Third Session, 42nd Parliament (2022)
OFFICIAL REPORT
OF DEBATES
(HANSARD)
Tuesday, May 10, 2022
Morning Sitting
Issue No. 202
ISSN 1499-2175
The HTML transcript is provided for informational purposes only.
The PDF transcript remains the official digital version.
TUESDAY, MAY 10, 2022
The House met at 10:03 a.m.
[Mr. Speaker in the chair.]
Routine Business
Prayers and reflections: T. Stone.
Introductions by Members
M. Dykeman: I have two introductions today. For the first introduction, I was wondering if the House could help me make trustee Rod Ross, the chair of the Langley board of education, and his lovely wife, Val, feel very welcome. They are visiting from Langley today.
Second introduction is that yesterday we missed MLA Routley’s birthday. Could we please wish him a very happy birthday.
Hon. M. Dean: It’s my pleasure today to introduce Ronia Sahine, Rena Hatikiama and Amelia Watson to the House. Ronia received an honourable mention anti-racism award in the category of emerging leader for their role in diversity and narrative. Together, with Rena and Amelia, they advocate for the racial and intersectional safety of students across school communities in school district 61.
I would love to say congratulations to Ronia and Rena and Amelia. We’re very honoured to have you in our community, and we’re delighted to see where your passions will take you.
Will everybody in the House please make them very welcome.
D. Clovechok: It’s not often that I get visitors from the Kootenays here, but I’ve got three today, I’m very pleased to announce.
I’ve got a couple of introductions this morning. One is a classic rural B.C. leader, community leader, and there’s little she’s not involved in. This individual is president of the Association of Kootenay and Boundary Local Governments, a member of the UBCM board of directors and a champion for the Radium Rotary Club. She and I are working very closely together at saving the sheep on Radium Hill from traffic fatalities.
She’s in Victoria today as a member of the B.C. Achievement Foundation’s community award selection committee. Those awards are later on today in Government House.
Would this House make my friend, Clara Reinhardt, mayor of Radium, feel welcome.
The second introduction that I have is very quick. One of the recipients of those awards is one of my community members today as well. Laurie Mack and his wife, Diane, are up there. Laurie and I taught together a couple of lifetimes ago back in Alberta.
Welcome, Laurie and Diane.
If you could make them feel welcome.
K. Greene: I’m very excited to welcome my first in-person guest from Richmond. Mia Montessori Academy grade 7s are here today on their grade 7 trip. These students are curious, insightful and keenly interested in democracy and how it works. They’ll be spending the morning here at the Legislature learning about the history of the institution and seeing members in action in question period. I know everyone will be on their best behaviour.
Will everyone please give a warm welcome to Mia Montessori Academy visitors Andrew Castillo, Dawson Reid, Maria Reid, Mauro Martinez and Meenu Chaudhary.
Hon. S. Robinson: I just want to welcome to the chamber today two from the Finance communications team. We have Sara White and Natalie North, who are joining us here in the chamber, and I want everyone to welcome them.
E. Ross: It’s not often that I get visitors here from the North. We have a number of registered nurses coming in. We have Matthew Le Gresley, Chenoalyn Le Gresley, Catherine Tanski, Connie Kearley. From Hazelton, we have Dennis Thomson. From Smithers, we have Kate Fodor and Beth Marko. From North Coast, we have Roxanne Fitzsimmons.
Also, from Terrace, we have Teri Forster. She is the regional council member representing nurses for the northwest region, spanning the North Coast, Skeena, Stikine and a small portion of the Nechako Lakes riding, Granisle and Houston. Can you imagine that on a job description?
Would the House please welcome my guests to the Legislature today.
As well, we have a frequent visitor, a frequent shopper here, the mayor from Fort St. John, Lori Ackerman, first female mayor of Fort St. John and a strong advocate for energy.
Would the House please welcome her here today.
M. Elmore: I am really happy to welcome some friends here to the Legislature. They’ve come all the way from Toronto. We have Michiko Sano and her daughters Akari Sano and Yoki Sano. We were down in Ucluelet this past weekend for the wonderful marriage of Michiko’s son Sano and Simka Marshall. Just a beautiful ceremony at Black Rock in Ucluelet.
It was perfect. The weather was shining. They’ve had great weather since they’ve been here. Michiko raised all four kids as a single mother, and Akari is very accomplished. She has returned to Victoria. She got her degree in photography here 20 years ago and is now in the fashion industry. Also, Yoki is based in Toronto in the jewelry business.
I just ask everybody — they’re right up here — to give them a big, warm welcome and to welcome them here for their first visit in the Legislature.
D. Coulter: Speaking of frequent fliers, like the member for Skeena introduced someone, I’m going to introduce the president of CUPE, Karen Ranalletta, and the legislative coordinator, Martina Boyd, who are here in the House with us. I got a good chance to talk with them yesterday.
As a former president of fighting local 3787, it’s my pleasure to welcome them into the House today.
T. Stone: I, too, am really happy to introduce some guests from my neck of the woods and on behalf of a number of my colleagues as well. We have about a dozen nurses from the Thompson–North Okanagan region — specifically, Kamloops, Vernon, 100 Mile and Salmon Arm areas: Chris Chernick, Scott Duvall, Topher Hansen, Brenda Childs, Val Kloska, Nadine Golz, Sarra Fedick, Angela Achoba-Omajali, Patti Wright and Leah Takats.
I would ask the House to please make our guests feel welcome.
I. Paton: I’d like to welcome someone to the House today that’s up in the gallery. We all know him very well. He doesn’t need to be introduced, because he’s here every single day, but I want to thank Jason Goertzen for the wonderful job he did this morning with our prayer breakfast with his guest speaker, Abe Brown, from Calgary. It was a great breakfast and a great morning.
Thank you, Jason.
H. Sandhu: I want to recognize and acknowledge lots of my B.C. Nurses Union activists, members and nurses, who will be outside at the gallery, hosting a rally. I have been there many, many times in previous years, and I know the work that they do to make sure our workplaces are safe.
Would the House please join me to welcome them all. They’re from several regions and taking the day to represent nurses here.
Statements
(Standing Order 25B)
DAY OF ACTION
AGAINST ANTI-ASIAN
RACISM
R. Singh: Today is the Day of Action Against Anti-Asian Racism, a day for all British Columbians to take action to combat discrimination.
During the pandemic, we have seen people of Asian descent targeted and scapegoated, leading to increased attacks against them. I would really like to take this opportunity to thank Stand with Asians Coalition, which started as a group of grassroots activists in Burnaby, for its incredible organization to turn the Day of Action Against Anti-Asian Racism into a national movement endorsed by municipalities and unions.
Today is about taking concrete action to disrupt systemic racism. It’s about asking ourselves: what are we going to do about it? Everyone has a role to play in building a more inclusive province, and it starts with us. It is not enough to be not racist. We must be anti-racist. Living in a society steeped in colonialism and systemic racism impacts us all. We each carry prejudices, and we must confront them.
As a province, we are committed to combat racism. Yesterday the legislation to pave the way for anti-racism data collection was passed in the Legislature, and B.C. will be bringing in its first anti-racism act next year. But we know there’s much more work to do.
A day like today, the Day of Action Against Anti-Asian Racism, is an opportunity to bring allies together to build a stronger, more inclusive society, where everyone can feel safe, happy and healthy.
COMMUNITY SERVICE BY STUDENTS
AT IMMACULATA HIGH
SCHOOL
R. Merrifield: This year a group of grades 10 to 12 students at Immaculata Regional High School have stepped up to help out those out in our community that need help. They’ve been volunteering with Mamas for Mamas, including a stint at Helen’s Acres, where the charity grows fresh produce for its clients.
Mamas for Mamas is a charity that was born out of Shannon Christensen’s desire to help mamas in need and is now across Canada.
Teacher and program coordinator at Immaculata Rhonda Sali explains: “The silver lining in COVID for us is that Mamas for Mamas is this great organization that does wonderful things right here in our own city. We’re super happy to be working with them and all the good things they do.”
Students were busy last week building chicken coops, cleaning up the garden, doing some planting, moving mulch, cleaning out sheds and painting stakes to go in the vegetable garden.
Sali calls it an amazing immersion experience, saying: “This is awesome for them and for me — that we get to get out of the classroom and learn about some real-life things. You can have your academics and your sports, and of course, that’s ultra-important, but what are you going to do with that when you get into adulthood?”
Each year Immaculata students perform general community service. While this year Mamas for Mamas was the beneficiary, this service embodies what makes my riding of Kelowna-Mission so special. Those that serve also become indirect beneficiaries. Students said going out and working in the community helped them realize how much poverty there was in Kelowna, and it gave them a broader perspective. Thus, the service that is done in Kelowna is a benefit to all.
A big thank-you goes out to all the students at Immaculata for your initiative and your example for all of us in this House.
METAVERSE AND
HIGH-TECH SECTOR IN
B.C.
B. Bailey: “Metaverse” is a term first coined by American novelist Neil Stephenson in his 1992 dystopian novel Snow Crash. It’s a very broad term, used widely, despite not being fully defined.
Can you define the future? In the ’70s, people spoke of the Internet, but could they possibly have been able to define what it would become and the role that it would play in our lives?
Experientially, multiplayer open-world video games are metaverse experiences. Meeting up with friends in Roblox or Fortnite or even the game I played at university, World of Warcraft, are metaverse experiences. We create avatars, online characters who represent us in the game, and meet real-life friends in an online space, interacting and building relationships through a digital experience.
There are significant applications outside of gaming and socializing. A local example is the creation of a fully explorable virtual reality twin of a complex mining project built out by LlamaZOO, a Victoria company. Many large tech players — Microsoft and, of course, Zuckerberg’s newly named Meta — are banking on the metaverse.
Many argue that they’re also a barrier. Competition leads to gated universes, as opposed to one interconnected online world. For many tech developers and investors, the metaverse, blockchain and crypto are intertwined and will become part of Web3, a decentralized Internet controlled by individuals rather than by big companies.
Why am I taking my two-minute statement to talk about the metaverse? It’s because we’re a hub for the creation of video games, visual effects, VR, NFTs and crypto. Vancouver and B.C. have a unique combination of skills and companies to become a major contributor to Web3, and we should be paying attention to this exciting and fast-moving space.
Building out the metaverse isn’t just cool; it’s a huge opportunity for our tech sector and for our province.
ISRAELI INDEPENDENCE DAY EVENT
AND ACTION AGAINST
ANTI-SEMITISM
T. Wat: I’m pleased to rise today to express my sincere gratitude to the Jewish Federation of Greater Vancouver and the Centre for Israel and Jewish Affairs, CIJA, and to congratulate them for another successful Yom Ha’atzmaut or Independence Day celebration.
This year we all note Israel’s 74th Independence Day, a day commemorating the Israeli Declaration of Independence in 1948. According to the Hebrew calendar, days begin in the evening, which is why Independence Day is observed from lightfall until the following evening of the designated day. That is why Yom Ha’atzmaut was observed from sunset to sunset of May 4 to 5 this year.
For this event, the Jewish Federation of Greater Vancouver put together a lovely event that featured an uplifting and exciting concert by the Israeli band Enjoy, who also shared the stage with talented local entertainers, including some local youth. Through events like this, I have been fortunate to learn much about the Jewish community and celebrate Jewish Heritage Month and their rich history.
However, we must also reflect on the hatred that this community has faced, both within our province and around the world. The Jewish community here in British Columbia experienced a 111 percent increase in anti-Semitic incidents between 2020 and 2021. Across Canada, the number of violent anti-Jewish hate crimes rose by 733 percent.
In the face of such horrific acts, I’m proud to stand with our strong Jewish community as we celebrate their contributions to our great province and show that there’s no space for violence, hatred, bigotry or anti-Semitism in our communities.
VOLUNTEER APPRECIATION AWARDS
AND RECIPIENTS IN
LANGLEY
M. Dykeman: I recently had the honour of attending the township of Langley’s volunteer appreciation awards evening. Nine nominees were recognized, and two awards were presented, honouring a diverse and remarkable group of role models whose commitment to supporting and uplifting others is truly inspiring.
First, the Eric Flowerdew Volunteer Award recognizes a volunteer who promotes an active living lifestyle and enhances quality of life, promotes recreation activities and enhances Langley’s community spirit. The three outstanding nominees for this award were Leslie Gaudette, Doug Johnson and Sue Westhaver. All three candidates showed tremendous dedication and service to our Langley community.
The award was won by Sue Westhaver for her ongoing work at the Langley Hospice Society, advocating for and volunteering with seniors and palliative care and engaging supporters for the Langley Hospice residence project. Sue has contributed over 3,500 hours of time volunteering with the Langley Hospice Society and the Langley Hospice Foundation.
Second, the Pete Swensson Outstanding Community Youth Award is awarded to a Langley student in grade 11 or 12 to recognize athletic achievement, scholastic effort, community involvement and personal qualities. The amazing youth nominated for this award were Cassidy Buchanan, Taelor Coxford, Evan Dyce, Cassandra Morris, Callum Neily and Jordan Williams.
The award was won by Callum Neily of Walnut Grove Secondary School, an outstanding student and athlete who created a national not-for-profit organization to tutor students during the pandemic and then donated the proceeds to the Langley food bank.
Volunteers are truly the heart of our community, and I am grateful to the township of Langley for hosting this awards ceremony and providing this opportunity to recognize these outstanding individuals.
Please join me in recognizing all of the nominees and winners of the Eric Flowerdew and Pete Swensson awards for outstanding volunteerism.
INNOVATIVE MULTI-UNIT
RESIDENTIAL BUILDING IN
PEMBERTON
J. Sturdy: The housing affordability crisis is having serious consequences on the quality of life for many British Columbians. The shortage of housing supply and skyrocketing real estate prices mean that far too many people cannot find a comfortable, affordable place to live.
The Innovation Building Group, operating out of Whistler for many years and led by Rod Nadeau and his partner, Ned Johnson, have been inspired by the overwhelming need to create environmentally sound and economically responsible MURBs, or multi-unit residential buildings.
In the way of the Orion building located in Pemberton, Innovation Building has demonstrated that they can exceed expectations using the nine foundations of a healthy building framework from Harvard University.
ZEBx, the Zero Emissions Building Exchange, has published a case study about the development of this near-zero-emission MURB. The Orion is a three-storey, multi-unit residential building containing 45 units with one level of underground parking. It was designed to meet step 4 of the B.C. energy step guide, even as it was required to only achieve step 1.
The building was designed from an envelope-first approach and incorporates a high-efficiency envelope to minimize energy loads. An advanced ventilation system allows the building to benefit from heating and cooling delivered through an integrated centralized heat pump system run on clean electricity.
Through conventional building materials, insulated concrete forms, reduced thermal bridging, energy recovery, heat pumps, insulation, efficient appliances and fenestration and an experienced and focused development team, Innovation Building has shown it is possible to bring in a step code 4 building at 15 percent to 25 percent less than similar residential step code 1 builds. With innovative design and construction techniques, it meets high sustainability standards while, at the same time, keeping construction costs below market.
The successful completion of this Pemberton MURB demonstrates that increasing the affordable housing supply and maintaining low-cost operations while responding to the climate crisis can be reasonably, efficiently and affordably accomplished.
Come to Pemberton, Mr. Speaker. We’d be happy to show you how.
Oral Questions
ACTION ON GAS PRICES
T. Halford: Years after this Premier promised to take action on high gas prices, people in B.C. have never paid more at the pump. This hurts families getting to work and school. It’s hurting truckers in communities like Surrey and Langley.
Kevin is a trucker in Langley who says: “You explain to me why we’re being taxed to death and our government doesn’t help us.”
My question is to the Premier. Why is this Premier breaking his promise to take action on sky-high gas prices?
Hon. M. Farnworth: I thank the member for his question.
Ever since this government has taken office, we have been taking action on the issue of affordability. That includes gas prices and recognizing the cost pressures that people face, themselves, on a day-to-day basis.
As we know, the situation with gas prices is a direct result of the situation in Ukraine. It’s not….
Interjections.
Hon. M. Farnworth: Jeez, hon. Speaker.
Mr. Speaker: Members. Members.
Hon. M. Farnworth: They don’t think that the war in Ukraine is having an impact on gas prices here and right across North America, all around the world? How out of touch is that opposition?
Every fuel expert, every gas expert will tell you that’s exactly what is happening. That is exactly what is happening. That’s why that there has been a rebate going out to assist people dealing with the cost of living, which includes gas prices. Those cheques are going out. Those debits are going out this very month. Action is being taken, and we will continue to do that.
Mr. Speaker: Member for Surrey–White Rock, supplemental.
T. Halford: I’ll remind the minister that British Columbia had the highest gas prices before the war in Ukraine, and British Columbia has the highest prices during the war in Ukraine, and if….
Interjections.
Mr. Speaker: Members.
Continue.
T. Halford: If action means, by this government, $2.22 at the litre in Surrey right now, boy, are we in trouble.
Skyrocketing gas prices mean the cost of everything is going up. For a commercial truck to fill up before, it was $650; now it’s over $1,500. Filling up a tractor used to cost $230; now it’s over $800 a day. The cost of everything is going up, especially groceries, and it’s making it harder for families to put food on the table.
Why won’t this Premier keep his promise to help us on sky-high gas prices?
Hon. M. Farnworth: We have been keeping our promise to help British Columbians with the sky-high problems and costs that that government created when they sat on this side of the House. Gas prices are going up because of the situation outside of this province in Ukraine. That’s a fact they don’t want to accept. At the same time, issues that impact on transportation costs, whether you’re trucking or a motorist — we’ve been assisting right from the get-go.
Removing the tolls…. The member wants to talk about Surrey. Taking the tolls off the Port Mann Bridge is saving businesses tens of thousands of dollars a year. That’s been a record of this government. Bringing in enhanced care insurance at ICBC, lowering the cost of insurance by an average of 20 percent — that’s helping people.
All of these measures and more build on themselves, make and deal with costs that have been going up. This government has been doing that, has been taking action, and we will continue to take more.
P. Milobar: Gas prices in Alberta and Washington state are 50, 60, 70 cents a litre less than in British Columbia right now. And last time I checked, the war in Ukraine would be impacting them the same way.
The minister wants to talk about out of touch. Well, let’s see what the cabinet did, what their priority was to address affordability. They voted themselves a $20,000 retroactive pay raise. Talk about being completely out of touch with the pain that British Columbians right now are facing at the pump.
Here’s a very simple question to the Premier. With gas at $2.23 a litre, does the Premier know how much it costs to fill up the average family vehicle today? I would love to hear that answer.
Hon. M. Farnworth: As a matter of fact, I can tell you how much it cost to fill up my vehicle the last time I was at the pump. It was $88. That’s what it cost to fill up my vehicle. But what I can also tell you is that the insurance on my vehicle is 20 percent cheaper than it was under that side, when they sat on this side of the House.
I’m not paying tolls to cross the bridge to go over to Surrey, and I remember talking to a small business person who told me that that was saving him $15,000 a month when we did away with that.
I’ll tell what you else I don’t have to worry about and the families in my community don’t have to worry about. They don’t have to worry about MSP premiums, which they used as tax grabs on hard-working families.
I know something else — that families have access to the child opportunity benefit that can save them $2,600 a year. That’s a huge savings. I won’t even get into the child care savings, because we’ll save that for, no doubt, the next question that’s coming up.
Oh, one more thing while on the topic of transportation. Kids in this province under 12 ride transit for free, something they never did.
Mr. Speaker: Member for Kamloops–North Thompson, supplemental.
P. Milobar: It shows just how out of touch this minister is. I’m not aware of many family vehicles that would run on 30 litres of gas and consider that a fill.
The average family vehicle right now, at $2.23, is not $80 to fill, contrary to what the minister thinks. It’s $200 to fill — $200…
Interjections.
Mr. Speaker: Members.
P. Milobar: …to fill at today’s prices.
Interjections.
Mr. Speaker: Members, let’s get the question, please. Members.
Please continue.
P. Milobar: Over a third of that is taxes and government policies. Under this NDP, since they have taken office, gas is up 90 cents a litre in British Columbia. We are still 50, 60, 70 cents higher than Washington state or Alberta. Let’s be clear. The NDP has no idea or a willingness to try to bring any relief at the pump.
We have suggested that they could suspend provincial gas taxes like they did in Alberta, which did see a 13-cent-a-litre drop at the pump. They could give a one-time rebate to the climate action tax credit, which actually would get into people’s pockets faster and is actually based on income, so the lower-income people would get more help, not treated the same. Or they could stop taxing the fuel imports, like they started on January 1, coming in from Alberta by truck, at 25 cents a litre, starting January 1, under this government’s watch.
Will the Premier even consider one of these measures to try to bring some short-term relief to people in British Columbia that simply cannot get by anymore with record-high gas taxes in British Columbia?
Hon. M. Farnworth: I’ll remind the member that the question he asked me was: how much did it cost to fill my vehicle? That’s what he did, and that’s what I answered.
Interjections.
Mr. Speaker: Members. Members.
Hon. M. Farnworth: It is a family vehicle I drive. I know there are two of us and a dog, but it is still a family vehicle.
Now, as I said, we have taken significant action on cost drivers that hit families right since we have taken office. I’ll repeat it again for the hon. members, because clearly they don’t seem to understand that when you eliminate MSP premiums, which they kept jacking up year after year that they were in office, that’s a huge cost burden to families. That’s a huge cost burden.
When you bring in child care to make it more affordable for families so they’re not paying sky-high child care fees, that’s making life more affordable. When you bring in enhanced care and save people 20 percent on their insurance, that’s helping families. That’s helping their transportation costs.
When you are able to give back rebates because of those changes, that’s money going right back into their pockets. That’s helped with all kinds of costs, not just fuel costs, but it helps with food costs. It helps with the challenges that we’re facing.
Finally, I’ll remind the hon. member of this fact: economists who understand the gas market have made it really clear that cutting gas taxes for the sake of cutting gas taxes does not guarantee that money goes back into people’s pockets. More often than not it is taken up by the gas companies that jack the price up.
The rebate is going out right as we speak…
Interjections.
Mr. Speaker: Members.
Hon. M. Farnworth: …in this month. That’s going into people’s pockets. That’s going to help motorists.
TELUS HEALTH SERVICES AND PRIVATE
PROVIDERS OF PRIMARY
HEALTH CARE
S. Furstenau: Four questions, four answers. We almost got there, but not quite, to the one piece of information here that doesn’t seem to get talked about when we talk about gas prices. That is that in 2021, big oil made $174 billion in profits, and that number is rising this year. Oil and gas companies, including the ones in Canada, are taking home a lot of profits.
Profits is something that I’m interested in when it comes to our health care system. The first quarter of finances of Telus were reported in a May 6 Globe and Mail article. Their profits are also up 21 percent due to rising revenues. One source of those revenues is Telus Health, which operates health clinics and provides services such as virtual care and health benefits management. It increased its revenues by $17 million.
Telus is planning to expand its health business, either by identifying strategic partners or by taking the division public following last year’s successful initial public offering of Telus International.
My question is to the Premier. Does the Premier believe that a for-profit corporation should be generating those profits in the publicly funded health care sector?
Hon. A. Dix: There were percentages. Then there were numbers there, and they weren’t in the same column. But I would say that we have our primary care system in British Columbia. Our health care system is more public than it was five years ago. That is the position of the government.
We’ve brought in rules and regulations to ensure that’s the case, but we’ve also taken specific action on primary care, on diagnostic care, on surgical care. All of the hospitals we’re building are fully public and 100 percent public-owned, and we’re going to continue to take such action.
The members have raised the issue of Telus, an issue with respect to one part of their operations we’ve referred to the Medical Services Commission, which is how we function under rule of law in British Columbia. In my view, we have a public health care system with more public health delivery than ever before, and we’re going to continue to move in that direction.
Mr. Speaker: Leader of the Third Party, supplemental.
S. Furstenau: I’m sure that all the members can recognize…. We can walk out the back of the Legislature and see a Telus Health clinic right there. But it’s not just Telus. It’s Maple health care, owned by Shoppers Drug Mart. It’s Harrison Healthcare, owned by Copeman medical.
My question is to the Minister of Health. While the Premier is asking the federal government for more public money for our desperately struggling health care system, for-profit corporations are settling into that system. Does he welcome the corporatization of health care in British Columbia?
Hon. A. Dix: You can only make that argument that the system is not becoming more public if you entirely ignore what’s going on. In 2017, there were 175,000 MRIs in the public system. In this year…. That was an area of health care where there was the largest implantation of private care prior to 2017, when people could get a higher place on the list by going to private care in the public system. So that’s changed.
What was the number this year? During a pandemic, 296,000 in the public system. How did that happen? Not by becoming more private but bringing private MRIs back into the public system, as we did two weeks ago when the government purchased two private surgical centres in this area and brought them back into the public system.
I would say that what is happening across the public health care system is a more public and direct approach and using those public resources more effectively. We’ve gone from using one MRI machine 24-7 to using ten 24-7, publicly done in the public system with more public health care workers doing the work.
NURSES’ CONCERNS AND
GOVERNMENT ACTION ON
ISSUES
IN HEALTH CARE SYSTEM
S. Bond: Our health care system is crumbling, and for days now, we have been bringing painful, difficult stories from nurses across British Columbia. Yesterday the minister’s answers were completely inadequate when we’re talking about a crisis. In fact, he chose to say how proud he was, not once but eight times.
Well, I can tell the minister that we are all proud of the nurses and health care workers across this province, the ones in the gallery, the ones who are going to be on the front lawn shortly. But they are not here to celebrate. None of us should be proud of the unsustainable situation in health care in British Columbia today under this minister’s watch. British Columbians deserve better.
The minister’s empty rhetoric does not address the daily reality of nurses in our province — stories of anger, frustration, heartbreak.
When will the minister end the empty rhetoric, stand up, acknowledge the reality of nurses today in British Columbia and do something to fix the problems?
Hon. A. Dix: Thanks to the member for her question.
It is beyond dispute that the last two years and, indeed, the last four months have been fundamentally challenging for nurses, for health science professionals, for doctors, for health care workers. In the past week, for example, we had a level of absence in the system, largely due to COVID-19, that was almost twice the ordinary level, including during the last year. That has presented exceptional challenges on the ground.
What I’m proud of is the work of our health care professionals and our health care workers, who had one of the highest weeks of surgery, in the most recently recorded week in April, in the history of British Columbia, while this is going on. I am proud of that, in spite of all of the challenges we’re facing.
I’m proud of the fact that we were last in orthopedic surgery in 2017. The Canadian Institute for Health Information reports today that the 90th percentile…. We’re first on hip replacements, first on knee replacements, first on cataracts — key areas of measurement of quality health care delivered. Last to first — I am proud of that. I’m proud of the nurses and the doctors and the health care workers who did that work.
There are exceptional challenges right now in our health care system — two public health emergencies and a profound impact on the daily reality of nurses in hospitals, in the community, as a result of the COVID-19 pandemic and the public health emergency.
That’s why yesterday I was specific about the actions we were taking: training more nurses, making it easier for internationally educated nurses to come, the measures we’ve taken in Northern Health and other places. These are specific actions — not rhetoric, just actions.
Mr. Speaker: Leader of the Official Opposition, supplemental.
S. Bond: Certainly what’s not up for debate is that every member of this Legislature is proud of what nurses and health care workers and front-line workers have done every day during the pandemic and before that. What the minister needs to realize is the impact that his words have when he seemingly dismisses the real issues that are facing nurses today.
We’re also concerned about the apparent disconnect between the Premier and the minister. Perhaps he should talk to the Premier. Last week, two weeks ago, the Premier said: “Time spent talking about new programs while existing programs are crumbling I think is wasted time,” and “It’s right across the board. This is a crisis.” Those are the words of the Premier.
If the Premier has decided and agreed that it is a crisis in health care across British Columbia, then it is time for this minister to recognize the concerns of nurses that are here today and those across the province. When will he stand up and take specific actions?
Yesterday he said: “Clearly we need to do more.” Can the minister outline exactly what else he’s going to do?
Hon. A. Dix: I think this is a pattern, and I don’t think it’s a good one. I engage with nurses all the time — with their representatives and with nurses everywhere. I attended and talked to many nurses last night — talked to them about their issues, what they’re facing on the ground.
We are facing, in our public health care system right now, exceptional levels, for example, of absences. This is not an excuse. It is just a fact that people deal with every day in the public health care system. To ignore it is to ignore their issues, to ignore the fact that this sixth wave of COVID-19 — with the omicron variant of concern and its subvariant — has had a huge impact, again, on the health care workforce. And not for nothing. There were five previous waves that also affected the health care workforce.
It affected them in every single possible way: in terms of absences, which affect shifts; its impact on patients, impact on the individuals involved; the fact that with the public health emergency that’s the overdose crisis and the public health emergency that’s COVID-19, people have had personal experiences — and nurses in particular, often on behalf of family members who haven’t been able to visit at bedtime — that have been profound and life-changing in terms of outlook.
You bet I hear what nurses are saying. That’s why we’re taking specific measures, many of them recommended to me by nurses to make things better.
STAFF CONCERNS ON
CONDITIONS AT HOSPITALS AND
GOVERNMENT ACTION ON ISSUES
L. Doerkson: The other day I said there was a difference between concern and action. Minister, if there is a pattern being built here, it’s one of you ignoring the comments from nurses.
A surgeon of 28 years’ experience has left Cariboo Memorial Hospital. Another doctor has made it clear that she is also leaving. Now I have a letter from 17 of 19 operating room nurses and 11 of 13 operating room physicians. Collectively they’re calling for “immediate actions to ensure a safe working environment and prevention of further harassment, bullying and intimidation of staff.”
My constituents deserve better. Will the minister commit today to immediately dealing with this serious issue so that not a single doctor or nurse leaves?
Hon. A. Dix: I think…. The member talks about action. In Williams Lake, there has been action. I went to Williams Lake — the member will know this; he wasn’t an MLA at the time, but he’ll know this — on my first trip as Minister of Health. Doctors and nurses and health care workers came to me and said: “We’ve got to rebuild the hospital. We’ve been waiting for years and years and years. There are four temperature zones in the pharmacy.”
What did we do? We went ahead with that project that had been waiting for years and years and years. It’s going ahead, and it’s being built. We’ve added, in the region, a primary care network to support primary care. We’ve added staffing at all the long-term care homes. We’ve invested in health care, and we’re taking the specific actions — being taken for nurses and for others in the workplace — in every health care facility across B.C.
I appreciate the exceptional challenge, particularly in Interior Health. While we’ve had a wave of COVID-19 now, the member will know that it’s been challenging, essentially, in the Interior since last July — unremittently challenging.
I hear the concern; of course I do. We’ve lived the concern together, all of us, as communities. We’ve lived these concerns together, and they continue to be challenging. We’re going to continue to support doctors and nurses and health sciences professionals and health care workers in Williams Lake.
R. Merrifield: The minister continues to do victory laps on empty rhetoric while nurses and staff are not being heard and our hospitals are falling apart.
This minister has done nothing to address, listen to or respond to the concerns of the doctors and nurses about the toxic environment that is driving so many to leave.
Here’s another nurse: “ICU seven nurses short last night and had triple assignments. If something tragic were to happen because our workload is unsustainable, what is protecting us or our licences?”
Will the minister act now to fix the crisis that is across B.C. and in our hospitals?
Hon. A. Dix: The members may wish to pretend that we haven’t been through and aren’t living through a public health emergency, two public health emergencies, throughout the last couple of years, which have affected people. They’ve affected people in Kelowna. They’ve affected people everywhere else.
What I would say, though, and what’s clear…. People talk about staffing and not providing support and not taking action — action on nurses, action on health sciences professionals, 6,600 more people in the long-term-care sector. There are today, from 2018, 38,312 more people working in the public health care system.
Here’s what else is true. We were at the bottom of national ratings in 2017, so that 38,000 may not be enough and is not enough. That’s why we’re continuing to train people and support people, and we’ve taken all of the specific actions I’ve listed.
Question period is not long enough to list off all of those actions. We will continue to, but we’re going to have a forum soon where we’ll have that exchange at length in this Legislature. I look forward to the exchanges, the positive ideas, which always happen during estimates, from members of the opposition as well.
The record is pretty clear. We are increasing nursing. We are supporting nurses. And this is the hardest time ever to work in nursing because we’re living through two public health emergencies.
T. Stone: Yesterday and today the official opposition has raised a series of specific concerns that have been provided to us by specific nurses and doctors in hospitals and health care settings across the province.
Each of these stories that we’ve cited, whether it be in Kelowna or Kamloops or Williams Lake or elsewhere, have a common theme of a health care system that’s in crisis. The health care workers who are in the midst of that crisis are crying out for this minister to listen to them. They don’t feel that they’re being heard.
At Royal Inland Hospital, the leaked information that has been provided to us indicates that that hospital is operating at a 9-to-1 patient-to-nurse ratio — 9 to 1. According to additional data, over the next two months, there are nearly 20,000 unfilled shift hours in the ICU and the emergency department at Royal Inland Hospital.
We heard yesterday about three ER nurses on one shift looking after 40 patients, with 40 more patients waiting at Royal Inland. We heard about Kelowna General, where there was one nurse on a shift responsible for 54 patients at the same time. We’ve heard about the situation in Williams Lake, at Cariboo Memorial, where 28 out of 32 operating room doctors and nurses are saying: “Enough is enough.” They’re not sure how much longer they can do it, and they may follow colleagues who have already walked out the door. This is a crisis impacting hospitals and care right across the province.
Now, to be clear, we are not questioning the minister’s heart here. We’re not questioning his motivations. But what we are saying — what these nurses are saying — is that this situation is unacceptable, and they want this minister to listen to them.
The minister has an opportunity again today, with a whole bunch of nurses sitting up in the gallery, many, many more watching, to address these nurses directly, acknowledge the specific situations that we have cited and speak to the specific actions that he’s going to take now to address this dire and worsening health care reality. Will the minister do that here today?
Hon. A. Dix: I think we have, over the last two years — and with respect to the overdose public health emergency, over the last six years — faced unprecedented times. No community in B.C. — I’ve talked to the hon. member, I’ve talked to him out of here, and I’ve talked to him in here about this — and no group of health care workers has done as much under more difficult circumstances than the health care workers and the nurses in Kamloops, some of whom are here, who I spoke to last night.
The COVID public health emergency has hit Kamloops hard. The overdose public health emergency has hit Kamloops hard. The heat dome, the wildfires…. We had people in those communities — and members in the region know this — moving from 100 Mile House to Kamloops, from Merritt to Kamloops. This is a group of workers — talk about celebrating — who should be celebrated for their courage, for their diligence, for their dedication.
Since January of 2021, we’ve hired 200 more nurses at Royal Inland Hospital. We’re hiring more as we lead to the period when we open the new tower at Royal Inland Hospital. We’ve added nursing places, both for nurse practitioners and for nurses, at Thompson Rivers University. We are adding staff and adding supports all the time, and we’re going to continue to do that.
What also is true — and this is where I think the hon. member and I can agree — is that this has been an unprecedented situation for everyone in B.C., but no group of health workers, none in the entire province, deserves our gratitude more than the nurses and the health care workers in Kamloops.
[End of question period.]
Orders of the Day
Hon. M. Farnworth: In this chamber, I call continued committee stage, Bill 10, Labour Relations Code Amendment Act.
In Section A, the Douglas Fir Room, I call continued estimates debate for the Ministry of Health.
Committee of the Whole House
BILL 10 — LABOUR RELATIONS CODE
AMENDMENT ACT, 2022
(continued)
The House in Committee of the Whole (Section B) on Bill 10; S. Chandra Herbert in the chair.
The committee met at 11:02 a.m.
On clause 3 (continued).
G. Kyllo: Yesterday at the end of day, we had a series of questions, with respect to clause 3, in and around some additional language that has been added on section 22(2)(b). The language indicates: “may decide the question without regard to the constitution and bylaws of the trade union.”
During the line of inquiry, my very first question was to try and understand what the rationale was for the inclusion of this additional language. The minister had indicated that this clause was part of the previous legislation, which was taken out about 21 years ago, in 2001. The minister had initially indicated that the advice had come from the chair of the labour board and then later recanted that advice, indicating that it was actually the ministry staff that had included this draft to the labour board for their review and consideration.
Just coming back to that same question, can the minister provide for this House the rationale, the reasons, for the inclusion of that specific language in clause 3?
Hon. H. Bains: We canvassed this question for a long time yesterday. I tried to answer it in every which way it was asked.
The interpretation the member is taking about where the labour board chair comes in is his interpretation. My position is that we consulted. The ministry consulted. They confirmed that that language was there prior to 2021 and that they agree that the language should be in there.
Now, I will try one more time. Section 22(2)(b) — I gave this answer last night as well, but we’ll do it one more time — confirms the existing LRB practice that the board does not concern itself with disputes or interpretation involving such provisions in any union bylaw or constitution. Instead, the LRB assesses membership evidence on the basis of the rules set out in the labour relations regulation, as it currently does.
That was the answer. We have gone over this for a long time. It’s the same answer. It’s not going to change. The member doesn’t like the answer, but that’s the answer.
G. Kyllo: Well, the answers that were provided by the minister have changed. There were a number of different reasons and rationales that were provided yesterday, one of which was when….
The minister indicated that it was the policy of the Labour Relations Board. Under further inquiry, the minister confirmed that there’s no written policy, that it actually relates back to case law and jurisprudence.
It was the advice of the chair of the labour board to the minister with respect to the inclusion of this language. Under further scrutiny, the minister indicated no. It was actually the ministry themselves that had provided the draft language to the labour board chair for review and consideration.
The importance of this specific section…. When government is looking to move away from the opportunity for workers, through a secret ballot, without any influence or pressure or scrutiny…. Government is taking away that opportunity for workers to make that final decision in secret. They are relying exclusively on a card-check system. I know that we did canvass this yesterday, with respect to the requirement for membership to be sought and identified through an actual card check.
I was wondering if the minister can clarify. Are there any other forms by which a worker’s right or consent would be considered without the specific completion of a membership card associated with that specific employer under that union drive?
Hon. H. Bains: The labour relation regulations provide the requirement with respect to membership cards, which includes…. I’ll read it for the member’s benefit.
The card must contain this statement, “In applying for a membership I understand that the union intends to apply to be certified as my exclusive bargaining agent and to represent me in collective bargaining,” and be signed and dated at the same time by the individual named on the membership card and be signed within six months of the application date. If the board isn’t satisfied these requirements have been met, the membership card will be rejected and won’t count toward the calculation of the threshold.
G. Kyllo: Thank you to the minister for that response.
Are there any situations where a membership drive for a specific bargaining unit within a corporation…? Are there any other opportunities for membership to be proven or considered by the labour board without a card that was actually presented to workers at a specific construction site?
Hon. H. Bains: For the benefit of the member, the membership requirement under the regulations of the Labour Relations Board, as I read parts of it, is still there. It remains to be the same, and nothing is being changed there.
G. Kyllo: The large part of the conversation and communication by the minister has been around card check. The minister is now indicating that membership can also maybe be proven, I believe, in other fashions.
Let’s assume Ed the electrician seeks employment on a unionized construction site. In order to gain employment to that construction site, there’s a requirement that he actually signs up as an IBEW member. Ed is now a member. Ed then, six months later, chooses to seek employment at a private company, a non-unionized company.
Would the labour board perceive or see Ed’s membership that was signed up for a separate, alternative construction site…? Would that membership card…? Could that card be utilized and considered by the labour board as his agreement to accept the membership of the IBEW under a separate bargaining agent?
Hon. H. Bains: I want to remind the member that the question he’s asking is not part of the bill that’s before us. But for the benefit…. I can explain it to him.
If you are a member…. If you apply to get a job at, say, one Safeway store and the parties have a negotiated, under the labour code, a collective agreement that, as a condition of employment, you must join the union that is representing the workers in that particular operation, that is one thing.
If you leave that operation, quit that job, and you are going to a brand-new grocery store opening up or you’re applying for a job and you are working in a different grocery store that is in operation…. It could be the same union where he came from, or it could be any other union now applying to represent those workers in that new company that I’m talking about. Then the bargaining unit in that particular operation and the membership card signed in that particular company by that union to be a representative of those employees is the card that will be considered.
It’s not because he or she was a member of that union at another place where he or she quit or was laid off. Now you’re working in a new company. It could be the application by the same union to represent those workers.
The board will determine based on the number of membership cards signed in that particular operation and will consider if that is the appropriate bargaining unit and if the union has sufficient support, as is required under the code. That’s how the decision will be made.
G. Kyllo: The question that was raised and brought to my attention is…. The labour board potentially has the right to give consideration to either a signed union membership card or evidence of an active, dues-paying membership.
I want to make sure that I’m 100 percent clear that a union certification drive for a specific company would not be able to rely, or the labour board would not in any way, shape or form rely, on membership dues paid by a worker at another entity. Whether those membership dues are even still current, a membership drive on a specific corporation would require a new card to be completed and signed that would meet the requirements of the 180-day period, including the date and signature as the minister had indicated, which is referred to as card check.
It’s a bit of a nuance. We were talking about card checks specifically. I gave the example yesterday, the hypothetical 100 members of a corporation required to have at a minimum 55 percent cards signed up under that application. Then the minister also started talking about membership.
I want to be absolutely clear that for membership confirmation by a union presenting the information to the labour board, there would be a requirement for new cards to be signed up for each and every one of those employees for that specific entity and that the labour board would not give consideration to previous or existing memberships that might have been signed with respect to an alternative place of work.
Hon. H. Bains: What’s in the bill in 22, “Process relating to application….” So (2) talks about: “In deciding whether a person is a member in good standing of a trade union, the board (a) must decide the question on the basis of membership requirements prescribed in the regulations.”
The regulations are not being changed. The regulations — I read parts of them, and the board will make those decisions based on those regulations. It’s not up to the minister to determine how the board makes those decisions. It’s their purview, and they have the regulations to determine the appropriateness of the bargaining unit and who are the members qualified to become part of the bargaining unit. They make those decisions, and they are in the regulations. The regulations are not being changed.
G. Kyllo: The importance of this specific clause 3, and why we’re spending so much time on this….
I believe the reason the minister is not providing necessarily the definitive answer is because what I have been told is that Ed the electrician — who may be a member of IBEW, as an example, working in one construction facility — leaves that construction facility for whatever reason and chooses to get employment at another construction site.
Just the sheer fact that he had signed up a membership card for the previous employer would give the labour board the ability to automatically determine that because he had signed a union membership card and was paying membership dues on an alternate construction site, the labour board would count that individual as giving their agreement to supporting the unionization of this other facility.
As we are moving away from that opportunity for that worker to make their own clear decision in secret, through the secret ballot, that is being stripped away from the worker under the provisions of this legislation.
It’s my understanding that a worker who may leave that unionized environment to work for a private sector contractor would not even need to acknowledge or in any way represent to the labour board their desire with respect to unionization of that specific facility. But the labour board would have the ability of giving consideration to a previous membership at an alternative construction site, an alternative company, and use that in support of the unionization moving forward with certification for an alternative site.
I want to be clear that when the minister referenced card check…. I think it’s pretty clear. I think most folks might be watching from home. If you work for a specific construction site and there’s a union drive, members have their free will to determine if they choose to move forward with union certification on that specific site.
It’s a whole different story if there’s the opportunity for the labour board to review a previous membership working for an alternative company on another construction site and bring that forward as the agreement of that worker to move forward without even necessarily their knowledge.
I’m hoping that the minister will be able to provide a bit more clarity with respect to the current regulation and what the labour board is able to give consideration to with respect to who is counted as being in support of unionization.
Hon. H. Bains: Again, I want to remind the member that the determination of the appropriateness of the bargaining unit and whether the member is appropriate to be part of that bargaining unit is determined by the labour board based on the regulations that they have already established, and those regulations are not being changed. I can give a bit more information from the labour board regulations.
As I have read earlier on about the membership evidence, there’s an additional section of regulations. By the way, it can be seen. It’s printed, and the labour board…. It’s available in the libraries, anywhere.
It goes on to say this. At 3.1, it talks about “Additional requirement for construction industry,” if the member was reaching out to the construction industry for an example: “In addition to the requirements of section 3,” which I read before, “a trade union making an application for certification in the construction industry on the basis of active membership referred to in section 3(c)(ii) must attach an expression of support from those members in the following form.”
There’s a form that they must also attach, which says: “I support the application by” — it’s blank; it would be the name of the union — “for the certification applied for.” Then the name of the employee and the date. That’s how that membership would be determined.
There are regulations that the board follows. They have their own…. Those are the procedures they established based on the regulation and the code.
G. Kyllo: Thank you to the minister for that.
The minister, in reviewing that specific section, showed a book that’s about two and a half, three inches thick. I don’t imagine the minister has read the regulation. I certainly haven’t, and I would be willing to guess that the majority of workers in B.C. probably have very little information or knowledge of the information contained within that voluminous regulation.
In any event, what I’ve been informed is that simply by the fact that a worker has gained membership and is currently paying membership dues — if we use Ed the electrician as an example, with the IBEW — and had previously signed and acknowledged their desire to be a member of the trade union on a different construction site, the union organizers, as they move forward to try and unionize an alternative construction site, would not necessarily require a new card to be signed. Without their knowledge, the previous membership dues could be utilized and given consideration by the board.
The minister referenced, in reading the regulation, the requirement of a second form. I just want to be absolutely clear that as workers are stripped of their right to make that final decision, in secret, whether they choose to join or not, there’s no provision or ability for a union organizer, in submitting that information to the labour board for consideration, to be relying on either paid membership dues or a membership card that was signed up specifically for joining a union on a different construction site.
I don’t want to belabour the point, but let’s look at a worker that might be working for a construction crew. He has signed a membership card with the Carpenters Union, leaves that employment and chooses to seek employment at a separate construction site with a private contractor that is not unionized. In order for the union organizers to present the information to the labour board for consideration, there’d be a requirement for either a new card to be signed or some other form of written, signed acceptance by that worker, specific to that new certification application.
Hon. H. Bains: I read the regulations that are required under similar circumstances. Those regulations are not being changed, and I expect that the board will continue to follow those regulations.
G. Kyllo: Thank you to the minister for that response.
The secret ballot that currently exists gives all employees working for an organization the right to make their final determination in secret, without any undue pressure or interference. It’s their business and theirs alone.
My concern, as I’ve stated a number of times now, is that there would be the requirement, as government looks to moving away from that secret ballot, taking away workers’ rights to have that second sobering thought on how they choose to move forward…. The minister has indicated that it used to be that card sign-ups, or cards that were signed for unionization, originally were only valid for 90 days. Government has moved to extend that for 180 days — so for six months.
A member or a worker could sign a card five months previously, and there are a lot of things that change on a worksite. In the relationship between the employees, the workers and the employer, things change over time. By taking away…. That right of the worker to have that sobering second thought and to make that final determination in secret is being taken away. It puts that much more impetus and importance on how those membership cards or the card checks are actually being undertaken.
I don’t want to belabour the point, but I just want to be absolutely clear that there’s no opportunity for the labour board to give consideration to a membership certificate or the payment of membership dues at an alternative construction site, and that that could be utilized by the labour board in determining the desire or wishes of the worker in a separate union drive for certification. I’m hoping that the minister can provide that additional clarity to this House.
Hon. H. Bains: For one more time, I would say, I would read that additional requirement. In addition to membership as part of section 3 regulations, 3.1 talks about exactly the same situation. I’ll read it again: “In addition to the requirements of section 3, a trade union making an application for certification in the construction industry on the basis of active membership referred to in section 3(c)(ii) must attach an expression of support from those members in the following form.”
That form must be signed and submitted with the application, which is the prescribed form. It says: “I support the application by ‘blank’ for the certification applied for.” Then there’s the name of the employee and the date that that employee signs. That additional requirement clarifies, I believe, that situation.
G. Kyllo: Thank you to the minister for again reading that section.
The form of acceptance or acknowledgment that the minister just read certainly did not reference a specific company, a specific location. So in accepting or obtaining the application or, I guess, the consent of a member with respect to a separate certification drive, how would the labour board have any knowledge or understanding on whether that acceptance or agreement was pertaining to a specific construction company?
The minister, as he read out the information to this House — there was no reference to the location of the application, no reference to the company that the worker would actually be potentially giving his acceptance to. Can the minister just provide any additional clarity on how the labour board would know that that acceptance was specific to a specific employer?
Hon. H. Bains: The member, perhaps…. As I suggested, maybe we should provide a separate briefing that would explain the process of applying for certification. The unions do not just go to the board with a blank application — that the board doesn’t know what company they’re applying for, what the address is. There’s a requirement to have full information about the appropriate union applied for, the company that they are employed by and the address.
All of that is there, and this thing here will say that I support the application by…. And this must be filled with the name of the union, for the certification applied for. So the certification applied for has that form that has all of the information. The board will see the certification application, the information in that form, and this member is saying that I support that certification that is applied for by a union that is going to be listed in this form.
The board has all of the checks and balances. These are the declarations that they have adopted, and these are regulations that have been there before. They are here today, and they will be there tomorrow. They are not being changed. They will continue to follow that, and this is nothing new that we are bringing in through this bill.
G. Kyllo: I appreciate the comments from the minister, but I don’t believe that that actually provides the clarity that I was seeking. It appears that membership elsewhere could potentially be used for the purpose of union qualifying for a vote, provided that there’s this additional form that is attached. That form that is attached or would be attached by the union organizers in submission to the labour board…. It doesn’t appear that the request or the authorization of that worker was specific to any particular construction site.
I’m just wondering if the minister can provide additional clarity, or maybe he can provide a sample of the form — what that form of authorization might actually look like.
He referenced from the labour code the specific information, and I understand that the authorization needs to include a date, the name of the union and the name of the individual. I don’t know that I heard that it had to be signed. I’m assuming that the signature would be there. But the missing piece that I see from that particular form is the company by which that authorization is being applied to. Can the minister just clarify those specific additional questions?
Hon. H. Bains: I think I have answered this question a number of times now. What the member is getting into is the operation of the labour board. They have regulations to follow. They’ve followed those regulations for a number of years, and those regulations are not up for debate here. They have followed them through certification processes in the past, and they will continue to use the same process, is my expectation.
I would just ask that the regulations that have been debated here are not before us for debate. I have tried to explain as much as I could how the board operates and the process of certifications, what the requirement is, sometimes additional requirements, as the member has asked. Those questions have been answered.
G. Kyllo: Well, unfortunately the questions have not been fully answered, certainly not to the satisfaction of this side of the House.
The removal of the secret ballot…. That opportunity for workers to make the final determination or their own decision in secret, with respect to should they want to choose to join a union or not choose a union, is being taken away from workers. Government has chosen to move and to rely exclusively on what we initially understood to be a card-check system, and I think we’ve canvassed that quite extensively yesterday.
A union organizer would work within a corporation to try and speak to employees and sign cards where employees would specifically agree: “With respect to my employment at company A, yes, I choose to move forward and support union certification.” That’s very specific to that company and that employment and the change in the relationship between that worker and their employer.
When we give consideration to what’s called membership…. And I believe that the labour board does have the opportunity to give consideration to other forms of that acceptance, so it’s not just a card check. The labour board also has the opportunity to give consideration to existing membership that that member may have with respect to employment at an alternative or a different employer.
What I’m trying to have a better understanding of is: if the fact that a member of a trade union associated with a separate construction site and separate terms of employment leaves that employment and chooses to work for a secondary company, a private company that is not unionized, what is the test? What is the requirement for obtaining that authorization of the union organizers to include that member’s consent with respect to application?
The minister referenced the regulation, indicating that the authorization was required to include the name of the individual, the date and the name of the union. I did not hear the requirement for a signed authorization or signature in some form, nor did I hear the requirement of the inclusion of the specific company that that authorization would be attached to. So it’s definitely tied directly to the impact of this legislation.
I hope the minister can just provide some additional clarity. If the minister is able to confirm that, yes, the name of the company which that authorization is attached to has to be duly noted on that form and that it has to be signed by the worker, then I think that I’m satisfied. But if that is not the case, I would certainly appreciate hearing that directly from the minister.
Hon. H. Bains: Let’s try one more time. I have explained, because the regulation in part 2, the regulation I read earlier on…. This is in addition to the first one, in construction. There is a requirement of applying. The membership card must be signed and dated at the time of signature. That is the first thing. Then it says that in addition — I think I read it very clearly — to the requirement of section 3, the remainder part, again, must be submitted — this part.
There is a card, signed, with a date on it, and then, in construction, this is an additional form that needs to go with it. If the member could read both of them together…. Again, the board has the authority and requirement to determine the validity of membership that the union is applying for. They do that all the time.
I think I will leave it in the capable hands of the board that there’s a requirement for a signed card, and then, in construction, this additional form needs to go with it.
Noting the hour, I ask that the House rise and report progress and ask leave to sit again.
Motion approved.
The committee rose at 11:53 a.m.
The House resumed; Mr. Speaker in the chair.
Committee of the Whole (Section B), having reported progress, was granted leave to sit again.
Committee of Supply (Section A), having reported progress, was granted leave to sit again.
Hon. S. Robinson moved adjournment of the House.
Motion approved.
Mr. Speaker: This House stands adjourned until 1:30 p.m.
The House adjourned at 11:54 a.m.
PROCEEDINGS IN THE
DOUGLAS FIR ROOM
Committee of Supply
ESTIMATES: MINISTRY OF HEALTH
The House in Committee of Supply (Section A); J. Sims in the chair.
The committee met at 11:03 a.m.
On Vote 32: ministry operations, $25,308,645,000.
The Chair: Minister, do you want to make a comment?
Hon. A. Dix: Thank you, hon. Chair.
We obviously have teams from the Ministry of Health supporting us and providing information in these estimates. I want to introduce Stephen Brown, the Deputy Minister of Health, who the members opposite will know well, and Jonathan Dubé, the Associate Deputy Minister of Health in our ministry. He’s joined our team more recently but is doing an outstanding job and working…. He’ll be assisting me with all matters financial.
As we like to say in the Ministry of Health, it’s just $25 billion. It’s a lot, and a lot of challenge, for everybody in our ministry.
I want to thank everybody in the health care system, to start with.
The staff in the Ministry of Health, everyone will understand, have worked with enormous dedication in the last two years and every year to deliver health services to British Columbia, which, when you need them, are the most important services government can give, I think. I want to express my appreciation to them.
The current budget increases the Health budget by $3.2 billion, over the next three years, to $27.05 billion in 2024-25. Obviously, we’re debating the current year, the 2022-23 year.
I want to keep this short, because really, the estimates are an opportunity for the opposition to bring comments and ideas and questions and for us to answer them, not for me to give a long statement. So I’m going to truncate what could be, inevitably, a 30-minute statement to a few minutes just to express my gratitude again to everyone in the health care system and to the people of B.C.
Never, I think, in our recent history have people come together in such an important way at every level — and I include, by the way, members of the opposition in this — to support each other in difficult times through our health care system. And while the health care system always faces exceptional challenges, it’s important to acknowledge what we’ve achieved together — one of the best responses to COVID-19 in the world.
That wasn’t me. That was the people of B.C., our health care professionals, our health care workers coming together and the communities coming together well beyond health care. Businesses, non-profits, community groups — people coming together to support one another.
If it’s the case that we did more surgeries last year than ever before in B.C., which we did, it’s because of the work of all of those people. They all had a hand in it. I think it’s important to recognize in these times the centrality, the central approach, not just at an individual level — if you have a family member or you yourself are in long-term care, if you need home care and home support, if you need a surgery, if you need primary care — and how important the public health care system is.
We have been through an extremely challenging period, and we’re still living through it. It’s hard, in some ways, to look outside of these events, which continue to profoundly affect us. This current wave of COVID-19 is different than previous waves but is no less challenging for our health care system to deal with. You see that, and you see that expressed every day. You hear that from the health care professionals I talk to every day and the health care workers I talk to every day.
Finally, I would say this. It is easy, I think, to be focused on the challenges facing our health care system, but I think the public support for that system continues to be higher than ever before. We’ve seen what public health care means to people in this pandemic on a daily basis in their lives, and I think it leads to a reinvigoration of that support. I believe that support is important, as we build and respond and improve a public health care system that is so important to the lives of people.
I welcome the Leader of the Opposition, also the opposition health care critic, to the debate. I look forward to the exchange over the next several days. I’m not sure how long. Four days I think it is. Who knows? The time of debate, as I am well aware, is up to the opposition more than the government. But we’re going to have lots of time to work through issues.
I want to acknowledge the members of the Green Party, who will be part of this debate as well. I look forward to their questions, and I hope to and will, to the best of my ability, provide answers. And I’ll just say this to the Leader of the Opposition: if it’s the case that we need a specific number, I’ll just say that, and we’ll move on. We’ll try to get it to you at the first break so we’re not delaying and searching for numbers, because I know the member has lots of questions, and we want to provide lots of answers.
With that, I leave it to the member for Prince George–Valemount, the Leader of the Opposition.
The Chair: I now recognize the Leader of the Official Opposition and the opposition critic.
Would you like to make opening remarks?
S. Bond: I would. Thank you very much, Madam Chair. I do know this. Our estimates will probably extend longer than I will be the Leader of the Opposition, which is exciting, and there will be some mixed feelings, I can assure you, as we move forward.
I, too, want to recognize the ministry staff. I know firsthand how hard the people in the Ministry of Health and in each ministry in government work to make sure that British Columbians are well served. I had the privilege of serving both as the Minister of Health and as a cabinet minister for 16 years, in fact, so I’m very appreciative of the work that goes into the estimates process and the work that’s done every day.
I’m also under no illusions. I know that this means that there are people all across British Columbia who are paying attention in health authorities, when they probably could be doing other things, as we move our way through this discussion.
I, too, want to begin my comments with a deep sense of gratitude for the men and women who serve in health care across British Columbia. They are selfless, and they are called. It is not just a job; it is calling for nurses, physicians and others.
Having said that, and while I certainly respect the minister’s comments today, what I hope that we will spend some time doing over the next number of days is talking realistically about what we are going to do to address some of those challenges. It is one thing to list off what’s been done. People need to know that their health care system will be there for them.
While we can say that British Columbians have faith and confidence in the system, there are certainly cracks in the system, and British Columbians are reaching out to me and my colleagues on a daily basis. You know, whether they’re sitting in a waiting room at children’s hospital for nine hours with a sick child…. It tends to erode confidence in the system. So our job is to make sure that there is a clear, well-articulated plan about what we’re going to do, not just in the here and now, but in the days ahead.
I look forward to the conversation. I have always appreciated the minister’s willingness to respond to questions. He’s also been very inclusive with briefings and information-sharing, and that’s not always the case. I do very much appreciate his willingness and the willingness of his staff, recognizing the briefings that Dr. Henry and the minister provided to us, along with the deputy of Health — deeply appreciated by our caucus as we went through those long years, in fact.
We do have a bit of a roadmap. I’m going to start with what I think is core to the challenges that we’re facing in British Columbia, and it really does impact every aspect of the system, and that is health human resources. I think we need to work our way through with some degree of detail about what people can expect to see happen.
I’m going to start with a very specific question. I’m wondering if the minister or his staff can tell me how much of the health care budget is currently spent on compensation?
Hon. A. Dix: The number is 72 percent.
S. Bond: That was a great start. We got a simple, straightforward question and an answer right off the bat. Well done.
I want to spend the next period of time talking about a health human resources strategy. I know that I have raised this repeatedly through estimates processes since the beginning of this government’s time. I think there is a growing concern about the fact that while we continue to say that we’re going to train more nurses and we’re going to do all of these things, there is not a plan for that that has been released by the government. That’s a deep concern for me. I have raised it, as I said, continuously.
It was promised or, at least, the indication was that the plan would be released in the fall of 2021. That was after waiting for it previous to that. Here we are in May of 2022, and no plan has been released. I’m wondering if the minister can give me a specific timeline as to when we will see a health human resources strategy in our province?
Hon. A. Dix: Just to respond very briefly to what the member said about briefings that have been provided here. People in British Columbia don’t understand that, typically, cabinet-level briefings aren’t given outside of cabinet, and there’s always a reason for that. Essentially, what’s been provided for two years are cabinet-level briefings around COVID-19 for members of the opposition in advance.
I want to be clear about this so that people understand. Nothing, ever, has been leaked out of those briefings in advance of public announcements. So offered, but also received, in the way that shows people working together. I just want to acknowledge the Leader of the Opposition, who’s led in that regard, and the work that she’s done.
I think the issue of health human resources is a central question. Financial questions are subjects of public debate, of course, and they’re decisions that we can make. They do impact, obviously, given the extent to which the Health budget is spent on human resources. They impact human resources. But one can always choose to — I don’t know — add to the tax base or reallocate resources. Those are political questions.
The key question for the future of B.C. in the health care system, given an aging population and an increasing complexity of care across the system, is to be able to add sufficient resources to meet that test. That aging population…. We’ll talk, I think, when we get into this, especially the primary care system, about the extent to which our health care workforce is also aging concurrently with the health population such that we have, in B.C., about 400 doctors currently practising over the age of 70, just to put that in context today. Those doctors, for example, tend to have panels of patients with them, their patients, who have been with them a long time, and the significance of their retirement is profound.
I think the health human resources issue — I agree with the member — is a central issue, and that’s why we’ve been working to develop a comprehensive health human resources plan, and we’ll be presenting one. I would expect it to come in September.
The work has been done, and the action has already been taken in many areas already. You see that reflected in the announcement on nurses, the pending announcement on health sciences professionals, and other parts of the plan that have been put in place.
What’s happened over the last two years, and why is that delayed? I think that we just have to acknowledge it was delayed. They said that we’d see it last fall. It’s that we’ve stood up some of the most significant health programs in the history of B.C. on very short notice in that time. Contact tracing — twice we got up to 1,500 people working in contact tracing. The largest immunization plan in history. And 6,600 people added in long-term care through plans. These are things that were stood up and happened that would not have happened in that way had we not had the COVID-19 pandemic.
Exceptional work was done. All of that was health human resources issues — not for the next ten years, but now. They had to be ready right now, and they were. Even the dramatic changes in the way we addressed primary care and virtual care and the change in billing codes were significant health human resources decisions.
Those are the issues that have been taking a lot of time. In spite of that, I would say, very strong action has been taken in a number of areas. I know the member has more questions, so I won’t do a long list of that.
On nursing, on health sciences, on health care workers, on doctors — the largest family residency program in Canada now…. All of the measures that have had to do with staff during COVID-19 such that, overall, our head count, in terms of the public health care system has gone, in 2018, from 184,000…. This is net — people coming in; people going out. In 2019, 186,775; 190,699 in 2020; 216,000 in ’20-2021; and 222,921 in 2022, so an increase in total growth in the system of 38,000.
I think the member will say this, and still, that was reflected…. We had a discussion in question period before we got here, reflecting the question still: real challenges in lots of places. Not just in the emergency room — although there, in many cases — but also in home care, home support, long-term care and other areas.
We’ve seen this extraordinary growth. We’ve seen these programs put into place that have an effect, which will be a key part of the plan, including contract repatriation, wage levelling and other things that allowed the long-term care system to continue to function and the acute care system to continue to function. All of these things are in place.
When will you expect to see the overall plan? I would say September. The work is done. It’s essentially ready. We go through, as the member will know, approvals for that. You’re seeing significant elements of that plan. I would say, when it’s announced, the significant majority of elements of the plan that involve new, incremental expenditures will already have been announced.
What the plan will be is to show the overall vision, but the overall vision has been set and established based on the work that has been done between the Ministry of Health, health authorities, health professionals, health care unions, the public and communities over the last number of years.
S. Bond: I very much appreciate, first of all, the comment…. As we do estimates, as we have done before together, there’s an opportunity for dialogue. I think it’s really important that that forms part of it. I really appreciate the recognition that government and opposition can work together constructively, and that is exactly what this minister has done in many areas.
That includes providing briefings to the opposition. We honoured the opportunity to have that information shared with us. I hope it speaks to other areas of government about how things could work. I’m always appreciative of the minister’s willingness to consider those things.
I’m relieved to hear that we’re going to have a plan, hopefully in September of 2022. But I think the challenge we face is that as we speak to health care professionals who feel today like they’re barely hanging on and are making decisions about leaving the profession, one of the reasons we need the plan is to give them some sense of hope that we actually have a longer-term strategy here to deal with some of these issues.
We can’t train physicians overnight. We can’t train nurses overnight. So I think that as we look at what the plan looks like, part of that is building confidence back into the system.
I want to ask the minister…. One of the things I know from my experience is that we need to have adequate labour market data. We actually need to know how many doctors and nurses we anticipate needing, and that needs to be done in conjunction with the Ministry of Advanced Education, obviously, because of the training component that is part of that.
Can the minister perhaps describe for us a little bit of the process that was involved? Is there an integration with other ministries in the terms of the plan? We need to know how many people we need, where we need them and what specialty fields we need.
How comprehensive is the plan? Has there been lockstep work with the Ministry of Advanced Education so that, as the minister outlines…. “Here are the needs for British Columbia over the next five years. Here’s exactly what we intend to do about that. Here are the labour market numbers, and here is the strategy to address these issues.”
If the minister could walk through the process…. Does he have accurate, up-to-date labour market data about who we need and where we need them?
Hon. A. Dix: I think the short answer is yes, in every way. For example, one of the key aspects — and this is dating back a number of years — of the surgical plan…. You can’t say, “Well, we’re going to improve our rating on hip and knees,” to go from tenth to first and say that’s a priority for people. It is. We can see there are several elements. There’s an aging population. We’re going to need to do more just to stay where we are. If we want to improve that, we have to do even more.
For example, in that process, one of the things that was added was a doubling of residency positions in anesthesiology. That was a health human resources part of the surgical plan. That’s an example of what we do. I see the key input that we are sometimes less able to deal with is the issue that the member identifies: the issue of attrition.
In terms of, for example, the community of doctors, it’s a different community than, say, the community of health care workers. There’s a doctor practicing in B.C. who’s over the age of 85 and has a patient panel in B.C. Well, that wouldn’t, in general, happen with a population of health care assistants, for example. You wouldn’t expect that to happen. In fact, it wouldn’t happen in those circumstances.
I think there are two sets of things. There’s the increase in demand. Demand for oncology is going to increase, because we have an aging population. We have to meet that demand. So there’s that side of it, and retirements and labour market analysis. So all of that goes into the assessment.
Part of the reason why we’ve moved ahead with a lot of the initiatives in the health human resources plan before the plan is what the member also said, which is that it takes, in many areas, a long time to train people — not just doctors, but health care professionals across the board. If you’re going to do that, we need to, and have been, starting up right away, so you see a lot of the measures in place.
When we announce the plan, what you’re going to see are a significant number of the measures already done. This lays out the vision and provides the public vision of the plan over the coming five to ten years.
S. Bond: Thank you to the minister. He anticipated my specific questions related to looking at increased demand as a result of retirements, for example.
What we can’t calculate at the moment is the impact of the system pressures that we’re feeling now, where we see…. When we look at the nursing population, for example, many of them are saying: “I can’t do this anymore.” What is going to make the process even more complex but ever more necessary is looking at how we retain people today so that we’re not driving up the numbers we need simply because of the stress load and the load that health care professionals are carrying.
If we’re going to see the plan in September, I’m wondering what funding is in place in this fiscal year. The minister has said that some of the pieces we will recognize, because they will have already been announced, but what funding is in place for implementation of the health human resource strategy in this year’s budget?
Hon. A. Dix: What I’ll do is I’ll go through some of this, and some of this material…. What I’ll do is I’ll share the material I have with the hon. member, because people have said to me that I list off too many numbers sometimes and that they’re hard to follow for most normal people, so I’ll try not to do too much of that. The parts of the plan that includes…. I’ll just give you a brief summary of the initiatives of the parts of the plan that are kind of there and funded in this year. There will be more.
The senior services direct care investment. That was the investment in long-term care to raise care standards. So when we talk about care homes meeting the 3.36 standard, that requires continued investment to continue to meet that standard, because there’s retirements and everything else, and we’ve gone well above that standard because of COVID-19 — because of the challenges of COVID-19, which are significant.
There’s the health career access program, sometimes called HCAP, which has, over the three years from 2021 to ’23, $585 million invested. Not a small amount of money. The primary care strategy. These are the funded elements of it. We mentioned in the House, I think, that 965 incremental FTEs have been added. They include doctors, nurses, nurse practitioners, Allied Health workers, etc. We have, in the coming years — it’s really over four years that we do it — 1,815 FTEs to add to the primary care centre — 965 are already in place. Another bunch to come.
The surgical renewal commitment includes a very significant training program. That’s the increasing specialty nurses training — 299 net new nurses since May of 2020, when we announced that, but also medical device re-processors, who are absolutely critical to the surgical process everywhere. It’s a critical issue in many places such as the North, where we want to maintain high surgical regimes. If you do that, you have to have all of those Allied staff in place and, of course, the recruitment of surgical specialties and anesthesiologists.
We’ll get into ambulance paramedics later. I won’t get into that, but there’s a plan around ambulance paramedics to add people, but also to reposition the ambulance service under the direction of Leanne Heppell and Jim Chu to reposition that to more full-time staff or permanent staff, in…. We keep using 2017. I’ll use 2016.
When we first talked about repositioning the ambulance service in that period, about just under 30 percent of people were not casual staff in some form. It’s now over 50 percent. We’ve got to continue to work in that direction, because we can’t any longer have a casual ambulance service. That’s a reality the previous government recognized, and we’ve done a lot to implement it. There are all the temporary measures, some of which will be repositioned to support other initiatives.
The immunization plan, which is a partnership with the Canadian Red Cross. The contact tracing. The infection prevention staff, particularly in long-term care. The wage levelling, which is continuing but is a huge cost item. The wage levelling for workers to come to the HEABC level, where we wouldn’t have had workers, probably, in many contracted long-term care homes. That’s an annualized cost of $147 million to the base, which obviously has an impact on recruitment.
There’s increased direct funding to post-secondary medical education spaces. Health care assistant spaces have increased. Other health sector expansions include allied health nursing and health care assistants. And then there are other programs, ones that the hon. member and her colleagues, particularly from Peace River but also from other places, and my colleagues from Smithers and from Prince Rupert on our side of the House also advocated, which is the Northern Health incentive program.
Hopefully, we’ll have some occasion to report on some of the details of that. I know that the member received a briefing from Cathy Ulrich on how that’s going, specifically. And if we don’t, I’ll remember to send that information to the member.
There’s the health care system bursary program. There’s the repatriation of health care workers in the acute care centres, which is, largely, Fraser, Vancouver and Island Health. That repatriation is, I think, regardless of the lengthy public debate over time on that issue, a necessary step to continue to recruit into those sectors. We did have people earning poverty wages who were also coming in with all of that uncertainty in April 2020, and that repatriation changes that in this part of recruitment.
The internationally educated nurses that we just announced. The Occupational Health and Safety Society, which is a key part of it, which is essentially run by the workers themselves in partnership, was created in 2019. But it had been a long-standing recommendation by Minister Lake and implemented under my watch.
Provincial loan forgiveness program. I think we have to look at doing more on loan forgiveness, perhaps in exchange for return of service, to get people started in a good way and not have our health care workers facing very significant burdens that would limit them from doing the work that we need them to do as a system. And of course, significant changes to the provincial nominee program.
Those are elements of it, of funded and announced initiatives, and there’ll be more coming forward in the coming few weeks.
S. Bond: While I appreciate that there are things that have been done, and that obviously they’re funded, I think we all recognize that unless we do more, we are going to face challenges that are going to continue to escalate over time. When I think about what’s necessary in order to give health care workers and British Columbians confidence that we actually are going to try to manage and support them, there are areas that we need to focus on: training, foreign credential recognition — and licensing, of course, as part of that — recruitment and retention.
When the plan is announced, does the minister intend to lay out a series of initiatives, perhaps under those themes, and be explicit about what additional steps will be taken and that there is funding to do it? We need to see that there is a recognition that it’s not all about retention, but that’s a pretty important piece of it right now.
I would suggest that if we don’t retain the health care professionals we have today, we are going to struggle to create enough training…. We simply can’t do it. The nature of training doesn’t allow it to be as instant as we need it. So could the minister describe for me a bit about what the plan will lay out?
Will it be thematic? Will there be targets? Will the minister be reporting regularly on progress? Those are the kinds of things that restore hope and confidence in people — when they can see that there’s a commitment, that there are metrics attached to it, and that there is regular public communication about progress that’s made.
Hon. A. Dix: Yeah, I think the kind of approach that we try to have is the approach of surgical renewal, which are — sometimes people in the media say too many reports — weekly reports saying what we’re doing, where it’s strong, where the challenges are.
I think it really helped us in periods where we had to interrupt some surgeries, because people knew where they were; knew the commitment; knew what the progress was and knew what the progress was in terms of FTEs and others. We do those sorts of reports, and we need to do, I think, a continuing and more effective job.
I would say, in workplaces, there is some sense…. I was reflecting on the CIHI report today. It says that we’ve passed all the other provinces. I don’t think, if you’re waiting for surgery, you care how they’re waiting in New Brunswick that much. You want to get the surgery. If you’re sitting in an emergency room, where you’re doing more than seemingly is humanly possible yet still doing it, you’re not concerned about our record on nurses. You need to report on these things, and they help build confidence.
There are really four key elements to the health human resources plan that have been the focus of the work. The first is…. Yes, metrics in place to make progress on all of these metrics. Here are the key metrics. So it seems to me.
One is retain and improve the safety of workplaces. How does that help you? It helps you in two ways. Hopefully, you reduce overall sick time. That’s why giving employees significant control and a role in occupational health and safety is important. It has been a consistent approach in B.C. It helps you, in that sense, improve the quality of work, which you always want to have.
I mean, these are always going to be difficult workplaces. They always are. It’s just in the nature of the work, and it’s what calls people, as the member has said, to that work.
We need to retain. It’s particularly important in regions. Successive governments have recruited a ton of people to Fort St. John. They have. Our retention rates have never been as high as in other places, and we’ve got to figure that out. It isn’t just the workplace. It’s ancillary issues like availability of housing. We’ve seen, in a community like Dawson Creek, real assistance in that from the community. Lots of communities are involved in that, especially small communities around family practice.
What are the goals there? Reduce turnover, reduce time-loss claims, reduce injuries, and a better life for the people working in the system. That’s how you, in part, retain people. It’s why…. I think it’s hard for people who aren’t in health care…. Even though we work in it as politicians, I think it’s hard for us to understand what each new wave of COVID-19 has meant to people in the work they’re doing. It’s been profound — and the overdose crisis as well.
That’s the first. It’s retention and to have measures on retention and to make improvements on retention — not just improvements provincially but retention in places where we have a challenge. If all the recruitment happens in the Lower Mainland, then our outcomes, for example, are in Metro Vancouver or on southern Vancouver Island, but if it doesn’t happen in the Interior and the North, then that’s important.
That gets us to the second one, which is recruit. That allows us to improve the quality of care and to replace people and to have the adequate staff in place. It’s recruitment from other jurisdictions, and that means reducing barriers. I think that’s one way to recruit. Recruiting and, I think, the overall effort to ensure…. When you’re increasing training to people and you have, for example, more family residency positions than everywhere else….
What happens when you train them? One of the problems with nurse practitioners was that we were training them here, but there weren’t any jobs for them here. So we were training the outstanding nurse practitioner community in Washington state, frequently, in the past. We’ve changed that. That recruitment is key, and that’s a key part of the system.
You need to optimize and to innovate. That’s the third part. That means filling vacancies. That’s the challenge. The member will know that there are positions — health sciences positions, in particular — in some parts of the province that haven’t been filled in a long, long time, maybe since she was Minister of Health. So what happens, effectively, is that service isn’t offered. I mean, the position may be open, and it may exist as a vacant position. Effectively, it isn’t offered. So both the filling of vacancies, which is critical for existing staff — it’s critical for retention — and providing recruitment support.
We’ve broken down some of the pathways for internationally educated nurses, but we know that’s not the whole story. If we have an internationally educated nurse — we did it at the announcement — who comes to Campbell River, you have to have an environment that makes that a success. It’s a huge change for that person. You need it to be successful, and you need it to be successful for the existing person as well. I don’t just mean, by the way, internationally educated nurses. I mean any new nurse.
One of the challenges that I heard the last time I visited Royal Inland, which was earlier this year, was the challenge…. They’d say: “Well, yes, you’ve hired lots of new nurses. We’re working hard. We also need to mentor and challenge and do that.” That’s a key aspect to that. So a redesign.
Finally, train. Not just train in one part of the province but train everywhere. I know it’s a passion of the hon. member. It’s a passion for me that we need to train more people in the North if we’re going to have a health care system in the North. It’s one thing to build a new surgical tower. We need to train in the North.
There was effort by the previous government — let’s acknowledge that — to do that, and there’s been significant effort by this government. We’ve got to train in the North but also ensure that the people we train in the North stay in the North and work in the North and contribute in the North. That’s a key part of it. That’s one aspect of it.
Adding a very significant number of training seats. We’ve added 602 in nursing, for example. It’s not just adding; it’s not just the training. Some of those are registered psychiatric nurses. Some of those are LPNs. Some of those are RNs. We’ve now more than doubled the number of nurse practitioner positions, creating positions, and we’re having quite a bit of success in that area, which is going to help us in primary care. So we’ve got to increase the number of credentials granted.
Finally, we have to, as a public health care system…. We had a report, the In Plain Sight report, which described issues of racism, not in some distant past but now, in the public health care system. We need more Indigenous people at every level.
The member and I have talked about it before. We visited Fort St. James. We’re building a new hospital in Fort St. James. That’s great. It was a temporary modular hospital. It was built in 1972. We’re going to have a new hospital, and that will help us recruit people. The fact is that there is a dramatic increase in the senior population in Fort St. James and across the North and a decline in the overall population under 65.
Of course, we need more Indigenous people who would be able to work in the community that they live in, in a public health care system. We need to address that. That has got to be an urgent part of what we do. It’s not just in the interests of Indigenous communities or a view of justice; it is a necessity for the health care system. A very disproportionate number of the younger community in those areas, the Nak’azdli or another First Nation in the area…. We need them to be part of public health care and to see those pathways and be supported in those pathways. It’s training as well.
Those are the four key elements. We can talk more about the details.
I’m sorry. I’ll take less time with the next answer.
S. Bond: I think we would roughly agree on how the minister outlined those components. It’s certainly the work that I’ve been thinking about. What are the pieces that need to be there?
I think, absolutely critical…. I would really urge the minister…. Perhaps he can just respond to this briefly. I think public reporting is essential. One of the things that we learned through COVID, for example, was…. The information shared was critical to people’s confidence in how we were managing through it.
I would like the minister to consider whether or not he would report out quarterly or however lines up best against the metrics. That’s going to be absolutely essential. I think they need to be reported out publicly.
I do have some questions on some of the specific components. I’m not sure…. Why don’t I ask two other questions quickly, and then I’ll come back to recruitment and retention when we begin again.
Did the government complete a gender-based analysis plus review of the issue, generally, and strategy?
Hon. A. Dix: Yes. That would be considered mandatory as well.
S. Bond: Also, in the hope of bringing people along with us…. There’s a lot of concern and worry across the health care system. One of the ways that we try to mitigate that is by bringing people with us and to say: “Here’s what we’re doing. Here’s why we’re doing it.” It’s not unlike the process that was used during COVID. How do you get people to do what they need to be doing? You give them as much information as you possibly can.
Could the minister let me know who was involved — professional organizations, representative bodies — in the creation of the strategy? That’s going to be essential, basically, to buy-in and to making sure that we’re able to deliver on the strategy once it’s made public.
Hon. A. Dix: I’ll move the motion after this 20-, 22-minute answer.
I’ll give the member a list of the key partners. They include, of course, the health authorities, who have a significant place; the Doctors of B.C.; the unions — HEU, HSA, BCNU but also, importantly, the BCGEU in long-term care, the UFCW in long-term care; the ambulance paramedics professional associations, who play a very important role, as you would expect; the regulators; all the health professional colleges.
We’ll have occasion to discuss that, probably during these estimates — the role of those health professional colleges. Sometimes the criticism they receive, which is, alternatively, “where are standards” and: “the standards are an impediment….” So they have challenges, they would say.
I think we have excellent health professional colleges. It’s one of the areas of collaboration with the opposition — where we’re working to reform our system of health professional colleges to make sure they have access.
Of course, the Health Employees Association of B.C. plays a critical role, and associations that are not employer organizations but have a lot of voice in these issues, such as the Denominational Health Association, the B.C. Care Providers Association. They are key players, because some of our efforts will be to advocate on labour market issues with Ottawa.
Also, Ministries of Education, Advanced Education, Municipal Affairs, Social Development and Poverty Reduction and numerous others and, of course, the Ministry of Finance and the Office of the Premier.
Finally, and significantly to the previous answer, the First Nations Health Authority, the vice presidents of Indigenous Health, health authority, of course…. All of those players are part of this.
This is a central question in health care. I agree with the member that metrics are important. We have a fair number of metrics now, but I think their presentation does build momentum. We need to send a positive message, and it’s very difficult. I’ve often reflected on this on other social areas.
I think we have, objectively, a great education system in our province, which served me well and served a lot of people well. To encourage more people to come to that system, you have to speak well of it, so the political debate and the public debate always has to, I think, recognize that these are extraordinary things to do.
There’s never a better time, professionally, to become a health care professional or a health care worker. We’ve got to reward those workers and treat them well to meet our goals of retention and the quality of work, but we also have to celebrate the work. I think some of that has taken place in the public during COVID-19, which assists us in recruiting a new generation of health care workers.
With that, appreciating we’re just getting started, I’d like to move that the committee rise, report progress and ask leave to sit again.
The Chair: Members, a vote is about to take place. The question is that the committee rise, report progress and seek leave to sit again.
Motion approved.
The committee rose at 11:48 a.m.