Orders of the Day

Hon. R. Kahlon: I call continued reading of Bill 36, Health Professions and Occupations Act.

Second Reading of Bills

BILL 36 — HEALTH PROFESSIONS AND
OCCUPATIONS ACT

(continued)

Mr. Speaker: Member for Peace River South.

[Applause.]

M. Bernier: That applause was almost as long as the applause for the Minister of Health during question period, but not quite as long. I do appreciate the opportunity to get up and stand and speak to Bill 36.

It’s an important day in a lot of ways, when we see a bill of this magnitude and this length. I’ll discuss some of the merits and that in a few moments. It’s a bill, which has been brought forward, that’s significantly going to impact our health care industry in many ways and right now, obviously, in a very critical time, a time that we’re watching a lot of stress and a lot of challenges that we’re seeing, provincially, in our health care system. Many are calling it a crisis that we’re seeing right now in the province of British Columbia.

Although it’s important to modernize and bring forward legislation…. I know there was a lot of work done on this. I think it’s also important any time we do this, though, that we remember the crisis we’re in right now and frame it around that, reminding ourselves of that as we work on any health care legislation or any change that we’re bringing forward in this House for consideration.

As I said, a lot of work was done by all members in this House on all three parties in this House. I know the steering committee that was put together, co-chaired by the MLA for Kelowna–Lake Country…. The Leader of the Third Party was part of that as well as the Minister of Health. It was really important work, I would say. That’s taken place over the last quite a few years — work that was done collectively to try to bring forward ideas and recommendations on how we modernize and change, specifically referring to the Health Professions and Occupations Act that we have in front of us today.

There were significant recommendations that were made by this committee, including cultural safety and humility, which was really important, improving our governance of regulatory college boards, reducing the number of regulatory colleges, which I’ll speak about in a moment, then the oversight of the colleges, which has been talked about for quite a while, and establishing an independent disciplinary process while revising the complaints process as well.

[1:35 p.m.]

We need to remember around this…. It’s supposed to be around transparency. It’s supposed to be around patient safety. Through that process, we need to ensure, as we’re modernizing any of the health acts that we have, especially in a time, as I mentioned, of crisis that we’re in here…. It’s about bringing trust and ensuring we have trust in our health system.

Again, when we have a crumbling health care system, as we have right now, it’s really important to make sure we have that broader context of everything that we’re talking about. I think it’s fair to say, though, as well, that this bill — acknowledged by pretty well everybody in this House — is not seeking to solve, specifically, the health care crisis that we find ourselves in. In fact, it’s around something that’s been working for a long time, as I mentioned.

Actually, the work for this started before we started talking about the pandemic. The COVID-19 pandemic, obviously, has consumed a lot of the discussion not only inside this House but outside the House. The work on the steering committee started before that.

Again, I think it’s really important…. Because of that, recommendations were made and work was done without having the COVID-19 lens brought into it at that time. So I think it’s really important, now that we have this bill in front of us, that we remind ourselves of that.

I know we’re going to get to some very pointed, frank and important questions and discussions during committee stage. It’s really important, as we’re making changes, that, because a lot of these recommendations and discussions took place before COVID-19 and before the crisis that we see ourselves in right now in the health care system, we don’t make it actually worse.

I understand and acknowledge, obviously, the intent of this bill and the work that’s been done is to try to improve a portion of the health care system governing the health professions. But again, we have to ensure we’re addressing it and looking at it holistically with all of the other challenges that we’re faced with right now in the province around health care.

Again, I want to acknowledge the work that was done. I understand this is not something that happens overnight. Obviously, it’s not only the work that took place for a couple of years of putting forward recommendations but the behind-the-scenes work that would have taken place by staff — staff in the Ministry of Health, Health staff and the legislative review committee behind the scenes.

In all of the years that I’ve had the privilege of sitting in this House, I don’t recall seeing a bill of 645 sections that pretty well takes up the bulk of the binder underneath my desk here in the Legislature.

[S. Chandra Herbert in the chair.]

Again, it’s important. We’re looking at a bill that’s going to affect around 100,000 health care workers, in one way or another, through the different colleges.

It’s important work. It’s important to ensure, for these colleges, for these health care workers, that we talk about transparency, that, through the colleges and the professions, we have people who are qualified, that we have people who are competent to do this work and that we have people who are, obviously, following the standards of practice that are required in health care in the province of British Columbia.

I think it’s important to note…. You know, this is not just about the public. That should be paramount in all our thought processes, yes, but it’s not just about the public as well.

I’ve talked to many doctors and nurses over this issue who also say that they want to ensure that those codes of conduct, the standards of practice, the discipline requirements…. The professionals themselves want to see this. They want to know, when they go to work every day, that not only themselves but their co-worker, the person working next to them, is also that same professional who is governed under the same standards of practice.

We’re ensuring, for not only public safety, again, that the trust in the system is there. We all want to see that, not just in this House and the public but the health care professionals themselves.

[1:40 p.m.]

As I said, 645 sections of this bill. One thing I should say surprises me…. But in all fairness, it doesn’t, after I have seen so many pieces of legislation that have been presented in this House. Once again, this is enabling legislation. For those many, many people who are watching right now on TV from home, enabling legislation…. Obviously, what that does is enable government and cabinet to make decisions at a later date, without bringing it back to this House.

That there, in itself, should be raising concerns in a lot of ways, when we have 645 sections of a health care change, a brand-new bill, a brand-new act that’s coming in. Time and time again, throughout this legislation, it says that decisions will be made at a later date by Premier and cabinet, without having to bring it back to this House for debate or discussion, without having to go through the scrutiny of public consultation. Things like that obviously have to raise flags and concerns for the opposition.

Now, of course, we’re going to ensure that we are doing our part to vote this through second reading to committee stage so we can ask those very important questions of the minister and staff, ask why some of the details are not in here — or the intent, in the future, of what government’s plans will be. With enabling legislation, I think that’s important around transparency. We talked about the transparency for the colleges in this act, but I think it’s also just as important, if not more so, for government to show that transparency so the public knows what they can expect when pieces of legislation are put into this House.

Again, I want to thank the steering committee that did all that work over that time. A lot of the discussion was around public confidence in the system, around patient safety. I think a lot of the discussion, as well, around this bill — for members of this House that are going to talk to this bill and through committee stage — again, is making sure we get it right.

When you see 645 sections in a bill, obviously, there’s a lot to digest. There’s a lot to go through, and I know this is probably going to take us some time. It’s important work that has to be done. But we also, again, need to make sure, in the context of these tough questions that we’re going to be asking at committee stage — that’s our job — that we’re having those discussions to make sure we get it right.

Right now there are 25 regulated health professionals that are being governed by 15 colleges, 15 different bodies. Their job really is around setting standards, registration requirements, maintaining a register that people can search, which is very important for the public and transparency. They help recognize education programs. And again, it’s all around the governance of their professionals, but looking through the eyes of building on a public health care system, public safety and trust, as I mentioned.

One of the things that I flagged in here, though, when we look at the colleges, specifically…. I think we will talk about this more in committee stage, when the minister has a chance to address this. Right now colleges have the right to elect their own board members amongst their peers. They decide who they want representing them — whether it’s nurses, College of Physicians, any of the other colleges. They decide who their board of governors — if you want to say that term — is in that college representing them.

One of the things that’s going to change, as I’m reading through this legislation, though, is that those positions now appear to be appointed by the minister. So of course, we’re going to have some specific questions around that, for him, when we get into committee stage.

[1:45 p.m.]

As I mentioned, this has been ongoing for quite a few years. The committee’s work began — again, as I said — before the pandemic, so it really didn’t take into consideration, I would say in all fairness, the crisis that we see right now in the health care system.

Over the last five or six years, we’ve seen us get to the point where we have one million British Columbians who are being wait-listed to see a specialist. We have some of the worst walk-in clinic wait times in the country. We’ve talked about the hundreds of thousands of people right now who are unable to get timely medical imaging that they require. Nobody is disputing the fact that we have almost one in five people in British Columbia who do not even have a family doctor.

These are issues that need to all be addressed. We have hospitals right now that are in chaos.

Interjection.

M. Bernier: I appreciate the heckling from the minister. We’ll have lots of time, I think, in committee stage to do the same thing, back and forth.

The minister, I think, would also acknowledge — because he’s heard me stand in this House and talk to him, even personally — some of the challenges we’re facing in parts of British Columbia. I think we all share the concern, and we need to fix that. So even though I think we all acknowledge…. By no means am I trying to say that this bill presented is not important work to look at, but it’s also important, again, to remember it’s not going to solve all of these other issues that I’ve just brought up.

I mean, we even have daily commentary that comes to, I think, most of our offices of people who are struggling right now in the province of British Columbia — and, I would argue, have lost a lot of faith and trust in the health care system. I want to emphasize the word “system,” because this isn’t the lack of trust in our health care professionals and workers. I know that they are doing what they can in this crisis, and we thank them for that.

We’re going to look at all of these different pieces that came forward in this bill. You know, many changes…. The main intent, I think, is to protect the public and streamline ways that we are operating within the colleges, within government, in the health professions as well. These are goals that we can support. Any time a piece of legislation is going to come forward that looks to improve a system, especially one that’s crumbling right now, that’s something that we are going to definitely look at and want to be able to be supportive of.

But before we can get to that point, I’m looking forward to committee stage, where we’re going to have a lot of questions that we have to ask of government and the minister. They’re important things that we need to be considering.

The health care system…. I mean, it’s evolving. It’s always changing, and in the time that it took this government to put this bill together, the system has changed yet again. By the time that we finish passing this bill — if that’s what government intends, which I assume it will be, obviously — there’s going to be more crisis. There are going to be other issues that we need to be dealing with.

We need to be remembering that even though we want to move this forward from second reading to committee stage, we need to acknowledge continually the challenges that we’re seeing in B.C.

I want to go back to the health care professionals for a minute, because this bill is really addressing a lot of them, their colleges. It’s about streamlining. It’s about the profession itself. When I talk about the challenges, we shouldn’t be losing sight of the stresses that our health care professionals are under, though, right now.

I had a very long talk, an unfortunate discussion, while I was home over the last couple of days before we came back to this week’s sitting, with some of the health care professionals in my riding to hear about the challenges and stresses they face, to talk about how things are working or not working within their profession. And again, we need to remember that that needs to be a part of our thought process as we bring this forward, because the last thing we want to do is make things worse in an already crumbling situation.

[1:50 p.m.]

I talked with a couple of nurses. I don’t want to say I had the privilege, but I was in the hospital last Friday, and while I was in there, I talked with the nurse that was treating me. I said: “How is your day going? How are you doing today?” His comment to me was: “You know, my first 12-hour shift was tiring, exhausting. I’m glad that’s over.” I said: “Why are you still here?” He goes: “I’m just starting my second 12-hour shift, because we don’t have enough staff. If I don’t stay on, we have to shut down the surgical ward, because I am the only nurse that was able to stay on to keep it open today in Dawson Creek.”

We need to remember that those are the stresses that our front-line health care workers are under right now, and we need to applaud those heroic efforts that they’re being faced with.

There’s also the other side of that. The same day, I spoke with a nurse who is from one of my smaller communities — I’ll leave the community’s name out of it, but one of the smaller communities in my riding — that I’ve formed a very good relationship with over the last couple of years as we’d talk about the crisis and the challenges in my communities. I asked the same question: “How are things going with you? I know you’re under a lot of stress right now with the shortage of nurses, all the diversions, all the hospital closures that we’re having to face. How are you coping? How are you doing?”

Her comment to me was one I wasn’t expecting, and she said: “Actually, I regret to inform you that I’ve just gone on stress leave. I’m no longer working at the hospital, because I’ve had a minor breakdown because of all of the stresses and challenges. I just can’t cope, and I need a break. I need to recharge, because I love the profession. I love helping people. I can’t be my best, and I can’t focus and support and help people, when I no longer can help myself because of the stress I’m under.”

We need to remember that as we’re working on this bill, as we’re framing Bill 36 and talking about the Health Professions and Occupations Act. We’re also remembering in this bill those kinds of stories, the stresses that people are under.

I spoke with a doctor in my riding, who had to tell me that in the last three months — think about this, in the last three months — he has not had more than eight consecutive hours of a break. That’s not a partisan thing that we need to be talking about. This is something that I think collectively, in this House, we need to be addressing. Even though this bill is talking about the governance model of the professions that I’m talking about, we need to, again, always be thinking of the work that they’re doing, the stress that they’re under and the supports that they need from us at all times.

I think as we talk about modernizing the governance models here, we need to be doing so with the understanding that we need to be recruiting, because of the comments that I just made. We need to be recruiting more people to these professions. When they hear the stories of how hard it is, when they hear the stories of the stress that people are under, under this collapsing system right now…. I don’t know about you, Mr. Speaker, but it’s not a good sales pitch for a recruitment strategy when people are hearing that.

We need to figure this out. I’m hoping, as we get into more discussion on this bill in committee stage, that some of those points will be addressed, because we need to ensure that through this bill, there are no unintended consequences that are going to make it more difficult or less inviting for people to enter into the health care profession.

As I mentioned, Bill 36, when we talk about it, is really expanding on the previous duties of the college and establishes a series of guiding principles that will be applied under this act, principles that, we need to remember, include procedural fairness, respect for privacy, promotion of a holistic healthcare system.

[R. Leonard in the chair.]

Kind of back to my point: we need to be promoting a system and have a system that we know is strong, that is inviting for people to move into. We need to make sure that we’re removing any barriers, really, that might actually make it harder for these professions to act, and also, barriers for extra-jurisdictional practitioners.

[1:55 p.m.]

A lot of that is referring to those who are internationally trained and educated. We need to remember that…. Something we’ve been calling on, on this government, is really recognizing the amount of internationally trained professionals that we have. A lot of that is due to the challenges right here in British Columbia.

A very close friend of mine…. His son graduated high school and wanted to become a doctor — tried and tried and tried, numerous times. They showed me all of these emails that he had, trying to get in, in British Columbia, so he could become a physician. We always talk about “train them here” and “keep them here.” But in this situation, and I’m sure we all have stories if we went looking for them, where somebody’s child, somebody who wants to become, let’s say, a doctor, has been unable to get into a training facility here in British Columbia.

In this case, because he was passionate about becoming a doctor, he finally went to London. He did all his schooling in London, and wouldn’t you know it? Now, because he’s internationally trained — and from what I’m told, graduated top of his class in London — he can’t get into British Columbia but got poached by the United States to go down there. But could not get regulated to come back to British Columbia, the place he was born and raised, somewhere where we could have used him in small communities like Dawson Creek and Chetwynd and Tumbler Ridge in my riding, who are all struggling right now.

You know, we had a call-out. Actually, the former mayor of Dawson Creek…. I can’t take credit for this. The former mayor, Dale Bumstead, and I were talking about the amount of people in our region that were internationally trained but were not working in the health care system. So he put the call out…. He did that as mayor, and I thank him for including me in it. He put the call out and said: “Hey, is there anybody here in Dawson Creek, internationally trained, who’s not working in health care that would like to? We’d love to hear from you.”

Just by putting a simple post, basically, on Facebook, he had a coffee talk a week later. Twenty-eight people showed up to this, mostly from the Philippines and a few from South Asia, who were living in my riding, who were not working in the health care system at all, but all had international credentials. In fact, I talked with one of the people who was registered as a nurse in the Philippines, and she told me that she worked for 12 years in emergency as a cardiac specialist in nursing and right now is working in a restaurant in Dawson Creek because she can’t get accreditation to work here in British Columbia.

All 28 people that showed up, and I’m sure there are lots more, in Dawson Creek are trying to get back into the profession they loved, the profession of helping people, the profession that, in their countries, they went through all of the scrutiny, training and experience…. All they’re asking for is the opportunity to prove themselves. They want the opportunity to be able to go and be approved, do whatever is required, so they can get back in the emergency room to help.

I mean right now, in Dawson Creek hospital alone, we have almost 30 vacancies for nursing. So I put that out there and said, “Well, I know enough people that can fill that gap tomorrow, if we only would give them the certification,” if we ensure — obviously, ensure for public safety that we talked about — that they meet the requirements and credentials to operate and serve in that field in British Columbia. They need that chance. Something that we’ve been calling for on this side of the House is that we need to figure out a system to allow them to get back into what they were doing.

Part of this bill is also seeking to create a clear path for unregulated health professionals to apply and receive designation.

[2:00 p.m.]

Bill 36 is actually creating a new office of a superin­ten­dent as an oversight body. This superintendent is going to be appointed by cabinet and would have a number of duties, including the ability to conduct an assessment of an unregulated health profession or occupation if regulation is needed or possibly if different regulation is needed.

The bill is putting in motion, really, a process on how an assessment would be conducted. However, once again, the parameters around this are being left to the minister to decide. That’s, again, something I want to highlight with some of my closing few minutes that I have here: why we want to ensure that we bring that scrutiny and those questions forward during committee stage. Because, time and time again, we see, not only in this bill but most bills that this government brings forward, that decisions will be made by the minister and cabinet at a later date.

This is an important piece of legislation — as I said, something that all three parties worked on a lot of recommendations for. But they weren’t part of the entire legislative creation, just recommendations that were brought forward. We need to ensure that we ask those questions of the minister at committee stage.

We know this bill is bringing forward new rules, regulations and provisions around the disciplinary tribunal and how that’s all going to look. Again, this is important, because we want to ensure that that process is fair and, at the end of the day, public. If there’s discipline that was required….

As we’re looking at this bill, it’s really about gaining and building a system that’s going to have public trust. We’re going to ensure that the policies are put into place that work for the health professionals themselves, obviously. But it’s something that’s going to help, in its small way, to start working towards fixing a crumbling health system that we’ve seen under this government.

Obviously, I’m looking forward to committee stage. There are a lot of questions we’re going to have of the minister. I know, as he smirks at me, that means he’s ready for all these questions. I can see the smirk behind his mask.

Deputy Speaker: Thank you, Member.

M. Bernier: But we’re ready and excited to ask those questions in committee stage and appreciate the time to speak to this bill. Thank you very much.

A. Olsen: Thank you for this opportunity to speak to Bill 36, the Health Professions and Occupations Act. It’s dense work, from what it looks like, from the Minister of Health — indeed, the largest, I think, piece of legislation that I’ve seen in my days here in the Legislature. As has been mentioned by the speakers previous, it’s going to take some time to get through this as we do the second reading and, as well, the committee stage on this bill.

This particular act repeals and replaces the former Health Professions Act. It’s building on the work of a steering committee that was created from the 2019 Cayton report. This goes back to when we were in the confidence and supply agreement with the B.C. NDP government.

Interjections.

A. Olsen: I was about to get there. They’re really wanting to make sure that there’s full and broad all-party support on this.

Interjection.

A. Olsen: Everybody’s got their opinions and arm-waving that’s going on. Thanks, Madam Chair, for keeping the decorum in this place.

Deputy Speaker: Serious.

A. Olsen: Anyway, this goes back to a time when the Leader of the Third Party, the member for Kelowna–Lake Country and the minister worked together in a really good way to bring forward the recommendations into this legislation that we are debating today. This is a good piece of collaborative democratic work, and everybody was very eager for me to get to that point.

[2:05 p.m.]

But I think that it should be held up. It should be held up as to how work in this Legislative Assembly can happen across party lines. Despite the differences of opinion that happen here — frequently or infrequently, depending on your perspective — the reality is that there is a lot of agreement that happens in this assembly.

Yes, we do like to highlight the areas that we may not agree with each other. However, I think that it is important to recognize that when we sit around the committee table together, when we look at the work that needs to be done on behalf of creating legislation and regulation that works for British Columbia, there is a lot of agreement on all sides, in all seats, of this House.

I think that what we see here in Bill 36, as a result of work that was done — collaborative work, proactively collaborative work — that was undertaken by the Minister of Health…. He didn’t need to take this approach, but chose this approach to be one that was going to give the outcome the greatest chance of success.

As the member who spoke previously to me mentioned, there is a role that the opposition plays in going through, clause by clause, in the legislation, to ask the minister why this choice or why that choice was made when the bill was being drafted. That’s the work that we do here on this side of the House.

It doesn’t mean there’s disagreement on the bill overall. There might be some different opinions about how we would approach certain aspects of this policy work. How­ever, overall, I think what you’re hearing and what the people are hearing about this important legislation is that broad support out of that 2019 steering committee and the Cayton report from before that. This bill is taking those recommendations and bringing them into law or providing the regulatory ability for the government, the minister, to regulate.

The bill creates an oversight role, the superintendent role, which currently doesn’t exist, as well as a reformed complaint process and independent discipline tribunal and changes the structure of the boards from elected to appointed on these colleges. It continues to reduce the number of colleges, in a process that the minister has been undertaking in advance of this bill, from 20 colleges that currently exist in the province down to six.

The regulatory colleges hold a register of all of the professionals working in a field, in a sector. They set standards of practice. They set and maintain standards of education and training and hold professionals to account through complaints, investigations and discipline processes.

These bodies are really critical to ensure that the people who are treating British Columbians, who are assessing their health and well-being and administering the treatment, are professionals, that they’re accredited, that they’re educated and that there is a process to hold those individuals accountable should they make mistakes in the work that they’re doing.

There are currently — or there were, and in the process of reducing — 20 regulatory colleges in the province that were established under the Health Professions Act. That now, as I mentioned earlier, is being reduced to six. Reducing the number of colleges makes for more efficiency, specifically from a government relations perspective.

I can imagine the Ministry of Health and ministry staff are going to be quite happy to have fewer bodies and to be able to relate to larger cohorts of health care professionals and occupations.

It also creates more efficiency for smaller professions like podiatrists, for example, and to be able to set consistent standards across professions as people move towards team-based care.

I think as the province…. It’s been a project that I know the minister, when he visited my riding shortly after the 2017 election…. The minister visited my riding, and we talked with my constituents about the move to team-based primary care. I think that this is a process that is underway. It continues to be underway. I know that many people in my community and communities across the province really yearn for a time when we see the fruits of that labour and can benefit from it.

[2:10 p.m.]

However, I think that as we’re taking a look at the regulatory side of the colleges, the consolidation of these colleges from 20 to six will really help in that work environment on the ground, in communities, in that team-based environment. You can just imagine having 20 different colleges involved and the complexity that that brings.

The six new colleges that will exist, as the minister continues the work, will be the College of Physicians and Surgeons, the College of Oral Health, the College of Allied Health and Care Professionals, the College of Pharmacists of B.C., the College of Nurses and Midwives, and the college of complementary and alternative health care professionals.

As I mentioned earlier, this bill will create a superintendent role to act as the oversight over the colleges. The superintendent is responsible for setting and guiding principles of the colleges; supervising their conduct, and in­vestigating when necessary; running an independent discipline office, for when that’s needed; and running disciplinary panels, as they’re required. It creates an independent discipline tribunal and a reformed complaints process that increases accountability and transparency.

Really, I think what is important to highlight here is that when it comes to people and their health care, when it comes to people and their relationship with those who are delivering that care, these are some of the more sensitive conversations that we have with professionals — our personal health and well-being, the state of our health. I think that what’s important is that the outcome of this process is to ensure that people who are in these vulnerable states are protected and, as well, that we’re ensuring that the most qualified people are working in the field.

This bill distinguishes between a “profession” and an “occupation” and creates a regulatory program for lower-risk occupations to be regulated but not designated. I think an example of this would be health care assistants versus counsellors. It expands the regulation of service providers; in the next steps, the minister is going to be regulating counsellors. Then, following that, diagnostic and therapeutic professionals.

I know that since my election in 2017, I’ve had some regular advocacy, in my constituency office, requesting that the provincial government regulate counsellors. I’m very pleased to see that advocacy has turned into a process where that will be undertaken. As well, it streamlines the process for designating new health professions and occupations. This gives, I think, a pathway for this minister and future ministers to be able to recognize and acknowledge new health professions or occupations that may emerge as time passes.

We know that in October of 2020 B.C.’s three nursing colleges were amalgamated into one college. In September of 2021 the nursing college was amalgamated with the College of Midwives, and the College of Physicians and Surgeons was amalgamated with the college of podiatrists.

As I mentioned, this is a process in which, even as this bill is being developed, the minister has been proactively working towards the consolidation of these colleges, the simplification of this. In September of 2022, just a few weeks ago, B.C.’s four oral health colleges, which included the dentists, dental assistants, dental therapists, denturists, dental hygienists and dental technicians, were all amalgamated into one regulatory college.

Also in this bill, I think it’s important to acknowledge here a few of the recommendations from the In Plain Sight report. This has been an unfortunate part of our history, with respect to how Indigenous people can access health care in our province and the experience that they have.

[2:15 p.m.]

Just a year or so ago we had a report that highlights the experience of the many thousands of Indigenous people in British Columbia who courageously shared those experiences. Those have been identified and published in the 2020 In Plain Sight report. Well, it’s not one year ago; it’s two years ago. It just goes to show how quickly time passes in this place. This bill is beginning to take some actions on that report. There are a number of recommendations, but specifically, there are four recommendations that are highlighted here and that may be addressed with this bill: recommendations 4, 5 and 20.

I think it’s important to acknowledge that in committee stage of the debate, I’ll be taking some time to talk with the minister about just exactly how this bill addresses the report that the government has in front of it. It might give some opportunity to ask the minister, on the record and for his purposes, the progress that’s been made overall on that report and how the government will work with these new colleges to ensure that anybody who is a registered professional or working one of these occupations is implementing, through their colleges, all of the recommendations from the In Plain Sight report. That will be something that I’ll be asking the minister about.

It’s important to acknowledge that this will be going from a process of where the members of the boards of these colleges will no longer be elected from the membership. Rather, they will be appointed from the government. There’ll be some questions about that and the choice to move from an election process to an appointment process from the government. Overall, I think what I’d like to highlight in this debate, really, are the first remarks that I made as I’m speaking to second reading here — on the collaborative process.

So often we can land on the disagreements and the differences of opinion. Also, we need to stop, pause and recognize the areas of collaboration. If we’re just passing over them and not reflecting on the areas where we’ve been successful together, then it’s going to feel fleeting. It’s important for us to recognize that the member for Kelowna–Lake Country, the member for Cowichan Valley and the Minister of Health have really worked together over the last number of years to get this very substantial reform in how the health care professionals and occupations are governed — their oversight, transparency and accountability and how that’s managed.

I look forward to asking and to engaging the minister in questions. I look forward to the questions from our colleagues here and from the members of the official opposition, and I appreciate this opportunity to speak to second reading today.

HÍSW̱ḴE SIÁM.

T. Shypitka: I’m pleased to respond to Bill 36, Health Professions and Occupations Act — a very hefty bill, as we’ve highlighted here a couple of times. Just looking at the bill itself, it’s — I don’t know — 645 sections.

Is that what it is?

Interjection.

T. Shypitka: Yeah, here’s what we’ve passed through the House so far this year, and here we’ve got this as number one. It’s beautiful. I want to compliment the minister on supporting the forestry industry. There’s lots of paperwork there; it’s awesome. He’s double-dutying here.

I want to highlight first, before I go into my debate on this bill, and recognize the importance of health care in B.C. It’s critical, as we know. It touches every single one of us. We’re having some troubling times right now in British Columbia. I really want to thank those health care workers and health professionals that are in the trenches right now, as we speak. It’s been a long haul for these folks, especially in the last couple of years through the pandemic and everything else that has been going on in British Columbia. It touches all of us.

[2:20 p.m.]

I know we all have stories of friends, family and colleagues that know health care professionals. We understand the stresses they go through every day. It’s heartbreaking, to tell you the honest truth, some of the stories I hear. I just want to make clear that they have supported not only members on this side of the floor but, I know, throughout the whole Legislature. We really…. You know, our hearts are with them all the time.

It’s a multilayered issue. There’s no single solution to our health care crisis. I think the minister has highlighted that, and he has recognized that. This is just one piece of what we need to see in British Columbia to address our health care issues.

Access to health care, for example, in my region of British Columbia…. We’re close to the Alberta border. We used to have a really good relationship with Alberta in getting that access to health care. We’ve seen even the crumbling effects in other provinces, and then those ties — that access to other jurisdictions — have been severed.

That’s been making it tough for places where I live. We see wait times being extended due to the fact…. We don’t have the boots on the ground that we need to have to address some of these issues, for sure.

Long-term care. I know in my region, as well as many others, our seniors…. We have an aging demographic right now that is putting additional strain on the health care system. Those long-term-care facilities need the support that they’re not currently getting.

The labour shortage is another issue that we’re facing. It’s tough to get good help these days. All ministries from all sectors of our economy and our governance here in British Columbia are feeling the effects of the labour crunch.

We look at additional stories that I hear of vaccine mandates that are in place right now.

Deputy Speaker: Member, if you can speak to Bill 36, please.

T. Shypitka: Absolutely, Madam Chair. I just wanted to lay the groundwork on this. Bill 36 isn’t just going to solve all our problems right now. We’ve got many other issues we have to deal with, for sure.

Speaking to Bill 36, then, Madam Chair, and how this bill came about. It’s a good story. It’s a story of collaboration. It’s a story of all parties coming together, sitting down at the table and modernizing and changing the regulatory framework around health care in British Columbia.

There were significant recommendations. I want to stress the word “significant.” They’re very game-changing, as far as I’m concerned, anyways. I’m sure a lot of other people in the House feel the same way.

There were several recommendations that were made. Include cultural safety and humility. Improve the governance of regulatory college boards. We’ve heard debate from other members of the House on the variety and diversity of those college boards across the province.

This is an attempt to improve the governance of those regulatory boards, reduce the number of regulatory colleges to make it more streamlined, strengthen the oversight of the colleges. This is to bring more accountability, more transparency to those board and establish an independent discipline process while also revising the complaints process with the aim to make it more transparent and focused on patient safety.

I think it’s absolutely critical right now, when we’re talking about a system that is strained, that we are focused on what’s right for the patient and ensuring that patient safety is at the forefront.

In short, I guess, this bill is a complete redesign of the Health Professions Act. It follows several guiding principles. The bill significantly expands on the previous duties of a college and applies these principles to all under the act. This is the colleges, the office of the superintendent, the director of discipline, and so on.

These principles include acting in accordance with the United Nations declaration on the rights of Indigenous peoples, or DRIPA. We heard my colleague from Vancouver-Langara speak, in quite detail, on the importance of how this act will act in accordance with UNDRIP and the importance of that.

We’re seeing examples of systemic racism through­out our health care system. I think this act attempts to rein that in and to bring more accountability and transparency to that.

[2:25 p.m.]

The steering committee that was set up to bring this act forward, as we see it today, was done in a time, I believe, before DRIPA was put in. They did support the principles and the guidelines of DRIPA during that committee. So that is reflective in this piece of legislation that we have here today.

Other principles include procedural fairness, respect for privacy, promotion of a holistic health care system, identifying and removing barriers for extrajurisdictional practitioners. I think that’s super important as well.

As I mentioned earlier, in my preface there, the labour shortage is one of those other barriers that we’re having here in British Columbia. The member for Peace River South, I believe, made mention of examples of some of these internationally trained professionals that are having a hard time getting into our system or those that are even domestic that want to get trained and are not finding the spaces to do so. This bill will happen to, hopefully, bring some more transparency to that process. We can get the spaces or we can get that accreditation transferred in a streamlined way into British Columbia so we have those extra resources.

I know, just myself…. As we travel back and forth to airports here and there, we get engaged with our rides to and from. I’ve talked to a couple of taxi drivers, as a matter of fact, that are trained and that have been trying to get into our system and trying to get accredited in British Columbia to be a physician. They’ve been here for years trying to get that accreditation.

Hopefully, this will bring the oversight to where it needs to be. We can make that streamlined, and we’re not waiting for these folks that deserve their shot here in British Columbia. They’re going to do everything they possibly can to meet the standards. And they should be high. We’re not talking about lowering standards. As a matter of fact, we’re probably talking more about tightening them up and putting the proper control measures in place so that the streamlined process that we all quest for is recognized.

It’s a shame, when we’re talking about one in five British Columbians that don’t have access to a family doctor, me being included in those statistics — I don’t have a family doctor anymore — to know that some of these physicians are out there waiting, wanting to do the right thing and wanting to help British Columbians with their health care needs. It’s heartbreaking to know that they’re sitting and waiting. We need them desperately.

Designation assignments. Previously, under the Health Professions Act, an unregulated health professional could apply to the minister for designation, or the minister could investigate a health profession to determine whether it should be designated. Bill 36 would enable the newly created office of the superintendent to conduct an assessment if regulation is needed or different regulation is needed, if it was required by the minister or if the superintendent determines an assessment would be in the public interest. He would be required to notify the minister if he chooses to do so.

The bill sets this process for how an assessment would be conducted. However, much of the parameters, scope, conduct, timeline, etc., are left to the minister to decide. We’re setting up another supervisory role, the office of the superintendent, to do that and to provide oversight to the process we’re looking to change. I think that could work.

We’re going to have to dive a little deeper into the bill itself in committee stage to understand exactly the scope and practice of what the office of the superintendent will do and what that relationship with the minister is going to be like. I think it’s a good start, and I think nobody on this side of the House really opposes that.

The superintendent will be required to make a report with recommendations, which will not be made public until the minister makes a decision. So once again, a process that streamlines what we’re trying to get to.

[J. Tegart in the chair.]

New oversight bodies. The bill establishes a new oversight body, as I mentioned, the office of the superintendent of health profession and occupation oversight, that consists of the superintendent, the discipline tribunal and other employees, as required.

[2:30 p.m.]

It is setting up a large forum of different professions’ oversight bodies that will help in this process. They say two heads are better than one. Sometimes we get lost in the bureaucracy. These are some of the things we’ll be exploring in committee stage, to be sure.

The purposes of the office are outlined in section 435 and include providing advice and recommendations to the minister on the administration of an amendment to this act and the regulations, the performance improvement of regulators and other matters as requested by the minister, to promote awareness and adherence to the guiding principles, to develop guidelines for regulatory college board appointments, to promote regulatory consistency, to report on regulatory performance and make recommendations for improvement, to publish information records that are deemed to be of public interest and other duties as set by the minister.

Once again, another function in this act will allow that type of transparency that we really need to see when we’re talking about health care in British Columbia — how the process works, how the disciplinary actions work. If there is a complaint, if there’s a safety issue, if there’s a discriminatory issue, if there’s a racist issue, then the office of the superintendent will look at all these and will decide whether or not disciplinary action will be warranted.

I believe it will still be with the colleges to hand out that disciplinary action. There still is a tie-in with the colleges and with the office of the superintendent, and I think that’s probably a good thing. All working for one common goal here.

Licensed duties among the duties established in this bill. There is a requirement for a designated health profession licence to practise ethically, which includes a requirement for a licence. To quote in the bill here, “practise a designated health profession in an ethical manner and in accordance with ethical standards,” as well as for a board to make bylaws respecting ethics standards. This latter includes requirements for a board to make bylaws respecting providing false or misleading information to patients or the public. So once again bringing more oversight to the health care issues we have here in British Columbia and how we get there.

As I said, it was a good act of collaboration between the member from Lake Country — I believe that’s what it is, Lake Country — and the leader of the Green Party and the Minister of Health to bring this forward, their steering committee. But the times have changed. When this bill was first brought out and was worked on…. We’re not seeing some of the issues that we’re seeing here today.

So as I mentioned at the onset, we need to be aware, and we need to be alive that this isn’t going to be the save-all. And I think, in all fairness to the minister, he’s not saying this is the save-all. This is just one big piece that we need. We see huge wait-lists in British Columbia. This will not solve that. Walk-in clinics — some of the worst in the country right now. This will not save this. Like I said before, one in five without a family doctor, me being one of them. This will not immediately save this.

But what this will do will bring a more streamlined process forward so that physicians, colleges can do the work that they intend to do with the proper oversight that the office of the superintendent will provide.

With that, I’ll see what happens in committee stage. As I said, this is a huge bill: 645-some-odd sections, and it will take some time to wade through it all. But with that, I have the best hopes that this will be the best thing for British Columbians.

C. Oakes: I’m glad to have the opportunity today to stand and speak to this very important bill before the House — speaking of the Health Professions and Occupations Act.

[2:35 p.m.]

I think it’s fitting for me to start my comments today on this specific act to reflect on my riding of Cariboo North and what I have been hearing from the constituents. I’m so incredibly grateful that they have reached out and they’ve engaged. In fact, I just finished a meeting in our caucus room with one of the constituents from Quesnel.

The comments that I regularly hear from the constituents are a significant concern about the challenges that we currently have in our health care system. There isn’t a day that goes by, I imagine, for all MLAs in this Legislature, where we have people that come to us in our offices and express their incredible concern and the challenges that they’re having.

It is my hope that as we go through this bill, specifically in the committee stage, perhaps this act provides some certainty or opportunity for our constituents to have that engagement with our health care system and raise the concerns that they’re having in our community. I commit to the constituents that I’ll continue to keep our constituents updated on how this piece of legislation moves through the House.

I think it’s also critically important that I take a moment to recognize all of the incredible health care professionals in Cariboo North for the work that they’re doing every single day. I don’t know if it’s unique to, maybe, our more rural or remote ridings, but everything seems a little bit more personal. When we have a health care professional that we reach out to and we talk to…. The challenges, the patients that they’re serving, in so many respects….

I reflect on many of the conversations I’ve had with the nurses and care aides and health care professionals and doctors in my riding. We know the families. Often that relationship goes back, in many respects, many generations. I understand that when the health care system is in the crisis that we’re currently experiencing, it just has a compounding effect on people. We’re seeing that play out in our communities.

I also want to take a moment to recognize some of the extraordinary changes, positive changes, that I’ve seen that have been evolving in Cariboo North. I want to take a moment to recognize the work that our First Nations are doing. As we’ve seen an increase in challenges in our health care system, I applaud the leadership of our First Nations, who have come together and said: “Is there a better, holistic way that we can improve health care outcomes in our communities?”

They have gathered the leaders in our community, and they have talked about a holistic approach from health care to housing, to social services, to the Ministry of Children and Family Development. They’re having those conversations right now, every month, in our community. When I see bills that come before this House that are critically important, I always want to make sure the lens of the constituents of Cariboo North is seen in the legislation before this House.

I reflect on what I have read in this very hefty piece of legislation. I think all members of this House understand and support the critical needs to make sure that everyone who accesses the health care system can do so with the utmost respect and humility and that we should ensure we have a trauma-informed system of care. But I want to make sure that legislation that is being brought forward — that our First Nations are heard in this. I want to make sure that we’re not forgotten about, and that is critically important.

[2:40 p.m.]

When I look specifically, now, at divisions of the bill, as we go into division to the guiding principles, I discussed a little bit about the anti-discrimination clauses that we will be going through in committee stage and the principles that are being put forward in this legislation.

Of course, I support fostering meaningful communication between patients and the regulated health practi­tioners.

For members, MLAs in this Legislature, I know that some of the most difficult conversations we often have are with constituents who come to our offices and have experienced some extraordinarily tragic events. Any opportunity to improve upon meaningful engagement and communication and look at how we can improve and do things better is critically important.

Again, as we look through the committee stage, I’ll be paying close attention on that examination of communication between patients and regulated health practitioners. How will our First Nations be included in that process, and specifically, how will they be seen in the guiding principles set forward in this act?

As we move into division 3 of this bill, when we talk about the actual licensing, this is where we get to whole bylaws of this legislation. As for so many people who have, certainly, had experiences on other boards, reviewing bylaws and regulations, or perhaps experiences with WorkSafe or other institutions, this can have a critical impact on the ground and can have a critical impact on people.

What was clearly identified in the bylaws in this legislation are the eligibility standards, education, training, experience and other qualifications, including the continuing professional development. I want to take a few moments to talk about this critical aspect of this bill.

I think a foundational piece that may be missed in this bill — I’ll certainly have the opportunity as we go through committee to review it — is that the foundation of every­thing that we’re talking about right now is: where are the people? How are we training? What types of investments are we making? Before we even start talking about the Health Professions and Occupations Act, let’s start talking about our labour shortages, and let’s start having these conversations across British Columbia with how we are investing in training.

How are we making sure that in our world-class post-secondary institutions, we’re meeting the demands today of what we need to provide the important professional labour and professional services and the health care and the social services? The list goes on and on. All of that is going to require an educational system that is invested in, that is supported so that we have the tools in place so that our graduate students, once they come out of the education system, have every chance of success.

I was at a rally a few weeks ago with the nurses in Prince George. One of the things that stood out to me — well, a number of things stood out to me — was the incredible pressure and the demands nurses are faced with every single day. I saw it at the rally. An individual came up and was hurling incredibly insulting words at the nurses. To be in that environment and to see that firsthand was incredibly troubling. I hope that the measures that the government has put in place recently will have an impact on that.

I also heard from the nurses the critical challenges with just the shortage we have of nurses — shortages in every part of this province. Right now in the health care and social assistant professions, there are 142,900 job openings. That’s what is being projected. Of that, what we heard was that there are 4,265 vacant nursing positions and that there’ll be a requirement of 26,000 new nurses by the year 2031.

[2:45 p.m.]

Equally as troubling, I learned that UBC has over 800 people on a wait-list for nursing spaces — 800 people on a waiting list. And that is just one of our post-secondary institutions.

While we have bills that come forward in this House and we debate important pieces of legislation, I cannot help but reflect on the challenges that are happening on the ground in our constituencies right now. Are we spending the time and the investment of the dollars to make sure that we’re solving those problems?

Further, what I’ve heard from students who graduated from nursing and are finding their way into the health care system is that they’re, unfortunately, being put into situations, because of such low staffing levels, that may not necessarily be getting the necessary staff support that they require. What we’re hearing clearly is that many of the recent graduates who are graduating from professional programs in British Columbia find themselves in incredibly challenging experiences on the floor in health care, and they’re making the decision to leave the profession.

While we discuss the important needs of making sure that we are setting up rules and authorities and disciplinary structures to make sure that there is that professional level for a variety of the professions in this piece of legislation, I wonder. At the heart of it, what does this bill do if we don’t actually have the people on the ground to do the jobs? What does that stress look like to that nurse who is put into such extreme circumstances — shortage, multiple shifts requiring overtime after overtime, the abuse?

Then layer what this bill says and what it’s setting out for requirements. How does that nurse who has just put in double overtime shifts and knows at the end of the day…? Or those other professionals who are so struggling — what does it mean now when, all of a sudden, there’s another additional body that says: “Now you have to carve out this amount of time to make sure we’re doing X, Y, Z”?

I think it’s all critically important. But at the heart, if we do not figure out how we manage the severe labour shortage that we have in British Columbia, this crisis that we are experiencing in our health care system is only going to get worse.

Then I look at the 645-plus sections of this bill. I look at all the bylaw requirements, and I look at all the challenges. Look, I’ve been in an organization. I’ve designed bylaws. I’ve had to do that work, and I think: “Well, where are the people that are going to actually do the work to design this?”

How many hours, how many people are going to be required to develop one of the most significant bills that has come before this Legislature? Where are the people to do that work? Are we going to be pulling nurses off the floor to be a part of what this looks like? Are we going to be leaning more heavily on health care professionals that are already deeply struggling?

So I wonder that. I wonder about the paralysis — that potentially this could happen in the system. Look, I think we need oversight, and I think we need to streamline, and the elements of this bill I certainly support. Again, I worry about the foundation of our health care system and every single one of our communities right now.

We recently received an incredibly troubling letter from the radiological society that rang the alarm bells about the estimated one million patients waiting to see a specialist physician in B.C.

“Radiologists see this crisis unfolding every day, with hundreds of thousands of patients waiting for medical imaging in B.C. We know that timely access to medical im­aging saves lives and helps prevent disease progression. We fear the tsunami of cancer cases that may be coming in B.C. because of delayed access to medical imaging.

[2:50 p.m.]

“We’re asking for urgent action to address this issue, and we want to work with you on the specifics of the solution.”

What goes further in this letter that was sent to minister Dix on September 26 is that the health human resource strategy identified that there’s a critical shortage of medical imaging technologists — X-ray, sonography and other modalities — in British Columbia and that nearly every facility in the province of B.C. is trying to recruit, with little success.

Many technologists are working excessively long hours to try to keep up with demand. Innovative solutions must be explored immediately to recruit and retain experienced technologists to increase short-term capacity, and more needs to be done to develop and train new technologists for the long term.

That does lead into division 3 of the guiding principles, around licensing in this bill and around some of the bylaws that are being developed, specifically around the extrajurisdictional credentialing issued by a person or body outside B.C. with the evidence of qualifications.

We’ve been calling on that. We certainly recognize we’ve seen a softening of a lot of the domestic students through post-secondary institutions in British Columbia. We have a recruitment challenge right across the board in all of our communities. And yes, we have been looking at ways that if we have trained professionals in our community….

The member for Peace River South talked about the 28 health care professionals in his community that they’ve identified who, if we could find a way to support their credentialing, would be in our health care system, and that would be an extraordinary win for the community.

I’m hoping that this bill, this piece of legislation, will help streamline that and will help provide the oversight to make sure that that’s happening, because what I’ve heard, to date, is a repeat of communications out there from the government that say: “Look, we recognize this. We’re going to streamline credentialing, and we’re going to streamline all these processes.” We just haven’t seen that play out in action.

When you have 28 professionals in a community that are waiting for credentialing so that they could help support a health care system in crisis, we have to do better. We have to find a better way to make sure that this happens. What I worry about is that sometimes when we look at a 645-section bill…. Is this going to create so much bureaucratic red tape?

Again, I support the process of making sure we need to streamline. I support the process of why we got to this bill. I just want to make sure it doesn’t make things worse. I want to make sure that all of the challenges that we are experiencing in our communities…. I want to make sure that I’m raising the concerns of my constituents here in the Legislature. Are we making things better?

I want to spend a moment to acknowledge the incredible work of our post-secondary institutions, our colleges, right across the province of British Columbia. I cannot imagine what the health care system in my community, in the region of Cariboo North and specifically in G.R. Baker Hospital, would be like if we did not have the nursing program, that partnership between the College of New Caledonia and the University of British Columbia in our community.

When I think of things that, as a Caribooer or as somebody that we can hold up as an extraordinary win in our communities, making sure that we have post-secondary education, colleges and training in our communities is incredibly important. What we’ve been asking for is: let us look at the LPN program. Maybe there are other things on the training side that could help. Does this bill help us understand the needs assessments in our communities? Is there an element of that within this bill?

[2:55 p.m.]

I certainly read through the bill. Information always can inform good governance. I’m looking for the type of information in this legislation that really sets forward what we require in our communities. I think it’s also critically important…. As I was going through the legislation in this bill, under division 5 of the duties of the licensing, I’m glad that informed consent was identified in the piece of legislation.

I want to spend a moment now to talk about students. Last week it was student advocacy week in the B.C. Legislature. We had the opportunity to hear from student associations right across this province. I always appreciate what they’ve been bringing forward and the concerns that they’ve raised.

One of the elements that I think is critically important that we have to start wrapping our minds around and listening closely to young people and the work that they’re doing right across the country is: as we look at informed consent and what that means, do we have a specific set of criteria across institutions, across government, that looks at what that means?

I applaud the students for pushing both the government and the opposition on looking at what consent looks like and how, as we do that training in our public institutions, there is a measure that is consistent across the board, and the sexualized violence policies incorporated to meet the minimum standard of care that’s necessary.

What I heard currently from the students is that while we tend to write in legislation that there are needs for policies in things such as having consent culture or what sexualized violence policies look like within our legislation, is that consistent? How does that get interpreted across the board in institutions? I want to thank the students and recognize and hope that they’re listening so that they know that the work that they’re doing is brought forward into this House. They’ve been doing important work with the Students for Consent Culture Canada, again talking about what is happening across Canada.

I also just want to take a quick moment, because I think it’s critically important, to read into Hansard and to have on record. One of the other fundamental challenges that I’m paying close attention to — it’s not just in British Columbia; it’s happening across Canada, and I know that in February and March in 2022, the House of Commons Standing Committee on Citizenship and Immigration have certainly been looking at that — is around the false expectation and dreams of a Canadian education and what that looks like.

How this ties into this bill is that whether it was the government’s announcement of the health resource strategy or the requirements, which we all certainly understand, that we need to look at international professionals to come into Canada, and specifically to come into the province of British Columbia, to help address our health care challenges…. What we have been hearing, especially in that House of Commons standing committee, is that there is a rapid rise in international student recruitment that really does spark a call for rules and standards to govern this.

What we’ve seen is a lot of promises about employment, housing, cost of living and what kinds of supports there will be. Are we making that more difficult here? When we embed into legislation the significant requirements that we certainly understand and know that we need to be leaning on international professionals to come into our system, do we have the rules and standards and levels of care to make sure that they’re being supported?

I think that’s something that we certainly need to investigate and understand. Are we making the decision more challenging when we start embedding things in legislation? That’s something for us to reflect upon. Because at the end of the day, this very lengthy piece of legislation…. I applaud the members that have been working on this for a long time. Look, things change. Things in our commu­nities certainly have changed. I mean, they change right now by the month.

Like I said, I started talking about there’s some great opportunities that we’ve seen. Is this an opportunity in British Columbia to seize our opportunities? Is this an opportunity for the government to say: “Look, we recognize that we have crises, and we have challenges, but is this the time that we can come together and look for opportunities”?

[3:00 p.m.]

Are there ways that we can improve systems? Absolutely. Is this the way to make sure that we’re solving the labour shortage? I am looking forward to seeing the Future Ready plan come forward.

I am looking forward to that funding review for post-secondary education because I think that’s a critical component to making sure that we’re solving the labour shortages, to making sure that we’re supporting the people of British Columbia, to making sure that they get access to health care, to making sure that when people have to find their way into the health care system, there are the necessary health care professionals to meet those services, to meet those demands. At the end of the day, I know that the health care professionals are such a caring group of individuals, specifically in my community.

I guess, at the end of the day, I want to make sure that my constituents are seen in this piece of legislation. I want to make sure that when the minister appoints a board, our communities have a voice in that. I want to make sure that when decisions are being made in Victoria, the Cariboo is reflected in that.

I want to make sure that when decisions are being made by a minister, they understand that the unique dynamics of rural British Columbia are often different than our urban counterparts. I want to make sure that when we’re talking about legislation, we’re talking about the challenges every day on the ground. Sometimes things look a little bit different in some parts of our great province of British Columbia.

I want to make sure that there’s an opportunity, not just through the minister appointing people on the boards. I want to make sure that our people have their voices heard. I will never apologize, and I will never stop fighting to make sure that the constituents in our rural communities have a voice in the legislation that we bring forward before this House, especially when a bill such as this has such significant impacts on their day-to-day lives.

So I’m calling on my constituents. If you have concerns about this bill, if you have ways to improve this piece of legislation, if you have ideas on how we can make things better — please reach out. If it’s not to me, please reach out to other members in this House, because the only way we’re going to improve and get better and get out of this crisis is if we’re listening to British Columbians.

Enough is enough. I’m tired of hearing story after story of people that just feel disenfranchised, people who just feel that they’re not being heard in this Legislature, that feel that they’re being ignored, that they’re raising alarm bell after alarm bell after alarm bell. They’re trying their absolute best, on a day-to-day basis, and they’re being ignored. It’s not good enough.

Every single member in this House has a lot more work to do. I want my constituents of Cariboo North to know that you have my commitment that as long as I’m here, I’ll continue to fight on your behalf.

Deputy Speaker: Thank you, Member.

Recognizing the member for Peace River North.

Interjection.

D. Davies: Thank you to my fan club that surrounds me here today.

Interjection.

D. Davies: Including the Minister of Health. I’m just getting started, Minister.

Thank you, everyone.

I’m glad to have the opportunity here to speak on Bill 36, the Health Professions and Occupations Act, and how it significantly does and will and could impact the health care system at a very critical moment in time. We talked, and many of the speakers before me have spoken to the size of the bill. It is quite large, to be honest, and I’m going to talk about it in some regards. I’ll weave, throughout my remarks, the unique impacts that it has on rural British Columbia.

Of course, I represent an area that is almost 175,000 square kilometres, which poses many challenges, just by the sheer size of our riding. Health care, as I’ve said in this place many times before, is probably the number one issue that I receive at my office. I have two offices. I have an office located in Fort St. John, as well as one 4½ hours north in Fort Nelson.

[3:05 p.m.]

It is the number one issue that my office faces, and a lot of it is around access to health care. I know Fort Nelson has been really advocating. In fact, I’m going to be doing a statement in the House here later this week, looking at some of the great work that Northern Rockies, Fort Nelson is doing around a committee they’ve formed to deal with some of these unique challenges around health care in that small community that is so removed from larger centres. Even calling Fort St. John a larger centre, it is quite removed from us.

Interjection.

D. Davies: Yeah, we have a nice pool. We do have a nice pool. They have a nice pool in Fort Nelson. They have a beautiful rec centre.

I think most British Columbians would agree that we are, if not already, at a collapsed health care system in this province. The system is broken. We’ve heard it for weeks in this place, talking about the changes that need to happen. Something needs to change.

I can’t remember. I think it was…. Yes, it was Einstein, I think, who said that if we continue to do the same thing over and over again expecting different results, it’s a sign of insanity. This is where I think we really do need to change, and Bill 36 is obviously looking at some of those changes. As mentioned, we will definitely have a lot more to say as we dig into it during committee stage over the coming days.

It’s not only British Columbians, the general public, that are saying that our system is broken and needs to change. We’re hearing it from people within the system. I’m trying to think. I think I was at a hospital getting some blood work done a week and a half ago. It doesn’t take much just to sit in the waiting room and listen to the conversations around, listen to the other health care workers, to hear that we’re in trouble. Our system is in trouble, because they’re also talking about it as people that work in our health care system.

But the legislation that is before us today, Bill 36, does not seek, I guess, to move towards solving the crisis that we’re in, and it has been in the works for quite some time. The minister, the Leader of the Third Party and the member for Kelowna–Lake Country started this work, and I recall back when this first started and we were talking about it.

The collaboration, I think, is something worth recognizing — the working together. Obviously, there are a lot of emotions that happen in this room. This room is for that healthy debate. But people outside these walls often focus on the negative side, the fiery debates — question period and such. But I think it is important, also, to recognize that there is collaboration, much more collaboration back and forth than there is this presumed “we’re always at each other’s throats,” because that is not the case. I certainly want to thank all three of those members for the time that they put into this committee.

But we really need to be careful. As I mentioned, our system is very fragile at this moment, and we want to make sure the last thing we do, moving into Bill 36 and what it is looking at doing — that it will not make the problem worse. Obviously, these are going to be some of the questions that we’re going to be looking at during committee stage. The last thing we want…. I think Peace River South, my colleague, had mentioned these unintended consequences. We need to make sure that there are no unintended consequences down the road that are going to make the problem or our health care system worse off than it already is right now.

I should follow my notes. I have already said a few pieces. I’m just skipping ahead.

[3:10 p.m.]

I also think it’s important to look at the work, again, that those three members of this House began working on. The system, the climate around health care, was much different when they started working on this and looking at where the health system was. Even when they met, we were starting to see some cracks in the system. Staffing shortages were starting to become more prevalent throughout the province.

Of course, this committee definitely started prior to the pandemic, when we saw definite, clear pressure that was put on the system, obviously propelling us into the complete chaos that we see our health care system in today. When this committee first started looking at these challenges, it was in a very different place than where we are now in health care in British Columbia. I think that’s really important to keep in mind as we move into the committee stage on this bill.

The main purpose of the committee is to make a series of recommendations to modernize. There’s nothing wrong…. We always need to be looking at different regulations, acts, legislation generally and making sure that it is modernized. But I would bet that if you were to talk to the average British Columbian around the framework that the Health Professions Act is, most British Columbians wouldn’t have a clue how the health care system is set up: the colleges, how they work, the regulation. I would say that most British Columbians would not know the inner workings of that.

In fact, I could probably say that I, myself, would be one of those that does not know the finer details of how all of these pieces work. I, like many other British Columbians, at the end of the day just want a system that’s going to be there when I need it — a system that is transparent and that each of us, as British Columbians, can put our faith and trust in and know that we are going to get the absolute best care we can have in our health care system, a system that is focused on patient safety.

I’m sure there are others in this House…. I can speak from a personal story that happened to me in 2018. I think anybody that was in the House obviously recalls that I got into a little bit of a run-in with a front-end loader and was crushed. This happened in the city of Fort St. John. I was rushed into the trauma room, the emergency room.

I’ll say that I never thought for one minute that I was not in good hands. The service that I received, the care that I received, was incredible. Everyone was where they needed to be. I will say, though, that there was one issue — I have talked to the minister about this: our air ambulance was the one letdown that caused me stuff that’s happening still, today. Because it was not in place, I had to sit for almost ten hours, waiting for an aircraft to medevac me over into Vancouver.

When I was in care in the hospital in Fort St. John, even during the medevac process on the airplane with B.C. Ambulance, transferred into Vancouver General Hospital, and the whole time I was in the general hospital, through my surgeries, I felt that I was receiving very good care. I never questioned it once. I was never worried that I was not getting the care that I felt I deserved.

I don’t know if I can say that today. I really don’t know if I could say that today. If I were to experience the same accident that I did in 2018, I believe I would be a little bit more nervous now about the level of service and care that I would get. It’s not based on the individuals. The doctors and nurses all do incredible work; the staff give it all. We’ve heard stories here today on the unbelievable work that our health care professionals are giving, working double shifts.

[3:15 p.m.]

Again, the member for Peace River South talked about two back-to-back 12-hour shifts. You know, these are heroes — nobody questions that — but it’s the systemic breakdown of B.C.’s health care that worries me. It worries, I know, many British Columbians right now, around: can they get the service? Can they get the health care that they need?

Will Bill 36 fix that? Well, no. Will it get us to a better place? We hope so. These, again, are going to be the things that we need to be focusing on during committee stage on this bill. The main intent of this bill is to look at the regulation of the health professionals that are working in our health care system. One of the things that we’ve looked at is to streamline that system. There are lots of things that we, obviously, agree on, and we don’t argue that. We will have many more questions moving forward as this is discussed.

As we move forward, we need to be looking at what started out in 2018, when this process started, to where we are right now in 2022. Things are really different, and we need to be almost dissecting this bit by bit and asking the questions that are now more prevalent today than they might have been in 2018 or in 2019. The pandemic has obviously had an impact on our health care system in showing these cracks and challenges, as has our opioid crisis. A lot of pressures are on our system right now, which is starting to show some of the issues.

As we’ve all alluded to on this on this side of the House, we are supportive of many of the goals and the direction of this bill, but it is a long and complex bill. I know it has been held up a few times. If you compare it to all of the bills that we’ve had in this House, it’s thicker than all of them so far this session. It will take some time. It is going to take a lot of patience, I’m sure, with the minister and his staff and the members on this side of the House. It’s a complete redesign of the Health Professions Act, something that one cannot take lightly.

The current Health Professions Act deals with the 26 regulated health professions, of which 25 are governed by 15 regulatory colleges. We can see, just by that sentence, the complexity of the system that we are presently in. Looking at ways that we can improve, looking at ways that we can streamline and looking at ways that we can make it more transparent are obviously some things that we are supportive of and that we’ll be looking at as we move forward with this Bill 36.

All of these colleges I have just mentioned have a legal obligation to protect the public, and I think it is something that they take very seriously. Questions have been raised around the transparency piece. Again, these are the pieces, I think, that British Columbians want to see. They don’t want to know the inner workings. They just want to know that the system will be there, that the system is transparent and that it’s a system that they can trust in.

Bill 36 expands much on the previous duties of the college and establishes a series of guiding principles that will be applied under this act — colleges, office of the superintendent, director of discipline, among a few.

[3:20 p.m.]

It was talked about earlier this afternoon — the creation of more layers, and I use the term loosely, of bureaucracy that have been identified so far in this government. My worry is that this is just more layers and will become something bigger and more of a barrier than it might be of something that will improve, at the end of the day, the most important thing, and that is the level of care that individual British Columbians will receive.

At the end of the day, this is about removing barriers, and it could easily become the opposite of that, and that is one of the things that does worry me moving forward. Again, a lot of these questions, hopefully, will be answered as we move into committee stage.

We’ve heard a few stories about internationally trained and educated health care folks that come from all over the world that work in our province. In fact, I think almost every speaker has probably mentioned a story.

Again, the challenges are much more prevalent in a smaller northern rural community, and I know many of us have identified people that are working in the service sector or working in different sectors that have years of experience in their country, years of university in health care professions that British Columbia needs. There is a breakdown in the system and the regulatory piece around getting these individuals that are already here living in British Columbia into something that they should be doing, and that is supporting in our health care system.

In fact, a few years ago the city engineer in Fort St. John and his wife had both moved up from I think it was Chile, and he was hired by the city as the engineer. His wife was an obstetrician-gynecologist, world renowned. She would go on speaking engagements all across the world. You can imagine, to our elation: “My goodness, we’ve got a city engineer that’s come in. Now we’ve got something….” In fact, the timing was perfect. The obstetrician was just retiring out of Fort St. John, so the timing could not have been better.

However, she was told: “You need a few more years of X, Y and Z. You need to do this. You need to do that, and then reapply to us.” It was a bit of a back-and-forth, and then she found that there was another way. If she were to go to the United States and practise, to move into B.C. would be much easier, so she did that.

Remember, her husband stayed in Fort St. John the whole time. She moved down to Pennsylvania and practised in a hospital, without an issue, by the way — just walked in and started. I’m presuming there were a few loops to go through to make sure that she met the requirements, but she started practising. Came back to British Columbia, as she was told to, and was told: “No, you need another year and a half, a bunch of these courses that you are missing.”

Anyway, unfortunately, we lost, because of that…. Both of these individuals went to Grande Prairie. She’s now running an entire department in Grande Prairie. Her husband now works for the city of Grande Prairie. British Columbia lost two incredible professional people because of, hopefully, some of the issues that we might get to in this bill.

I think it’s important to tell these stories, and I think it’s important that all of us share these stories in our communities of people just like that, just like the member for Peace River South spoke about in his community. These people are out there. These people are in every single community across British Columbia, that love serving people. They love being in health care. That’s what they got into it for. We need to find ways to expedite these folks. Hopefully, this is something that Bill 36 will look at a little bit deeper in regard to regulating and the colleges and how they look at that.

[3:25 p.m.]

We need to have a clearer path, and this is something that’s been spoken to I can’t even remember how many times. Over and over again, it comes up. Here, throughout the province, we read stories about it. I know that even in our Alaska newspaper, there have been stories that there needs to be a clearer path for health care professionals from other countries to apply and receive their designation here in British Columbia.

As I mentioned, Bill 36 does create a new position, the superintendent, as an oversight body of these colleges and these regulatory groups. But again, as I mentioned, I worry that this is just another barrier that could be created, as opposed to reducing barriers. And we want to make sure that that is the last thing that we do. It’s to be reducing the barriers, not creating more barriers.

There are also some funding challenges regarding funding of this office and the fees. What does that look like? We’ve already heard from family physicians across the province that they’re going broke. They’re unable to keep their offices over due to the general costs of just doing business in the province of B.C. This is…. It doesn’t matter if you’re looking at utilities, your rent. All of these things add up and now, potentially, an increase in fees. Is this something that could have these unintended consequences down the road? It’s now more money that we’re going to be asking our doctors, who are already strapped, to be making.

We want to make sure we do identify what this looks like moving forward. Is this another cost that’s going to be passed on to our doctors? Another cost that’s going to potentially…. When we look at our doctors and health care professionals, it’s a very competitive field. We have Alberta looking at us. We have Saskatchewan looking at us. It’s a very competitive field, and everyone is looking at trying to attract doctors. It’s not just here in Canada. It’s going international to the United States because these shortages are everywhere.

We want to make sure that these alluded-to unintended consequences don’t in fact become real, because the last thing we want to do is make ourselves less competitive when we’re trying to attract health care professionals to the province of British Columbia.

I mentioned earlier…. Around my office, the number one call we get is around health care. But another piece is we get a lot of people that are calling about the ability to lodge a complaint. The ability to complain, the ability to be heard in our system.

One of the pieces in here is to look at creating a new independent discipline tribunal. It is something that I’m going to be definitely looking at closely to see what it looks like because, at the end of the day, we definitely want a system that is responsive to people that, when they have a complaint, they know that they’re going to be heard and there’s going to be follow-up. I think that is something worth highlighting that is in Bill 36 to make sure that it is something, again, that’s not more of a barrier, but is going to have a good outcome for British Columbians if they do need to pursue a complaint within the system.

Bill 36 is largely enabling legislation. Much of what this means is, down the road — will come out of regulation. I’m not sure how many bills we’ve seen go through this House in the last few years that leave a lot up to regulation. That is one thing that kind of sets a flag off in my mind.

[3:30 p.m.]

We’re going back to the transparency piece here. British Columbians want to know, as do people that are working in the health professions — their boundaries, what they’re allowed to do, what they’re not allowed to do, the direction they need to go.

When you bring this big umbrella — this is a big um­brella, 630-some pieces — of enabling legislation, it leaves it open to an incredible amount of regulation that can happen around the cabinet table. That, again, raises some flags for me around where this could go, how this could go and the long-term implications that it could have on our already crumbling — I’ll say fragile — health care system that we have in this province.

Hon. Speaker, I’ve noticed that my time is almost up. Everything that I do, since I’ve been elected to this place, is to make sure I represent the constituents of Peace River North. I’ve mentioned a few times now that health care is probably one of the biggest things — not one of; it is the biggest challenge that we have — in my riding. Whenever we see any piece of legislation that comes through on health care, we need to make sure that we are not just doing a cookie-cutter approach, which is often done by…. It’s every level of government, I will say. This isn’t just one government.

Cookie-cutter approaches do not work. This province is much too diverse when we look at…. Vancouver is not Victoria, as it is not Fort St. John or Prince Rupert. We need to make sure that when we are coming forward with solutions, they are going to be solutions that are going to work in these areas or that we have the ability within the legislation to make sure that we recognize the uniqueness and the challenges in all four corners of our province.

With that, and in closing, I will make sure that we’re going to be very engaged over the next little while on the committee stage, making sure that these hard questions are asked.

In closing, I do want to again thank our front-line workers, our health care workers, our doctors — those people that are doing two back-to-back 12-hour shifts. They really are heroes, and I know all of us in this chamber, obviously, do want to thank all of them for the incredible work that they do. With that, I’ll take my place. Thank you for the time.

Deputy Speaker: Recognizing the Minister of State for Infrastructure.

Hon. B. Ma: Hon. Speaker, I was worried that maybe I needed to be a bit taller for you to see me. Thank you for recognizing me.

It’s my pleasure to rise and speak in favour of Bill 36, Health Professions and Occupations Act. I will try not to take up too much speaking time. I know that there are a lot of members who want to speak as well. It is an important piece of legislation, a massive piece of legislation — 645 sections. My goodness.

[S. Chandra Herbert in the chair.]

For those who are watching the second reading here, we have a first reading. We’re in second reading right now, and then we’ll go into Committee of the Whole, where we will debate every single one of those 645 sections, one by one. Then there’ll be a third reading, and then a final vote. We’ve got lots of time on this piece of legislation.

I do want to take the opportunity to recognize the incredible work that health care professionals have been doing, not just over the last few years of the pandemic but for decades, my whole life. In the entire time that we have had a public health care system here in British Columbia, we have relied on the professionalism and expertise of doctors, nurses and other health care professionals. They have been doing incredible work, supporting us and taking care of us, helping us when we need them the most.

[3:35 p.m.]

Of course, I also want to acknowledge that although the challenges are not new, a lot of different, overlapping crises have brought us to the place where we are today, where lots of people are challenged in terms of accessing health care, and that’s important to acknowledge. Of course, we have brought in and hired tens of thousands of net-new health care professionals over the last several years — 38,000 new health care workers in the public health care system. We’re signing up new family doctors. We have more family doctors than ever before. Yet the demand and the strain on the system, the need, is so great, and there is still lots, lots more to do.

I’m so grateful to the Minister of Health for his work on the health care workforce strategy that was released a few weeks ago. Of course, the release of a strategy in and of itself is not enough. We must implement it. So all of that work is happening now.

Of course, this is part of the overall work. It is not all of it. It is just one small, important — well, I wouldn’t say small; I mean, 645 sections of the bill is not small — part of all of the different types of work that we need to do in order to build up a stronger public health care system that can provide services to people and their families and communities when and where they need it, because that’s what British Columbians deserve. That’s what Canadians expect. And that’s the work that we need to do in order to get there.

This particular act, though, is very interesting. It’s about adapting to the changes in our health care system and ensuring that regulated health professionals are keeping up. We’re looking to improve patient safety and public protection, efficiency and effectiveness of B.C.’s regulatory framework around health care professionals and public confidence through transparency and accountability.

Some of the changes that this piece of legislation will bring in include — just very high level, because again, 645 sections of the bill…. We are looking to a streamlined path to reduce the number of regulatory colleges through amalgamation. There are currently — oh, man — 15 colleges, and we’re going to be reducing that down to six through two major amalgamations.

One of these amalgamations will combine the colleges for dietitians, occupational therapists, opticians, optometrists, physical therapists, psychologists and speech and hearing professionals into one regulator. The other amalgamation would combine the colleges for chiropractors, massage therapists, naturopathic physicians, traditional Chinese medicine and acupuncturists into another college.

I will note that I’ve been hearing from a lot of therapists in British Columbia that they’re also looking to become a regulated health care professional. I think the reasons for doing so are…. They’ve made their case very strongly, and my understanding, as well, is that by streamlining the regulatory framework for the regulation of health care professionals it actually provides a more streamlined path for more health care professionals to also become regulated, so that’s really important.

This act also enables the creation of an oversight body. Now, this is something that’s familiar to me through our previous work on the Professional Governance Act. A couple of years ago — maybe, my goodness, was it three years ago now? — we actually brought in the Professional Governance Act that sought to streamline the oversight of…. How do I say this? It sought to streamline and standardize the oversight of professions that are regulated through professional reliance.

As an example, the Professional Engineers and Geo­scientists of B.C. and four other professional regulatory bodies were brought in under an umbrella legislation called the Professional Governance Act, and a new superintendent’s office was created to provide oversight there. So the creation of an oversight body that promotes accountability, transparency and consistency across regulatory colleges at the health care professional level makes a lot of sense to me.

[3:40 p.m.]

The legislation also seeks to improve transparency around complaints. What particularly interests me about that piece is the creation of a safer complaints process. When patients go to a health care professional, they’re putting themselves in an extremely vulnerable position. They put themselves in a place where they are, basically, putting all of their trust in this health care professional to provide them the best care possible. The vast, vast majority of health care professionals absolutely do.

In those cases where something goes wrong, where something has happened to create cause for a legitimate complaint…. I have had constituents come to me with those complaints but refuse to actually submit a proper complaint out of fear of retaliation. They’re worried that if their health care provider found out that it was them that made the complaint, they might not be able to access a doctor or that health care professional in the future, even though the complaint that they have to raise is very legitimate.

Those kinds of scenarios really concern me. Some re­cent examples have been…. A constituent was very worried about a very unusual charge they were being charged. They’d never seen this charge before, and they really wanted my help, my office’s help, to help them understand what the charge was. But in order for them to do so, we would actually need to know the name of the health care provider. They were very worried about providing us the name of the health care provider, because they didn’t want to have it found out that they were asking these questions out of fear that this health care provider wouldn’t see them anymore.

We also have heard from some patients who have had their primary health care provider refuse to see them in person, insisting that they would only see them virtually. I recently learned from the College of Physicians and Surgeons that they actually have a standard of practice around doctors seeing patients when the patient feels they need to be seen in person. They expect doctors to see patients in person when the patient feels they need to be seen, not only when the doctor feels they need to be seen in person. Apparently, refusing to see a patient in person is grounds for a complaint to the College of Physicians and Surgeons.

This is something I did not know until very recently, when the College of Physicians and Surgeons — representatives from the college — made it very clear that that’s grounds for a complaint. But if you are a patient who is worried about being able to access medical care at all, let alone virtually or in person, you might not feel comfortable actually making that complaint in the first place, in which case it might never be resolved or dealt with.

So the safer complaints process, which allows an ability to protect the identity of complainants, is very important. I think that that’s an important part of the improvements that this legislation will bring in.

The commitment to cultural safety and humility is also very, very important. The In Plain Sight report that was commissioned during the pandemic brought to light some very serious concerns around discrimination and, in particular, systemic racism against Indigenous people. We are all learning. Nobody is perfect in this. Our government is learning; our communities are learning. We’re all learning what it means to reconcile with the systemic racism of societies past and how that influences the ways that we behave and the ways that our system operates.

With that, part of that work, of course, is to ensure our medical system is also doing better each and every day. So this commitment to cultural safety and humility is so important.

Last two changes I’ll note. It improves information-sharing. Of course, we have to be careful, in terms of privacy and protection of personal information, but allowing colleges to be able to share information more easily between one another and with other agencies will hopefully help enhance public safety and protection and, of course, improve governance. Shifting away from the election of board members and instead creating a board system where all of them are appointed, based on competency and through a process, will make sure board members of these colleges do not feel beholden to the people who elect them.

[3:45 p.m.]

That’s important, because the purpose of a health profession regulatory college is that they are responsible for ensuring that regulated health care professionals provide health care services in a safe, competent and ethical manner. They’re there to protect the public. They are not a lobbying or advocacy group on behalf of their members; they’re there to protect the public.

These are all, I think, very important things that we need to do. None of it is to suggest that this is all that we need to do. There’s more, of course.

Before I give up the floor to the next speaker, I do also really want to thank not only the Minister of Health for the work that he and his team, of course, have put towards this piece of legislation but also the collaborative efforts of members from the opposition as well. The MLA for Kelowna–Lake Country played an enormous role in making sure that that this piece of legislation took into account all the different perspectives of the House, along with the member for Cowichan Valley. Having an all-party approach on this piece of legislation, I think, was really, really important. I’d like to see a lot more of that collaboration happen in this House.

You know what? I would be remiss if I didn’t throw one more thing in there before I sat down. When it comes to improved transparency around complaints, it reads pri­marily that we’re talking about complaints from patients. But improved transparency, I think, could also benefit in a number of other areas. Actually, the member who spoke directly before me had mentioned international medical graduates. If we can streamline processes, if we can make the process for helping internationally trained medical graduates get licensed to work here in British Columbia — if we can make that process more transparent, I think it would benefit all of us.

There’s enormous expertise and value and experience that comes into Canada from elsewhere around the world. We need to be making sure that they’re given the best opportunity possible to utilize their skills safely and effectively, of course, here in British Columbia in order to support our population but also to support their families.

I know so many internationally trained medical graduates who have made very difficult decisions to bring their whole families over here to Canada in hopes of being able to build a better life. They really want to be able to contribute to the communities that they now call home. I think that it would benefit all of us to be able to find ways to allow them to get trained up and get up to speed on the expectations of practice here in Canada so that they can contribute to the solution on behalf of all of us in our communities.

I will take my place and hand over the floor.

R. Merrifield: I’m going to agree with the minister, who spoke before me. This is a monumental bill. This is truly a huge piece of legislation, and a tremendous amount of work has gone into it. In fact, she mentioned the 645 different sections, and the Speaker will recall the riveting committee debate on the one section of the environmental bill. I couldn’t even get the right section at that point, so the Speaker gave me aid and actually helped to adjust how we were going.

I do recognize how heavy and how weighty a piece of legislation of this nature is. I’m really happy to be able to have the opportunity today to stand and to speak to the House about this bill, because I truly believe that this bill will impact our health care industry at a very critical moment in history.

We’ve heard a lot of conversations in this House, just as of late, about our two health care emergencies. First, we had the opioid crisis that began back in 2016 and that still, to this day, rages out of control, with more deaths this year than ever before.

[3:50 p.m.]

Then there was the second health care emergency, with the pandemic. It was just before the pandemic that this piece of legislation and the committee were struck so that we could actually figure out a new way to do health care.

I don’t think any of us could imagine this third health care emergency that we’re in the middle of right now. I don’t think any of us could imagine how monumental this piece of legislation is in the middle of a deadly health care crisis, with a collapsed system being hobbled together by truly extraordinary front-line workers, whether it’s the nurses and the doctors, whether it’s the care aides, whether it’s those that work to keep our hospitals moving forward, like the cleaners or the cooks or the facilitators.

I would rather have those nurses on the front lines than marching with signs. I’d rather have those doctors performing surgeries or diagnoses than on the front steps of this building.

I think we all agree that something needs to change. I do think that this piece of legislation is part of that change. If we look at this bill through the lens of how the system could shift, I do think that it could be a part of the solution.

In evaluating this legislation…. Obviously, I’m going to approach it from the perspective of my riding and those amazing citizens who have elected me and have put me here. I’m going to evaluate it from an Okanagian or from a Kelowna resident and their perspective.

In as far as this is a piece of reformation of our health care, I don’t think that this bill will do what we need it to, to solve our health care crisis. I don’t think it was actually imagined or struck in committee with such a crisis in mind. I do believe that it can still have a positive influence. I do believe that this can still move the dial slightly forward. But I don’t think that we can look at this bill as somewhat of a cure-all. It just won’t.

As with any piece of legislation, we need to approach Bill 36 with a critical eye to make sure that there are not things that we need to change within it and to ensure that we don’t have negative indirect consequences. Speaking of the earlier environmental bill, in that one…. That was directly to change something that had been inadvertently placed inside of a bill that shouldn’t have been changed then that was. We don’t want Bill 36 to go through that same process. We want all 645 sections to truly be what they need to be without indirect consequences that are negative.

This bill is not going to address the loads that our hospitals face on a day-to-day basis.

In the Okanagan, we are incredibly short-staffed. Our Kelowna General Hospital…. I just want to throw huge kudos out to everyone that works there on a daily basis. They fluctuate between 120 and 140 percent occupancy daily. That’s monumental, heroic, the efforts of those individuals working there. Our operating rooms try to stay open but routinely have only two-thirds of the nurses that are necessary to truly run efficiently or effectively. Oftentimes patients are sent home, even sent home to rural and remote communities from which they’ve driven to the Okanagan.

[3:55 p.m.]

It would be great if this bill sought to fix some of those issues. It would be great if somehow this bill could bring light to some of those staffing issues. But this bill has been in the works for many years and doesn’t address this aspect.

Now, what are the successes? I think there are successes inside of Bill 36. The first one I would laud is the democratic process of collaboration. I know many, who have been here for longer than me, will roll their eyes and say: “Yeah, it’s great, when you’re in opposition, to say that you want collaboration. Much harder when you’re in government.” I do believe the best processes and the best legislation and the best decisions come through a collaborative process and come through disparate opinions that will conflict in fierce conversations and bring to light unanimity.

I am proud that this work was done in collaboration, prior to the snap election of 2020, prior to when this government no longer needed our collaboration. Previously, when the NDP were forced, without a majority, to work together, they did collaborate, and I would argue that better work ensued.

As mentioned before, this piece of legislation has been borne out of the recommendations of the steering committee that was co-chaired by the MLA for Kelowna–Lake Country, part of Team Okanagan, the Leader of the Third Party as well as the Minister of Health.

As I mentioned before, the committee’s work began before the pandemic and before our system was showing the explicit outward signs of crisis. It was before the health care system collapsed, before we had a million British Columbians without a primary doctor and before we had a million B.C. patients waiting for specialist care.

The other day I was driving with my spouse. I hap­pened to get a phone call from someone that I knew and knew fairly well, a constituent. Recognizing the number, I answered it. I said: “Hey, you’re on speaker phone with me and Carlos. So just to let you know that you’re going to be heard by both of us. I can give you a call back if you need privacy.”

They went on to say: “No. It’s pretty immediate. I need to talk to you.” They had just learned their family doctor was retiring. They went on to say that they needed help finding one, that they have medications that need to be refilled. When I got off the phone, my spouse looked at me and said: “He sounded really scared.” British Columbians are scared.

This bill is addressing how we are actually going to regulate the doctors, but it’s not addressing the fact that we need more doctors. With this constituent…. I didn’t have the heart to tell him that he is one of the 35,000 residents of Kelowna without a family physician. I didn’t have the heart to tell him that we have 16 family docs retiring in 2022.

The minister before me indicated that we’ve hired all these new doctors. I don’t know where they’re going, but they’re not going into family practice. It’s like a war analogy, where you’ve got the infantry and the front-line soldiers. We keep telling them: “Help is coming.” We’re hiring and developing soldiers that we’re now employing as strategists or as administrators or as anything but the soldiers who are on the front lines of health care.

The main purpose of this committee was to actually make a series of recommendations to modernize the health profession regulatory framework. They debated. This was not a quick process.

There was also a lot of consultation. From that, there were these recommendations that were made by the committee to include — I’m going to read the list, because I think it’s quite phenomenal — cultural safety and humility, improve the governance of regulatory college boards and establish an independent discipline process while revising the complaints process with the aim to make it more transparent and focused on patient safety.

[4:00 p.m.]

That’s extraordinary. That’s amazing. It’s also through that lens that we critically approach this bill to make sure that this bill does what it was intended to do, that this bill was written with those changes in mind.

As I read through…. Don’t read it late at night, because all 650 sections get a little bit dry. I read it late at night. But reading it, it does seem to include many of these changes. The main intent is to protect the public and streamline the way we currently regulate health professions. Well, that’s a goal that I think most would support. Of course the public needs to be protected. It’s one of the reasons that this side of the House has been sounding the alarm bell about the state of our health care system. It’s because we’re trying desperately to protect the public.

As the Minister of State for Infrastructure was speaking earlier, she inadvertently mixed up some words and said: “The public perception.” But she’s right. I would argue that since this committee was struck over 3½, four years ago, public perception has shifted.

Inside of this bill, there is this creation of greater transparency and greater protections. I want to believe that this bill will achieve that. But I have to say that there is very little trust for health care out there. There is a lack of public confidence.

We heard other members of this House stand up and talk about their stories of: would the ambulance be there if they called today? I just spoke of talking with a constituent and telling him that I didn’t have a fast-track system to get a new family doctor. I’m working with another constituent. He’s actually talking about going out of country to get a surgery that he desperately needs. The public has a real lack of confidence right now in our health care system.

This bill actually sets up that the minister and cabinet will be appointing many of these positions. I would argue that we don’t need to look further than the firing of an entire B.C. Housing board to see how sometimes that can backfire. I say “sometimes” because I still remain hopeful. But right now, we don’t have that level of detail articulated, even though we have 645 sections.

When we talk about transparency…. Well, the most secretive government in Canada award doesn’t go to those who are transparent and open.

Where’s another success? Well, I believe that the aspect of mental health…. This bill could actually pave a way forward for counsellors to become accredited and to be professionally regulated. This could be a way to bring that oversight forward.

Previously when they submitted their desire for professional designation and oversight, well, they were told they had to wait for this legislation. Actually, Bill 36 could make that way forward. We know that with mental health where it is today in British Columbia, these positions are desperately needed. But again, we need to protect the public and make sure that this is a regulated profession, that there’s excellence and that there is a way for public to actually hold to account.

I hope that Bill 36 actually is that paved road forward. But there are still other designations that are still waiting, other professions that are still waiting: physician assistants, anaesthesia assistants, surgical assistants. These are all still waiting for this legislation. They’ve all been put on hold for the last 3½ years.

[4:05 p.m.]

As our health care system has absolutely moved into crisis and imploded, we have other means and mechanisms. We are the only jurisdiction that does not recognize physician assistants in Canada. A physician assistant could actually help all of our family docs extend their reach and could be an augmentation for family practice and a means of attachment for patients today.

Therefore, this legislation is before us right now, but it needs to be enacted sooner than later. I agree that there are very important matters to consider. But I also want to just acknowledge that, over the course of the last three years, the health care system has changed. Part of the committee stage of this bill will be to make sure that this piece of legislation truly does what we need it to do in the current context.

Both in second reading…. As we draw attention to some of the aspects or issues — things like transparency, things like whether or not the minister and cabinet should be the appointing body — other aspects of if there should still be elected officials of some sort or aspects of how and who is going to pay for this system need to be considered. It has to be done with the broader context in mind of our crumbling health care system — a system of closed emergency rooms, closed hospitals, hospitals on diversion. I mean, there are entire Twitter feeds dedicated to articulating and announcing when the hospitals are going to be closed. It tracks them by day and calculates how many days we have of closures.

The public are scared. They’re concerned. Are they concerned around the issues that this bill addresses? Are they concerned about how their doctors are regulated? No. They are concerned how many doctors are in their ERs, how many doctors they’re short in their community, how far they have to drive for care, how long they have to wait for an ambulance or if they can get into a walk-in clinic or the UPCCs. They care about understaffing, open positions.

While I’ve alluded to it already, I’m supportive of many of the goals of this bill. The length and the complexity…. I mean, we’re going to have to seriously scrutinize what’s in here. And I’m excited for that fulsome debate in committee stage as well, because it’s really important to establish, from the beginning, that this bill is a complete redesign of the Health Professions Act. I wish that we were debating a complete redesign of the entire health care system on how we were going to deliver care to British Columbians.

But the Health Professions Act deals with the 26 regulated professions, currently of which 25 are governed by 15 regulatory colleges. These colleges already have a legal obligation to protect the public through the regulation of their registrants. So there is already this public protection in place. At present, the colleges review all the complaints, and they go through that. That’s not going to change in terms of part of what this Bill 36 does, because the colleges will have to do all of the investigative work.

So while Bill 36 significantly expands on the previous duties and establishes these guiding principles, we need to question: is this just more bureaucracy? Is this more time, more money, but the same outcome? If so, that is just another bureaucratic layer that will further bog down the system.

[4:10 p.m.]

One of the things I am also…. This will be my third success. One of the things I am really excited about is the UNDRIP aspect, the united declaration on the rights of Indigenous people. This is an important piece of this legislation and something that I know my colleagues are going to debate later in greater detail, because we want to know the details.

I thank all of my teachers in my life, my Indigenous teachers, the ones that taught me about their culture, how special their families are, how prominent this is, some of their traditions. All I have learned has made me a better person, and we will all be better with a collective learning. I’m excited that this bill actually addresses some of those aspects.

I really like other aspects as well, like procedural fairness or respect for privacy. One of the things I talked about in my very first response to the throne speech was the promotion of a holistic health care system, one in which we would try and stay healthier — instead of just treat us when we are sick.

This bill also is an attempt to remove barriers for extra-jurisdictional practitioners, and that speaks of those that are internationally trained. This is a huge benefit. I have been working with some professionals who have taken two and three years to transfer some of their accreditation, whether it’s from the U.K. or Australia or the United States.

Because our physician spaces and medical school spaces are so restricted, without that additional space at SFU yet, we only have the 288 that were increased, during the B.C. Liberals’ time, from 134. With that in mind, when you have an A student, who has incredible extracurriculars and has done over 510 to 515 on their MCAT, they are going to go. They are going to leave B.C. and go and be trained in the U.S. or be trained in Australia or be trained in the U.K. Yet when they want to come home, they have an incredibly difficult process to get them there. I’m excited about how Bill 36 could actually address this.

Yes, we are going to have a new superintendent that’s appointed by cabinet. Well, we need to make sure that there are details present for how that appointment is going to be done, one that will actually allow public trust to be restored in small ways that will address the concerns that the public has. Right now, this bill is a little bit like a blank cheque. It allows government to be very nimble in how it’s going to put regulations out later at the discretion of the minister. So much of this bill is actually legislation that seeks to accomplish things that are not done within the text but actually will be done through regulation.

We’re kind of tired of the government’s closed-door meetings and blank-cheque policies. Some regulation-making powers makes sense, but we just don’t know how much this actually does or how it will actually impact our health care system. We need some of those details.

[4:15 p.m.]

We also need to understand that while the office of the superintendent is an independent body, there’s a provision in this bill that requires the superintendent to comply with any orders the minister makes. What if the minister is politically motivated? What if this political motivation is in direct conflict with the public’s best interests? This bill almost seems to sabotage the very thing it seeks to accomplish, which is the public’s protection.

So, as such, we’re going to be examining this bill closely and thoroughly in committee, particularly as to what this is going to look like in practice. What will happen if the minister is in conflict with the public’s best interests? We cannot forget that we’re still in the middle of not two but three health care emergencies. Our hospitals are in chaos. People cannot get care. People are waiting for ambulances, and that’s in Kelowna. Never mind some of the more rural and remote communities.

We’re dealing with hospital closures in every corner of this province. Our specialist lists are over a million long. Access to medical imagery is incredibly difficult, with very long wait-lists. And let’s not forget about the one in five British Columbians that still are without a family doctor.

The legislation before us today is simply one piece of the issue of public and patient safety. It’s not by any means going to cure what ails us, and it’s not going to give that constituent, who called me, a family doctor.

But to be fair to the minister, he hasn’t really touted it as a cure-all. There has been a tremendous amount of work that’s gone into this legislation, so I’m committing to look at this legislation with optimistic eyes — critical, but optimistic — and have the conversation about health and consider all of the challenges and all of the issues that stand before us today. I feel like we all owe that to the patients and the residents that have elected us here.

Hon. N. Cullen: I have been listening both here in the House and outside to the comments from the opposition and from some government members — and, of course, the Health Minister himself — with respect to this bill that attempts to do something very specific and something very important in improving the health outcomes and the lives of British Columbians with respect to their interactions with the health care system and, as well, improve working conditions for those in the health care system in the broadest possible sense.

I was looking through the number of disciplines and professions that will be affected by this very large piece of legislation, and I think that many, many people listening and trying to understand what the impacts of this are going to be would be encouraged to know how all-encompassing it is with respect to the regulations that guide the professions that serve us in the health care field.

I’m looking through the list here. While I have some time available to me, I won’t take all of it in listing all of the professions that are going to be impacted in some significant and positive ways, but clearly, the nurses and midwives being brought into a college. Having a college for the oral health professionals broadly defined, so that it’s not just within dentists, but dental assistants, hygienists, surgeons, technicians, denturists and therapists, on down the line. The College of Dietitians, massage therapists, Physicians and Surgeons of B.C., and on the list goes.

[4:20 p.m.]

In helping consolidate the system…. Some members have expressed some trepidation at the size of the legislation. Well, in order to take on what I think is some generational work in improving the professions that we have here in British Columbia, this is long overdue, as has been argued by many patient advocates and by many of those who work in the health care professions.

It does four essential things which, I think, are incredibly critical. I would hope that there would be bipartisan and multipartisan support for these efforts, because when looking at improving the health care outcomes in this province, one has to look at the systemic nature of some of those challenges. Our government has taken those on in many different fields — the Health Minister in particular — all the while fighting two public health emergencies.

The context of that is very important. One could very much understand why there has been so much strain and stress on our health care system — not just here in British Columbia, not just in rural B.C. or urban B.C. but right across Canada, throughout the United States, through Europe and in fact through every country in the world. Our health care systems have been under incredible strain, and it shouldn’t ever go without saying that the gratitude that we, as elected people in this House, have towards our health care professionals truly knows no bounds.

We have personal stories that members have shared throughout this debate of their own interactions or the interactions of their family members and of the people that we represent when engaging with the health care system and knowing the tireless advocacy, work and care that those within the system bring to work each and every day, despite 2½ years of a global pandemic, and despite the more than five or six years in the health care emergency that has been the opioid crisis that has devastated so many families across our beautiful province.

Now, how does this help? This important bill that is in front of us today, the Health Professions and Occupations Act, is to streamline the process and the path of the number of the regulatory colleges and agencies. Why this is important is that sometimes the labyrinth of different colleges that exist makes it very, very challenging to hold transparent and accountable standards up for all those that are governed by those in those health professions.

The second piece which is, I think, critical — and which, I would hope, again, that members of the opposition could come and support — is the notion of having an oversight body. The creation of an oversight body is critical because there have been cases — sometimes rare but important cases — where oversight was not made available when this would very much have helped patient outcome disciplinary actions within the profession.

When we’re talking about tens and tens of thousands of workers, of course there are going to be challenges within any field. Health care, being as complicated as it is sometimes, having an oversight body that will promote that accountability, transparency and consistency across all of the different colleges we talk about is incredibly important.

I don’t know if other representatives in this place have had constituents in their office with significant complaints about their treatment or their care. We saw, in a recent report about systemic racism within the health care system, that these complaints, for too many years, fell on deaf ears and, for too many years, were ignored, that people were told they were being irrational.

I represent in Stikine, in northwestern British Columbia, many, many communities. The report that we commissioned particularly needed to focus in on and empha­size the systemic racism, particularly towards Indigenous people, within the health care system itself.

I’m looking at my friend across the way from Skeena. We know of cases, he and I both, of interactions between Indigenous people in the north — not just in his riding but certainly in mine, in Prince George and other places — where the treatment, from one patient to another, was too often determined by the indigeneity of that person. These are hard things to talk about as we hold up and lift up our health care workers.

Knowing that there are problems within the system requires the courage of all of us, collectively — and particularly us as government and, in this case, the Health Minister — to deal with those. One of the ways that you deal with them is the very act that we are talking about here today. An oversight body with greater accountability, greater transparency and consistency across those regulatory regimes is certainly something that was called for in the commission’s report. It has been called for by health care advocates, Indigenous advocates, the First Nations Leadership Council and many Indigenous leaders across B.C., and I’m glad to see it here.

[4:25 p.m.]

Is it a silver bullet? Of course not. In rooting out these types of issues that have been generations in the making, one continues to light a candle rather than curse the darkness. Improving the transparency around complaints, I think, is essential. I think this helps out health care providers themselves. It certainly helps out the broader public, because having an adjudication system will allow us to have clear disciplinary processes and separate out the very key stages that we are facing.

Lastly and importantly, this commitment to cultural safety and humility. This is not a word you see described in legislation and in briefing notes for the opposition and in public disclosure, talking about the requirement of cultural safety and humility within our large systems. I think this doesn’t stop, of course. In this case, we’re talking about the very broad field of health care, but this of course extends to our education system, to our policing system, to the various systems in which communities come up in some interaction or another, and they have not had components of cultural safety woven into them.

I know a number of folks that work within our policing system, within the RCMP in particular. We’ve seen some changes over time, some progress made by the leadership and some members who understand the importance of understanding the various cultural communities in which they are policing.

If I could take a small parenthetical note, it was of some disappointment in watching the attempt yesterday by the Heiltsuk Nation in Bella Bella. Of course, two of their members, who received incredibly difficult treatment in Vancouver by the VPD, by two members of that police force, then went and offered up a healing ceremony for both parties to come together, and those two officers chose not to attend.

On this bill, and talking about cultural safety within the health care system…. The reason I raised the policing incident is because it has some transference over to our larger systems that serve the public, be it in education, be it in health, be it in policing, be it in government more broadly. We know our capacity for oversight has been constrained in the past by the very structure which we have inherited and has not had a proper review in some time.

There is a massive amount of investment our government is making in the health care system, broadly, since we took office. We know that we have been increasing the number of nurses, for example, by over 2,200 into the system, more than 30,000 workers across the health care system more broadly. We know we have made it easier, with more work to do, with respect to foreign credential recognition. Too many of us here and the people we represent have the stories of health care professionals, doctors, nurses, people who are clearly capable and could be qualified to work in long-term care, and we have this massive shortage.

Now, this is a personal perspective of mine. Perhaps it’s a bit dated, but in some of my previous interactions with some of these colleges, one in advocating for the particular credentialization of someone who has come to Canada in our immigration system, which awarded them points — it’s a point system — for having attained medical degrees, having professional capacity within the health care field….

Our federal government says: “You would make a great Canadian citizen.” So they achieve points, which allows them into the country, and then, arriving here, find out that there are barriers that were not talked about when they were going through the immigration process, which has sometimes been the colleges themselves, where they have not been transparent, sufficiently, I would argue, have not been accountable enough, I would argue, to the people who are applying to come in and provide that health care service to us and have been sometimes referred to as more protectionist than they ought to be, need to be.

I think the transparency we’re calling on…. We need the expertise of our doctors, our nurses, the people sitting within those colleges to be able to verify, to keep everyone safe, that the talents and the skills and the training that somebody has when coming into Canada, coming into British Columbia, will meet our standards, and if not, how they can achieve those standards now that they are in country.

It has been an incredible source of frustration. On the one hand, we have all these demands and needs within our health care system. We know we need more workers. We have an available talent pool that have actually immigrated now and are in country, are in province, and there’s a barrier that remains.

Some of the rulings that I’ve seen — maybe, again, I might be dating myself — from some of the colleges, sending somebody who is a qualified surgeon in their home country, asking them to go back to first-year medical school in order to qualify to be a general practitioner in B.C.…. It’s crazy. It’s not right. In the meantime, how does a new immigrant to Canada afford going back to college, back to medical school, first year, while they’re just trying to simply make ends meet, particularly with the cost of living?

[4:30 p.m.]

We’ll continue to repair, I would argue, some of the damage done under previous governments and administrations. We saw the taking out of HEU workers, Hospital Employees Union workers, of the ability to have a pension, to have worker protection. They were essentially privatized.

It’s unfortunate, but it seemed there was some connection between the willingness of the government of the day to go after these workers and who they happened to be: predominantly women, and predominantly women of underrepresented groups, minority groups, within our province. The attack was mean, the attack was ultimately unhelpful, and the attack very much weakened our health care system.

We saw the number of nurses that were let go. The number of nurses lessened, under the current opposition leader’s watch, while he was Health Minister. It was significant. More than 1,400 fewer nurses were available to us.

We know that the work we’re doing here in this legislation is to improve accountability, to improve the way that the colleges work, the certification, the accountability that those colleges must be held to and the transparency of what they’re doing. It’s so that those applying to move through and become accredited health care professionals can fully understand what they need to do more of, that there’s something verifiable, that there’s an appeal process and that people can come through the system more efficiently and ultimately do what they’re trained to do: help serve our communities, help keep us safe, attend us when we’re sick, look after our families.

I’ve heard noises of support coming from the opposition. I can’t classify it as full. It seems to be wavering, or there’s some element of mistrust. Maybe it’s the scale and scope of the bill that the Minister of Health has put together, but this is a big thing to tackle. Those big things tend to take a few pages of legislation, because the details matter.

In this case, in terms of the consultations with our health care professionals, with patient advocacy groups and with the broader community through the health care committee and through others, I think it’s sufficient to give opposition some strength and confidence that what we’re doing is right, correct and, if any criticism, perhaps overdue.

A system like this is so important as to how we come together, how we qualify and certify people, how we cre­dential them and make sure that they’re there for us when we need them. We have to be there for those that are applying to become those health care professionals all across the fields that I mentioned earlier.

I’m very proud of this legislation. It has been one of those things that in a former life, serving at the federal level, we saw this again and again: how do we reform the colleges? How do we make things more transparent, more accountable, more efficient?

I was always told that this was just too big a mountain to tackle, that it was too institutionalized, that it was too old, that it was too ancient. There was something to it that could not be touched, some kind of sacred cow within our health care system. I never really believed that, but that was the mantra of the day, certainly from the government of the time.

I am very glad we’re taking this on. I’m very keen to hear from other members, from opposition members and again, of course, from the Health Minister, who’s very esteemed and very well regarded, as he should be, despite the opposition’s attempts to paint a picture otherwise. I know he doesn’t take it personally. He ought not to, because he’s done an excellent job for us through the ongoing efforts through two public emergencies — which has been a strain, certainly, on his team and on the public health officer, whose confidence we maintain.

Throughout the pandemic, in particular, B.C.’s health care system has, in comparison to others, held itself in incredible regard. Our health outcomes, in terms of people who have passed from COVID, were remarkably good. Too many died, but fewer than otherwise would have if we had different administration, if we had, perhaps, a different officer of public health — who, I think, guided us very ably. Our schools were closed at a minimum. Our economy rebounded in the most significant way of any province across the country. A great deal of debt is owed to those in the health care system.

I think this ultimately supports those workers, those many workers that support us. I think this legislation should have its due reading and pass so that we can get on with the work.

E. Sturko: Well, I am certainly glad to have an opportunity to stand here and speak to Bill 36 before the House.

[4:35 p.m.]

I will let my esteemed friend from across the aisle know that I’m not speaking today because I want to, in any way, draw out the passing of this bill. But I think that when we’re dealing with something that is as onerous, with 645 sections, and that deals with something in our province right now, health care, in which we’re in an absolute crisis — no one can deny that — I think it’s important that we take the time to make sure that we are doing everything we can so that we’re not exacerbating any of the problems that we have.

While this bill is dealing with things that are, for the most part, of an administrative nature — we know how tied to administrative things, particularly when it comes to accreditation, when it comes to making sure that we’re upholding the high standards of our health care system — that we’re doing everything we can to go through this bill as thoroughly as possible. With 645 sections, it’s quite a feat to come together on such an incredible bill.

I do thank the Minister of Health. I thank the members of the official opposition who worked so tirelessly on this piece of legislation. I’m sure that we will be able to come to many things that will bring us through this legislation successfully, to make sure that we’re serving everyone in British Columbia the best way that we can. We’re in the middle of this deadly health care crisis, as I said, and things do need to change. The legislation before us — it’s not really seeking to address some of the most critical parts of our health care crisis. This has been in the work for quite some time, and it deals with the regulation of health professionals.

Like I said, we don’t want to go through a process, particularly with 645 sections, and lead to something that is ultimately going to affect our system as a whole in any negative way. I am the member who has been on the campaign trail most recently, and I can tell you that I’ve heard, very clearly from the residents in my riding, just how important and how concerned they are with this health care crisis.

On almost every doorstep, we heard from people talking about their concerns — multiple people, I would say, on an almost daily basis, with problems getting access to primary health care. Of course, we were hitting the doors of health care workers themselves — people who are in nursing, people who are working in diagnostic imaging, people who are nurses and doctors who are administering cancer treatments in our province. All of them are concerned with the lack of boots on the ground — people to help them in the very important work that they’re doing.

This is where I can see there are a lot of good things that are happening here with Bill 36. We want to make sure, as we’re going forward with this legislation, that we’re doing things that can, hopefully, streamline some of these administrative processes and make it more effective and easier for us — as the minister across the way had mentioned — to get doctors who are foreign-trained into our work faster.

Of course, Bill 36 deals with all these governances and regulations, and that’s why it is important for us to be going through this in such an onerous way, because, as I said, health care is one of the most critical things that we’re facing in our province right now.

One of the things that came up a lot as well was about doctors retiring. We are seeing, more and more, across this province right now that people’s family doctors are retiring. I have a long list of meetings in my own constituency office this Friday, and it is just simply packed with people who have concerns about health care. Some of the concerns are about complaints and complaint processes, and from people looking for a way to have more accountability within our health care system.

Of course, it is important that we look at Bill 36 and see the ways in which we can better address concerns of professionals within our health care system, and then looking at ways that we can also address the concerns of the public that the health care system is seeking to serve. A lot of people not only have fears that they’re not going to be accessing health care from a family doctor, cancer providers and nurses, but they’re also worried about long-term-care counselling.

I know that there are a lot of professional organizations, of course, that are happy to see Bill 36 and to see this legislation coming into effect. I know that the associations of clinical therapists are happy to see this. Social workers are very happy to see this. We are looking very thoroughly at this legislation on their behalf as well, to make sure that it is going to meet the needs going forward.

With the great deal of problems that we have right now with a lack of services — particularly shortages of nurses and doctors, which everyone has been saying — this is a shortage that we’re seeing across the country. We know that we’re going to be bringing in a lot of new people. We’re going to be bringing people in from different jurisdictions.

[4:40 p.m.]

That’s why Bill 36 is all so important. We do have new accountabilities, we’re streamlining those processes, and we can make sure that as our health care system is expanding and is growing to meet the needs of British Columbians, we’re upholding those important and high standards — and also that we’re maintaining accountability and that our public transparency is bolstered.

I think that’s one of the things that people in British Columbia, certainly people in my constituency, have come forward and said. They do feel that there is a lack of transparency and accountability. So I’m hoping that as we go through Bill 36, we have some ability to go through that and answer some questions that the public has in terms of how the public transparency and accountability will be bolstered. We want to make sure that those professional standards remain high, and I know that that’s important to both sides of this House.

Many of these care providers are welcoming the new regulations. We will continue to also look into that, to make sure that everyone has a chance to have their voice heard as we move forward. This is a very critical time. We have one million British Columbians wait-listed to see specialists. Of course, these types of specialists are the ones that are regulated by the colleges and other bodies here within British Columbia and will be impacted, of course, by this bill.

Walk-in clinics are at the worst wait times in our country. In fact, I just had someone come into my constituency office last week — it’s actually quite a sad story — a person who believes that they may, in fact, have cancer. They don’t have a family doctor; their family doctor had retired. So they went around, drove all around the city, to try to find a family doctor.

Time after time there are no doctors taking patients. In fact, they wouldn’t even be able to get on the wait-list. So this gentleman ended up having to wait for nine hours in the emergency room, ended up getting some referrals to have some blood work done. But it’s extremely hard, and people are looking for that accountability.

I do hope that this is the kind of thing that can be addressed within this legislation. There’s a lot for us to go through. But I’m sure…. It has been very detailed. Again, I really commend the work done on both sides of this House.

This past weekend in my own riding, I actually was notified by one of my constituents that she had experienced a traumatic and distressing incident after her friend — who’s only 56 years old, by the way — had collapsed. She was having an apparent stroke in the Shoppers Drug Mart in Grandview Heights in my riding. She then also began to have a seizure. They immediately called 911 and reported the urgent situation, but it actually took over an hour for the ambulance to come and take this poor woman to the ICU.

I know that this is a very important piece of legislation, especially where we’re talking about accountability, where we’re talking about making sure that we’re holding up the high standards of our health care system. There’s part of me, though…. I feel a little bit like…. Of all the things that we could be tackling right now, this huge piece of legislation…. I know it’s important, but I do feel some responsibility that I do need to note that for people in my constituency, there are many pressing issues that I hope we’ll be looking at very quickly here, to make sure that this type of thing can be resolved and doesn’t happen again.

In addition to that, this weekend, too, we also had hundreds of people gathered on the front lawn of the Legislature here. They were demanding change, but they also were here for a chance to speak to a family doctor. Family doctors had provided some health care here in a field tent. So it was medicine like what you would see in a war zone. This is not what we want to see. I think, on either side of the House, here, we don’t want to see this kind of thing happening. But again, here we are, dealing with a large piece of largely administrative legislation, and we have things like that going on here in the province.

This is what the rally organizer, Camille Currie, said on the weekend: “We’re frustrated, and we continue to see that this crisis goes on unabated by this government, and we need change now.” I think a lot of us in our constituency offices are hearing things like this. This one is quite spectacular. Here we have a field medicine tent set up on the very lawn of our Legislature. I think, again, it really points to the urgency of our health care crisis and why it is important for us to maintain those high standards and regulations.

[4:45 p.m.]

The recommendations made by the committee include cultural safety, humility, improving governance of regulatory college boards and establishing independent discipline processes while revising the complaints process. All this, of course, is with a goal of making it more transparent and focused on patient safety. The bill, as written, includes many of these changes, of course. We agree with those. It’s important to…. The main intent is that we want to protect the public and streamline the way that we currently regulate these health professions. These are both goals that we’re supportive of.

But the legislation doesn’t seek to solve the health care crisis as it stands. In fact, it’s been in the works for quite some time, and it only deals with the regulation of health professionals. But again, that doesn’t necessarily mean that it won’t have an impact on the system as a whole. I already alluded that we are in support of many of the goals, but it’s complex, and it does need serious scrutiny before we can be fully supportive.

One of the things that my mind turns to is that financial statements show that despite a crippling staff shortage, the amount of funding going towards corporate administrative expenses under the NDP has increased by $1.3 billion across health care authorities. Taxpayers will likely be dismayed to see that increase. This is for corporate bureaucracy, okay, and not for front-line workers. That includes having 64 vice-presidents making an average of $400,000 a year.

I’m bringing this back to this bill, because here we are again, and we’re dealing with a very administrative bill. We’re tackling another administrative process. I’ve heard from people in my riding that they are very concerned with the amount of administrative burden and administrative processes that we currently are dealing with, particularly in health care.

When I was on my campaign to make it to this wonderful Legislature, I talked to a lot of health care providers. They are very concerned with a top-heavy health care system. They’re very, very concerned with the amount of management compared to the ratio of actual boots on the ground. I’m hoping that in dealing with this administrative bill, we’re not actually delaying an opportunity for us to do even more to support getting those boots on the ground.

Not only is paying more and having more administrative burden a massive waste of tax dollars, but right now, too, taxpayers might be dismayed to find out that we’ve had an unconscionable increase to the use of private nursing agencies. Their use has skyrocketed about 600 percent, and that’s a massive waste of taxpayer dollars. It’s paying, at times, 2.5 times the public rate for these temporary contracts.

I bring this back to the bill, because it’s also destroying morale for nurses. This is a bill that’s meant to help get rid of toxic work environments. It’s meant to support front-line staff by getting rid of the animosities and a lot of the stressors that we know have just been exacerbated during COVID.

I want to be clear, too. Let me just take a moment to be clear that as a front-line police officer for many years, I have worked very closely with people in health care, bringing people who were in crisis to our emergency rooms and dealing with people who were seriously injured and wounded. I have a very deep respect — well, the utmost respect — for people who take on the roles of working in our health care system. The things that they go through on a daily basis…. It’s hard to imagine the amount of stress and just absolute commitment that they’ve had to make to get us through this pandemic.

But again, our platitudes, our words, banging pots…. It’s just not going to be enough. We truly do need to address these workplace cultures and to make sure that our health care workers, particularly in the most stressful units and areas, have the support that they need.

That includes being respectful of their professions, making sure that we aren’t allowing for ever more temporary contract nurses to be coming into the workplace. In addition to this bill, which helps make sure that we secure high standards for the health profession, their occupations and within their colleges, making sure that we provide oversight and making sure that we’re able to bring in more people in a more efficient way….

I would also say that allowing for someone to quit their job to come back as a contractor and then work side-​by-side with someone where they’re now making double their rate certainly would have an impact on a toxic work environment.

[4:50 p.m.]

Nurses tell us, and I’m going to quote here: “Morale is terrible. Staffing is awful. We feel unsupported and unappreciated. We feel abandoned. Never in my life have I felt as worthless and expendable as I do now.”

You see why I am concerned with ensuring that we have a thorough review of these administrative changes. It is important that we do support having a healthy work environment. We don’t want to have toxic work environments. We do want cultural safety for people so that we can have inclusive workplaces.

I think one of the things that…. Myself, as a member of the LGBT community, having different forms of legislation come in that could protect me in the workplace has been incredibly important to getting me to where I am today. I’m extremely grateful for those legislative changes. I think, looking in Bill 36, that’s why it’s important for us also to support things like cultural safety, to make sure that people can be attracted to the health care system.

We need workers from all over the world. Whether you are born in Canada or born abroad, we need people to feel that Canada can be your home, a place where you will be respected, regardless of who you are, and valued for the work that you’re doing and for what you bring to our country. The different types of things that people bring from other countries — their initiatives, their cultures, their languages and of course their family and friends — are very valuable to our country. This is a great thing that we’re doing by helping support cultural safety. Of course, it’s not only for our workers in the health care system; it’s also for our patients.

I’m very happy to see the review that was done to make sure that we’re addressing systemic racism within health care, particularly with respect to Indigenous people who are in this land. Many of us have heard just horrific stories of the injustice that’s being done. We’re not talking about decades back. We’re talking about people who have come into contact with our health care system recently.

So I’m very proud that people on both sides of this House have worked together collaboratively to make sure that we are taking care and working in the spirit of reconciliation to make sure that everyone has the opportunity to feel like health care is something that they can access, that they feel like it’s something that they can provide and that we can move forward to continue to give proper health care to anyone who needs it in our province.

I mentioned earlier that I have been meeting with peo­ple in my constituency office, who have been coming into contact with the health care system. Unfortunately, the majority of those people have had issues. They’ve had trouble accessing primary health care. I mentioned an individual who was having trouble receiving a diagnosis for suspected cancer, but that’s not all there is to the story. In fact, as he was telling me his story, he also said that he was trying to come over to the Island as much as possible. He lives in my riding, but in fact his daughter and son-in-law live in the Premier’s riding, in Sooke.

I asked him what he was doing there, and he told me that he goes there, and he chops wood. He’s been cutting many cords of wood despite the fact that he’s very sick. When I asked him why that was, he told me it was because his son-in-law, who works in the trades, has been waiting 1½ years for a hip replacement. He’s not working. They’re running out of money. They’re having a hard time heating their home. At this point, with winter coming, they think that the only way that they’re going to be able to heat their home is by cutting wood.

Here we have a guy who’s struggling himself with health care issues. He’s coming over to Sooke to cut wood for his son-in-law because he’s waiting. He can’t provide for his family, can’t work in the trades right now, because he’s been waiting so long for his hip replacement.

It’s hard to imagine that these stories can happen in this province. We’re a province that has so much, yet here we are. When you don’t have your health, what do you have?

I hope that this legislation…. I think it’s important that we maintain the standards, that we maintain people’s ability to work through a complaints process, that we streamline these things. I hope that in streamlining that, like I said earlier, we’re able to do more to quickly recruit people. By bolstering our protection for cultural practices, by having cultural safety in our health care system, then it is attractive to people from everywhere.

[4:55 p.m.]

We want people to be able to come, because cases like this individual from my riding, with ties to the Premier’s riding…. We simply can’t go on like this any longer.

This legislation, as I said, that we are speaking to, before us today, does not solve the health care crisis. The fact that it has been in the works for so long, the fact that it is…. It’s administrative, but we really have a lot of things that are happening on the ground today that we need urgent help with. At least my constituents have come to me, time and again, to say that they want us to act urgently. I do hope that a lot of the 645 sections that we have to go through…. I hope that some of these will be streamlining some of these processes.

I did hear my colleague talk about the accreditation process for people who are foreign-trained physicians. While I was campaigning in South Surrey, I met many, many peo­ple. A lot of their children are actually training as physicians, which delighted me, because of course we need as many docs here in British Columbia as we can get. But then I was a little bit disheartened to find out….

Many of these Canadian-born physicians now have left the province. Most of them have left the country, because it was easier for them to get a placement in the United States, places like Australia, Ireland and other foreign medical schools. Now, even though they want to come back to Canada, there aren’t as many paid internships, and it’s harder for them to go through the process. Hopefully, through Bill 36, we will be able to make sure that we can streamline those processes.

Of course, I think people often conflate…. When we talk about foreign-trained physicians, they may not necessarily be equating that with someone who’s actually Canadian, but they chose to leave our province because they could not get a placement in a medical school here in our province — and that’s unfortunate.

We will need a lot of workers to help with our crisis. We do need to have a swift accreditation, and holding those professional standards to account will be ex­tremely important.

Over my time as a police officer, I also saw many people who did not act in good faith. There are fraudsters among us. I think, on the news this year, there were a couple of different cases that actually gained quite a following in the media, of individuals who’d posed as nurses. I think there was an individual who posed as a social worker and took advantage of a child in the Interior — again, another example highlighting just how important legislation like this truly is, to make sure that we’re protecting our most vulnerable.

That is why we also have the support of other associations, like the associations for counselling therapists in B.C. They strongly welcome this legislation, because they are looking to have that guidance over who can be designated as a counselling therapist.

[J. Tegart in the chair.]

When it comes to things where people are so vulnerable, like our mental health care, when we’re dealing, particularly right now, with the opioid crisis…. We’re dealing right now with a lot of untreated mental health and, of course, just getting through this pandemic. I think you don’t have to go even further than Reddit to see how many people are under extreme stress.

We’re seeing volatility at times, conflict in neighbourhoods between neighbours, because people are stressed out. That’s why it’s important for us to have things like proper accreditation to make sure that, when someone finally does reach out for help, they’re going to be able to see a trained professional and that, for anyone who hasn’t received the proper accreditation, there are actual consequences and that those systems for ensuring consequences or dealing with complaints are done in a streamlined effort, with more transparency, which can protect the public.

Transparency has been very, very important. I think many people have spoken out in the past about concerns with transparency in health care.

I think that while we have to be mindful, always, of things like the privacy act, we also have to ensure peo­ple have enough information about what’s happening in our health care systems so that they can be fully informed, so that they can come, for example, to their MLA’s office. They can bring forward the issues that mean the most to them, to make sure that we’re properly serving our communities.

[5:00 p.m.]

That’s why having transparency and accountability is very important. Without the feedback from our communities, it would just be too onerous, too hard. People, of course, would be having to constantly go through access-to-information and FOI-type requests, which just adds more bureaucracy in what I have heard from many of my constituents is already a very administrative and bureaucratic process.

As we go through the bill…. Of course, this isn’t going to be able to solve all the problems that we’ve been facing, particularly with boots on the ground. It’s unfortunate that this government hasn’t brought in some legislation that’s dealing with that because that is what I would like to see. I would like to see more legislation brought in that would help us to fill some of these empty seats and training facilities and to make sure that we have more front-line care workers.

I’ve actually never knocked on a door in a neighbourhood and heard anyone in my riding say that they wanted us to add more administrative processes or streamline an administrative process. They actually said…. They think they have cancer, and they can’t get an MRI. They’re very worried. They’re concerned. Since their parent’s long-term-care facility is closing down, their parent has no­where to go.

There are a lot of things this bill doesn’t cover, although this will allow the government to be more nimble in situations where flexibility is needed. Of course, it also raises some questions. A lot of the things will be made up in regulations, of course, and that’s okay. Some of the regulation-making powers make sense, but it means that there’s a lot that we don’t know about the bill as well. I hope that, through this process, we will be able to learn.

We can never forget that we’re in the middle of a crisis. I hope, as we go through each of these 645 sections, that we view each of these sections through that lens and never forget that, for every complaint we receive or every question period we go through or every phone call someone makes, these are people.

We talk a lot about the systems and the processes and the administration of our health care. It’s a system. We call it a system.

In reality, this is about caring for people. At the end of the day, whether we’re talking about Indigenous people, who have the right and who deserve to be treated with dignity and respect in our health care system, whether we’re talking about people who are worried that they have cancers and now may be facing just unimaginable stress and strain because of delays or whether we’re talking about people just trying to simply access primary health care, these are all people. I think that should always be the lens through which we are looking at this important legislation.

Again, I just want to thank everyone who worked on this piece of legislation. I know it wasn’t easy. There is a lot of stress to get through health care legislation as quickly as possible because so much is counting on it. As we do, we always have to look at it through the lens of this incredible health care crisis that we’re currently facing.

M. Morris: My colleague that just spoke was speaking about Bill 36 and the number, 645, of sections in this bill. It’s enormous. My hat is off to the people that put this together. There’s a lot of writing involved and a lot of legal research in putting this together.

It won’t be the panacea. It’s an accumulation of recommendations made by a bunch of expert people — there’s no question about that — and input from organizations like the Health Professions Review Board, which I was a member of a number of years ago before I got into politics, and other organizations that are providing such a great service to British Columbians right across the province here in exercising health care services.

[5:05 p.m.]

There has been a significant increase in violence against health care workers who are covered under Bill 36 — nurses, doctors, lab techs. It doesn’t matter. There doesn’t seem to be any discrimination between the health sector providers and the amount of violence that they face every day in this province.

Violence has been around…. I remember, as a constable working in the smaller communities…. Oftentimes I was called to go to the hospital or the local health clinic to assist a doctor or a nurse in subduing a very aggressive patient. Oftentimes they were high on alcohol or drugs at the time but suffering from fairly significant injuries.

It’s a part of policing duties throughout British Columbia. In hospitals that had psych wards, we often found ourselves assisting the hospital in trying to control patients who had lost control. We see this…. This has manifested itself in the way our health care system provides the services today.

It is my understanding that many of our hospitals, in every health authority across the province, have beds that are occupied by patients suffering from some kind of psychosis. This has placed an enormous stress upon a lot of the nurses providing primary care in those hospitals. They’re not psych nurses. They’re ill-equipped to provide that level of service.

Every hospital has them. I understand that in some hospitals, we have psychiatric patients that have been in there for three to a dozen years in that same hospital. That leads me to believe…. There needs to be another solution available to government and to this province to address those issues.

We have difficulty attracting health care professionals in this province. A lot of it goes to what I just referred to as the number of psychiatric patients in our primary care facilities and the lack of health care workers. We can’t attract them in some of our hospitals. In just about every hospital in every health authority that we have across the province here, they’re under-resourced and understaffed. They’re susceptible to burnout. A lot of them are working a lot of overtime. A lot of them have suffered from the effects of COVID.

There are impacts on the health professions right across this province that the act doesn’t address. It won’t go into those kinds of details. It talks more on the regulatory side and the discipline side. I will get into some of those areas here shortly. It doesn’t provide the atmosphere to attract and retain the level of health care workers that is required in this province, the numbers that are required in this province.

I look at hospitals like the Mackenzie Hospital in my riding. I know there have been hospitals that are on diversion and whatnot right across the province here. Mackenzie is situated…. It’s roughly a two-hour drive north of Prince George. A population of about 3,500 people in this community. It’s an industrial community: forestry, mining. The Mount Milligan mine is not too far away. There’s manufacturing within that community. The susceptibility to trauma related to the industrial accidents that we have in the area is there. It’s a real factor to deal with.

In 2022 alone, and we haven’t finished with 2022 yet, there have been 22 closures. Out of that, we’ve lost 268 hours of hospital time because of the hospital being shut down. Mostly, it’s got to do with the lack of the nursing staff. The policy requires that they have so many nurses on duty at any particular time, and they just haven’t been there.

For a small community that’s a two-hour drive north of Prince George, that is off the beaten track…. Highway 97 north, the John Hart Highway, just bypasses it by about 40 clicks or so. It’s out of the way. A lot of people don’t go there. A lot of people don’t even know that it exists. Those that have gone there realize that the Mackenzie area has a lot to offer, from recreation and hiking and those kinds of facilities there. A lot of the health care workers and other professionals in the area have taken advantage of that, but it’s still difficult to attract them.

[5:10 p.m.]

Mackenzie is oftentimes without an ambulance, because they don’t have any ambulance attendants available there. The nearest one would be about 40 kilometres away at a part-time station at Bear Lake. Oftentimes that’s not staffed as well.

A couple of incidents. Not too long ago, a few months ago, we had a gentleman in a logging camp that had a heart attack. The hospital was notified. He was rushed into the hospital by the paramedics that were at the logging camp, brought to the hospital, right to the emergency room door, pounding on the door to get access to the hospital. Nobody would let them in because they didn’t have enough nursing staff in there.

They were told to call 911 and get the ambulance. They called 911, and the ambulance was not available because it had already taken somebody into Prince George, and it would be hours before the ambulance would be available. Yet that individual was still suffering from a major heart attack, and he ended up having to be transported from Mackenzie to Prince George and then down to a cardiac facility — because Northern Health doesn’t have any cardiac facilities — to be treated down south.

This act, Bill 36, regulates and stipulates how the processes need to be undertaken in order to licence the doctors and health care professionals that we have in the province, but it does nothing to address the shortages that we have.

The trauma — I just alluded to it earlier — that requires these health care professionals to provide immediate help to a lot of these patients who have suffered some sort of traumatic injury as a result of industry, a car accident or whatever the case might be. The availability for patients in the Lower Mainland is subject to a lot of the ambulance issues that they have down here as well. They’re down in the Lower Mainland.

Traditionally, in the rural parts of British Columbia, the industrial parts of British Columbia, there is no air ambulance service available. There’s no helicopter service available. The nearest ambulance could be hours away. Paramedics and first aiders will provide that response.

Often in cases, this has led to increased morbidity amongst patients and a lifetime of support by our medical professionals to support them as a result of the trauma injury that wasn’t treated as soon as possible in some of these areas. So we need to have a real look at what we can do to increase that.

The other issue that’s impacting our health care professions right across the province is the opiate crisis. It gets worse by the day. The number of deaths we see tragically increasing in every community that we have across the province. But the impact I’m referring to here is more related to the overdoses that we have where the patients don’t die but end up having serious organ damage or acquired brain injury as a result of repetitive overdoses that deplete the oxygen in the brain. That does a number of things for the patients here.

I don’t have the stats available to me right now, but I did review them a while ago. There are thousands. There are literally thousands of overdoses every year in British Columbia where the individual doesn’t pass away but he or she will suffer indefinitely, probably for the rest of their life, with organ damage, including acquired brain injury. This places a lot of stress on an already overburdened health care system.

In addition to the overdoses from fentanyl, carfentanil and those types of opiate overdoses, we also have the scourge of drugs, crystal meth.

[5:15 p.m.]

The brain injuries and the psychosis that are caused by continual use of crystal meth place all kinds of pressure on our health care professions, in hospital, outside of hospital, on our paramedics, on our first-responding police forces, on our fire departments, on a number of different people here. That number is immense, and it’s something that isn’t addressed with this particular statute. There are thousands of overdoses every year.

The other thing that Bill 36 doesn’t address — and hopefully someday we’ll see something that addresses this — is the treatment facilities for those suffering from mental illness or some sort of psychosis. To leave them on the streets, to leave them unattended, unavailable for these health professionals to try and help them…. To leave them on the streets is unfathomable. It’s something that is inhumane.

Why hasn’t more attention been placed in building compassionate facilities that can house these vulnerable individuals that are currently languishing on the streets in the cold and the rain and the weather without a health care professional available to look after them? We could have had all kinds of facilities built across the province for that.

In addition to that, the pressure that we will have on our training systems for health care professionals to train the level of psych nurses that we need to treat mental health issues in the province, the psychiatrists that we need to train and all the other health care professionals that will be required to provide that wraparound level of care for the vulnerable people in our society is going to be enormous. Whether this bill, Bill 36, provides the ability to be nimble in ensuring that we have the health care providers who want to move to B.C. to come here from other jurisdictions around the world…. We’ll wait and see whether we have that capacity or not.

Adequate treatment centres for addictions as well. We will have to train health care professionals to treat the folks suffering from addictions and provide the long-term recovery opportunities for people, so facilities with no arbitrary time limit of 90 days but a recovery centre that will provide that level of service to not only help the individual get over their addictions but also reintroduce them into society and the workforce and provide housing and all the other necessary things that they need in order to survive.

The bill before us here, Bill 36, is complex. It’s significant, with the 645 sections there, but it has done a couple of good things — well, probably a few good things. I’ll have to give government credit for some of the good things in the act here.

I was a member of the Health Professions Review Board. I am one of the founding members, back in 2009, when it started. I sat on the board up until I let my name stand for election and ended up in this House in 2013. We had, as a board…. I chaired a number of files and adjudicated on a number of files.

There were, I think, 24 colleges at the time, when I was sitting on the board. We had the physicians and surgeons, which is the largest, and the B.C. nurses college, which was another large college. They had the ability to investigate the complaints in a timely manner. They had in-house legal counsel, and they had the ability to get that legal advice that they needed, moving forward.

[5:20 p.m.]

But many of the other colleges didn’t have that. They weren’t big enough to have the infrastructure in place and the resources in place to investigate in a timely fashion. They didn’t have the ability to have that legal advice that they needed from time to time, because a lot of these issues that come across the desk are complex. As a result of that, in holding a hearing, I found it difficult to chair a lot of those hearings and to try and reach out as best I could to the complainant and to the college that was involved to try and shepherd them through the process. Oftentimes it was difficult.

It was quite the opposite when you had the larger colleges that had counsel sitting at the table. Then an unrep­resented complainant trying to go through the system as best they can was quite difficult. So I applaud the government in amalgamating a number of the colleges and reducing the numbers.

The only thing I’m concerned about, and maybe a cautionary note with that, is we’re now going to reduce the number of colleges to six. Will they still have the ability to ensure that some of these underrepresented professions receive the help from these larger organizations and receive the legal advice from these larger colleges? Is it going to have a financial impact on some of these other health professions in coming into a college? Is there a cost involved for this amalgamation? I think we’re going to have to keep an eye on that to a great extent.

I’ve heard a couple of comments this afternoon from different speakers talking about the oversight and the lack of oversight and how this bill brings the oversight in with respect to discipline, which is an issue by itself. But there is a lot of oversight already existing for health professionals right across the province here. And one of those oversight mechanisms is a college.

The other oversight mechanism is the Health Professions Review Board. There is a Patient Care Quality Re­view Board as well. There’s the alternate dispute resolution mechanism that we can bring into play through either one of those different oversight agencies.

That was one thing, when I was on the Health Professions Review Board…. Although I adjudicated dozens of files, I used to look forward to the opportunity to mediate, to go through the alternate dispute resolution process. They were oftentimes very emotional, where patients would have a certain view of how something happened. The specialists, whether it be a physician, a nurse, a dietitian, a psychiatrist, radiologists — whoever they might have been at the time — would have their professional standards that they had to apply. Oftentimes I found that it was a lack of communication between the patient and the respondent.

But I also found that there was a reluctance oftentimes for colleges to go one-on-one before it was adjudicated because of fear of a doctor or a nurse or a member of the college saying something or admitting to something that might put them in a situation where they could be open for litigation.

Going into those mediation situations, I had that in mind all the time. It was oftentimes more of a listening exercise where I would have one side speak and then I would have the other side speak. I would try to reflect their main points that they were talking about. I always had to make sure that there was a box of Kleenex available because it always, for the most part, ended up in tears on both sides, including myself, oftentimes, hearing the tragic stories that a lot of these individuals had to say and the miscommunication that took place between the health professional and the complainant.

When that aha moment came and everybody realized exactly what it was, it was like a big weight was lifted off their chests, and everybody went on their merry way. It’s just one of those things where most people just want to be heard, and most people just want the opportunity to be heard.

[5:25 p.m.]

That’s what that Health Professions Review Board specialized in. I know that a lot of my colleagues that are still on the board — and there are new ones on the board now — liked the mediation because there are a lot of rewards in finding that resolution at the end of the day. Some things…. Oftentimes I came across files that couldn’t be resolved.

The Health Professions Review Board is the board that holds professionals to account, holds the colleges to account. They review licensing decisions. I’ve sat on many boards where I’ve had to render decisions on licensing decisions and requirements.

There is a change in this bill that talks about the deci­sions that affect the Labour Mobility Act. It was a situation…. Just from reviewing this and remembering some of the conflicts that I would have on the board where there was no…. The college, perhaps, should have made a decision to register that individual who might be already registered in another province in Canada. For some reason, it just didn’t meld or meet the criteria that the college had set for registration.

The Labour Mobility Act states the college must recognize those. If they’re recognized in another jurisdiction…. I’m paraphrasing. I’m probably oversimplifying it.

I see the changes now require or provide the opportunity for the college or the Health Professions Review Board to refer any of the arguments under the Labour Mobility Act to the B.C. Supreme Court for a decision. I think that’s probably a good thing.

I haven’t heard from any of my colleagues in the health professions review field yet as to what their thoughts are on any of these changes in the legislation. I’m sure I will. I’m sure if I’ve said anything that sparks their attention, I’ll probably hear from them sooner. But that ability is there.

The other decisions that are looked at — they comprised most of the adjudication work that I did — are the complaint disposition reviews. The committee examines a complaint, and they will render a decision. Either the member of the college or the complainant aren’t happy with a particular decision, and they ask for a review by our board. We will go over the details.

Most of the time it’s a review on the record. I would have all the information mailed to me back in those days. I think nowadays a lot of it is electronic records that come in on the computer. You’d have the entire record sent to you that the college used in order to make their decision, and you’d provide the complainant and the college to provide any more additional information. There are some strict guidelines, under the Health Professions Act and the Administrative Tribunals Act, that we have to follow.

We would have a look at that and render our decision. Most times it was in support of the college’s decision. Def­erence had to be provided to the college. The basis was on the reasonableness of the college’s decision. There were a number of factors that we would look at. The odd time we would send it back to the college and say: “Can you guys have another look at this? We think you might have missed a little thing over here or something over here.”

I’m glad to see that all those provisions are carried forward into this particular bill, into Bill 36. The Health Professions Review Board does provide a very significant layer of oversight to the health colleges in the province here.

Then the other one is timeliness. We had a few decisions that related to the timeliness of meeting deadlines that were either statutorily imposed or imposed by regulation. Oftentimes the college would dismiss it because of that. We would look at it. We’d have to assess the reasons why the delay took place in the first place. I see that a lot of those provisions are carried over into this. This provided a pretty valuable service.

[5:30 p.m.]

Oftentimes, the Health Professions Review Board, if a college…. And it happened; I was tasked with this once or twice. If a college delayed conducting an investigation — oftentimes it was related to the size of the college and the fact that they didn’t have the resources available to investigate the types of complaints that they had — it would be referred to the Health Professions Review Board, and we could be tasked, at the time, with investigating that particular file on behalf of the college and rendering our decision.

I see that some of those provisions have been removed under this new bill. I’m going to examine it more. I get the opportunity, during the committee stage, to pop the hood open on part 6 of the act, which deals with the Health Professions Review Board. We’ll examine them in a little bit more detail to ensure that the review board isn’t hampered in any way in functioning to the full extent that it should and that its authorities haven’t been reduced to the point where they can’t render the necessary decisions that they need in order for the colleges to function and flourish in the future.

This was a lot of work, this bill. It’s a lot of work for the critic and all those that are responding in the committee stage to go through 645 sections and try and understand exactly what it’s all about, but we will be doing our very best. I hope the minister is prepared for a lengthy process at the committee stage as we go over the 645 sections in the not too distant future. On that, I’ll take my seat.

E. Ross: Hon. Speaker, we’re talking about Bill 36 here, the Health Professions and Occupations Act. It’s quite the lengthy bill; it has 645 sections and about 276 pages. A tremendous amount of work has gone into it, as a lot of MLAs have mentioned here today.

I’ve been sitting here listening to all the debate on both sides of the floor here, talking about what this bill entails and what it proposes to do. I’ve got to mention that some of the comments made by members on that side of the House conveniently forget where they came from in the first place. There are members that sit on that side of the House that sat in opposition in Ottawa, that were doing the job that we’re trying to do right now as opposition here in B.C. It’s our job.

It’s a fundamental part of this governmental system that’s employed here in B.C. to ensure that accountability is enacted when government tries to propose a bill. So the forgetfulness of some of those Members of Parliament that are now in government does not do the members in B.C. any service, especially when you’re talking about democracy, especially when you’re talking about why we were elected here as 87 MLAs in the first place.

We’re supposed to represent our ridings’ interests — period. We’re not supposed to represent our parties here. We’re not supposed to represent speaking points or party lines, especially when we’re talking about something as critically important as health, when it has been acknowledged by every speaker I’ve heard we’re going through one of the worst crises in B.C. health history, whether we’re talking about COVID as a crisis or whether we’re talking about the fentanyl and overdoses as a crisis.

More now than ever, accountability is needed, not secrecy, and we know this government has got an award for the most secret government in Canada already. This process and what we’re doing in questioning this bill before the committee stage is what we’ve been elected to do here on behalf of all British Columbians.

[5:35 p.m.]

Bill 36, the Health Professions and Occupations Act, replaces the Health Professions Act. For all those at home that are not going to read this proposed bill, you probably haven’t read the existing Health Professions Act either. I don’t blame you; it’s not your job. It’s our job as legislators. But the explanatory note of Bill 36 actually captures, quite efficiently, what this bill is proposing. I’ll quote the explanatory note:

“This bill replaces the Health Professions Act. The primary objectives of the bill are to prioritize protection of the public and to facilitate good governance by regulators. The bill expands the regulation of health service providers. While the practice of health professions continues under this bill to be fully regulated through self-regulating bodies, more flexible models of regulation are available under this bill for the practice of health occupations that present a lower risk of harm to the public.

“The bill streamlines the process for designating new health professions and occupations. It also clarifies processes for creating and combining regulatory bodies and transferring the governance of health professions and occupations between regulators.

“The bill establishes the office of the superintendent of health profession and occupation oversight. The superintendent is responsible for preparing performance standards for regulators and guidelines with respect to regulatory best practices. The superintendent will review governance practices, including by responding to complaints and conducting audits, investigations and systemwide reviews.

“Finally, the bill establishes, within the superintendent’s office, an independent discipline tribunal. This enables investigatory and disciplinary processes conducted with respect to licensees to be separated, ensuring that the determination of discipline matters is independent of regulatory colleges and licensees and focused on protecting the public.”

Now, when we go back, when we talk, or more importantly, when our constituents come to our offices…. I’m sure every one of the 87 MLAs has experienced this back in the constituencies. When they come to talk about health care that’s being provided right now in our regions, it’s not about this. That’s what they expect — for us to come back to Victoria and get an answer to what they’re facing, in terms of the crisis that so many members have already talked about and explained today in debating this bill, like the real case scenarios that happen in my riding.

For example, a woman is waiting to get air ambulance out of Terrace. The air ambulance, which is hard to get in rural areas because it’s a schedule that it actually operates, makes it to Terrace. Because there’s no ambulance driver, she can’t make the ten-minute drive from Mills Memorial Hospital to the airport. So the air ambulance goes back to Vancouver empty. Those are the kinds of issues that my constituents want answered. When I go back and when they’re watching, I have to tell them that that is not what we’re talking about here today.

Granted, this bill — 645 sections and 276 pages — represents a lot of hard work and a lot of good intentions from all sides of this House, but it comes from a time that precedes the health care crisis that we’re facing today. It’s good that this is getting fixed and getting updated and that this is going to replace the existing Health Professions Act, but this is not going to excite my constituents.

[5:40 p.m.]

It’s not going to be the topic of conversation when I go home. They will not be asking about section 57(1)(b). They will not be asking that. They will ask me: did I make any headway in terms of getting a family doctor to Terrace or Kitimat?

This bill was actually a collaboration by all three parties in this House. It was based on the recommendations of the steering committee that was co-chaired by the Leader of the Third Party, the Minister of Health and my colleague the MLA for Kelowna–Lake Country. In this case, I’m very grateful for the member for Kelowna–Lake Country, because he represents a lot of history here and knows a lot about the health care system in B.C., if not Canada.

I’ve tried to understand the health system as it exists today, but it’s terribly complicated. It’s complex. Representatives in Terrace and Kitimat — the people I have asked to try to get an understanding of the structure of the health care system, including lines of jurisdictional authority — really can’t answer me, because my simple question, right out of the gates, is: who’s in charge?

I need to know who to direct my questions to in terms of ambulance services or lack of ambulance services or why doctors are leaving Skeena, why nurses are crying and quitting. I need to know. So who is it? Is it the College of Physicians? Is it the hospital directors? Is it the health authorities? Is it the minister? It is terribly complex.

This is not the fault of anybody. This structure has been built over decades, and it does flow, in my mind, from a national health care program. I’ve heard in this House that somehow public health care is sacred in Canada. You can’t touch it. You can’t even talk about private health care. Yet we find out that private nursing is allowed to exist beside public health care nurses in our hospitals. So that kind of clouds the issue of private health care. Not only that — these nurses, the private nurses, are making two to three times more than a public health care nurse. But as I say, that will not be covered in Bill 36.

Bill 36, like all other bills that have been presented in this House, has been presented with a reference to UN­DRIP, the United Nations declaration on the rights of Indigenous peoples. But as we found out with every single piece of legislation that was tabled here in the House…. We now find out that the government not only did not live up to the commitment to consult with the rights and title holders in terms of every single bill that came up in this House; they are not working to align every single law in B.C. with UNDRIP.

So now we’re hearing different stories that are actually contrary to the debate that we had here with UNDRIP in the first place. Now we’re hearing from the legislation that they consulted non–title holders, non–rights and title holders. They consulted with the leadership council. They consulted with the B.C. Assembly of First Nations. They consulted with the summit. These are advocacy groups. They do not represent rights and title.

[5:45 p.m.]

To fully realize that consultation, first, you have got to know the deep meaning of consultation as dictated by case law, and No. 2, you have got to have a meaningful consultation with 203 bands in B.C., who are the true rights and title holders. We’ve gone over this ad nauseam with every single bill here, so I suspect that the consultation with this bill, like every other bill that came through this House, is not going to have that level of consultation.

Even with the definitions in Bill 36…. It says in there that the definition of Indigenous governing body will be in respect to the definition found in the UNDRIP bill. Well, the DRIPA bill says: “‘Indigenous governing body’ means an entity that is authorized to act on behalf of Indigenous peoples that hold rights recognized and affirmed by section 35 of the Constitution Act, 1982.” And that definition does not mention the leadership council. It doesn’t mention the Assembly of First Nations. It doesn’t mention the summit. Rights and title holders are the 203 bands in B.C.

I even had a discussion here with the Solicitor General on a bill a few days ago, where he admitted notification was given. Well, case law speaks to that. You can’t just notify a rights and title holder of your intention to pass legislation. You can’t. So I’m pretty sure that in committee stage, we’ll get some form of answer that explains why this government did not and will not consult, the legal definition of consult, the true rights and title holders of B.C.

The work here, like I say, is incredibly important. Multiple years, in fact, went into this. But it is not going to address the issue of the day. I hope it does, actually. I hope somewhere these clauses address why doctors are leaving Skeena, for example. I mean, somewhere buried in here, I hope that we’re talking about the cost that a doctor has to incur to set up a business or set up a practice in a place like Skeena, because all I hear is that doctors find it incredibly hard to do business in B.C. because of their overhead, because of their bills, because of their taxes.

In all the conversation we hear in this Legislature talking about how to recruit doctors, whether we’re talking about domestically here in B.C. or Canada but also internationally, there’s not much talk about retention. I’m hoping Bill 36 addresses this, because we are talking about health professions and occupations.

In the beginning of October, I was forwarded a letter — 2022. It came from a patient that received a letter from their doctor. It’s relevant because we are talking about health professions and occupations. The letter reads…. This is from a doctor to a patient, and it was my understanding this letter went out to 2,500 people in Terrace and the surrounding region.

The doctor writes to the patient:

“I am writing to inform you that I will be closing my practice on October 31, 2022. Unfortunately, I have not been able to find a new physician to take over my practice, largely due to the state of affairs of primary care in this province that many of you have likely seen in the media. I encourage you to consider advocating to your MLA for change, as I fear that the loss of family doctors will only continue if the system continues to treat family physicians the way it currently does.”

[5:50 p.m.]

But there’s no explanation. This is part of my problem in trying to go to the people in charge and say: “Who’s in charge, and what’s this doctor talking about? Is he talking about disrespect? Is he talking about cost? What’s this doctor talking about?” In the meantime, the doctor suggests to the patient to visit the Pathways Medical Care Directory, contact HealthLinkBC, contact their local division of family practice or use the Northern Health Virtual Clinic — all of which…. The people in Skeena come back to me and tell me that doesn’t work.

At last count, in Skeena and Terrace alone…. Seven doctors left Terrace this past year, and I couldn’t verify that number. For some reason, doctors, whether they’re talking about the crisis that they’re facing right now or the politics of this, don’t want to come out and explain exactly how they’re being treated or why they’re leaving.

It’s quite sad, but I understand where it comes from. My constituency of Skeena was mentioned by a previous speaker from the government side there, in regards to racism, systemic racism, and yes, he’s right. I know what racism is. Without a doubt, I know it. Growing up on reserve, I know what racism is. Fortunately, or unfortunately, I did not experience the worst of it just because of my looks. But I used get it as a kid, being on reserve, because of my looks.

In terms of the reaction to incidents in B.C., I did not react the way a lot of politicians did when there were charges of racism against our health care professionals. I did not react the same way politicians did when the charges of racism were levelled against the RCMP, because back in Haisla Nation Council we were taught not to make major decisions until you had all the facts.

In cases involving Skeena, regarding the health system, in terms of charges of racism, I went in there and tried to get to the bottom of these stories and find out if, indeed, racism did exist in circumstances. I found out that, no, it was a misunderstanding. I couldn’t even get details of the incident because of confidentiality rules. But I could look at the policies. I could look at the processes. I could look at the regulations, and I could ask the questions. “Did you follow this policy?” Yes. “Did you follow this regulation?” Yes. “Then how did this happen? How did this charge of racism come about?” It came out as a misunderstanding.

When the other politicians jumped on the bandwagon of systemic racism, I tried to point out that if it is racism that’s in our system, the entire system includes this Legislature. I’m not racist. In fact, I don’t think I’ve met a racist person in this Legislature. But we’re part of the system, because we lay down the rules for the health profession.

In asking the questions and trying to determine whether or not these racist incidents happened, I came across groups of nurses and doctors that couldn’t disclose incidents or facts related to it because of confidentiality rules, but I did sit there and watch them cry — cry their eyes out, begging for somebody to believe them when they were saying they are not racist.

[5:55 p.m.]

I had nurses crying and saying: “Look, even after my shift, my double shifts, and I’m exhausted and want to go home to my kids, I make the extra effort to drop off prescriptions to patients, and it doesn’t matter to me what their ethnicity is.”

I had doctors that were telling me that they’re not racist, that they’re trying to provide the best service that they possibly can under the circumstances. This was heartbreaking, because it was politics.

It’s going to be interesting to see how Bill 36 can help resolve discrimination or racism. You have to have an investigation first, to determine that that discrimination or racism existed, either in a system or in specific circumstances, and then maybe you can move to disciplinary action. But in a case when you find out whether or not an incident happened, of racism, you can’t disclose it.

I don’t think Bill 36 is going to change the rules around confidentiality. I don’t think you really can change them — and I’ve tried. Even though I could get the permission of the patient in question to disclose some of the information that I was requiring to make a judgment and to try to see if I could help the situation, I was denied.

Hopefully, this does address the issue of whether or not systemic racism exists. From what I’ve seen, doctors and nurses are guilty as charged in the public realm, especially on social media. There’s no way for them to defend themselves, especially now with the crisis that our health care system is in. I think what we’re trying to do here, as legislators, is to promote fairness, along with promoting provisions for safety for the citizens of British Columbia when they’re trying to access health care.

I see I’m running out of time here, hon. Speaker, but I will cover something that a lot of other speakers have covered here as well. That’s the recruitment of doctors. I’m like a lot of MLAs in this House, where it doesn’t make sense to us, as laymen, why we can’t allow doctors who are educated in other countries around the world. Why can’t we just let them come in here and practice health care?

I do get it. There are different levels of authority here. We’re talking about the federal government on immigration, for example, but B.C. does have the right to advocate, and I know that there’s a provision here that actually speaks to internationally trained health care providers. Now, will it go as far as to say that the person who has trained as a doctor but who now works as a taxi driver or works as a hotel clerk will be given the opportunity to show that they can provide a professional service to patients in British Columbia, based on our standards?

I know that a lot of people in Skeena don’t understand this, especially when there’s such a shortage of doctors and nurses, but Bill 36 does propose to at least speak to it. I think that shows that all sides of this House realize that we’ve got to change things if we want to address the health care provider shortage.

[6:00 p.m.]

It’s not just doctors. We’re talking about nurses. We’re talking about health care providers, which I found out is a different term. I just thought health care providers were nurses and doctors, period. I was educated quite promptly on that, including not understanding the relationship of clinics to the government of B.C. as well as to hospitals.

This is why it’s so important that…. I will commend the minister for having the member for Kelowna–Lake Country as well as the Leader of the Third Party to participate in putting together this piece of legislation that it is truly needed. But there’s more to be done.

Currently we’ve got to address this doctor shortage. We’ve got to address the nurse shortage. We’ve got to ad­dress their burnout. We’ve got to address the stress that they’re facing. If we can, let’s address the overhead costs that doctors are facing. Let’s try to address the safety of these health care providers, who…. When something bad happens, whether it’s an incident in a hospital or maybe a political statement was made, they fear leaving the hospital to go to their car in the parking lot.

Let’s hope this bill addresses this. I do understand we’re trying to address the safety of British Columbia patients, but we can’t ignore the fact that a lot of doctors and nurses over the last couple years have gotten threatened and they fear for their own safety.

I’m sure there will be a lot more to talk about and question in committee stage, but those are my comments re­garding Bill 36 for 2022.

B. Banman: As a health care professional myself, it is indeed an honour and a privilege to speak to what I understand is one of the largest bills that has come before this House in decades.

As has been mentioned by many others, it is quite extensive — 200-some-odd pages, 600-some-odd different clauses in here. It is indeed a monumental task. I do want to thank the Leader of the Third Party and the member for Kelowna–Lake Country for bringing this to us and, of course, the Health Minister himself.

For those that don’t know, I was a chiropractor for many years of my life. It was indeed a privilege and an honour to serve my patients. Actually, some of the toughest conversations I had were when I let them know that: “No, I won’t be able to see you anymore. I’m coming to do work here in this House.” There is something magic about the relationship that a health care provider has with those that entrust their health in your care.

I’m not going to say this act is not needed. It clearly is. But what I will ask is why now? When we have the health care system tumbling and collapsing…. When the house is burning, that’s not the time to discuss what colour paint you want to put on next week. That’s basically what this does. Its priorities are way out of whack.

The calls I get to my office are not about a health care profession act. They’re pleading to help them find a doctor. They’re pleading to help them get a mammogram so that they can go see a specialist. They plead for health care.

[6:05 p.m.]

Now, the Health Professions Act we had was perhaps not perfect. As I said, I do want to thank the members that participated in putting together this massive document. They did as they were asked to do, and they did so honourably. But it speaks volumes about this government’s priorities.

Honestly, we are talking about this when we should be looking at regulations to fast-track the training of professionals. Over one million — or close to one million, rather — people in British Columbia do not have a family doctor, yet government says: “You know what? This is what we ought to spend our time in the Legislature on.” It’s embarrassing, almost, that this is what we’re spending our time on.

I don’t know what I’m going to say to my constituents when they ask me, if they happen to be watching this on TV: “Bill 36 was talking about health care professional oc­cupation act, and I don’t have a doctor. What’s the point?” I have to say I agree with them.

I take a look in this bill, and nowhere in this does it say…. Let’s take Ashcroft, for instance. Ashcroft Community Health Centre was closed overnight on July 29 and 30. It was closed for the weekend July 15 and 17 this year. It was closed April 6 and 8. It was closed January 20. It was closed January 16 and 21, December 3 and 5 in 2021, October 8 and 10 in 2021. This bill doesn’t help people that were seeking emergency care in Ashcroft. Is that not more important? Is that not what we should be trying to do in this House?

We have a health care system that is falling apart. The Premier said it was teetering. Well, it’s not teetering any longer. It has actually collapsed. Every single sign says that it is imploding. And I just wonder why it is we are even discussing this bill at this particular point in time. For the life of me, what are we doing? It is no wonder the public is upset. Can we not do better than this?

It’s not to say that this is not good work, but it certainly does not address the cancer patient that moved from Alberta, that phoned up my office, who could not get a medical doctor to see her. And because she could not get a medical doctor to see her, she could not get a prescription for the life-saving drugs she needed. Is saving a life not more important than how you discipline professionals?

I heard the member opposite say: “Oh, we’re going to lump in chiropractors and acupuncturists and Chinese medicine and a few others all under one group and one umbrella right now.” I find it interesting that the lawyers that are going to be appointed — they still get to vote for who they want to represent them for their disciplinary board. Yet, the ones that are all in here…. If I was appointed — and I could be — I would not even begin to imagine that I know what best practices of Chinese medicine would be. It’s outside of my scope.

There are some questions in here that I just…. They will come out in committee. Yet once again this government has decided to put this massive bill forward, and most of what will actually happen will be left to regulations and happen behind closed doors.

[6:10 p.m.]

What they are asking for is noble. One of the things I commend is that they want more transparency. If my health care provider has been before a board and has had a judgment and has been disciplined, I think, as a patient, everyone has a right to know that.

But I find it just a tad ironic — hypocritical, perhaps — that the government that got the most secretive award, the government that changed all the FOI requirements, thinks that they want health care professionals to be transparent. It’s a clear case of: “Do as I say, not as I do.” We’re going to protect ourselves but, when it comes to others, we expect more transparency out of you. It’s a noble cause, but it’s a tad laughable.

We have the worst walk-in clinic wait times in the country. Hundreds of thousands — I agree with the minister, actually; it is a bit of a joke — are unable to get timely medical imagery. We heard a story today of someone where the delay was so long that their cancer, by the time they were done with the wait-lists, had gone up to stage 4. It could have been prevented, yet here we are in the House talking about how we’re going to discipline health care professionals.

If anybody needs to be disciplined, it’s the government for allowing the health care system to get this bad. One in five don’t have a family doctor. Why are we not addressing that? No. Let’s talk about punishing the doctors that are out there and making them way more transparent. It’s not that that isn’t necessary. It’s just that the priorities of it are backwards.

During a crisis, what we should be doing in this House, right now, is putting our heads down and figuring out how we can get more doctors, how we can get more nurses, how we can get more health care professionals to help save the system that is crumbling around us.

Instead, what we see are people dying after waiting on a stretcher for a couple of days. Ambulance delays. Some poor woman lying for hours screaming and writhing in pain because she’s got a spiral fracture as she waits for an ambulance. That’s not addressed in this bill. ERs after ERs, emergency departments, are closing down because we don’t have the personnel and the health care professionals to man them, to make sure that, in our time of need, someone is there.

There’s also some stuff in here that I look forward to talking about in committee, like when it comes to public health care emergencies, as we just went through, will we be able to call on health care professionals that have retired? What’s the process to actually get them so that they can come back to help? What kind of regulations and educational hours and upgrading will be required, if any? Will we be able to end…?

Who gets to sit on these committees? One of the red flags that I see is that this puts an awful lot of power into the minister. The minister basically will be able to pick who is on these disciplinary committees.

[6:15 p.m.]

Why that’s important is: what happens if someone on that committee is out of step with the current philosophy of the government and whatever they think health care is? Will that particular individual be yanked from the committee at the whim of the minister? If a person on one of those committees does something that is embarrassing to a particular philosophy of the government, will that person be removed? I look forward to finding out the answer to that in the committee. Who actually is going to be in charge of…?

[Mr. Speaker in the chair.]

My understanding is that there will be a list of names that are given to the minister and the superintendent. The superintendent will give it to the minister, rather, and the minister will be able to pick and choose who they wish. I am unsure as to whether that is wise. Whether it be this government or the next government, whatever regime is in there, I don’t know that it is healthy to have that kind of power in one person’s hand or in one minister’s hand.

Welcome, Mr. Speaker. It’s good to see you. I’m sure you’ve been riveted by the discussion on Bill 36.

There are an awful lot of things in this bill, and as the minister has rightfully stated, we have gone through some extraordinary times. The pandemic has stretched the system to the max.

What the nurses who talk to me say is…. One of their greatest concerns is, actually, that the workplace has be­come toxic. I’ve heard it numerous times, in different places and at different times, from different nurses. They say that it’s toxic. They’re at the end of their rope. I don’t think that this throws them much of a lifeline.

I look forward, in committee stage…. I hope that there is something in this particular massive act that will help improve the toxicity of their workplace. Perhaps that toxicity is why many of them are choosing to go into, basically, a privatized system where they work for an agency.

The other thing on this…. I guess the reason why I ask about having an awful lot of power in one particular area is because…. For those that don’t, perhaps, know the history of chiropractic, the early chiropractors were actually charged for practising medicine without a licence. They went to jail. They went to court. Then we went…. That was overturned, and they were found out. They weren’t practising medicine. Chiropractic was unique. The profession grew and expanded from there. As the minister rightfully pointed out, it’s why we have colleges.

Again, I go back to…. I admire the work that was put into this. It was good work. There were a lot of great things. I just think it’s at the wrong time. I think that our efforts would be much more appreciated by the public in trying to find them a doctor, trying to find them a health care professional, trying to find them imagery so that they can reduce the wait-lists.

These are all things that my constituents are talking to me about. I’ve yet to talk to one that says: “You know what? We need a better health care professions act.”

[6:20 p.m.]

I think we’ve kind of lost our way. It’s not that this…. The time and effort that was put into this huge bill…. What kind of time and effort could have been put into finding better ways to get more health care professionals to come into this area?

Mr. Speaker, would you like me to say “noting the hour” now, or would you like me to carry on for a bit? I can carry on for quite a while, if it’s….

Noting the hour, I wish to reserve my right to continue my speech, and I move adjournment of debate.

B. Banman moved adjournment of debate.

Motion approved.

Hon. A. Dix moved adjournment of the House.

Motion approved.

Mr. Speaker: This House stands adjourned until 1:30 p.m. tomorrow.

The House adjourned at 6:21 p.m.