2013 Legislative Session: Fifth Session, 39th Parliament
HANSARD

The following electronic version is for informational purposes only.

The printed version remains the official version.

official report of

Debates of the Legislative Assembly

(hansard)

Thursday, March 14, 2013

Morning Sitting

Volume 44, Number 6

ISSN 0709-1281 (Print)
ISSN 1499-2175 (Online)

THURSDAY, MARCH 14, 2013

The House met at 10:02 a.m.

[Mr. Speaker in the chair.]

Prayers.

Orders of the Day

Hon. M. Polak: I call committee stage debate on Bill 7, the Emergency and Health Services Amendment Act.

Committee of the Whole House

BILL 7 — EMERGENCY AND HEALTH
SERVICES AMENDMENT ACT, 2013

(continued)

The House in Committee of the Whole on Bill 7; D. Black in the chair.

The committee met at 10:05 a.m.

On section 3.

M. Farnworth: Under the section 5, under staffing, I've got a number of questions related to that, because the language is different than in previous legislation. What I'd like to know is: is the intent of the legislation to place a responsibility and duty upon the new BCEHS to perform all of the specified purposes that are contained within the legislation? Is there a responsibility to place new duties?

Hon. M. MacDiarmid: Can I ask the member…? Are you asking questions about section 5 now?

The Chair: Through the Chair.

Hon. M. MacDiarmid: Sorry, through the Chair.

M. Farnworth: This was under section 2. That's when they said we're going back to section 2. Section 2 goes all the way to page 11, so within section 2, part 5 is where the question relates to.

The Chair: Minister of Health.

Hon. M. MacDiarmid: Thanks very much, and thanks for that clarification.

Through you, to the member opposite — so the BCEHS core mandate will be continue to be provincially coordinated ambulance and emergency health services.

M. Farnworth: So we're not looking at adding anything additional conditional to that core mandate?

Hon. M. MacDiarmid: There is the potential for change. There are provisions in the mandate, which include urgent health services and ancillary health services, to support the integration of emergency medical assistance into the broader health sector.

M. Farnworth: That's also what's referred to in section 5.1(1)(f), I take it. It refers to making available other persons on a continuous, continual or temporary basis for the purposes described. Is that what you're referring to when you talk about…

The Chair: Through the Chair, Member.

M. Farnworth: Through the Chair.

…other services or individuals?

[1010]

Hon. M. MacDiarmid: Yes.

M. Farnworth: And we're all on the right section, which is probably the best place. It is still early in the morning.

If that's the case, then, what is the ministry anticipating in terms of what persons, other than licensed EMAs, are contemplated as providing ambulance services for the BCEHS?

Hon. M. MacDiarmid: The primary focus is on ambulance paramedics being deployed to provide urgent or ancillary services, but the act continues to contain language that's been there for probably 40 years. What currently happens is that, for example, doctors are used at times to give advice to ambulance paramedics, and nurses are used at times. So the language here is the same as has been used for years. The other health providers — such as, for example, doctors or nurses — would continue to be included in the way that they are now.

M. Farnworth: In essence, then, the legislation isn't anticipating additional, but rather, bringing up to date what is already the practice. Would I be correct in that assumption?

Hon. M. MacDiarmid: The purpose of the legislation, in part, is to enable the use, potentially, of other health care providers. So it is possible that other providers that aren't currently involved today could be.

I know the member hasn't asked me this question, but if you look at what's been happening in the ministry over the past few years, there has been real striving to have people work to the full extent of their scope of practice, to work within the full range of their activities.

Just to circle back to the original question, it's possible that people who aren't currently involved in providing services today could be in the future.
[ Page 13586 ]

M. Farnworth: Could the minister be a bit more specific in terms of what health care providers or health care professionals she would potentially see, then, as being covered or as being able to provide services that we might not necessarily think of as doing them at the current time? That would be appreciated.

[1015]

Hon. M. MacDiarmid: I don't actually have examples. There is the idea that providers could be included, and the purpose of the bill is to provide the flexibility for that to happen, but that would be part of planning going forward. We actually don't have current examples.

I think the member probably knows that I'm not keen on the hypothetical. I literally would be making it up. I could hypothetically think of a health care provider that could be included, but this is to allow flexibility.

I have already acknowledged that there are people currently in our health care system — professionals — who are doing things that didn't previously do it. For example, outside of this, pharmacists are providing immunizations. That's not a role that they've played before.

M. Farnworth: Would it be the minister's expectation, then, that before change or other providers are being brought in, there would be consultation and discussion with those who are currently doing the work so that there's an opportunity for input and a sense of exactly what's taking place as opposed to having something sprung on them?

Hon. M. MacDiarmid: Yes.

M. Farnworth: Okay. Has the ministry given any thought in terms of the qualifications that would be considered for people being brought in, in terms of how issues such as licensing would be dealt with or medical oversight being provided? Has the ministry advanced that far down in looking at those particular issues that would no doubt arise with this section and this increase of scope, as it were?

Hon. M. MacDiarmid: The section that we're talking about is about the urgent or ancillary services that additionally would be provided. It doesn't change at all the core mandate, which is for ambulance service and emergency health services. We are aware that licensing would need to be addressed, but in the progression of things, first the act would be passed and then the consultation would happen. There is definitely an awareness that we need to look at issues such as the member has raised.

M. Farnworth: I seek the Chair's guidance. We can deal with the individual 5.1(1)(f), or we can go on to the next set of questions, which are in 5.1(3) and then deal with the whole section after we've gone through 5.1(3), 5.4(1) and then 5.5(2).

The Chair: Continue, Member.

M. Farnworth: Thank you, hon. Chair.

Section 5.1(3) refers to a limitation upon persons providing various services that the BCEHS has a purpose without written authorization or consent — terms and conditions from the BCEHS.

The minister has got the appropriate section? I see heads nodding. Good. Thanks.

[1020]

What governmental agency will be responsible for the review and inspection of various operations, including first-responder programs, patient transfer services, first-aid companies, insurance company–utilized ambulance services and other operations to ensure that their operations are in compliance with the terms and conditions of the BCEHS and that they have consent to operate?

Hon. M. MacDiarmid: The commission has this responsibility now, and BCEHS will continue to have this responsibility with the passage of this legislation.

M. Farnworth: In other words, then, the current practices and procedures and roles and responsibilities will continue to remain as they are now?

Hon. M. MacDiarmid: Yes.

M. Farnworth: Are there any issues around staffing reductions within the existing B.C. Ambulance Service being contemplated to facilitate the consent for contracting out of any services?

Hon. M. MacDiarmid: No.

M. Farnworth: Where a patient is transported in an ambulance not operated by the BCEHS but operated with the consent of the BCEHS, what fees will be determined to be applicable, who will compensate the operator, and how will those fees be collected?

Hon. M. MacDiarmid: The fees are currently in regulations that are approved by Treasury Board, and that will not change.

M. Farnworth: It'll be Treasury Board and cabinet, then, that continue to decide. Okay.

Section 5.4(1), as worded, provides the minister the ability to delegate intergovernmental or foreign jurisdictional agreements for service provisions to the BCEHS. BCEHS, in turn, may delegate these authorities to various managers. In essence, a manager can make a foreign agreement without explicit governmental knowledge or oversight.
[ Page 13587 ]

What is the nature of limitations contemplated for the authority to make agreements government is prepared to delegate to the commission? Do you see any changes in terms of how that's being done, any expansion of the ability to do that? Under what circumstances do you see that delegation taking place?

[1025]

Hon. M. MacDiarmid: Going forward, for any agreements, the minister would have to give prior written approval.

M. Farnworth: So if you were looking to make an agreement with Alberta, for example, anything outside of the regular agreements that are already in place would require the written approval, then, of the minister. That's correct?

Hon. M. MacDiarmid: Any agreement that would be covered under this section, going forward, would have to have that written approval from the minister.

M. Farnworth: Section 5.5(2) provides the government a mechanism to bring replacement workers from out of province without regard to B.C. licensing requirements for up to 72 hours. I know that the minister…. This is a crucial area. This section allows the visiting health professionals to provide services described in (3)(d), including services in (3)(d)(ii), which they are not actually authorized to provide in the home jurisdiction of their governing body. So in what circumstances and under what limits is a visiting health professional able to replace existing B.C. workers?

The Chair: The member for Alberni–Pacific Rim seeks leave to make an introduction. Shall leave be granted?

Leave granted.

The Chair: Please proceed, Member.

Introductions by Members

S. Fraser: I'm very honoured today to welcome to this House — they've come all the way from Ucluelet Secondary School — Mr. Nixon's grade 10 class of 33 students. They've just been on a tour. Just so they know, this riveting debate right now is Bill 7, Emergency and Health Services Amendment Act. I hope you're having a great time, and I hope you have a great day. Will this House please make them feel very welcome.

Debate Continued

Hon. M. MacDiarmid: I have not introduced the staff that's with me from the Ministry of Health, so I'm just going to take a moment to do that. I've got with me today Liv Brekke, Carolyn Bell and Daryl Beckett. I very much appreciate their presence.

These workers would not be replacement workers. They would be supplemental, and it would be in situations such as a natural disaster or an emergency transfer. They would have to be done in accordance with an interjurisdictional agreement that had previously been approved by the minister.

M. Farnworth: Just confirming that this would be for very specific issues — as the minister just said — such as natural disaster, for example, and would not be something that could be done as a matter of course or to deal with a regular situation that would normally be done by the people delivering the service under the BCEHS?

[1030]

Hon. M. MacDiarmid: Again, this would be considered supplemental and, as I said previously, would have to be done in accordance with an agreement that had been signed by the minister under the section we were talking about previously.

M. Farnworth: That, I think, just about completes the questions. I just want to go back and ask one question under section 5.1(1)(f).

With the implementation of Bill 7, does the government or BCEHS intend to staff any ambulances not with paramedics but with another health care provider or other persons as has been defined in the sections above section 5.1?

Hon. M. MacDiarmid: Again, this legislation is enabling legislation which could allow for different providers to be in an ambulance. But I would say to the member opposite that that happens today. Today there are cases where nurses are in ambulances providing health care, medical care — and occasionally physicians as well. So that is the case today.

M. Farnworth: I appreciate what the minister is saying. I guess I just want to make clear, then, that it is not the intention of this legislation to be replacing paramedics who are currently doing that work with other health care providers. That's the question that I'm looking at the minister for. And with any change in that regard, I would expect the minister would want to make sure that consultation and discussion are also taking place in terms of changing the scope around those decisions. Am I correct?

Hon. M. MacDiarmid: It is not the intention of this legislation to replace ambulance paramedics, but it is the intention of the legislation to allow flexibility so that there's the possibility of different providers being included in providing care, very much focused on the best pos-
[ Page 13588 ]
sible care for patients in emergency situations.

M. Farnworth: Then given the minister's statement, I would ask: is it the minister's intention that with that goes the responsibility that if there are changes and to expand it, clearly consultation with paramedics and the individuals doing the work currently is of paramount importance and needs to take place?

Hon. M. MacDiarmid: Consultation will need to take place, and it will be important.

[1035]

Sections 3 to 31 inclusive approved.

Title approved.

Hon. M. MacDiarmid: I move the committee rise and report the bill complete without amendment.

Motion approved on division.

The committee rose at 10:36 a.m.

The House resumed; Mr. Speaker in the chair.

Report and
Third Reading of Bills

BILL 7 — EMERGENCY AND HEALTH
SERVICES AMENDMENT ACT, 2013

Bill 7, Emergency and Health Services Amendment Act, 2013, reported complete without amendment, read a third time and passed.

Hon. M. Polak: I call committee stage debate on Bill 18, Health Authorities Amendment Act.

Committee of the Whole House

BILL 18 — HEALTH AUTHORITIES
AMENDMENT ACT, 2013

The House in Committee of the Whole on Bill 18; D. Black in the chair.

The committee met at 10:39 a.m.

On section 1.

S. Simpson: Could the minister tell us what the purpose of this bill is?

Hon. M. MacDiarmid: I'd like to thank the ministry staff who are with me to support me today — Graham Whitmarsh, Jodi Jensen and Corrie Campbell. I appreciate their assistance.

The purpose of the bill is to amend the definition of "nurse" by adding a reference to licensed practical nurses along with registered nurses and registered psychiatric nurses, striking out "an enactment" and substituting "the Health Professions Act" in the definition.

S. Simpson: Could the minister tell us what the result of that will be in terms of how it potentially impacts bargaining and bargaining structures?

[1040]

Hon. M. MacDiarmid: The result of this will be that the licensed practical nurses will be part of the Nurses Bargaining Association table.

S. Simpson: Could the minister tell us: what does that mean in terms of representation? They'll be part of that association. We know today that, I believe, there are two unions involved in that association: the B.C. Nurses Union and the Health Sciences Association, which represents psychiatric nurses in that area. How will this affect representation, and which unions?

We know today that there are still about 1,200 nurses, I believe, who are represented by the Hospital Employees Union, maybe another 400 or 500 who are represented by the B.C. Government Employees Union and some by the United Food and Commercial Workers. How will this legislation affect that representation?

Hon. M. MacDiarmid: No union will lose members as a result of the legislation. The legislation will move licensed practical nurses from their current multi-union bargaining associations — so the Facilities Bargaining Association and the Community Bargaining Association — to the Nurses Bargaining Association. That already includes members of the B.C. Nurses Union, the Union of Psychiatric Nurses and the Health Sciences Association.

Licensed practical nurses who are currently members of the Hospital Employees Union or the B.C. Government Employees Union or the UFCW will retain their current union membership, and that won't change as a result of this legislation.

S. Simpson: So to clarify here, could the minister tell us: does that mean that now in the Nurses Bargaining Association — there are currently three unions who represent nurses in that association — there will be five or six unions that will represent nurses — of course, contingent on any changes in representation that happened through the labour code in future? But does this mean that there will now be five or six unions in that Nurses Bargaining Association who will be participating and bargaining through that association?
[ Page 13589 ]

Hon. M. MacDiarmid: Yes.

S. Simpson: Could the minister tell us what the consultation process was in order to arrive at this decision to do this at this time?

Hon. M. MacDiarmid: The amendment will come into force by regulation of the Lieutenant-Governor-in-Council, and this will allow consultation with the affected unions and employers to be completed prior to implementing any of these changes. This change will not take place until we've consulted with all the affected unions and employers to identify concerns regarding the change of the definition of "nurse."

The Ministry of Health and Health Employers Association of B.C. will consult with affected unions and employers, who were contacted this week to initiate that consultation process. There was some informal consultation earlier with health employers, but they will be included in the formal consultation process going forward.

S. Simpson: I just ask for a clarification. I'm not sure that I heard the minister correctly. The minister said there was or there wasn't consultation with health employers prior to the introduction of this legislation? I just didn't hear the minister properly.

[1045]

Hon. M. MacDiarmid: I'm sorry. I'll speak up. There was informal consultation, but there will be formal consultation with the employer going forward, as there will be with the unions.

S. Simpson: Maybe the minister could clarify. Was there consultation with the Nurses Union and with any others prior to the decision to introduce this legislation and that? Was there consultation with some entities? I understand that other unions and, formally, the employers were not consulted, based on what the minister just said, and that other unions were not consulted prior to the introduction of the legislation. Were there some people consulted, including the nurses?

Hon. M. MacDiarmid: The nurses made a request of us. There was not consultation with them, but they did make the request to me personally at, at least, a couple of meetings. They've made other requests, and there's been writing of letters and so on. But there was not a consultative process, just a request to do this.

S. Simpson: I know I read a bit of the transcript of the minister's interview with Mr. Palmer on Voice of B.C. I believe that this question of consultation was addressed during that interview. The minister had said that she had received advice that consultation prior to the legislation would not have been a good idea — or something to that effect. I'm paraphrasing. I'm sure the minister will correct me if I'm wrong here.

Could the minister explain why the decision was made to not have consultation before moving this bill forward? And just to get a sense…. We have a piece of legislation that's in front of us today, the Senate election bill, that has been introduced by the government, with the government saying quite clearly: "We're introducing this legislation we have no intention of passing at this time, but it allows an opportunity for a discussion to occur in the community about the appropriateness of this."

So it's, you know, an opportunity to do that and to allow a broader consultation. Now, that's a different matter — elections. I understand that. But could the minister explain why it wasn't a good idea to have discussion around this matter prior to what will presumably be the passing of this legislation some time today?

Hon. M. MacDiarmid: There were a range of options that were open to government. What we chose to do was to structure this bill so that upon passage it requires the Lieutenant-Governor-in-Council order, in order to actually implement it. That will give us as much time as we need in order to do the consultation.

With respect to my appearance on a television show, as I recall, when I was discussing this with the host, there was one of the unions which was actively negotiating and ratifying an agreement with us up until very close to…. It was, like, just within the last two or three weeks. The recommendation I had from the ministry that was with that particular union was that it wouldn't have been an appropriate time to consult. But that's, really, I would say, an aside.

[1050]

We did make a decision as government that we would structure the bill in this way so that when it's passed, it does not come into force. We will have, as I said, as much time as we need to consult. There's not contemplated that there would be any kind of immediate need to have this bill come into force.

S. Simpson: I'll just clarify this so I understand this better before I come back to some of these questions. Is the minister saying that should this bill be passed today, it's not going to get the appropriate orders-in-council or whatever to, in fact, allow it to be in force — that somewhere down the line that will happen? And if so, could the minister then maybe give a bit of an explanation of what's going to occur after third reading and passing till the time when in fact this thing does get signed into force by the LG?

Hon. M. MacDiarmid: I've acknowledged today in the House and previously in other comments I've made that we have to consult. That hasn't happened, so that is the next step. There has not been a timeline put on this.
[ Page 13590 ]
It is not the intention to proceed with the Lieutenant-Governor-in-council order. The next step will be the consultation.

S. Simpson: Does the minister — I understand that you can't be very specific about this, and I appreciate that — have a sense of what that timeline might look like?

Presumably, the ministry has given some thought to what that consultative process will look like post passage of the bill and what that might be. I'm sure that that has been contemplated within the ministry. So maybe the minister could give us some indication of what that timeline might look like — respecting that these timelines can move and usually get longer, not shorter, but they can move — and what the expectation is.

Hon. M. MacDiarmid: The member opposite is correct that I really…. It's not possible for me to put a timeline on this. I've tried very hard to operate out of the hypothetical realm.

What I can say is that the initial contact has been made with all of the impacted unions. Letters have gone out, as I understand it, I think this week. I don't believe there would have been any response yet, but we'll establish meetings. It may be a very short consultative process, or it may be lengthy, but it's important that we undertake it.

S. Simpson: This is a question about legislative parliamentary procedures that maybe somebody can answer here for me. Could the minister tell us whether…? If this passes, but if it's not brought into force by the LG prior to the election, does it die if it hasn't been brought into force by the time of the election?

Hon. M. MacDiarmid: The answer is no.

S. Simpson: I appreciate that.

On the question of consultation. We talked about that, the minister will know. In my second reading comments I talked a little bit about Bill 29. We all know the history of Bill 29 and the Supreme Court decision, and we know the Supreme Court decision which rejected portions of Bill 29 and directed the government to go back and consult with the appropriate unions.

It's my view that largely what the court said is…. The court didn't say the government doesn't have the ability to do these things. The court said, "You have an obligation to consult in a meaningful way prior to implementing Bill 29," and rejected pieces on that. Then the government has gone back, and there has been some resolve of those matters in some fashion.

[1055]

Did the government — did the minister — give consideration to what the courts told the government in that Supreme Court decision before this proceeded, which does change labour relations in a meaningful way for these unions and for these workers? Was Bill 29 a consideration, and the court decision there, before this bill was introduced?

Hon. M. MacDiarmid: Consideration was given to Bill 29, and although I've heard the member and others drawing parallels between what's contemplated in this bill and Bill 29, in fact this legislation has nothing to do with Bill 29. It has nothing in common with Bill 29.

This legislation does not interfere with the terms of the existing collective agreements between health employers and the multi-union bargaining associations with which they've negotiated those terms. This legislation does not prohibit future bargaining between health employers and the multi-union bargaining associations on important terms and conditions of employment.

The licensed practical nurses and the unions that represent them have full opportunity to participate in meaningful negotiations over the terms and conditions of their LPN members and other members.

S. Simpson: Did the minister seek a legal opinion on that prior to going forward with this? And presumably, the commentary that we just heard from the minister about the differences that are material differences — is that part of a legal opinion? Was a legal opinion sought on this matter so that we don't end up going through the Bill 29 exercise again, possibly? If so, could the minister tell us?

Hon. M. MacDiarmid: I am satisfied with the advice that I've received on this.

[H. Bloy in the chair.]

S. Simpson: I appreciate that. That wasn't the question. The question was: did the minister seek a legal opinion on this matter, related to the Supreme Court decision on Bill 29?

Hon. M. MacDiarmid: Yes.

S. Simpson: Would the minister make that legal opinion available to the House?

Hon. M. MacDiarmid: I'm advised that that would breach privilege.

[1100]

S. Simpson: Maybe the minister could tell us whose privilege it breaches. If the minister…. Presumably, it's the minister's advice that would have come to her on what the possibilities for this are. I imagine it's the minister who would make that decision, because it would be advice to the minister, I assume, for her to be able to make a determination whether to go forward. Maybe the
[ Page 13591 ]
minister could be a little clearer just as to whose privilege is getting breached here.

Hon. M. MacDiarmid: I would just say that if there are any other individuals or groups that are concerned about the legality of this, of course, they have the ability to seek their own legal opinions.

S. Simpson: I have no doubt that that's going on, probably as we speak. Unfortunately, what we have here is a situation where the minister has got up and told us that there's nothing to see here, in terms of any relationship between Bill 29 and the court decision around the need for meaningful consultation and Bill 18.

The minister has then said: "Yes, I have a legal opinion that supports that view." But unfortunately, she isn't prepared to make that opinion available, which probably could save…. If it's a solid legal opinion and supports that view, it might save a lot of people, including the government, some money. It might make a few lawyers a little poor, but it would save a lot of people a lot of money, who may well be going to court. If the minister truly wants to be consulting and advising and trying to do something of a collaborative nature, that might have been a good start.

The minister says that it's her view that this won't change, have an impact on, collective bargaining. That was the premise of the comment around 29. One of the things the minister said was that Bill 29 was about impacting collective bargaining and that this won't, in fact, do that, so it's different. Can the minister tell us what the purpose of this is, in terms of collective bargaining, if it's not having an impact on collective bargaining?

Hon. M. MacDiarmid: I certainly appreciate the comments of the member opposite, being very thoughtful about saving the government money and being collaborative. It's very welcome.

Can I just start by talking about how this contemplated change could help the health system? From a management perspective, to have all professional nurses bargain together for a single provincewide nursing agreement can optimize opportunities to identify and resolve professional practice issues within and between nursing designations that have direct impacts on work design and the cost of care delivery.

A single provincial collective agreement that covers all nurses, whether they be registered nurses or licensed practical nurses, holds potential benefits for both management and labour.

I believe the member opposite was paraphrasing me but, certainly, misquoted me in his comments previously, so I did want to say, once again, that this legislation does not have anything to do with Bill 29.

It doesn't interfere with the terms of existing collective agreements between health employers and the multi-union bargaining agents with which they have negotiated these terms. It does not prohibit future bargaining between health employers and the multi-union bargaining associations on important terms and conditions of employment. LPNs and the unions that represent them will have full opportunity to participate in meaningful negotiations over the terms and conditions of their LPN members and other members.

[1105]

S. Simpson: Talking a little bit more about bargaining, obviously this affects the 8,000 or so LPNs that are in the province who now will be moving from the current bargaining structures that they're involved in over to the Nurses Bargaining Association. Can the minister tell us what she anticipates the impact will be on LPNs to have made this move into the Nurses Bargaining Association? What's her expectation about what that means in material terms for those LPNs to now be there?

The minister has made the decision that this is a good thing to do. It may well be a good thing to do, but she's made this decision it's a good thing to do. What does she anticipate the impact will be on LPNs — who are the most impacted group, presumably, in this decision?

Hon. M. MacDiarmid: In terms of the material impact on licensed practical nurses, the way that our government has seen this is that there was very democratic process that followed rules that are laid out. And 69 percent of the LPNs who voted, voted for this change. I believe they perceived that there would be material changes that are advantageous, but I wouldn't want to speak for them.

S. Simpson: There's no doubt that a significant number of LPNs made the choice through the appropriate procedures available under the labour code to be represented by the Nurses Union, and that's quite appropriate for them to have made that decision. As the minister will know, this piece of legislation is a couple of sentences, without a lot of explanation around it. It's a pretty brief bill but a big implication. I'm trying to just understand: what is the expectation of what the impact on LPNs is?

There has always been debate around, of course, scope of practice and those kinds of issues with LPNs versus RNs and others. That's always been to some degree — sometimes positive but some dynamic tension. How does this change in terms of how they bargain and have impacts on those LPNs moving forward? Has there been some thought put to that? I'm trying to get a sense of it in those terms.

Hon. M. MacDiarmid: These will all be topics of discussion should this legislation pass. Just speaking generally, the scope of practice of LPNs over the last number of years has changed markedly. Their training has changed, and their scope has expanded. With this legislative change, in the bargaining unit there will be licensed prac-
[ Page 13592 ]
tical nurses along with registered nurses and registered psychiatric nurses. I believe it could facilitate further expansion of scope of practice.

I've spoken about this in an earlier bill today. Over the last number of years our government certainly has shown that we're committed to having health providers work to their full abilities and to work to the fullness of their individual scope of practice. That change could be enabled by this, but it was happening regardless.

S. Simpson: On a matter that is not entirely related but somewhat related — it certainly could have an impact — we know that the government announced the intention to hire somewhere in excess of 2,100 new nurses and to bring them in. Is there any expectation that those new nurses coming in…?

[1110]

I know there's an open debate about where the money for those nurses comes from. Are there any implications of or impacts on that decision by the decisions around Bill 18?

Hon. M. MacDiarmid: It's perhaps not relevant to the bill that we're debating, but I certainly would like to correct the member opposite. He may be having a debate, but there's actually no debate about the funding. There is clear funding in the Health budget for the 2,125 nurses. This was part of the recently negotiated agreement with the B.C. Nurses Union. According to the terms of that agreement, these are registered nurses, and we have every intention of fulfilling the obligations, over four years, for the hiring of at least an additional 2,125 nurses.

S. Simpson: Part of the assurance…. The minister says that the money is there, and it's probably a couple of hundred million dollars to do that, I assume.

Could the minister tell us, then: is this decision to bring in these nurses, the new RNs, not going to affect the number of LPNs who will be in that bargaining unit directly, by them coming in? I'm just trying to determine whether these nurses get affected by being in the same bargaining association. Is it going to affect the number of LPNs that are there?

Hon. M. MacDiarmid: The two collective agreements come together. There's no impact on either of those agreements or on the number of people in either agreement.

S. Simpson: Can the minister tell us, then…? I believe these collective agreements expire later in 2014. We're a year, or a year and a bit or so, out from expiration of the collective agreements that we're talking about here.

I'm going back a little bit to the consultation question, because we had determined here that the bill won't be brought into force until there's consultation completed, in some indeterminate period of time. It could be brief. It could be longer, I guess, depending on how it all goes.

I guess, in theory, if collective bargaining is a year or a year and a bit out — and I'm sure the minister can clarify those dates for me — we have that period of time, or a portion of that period of time, to finalize this, to allow this new bargaining association to come into play both on the employers and the union sides and to allow them some time to do what they need to do.

Is that really the deadline here — the next set of collective bargaining and getting this thing finalized in advance of that, to allow all the players to that next set of bargaining to be able to do their work under this new structure?

Hon. M. MacDiarmid: I'll say, as I've said before, that it is not clear to me at this point how long the consultation process will take. I'm not prepared to even make a guess as to that. But the member opposite is correct. These two collective agreements expire at the end of March in 2014.

S. Simpson: Is there an anticipated financial impact for government of moving, of this restructuring? Is there an expectation of a financial impact of this move?

[1115]

Hon. M. MacDiarmid: The answer to the member's question is that there could be no cost at all or there could be a small cost. It would depend on the negotiation as to how the two tables would come together into one.

S. Simpson: Maybe just a scope. When we talk about government money and a small cost, I don't even know what that means in government anymore. Small numbers are in the millions sometimes, relative to the big picture of government's overall spending.

Could the minister give us an idea of what "small cost" means? Is there some kind of range there that the minister could give us and what kind of range the small cost might be?

Hon. M. MacDiarmid: I appreciate what the member is saying. As the Minister of Health, my definition of "small" has changed massively since I was in other ministries.

I'm told that the compensation for registered nurses in the province is a little more than $2 billion annually, so it would be relatively small compared with that. Given that we are going to embark on consultation but we haven't done that yet, and given that there will be a negotiation as part of this process, I will stay with my previous answer, which is that it is a relatively small amount or it could be zero.

S. Simpson: Could the minister just clarify…? The
[ Page 13593 ]
minister said there'll be a negotiation as part of this process. I know, ultimately, there will be a negotiation come 2014 when collective agreements expire and that happens. Was the minister talking about that negotiation? Or was there some negotiation to go on prior to that that is different?

Hon. M. MacDiarmid: Let me call what would happen a discussion. It's not negotiations as we think about it — going to a bargaining table. But as the licensed practical nurses…. If they are to be brought into the Nurses Bargaining Association, there would be discussions around that. That is the issue that would need to be discussed and that could potentially have no cost to it, or it could potentially have a small cost to it.

S. Simpson: I'm just about done here. I just want to maybe wrap this a little bit on my understanding on a couple of key questions that I believe the minister has been pretty clear about. But I'll just kind of try to be clear on this on three clear questions.

[1120]

First of all, the minister has recognized that there is a need for consultation here. This act, this legislation, should it be passed today, will not be enacted until there's been an opportunity for that consultation to occur and then, subsequent to that, there'll be a decision about enactment with the LG and that. But there is to be a consultation with all the unions and employers prior to that occurring, that enactment.

[L. Reid in the chair.]

The second thing is that the current bargaining agents who represent LPNs, whether it be the Nurses or the Hospital Employees or the Government Employees Union — that representation will not be affected. They will all just come into this association and become part of this association as members.

Obviously, the Nurses Union will be the dominant partner in that, clearly, but the other unions will be in there at the table in some form of bargaining council. That's the intention. Should members move through other processes under the code, that's an entirely different matter.

Then the third thing is that there is no expectation on the part of the minister that this will diminish the numbers of LPNs that currently exist in the province.

Hon. M. MacDiarmid: Apparently, I'm trying to make things too difficult. The answers are: yes, yes and yes.

Sections 1 and 2 approved.

Title approved.

Hon. M. MacDiarmid: I move the committee rise and report the bill complete without amendment.

Motion approved on division.

The committee rose at 11:22 a.m.

The House resumed; Mr. Speaker in the chair.

[1125-1130]

Report and
Third Reading of Bills

BILL 18 — HEALTH AUTHORITIES
AMENDMENT ACT, 2013

Bill 18, Health Authorities Amendment Act, 2013, reported complete without amendment, read a third time and passed on the following division:

Hon. C. Clark: I seek leave to table a report.

Leave granted.
[ Page 13594 ]

Tabling Documents

Hon. C. Clark: I table the Review of the Draft Multicultural Strategic Outreach Plan. This report was compiled by Deputy Minister John Dyble and his team following a review which I requested on February 28 of this year.

Hon. M. de Jong: I call committee stage debate on Bill 10, Seniors Advocate Act.

Committee of the Whole House

BILL 10 — SENIORS ADVOCATE ACT

The House in Committee of the Whole on Bill 10; L. Reid in the chair.

The committee met at 11:33 a.m.

The Chair: With your indulgence, by leave we'll hear from two individuals who want to make introductions.

Introductions by Members

J. Horgan: Joining us in the gallery today and in fact all week has been someone certainly known to me but perhaps not to all members of the House. Lynn Klein, who has a rather famous brother who was the Premier of the province beside us, has been here all week observing the debates, I think particularly around how it would affect ambulance paramedics. I would like the House to please make him very, very welcome.

G. Gentner: It's a great pleasure to introduce to the House the students of Gibson Elementary School in Delta North. We took them on a great tour and also down below in the dungeon and showed them the jail. Regrettably, they had a few names of fellow colleagues in this House that felt maybe they, too, should spend some time in jail. Will the House please make them welcome.

Debate Continued

On section 1.

K. Conroy: This bill — the definition sets out a rather large scope of issues for the advocate to deal with. It's a very broad definition of prescribed services. I'm just trying to get a sense of where the legislation is going with this. If someone had an issue with their local recreation complex, for example, and referred to that as a health issue, by this definition it seems like this would be something that the advocate would have to deal with. I just would like information from the minister if that's correct or not.

[1135]

Hon. M. MacDiarmid: The seniors services that will be monitored will be prescribed in regulation. When we get to a further section, section 3, it will become clear that the seniors advocate can also analyze issues that he or she believes to be important to the welfare of seniors generally.

I know that you are giving kind of a general example, but it would really depend, and the seniors advocate themselves would have the ability to make determinations about what they would look at. They would have that independent ability to see if they thought that an issue pertained to the needs of seniors, and then they would be able to look at it.

K. Conroy: We'll talk about the independence later. That seems to maybe be the only independence this position has. I'm wondering, then. Facilities that are under the jurisdiction of private owner-operators or non-profit organizations that also provide services to seniors — would they be covered by this legislation or by this position?

Hon. M. MacDiarmid: For the purposes of monitoring, the services, again, would be prescribed. But from the point of view of any issue that the seniors advocate believed was relevant or important to look at, he or she certainly could do that.

K. Conroy: Then this would mean that facilities that are independent housing or small organization-run independent facilities — independent housing for seniors — would be covered under this legislation. So if seniors had issues with the providers of care from these facilities, they could take their issues to the advocate, and they would be dealt with?

Hon. M. MacDiarmid: The seniors advocate will not be looking at individual cases, but it's quite possible that an individual case could come forward which sort of serves as an index case where it becomes clear to the seniors advocate that this is something that impacts on multiple seniors and raises an issue that he or she wishes to address and look at.

K. Conroy: I'm taking from that answer that if the advocate then does see there are individual cases, the advocate will be able to take on those individual cases as a systemic issue. Am I hearing that correctly? Is that what the minister said?

[1140]

Hon. M. MacDiarmid: When an individual case would come forward, there is the potential that the seniors advocate would look at that and say: "This appears
[ Page 13595 ]
to be a systemic issue, and I am going to study that issue and make a report on it."

But with respect to any individual case that would come forward, the seniors advocate could refer that person to an appropriate agency but only with their consent.

K. Conroy: I think we'll canvass the scope of practice for this position later on in the bill.

B. Simpson: Just on section 1.

We're going to get into the appointment and reporting functions in the act later on. In section 2 the appointment is by Lieutenant-Governor-in-Council. Effectively, it's a cabinet appointment. Then section 4: "The Seniors Advocate must advise…the minister…."

For point of clarification, just so that I can ask a question on the definitions, is the minister in that case the Minister of Health? Is that where the direct reporting is?

Hon. M. MacDiarmid: It is the minister responsible for seniors issues. Currently it is the Minister of Health.

B. Simpson: One of the questions, of course, is that if this entity and this person are a function of the Minister of Health or wherever seniors go in a cabinet reorganization post-election…. Under "seniors' services" in section 1 the definition states that seniors services are "prescribed programs, services or systems of support in relation to health care, personal care, housing, transportation or income support that are used by or associated with seniors."

My question to the minister is: if this individual is merely a function of the Minister of Health, what authority or what opportunity would they have to go in to other ministries — ministries that deal with income support, transportation or housing — that are not under Health? How would that person have the authority to be able to go and do investigations or to see what's happening in ministries other than the Ministry of Health?

Hon. M. MacDiarmid: The model that we've used here is a statutory officer. So there are other statutory officers, such as the director of child welfare or the comptroller general, that work across ministries. Although, as the member has pointed out, there are things — for example, housing or transportation — that are clearly not health issues, these were issues that were identified as the ones of most concern to seniors. That's why they've been included in the seniors services. But my expectation — or government's expectation — is that there would be cooperation across ministries, as there is with other statutory officers.

B. Simpson: I mean, I've made it plain in my second reading speech on this bill that I don't think this is the right structure for the seniors advocate. It ought to be an independent officer of the Legislative Assembly. Even independent officers of the Legislative Assembly have difficulty getting information out of ministries and often end up in combative relationships with government in general.

We've seen that recently with the Auditor General trying to get information around B.C. Rail. We've seen it with the Representative for Children and Youth trying to get information out of some of the ministries to do her work.

[1145]

So what in this would guarantee to the public that this statutory officer will actually get the full cooperation of, say, the social services ministry — whatever it gets named after the election — or the Transportation Ministry or even the health authorities, which stand apart from government? What guarantee can the minister give to this House that this statutory officer would get the full support of all agencies, independent from government or within government, to do his or her job?

Hon. M. MacDiarmid: The member opposite has made an interesting point that even in the case when there are statutory officers, cooperation is not always forthcoming — or that that's his perception. Certainly, what I would say is the mandate of the seniors advocate will be clear — the expectation that there will be cooperation within government and that this is a collaborative and constructive role. When we come to later sections, we will be able to talk about the authority to require service providers to provide information. That's the outside-of-government part of this.

B. Simpson: And to the minister's point, though, the fundamental difference that I would see is…. I don't think a statutory officer that reports to the minister will be going into the public domain to force government or government agencies to actually comply with their request, which independent officers can do. They can bring it to a head by way of engaging the press and the public or in the way of reports to Public Accounts that they want the information released and they need the information released to do their job. This function of government — seniors advocate — I doubt very much would ever have the freedom to do that.

On my final question on the definitions under "service provider," the minister may have indicated we can get into it a bit later on. But again, as a statutory officer of government, what ability will this individual, as a function of a minister, have to go to agencies that are contracted under other ministries to do a certain amount of work? We've already seen problems with contracts being deemed to be proprietary, not available for individuals to get access to. The "service provider" definition means "a prescribed public or private person or body" which provides services to seniors.

What authority or what ability would this statutory of-
[ Page 13596 ]
ficer have to compel contractors with different ministries to actually reveal to them the nature of the contracts or the nature of the work done under the contract or the deliverables that they're held accountable to under the contract?

Hon. M. MacDiarmid: Madam Chair, I'm going to take direction from you. We really have now moved to section 8. If the Chair wishes for us to do that, we can. But that is very clearly covered under section 8.

The Chair: Member, do you wish to pass section 1 and then proceed?

B. Simpson: Again, Madam Chair, we're dealing with definitions. Definitions are what inform the other sections. I am asking for clarification — under the definition "service provider," the inclusion of "private person." Now, if the minister is saying we can actually get to that relationship, that's fine. But it is under the definitions that the inclusion of "private person or body" is part of the function of this individual. If the minister wants to answer those questions now, then we'll proceed in the debate. If she wants to leave it to later on, then we'll just come back at it. Either way, we're going to address the issue.

The Chair: Member, if your questions pertain to the definitions section of section 1, please proceed. If not, we'll pass section 1 and we will continue.

[1150]

B. Simpson: Well, I think there are other speakers for section 1, so I'm asking for the minister's direction. I asked a question about the definition in the inclusion of a "private person" in the definition. If the minister wants to wait until an appropriate section in the bill, that is fine. Eventually we will get an answer to the question.

Hon. M. MacDiarmid: I hope I'm answering the question. Under the service providers, it outlines that it will be identified in regulation. There is the possibility that it could be a private entity or a private person. That's possible within the definition.

N. Simons: Just to clarify and maybe put an example to the hypothetical point that my colleague from Williams Lake brought up….

Interjection.

N. Simons: I'm just generalizing.

If seniors in general were to have concerns about a specific program — for example, the DriveABLE program, which was subcontracted by the office of the superintendent of motor vehicles to a private entity…. Perhaps that would be an example that would be useful for my friend from Cariboo North.

To put a specific on a very important question, because this program had extremely serious negative impact on many seniors…. I think, when seniors see an opportunity for a public body to protect their interests, they want to know that it has the ability to do that. Here we have an internal representative that reports directly to a minister, and we've seen in the past that the minister was perhaps more interested in protecting a program than in assessing whether it was actually a good program for the seniors.

In this kind of instance, would we see that a service provider…? Could we also include the authority of the seniors adviser or seniors representative to look into those kinds of issues — the office of the superintendent, for example, or a private entity like DriveABLE?

Hon. M. MacDiarmid: I believe we're on the definitions. To answer the question with respect to the definition of service providers, we've made it, I think, quite clear that it's a subset of the broader set of seniors services, which would be identified in regulation. I could give some possible examples, which could be health authorities, B.C. Transit and local governments. But those are just some examples. It's possible that private sector service providers could also be prescribed.

V. Huntington: Under the definition of "service provider," does the minister anticipate that it will include municipalities, regional districts and treaty First Nations?

Hon. M. MacDiarmid: I don't believe that treaty First Nations would be included, but the other examples that the member has given could possibly be prescribed under the "service provider" definition.

V. Huntington: "Could possibly be prescribed" is not really a fulsome answer, in my opinion. But why wouldn't a treaty First Nation be considered a prescribed provider? They are subject to the primary laws of the province, and if they are providing a service to seniors, would they not be considered a public body?

[1155]

Hon. M. MacDiarmid: There are some real complexities around the question of treaty First Nations, but what I understand from a brief consultation with the minister is that each treaty is different, and in some cases health services could be provided, might be provided. So those services could be prescribed services under the "service provider" definition, but it really does depend.

Then there's some further complexity introduced by the fact that we will shortly have a First Nations health authority. So it's difficult to give a really straightforward black and white answer to her question.
[ Page 13597 ]

Section 1 approved.

On section 2.

K. Conroy: Hon. Chair, I move the amendment to section 2 that is in the possession of the Clerk.

[To amend as follows:

Section 2, by deleting the text shown as struck out and adding the text shown as underlined:

Appointment of Seniors Advocate

2 (1) The Lieutenant Governor in Council The Legislative Assembly, by resolution must appoint a Seniors Advocate who has been unanimously recommended for the appointment by a special committee to fulfill the responsibilities of the Seniors Advocate under this Act.

(2) An appointment under subsection (1) must be made under section 15 (1) (b) of the Public Service Act. The representative is an officer of the Legislature.

(3) The representative must be appointed for a term of 5 years and may be reappointed under subsection (1) for a further 5 year term; for a maximum of two terms.]

On the amendment.

The Chair: Minister, noting the hour. We can return to this after lunch.

Hon. M. MacDiarmid: Noting the hour, I move the committee rise, report progress and ask leave to sit again.

Motion approved.

The committee rose at 11:58 a.m.

The House resumed; Mr. Speaker in the chair.

The Committee of the Whole, having reported progress, was granted leave to sit again.

Hon. M. Polak moved adjournment of the House.

Motion approved.

Mr. Speaker: This House stands adjourned until 1:30 this afternoon.

The House adjourned at 11:59 a.m.

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