS, LIKE ALCOHOL,
WE'RE DISCOVERING THAT
BENZODIAZEPINES ARE VERY STICKY
IN OUR BRAINS AND IT'S HARD.
I USED THE WORD STICKY.

Steve says THAT DOESN'T FOUND
LIKE A PHARMACOLOGICAL TERM.

Tamina says IT'S PRETTY TECHNICAL.
IT'S A GOOD WAY TO THINK ABOUT IT.
CERTAIN MOLECULES ARE MORE
STICKY THAN OTHERS AND CERTAINLY
BENZODIAZEPINES ARE RIGHT UP
THERE.

Steve says DO YOU THINK THEY'RE
OVERPRESCRIBED?

The caption changes to "Alexander Caudarella. University of Toronto."

Alexander is in his forties, clean-shaven, with short curly brown hair. He's wearing glasses, a blue suit and a white shirt.

He says YEAH.
WE'VE SEEN A LOT OF PEOPLE WHO
HAVE BEEN PREVIOUSLY PRESCRIBED
AND A LOT OF PEOPLE ARE
STRUGGLING TO EITHER TAKE PEOPLE
OFF OF THE MEDICATION OR TO FIND
ALTERNATE TREATMENTS.
THEY MAY BE OVERPRESCRIBED IN A
CERTAIN WAY BUT I THINK THEY'RE
CONTINUING TO BE PRESCRIBED IN
ANOTHER WAY BECAUSE PEOPLE
AREN'T COMFORTABLE REMOVING
THEM.

Steve says DO YOU THINK THEY'RE
OVERPRESCRIBED?

The caption changes to "Yarissa Herman. The Centre for Addiction and Mental Health."

Yarissa is in her forties, with long curly brown hair. She's wearing a printed black blouse.

She says YES.
ALSO, I THINK IT'S IMPORTANT TO
RECOGNIZE THAT THERE ARE
ALTERNATIVE POSSIBILITIES TO
TREAT ANXIETIES, SUCH AS
PSYCHOTHERAPY AND POTENTIALLY
WITH THE ADDITION OF
PSYCHOTHERAPY PLUS A
PRESCRIPTION OF BENZOS, WE SEE
QUITE GOOD OUTCOMES.
WE SEE WHEN PEOPLE COME OFF
BENZOS, THEY RECEIVE SOMETHING
LIKE CBT...

Steve says LIKE WHAT?

Yarissa says COGNITIVE BEHAVIOURAL THERAPY.
APOLOGIES.

Steve says THIS IS AN
ACRONYM-FREE ZONE.

The caption changes to "The Week in Review. @theagenda. Tvo.org.

Yarissa says THEY'RE LESS LIKELY TO
RELAPSE INTO ANXIETY.
SO I THINK THAT THEY ARE
OVERPRESCRIBED AND I THINK IT'S
IMPORTANT TO RECOGNIZE THAT
THERE ARE SOME ALTERNATIVES.

Steve says YOU KNOW, I GUESS IT
WOULD BE EASY JUST TO SAY, WE'RE
GOING TO BLAME ALL THE DOCTORS
FOR OVERPRESCRIBING.
BUT I PRESUME PATIENTS ALSO PUT
A LOT OF PRESSURE ON DOCTORS TO
GET THESE PILLS BECAUSE THEY'VE
HEARD SO MUCH ABOUT THEM.

Yarissa says SURE.
THEY'RE EFFECTIVE AND EASY
ACCESSIBLE AND THEY'RE QUICK.

Steve says MEANING WHAT?

Yarissa says THEY WORK FAST.
WHEREAS SOMETHING LIKE
PSYCHOTHERAPY CAN TAKE A LOT
LONGER AND BE A LOT MORE WORK.

Steve says ROGER, WHO GETS TO
PRESCRIBE THESE MEDICATIONS?

Roger says WELL, ALL HEALTH CARE
PROVIDERS LIKE PRESCRIBING THEM.
THERE'S CERTAINLY BEEN A WIDE
USE OF THESE MEDICATIONS IN
SPECIALTY SERVICES,
APPROPRIATELY IN SOME SETTINGS
LIKE PSYCHIATRY AND NEUROLOGY.
FROM A RECENT REPORT IN THE
UNITED STATES IN PRIMARY CARE,
THERE'S BEEN A STEADY INCREASE
IN THE PRESCRIPTION OF
BENZODIAZEPINES IN THE LAST TEN
YEARS.
THIS IS WITH OPIOIDS.
OBVIOUSLY THIS IS VERY
CONCERNING BECAUSE ONE OF THE
STATS YOU HAD AT THE START WAS
THE TOXICITY IN TERMS OF
OVERDOSE.
WE KNOW WHEN BENZODIAZEPINES ARE
COMBINED WITH OPIOIDS, IT
INCREASES THE TOXICITY OF THESE
MEDICINES.
I AGREE WITH MY COLLEAGUES THAT
ARE WITH YOU IN STUDIO, I DO
THINK THERE IS IN FACT AN
OVERPRESCRIPTION AND MORE
SPECIFICALLY I DO NOT THINK IN
FACT THERE'S BEEN THE
APPROPRIATE ASSIGNMENT OF
TREATMENT TO PATIENTS.
I SPENT THE LAST 15, 20 YEARS,
ALMOST A FULL-TIME JOB, TRYING
TO TAKE PEOPLE OFF OF THESE
MEDICINES.
PEOPLE TAKE THEM FOR A VARIETY
OF REASONS.
I ENUMERATED SOME OF THE
INDICATIONS.
BUT ONE OF THE PRIMARY REASONS
THEY TAKE THEM IS BECAUSE THEY
WORK AND THEY WORK VERY QUICKLY.
BUT THAT BEING SAID IS THAT THE
SHORT-TERM GAIN THAT THESE
MEDICATIONS OFFER, OFTEN PEOPLE
ARE OVERSHADOWED BY THE LOSS
(inaudible).
I AGREE WITH THE COMMENT ABOUT
PSYCHOTHERAPY.
I THINK THERE IS CLEARLY LOTS OF
EVIDENCE TO INDICATE THAT CBT,
COGNITIVE BEHAVIOURAL THERAPY,
IS THE BEST WAY TO TREAT ANXIETY
IN THE LONGER TERM.
THE ISSUE WE GET INTO IS REAL
WORLD.
AND THE REAL WORLD IS MOST BUSY
PRIMARY CARE PROVIDERS SAY, I
DON'T HAVE A PSYCHOTHERAPIST
NEXT DOOR.
I DON'T HAVE THE ABILITY TO GET
PATIENTS ON THE INTERNET AND
COACH THEM THROUGH IT, THEY LACK
THE MOTIVATION.
SO SOME OF THESE STRUCTURAL
ISSUES UNFORTUNATELY END UP
CONSPIRING AGAINST UP, LEADING
TO BENZODIAZEPINE
OVERPRESCRIPTION.

Steve says ALL OF THAT HAVING
BEEN SAID, ALEXANDER, WOULD A
WAY TO REDUCE THE PROLIFERATION
OF WRITING SCRIPS FOR THIS
MEDICATION WOULD BE PREVENTING
FAMILY DOCS FROM DOING IT ANYMORE?

The caption changes to "Alexander Caudarella, @acaudarella."

Alexander says I DON'T THINK YOU CAN BLAME FAMILY DOCS.
ARE LOT OF THEM ARE CONTINUING
OLD PRESCRIPTIONS AND WE DON'T
NECESSARILY WANT PEOPLE RIPPED
OFF OF THESE MEDICATIONS.
THAT COMES WITH HARM TOO.

The caption changes to "For more on this story visit: tvo.org/theagenda."

Alexander says PEOPLE REALLY WANT TO HELP THE
PEOPLE IN FRONT OF THEM.
I THINK AS WAS JUST MENTIONED WE
HAVE TO PROVIDE MORE SERVICES
AND MORE HELP FOR FAMILY
PHYSICIANS TO BE ABLE TO DO
THINGS.
I THINK THE LAST PART IS, IT'S
NOT ONLY THE PRESCRIBING, IT'S
THE WAY THEY'RE PRESCRIBED.
SO THE DOSES, THE HIGH DOSES,
BUT ALSO THE FACT THAT PEOPLE
ARE GOING HOME WITH MONTHS OF
PRESCRIPTION AT A TIME, WHICH
MEANS THAT A LOT OF IT CAN GET
EITHER DIVERTED TO THE STREET OR
BE TAKEN INAPPROPRIATELY.
SO EVEN JUST TRAINING PEOPLE TO
PRESCRIBE IT IN A SAFER WAY
MIGHT BE A WAY THAT WE CAN HELP
CURB SOME OF THESE OVERDOSES
THAT ARE HAPPENING.

Now music plays as an animated slate reads "The week in review."

Steve sits with different guests.
A caption on screen reads "Electroconvulsive therapy. The mythology."

Steve says LET'S SET THIS UP.
THIS IS A PLAY ABOUT A WOMAN
WITH SEVERE DEPRESSION.
YOU PLAY THE LEAD.
SHE'S GOT A LOT OF MENTAL HEALTH
ISSUES.
AT SOME POINT HER PSYCHIATRIST
SAYS TO HER, ELECTRO-CONVULSIVE,
ELECTRO SHOCK AS IT IS CALLED,
IS ADVISED.
LET'S START THERE.
WHAT IS ECT?

The caption changes to "Daphne Voineskos. Centre for Addiction and Mental Health."

Daphne is in her late thirties, with long straight auburn hair. She's wearing a black blazer, burgundy blouse, and a golden pendant necklace.

She says ECT HAS BEEN AROUND FOR A
LONG TIME.
IT'S OUR MOST EFFECTIVE
PSYCHIATRIC TREATMENT FOR
TREATMENT RESISTANT DEPRESSION,
SO DEPRESSION THAT HAS NOT
RESPONDED TO MEDICATION OR TALK
THERAPY.
IT'S ONE OF OUR ONLY PROCEDURAL
TREATMENTS IN ECT.
AS OPPOSED TO TAKING A PILL,
IT'S QUITE A BIT MORE INVASIVE.
UP TO 70 PERCENT OF PEOPLE WITH
TREATMENT RESISTANT DEPRESSION
CAN RESPOND TO ECT.

Steve says CAN YOU PUT MORE
FLESH ON THAT BONE?

The caption changes to "Peter Giacobbe. Sunnybrook Health Sciences Centre."

Peter is in his late forties, clean-shaven, with short gray hair. He's wearing glasses, a gray suit, white shirt, and spotted black tie.

He says ELECTRO-CONVULSIVE INVOLVES
THE APPLICATION OF A BRIEF SHORT
ELECTRICAL STIMULUS TO THE SCALP
TO INDUCE A SEIZURE UNDER
GENERAL ANAESTHESIA.

Steve says DOES IT CAUSE MEMORY
LOSS?

Peter says SO MOST OF THE DATA WOULD
SUGGEST THAT IMMEDIATELY AFTER
THE TREATMENT, THERE IS SOME
DEGREE OF MEMORY IMPAIRMENT, AND
THAT MAY BE DUE TO THE
ANAESTHETIC, DUE TO THE
PROCEDURE ITSELF.
BUT WHEN YOU LOOK AT FOLLOW-UP,
THREE TO SIX MONTHS LATER, IN
GENERAL PEOPLE'S MEMORY
IMPROVED.
AND PART OF THE REASON FOR THAT
IS WHEN PEOPLE ARE DEPRESSED, IT
CAN HAVE A PROFOUND EFFECT ON
THEIR MEMORY.
WHEN YOU SUCCESSFULLY TREAT
THEIR DEPRESSION, THAT CAN
IMPROVE.

Steve says WHAT DOES THE
EVIDENCE SAY ABOUT WHETHER OR
NOT IT CAUSES ANY DAMAGE TO THE
BRAIN?

Daphne says THERE'S NO EVIDENCE THAT
THERE IS DAMAGE TO THE BRAIN AS
FAR AS WE CAN TELL.
THERE IS MEMORY IMPAIRMENT AND
THE PERIOD OF TIME AROUND ECT
AND INCLUDING THE TIME THAT YOU
HAVE EC, IT UP TO A FEW MONTHS
ON EITHER SIDE CAN REMAIN QUITE
A BIT FUZZY FOR PEOPLE IF THEY
HAVE MEMORY IMPAIRMENT.

Steve says I WANT TO KNOW HOW
MUCH YOU KNEW ABOUT ALL OF THIS
BEFORE YOU TOOK ON THIS ROLE?

The caption changes to "Ma-Anne Dionisio. Actor, 'Next to normal.'"

Ma-Anne is in her thirties, with long straight chestnut hair. She's wearing a printed blue blouse.

She says NOT VERY MUCH WHEN IT COMES
TO ECT.
I HAD JUST A VERY, VERY BASIC
KNOWLEDGE OR UNDERSTANDING.
ALSO, SHARED EXPERIENCES FROM
PEOPLE WHO HAVE ADMINISTERED ECT
AND WHO HAVE RECEIVED IT.
MY UNDERSTANDING IS IT VARIES
WITH EACH PERSON, LIKE THE
DEGREE IN WHICH THIS THERAPY
AFFECTS THEM OR IF IT IS
ACTUALLY EFFECTIVE FOR THEM.

The caption changes to "The Week in Review. @theagenda. Tvo.org."

Steve says AS AN ACTOR, I
PRESUME YOU DO SOME RESEARCH
INTO EVERY ROLE THAT YOU GET.
WHAT KIND OF
RESEARCH WOULD YOU HAVE DONE TO
GET READY FOR THIS ONE?

Ma-Anne says WITH HER IN PARTICULAR, I
JUST EXPLORED HER CHARACTER, NOT
SO MUCH ON THE ECT LEVEL BUT ON
THE LEVEL OF HER GRIEF AND WHERE
IT COMES FROM BECAUSE I THINK
SHE MAINLY DEALS WITH THE LOSS
OF HER CHILD AT A VERY YOUNG AGE
AND BECAUSE IT WAS SUCH A SUDDEN
LOSS, WITHOUT HER ACTUALLY BEING
ABLE TO HAVE THE COPING
MECHANISMS TO DEAL WITH THAT
LOSS.
AND THEN I GUESS AT THE TIME
THAT SHE WAS TRYING TO DEAL WITH
HER GRIEF, OTHER OPTIONS WERE
PRESENTED TO HER, AND WHETHER OR
NOT THOSE OPTIONS WERE ACTUALLY
THE RIGHT THING FOR HER OR IF IT
MADE THE SITUATION WORSE IS I
GUESS WHAT I HAD TO EXPLORE AS
THE CHARACTER.

Steve says I PRESUME YOU WANTED
TO DO THIS SHOW BECAUSE (a)
IT'S A GREAT SHOW (b) IT'S A
GREAT CHARACTER YOU PLAY, BUT
SOMETIMES ACTORS HAVE AN ACTUAL
PERSONAL CONNECTION TO THE
SUBJECT MATTER.
DO YOU IN THIS CASE OR YOUR
FAMILY OR ANYTHING LIKE THAT...

The caption changes to "Ma-Anne Dionisio, @Mirvish."

Ma-Anne says ABSOLUTELY.
I THINK THAT, ESPECIALLY IN
SOCIETY TODAY, I THINK YOU WOULD
BE HARD-PRESSED TO NOT HAVE SOME
KIND OF RELATIONSHIP WITH A
MENTAL HEALTH ISSUE.
I THINK AS A SOCIETY IT'S
DEFINITELY SOMETHING THAT WE
NEED TO ADDRESS, IT'S... I'M
GLAD THAT PEOPLE ARE ACTUALLY
TALKING MORE ABOUT IT, SHEDDING
LIGHT INTO THE SUBJECT BECAUSE
THERE ARE SO MANY... THERE ARE
VARYING DEGREES OF DEPRESSION
AND MENTAL HEALTH ISSUES.

The caption changes to "For more on this story visit: tvo.org/theagenda."

Ma-Anne continues THERE'S JUST TOO MANY TO EVEN START.

The clips end and Steve stands in the studio alone.

He says THAT IS THE AGENDA'S
WEEK IN REVIEW FOR THIS FRIDAY,
MAY 10th, 2019.
ALL OF THOSE CONVERSATIONS ARE
AVAILABLE ON OUR WEBSITE, THAT'S
tvo.org, ON OUR YouTube CHANNEL
AT youtube.com/theagenda, AND ON
OUR TWITTER FEED, THAT'S:
twitter.com/TheAgenda.

Watch: The Agenda's Week in Review