Health — Issue No. 11 — Thursday, March 26, 2015 (HTML)

Present: Linda Larson, MLA (Chair); Dr. Doug Bing, MLA; Sue Hammell, MLA; Richard T. Lee, MLA; Dr. Darryl Plecas, MLA; Jennifer Rice, MLA; Bill Routley, MLA; Dr. Moira Stilwell, MLA

3. The Committee discussed a proposal to create a Sub-Committee to review submissions received on dying with dignity.

4. Resolved, that a Sub-Committee comprised of the Chair, Linda Larson, MLA, the Deputy Chair, Judy Darcy, MLA, Sue Hammell, MLA, Dr. Doug Bing, MLA, and Dr. Darryl Plecas, MLA be established to consider and make recommendations to the Select Standing Committee on Health on the topic of dying with dignity.

The Sub-Committee shall have all of the powers of the Select Standing Committee on Health and is authorized to consider related written submissions received by the Select Standing Committee on Health during the 40th Parliament. The Sub-Committee shall convene at the Parliament Buildings for the purpose of examining the evidence it has received and shall report to the full committee by June 30, 2015 its recommendations on the specific matter referred to it. (Jennifer Rice, MLA)

5. It was agreed that Committee Members would provide the Chair and Deputy Chair with the names of the stakeholders who made written submissions to be invited to make a presentation to the Committee on the topic of best practices to improve end-of-life care.

6. It was agreed that the written submissions received in response to the Committee’s call for submissions would be posted on the Committee’s website.

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
Committee Workplan and Meeting Schedule	165
Formation of Subcommittee	166
Stakeholder Consultation Process	167
Written Submission Process	167

L. Larson (Chair): Good morning. My apologies for the late start. We do have a quorum. I know everybody has other commitments this morning as well, so I think we will just move on, if that’s okay with everyone.

L. Larson (Chair): On the agenda, the first item we have is a draft workplan and timelines to deal with — obviously, the submissions that we’ve had over the last months and to move forward on some of these more specific items. I hope you’ve had a chance to take a look at the workplan.

The only thing that has come up is that we definitely…. When you look at summer to try and talk to people, that’s maybe not such a good idea in July and August. Perhaps we would look at the beginning of September as an opportunity to meet with people — and June, of course.

L. Larson (Chair): Yes, it’s one of these areas we’re at right now where we’re a little bit in limbo. We want to kind of get started and actually move on specifics instead of the broader picture.

Just to look at this workplan, at the meeting on the 15th of April it’s suggested that we invite the Ministry of Health to come in and discuss two topics with us. One of them, as you’ll have noticed from the amount of submissions that we had, was the request for right-to-die legislation. Judy and I both thought it would be a really good idea to have the minister come in and tell us what plans the provincial government may have on the issue of right to die and whether they’ve looked at it; where it may be legally, politically, etc.; and do they know what’s happening from a cross-Canada perspective as well. That could be the first part of the meeting on the 15th.

In the second part, perhaps while we have them here and so that we don’t have to ask them to come twice, we would ask them to give us an update on what they’ve been doing in rural British Columbia related to rural health, because that was also in our submissions, and it would probably be a great idea to find out what’s already being done. And, perhaps, the best practices they know that are out there may give us some other ideas about who to invite to come in and speak to us as well, in addition to the ones we do have on our list.

If that’s all right with you, for the first meeting on the 15th of April, we’ll set it up in that format, where we just ask the Minister of Health to come in and give us an update on those two issues.

L. Larson (Chair): Yes, we do, but if you look at the workplan, we’re not going to tackle those two issues until later.

L. Larson (Chair): Yeah. We’re going to start…. After discussing this with Judy and so on, we felt that we would, sort of, tackle one item at a time. So the first one to tackle would be the issue of….

Because we have the ministry here, we’ll get them to tell us about that. But in actual fact, the big one we wanted to tackle was the one about end-of-life care. Yes. That’s the one that we will hopefully get people to come in and talk to us about.

The rural one is going to end up coming up later, but because we will have Health here, we thought we’d just get them to put their things on the table as well at the same time. Okay.

Yes. You are absolutely correct. It is the end-of-life care that is the topic we want to tackle. It was — by the submissions, as you know — one of the most important on the list.

S. Sourial (Committee Clerk): Members, you will have this list of all the submissions on end-of-life care. One of the requests was that you go through the list and let the Deputy Chair and Chair know which of these stakeholders you would like to invite to make a presentation to the committee to follow up on the information that they’ve presented in their submissions.

One of the items we’ll get to at the end of the meeting is the committee’s agreement or discussion around whether or not to post all the submissions on line. Right now the submissions are available to members in the database, which you can access through either a laptop, your computer, iPad. We can also post them on line, and that way they’d be available to the public as well.

The first thing, though, is to go through the submissions and determine which groups you would like to invite to appear before the committee, and then we will populate these meetings on the 15th and April 22, 29,
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May 13 and May 27 and hopefully have some robust hearings and discussions.

L. Larson (Chair): Just looking at the agenda, the draft plan itself minus the summer, is there a general agreement that we’ll start out with this particular workplan? It’s certainly fluid, and there is no reason that it can’t be changed at any point if we find we run up against issues.

As it sits right now minus trying to get out in July and August, is it an acceptable workplan?

L. Larson (Chair): We also discussed, Judy and I, quite in depth the fact that, as you know, from the amount of submissions that came in, a huge portion of them were to do with right to die. Because of that, we’re, of course, obviously inviting the minister or staff in to tell us about what’s happening in B.C. on that issue.

It was felt that that should be, actually, taken off of the table of this committee in general and given to a subcommittee of this committee to look at just that particular issue. Because we didn’t want to end up…. It’s a very emotional issue. There are legal ramifications as well. Consequently, we thought that it would be good if it was dealt with by a subcommittee of this Select Standing Committee on Health, and then they could research it further but sort of off of our table.

Again, it was one of those things that came up unexpectedly. A lot of the submissions on it are certainly from one particular group of people that sent in just one-liners, but it was not part of our ask when we went out for submissions. It just inadvertently, due to the situation back east and to Ottawa’s decision, ended up being kind of top of mind during the same time frame that we put our submissions out.

I would like to ask of this committee if any of you are interested in doing some follow-up on this particular topic. Like I say, it’s a very emotional one, but definitely there are a couple of groups that we did identify that it would be good to talk to in this process. I’d like to know if any of you would be interested in looking at it.

M. Stilwell: First of all, obviously, some people used the call for suggestions to express their main concern rather than address a topic that we’ve asked for expressions on previously. I do think it’s important to separate it because I think right to die and health care sustainability have an obvious link that is not necessarily what we planned. So I do think it’s important to separate it.

I also think that…. I do see that you include presentations from invited stakeholders on best practices to improve end of life, but obviously — and I’m sure the point has been made — the availability and access and quality of palliative care will influence a patient’s choice to exercise their right to die. I think that subcommittee needs to be crafted in a global enough way to address concerns of the disabled community and palliative care, etc.

S. Hammell: I would assume that the Chair and the vice-Chair would be on the committee.

S. Sourial (Committee Clerk): One of the things in terms of the terms of reference of the subcommittee would be that they could really only look at the submissions already received during the first call for submissions, rather than having another call for submissions. It would be considering only the information around dying with dignity that the committee has already received.

M. Stilwell: Then would you produce a report from just the limited number, or it’s simply to cleave it off, look at the representations and summarize them? Is that the idea?

S. Sourial (Committee Clerk): Not even necessarily summarize. It’s entirely up to the subcommittee. They could have public hearings with the groups that made submissions and then essentially just make some recommendations to the full committee. It doesn’t have to be a full-blown report. It can just be a list of recommendations on based on that little piece of the committee’s consultations.

B. Routley: Just to be clear, I support the notion of a subcommittee and focusing on this issue, but I do think their report should come back naturally to this committee and for any final document to go away from the committee. I do think we want to show that we’re all equally concerned about the issue, but I do believe it’s the right approach to have a subcommittee.

S. Sourial (Committee Clerk): Yeah, the subcommittee would, just by its nature, have to report back to the full committee. I think the way the Chair and Deputy Chair envisioned it is that we’d have five members on the subcommittee. So there’d be the Chair, the Deputy Chair and another three members. I think it’s…. Well, I’ll let the Chair….

L. Larson (Chair): That way, basically what we…. Certainly, as you look through the submissions you’ll know that a great majority of them came from one particular group. Definitely, they would be somebody that
[ Page 167 ]
the subcommittee would call in and let them do a presentation and talk about it, plus anybody else that they might need to ask the questions of. Certainly there are, like I say, moral and legal aspects to that particular piece.

But we would not be looking at this as a year-long process; rather, a couple of meetings to kind of pull together what information there is that came in, in our submissions, so that we’ve dealt with it and then just put in a report to this committee as to what we’ve discovered — in other words, what the province is doing, what the federal government is doing in looking at this and just what the general public, from the submissions, etc., thought about it.

Could I have some volunteers that would be willing to look at this particular topic?

S. Sourial (Committee Clerk): I do have a draft motion here, and as soon as we have some members, I’ll circulate the draft motion.

J. Rice: I move that a subcommittee comprised of the Chair, Linda Larson, MLA; the Deputy Chair, Judy Darcy, MLA; Sue Hammell, MLA; Doug Bing, MLA; and Dr. Darryl Plecas, MLA, be established to consider and make recommendations to the Select Standing Committee on Health, on the topic of dying with dignity.

The subcommittee shall have all of the powers of the Select Standing Committee on Health and is authorized to consider related written submissions received by the Select Standing Committee on Health during the 40th parliament. The subcommittee shall convene at the Parliament Buildings for the purpose of examining the evidence it has received and shall report to the full committee by June 30, 2015, its recommendations on the specific matter referred to it.

Any discussion on that? Is everyone all right with that? Like I say, it will require a few extra meetings, between now and June, of that smaller committee, but basically just to review what we have received already and to ask of Health whatever we need to as well.

L. Larson (Chair): Stakeholder invitations. Susan did raise that. Basically, you’ve got this. We really need to know by the next meeting who you would like to talk to from the submissions that we’ve received on the end-of-life care issue.

It’s quite broad, because it’s everything from who should be doing end-of-life care, all the way through the whole gambit. It does include and think about, as well, when you’re looking at the submissions….

Rural British Columbia and urban British Columbia have two different opportunities, I guess, to do end-of-life care. Certainly, the bigger the population, there’s more likely to be a greater amount of support and help for those types of initiatives. When you get out into the rural areas, sometimes it’s just a very small hospice house or whatever.

As Dr. Stilwell pointed out in her earlier comments, what we do with end-of-life care often determines whether people get to the point where they request the right to die. Perhaps we are, in some instances, not making that transition for people as good as it should be and therefore putting them in a position where there is no other option. Definitely, we want to explore that.

In B.C., for sure, we want to make that transition for people to be a very natural one and for them not to be ripped out of their surroundings and taken to places where they don’t have that family and comfort zone and so on.

Please go through the submissions that we’ve received and let us know who you’d like to talk to. Then we will set up those people to come in and talk to us, and you can ask them questions. There were some groups and organizations that had some wonderful ideas on that and who should be doing it and so on. So please go through it and just get your list in as quickly as possible to Susan. Then Judy and I will take a look at it, and we’ll set up those appointments to come and talk to us here between now and June.

S. Sourial (Committee Clerk): Or you can send them to the Chair and Deputy Chair.

L. Larson (Chair): Yeah, or you can send them to Judy or myself or whatever. Just as long as we get them by the 15th of April — not very long, sorry, but yes, if that’s all right with everyone.

L. Larson (Chair): Now, the submissions — putting the submissions up on the website. Is there anybody that has an issue about doing that? It was a public call. I’ve been through and read most of the submissions, and I
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can’t see that there’s anything there that is an issue. If it’s all right, by general consensus, that we post publicly what we received? Thank you. So by consensus, we will post. All right.

The other thing that’s happening to Susan…. I don’t know if it’s happening to the rest of you, too, but certainly to me. I’m still getting submissions. There are still people that are sending in. All of a sudden I’ll get an e-mail, quite long, that says they want to make a presentation, and obviously, our submission thing is closed. Sometimes it’s totally unrelated, so that’s an easy one to take off the list.

Keep in mind…. If we do get to where we’ve talked to everybody that actually did a submission, if there are other organizations, institutions, groups out there that you also feel would have some value to come to talk to this committee, please let us know, okay? We certainly would take the people who have made an effort to make a submission first, but that doesn’t mean there are not other groups out there that you know of that do a wonderful job of end-of-life care. You may want to have them share their experiences with us. I want to leave that door open in case there is someone.

All right. Anything else that anyone can think of? We’re actually finishing earlier, but we started late. My sincere apologies to you again for being late myself and for the rest of the members here who were also late because they were also at other meetings.

Thank you very much, everyone. So on the 15th we will look at those two items and just have Health itself, the Minister of Health, come in and talk on those issues. Then from there we’ll move on. All right?

S. Sourial (Committee Clerk): Yes. Given that the next meeting after the 15th is the 22nd, it would be ideal if we could have the list of stakeholders to invite sooner rather than on the 15th. If it’s the 15th, that only gives us a week to notify people and get them in. So the sooner….

L. Larson (Chair): The other thing is, too, if you tell us who you’d like to see, and the first one or two can’t make it, we’ll just keep going till we hit the ones that can make it on the 22nd. We’ll slot everybody else in as available.

R. Lee: For the new invitees to submit, would they also be invited immediately or later?

L. Larson (Chair): Not until we’ve exhausted the people who actually did submissions. If we get through those and we’re still not getting to a place where we’re comfortable, and there are other people that might be able to help us along our path and help us with our mandate, then by all means. But we’ll go with who did it within our time frame first, out of courtesy.

L. Larson (Chair): They could. They could be good as well, so yes. We want to hang on to them, but we will not use them until we get to the end of the ones who have done it.

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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)
	Sue Hammell (Surrey–Green Timbers NDP)
	Richard T. Lee (Burnaby North BC Liberal)
	Dr. Darryl Plecas (Abbotsford South BC Liberal)
	Jennifer Rice (North Coast NDP)
	Bill Routley (Nanaimo–North Cowichan NDP)
	Dr. Moira Stilwell (Vancouver-Langara BC Liberal)
Clerk:	Susan Sourial

REPORT OF PROCEEDINGS(Hansard)

SELECT STANDING COMMITTEE ON HEALTH

REPORT OF PROCEEDINGS
(Hansard)

SELECT STANDING COMMITTEE ON
HEALTH