Health — Issue No. 7 — Tuesday, May 27, 2014 (HTML)

Present: Linda Larson, MLA (Chair); Judy Darcy, MLA (Deputy Chair); Donna Barnett, MLA; Dr. Doug Bing, MLA; Katrine Conroy, MLA; Sue Hammell, MLA; Jane Jae Kyung Shin, MLA; Michelle Stilwell, MLA; Dr. Moira Stilwell, MLA

1. There not yet being a Chair elected to serve the Committee, the meeting was called to order at 9:06 a.m. by the Deputy Chair.

2. Resolved, that Linda Larson, MLA, be elected Chair of the Select Standing Committee on Health. (Donna Barnett, MLA)

3. The Committee reviewed its revised Call for Submissions and its stakeholder lists.

4. Resolved, that the Committee adopt its revised Call for Submissions as amended. (Dr. Moira Stilwell, MLA)

The following electronic version is for informational purposes only.
The printed version remains the official version.

REPORT OF PROCEEDINGS
(Hansard)

SELECT STANDING COMMITTEE ON
HEALTH


CONTENTS
Page
Election of Chair	149
Revised Call for Submissions: Review	149
Stakeholder Consultation Process and Timeline	151

J. Darcy (Deputy Chair): Welcome, everybody. Our first order of business today is to elect the Chair of the committee. Norm Letnick has been appointed Minister of Agriculture; therefore, the position of Chair of the committee is vacant.

Are there any other nominations? Are there any other nominations? For the third and final time, any other nominations? Hearing none, nominations are now closed.

J. Darcy (Deputy Chair): Okay. Congratulations to the new Chair of the Select Standing Committee on Health. Now I will relinquish my brief time as Chair.

L. Larson (Chair): Good morning. Thank you very much. I really feel privileged to be Chair of this committee.

Also, I've had the privilege, too…. Over the last little while Judy Darcy and I have had a chance to talk about a lot of issues related to this committee. I hope that you will feel the same way as we do about trying a slightly different direction with the committee, perhaps, this time round or for this year, and that is to look at narrowing the type of submission that we put out.

L. Larson (Chair): The next item on the agenda is to review the draft of the submission. Judy and I had gone over it several times with Susan and had done quite a few rewrites ourselves before we got it to this point. I would certainly welcome your comments on what we've done with this in moving forward. Anybody can leap in if they'd like to.

J. Darcy (Deputy Chair): Well, let me just say it has been a pleasure working with Linda and discussing a renewed focus or a more narrow focus, if I can call it that. All of these questions, in one way or another, were on the longer list. It was just a much longer list. What we really tried to do was take a few different parts of health care, segments of our health care system, and narrow it down to more specific questions in that area.

In the case of improving health and health care services in rural British Columbia, which the committee had agreed was a big priority, we thought we should focus in particular on what long-term solutions can address the challenges of recruitment and retention of health care professionals in rural B.C., because that is an enormous challenge and continues to be.

The second was about interdisciplinary teams, which again is in the ministry's priority documents. It comes out of the last report of the first phase of this committee's work: how can we create a cost-effective system of primary and community care built around interdisciplinary teams?

Then, as far as end-of-life care, that was also a big concern and one that's been raised with many committee members. We thought we should focus in particular on: what are the best practices? What is it that we can learn from to improve end-of-life care?

Then, finally, mental health and addictions is a huge area. Originally we had the very broad areas on our lists. We thought it made sense, after consultation, to narrow it to how we can enhance the effectiveness of addiction recovery programs so that it has a very specific focus.

We also were trying to frame questions in such a way that we could receive submissions from a wide variety of people. We certainly welcome submissions from health policy experts, as we've had before. But we also wanted to…. This is something that Linda had really emphasized. It's really important to also be able to hear from front-line health care providers involved in delivering some of these best practices in health care across B.C.

L. Larson (Chair): Yes. Thank you, Judy. It was mainly because of all of the different presentations we've had already and also throughout this last number of months here in Victoria from many, many different health care organizations and professionals, and so on.

They all have amazing ideas about how they can do what they do better, how they can also do things that maybe are being done in another sector and how their sector could actually do them more cost-effectively and with better end results for the patients themselves. We didn't want to not have those front-line people that work every day in health care. We wanted to make them feel comfortable in putting their ideas forward as well.

That was why we've kind of made it…. It's not simple, but it's a little more understandable for anybody at any level. Again, when we get looking at this, too, and we look at the list of people that we have originally put here to send our request out to, I need you all to take a real-
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ly good look at that list again and make sure we haven't missed those front-line people in that list when we do go out with this.

Moira Stilwell: I'm jumping in, in the middle, so pardon me if I'm asking you to go over already trodden ground.

One of my concerns is…. First of all, many people on this list have been asked many, many times in the past 12 years to contribute, and other people will contribute who may or may not have. I think it's equally important for people who have contributed many times or people who contribute for the first time that unless something is going to happen with their work, it's actually very demoralizing.

I assume that we will publish a report, but will there be gathering together of the contributors? What's going to happen to make people feel that it's worthwhile and to continue pursuing that kind of relationship with us?

L. Larson (Chair): When the submissions actually come in, Moira, I think that's probably more where we can decide or look at what we're going to do with them and what the next steps would be, because we don't know what will come in.

Like you say, I know these people have…. They're good professionals and all kinds of people and to constantly put something in and then never hear anything back again is very discouraging. I hope that as a committee, when the submissions come in this time, we can narrow the focus enough so that we can actually respond appropriately to those submissions.

Moira Stilwell: Will we post the submissions on line, or are we going to wait till we see what comes in?

L. Larson (Chair): Yeah, I think that we'll wait until we see what we have, and then we could make that decision from there.

K. Conroy: I want to thank you both for the work that you did on this, because I think it narrows the focus in a good way. I think it's positive, and I thank you for the questions that you've come up with.

Two questions I have. Can we just send any additional people that we think should be on this list to Susan?

Further, along with what Moira was saying, I'm hoping that at the end of this there is actually going to be a report with recommendations that we can move forward on. That has been our goal for a long time now, I think for four years. We might eventually have a report where we could say that these are some succinct recommendations, moving forward, that could be utilized by persons of power within the ministry, and moving forward on plans for the Ministry of Health.

L. Larson (Chair): I agree with you 100 percent, and I think that's why Judy and I decided to narrow the focus down to some specific areas that are actually in the Setting Priorities for the B.C. Health System that came from the ministry. So if we get something that is really better for the patient and a cost-saving measure at the same time, it is something that the minister would seriously look at implementing.

D. Barnett: I agree with everything that people have said. My issue is rural health. When I look at these lists here…. I'm not knocking the professionals. I'm not knocking anybody.

I hope that we're going to have more than just ministry stakeholders. We have many small communities out there that have health committees, senior citizens and local people involved. I think we need to hear from those people as well as the professionals. That, to me, is very important.

L. Larson (Chair): I agree with you. I've got a hospice group that I sincerely hope will put in a submission.

S. Sourial (Committee Clerk): What will happen is that we have this list of stakeholders, which is by no means comprehensive, and there is no deadline by when we have to know who is on the list. We will send it to….

All the members of the committee will receive a copy of the call for submissions. It'll be posted on the website as well. So if you have organization groups, individuals in your community, please direct them to the committee's website or to contact my office. It is open to anybody to contribute. It's not limited to this list of stakeholders. This list of stakeholders is a starting point to get the information out there.

J. Darcy (Deputy Chair): Just to underline what Susan
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said, I think that means that all of us need to really pore over it and see what groups we can add from our communities and, if the range of groups is not wide enough, that we add to it. That's one of the reasons the list is in front of you — so that you can see who is on it now and can make proposals about who ought to be on it.

I wanted to just go back to the question that Moira asked. In the earlier version of this, I think the way it was structured was that people would give submissions by a certain date. Then the committee would consider them and the committee would decide who they would hear from, from amongst those groups.

I think we want to embark on a more inclusive process than that. But we decided not to spell it out before we received the submissions. I think the idea of bringing people together around a specific topic, people who have made submissions and who we think have a lot to contribute to the discussion…. I think having round tables on each of these topics separately might be a very, very good idea. That's certainly something I would be very open to. I see the Chair nodding. But we didn't map out where we go beyond the initial round of submissions.

J. Darcy (Deputy Chair): And we all share the sentiment that we don't want a report that just sits on a shelf.

Moira Stilwell: I think we're going to receive a bunch of dusty reports. I think that's my concern.

S. Sourial (Committee Clerk): Just to clarify, the committee does have a website at the moment. We are in the process of revamping it, and I will send out what the new website will look like.

But we have not posted the call for submissions on that website yet. That won't happen until the committee approves and we sort of have a start date for that — until the committee approves a start date for the opening of the submissions.

S. Hammell: Maybe this is to Susan. My understanding is that the Children and Youth Committee has a committee up on youth and mental health. That's a very good place for the mental health piece to be placed, I think, initially.

The focus for us on addictions and recovery, I think, is an excellent one to put our thoughts together around. I just wanted to clarify that there was the mental health piece being done in another committee, at least when it comes to children, and that's probably a good place for it right now. We can leave our larger mental health issue alone and just focus on addictions and recovery.

D. Barnett: I think, too, MLA Plecas's report that he's been going around the province doing with…. His committee on the judicial system, etc., has been doing a lot of work and collecting a lot of data on addictions. I think, out of that committee, there may be some good information that we can utilize.

Looking at what we've done as a draft, is there any tweaking that anybody would like to do with it, any particular words that you'd like to change? We've done it a couple of times. Judy and I have gone over it a couple of times. Our whole purpose was to make it very targeted and also very simple, in that anybody could read this and understand what we were asking.

If I don't have anyone who wants to tweak or change it any further, then we do need a motion to accept this.

L. Larson (Chair): The next thing is timing. We know we have a list of people that we have sent out these requests to before. I also know — and from what Donna has said, too — that there are, in our own communities, groups that probably are not on this list and that should be, ones that you know run programs that are really good.

It may or may not be a program that could be put everywhere in the province. That is going to be a little more difficult. I have the same thing. I'm thinking of
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different groups in my area. When we get into the more rural parts of British Columbia, there are quite small groups, and they may have figured out something very localized that may or may not be something that we could do provincially.

We want to hear from them, so we kind of have to leave it up to you to talk to your caucus members and so on about those groups and make sure that we get their names. The names come to Susan, if you specifically want them to get their own request from us, so that we know that they're going to submit something. It will be difficult, and I know we're going to miss a bunch of things out there.

S. Sourial (Committee Clerk): Just to also clarify, even if it doesn't come to me, if you do know of a group in your community, just forward them the link to the website, or forward them the call for submissions. It doesn't have to be a preapproved stakeholder. It's an open call for submissions. It's a public call.

L. Larson (Chair): Well, that's up to us to decide right now — when we're going to put this out and what the deadline is going to be. When Judy and I talked about it, we pulled the deadline back a couple of months, to October 31, rather than December 31. If that date is all right, we can still run with that one. Putting it out — it's up to you right here and now to say when you want this put out.

D. Barnett: Well, I think the sooner the better, personally. What I've heard around this table is that we want to have an accomplishment. We want to do something.

The sooner we can get doing something and get input from people back to us, I think, then we can make some good decisions and probably help the health care system, hopefully, in our areas.

K. Conroy: My only concern is that if this goes out now it will go out in June. People tend to take time off in the summer. It really only gives people two months to focus on pulling a report together. We're looking at…. A lot of these groups are groups; they're not individuals. They have to get a report together and approve it through a process within their group.

I'm a little worried that we might not be giving some of the groups enough time. I mean, there might be plenty of time. But I'm wondering, if we give an extra month, if that's going to hurt us at all. We're probably, realistically, not going to be looking at the…. There's going to be some going over of the submissions as they come in, but realistically, we're probably not going to have time to sit down and really do it in depth as a committee until the new year.

L. Larson (Chair): I'd love to just sort of put a timeline to it. There is no reason at the end of October that we couldn't extend the deadline if we didn't get an appropriate number or a broad enough number — along that line. I think we could extend the deadline if we needed to if the submissions were not coming in the way we had hoped.

The other thing is that I hope we're going to look at those a lot sooner than that. In other words, my timeline would be towards the end of summer when we would get together and take a quick look at everything that has come in to that point and see whether we are getting the type of feedback that we were hoping to get. That still gives us another couple of months to send it back out again or to do whatever we might need to do to do that.

I want to be looking at this in the fall, before the end of the year, because when you look at budgets for Health and different things like that, if we don't have something to recommend by year-end, it won't get into next year's budget. I really would like to see…. If we come up with even one item that is practical, doable, will save money — a best practice that's good for the people of British Columbia — we could get something into next year's budget. That's my only concern about extending the timeline too far.

S. Sourial (Committee Clerk): Just to clarify in terms of the committee's report and recommendations, the committee recommends to the Legislative Assembly. It's entirely up to the assembly whether it adopts the recommendations or if the ministry adopts the recommendations that the assembly has adopted.

S. Hammell: Hearing your arguments, I am happy to support the timeline, though I do know that in the recovery field it is not, necessarily, a tightly organized field. It will need a lot of nurturing and prodding to move pieces in, so that will take time. But I think that we should target…. If we do have the flexibility to back up if we don't have the material we need to move forward and we know it's there, then we can go out and get it. Then, I'm good with October, though I do hear what Katrine has said.

D. Bing: Yeah, I think that we should stick to the October 31 deadline. I think people work to a deadline, so this is good to have a goal for them to work to. If necessary, as you said, we can always have an extension. It would be good to see what comes in before October 31.

L. Larson (Chair): All right, general consensus, then. We'll stick to October 31.

S. Sourial (Committee Clerk): In terms of how soon we can get this up, a few little technical details. We have to set up a back-end database to collect the information, so
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we have a little bit of work to do with systems. Hopefully, early next week we could get the website up and the call for submissions posted.

In terms of the e-mails to the stakeholders, those can be ongoing. We can start with those early next week, and then as we receive other names, we can add them. It's an ongoing process.

S. Hammell: Linda, you and Judy had discussed the possibility of actually going out, holding round tables. Is that after the deadline?

L. Larson (Chair): Yes. The idea would be, certainly once we've got the submissions, that we would narrow them into the groups that they are. You know, group them and then invite those people who we feel had some great submissions — for instance, in addiction recovery — to come and sit with us and talk to us about that. Then we'd create some sort of recommendation out of that.

J. Darcy (Deputy Chair): Sorry. Something just came to me. I think we want to make sure that people don't feel they need to address all four of those questions.

J. Darcy (Deputy Chair): It didn't occur to me until now, but in the second sentence — "Committee seeking written submissions that address the following questions" — maybe we should say "any of the following questions" or "one or more of the following questions."

J. Darcy (Deputy Chair): The whole idea was to focus and have people who are able to bring practical solutions to at least one area.

Anything else that anyone caught on this before we give it our approval? All right, thank you.

If general consensus is that we'll take a run at this…. I mean, "nothing ventured, nothing gained," is one of my things. If we don't put it out there and get started down this path, we're never going to get anywhere. If you're all in agreement, we will do what we've discussed.

Definitely, I do feel very strongly that by the end of August we should take a look at what is coming in. Through Susan, we'll try and set something up that's convenient for as many of you as possible to take a look.

J. Darcy (Deputy Chair): This is a request to Susan. It might be a good idea for you to remind committee members — several times — about adding names to the list, adding stakeholders to the list, because I know everyone around the table is incredibly busy. When we get back to our communities, we'll be caught up in that, and this might not be front and centre. The more reminders, the better. We won't consider that you're hounding us mercilessly.

L. Larson (Chair): All right. Thank you very much. If there is nothing else, then, I guess we stand adjourned. We will keep in touch with each other.

D. Barnett: When we get to the point where we know when we're going to have, possibly, some meetings, could you let us know as soon as possible? Some of us have a few other committees.

Actually, it will be easy to judge as we see what's coming in. If we're getting a high volume of things coming in, we can set a meeting date fairly quickly. If the volume's low, we'll kind of let it slide a little bit further. Definitely, if we start to get a large volume of submissions, we'll want to get on top of those.

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Chair:	* Linda Larson (Boundary-Similkameen BC Liberal)
Deputy Chair:	* Judy Darcy (New Westminster NDP)
Members:	* Donna Barnett (Cariboo-Chilcotin BC Liberal)
	* Dr. Doug Bing (Maple Ridge–Pitt Meadows BC Liberal)
	* Katrine Conroy (Kootenay West NDP)
	* Sue Hammell (Surrey–Green Timbers NDP)
	Richard T. Lee (Burnaby North BC Liberal)
	* Jane Jae Kyung Shin (Burnaby-Lougheed NDP)
	* Michelle Stilwell (Parksville-Qualicum BC Liberal)
	* Dr. Moira Stilwell (Vancouver-Langara BC Liberal)
	* denotes member present
Clerk:	Susan Sourial
Committee Staff:	Gordon Robinson (Committee Researcher)

REPORT OF PROCEEDINGS(Hansard)

SELECT STANDING COMMITTEE ON HEALTH

REPORT OF PROCEEDINGS
(Hansard)

SELECT STANDING COMMITTEE ON
HEALTH