Orders of the Day

Hon. M. Farnworth: In this House, I call committee stage on Bill 14, the Heritage Conservation Amendment Act. In the Douglas Fir Room, I call continued committee stage debate on Bill 19, the Energy Statutes Amendment Act. And in Committee C, the Birch Room, I call continued debate on the estimates for the Ministry of Health. If those were to wrap up, then it would be the Ministry of Attorney General estimates.

[1:35 p.m.]

Committee of the Whole House

BILL 14 — HERITAGE CONSERVATION
AMENDMENT ACT, 2019

(continued)

The House in Committee of the Whole (Section B) on Bill 14; J. Isaacs in the chair.

The committee met at 1:39 p.m.

On section 14 (continued).

M. Bernier: Thanks to the minister. In section…. Actually, I’m not sure where in this bill, but section 14 looks like it might be the appropriate place.

[1:40 p.m.]

It was my understanding, and I’m just trying to find it in here…. When I look through the Peace region, part of the Elk Valley and other areas where we have some of the majority of the paleontological finds in the province of British Columbia, I’m wondering if the minister can point to in this bill, under the heritage protection, if or where we have protection for those particular finds that we have in British Columbia.

Hon. D. Donaldson: Paleontological finds are not automatically protected but can be protected under a formal designation, which is the way they’re protected under the current act and the way they’ve been protected in the past. So those kinds of formal designations can happen on private land under section 9 of the act that we covered already and under Crown land under section 11.1 that we covered already. That’s under the newly formatted sections of the act under these amendments.

M. Bernier: Sorry. I know the minister…. If I heard him correctly, it’s not specific. This is one of the, I guess, questions I have. This is something that most of the local governments, communities, regional districts around the province that have these specific, I would say, assets have been asking for.

When you look at, right now, I believe, within this minister’s purview and jurisdiction, everything appears to be more of a handshake deal if it’s on Crown land. I’m curious on what the thought process was when this bill was being drafted, why it’s not in here. Or is there something that’s going to be applied maybe later in regulation to actually protect this provincial asset, which is of huge significance.

As the minister knows — I believe he knows — in the northeast, for instance, we have a UN designation as a global geopark because of these paleontological finds, some that are very unique and some of the only specific fossil finds that we’ve found anywhere in the world. So we get that designation because of it.

In order to keep that UN designation, which the province has been very proud about, we have to have some form of regulation legislation in order to protect these finds. One of the challenges that we have right now is that there is nothing stopping someone from going into my area, the Elk Valley, and taking an amazing asset, fossil find, and transporting it out of the province, whether it’s for financial gain or even just into a museum to showcase. The thought is — and I hope the minister agrees — that these are B.C.’s assets and we should be showcasing and touting them.

Back to the point, I assume I heard the minister right when he said there’s nothing specific. Is there a way through regulation, if this bill passes, to put something in to protect these fossils that are mostly in Crown areas around the province?

S. Chandra Herbert: If I might make a request for leave to make an introduction.

Leave granted.

[1:45 p.m.]

Introductions by Members

S. Chandra Herbert: I want to welcome students, teachers, parents from my neighbourhood, from King George. Of course, they’re represented by myself, but they live in the West End, Coal Harbour, downtown Vancouver and from across Vancouver, coming down to King George. It’s a great pleasure for me to be their representative, to stand on behalf of themselves. They can’t vote yet, but they certainly have opinions. I look forward to meeting with them after they view this proceeding — to hear them so that I can better represent them as their member of this Legislature.

Please welcome King George to the House.

Debate Continued

Hon. D. Donaldson: What is or can be protected under the act is not changing. There’s no automatic designation or no automatic protection for paleontological discoveries or finds or artifacts, I guess. However, under section 11.1, they can be formally protected on Crown land.

M. Bernier: I appreciate the minister’s comments, and I read that in here. I guess my question is: is there any intention to…? When the minister is saying it can be….

One of the things that we’ve been trying to get in legislation, or through regulation, even, is the designation for paleontological finds to actually be identified as a heritage find in the province. I was always told, and the minister can correct me if I’m wrong, that under this Heritage Conservation Act…. That’s where I was told would be the best place.

Originally, we were trying to see, you know, if there is a better way to do this — through, maybe, a different act, a different regulation specific to paleontological finds. But under 12.1, when it talks about heritage protection…. I mean, everything — it’s in 12.1, under section 14 — talks about how we should be protecting heritage finds.

I guess my question is, back again: is there an intent by this government or by this minister, even though it’s not specific in wording, because he said just now that it can be…? Is the intent that it will be, after this act passes, able to bring in designation around paleontological finds as well?

[1:50 p.m.]

Hon. D. Donaldson: The intention is to protect paleontological resources as it is now, using a formal designation. So if there’s a fossil discovery, then the ministry is able to go and inspect that discovery and to assess the significance of that discovery. Then depending on that, a temporary protection order under the existing act can be issued until the significance of that discovery is assessed. If it’s decided that it’s a significant site, then under the existing act as it is now, a formal designation can be created.

M. Bernier: I appreciate…. I’m bringing this up, obviously, as the minister is aware. But I guess I should backtrack a little bit and quantify the views that I hope to see as we go forward.

Obviously, the last thing I want to see is back-country areas shut down because of paleontological or heritage sites. What we hope to see, though, is that relationship — created through local government, industry, provincial government, as well, whether it’s regulation or in the act — to make sure that these significant finds are protected.

The minister, if he’s ever travelled to places like the Museum of Natural History in New York, if he’s gone to Drumheller in Alberta — places that showcase amazing paleontological resources and finds — what he will notice is a lot of those are from British Columbia. The reason why I bring this up is I think we’re missing out on a huge opportunity here.

This isn’t about necessarily protecting the land base. It’s about making sure that we have opportunities and policies to make sure that when something is found, we can actually benefit from it. The people of B.C., the local governments, can benefit.

If the minister hasn’t been there, I encourage him to stop by Tumbler Ridge specifically. This all started as volunteer-based. We have an old school that was closed down that is now turned into a museum. Volunteers working with partnership and sponsorship from industry — in the coal-mining industry specifically — have worked really closely with the communities and the volunteers to set up an amazing resource that they have there, as well as not only the discovery centre.

They’re doing all of the paleontological research. We have some of the only paleontologists in British Columbia based in that region because of the immense finds.

I guess it’s that tricky area. We’ve been very lucky — and I’ll use the word “lucky” in a sense of good stewards — in the fact that the industrial partners we have up in the area…. If they found a find or something that they think might be of historical value of any sort — whether it’s under the heritage act, as it is right now, or their due diligence as good partners in the area working with the volunteers — they’ve done the right thing and stopped whatever activity they’re doing, called in the experts that we’ve been able to get.

Because of that, again, these finds that we have, have now been recognized globally, without regulation or policy. But what has happened, as I said at the onset of this time, was that there’s nothing guaranteeing that those stay in B.C.

Again, I just want to…. I guess, if the minister has given some answers that it’s not in the act, it’s not something, obviously, I’m wanting to put an amendment on or anything. It’s more of a comment, then, to the minister that as this goes forward, I invite him, again, up to the region for him to see firsthand, and also through the Elk Valley and other areas.

The minister would obviously note that where most of these finds are, are in areas where we have active mining operations. Specifically, because you’ve got historical coal beds, which typically, also because of the geology, bring out a lot of the time — through about 100 million years ago, where these species were on earth.

[1:55 p.m.]

I’m hoping that the minister will take note of the fact that we want these assets to stay in B.C. We want support for our local governments who are doing the best they can to promote these assets with no help or support from government. Actually, I will quantify that again by saying that’s not specific to this minister or this government. It’s something I’ve been working on for a while, and I think it’s time that we get those supports in place.

Does the minister look at anything, then, after this bill to try to work with local governments around these finds to actually identify them more specifically? And can he, maybe, tell this House what his plans are going forward on that?

Hon. D. Donaldson: The member covered a lot of ground there, but I think the essence of the comments was the importance of these finds in B.C., not just for the natural history that they represent but the opportunities for local communities. I take those comments to heart. The bill that we’re considering here does not contemplate that blanket designation through regulation or otherwise. I think the member, in the beginning of his comments, pointed out what could be some unintended consequences of that, as far as access to the back country and other factors.

There’s still, as I said, the ability to create a formal designation. If a site has been formally designated — and the act has permitted this since 1994 — then if artifacts are removed, people can be charged. If they’re taking them out of the province from a formally designated site and transporting them out of the province, then that’s an offence.

As far as the member’s comments about how to work through some of the concerns that he has voiced on the future, I’d be more than happy to meet with him and talk about some of the possibilities that he has in mind. As well, I’m always happy to meet with local governments who have those concerns, to see if there are solutions in the future that go beyond what we’re contemplating today.

J. Rustad: When last we were speaking about this, on section 14, we were talking about the requirement to pay for an order that is being done. I’m just curious. Under section 14, 12.3(3), the comments at the bottom there: “…the minister may require the person purchasing, subdividing, developing or using the property to undertake or pay for the heritage inspection or heritage investigation.” But under 12.3(5), if there is damage done, it’s the government that would be required to pay or compensate for any damage that might have been done to the property.

I’m just curious as to why the difference there between government asking a proponent to pay on one hand, but if something is done, then government is offering to pay for any particular liability or damages that are created.

[2:00 p.m.]

Hon. D. Donaldson: Just to clarify, under section 12.3(3), the minister may order a person to pay for a heritage inspection. And then under 12.3(5), if the person has been ordered to undertake the inspection and that person has contracted somebody, or during the course of the inspection that has been ordered, damage occurs, then the government is responsible for that damage, liable for that damage, because that order was issued by the government in the first place.

J. Rustad: So the order was issued by the government. The individual or group has to pay for that order, but if there are damages done, then the government is liable for the damage that has been done.

The reason why I’m asking, as well, and we’ll get to this under section 24, where it says that to preserve…. This is the issue of if the minister considers the property protected. The minister “may order the owner, subject to requirements, specifications and conditions that the minister considers appropriate, to preserve the property” at the expense of the government.

I know that we’re not at that section yet, so I’m not asking a question specifically about that. But we’ve got a case here, where, if something is found and protection is put in place, government is ordering that to be preserved. Government will pay for that. We’ve got a case where if there are damages done, the government will pay for that. But the individual is still required to pay, if the ministry asks that individual to, for the actual inspection process.

I’m just wondering why it’s not consistent all along. Why wouldn’t we have the situation where, if an order is put in place to do an inspection, there’d be an expectation that government would pay for that order?

Hon. D. Donaldson: I would suggest to the Chair that we’re on section 14, and there is no inconsistency in section 14 between 12.3(3) and 12.3(5). If the member wants to bring up inconsistencies that he feels exist around section 24, we can deal with that when we get to section 24.

J. Rustad: It wasn’t a matter of inconsistency. The question directed to the minister is: why is the minister asking individuals to be burdened with that cost — or potentially, they may be burdened with that cost — when in other circumstances, the Crown accepts its responsibility?

Hon. D. Donaldson: This section, 12.3(3), is if…. The minister may — it’s discretionary — require a person purchasing, subdividing or developing the property to undertake or pay for a heritage inspection. If a proponent is developing the property, the minister may require a heritage inspection and may require the developer to pay for that. If damage occurs during that undertaking, the government is liable for that damage because the government ordered the developer to undertake that heritage inspection in the first place.

J. Rustad: I guess I’m not stating the question clearly enough. Perhaps I’ll try it a different way. Does the minister feel it’s appropriate that, from an order from the Crown to undertake work, the individual or party responsible should be required to pay for that order?

[2:05 p.m.]

Hon. D. Donaldson: As we’ve stated before around this section, this is no change from the existing act. It’s a discretion for the minister, who “may require the person purchasing, subdividing, developing or using the property to undertake or pay for the heritage inspection….” This is consistent with the proponent-pay policy that we see in other legislation, such as in the Environmental Assessment Act.

J. Rustad: I’d love to get into the Environmental Assessment Act, but that isn’t what we’re here to debate.

Maybe I should ask this question first before we go any further. Have there been any orders under this section of the act since its introduction in the Legislature in 1994? How much was the cost to the individual or group that that order was given to, in terms of carrying out the inspections?

Hon. D. Donaldson: There have been orders since 1994 of the type that is referenced in this section. As far as what have been the costs of those orders to those developers or individuals — the persons purchasing, subdividing, developing or using the property — they’re not required to reveal those costs to the ministry, so we don’t have an accurate figure on how much that has resulted in costs to developers. But as I already answered in a previous question, costs for these kinds of inspections can vary from hundreds of dollars to tens of thousands of dollars, depending on the scope and scale and the geographic location where the inspections take place.

J. Rustad: As I mentioned last time, when we were discussing this the other day, the cattlemen have come and expressed concern with regards to having to pay. They had a recommendation that the province establish a process to fund these sorts of inspections and assessments that are required to be done. I have heard from developers. I’ve heard from individuals that have expressed concern.

For example, there is an area where I live, at Cluculz Lake, that has a designation as a potential heritage site. People have said: “I want to build. I want to put in a driveway” or “I need to build a shed on my property” or “I want to do some modifications to the home.” The cost they had estimated ranged anywhere from $30,000 to $80,000 for an individual, for a house on a lake, to do something simple in terms of a modification to a property. And because these areas are not identified — they’re not necessarily out there on a map — it’s buyer beware. This is a real challenge for individuals as they buy a piece of property, and they want to do something. Or maybe they had this property for years or in the family, and they wanted to do something on the property.

[2:10 p.m.]

I know we all have the desire or interest in terms of wanting to protect the values that are of an archaeological nature. You may think of $30,000 or $50,000 on the Lower Mainland, where housing prices are $1 million, as not being a lot. But in a place like Cluculz Lake, where I live, where housing prices might be $250,000, you’re talking about potentially up to a third of the value of the home and property having to be spent on an archaeological assessment to maybe find something or maybe not find something in terms of this.

Now, that isn’t necessarily an order as per this section, but it speaks to the issue that I’m trying to get at, which is: this act creates a burden, whether it’s on property owners or people that want to do things, whether it’s on private land or otherwise, that is, of no fault of theirs, an interest to the province.

The province has said it wants to protect its heritage, and I don’t disagree with that. I think we need to protect the heritage. But there needs to be a mechanism, because these kinds of costs could lead to a situation where people don’t want to report because they don’t want to have to go through this stuff. I mean, that would be breaking the law, and I’m not suggesting anybody should do anything like that, but I’m concerned that you may end up in a situation where you’re missing valuable archaeological information or artifacts simply because the cost becomes too prohibitive for an individual to be able to proceed. So it’s a real concern.

For that purpose and for that reason, I’m suggesting an amendment. I’d like to move the following amendment to this section. There’s only small change, but I’ll read through the whole section which starts off with 12.3(3):

[SECTION 14, by deleting the text shown as struck out and adding the underlined text as shown:

12.3 (3) If an order for a heritage inspection or heritage investigation made under subsection (1) relates to

(a) alienation of government-owned property,

(b) a public work authorized to be undertaken under an Act,

(c) the extraction or harvesting of resources from land,

(d) the subdivision of land, or

(e) changes in use or development of land,

the minister may require the person purchasing, subdividing, developing or using the property to undertake or pay forthe heritage inspection or heritage investigation and have all related costs reimbursed by the government.]

On the amendment.

J. Rustad: The piece that is changed is taking out the “or pay for” and adding in at the end “and have all related costs reimbursed by the government.”

The intent, once again, with moving this motion forward is that it is a government responsibility for heritage in the province of British Columbia. We recognize that. We have an act that is in place to protect the heritage values. It shouldn’t be a burden upon individuals who, by no fault of their own, may find themselves in a situation where there’s an order in place to investigate the potential heritage value.

By putting this in, it creates ability for people to be able to come forward with information willingly because they know it’s not going to be a significant financial burden. Quite frankly, it is the responsibility of the Crown, so that’s henceforth why I’m moving this amendment.

The Chair: Could I suggest a two-minute recess until we get a copy to the minister?

The committee recessed from 2:13 p.m. to 2:15 p.m.

[J. Isaacs in the chair.]

The Chair: The question is the amendment to section 14 proposed by….

Member for Nechako Lakes.

J. Rustad: Thank you, Madam Chair. I think the minister was going to be responding. You sounded like you were about to call the question. I just wanted to be careful, because there may be some discussion about this before we get to the question.

The Chair: Fair enough.

Hon. D. Donaldson: Before we call the question, I would just say that the consequences that are outlined by the member in this proposed amendment could have significant financial costs to the government, so we’re not going to be able to contemplate this amendment at the time.

For instance, on looking at it, it would require the government to undertake all costs related to a developer proposing a major development if the minister has ordered that a heritage inspection has to occur as part of that development. We can’t support this amendment because of the significant potential cost to government.

J. Rustad: I find that somewhat interesting from the perspective of the minister talking about the potential of a significant financial burden upon government. What do you think that would be to an individual, in terms of this going forward — as individuals that are out trying to do something?

I get that there may be a situation where there may be some talk with regards to a developer and a large product and that side of things. But if somebody is just trying to put in a shed, and they have to incur a significant financial burden, that is not fair. It’s not right.

It’s the province that values the heritage components that are out on the land base. It’s the province that has asked for this. It’s the province that should have that responsibility to pay.

If the minister is worried about a significant contractor, a large developer doing a project, perhaps there’s a way to modify this. But we need to find a way so that we aren’t overburdening individuals in particular, whether it’s ranchers or others, with the costs associated with doing this type of project, and create a potential fund or some other mechanism where government can help or cover the costs associated with this.

I’d ask if the minister is interested in potentially even standing down this section, assuming the amendment does not fail, to give an opportunity to be able to work collaboratively to come up with a process that could see individuals not having to cover these sorts of significant costs.

Hon. D. Donaldson: We’re not considering this amendment in its current form because of the potential implications, which are unaddressed, to significant financial costs to the government.

The member talks about some other examples beyond major development. We’ve already covered the ground around fence posts and ranchers, where, if there is low impact to potential sites, they might not even be required to get a permit. There could be blanket exemptions, depending on specific circumstances.

[2:20 p.m.]

The member brings up an example of a shed. If it’s not a ground-altering project, then a shed could be permitted or not even require a permit, depending on where and the circumstances. If there were potential impacts, then the ministry can work with the proponent to create mitigative measures, so we’re not going to be entertaining this amendment at this time.

J. Rustad: It’s a shame. The minister knows that if you’re putting in any structure, whether it be a septic tank or a shed or something else, you pretty much have to lay some foundations of some kind or put a hole in the ground to be able to do these things. If that is within an area that has potential archaeological values, there’s a potential issue with doing that.

It’s unfortunate the minister won’t consider the amendment. We’ll let the amendment go forward for a vote, and then I’ll ask the minister about potentially other options that we could consider.

Amendment negatived on division.

J. Rustad: Well, like I say, it is disappointing. Would the minister consider, like I mentioned earlier, potentially standing down this section to find a way to create a bipartisan approach, a mechanism by which individuals — small projects — would not have to burden the cost of such inspections or orders?

Hon. D. Donaldson: This section is a discretionary section. It says that the minister may order a proponent, a person “purchasing, subdividing, developing or using the property to undertake or pay for a heritage inspection.” It doesn’t say it has to happen. It’s discretionary.

I’ve already discussed some of the measures that can be taken into consideration, site-specific, and how those can be applied in cases where individuals are bringing either the construction of a shed or fencing. So I’m not willing to stand down on this section.

J. Rustad: Moving past section 14 on 12.3(3), looking in particular at 12.5(3): “A permit does not authorize the permit holder to enter property, or to make any alteration to property, without the permission of the…occupier.”

[2:25 p.m.]

Later in the act, when it talks about entry and inspection, it talks about being able to go onto property. I’m just wondering why, under the permit requirements and conditions, it does not allow the authorization to enter onto the property, in particular, without permission of the owner.

Hon. D. Donaldson: This section 12.5(3) refers to a permit holder — a site alteration permit, for instance. It just gives the permit holder the ability to do the site alterations, not to enter property.

We’ll get what the next section that the member referenced…. When we get to that, that’s regarding not permit holders but natural resource officers.

J. Rustad: I’m just curious. How does one go about getting a permit to undertake work on a piece of property that isn’t their own?

Hon. D. Donaldson: An example of that would be Crown land.

J. Rustad: Okay. That’s an interesting example. So the Crown has issued a permit to go onto property, and they have to get permission from the Crown to go onto the property? Is that what the minister has just said?

Hon. D. Donaldson: The permit authorizes the permit holder to conduct an activity, and that’s what the permit is strictly referencing. To access the property in order to do that activity requires permission of the property owner. That’s what this section is about — that the permit issuance for the activity doesn’t automatically grant the permit holder access to the property or permission to enter the property.

J. Rustad: I’m just curious about this again. I need some further clarification from the minister, if I could. How does an individual or a group organization receive a permit for an activity on somebody’s property, without their permission to do that? I’m not quite sure. I’m not sure exactly what this is trying to get to.

Assuming you’ve got somebody who is going to do some construction or some work or a road or whatever it may be, there would have been some sort of agreement in place to get on the property. Otherwise, they would never have been able to get access to a permit. So I’m just curious. I’m confused with the minister’s answer, so perhaps the minister can provide some more details.

Hon. D. Donaldson: Again I want to emphasize this is the current wording from the act. It’s not changed under the amended act that we’re considering today. This is simply to provide legislative clarity that because you hold a permit doesn’t mean you necessarily can enter the property.

An example might be that a property owner might not hold the permit because the permit might require some specific recognized skills that are required under archaeological training. So an owner would not be able to access that permit.

[2:30 p.m.]

The heritage branch, under this act, or the government, the ministry, would issue the permit to a qualified individual. That’s legislative clarity. In no way does that allow the professional entry to the property, unless it’s under the authorization of the property owner.

J. Rustad: To the minister, thank you for that explanation.

[R. Chouhan in the chair.]

I want to continue moving on through section 14, in particular, looking at No. 12.7 under section 14: “Amending, suspending or cancelling permits….” Under (2), it says, “The minister may take any action under subsection (1) if the minister has reasonable and probable grounds to believe any of the following,” and it goes through a list of a number of things.

Where would the minister receive information that would lead the minister to have probable grounds to believe that any of those followings may have occurred?

Hon. D. Donaldson: The probable grounds. The member was asking how the minister would get information around probable grounds. Well, that would come from expert witness testimony. For instance, an archaeologist could be on site monitoring the work and inform the ministry that there has been a contravention. That would be probable grounds.

J. Rustad: I would recognize that — if there was such oversight that was happening in an activity and it was reported. What I’m concerned about in this particular section is if a member of the public at large, of no particular skill set, were to report something to the minister, whether that would be giving the minister probable grounds to believe that any of the following had occurred.

Hon. D. Donaldson: Obviously, part of the act is to ensure the protection and conservation of heritage values. If a person reports concerns to the ministry and, therefore, to the minister, it would depend on the circumstances — whether they had, for instance, photographic evidence or otherwise. Those are just examples. If it’s deemed that there’s a possibility, then the minister could ask the ministry to send a qualified individual out to inspect the site to determine if probable grounds are there.

J. Rustad: Is there any penalty or other consequence for somebody making a false claim with regard to potential activity that may be happening or potential archaeological value that may be there?

[2:35 p.m.]

Hon. D. Donaldson: There’s no penalty in this act. There are other forms in other acts that would qualify for Criminal Code mischief. Staff are well versed in working with individual members of the public. I’m sure that the member’s constituency assistants know about what can sometimes become people who are continually registering false assertions. The staff is well able to understand legitimate, serious concerns from those that aren’t as valid.

J. Rustad: The situation, in particular, I was thinking about was a situation where there were some artifacts that were found on the Coastal GasLink project which were likely had been placed there after the fact and then, of course, reported through to the ministry, looking for a way to be able to stop a project. The concern, of course, is that that obviously could potentially have financial consequences or other consequences to a project that might be moving forward. I just use that as one example.

In cases like that, obviously, there’s a requirement — or the minister may, at his discretion, decide — to do a follow-up and look at it. That’s a situation that could be quite serious, particularly for a small developer or for other types of projects where there may be some contentious issues that are going on. That’s just why I was considering that.

If the minister thinks that it’s covered off under Criminal Code activity, then perhaps that’s good enough. But I want to just ask the minister for some clarity around that so that if one of those circumstances does happen, there’s some clarity in terms of how this act would be applied.

Hon. D. Donaldson: The member brings up and makes some statements about a specific situation. I’m not going to address those specifics because there have not been the determinations that he has outlined. However, I am willing to discuss the broader question that he addresses of how the act deals with considering probable grounds when it comes to information reported by members of the general public.

Again, I’ll say that once those concerns are registered with our ministry, staff assesses those concerns and any evidence presented and then can send a qualified staff member from the ministry to the site to investigate the report. There are opportunities to address the concern if it is found to be valid. In the section we’re discussing, 12.7(2), it outlines what actions can be taken if it’s deemed by the minister as probable grounds. If there are cases where the situation warrants it, then investigations can lead to violations under the Criminal Code. That’s often up to law enforcement or even the proponent.

Sections 14 to 17 inclusive approved.

On section 18.

Hon. D. Donaldson: Before we get to the member’s question, I move the amendment to section 18 standing in my name in the orders of the day.

[SECTION 18, in the proposed section 15.1 (3) (d) (ii) and (iii), by deleting “or control of” and substituting “or control, of”.]

On the amendment.

The Chair: The member on the proposed amendment.

J. Rustad: If we could take a two-minute recess, I just want to read the amendment that the minister is putting forward. I haven’t seen it yet. So five minutes here.

The Chair: The House will be in recess for ten minutes.

The committee recessed from 2:40 p.m. to 2:48 p.m.

[R. Chouhan in the chair.]

Hon. D. Donaldson: I move that the committee rise, report progress and ask leave to sit again.

Motion approved.

The committee rose at 2:49 p.m.

The House resumed; Mr. Speaker in the chair.

Committee of the Whole (Section B), having reported progress, was granted leave to sit again.

[2:50 p.m.]

Report and
Third Reading of Bills

BILL 19 — ENERGY STATUTES
AMENDMENT ACT, 2019

Bill 19, Energy Statutes Amendment Act, 2019, reported complete without amendment, read a third time and passed.

Hon. D. Donaldson: I call estimates for the Ministry of Attorney General in the Douglas Fir Room and continued committee stage of Bill 14 in this chamber.

Committee of the Whole House

BILL 14 — HERITAGE CONSERVATION
AMENDMENT ACT, 2019

(continued)

The House in Committee of the Whole (Section B) on Bill 14; R. Chouhan in the chair.

The committee met at 2:51 p.m.

On section 18 (continued).

Amendment approved.

On section 18 as amended.

J. Rustad: I’m curious. Through this section, there are fairly sweeping powers that are in here in terms of entry and inspection where an order’s been put in place. I’m just wondering if this lines up with the Criminal Code and the authorities that have been enacted for RCMPs for peace officers.

Hon. D. Donaldson: I’ll actually read to the member the intent of the change in this section, provision. I believe that will help to answer his questions. This new provision brings the Heritage Conservation Act into alignment with enforcement provisions in other natural resource legislation such as the Forest and Range Practices Act, which provides these powers for the Forest Act and Range Act, the Environmental Management Act, the Wildfire Act and the Water Sustainability Act.

Those are just a few examples of natural resource officers having the provisions that are being outlined in this amendment. Of course, these were drafted by legislative counsel to ensure that they adhere to constitutional law.

Section 18 as amended approved.

Section 19 approved.

On section 20.

J. Rustad: Just a quick question on section 20.

[2:55 p.m.]

In 16.1(1), it talks about a “stop work order that prohibits any alteration of the property for a period of up to 120 days.” Is that standard with other acts that may see similar types of orders being put in place?

Hon. D. Donaldson: The 120 days that’s referenced in this section 16.1(1), under stop-work orders, is consistent with the current act. There’s other natural resource legislation that has stop-work order provisions as well. A couple of examples are the Wildfire Act and the Forest and Range Practices Act. Those periods of time vary. That isn’t necessarily the same as the 120 days, but there are stop-work order provisions in other acts as well.

Sections 20 to 23 inclusive approved.

On section 24.

J. Rustad: I referenced this earlier with regards to 21(1), which talks about the expense of the government with regards to preservation intervention. Perhaps I can give an opportunity for the minister to explain why, and with this particular section, it’s appropriate that government would pay for this action.

[3:00 p.m.]

Hon. D. Donaldson: This is in reference to damage or deterioration that may be happening to a designated site or a site that’s outside of the proponent proposing something under site alteration or outside of an archaeological investigation. If there’s some kind of natural erosion that could be damaging or deteriorating a designated site on a property, then in order to preserve the property, it can be done at the expense of government.

J. Rustad: Not to belabour the point, but in the discussion we had under section 14, under 12.3 was an order by government to do an inspection in case there was an issue, and here we’ve got an order for a further action should there be potential for damage and deterioration.

Once again I’m asking: what is the difference? Why is government paying in this case, where in that case the government was not paying? Sorry. To be clear, government may not pay, of course, because it is at the discretion of the minister — back in the previous section.

Hon. D. Donaldson: This section — I believe it’s section 24 that we’re on — is in reference to immediate temporary protection for the site or the objects on the site. It’s not in reference to archaeological impact assessments, which the previous section was.

In the previous sections, we talked about a minister being able to order an archaeological impact assessment. If, during the activities of that assessment, it’s deemed that further damage or deterioration may be occurring, then the minister may require the property owner to take measures around preservation. The example we had with that in previous discussions in this committee stage was a tarp being put in place.

This section that we’re referencing right now, section 24, is about being able to take actions to prevent further damage or deterioration. An example is if natural erosion is occurring and it’s impacting a designated site on private property. Then it’s at the expense of government to undertake that.

J. Rustad: I do understand that side. But just once again, not to belabour it, you know, there is that fairness factor. In some cases, that fairness seems to be in place, and in some cases, it doesn’t.

With that, that concludes all the questions I have on Bill 14.

Sections 24 to 40 inclusive approved.

Title approved.

[3:05 p.m.]

Hon. D. Donaldson: I move that the committee rise and report the bill complete with amendment.

Motion approved.

The committee rose at 3:06 p.m.

The House resumed; Mr. Speaker in the chair.

[3:10 p.m.]

Reporting of Bills

BILL 14 — HERITAGE CONSERVATION
AMENDMENT ACT, 2019

Bill 14, Heritage Conservation Amendment Act, 2019, reported complete with amendment, to be considered at the next sitting of the House after today.

Hon. D. Donaldson: I call the committee on Bill 21, intituled Forest and Range Practices Amendment Act, 2019.

Committee of the Whole House

BILL 21 — FOREST AND RANGE
PRACTICES AMENDMENT ACT, 2019

The House in Committee of the Whole (Section B) on Bill 21; R. Chouhan in the chair.

The committee met at 3:12 p.m.

On section 1.

J. Rustad: Before we start on this, I forgot to say this on the previous bill: just a thank-you. I appreciate the staff and the work that they’ve done on this and on the previous bills. There may be some difference of opinion, but I always appreciate the work that staff do.

On section 1, definitions. I’m actually kind of curious about “ecological community” and “a group of different species occupying a particular area.” I’m just curious as to that particular definition and what the minister anticipates. Why is that a significant component that needs to be in these definitions?

Hon. D. Donaldson: The new definition for the term “ecological community” is added, as the member has pointed out. An ecological community is a group of organisms occurring together in a particular environmental setting. Examples include some of the most imperiled ecosystems in the province, such as antelope-brush and needle-and-thread grasses.

[3:15 p.m.]

The definition added by this amendment allows the protection tools in the act, the general measure tools, to be extended to ecological communities. Similarly, what exists already in the act is equivalent to the wildlife measures already in the act, as far as extending those protection tools. This definition just provides more clarity around those potentially imperiled ecosystems.

J. Rustad: Under (b), I recognize, from second reading, the desire to take out the range stewardship plans. There are other sections in the act where we could speak about this, but I thought I would give the minister an opportunity right now to provide a rationale for the removal of “or a range stewardship plan.”

Hon. D. Donaldson: Certainly, I would like to address the reasons for striking out range stewardship plans under the definitions section, under 1.1(c), as referenced by the member. He’s right; we can also get into that later, but I will give him the rationale at this point, since we’re in the definitions section.

The rationale is that of the approximately 1,570 range agreements, no range agreement holders currently use a range stewardship plan, given their complexity and additional costs, without significant improvement to the quality of range management. We’re repealing the authority of the minister to authorize a range stewardship plan, which comes later, but it’s consequential to have this repealed in the definition.

It will provide for a single range plan, an example being a range use plan when grazing or cutting hay. So this will simplify regulatory requirements and provide administrative efficiency not only for government but for range agreement holders, which I know was much appreciated by the B.C. Cattlemen’s Association when we met this week.

J. Rustad: I appreciate the minister’s willingness to pro­vide a bit of an explanation under definitions. It wouldn’t be in the normal place where you’d raise this sort of a question, but I thought it might be simpler than many other places in the act where there are changes associated with it.

Just along those lines, I had heard from some ranchers that range stewardship plans were often considered or even developed, in part or in whole, by some ministry staff. Now, I don’t know…. I wasn’t given any examples of that, but perhaps I could ask the minister if he knows of any examples where a range stewardship plan was enacted or worked on within a ministry for a particular client.

[3:20 p.m.]

Hon. D. Donaldson: There have been range stewardship plans presented in the past to the ministry. An example would be that Judith Guichon had to have submitted a range stewardship plan over tenure that she was using for range. Similar to the forest stewardship plan, a range stewardship plan was required to be submitted by the proponent or the tenure holder. Oftentimes they had to hire a professional agrologist to create one and to submit it to government. It’s not the work of government to undertake these plans.

As noted, there is no longer a requirement if and when this bill receives royal assent. The direction this bill takes in eliminating the requirement for range stewardship plans was supported by the B.C. Cattlemen’s Association and the Guide Outfitters Association of B.C.

J. Rustad: Back to ecological community just for a moment. Something just popped up that I was thinking about. There’s a group of different species occupying a particular area. As the minister knows, there could be, obviously, invasive species that are not native or not normal within an area. Does this definition or that component consider whether or not that ecological community would be required to be native to the area or whether it could be a combination?

Hon. D. Donaldson: Ecological community is an established term in biology. It does not include invasive plants, as the member was asking. These are about imperiled ecosystems in the province. As I said, the examples I gave were antelope, brush and the needle-and-thread grass ecosystems. So it’s about an established biological term. It’s not about invasives.

Sections 1 to 3 inclusive approved.

On section 4.

J. Rustad: I think the minister provided some explanations during second reading. The gist of what this bill was about was to restrict the ability to be able to extend the stewardship plans beyond five years and require them to be done and posted. I’m just wondering if the minister can provide some rationale for the intent — to expand, if he could, on his comments from second reading — of limiting these plans to the five years for a forest stewardship plan with only the option for the small number of either months or a couple years of potential extensions.

[3:25 p.m.]

Hon. D. Donaldson: I believe the member was asking for the rationale behind this section. There are a couple of reasons for the changes that are reflected in this section. They have to do with, first off, the fact that there’ve been, of late, many changes on the landscape, whether it’s from pests like the mountain pine beetle or larger fires.

After these changes on the landscape through, oftentimes, natural disturbances but to such a large degree, having the forest stewardship plans renewed every five years and resubmitted every five years…. First of all, it allows the public to be better informed about how forest companies are addressing the changes on the landscape that have happened. It allows First Nations and the public to be better informed. So there’s a transparency aspect there.

Also, it allows more frequent review to ensure that the best forest management practices are being applied on the landscape, due to these large-scale disturbances, under forest stewardship plans. The way the act is now, some of the forest stewardship plans have been continually extended. Some of them are ten years old, and some of them are even 15 years old.

J. Rustad: I thank the minister for that. Has the ministry done a cost analysis in terms of what additional costs this may bring to forest companies?

[3:30 p.m.]

[J. Isaacs in the chair.]

Hon. D. Donaldson: There will be some additional costs associated with now having to submit forest stewardship plans every five years, but we anticipate there is going to be a trade-off there in that there is going to be greater security for tenure holders, knowing that their forest stewardship plans are going to be looked at every five years. With that increased transparency, there is less likely to be opposition from public or FSPs being held up by public concerns when the public is concerned about forest stewardship plans being so long overdue that they haven’t addressed some of the events that have been occurring over the five-year, sometimes even ten-year, period.

So a balance between additional costs. There’s also greater security for those submitting the forest stewardship plans — because less likely for holdups in implementing those plans and less likely because of the transparency factor in opposition from the public, who don’t have the ability to understand what’s going on, on the land base, by a tenure holder.

J. Rustad: We’ll get to section 6, which has the discussion around damages and what have you that may trigger it. I’m curious, though. If there were changes to the landscape because of natural disasters, fires, pests, other types of activities that may happen, it makes sense that there would need to be an updated plan, and I think that’s probably reflected here. But where there are no changes, why would there be a requirement to update the plan when a plan lays out harvesting activities for a longer period of time?

Hon. D. Donaldson: It’s because requiring every five years for the plans to be submitted triggers public review and comment, and it’s part of government’s role to provide opportunities for that public review of forest stewardship plans on Crown land.

J. Rustad: I’m curious. Forestry is a long-term activity. We’re talking about harvesting within an area, through a rotation — 80 to 100 years, maybe 120 years. A shorter rotation sometimes on the coast, in those areas. The activity, of course, is carrying on. It’s not like they’re not going to be logging or they’re going to be increasing logging. It’s logging based on the cut controls.

Without there being significant changes to the area of operations, without there being significant changes to the landscape that’s going on, the public is aware of and obviously engaged with the forest activities, whether it is guide-outfitters or range or mining activities or recreation or other activities within a particular area. All of these things are known in advance. They’re all contacted. They’re all engaged in terms of when a plan comes forward.

Why would there be a need to force everybody to have to go through looking at this every five years if there are no substantive changes to the activity or to the approach that a company is taking within an area? In a way, it would actually, potentially, raise concerns, because people are wondering: “Why am I getting these questions again when I thought I’d just looked at it five years earlier, and there was no substantive change?”

[3:35 p.m.]

Hon. D. Donaldson: First of all, just in a general sense, certainly more opportunities to avail people of participating in oversight of the forests in their communities is something that I think is good and this government thinks is good. We’d rather err on the side of caution when it comes to the ability of the public to have a look at forest stewardship plans. That’s why this transparency factor and requiring them to be submitted every five years is part of the amendments that we’re introducing in the Legislature.

The member does bring up a good point about: well, what if not a lot has changed in the area covered by the forest stewardship plan? I think he was referring to a natural disturbance. If that’s the case, then the job of redoing and then resubmitting the forest stewardship plan wouldn’t be very onerous.

However, there are other changes that could occur over the five-year period that aren’t related specifically to a natural disturbance. There could be new rulings from the courts around Aboriginal rights and title that become an overarching direction that has to be considered in a forest stewardship plan. There might be impacts from climate change over a five-year period that have to be addressed. There might be ungulate winter range changes over five years that need to be addressed.

This requirement to have a plan every five years, resubmit a plan, is able to cover all those and address transparency so that the public is more aware of what’s going on in the forests that surround their communities.

J. Rustad: Forestry activity requires a significant amount of capital, whether you’re investing in a sawmill or some sort of processing facility. Boards or owners of these companies have to make these decisions based on the reasonable expectation for return; the reasonable expectation of being able to have certainty, particularly in fibre; the reasonable expectation to be able to operate on a land base.

Now, there are, obviously, factors — whether it be government changing the land base because of an agreement with a First Nation, a natural disaster or these types of things — and those need to be factored in. But for a company that wants to invest significant dollars for operating, they’re looking for some security. They’re looking for some certainty, or at least predictability, in terms of the fibre supply, in terms of what they can think going out.

They know the risks, and they have the understanding of issues such as forest health or other types of things. They also know about the uncertainty on the land base because the land question has not been addressed or settled with First Nations.

[3:40 p.m.]

Adding this layer in of additional reporting, without being able to extend where there are no other changes, adds a layer of complexity. It may create additional uncertainty for companies that are trying to operate on landscape as to whether or not they should make a decision to invest in the landscape.

As the minister well knows, we’re in a very challenging time in British Columbia at the moment for a variety of reasons. The uncertainty that is being created on the landscape, as well as in the markets, has led to many companies holding back on investments. There’s a concern, of course, that this is just yet another piece of uncertainty.

I guess the question to the minister…. The minister said, I believe…. I’m trying not to put words in the minister’s mouth. From what he said a couple of answers ago, he believes that going back and having to redo plans every five years, going back and engaging the public, going back and engaging various stakeholders and stuff on the landscape will add certainty. The argument, I would suggest, is that it will do the opposite.

Does the minister have any performance measures or any other types of way to measure whether or not this type of policy approach of not being able to extend these beyond five years will create a disincentive or uncertainty for companies, at least over the short term, while there’s an adjustment, or potentially even over the long term?

Hon. D. Donaldson: I know that we covered these kinds of discussions at second reading debate. This is committee stage, so if the member wants to address the question in the context of section 4, or address changes that are contemplated in section 4, then I’d be happy to consider the question.

J. Rustad: Well, it was actually in the context of 4. Section 4 is what drops the forest stewardship plans to five years without the possible extension for another five or ten years, which is what, potentially, is creating uncertainty. This is why I’ve asked the question, so I hope the minister would consider the question relevant, associated with section 4.

Hon. D. Donaldson: In reference to section 4, which requires the forest stewardship plans to be submitted every five years, the reason that this increases certainty for those who are providing the FSPs and are required to provide the forest stewardship plans is that it would be in the realm of the public. There would be less opposition to a plan that is reviewed every five years. The corollary of that is there could be public opposition to a plan that has not been updated publicly or publicly viewed for over five years.

[3:45 p.m.]

This is an ability for the tenure holders to make their harvesting plans explicit on the land base. It helps them in their relationships with the public and First Nations. This act, this new provision, does not speak to tenure. Tenure is for a set period.

Simply put, what’s being addressed in section 4 is how the company will operate on that tenure, and that is through a forest stewardship plan, and a forest stewardship plan is required in order for the company to harvest. By requiring it every five years, it heads off a lot of potential concern from the public if it goes beyond five years and people aren’t aware of what’s planned for the harvesting close to their communities.

It does not, in this section, prohibit an extension. For instance, that five-year plan, under certain circumstances, can be extended. We can give the extension for up to six months if there’s something that is beyond the tenure holder’s control regarding why they weren’t able to resubmit their plan.

Sections 4 and 5 approved.

On section 6.

J. Rustad: This is the section we were talking about, made reference to earlier, with regard to catastrophic damage changes on the landscape. And I’m just curious with regard to this particular section…. As we know, the landscape is dynamic. There are always changes on the landscape. Some of it could be significant, in terms of a large fire; some of it could be relatively minor. What does the minister consider to be catastrophic damage?

Hon. D. Donaldson: Before I begin the part of the answer that relates more directly to the question, I just want to make sure you note in 8(2) that “The minister may order the holder of a forest stewardship plan….” So under this, it’s not a given, but it’s discretionary.

Of course, this is the section related to catastrophic damage. That is left to be decided under the discretion depending on…. It can depend on climate change. It can depend on insect attack. It can depend on fire. But really, the Forest and Range Practices Act was created in order to empower statutory decision–makers at that statutory decision–making level to have the ability to make discretionary decisions about what could be, in this case, catastrophic, because they’re the ones who are in the best position, knowing the local and regional conditions and local and regional concerns of industry and the public and First Nations.

[3:50 p.m.]

J. Rustad: I’m just curious. What is considered to be within the vicinity of a forest development plan? I understand there may be impacts within a plan, but I’m just curious as to what the minister is considering with that.

N. Simons: I seek leave to make an introduction.

Leave granted.

Introductions by Members

N. Simons: I just want to introduce a class from Presidio Middle School, I believe, from Richmond, California — grade 7s, 25 of them. They’re here visiting with another group that’s coming in later.

I just wanted to say welcome to British Columbia, welcome to Victoria, and it’s nice to have you here.

Debate Continued

Hon. D. Donaldson: This is about managing ecological risk. There could be a number of forest development units within a forest stewardship plan, so what might have an impact on one forest development unit might impact another part. Therefore, that’s the reason for the language around “within the vicinity of a forest development unit.”

An example of this could be fires that run across forest development unit boundaries or nearby, as it says in the plan, the vicinity of the forest development unit — if there are ecological disturbances nearby that are impacting water flow, for instance. These are all what are captured by the language “or within the vicinity of a forest development unit.”

Sections 6 and 7 approved.

On section 8.

J. Rustad: Just for purposes of this discussion, I’m curious: what is the time frame of a woodlot licence plan?

Hon. D. Donaldson: The woodlot licence plan term remains the same as it is in the legislation right now, and that’s a ten-year plan.

J. Rustad: Given the small size and the nature of woodlots in a very specific area base, does the minister consider ten years appropriate? I’m just curious whether the minister considered any change to that — potentially extending it.

[3:55 p.m.]

Hon. D. Donaldson: I understand that the member typifies woodlots as small. Whether I thought the requirement for a plan every ten years is appropriate…. I know woodlot owners. I know there can be up to 1,200 hectares. However, there are 855 woodlots across B.C., so from that point of view, they’re not necessarily small, and the stewardship role that they play is significant. So we do feel it’s appropriate for a plan to be required to be submitted every ten years, as it is laid out in the act currently.

Sections 8 and 9 approved.

On section 10.

Interjection.

J. Rustad: The member from the Sunshine Coast thinks it’s too late. Maybe it is too late on a Thursday afternoon.

Under section 10, flipping over to 15.3, “Exemption from requirement to publish a forest operations map.” I’m wondering if the minister can explain the rationale for that exemption.

Hon. D. Donaldson: Just to clarify, was the member talking about section 15.1(3) or 15.3?

J. Rustad: What I was looking at was just where it says: “The minister, in writing, may exempt a person from section 15.1 or 15.2 if the minister considers that timber should be harvested without delay because the timber is in danger of being (a) damaged, (b) significantly reduced in value, or (c) lost or destroyed.”

The reason why I ask that question is that earlier there was the need and the potential desire to update plans if there was a catastrophe or if there was damage being done. And here, it’s saying the minister, in writing, may exempt the person if it’s damaged and to carry on. So I’m just wondering about the rationale for the difference between the two, where one is saying that you may need to update a plan and the second is saying to hurry up and go harvest.

[4:00 p.m.]

Hon. D. Donaldson: Just to give the context under the proposed amendments to this legislation, a forest operations map has to be published by the tenure holder two years before applying for a cutting permit, with approximate locations of the cutblocks and the roads.

If something happens in that two-year period that could result in losing the shelf life of the timber for its merchantability to be used after being harvested, then this exemption gives the minister the flexibility to allow for that harvesting to occur, even if it wasn’t in the forest operations map that was submitted two years earlier.

Sections 10 to 12 inclusive approved.

On section 13.

J. Rustad: Not that I have a question specifically on 13, but just to let you know that I have no other further questions to this bill.

Sections 13 to 62 inclusive approved.

Title approved.

Hon. D. Donaldson: I move that the committee rise, report the bill complete without amendment.

Motion approved.

The committee rose at 4:02 p.m.

The House resumed; R. Chouhan in the chair.

Report and
Third Reading of Bills

BILL 21 — FOREST AND RANGE
PRACTICES AMENDMENT ACT, 2019

Bill 21, Forest and Range Practices Amendment Act, 2019, reported complete without amendment, read a third time and passed.

Hon. D. Donaldson: Could I request a five-minute recess while we get the House Leader and call the next item of business for this chamber?

Deputy Speaker: This House will be in recess for ten minutes.

The House recessed from 4:05 p.m. to 4:20 p.m.

[R. Chouhan in the chair.]

Committee of Supply (Section C), having reported progress, was granted leave to sit again.

Hon. M. Farnworth: In this chamber, I call continued debate on the estimates of the Ministry of Health.

Committee of Supply

ESTIMATES: MINISTRY OF HEALTH

(continued)

The House in Committee of Supply (Section B); J. Isaacs in the chair.

The committee met at 4:21 p.m.

On Vote 31: ministry operations, $20,698,339,000 (continued).

Hon. A. Dix: For people keeping an eye on the debates at home, my many colleagues in the House — I think about 27 MLAs so far — have participated in the debate with respect to the Ministry of Health — in particular, my colleague critics, the member for Kelowna–Lake Country, who’s the opposition critic for Health, and the member for Richmond South Centre, who’s the opposition critic for seniors. We’ve done about 14 or 15 hours of debate. We don’t want anyone to think we’re just starting here now and will end an hour from now. We’ve had a substantial debate on lots of issues.

These are the estimates debates, and I’ll leave the floor to my colleague and friend from Kelowna–Lake Country.

N. Letnick: Thank you to the minister for the 15 hours of debate. We were actually in another room where we were just a few feet from each other. Now we’re at least six sword-lengths from each other, so it’s a different dynamic. I feel like I skipped a couple of grades in school, right? We’ve gone from this little room, skipped the Douglas Fir Room and come to the big House. This is the only big house I ever want to see, by the way. I don’t want to ever see that other kind of big house.

We were actually getting along really well in the other room. Now that we have to scream and yell and shout so we can hear each other, I’m not too sure if the dynamics will be the same, but let’s give it a try.

Since we had a break over the last 3.6 minutes, I thought what I would do is finish off binder No. 1 and come back to drugs in just a sec.

The town of Sidney has problems with physicians. They have five doctors but are told no nurses, so they cannot deliver babies in the area. The medical transportation is an issue. They have no ultrasound, it’s hard to get X-rays and, as I said, no maternity.

No flights for Fort St. John. They need to go to Prince George, and most people need to transport themselves and wait two to three days for emergency evacuation. Obviously, that’s a challenge as well.

Northern Health bus is available, but they cannot afford, in some cases, the hotels required. Their idea is to have a weekly charter to Fort St. John and wanted to know if the minister would be interested in looking into such a solution.

[4:25 p.m.]

Hon. A. Dix: I think the issues raised by the hon. member, issues especially of transportation between rural and remote communities and major centres…. Sometimes we imagine those centres to be Vancouver, but sometimes, of course, people in the north view communities such as Fort St. John or Prince George as the centre that they sometimes have to go to and sometimes have concerns about in getting access to all the resources.

I appreciate the member raising issues around the community of Sidney, around the concerns around doctors. What I’ll undertake to do is undertake to have a discussion with the president of the Northern Health Authority, Cathy Ulrich, who is an outstanding leader there, to talk in particular about transportation issues.

I think one of the positive initiatives, an initiative that we’ve improved since we’ve become government but was an initiative undertaken under the previous government, was the Northern Health bus that’s helped many communities. But it doesn’t help all of them, and it doesn’t help people in every circumstance. The member makes a suggestion there. I don’t reject it in principle. I just would want to learn more about it. Now that he’s put it on the agenda, I’ll certainly be asking Ms. Ulrich and also officials of Northern Health to respond with ideas.

I think that in general — and the member will know this because we’ve had this discussion on previous days in estimates — issues around travel assistance and travel are some of the most challenging issues in rural health. Over a period of decades, we’ve centralized care in big cities, partly because we’ve improved care, improved the level of care. The result of that has been….

For communities up here in Logan Lake, it means centralizing care in one place. If you’re in Sidney, it means centralizing care in another place. Generally, health systems have responded to the concerns of rural communities by saying that the issue of transportation is a matter of personal cost, not a health system cost, which has actually improved the case for centralization in many cases.

I’m interested in what the member is suggesting. I would guess it comes from the community. And I would be interested in any material that he has. We’ll be in touch. I know they’re watching on TV now in Northern Health, so I’ll be in touch with them to talk about issues around that community, and I look forward to meeting with people in that community at some point in the future.

N. Letnick: Thank you to the minister for his positive response.

Just for the record, it might help to say who was leading in this particular initiative. Mervyn Lougher-Goodey is a councillor with the town of Sidney, and also Bill Streeper, mayor for the Northern Rockies regional municipality. That might help in the communication. Feel free to tell them I sent you, and feel free to do so prior to UBCM in September, because if he doesn’t, they’ll probably want to make one of those many appointments with the Minister of Health. I think the Minister of Health gets as many appointments as the Minister of Transportation. I’m not too sure who wins that pool, but quite close.

I look at all the things that we’ve covered over the last three days: the health budget, the regional health budget, MSP beneficiaries, people moving in from other provinces, the estimated federal health transfer analysis and GAAP, the office expenses of the minister, the status of Mills Memorial Hospital, medical school spaces, resident spaces, doctor resident remuneration, physician supply, interprovincial mobility and foreign immigrants, violence against nurses, LPNs, chiropractors’ scope of practice, urgent care centres, primary care networks, medical homes. We talked about concerns from family doctors, what defines an attached patient, a non-attached patient.

[4:30 p.m.]

We looked at non-surgical wait-lists for northern communities, particularly in long-term care, surgical wait times — maybe that’s, probably, the only time we saw a little friction in the room, if I might say that; we’ll see — DBS surgery, bariatric surgery, organ donation, MRI strategy and results, pain management. And that was just the first binder. It’s just amazing how much we’ve covered over the last three days. We’re coming down to the last 50 minutes.

With that, I’d like to ask, on behalf of seniors — the Canadian Association for Retired People, or CARP, and in this case, CARP British Columbia…. Jeff Cowan and Beverly Baxter had a request for the government to look at funding some important drugs.

They represent 74,000 members in the province, approximately, and, of course, there are way more than 74,000 seniors in this province who would benefit from this. Currently MSP pays for the standard dose of influenza protection, but the high dose of influenza vaccine is four times more powerful and, in fact, has been recommended as the vaccine seniors should have by the National Advisory Committee on Immunization in 2019. The challenge, of course, is that seniors have to pay for it. The average retail price is $90.

[R. Chouhan in the chair.]

Prevnar 13 is the best vaccine for pneumonia, but seniors also have to pay for that, and the average price, I believe, is $120. I say I believe, because I did my three-hole punch, and it went right through the number. So maybe his staff can confirm if it’s $120. The Shingrix vaccine is the best possible vaccine for shingles, and of course, seniors have to pay for that. The average price is approximately $330.

Given that the average cost for a three-day stay in a hospital in B.C. to treat lab-confirmed influenza was about $15,000 in 2017, the investment in all vaccines would be offset by keeping just 5,800 patients from getting influenza in the first place. Their research from the UBC college of pharmacy says that some 16,000 folks required treatment last year alone.

The ask is simple: could all three be made available to seniors at no charge to them, just like it is in Ontario and several other jurisdictions?

Hon. A. Dix: There is a process, both nationally and in B.C., to assess the value of vaccines — to assess them and their efficacy compared to one another. I think it’s fair to say in the case…. The member said that in some jurisdictions, some of these drugs are covered. In the case of shingles, for example, it’s not Shingrix. I do not believe it’s covered anywhere in Canada.

The one province that has coverage, in terms of vaccine coverage, is Ontario. It’s for a drug called Zostavax. They estimate, in Ontario, that that drug…. I think Zostavax has a 50 to 55 percent efficacy rate, if I recall. The cost in Ontario of that program is $68 million.

What we’ve done and what we continue to do is to assess the value of vaccines every year, including flu vaccines, including high-dose vaccines, including shingles vaccines and others. We review those issues of cost every year, and we base that in the same way that we review the prescription drugs and other medications. We get recommendations nationally and then here in British Columbia, and we make decisions accordingly.

I know that there is a lot of interest, amongst senior organizations in particular, in expanding coverage for a variety of vaccines. I would say not just in seniors’ populations but in other populations as well. There are also, as the member will know, in some cases, with some of the vaccines, very extensive advertising campaigns that you can see in areas, essentially to promote the direct sale of vaccines, which happens. I have one of the ad campaigns in my head now, but I won’t share that with the member.

[4:35 p.m.]

These are challenging questions. We base our responses on the evidence. The B.C. Communicable Disease Policy Advi­sory Committee reviews the provincial immunization schedule annually. It assesses and monitors the evidence and efficacy of all high-dose vaccines for potential inclusion in the immunization process. My job as minister, then, is to respond to those recommendations.

N. Letnick: Thank you to the minister for that answer.

The minister did say that the government does review these requests annually. Could the minister please tell us if that means that on a specific day, the decisions come out, or is this an ongoing thing throughout the year? In other words, does annually mean that at the end of the fiscal year a decision is made, or are they made on a case-by-case basis all the time?

The Chair: Minister of Health.

Hon. A. Dix: Thank you very much, hon. Chair. It’s so delightful to see you in the chair this afternoon too. It raises all of our spirits, I think.

As I noted, the B.C. Communicable Disease Policy Advi­sory Committee reviews. It sometimes reviews more frequently than annually, because there may be new information about particular vaccines. I’m told that routinely, though, that review happens around June and then is forwarded to the ministry to assess the conclusions of the reviews.

N. Letnick: Thank you for that answer. That’s a good answer. This way, all of the interested parties will know at some point — whether June or July, whatever the particular date is — whether they’re getting the funding or not.

Is there a publicly accessible list of what’s being asked for by the ministry, and then the decision whether or not they have been approved when they do that annual review?

Interjection.

N. Letnick: Let me try it a different way. After three days with the minister, we kind of know each other’s tells.

If we review the requests annually, let’s say in the case of Orkambi, and the decision is made in June or July, will something be posted on line that shows Orkambi approved, a tick, or Orkambi not approved, an x, and perhaps the reasons why, along with all of the other drug requests that have come into the ministry over the last year that are also approved annually in the June time frame?

Hon. A. Dix: We were talking about immunizations. There’s a review process for immunizations, vaccines.

With respect to Orkambi, it’s obviously a different process. It’s not an annual process — or drugs such as Orkambi. The member may be asking about Orkambi, and therefore, I can give him an answer on that now, should that meet his needs.

In this case of Orkambi, the process is first guided by the manufacturer, of course. They submit in the CADTH process, the Canadian Agency for Drugs and Technologies in Health process. In the case of Orkambi, that occurred in June of 2016. The original decision was made in June-July 2016. There was an appeal by Vertex, which is the manufacturer. That appeal was essentially….

[4:40 p.m.]

The do-not-list recommendation from CADTH came forward in November 2016. It was then reviewed by the Drug Benefit Council in February of 2017, roughly, and the decision was made by the Ministry of Health, in March of 2017, not to list Orkambi. In the summer of 2017 — I’m just trying to make sure I have the chronology right — the issue of Orkambi became a more significant public issue.

There were a number of patients that had expressed concern, obviously — and people were concerned throughout the summer — particularly a number of patients who had received private coverage for Orkambi and then were seeing that private coverage withdrawn. They had started on the drug, and then they had seen coverage withdrawn. We made a number of changes. One of the concerns that Vertex, the manufacturer, and others had had was some information they’d felt they could bring to the table in the assessments of the common drug review of CADTH. They hadn’t been able to do so.

Working with other jurisdictions, British Columbia led this process. We expanded the types of evidence that they could submit in that process. It’s sometimes difficult to do the kind of reviews when you have a rare-disease drug, because the number of people that can be part of the clinical trial is, by definition, small. We made those changes. There was a resubmission by Vertex and, subsequently, a new decision by CADTH, the common drug review, to not list, again, in this year. That’s where we are now. In that case, decisions weren’t made at a particular time of year.

Obviously, decisions in British Columbia are made based on evidence-based information. The CADTH process is a clinical process and also assesses the value of the drug, the value for money — value of the drug as well. That’s the process they’re in. In British Columbia, since we had the CADTH process, I think only one drug that hadn’t received CADTH approval — a drug called Duodopa, which the member might be familiar with. That was approved by the previous government, but that drug had simply not been resubmitted for ten years in the CADTH process and had been approved in many other provinces. That was the one exception in the last 14 or 15 years, a really significant exception.

I say all this, and the member will know that we’re obviously very concerned. There is a full schedule for patients suffering from cystic fibrosis. We know what a debilitating disease it can be for people. I’ve certainly spoken to many people, in the discussion and debate about Orkambi, about those very questions.

The member will also know, of course — I’ve tried to be as open as possible in this forum, and I continue to be — that at least one patient, I think patient group, is currently suing me, suing Mr. Brown and suing the government around the coverage decisions here, which is their right. That’s a process that they’re going through right now.

The information that I’ve just laid out is our public outlook on what happened. It’s an exploration, a little bit, of what the process is. The process is something that will be approved. It comes forward, and then we have to assess — through the Drug Benefit Council first and then through the ministry — when coverage is provided. It’s not a particular time of year that that would happen. The immunization schedule, which is a different thing, is assessed in a more regular way, because immunization programs run that way. In general, we’re working all year round. The assessments can come when they’re ready and when CADTH does the assessment. It’s not a particular time of year.

That is a very long answer to that question.

N. Letnick: Thank you to the minister for his comprehensive answer to the question.

On the Orkambi, I think it’s important to provide some context for the listeners who aren’t familiar with the issue of cystic fibrosis. I have many, many letters describing individual cases. I’ll just pick one — a Ms. Lilia Zaharieva. This is from the Globe and Mail. I don’t have the date. I’ll find it later.

[4:45 p.m.]

“The 31-year-old said her health has improved dramatically since she started Orkambi two years ago, initially paid for by private insurance, now” — as the minister has said — “under Vertex’s compassionate use program. In the year before she started the twice-daily pill, she spent 45 days on intravenous antibiotics fighting infections. She was weak, struggled for breath and had coughing fits that sometimes led to vomiting. ’Before Orkambi,’ she said, ’I felt like I was starved for air all the time. It was a terrifying way to exist.’

“Her lung specialist gave her two to five years to live. She says: ’I was ready to transition out of this world, thinking about how to wrap up loose ends in my life at 30 years of age.’ But her grim prognosis changed in September 2016.”

Because she was a UVic student, she had Orkambi through a health plan, but it did cost $250,000 a year. It treats the underlying cause of cystic fibrosis, rather than suppressing its symptoms.

It changed her life. Obviously, it was a miracle to her. She said: “I took a deep breath in, and it was nearly effortless.” However, in September 2017, she learned that the drug would no longer be covered under her student plan. She was, of course, asking for the government to look at funding it. The company that manufactures the drug gave her a 90-day free supply on compassionate grounds.

Dr. Elizabeth Dunn, PhD, biochemistry and molecular biology, would like to add to the discussion. She says 40 percent of CF patients in Canada are children. CF patients with genetic type 4, for which Orkambi is effective, spend 30 to 90 days in hospital every year without the drug. The cost to occupy a bed at B.C. Children’s, on a daily ward, is $3,300 per day, and the ICU is $4,300 per day. This means taxpayers spend between $99,000 and $300,000 every year just to hospitalize a single patient at B.C. Children’s Hospital before even considering the costs associated with doctors’ fees, services, diagnostic testing, imaging, pharmaceuticals, etc., to name a few.

Orkambi has been shown to substantially decrease hospitalization. It does not take long for savings like this to nullify the cost of the drug. Orkambi is scheduled to undergo further consideration at the national level, as the minister has said, by the common drug review, in the spring and summer.

My question. The government has, in other cases — the minister has pointed to one — not followed the recommendation of CADTH. The government does use the therapeutics initiative to review drugs. Did the therapeutics initiative give any indication, through the process, as to whether Orkambi should or should not be covered? I already hear…. But I’ll ask it anyway. Is the government currently reviewing whether Orkambi should or should not be covered in light of the court challenge that’s now in front of the minister?

Hon. A. Dix: As the member knows — I think I went over this, but I may not have made this point — on February 15, 2019, the pan-Canadian Pharmaceutical Alliance advised Vertex that it would not be entering into negotiations for Orkambi.

The member talked…. I put the issue of the case of Duodopa because we want to have all the information out there. We’re talking about hundreds of decisions and thousands of compounds. The governments consistently, over time, have followed an evidence-based approach to making these decisions, and the evidence-based approach that we use, collectively, is the CADTH process. They decided in July 2016, again in November 2016 and again, more recently, to recommend not to list Orkambi on formularies — not to recommend its listing on formularies. That decision was also made by the Drug Benefit Council and, of course, the Ministry of Health in March 2017 as well.

[4:50 p.m.]

I think the member will know that one of the things that concerned me was to ensure that Vertex, on this drug, would have the opportunity to include non-randomized controls trial data as part of its resubmissions. We advocated for that. We helped make it happen. They did allow all of that information to come in, and they had the same recommendation: not to list.

I think we’re talking about a drug that would cost B.C. taxpayers, should we support it, in the neighbourhood of $90 million over three years, and those estimates may be low. To recommend a drug under those conditions, which doesn’t meet the evidence-based thing, would obviously require a political intervention, I would say, over the evidence. That has not been the approach of Ministers of Health for decades in B.C., and it’s not my approach.

However, I’d say one other thing. The Patented Medicine Prices Review Board has begun investigating the current price of Orkambi in Canada for being excessive. It’s unknown when that investigation will be completed, but I think it’s appropriate. There have been years when senior executives at Vertex made tens of millions of dollars. Their list price for this drug is $250,000 per patient per year.

This is an important question as well. So we have to also be voices, I think, to companies such as Vertex for fairer prices. The issue that faces Canadian jurisdictions is also facing other jurisdictions. The member will know that there’s a significant debate in the United Kingdom going on right now, and some very novel suggestions are being suggested by members of the United Kingdom government with respect to how to deal with Vertex in that discussion. I encourage him to review those.

This is a part of the challenge. We work hard to negotiate when drugs meet a clinical value. In this case, unfortunately for Orkambi, the common drug review has now consistently — on the original decision, on the appeal and now again — decided to recommend not to list the drug. That’s very difficult, I think. Obviously, this makes for challenging decisions for people. I know that many people who support and have friends and who are living with cystic fibrosis do not like that decision. I appreciate that and respect that.

We’re continuing to work together with them to improve other supports for people with cystic fibrosis all the time. I think the results…. The life expectancy of people with cystic fibrosis has been increasing dramatically in recent years, and that’s a tribute, to the whole community who are supportive around the disease and the individuals involved and the many doctors who provide enormous service. I’m very respectful of all that, and it’s our challenge to continue to do that. It’s also our challenge, I think, on these difficult decisions around prescription drugs, to follow the evidence, to respect the processes that we’ve set up and to ensure that we’re making evidence-based decisions.

N. Letnick: Thank you to the minister for that.

The Pacific Hepatitis C Network sent me a letter. I can’t remember specifically if I had a delegation or not. Daryl Luster, the president, talks about hepatitis C as a blood-borne virus that causes liver disease over time, but symptoms can be present and debilitating long before. Approximately 73,000 people live with chronic hepatitis C in British Columbia, a disproportionately large portion of the estimated 240,000 Canadians living with hep C.

Their recommendation to the government is that the government commit to the development and implementation of a hep C–specific plan to eliminate the virus in B.C. by 2030 and that the plan to eliminate hep C in B.C. include meaningful and robust community roles both in the development of it and the implementation. Will the government commit to such a plan?

[4:55 p.m.]

The Chair: Minister.

Hon. A. Dix: Thank you, hon. Chair. I’m encouraged by your rapt attention here, hon. Chair, to all that I’m saying.

The answer to the question… Community-based organizations, particularly the Pacific Hepatitis C Network, for which the member is bringing forward their question, play a very important role — the member will understand this — in B.C.’s viral hepatitis response. They make connections between individuals, communities and health services. They provide education and public awareness. They provide support services of many kinds, including harm reduction and testing, and they bring the voice of lived experience, which is always important to policy-making.

The member will know, perhaps, that there was a hepatitis strategy in 2007. It’s that hepatitis strategy that we are in the process of updating. Happily, we’re close to that updating of that process. I was handed a draft strategic integrated approach, so we’ll hopefully have that released soon.

I should say that there’s very significant work being done in this area, especially building on the lessons learned from our response to HIV and the approaches aligned with World Health Organization guidance and global approaches, to eliminating hep C in B.C.

It should be said, also, that we’ve seen increasing coverage over the last number of years in very effective hep C drugs. That’s why we can say with some confidence that we’re able to eliminate hepatitis C. We currently cover seven different direct-acting antiviral drugs for hepatitis C. Those drugs will go a long way in helping us to do what we hope we’re coming close to doing as well with HIV/AIDS, which is coming close to reducing and, we could say confidently, making hep C an issue of the past, hopefully soon in B.C.

N. Letnick: Thank you to the minister.

The ALS Society has also written, through me, to ask a question of the minister. We had a delegation last week — I think it was last week, maybe two weeks ago — a very moving delegation.

One person, Brad MacKenzie, told his story. He’s currently 33 years old, diagnosed with ALS three years ago at the age of 30. Prior to that he lived a very ordinary and typical life for a young man of his age. He says: “I was born and raised in British Columbia. I spent my younger years planning for my future, and eventually I managed to work my way through an electrical engineering degree from UBC. Then one day I noticed some weakness in my left hand. Thinking nothing of it, I kept working, but gradually I noticed that this weakness wasn’t getting any better, and it was spreading to other parts of my body. After consulting with my doctors, I eventually got diagnosed with ALS.”

[5:00 p.m.]

ALS is a terminal, degenerative neurological disease for which there is no known cure nor any effective treatment. It can happen to anyone, and he was diagnosed with ALS at 30 years of age. He was very brave to come and share his story with our caucus. I imagine he did the same with the government caucus.

Wendy Toyer, the executive director of the ALS Society of B.C., as well as David Taylor, would like to know if the government would consider partnering with the ALS Society of B.C. to increase capacity at the ALS Centre to host clinical trials and to foster clinical research. ALSBC has raised, through fundraising, $1 million to contribute and has established the ALS Centre of Excellence fund. They’re looking for the government to match that $1 million over the next five years to help people who have ALS.

Hon. A. Dix: Amyotrophic lateral sclerosis is, obviously…. If anyone has ever met…. I know members of the Legislature met with people living with the disease. It’s one of the most difficult diseases.

As members will know, it gradually paralyzes people, because the brain is no longer able to communicate with the muscles of the body. It is sometimes known, as the member will know, as Lou Gehrig’s disease because it afflicted the famous baseball player from the 1920s and 1930s.

I understand that recently Ms. Toyer, with the ALS Society, has submitted a proposal to the government. It’s fairly recent. I think it was at the time of the visit of the society here. Certainly, we’ll be reviewing that proposal and taking a look at it.

I expect to be meeting with the society myself again soon and following up on some of the work we’ve done over time. There’s significant work as well…. Some of those issues involve, of course, expensive drugs for rare diseases, but a lot of the issues raised by the society also involve issues of care, including home care and home support and other issues that people living with ALS face. Obviously, we would be very interested in the proposal by Ms. Toyer and by the society.

N. Letnick: Thank you to the minister for that.

Schizophrenia. Schizophrenia impacts many, many families throughout British Columbia. The B.C. Schizophrenia Society is looking to help fund, for families…. There was a presentation to the Finance Committee, which actually made their Budget 2019 consultation report. It says: “Stable funding to expand existing BCSS programming throughout the province, beginning with $2.75 million in the next fiscal year, to demonstrate a commitment to mental illness and family caregivers….” And it describes some of the areas that it would be in.

I’m just wondering if the minister or his staff are currently reviewing this recommendation in the Finance Committee report for sustainable funding for the BCSS?

[5:05 p.m.]

Hon. A. Dix: This is an area that my colleague, the Minister of Mental Health and Addictions, has been working with. I would say that the society has received some significant funds from the health authorities and directly from the Ministry of Health over the years. I believe they’ve made a proposal to the Ministry of Mental Health and Addictions and the Ministry of Health late last year that was a proposal for $2.75 million. Those requests and the role of the society will be under consideration, and I’ll certainly pass on the representations of the hon. member to the Minister of Mental Health and Addictions.

N. Letnick: Perhaps, in addition to the answer for the next question, if the minister could also provide any timeline on the answer to the Schizophrenia Society — if we’re talking months or weeks or that kind of thing — it would be helpful.

Hemochromatosis is something I wasn’t familiar with. In my capacity as critic, I’ve now become a little more familiar. It is the most common genetic condition, and early intervention would prevent future chronic illnesses like severe tiredness, arthritis, diabetes, liver disease. There are ways to help prevent it. Prevention is as simple as a blood donation or phlebotomy. That sounds dangerous. People with hemochromatosis sometimes require phlebotomies weekly, biweekly or monthly, which requires them to go to the hospital instead of the schedule of the Canadian Blood Services. When the blood is collected, it is then thrown out.

Can the minister explain why blood that the Canadian Blood Services will take is on a regular schedule, but blood collected in the hospital is not?

Hon. A. Dix: I think there is some inconsistency between the question and the information I have. What I’ll resolve to do — because I think, in some ways, it’s a pretty technical question — is to make sure we get the appropriate information so that we’re not just guessing between ourselves. I’ll also be able to provide that response to the member, who can pass it on to the society.

I want to just note that we have an answer for the member for Cowichan Valley, who asked a question earlier. This is something that I hesitate to even present with the Minister of Finance in the House, because it’s actually good news for the first time in several days. But the Cowichan hospital…. As members will know, we are building a new Cowichan hospital. It’s an extraordinary thing, and I had the opportunity last year with the Premier to celebrate with the local community. It’s an enormous achievement for them that they’ve been advocating for, for a long time.

[5:10 p.m.]

The member for Cowichan Valley talked about a stopgap measure to move administration folks out of the hospital to two 12-by-60 trailers that VIHA owns and then convert the space that they use to clinical space. This is necessary because, obviously, even though we’re building the hospital, it will take some period of time. This will create eight in-patient beds.

The cost is $1 million. We are working…. There’ll be a funding breakdown soon, but the funding will be provided by the foundation, by the regional hospital district and, of course, by the Ministry of Health/VIHA.

I’m happy to say, in response to the member’s question earlier, that we’ll be making progress on that issue and that I have a positive answer to her question.

N. Letnick: Alzheimer Society. Of course, we’re all familiar with the First Link program. It’s frequently funded through year-end dollars. I know that the minister is looking to move things to base funding, as opposed to year-end.

What’s the progress on the First Link program finding permanent funding?

Hon. A. Dix: I was delighted, a little over a week ago, to be joined by my colleague from Vancouver-Fairview in making an announcement of $2.7 million to the Alzheimer Society to support First Link for another year. As the member suggests, that has been year-end money, which has been the consistent pattern over time. In fact, over the years, the Ministry of Health, through the Provincial Health Services Authority, has provided $21.8 million to the society to support the First Link program.

In general, I agree with the member. I’d like to move that. I think I suggested this last year. I would like to move that program out of the process of year-end and into a more regular process, reflecting the fact that it is something that I would expect us to be supporting two years from now, four years from now and six years from now. As you know, that’s a budgeting challenge, but it also reflects, I think, the extraordinary role that the Alzheimer Society and this program play in the lives of British Columbians.

One of the interesting things that people may not know is that while Alzheimer’s disease and other dementias are associated with aging, there are thousands of people — 6,000 to 7,000 people in British Columbia — under the age of 65 dealing with Alzheimer’s and other dementias. I think the society plays a central role in providing information.

We had this discussion earlier with his colleague from Richmond South Centre. I’m a huge supporter of the program. We are going to continue to support the program as long as I’m the Minister of Health.

I’m sure members on the opposite side would agree that it would continue to happen should they ever form a government again. In any event, should that happen…. These are uncertainties. I like to put these things in the conditional tense at this point. I think that statement came out much stronger than I really intended it to.

In any event, it’s an extraordinary program, and I’m very proud to work with the society. I’d like to see that happen, and we’re working to see that happen. In the meantime, we continue to provide the funding well in advance so that the Alzheimer Society can have no doubt that they’re going to continue to run the program.

N. Letnick: Normally, I would bite on his comment about should we ever form a government again, but given that I only have five or six more minutes, I’ll just skip that and go straight to the next condition.

ME is a systemic neuroinflammatory condition, usually with an acute infectious onset, characterized by a marked reduction in functioning and a severe worsening of symptoms after even minimal exertion.

It is a devastating multisystem disease that causes dysfunction of the neurological, immune, endocrine and energy metabolism systems. The most typical symptoms include cognitive impairment; muscle pain; headaches; severe sleep disturbances; sensitivity to light, sound, touch, smell; muscle weaknesses; digestive issues; inability to tolerate an upright position; difficulty breathing; body temperature fluctuations; and post-exertional malaise — amongst other things.

Obviously, a very serious disease. There are several requests. Given the time, I’ll just ask two. One, would the government agree to developing a provincial strategy to address unmet health care needs for British Columbians living with ME? And two, would the government commit to timely implementation of diagnostic and billing codes for ME?

[5:15 p.m.]

Hon. A. Dix: The Myalgic Encephalomyelitis and Fibro­myalgia Society of B.C. Obviously, they were here this week, as the member will know. They had an event outside the Legislature. He and I were in estimates. He may have been able to visit with people from the society. I wasn’t. But the member will know that representatives of the society met with the representatives of the Ministry of Health. I think this is, obviously, a very significant problem for people. We understand and appreciate that and are committed to continuing to work with people dealing with the issue.

Ministry staff who’ve talked to me are not aware of any specific drug therapies that are being requested, related to ME, and none are currently under review by CADTH, just to be clear about that. While there are studies examining the use of antivirals for treatment of ME, the National Institute for Health and Care Excellence in the U.K. does not recommend the use of antiviral agents to treat ME.

Health Canada does note that there’s no cure for ME and that treatment deals with managing symptoms with the use of medications, specialized exercise programs, alternative therapies and lifestyle adjustments. Reviews by both Health Canada and the CDR, of course, are indication-specific. That means off-label indications are not considered by the CDR.

In B.C., the B.C. Women’s Hospital and Health Centre operates the complex chronic diseases program, where the goal is to provide patients with symptom-centred support and to emphasize treatments that account for patient preference and support self-care.

Just as an example, in the United Kingdom, the National Health Service’s main recommended approach is activity management. Over-the-counter painkillers and antidepres­sants can be used to relieve some symptoms of ME such as pain or difficulty sleeping. Those are some of the elements.

This is a struggle. It’s a struggle with respect to diagnosis. There’s a lot of frustration amongst people who are addressing and living with these chronic conditions. Some of that was expressed this week, and I’m very respectful of that. I think people in the Ministry of Health are as well, and we’re going to continue to work with the groups. But there are no…. I know there’s a desire for answers and for us to respond. There aren’t easy answers here, and we have to acknowledge, sometimes, those limitations and just continue with our commitment to work with people who are struggling with this and, obviously, to work with clinicians around this.

N. Letnick: I’ll switch now to people with diabetes. Something the minister has made very publicly known is that he is a type 1 diabetic. He probably doesn’t need any of his staff to answer any of these questions.

People who use insulin pumps require rapid-acting insu­lin. I understand the government has waived the deductible for low-income British Columbians, but the co-pay has not been removed for any British Columbians requiring rapid-acting insulin.

[5:20 p.m.]

Fair PharmaCare will only pay a portion of the cost of this insulin, to a maximum price equal to the regular insulin, and requires the patient to pay the remainder. This is a concern, certainly an important one for British Columbia, for those living and managing the cost burden of diabetes.

Joan King, government relations for Diabetes Canada, says: “Regular insulin isn’t recommended for pump use in Canada. Rapid-acting insulin like Humalog is considered to be the best practice based on research.” So the government’s policy for coverage is outdated and not in keeping with our clinical practice guidelines.

The patient, in this case a constituent, who is looking to get…. And other people…. Patients would have to then pay out-of-pocket to access the medication that the guidelines suggest would be best for their care.

In a letter from the executive director of PharmaCare benefits branch, dated April 23 of this year, in response to a person that was asking about this rapid-access payment, the author says: “I’m happy to report, though, that we are actively reviewing the reimbursement policy for rapid-acting insulin. The timeline for completion of this review has not been established but is considered a priority.”

Could the minister provide a little more detail as to when we might hear back on this important decision for people who need this rapid-acting insulin for their pumps that are paid for by PharmaCare?

Hon. A. Dix: Like the hon. member, I met with representatives of Diabetes Canada. I think I’ve met with and attended an event by a group called Young and T1, which is a really dynamic group, as well, recently. I think I’ve attended about three diabetes events in the last couple of months.

One of the challenges with diabetes, for us, is if you look at type 1 and type 2 diabetes, you’re talking about probably in the neighbourhood of just under 450,000 people in B.C., which is getting close to 10 percent of the population. The overwhelming majority of that population group is for type 2 diabetes, of course. I think it’s just around 30,000 for type 1.

Last year, as the member will know, we expanded insulin pump coverage, which had first started for children I think around 2008. I remember attending an event with Premier Campbell at the time. So it would have been prior to 2011, in any event, in his constituency.

After the 2013 election, we made that a bit of an issue. The government extended that coverage to 25, because a lot of people were reaching the age of 18 and then got it to 25. Then, obviously, we expanded it to everybody. I think that was an important decision and one that made sense and made sense from a public health perspective.

[5:25 p.m.]

We provide, each year, through PharmaCare support for medications and supply, coverage of about $80 million right now. Just to give a sense of the cost of the disease just to PharmaCare. That’s not the ancillary costs to the health care system of the disease.

There are a number of proposals now. I do recall that the day I announced the insulin pump expansion coverage, I started to get requests for the next phase in that, which are CDMs and other equipment. These are all proposals to be considered. I think it’s not exclusively for insulin pumps that one could consider such a thing, right?

If you were going to expand coverage to rapid-access and so on, it would have to be generalized, in my view, regardless of the clinical standards. There’s a debate about these types of insulin, but it’s one of the issues that’s before us. A number of years ago the government actually provided more management to the supply of blood glucose strips, for example, and actually reduced some of those costs in order to support other things.

These are all proposals before us. There are lots of them for type 1 and type 2 diabetes, including pharmaceuticals that are before us now that have received common drug review approval. We’re managing those and managing the diabetes budget. This is one of the proposals before us to consider for funding.

N. Letnick: Our time is up. To the minister and staff, it has been a great three days. I look forward to the next 11 months or so to prepare the next batch of binders so we can meet again on this hallowed ground and represent the people of British Columbia. You did a great job, as usual. To all the staff and to the minister himself, congratulations on a good estimates. Thank you very much.

Hon. A. Dix: I wanted to thank the opposition Health critic for really an exceptional job, not just with presenting his arguments and his questions but with managing his caucus team, who did an excellent job bringing community issues. I think we had somewhere between 25 and 30 MLAs participate, and that’s a real tribute to the generosity of the Health critic. I don’t recall, when I was Health critic, that same level of generosity, perhaps, to my colleagues. I appreciate the efficiency of the member for Kelowna–​Lake Country.

I also wanted to give my thanks to the member for Richmond South Centre, the new critic for seniors, who did an excellent job as well. I thank all of the members of the House.

I thank Steve Brown, who is to my right, who many of you will know in this House is an outstanding Deputy Minister of Health — to all the team and all the people in the Ministry of Health up there in my office who have been helping us for the last number of days.

I’ve made a number of commitments to provide information to hon. members, and I would hope to do so in the next few days — certainly before the House returns.

With that, I’ve got a motion to move.

Vote 31: ministry operations, $20,698,339,000 — approved.

Hon. A. Dix: I move that the committee rise, report resolution and completion of the Ministry of Health and ask leave to sit again.

Motion approved.

The committee rose at 5:28 p.m.

The House resumed; Mr. Speaker in the chair.

Committee of Supply (Section B), having reported resolution, was granted leave to sit again.

Committee of Supply (Section A), having reported progress, was granted leave to sit again.

[5:30 p.m.]

Mr. Speaker: Members, I’ve been informed that the Lieutenant-Governor is in the precinct.

Her Honour the Lieutenant-Governor requested to attend the House, was admitted to the chamber and took her seat on the throne.

[5:35 p.m.]

Royal Assent to Bills

Acting Clerk:

   

Witness Security Act

Business Practices and Consumer Protection Amendment Act, 2019

Civil Forfeiture Amendment Act, 2019

Protected Areas of British Columbia Amendment Act, 2019

Environmental Management Amendment Act, 2019

Workers Compensation Amendment Act, 2019

Energy Statutes Amendment Act, 2019

Medicare Protection Amendment Act, 2019

Forest and Range Practices Amendment Act, 2019

Land Owner Transparency Act

Business Corporations Amendment Act, 2019

Coastal Ferry Amendment Act, 2019

Financial Services Authority Act, 2019

Ticket Sales Act

Miscellaneous Statutes Amendment Act, 2019

Police Amendment Act, 2019

Protected Areas of British Columbia Amendment Act (No. 2), 2019

Business Corporations Amendment Act (No. 2), 2019

In Her Majesty’s name, Her Honour the Lieutenant-Governor doth assent to these acts.

Hon. J. Austin (Lieutenant-Governor): Thank you, Kate. That represents a lot of work. [Applause.]

Thank you, all, for participating and for all your truly splendid work.

ÍY SC̸ÁĆEL. ÍY, C̸NES QENOṈE ṮÁ.

I would also just like to express my hope that you have some time this weekend to enjoy the Victoria Day long weekend, the day upon which we celebrate the official birthday of Her Majesty Queen Elizabeth II, and enjoy some time with your families and friends. I’ll look forward to seeing you all again very soon indeed.

Take good care. Bye now.

Her Honour the Lieutenant-Governor retired from the chamber.

[5:40 p.m.]

[Mr. Speaker in the chair.]

Hon. M. Farnworth: I hope everyone has a great long weekend, and then we’re off for a week. We’ll see you in a week for the last four days of the session.

With that, I move the House do now adjourn.

Hon. M. Farnworth moved adjournment of the House.

Motion approved.

Mr. Speaker: This House stands adjourned until Monday, May 27 at 10 a.m.

The House adjourned at 5:42 p.m.