Orders of the Day

Hon. M. Farnworth: I call continued second reading, Bill 36.

[J. Tegart in the chair.]

Second Reading of Bills

BILL 36 — HEALTH PROFESSIONS AND
OCCUPATIONS ACT

(continued)

Deputy Speaker: Recognizing the member for Abbotsford South.

Interjection.

B. Banman: Well, thank you for that splattering of applause. Thank you very much.

[3:25 p.m.]

It is indeed a pleasure to talk about this massive bill that’s before us, a historic bill that is over 200 pages long and has over 640-some-odd clauses or sections in it. It is all about the Health Professions and Occupations Act.

The goal of the act is to replace the current act, which was working — although, as I said before, I do appreciate the work that went into this by the members of the House that worked on this. I would say that the major goal of this act is to protect the public. That is a very noble goal.

I find just a little bit of irony in it that Bill 36’s job is to protect the public, yet we currently have this catch-and-release program going on. We have absolute pandemonium going on in our streets, yet we are here talking about protecting health care professionals.

Deputy Speaker: Member, I would remind you that we are debating Bill 36.

B. Banman: Thank you very much, Madam Speaker, for that for that advice.

Yes, we are talking about health care professionals and protecting the public. As I was saying once before, I was a health care professional myself. When you talk to health care professionals, they would be very much in agreement that protecting the public is important — and then, when a health care professional steps out of line, there should be sanctions and/or penalties as a result of that. This act does go into some of that.

I know, in my profession, we talked often amongst our­selves that protecting the public was of utmost importance. Our patients would entrust their care to our hands, to our knowledge, to the art that is health care. There is a science and an art to health care. When someone comes into your office, they trust that the health care practitioner is going to have their best interests at heart.

It’s important that legislation such as this come before this House. As I said once before, I question the timing of this. Quite frankly, I think there are other, more pressing matters that could come before this House, such as protecting the public at large.

Yes, I know that’s not in this particular bill, Madam Speaker, but in actuality, it kind of is because this is protecting the public at large. There is a connection to that.

This bill also talks about transparency. If a health care practitioner has done something wrong, I think you’d find most health care practitioners would agree that a client or a patient has a right to know if the professional they’re about to see has done anything outrageous, anything egregious — if they’ve had any sexual misconducts, if they actually have the right to practise at all.

[3:30 p.m.]

Transparency is quite important. I do find it, tongue-in-cheek again, interesting, coming from a government that has won the most secretive award by the Canadian journalists. I said it once before, and I’ll say it again. This is a case of do as I say, not as I do. The government should take a note out of the transparency that most health care practitioners are more than willing to comply with. It’s a shame that this government doesn’t follow its own advice, which is in this piece of paper.

Interjection.

B. Banman: Well, thank you very much.

But the bill here talks an awful lot about transparency. It talks an awful lot about safety, and it talks an awful lot about penalties that exist if those particular items are not fulfilled. Those are all good things, and I would again suggest that as this House goes through there, it looks at this model that they think is important.

This government brought this transparency to this House in this act. Yet, when it comes to other things, I think that they should follow the advice in Bill 36. It’s a clear pathway to transparency, and it would be good if this House were to use it as a model for other bills as we move forward.

I also was mentioning that we are going to see an awful lot of these individual colleges now be compressed. What was mentioned on the other side of the House was, for instance, that chiropractors, Chinese medicine, acupuncturists and others will now be put under one disciplinary body and that in order to get those, there would be a lawyer, of course, that would be on that disciplinary board.

I find it interesting that the legal profession still gets to elect their representative. I fully and heartily agree with that. Here’s why. In each profession, it’s important to have someone elected by your peers to represent you. The reason that’s important is because on that entire disciplinary board, you need to have someone there that understands your profession forward and back. You want to have the person that can best articulate what standards of practice within your profession are.

To leave that up to someone to choose, for a group of names to be picked by the superintendent and then be given to the minister, I think is a huge red flag. The reason that’s a red flag is no matter whom it is that’s in government from now on….

Governments come and go. Governments change. Ministers come and go. Ministers change. What’s important and why it’s important to have elected officials and why it’s important that that profession has some input and some say is because if it is left up to an individual minister — I look forward to hearing the minister talk about what safety guards there are in place — that power could be abused.

If a particular individual from a profession, especially when that profession does not necessarily follow mainstream allopathic medicine, such as…. Let’s take Chinese medicine, for instance, or naturopathic medicine or chiropractic. It is not always in total harmony with allopathic medicine.

Whatever the sway or attitude of the Health Minister is, I would think that those professions would worry that if that particular representative from their profession is out of step with whatever the philosophy of the Health Minister is, they would be removed. Be it you’re a nurse or a medical doctor, dentistry, psychology.

[3:35 p.m.]

Many of these professions that will be put inside these particular colleges and moved into this particular bill…. I think it’s highly important that they have some say and some vote as to who that representative is, because they may or may not always agree with whatever philosophy of the minister who ultimately, according to what I’ve read, signs off on the recommendations.

To cherry pick, especially after we take a look at the controversy that went through during the pandemic, where there were all kinds of discussion and disagreements…. I could see a point, where whatever particular health emergency is going through, that a particular college that exists now may not be in full step with government. For government to have the power to pick and choose who they want that aligns with them should be concerning for all of us.

I look forward, as we go through this act, to finding out what safeguards are here to protect that, because medicine is not always in 100 percent agreement in what they do. In my own profession, we would have huge discussions about what is a best practice. We would not always agree, and that’s a healthy thing, because you end up getting to a general consensus as to what best practices are by having that disagreement, by having that discourse.

A Health Minister is not necessarily a health professional, and it is very hard for a layperson to understand that discourse that happens. It is tough for a layperson to understand whether or not….

Deputy Speaker: Thank you, Member.

B. Banman: Thank you very much, Madam Speaker.

B. Anderson: I am proud to speak in support of this bill, Bill 36.

I want to thank my friend. This is my childhood friend Nicole Ripley, who, almost the moment after I was elected, sent me an email and was advocating for this. She is a professional counsellor with over six years of experience through education and then a long professional career after that.

What she was primarily concerned about was public safety, because counsellors haven’t been included before. Now this bill will provide them with the opportunity to be considered and regulated, which is something that their profession knows is important. This is important because they’re dealing with children. They’re dealing with people with severe trauma. They’re dealing with people that are suicidal. So we need professionals in order to provide them the support.

I want to thank, again, my friend Nicole for the advocacy work that she did and the team that she also worked with so that we’re able to make progress in public safety today.

Thanks, Nicole.

Deputy Speaker: Recognizing the member for Cariboo-Chilcotin.

L. Doerkson: Thank you, Madam Speaker. I bring greetings, of course, as you mentioned, from Cariboo-Chilcotin, certainly the most beautiful riding in British Columbia. I’m sure that we can agree on that point here this afternoon.

We’ve heard a number of words. The one that has been thrown around quite a bit over the last day of debate with respect to Bill 36 is “transparency.” I’m going to talk a little bit about that, but it is certainly a privilege and an honour to stand before you and make some comments about Bill 36, the Health Professions and Occupations Act.

Yesterday we had much debate in this room, and one of the members — the member for Skeena, actually — mentioned that he didn’t think people at home would be excited to hear what we were debating. I can appreciate his comments yesterday. I agree. They probably wouldn’t be. But I’m hopeful that this legislation that’s before the House will be an opportunity to have ripple effects throughout other parts of our health care system.

[3:40 p.m.]

I think that he’s right in saying that what the residents of British Columbia want us to be debating is how to fix a system that’s seemingly in crisis right now.

I’m going to try, through my comments, to relate back to the Cariboo-Chilcotin. I’m going to talk a lot about transparency, because I think there’s no question that my residents are hopeful for that transparency, not just in Bill 36, but Bill 36 will be a catalyst for that. I think it’s important to have so much of this in the open and to be transparent. But I want to talk a little bit, during my comments, about some of the incidents that have happened in my riding as well.

I’ve met with nurses — I’m going to say dozens and dozens — in my riding, in 100 Mile House and Williams Lake, and they’re concerned, for certain. We’ve heard it many times. This bill will talk about public disclosure and public consultation. We’ve heard it many times, and I think that nurses are genuinely appreciative of what may come forth. But we’ve also heard, a number of times, I guess, questions around our support for the bill. Frankly, it’s a massive bill, and I think there are a lot of questions to be asked here.

Certainly by the health care professionals in this province…. I think they’ve spent the last week trying to digest it, as well, and trying to get a handle on what it could mean for them.

I know that nurses that I have spoken with on many occasions are extremely frustrated with transparency. It’s not just around staff mistakes, errors or things that may require discipline. It’s around decisions made by health care authorities, certainly decisions made by layers of management. All of those things are coming into question by people of this province and, certainly, people in my riding. There’s no question about that.

We saw a time last Saturday where hundreds of people were on the front lawn of this Legislature, trying to reach out to doctors, because many of them don’t have doctors. I think that is a pretty clear indication of what’s happening. I can’t imagine that we’re not all receiving questions from our residents, from other people in the province, around this extremely sensitive topic.

I really feel that the transparency portion of this bill will give us an opportunity to get some of that into the open, because I honestly don’t think we can solve the problems in this province, specifically around health care, unless we are able to speak openly about it.

I’m going to outline a number of stories, as I go forward, that will show where that transparency will be helpful to constituents and certainly people that have had some pretty significant events happen with respect to their health care.

Again, I want to try to draw it back to Cariboo-Chil­cotin to show how Bill 36 will have an impact, certainly, on our people.

I want to talk a little bit just about the actual bill itself, the size of the bill. It is more than 640 sections. That has been pointed out repeatedly. I know that while we have thanked the MLA for Kelowna–Lake Country, the Leader of the Third Party and, certainly, the Minister of Health, I also wanted to take a moment to obviously thank so many people that had an unbelievable amount of commitment to bring a bill of this size to this chamber. I certainly can appreciate that it has taken a massive effort on their part.

Those significant recommendations, of course, are before us now. This is going to establish an independent discipline process while also revising the complaints process, with the aim to make it more transparent and focused on patient safety. Of course, there’s that “transparency” word again. Amongst the 640-plus sections, that is the item that is most important to me. There are obviously other things about the bill that are important, but that one is the one that is most important to me. I just can’t stress enough how that can help with real repairs to a system that certainly needs it.

[3:45 p.m.]

It’s important to establish from the beginning that this bill is a complete redesign of the Health Professions Act. The Health Professions Act deals currently with 26 regulated health professions, of which 25 are governed by 15 regulatory colleges. At present, the colleges review all complaints about the professionals that they regulate, including both the current and the former registrants.

Bill 36, of course, significantly expands on the previous duties of the college and establishes a series of guiding principles that will be applied to all under the act — colleges, office of the superintendent, director of discipline, etc. In light of that, there’s no question that there will need to be transparency, for certain.

The principles include acting in accordance with the united declaration on the rights of Indigenous people — of course, UNDRIP. I want to speak a little bit about that, because I know that oftentimes in this House we have debated or questioned whether or not Indigenous people have been fully in the loop as far as making these decisions. Certainly, with respect to Bill 36, I have a number of First Nations in Cariboo-Chilcotin, and I want to be perfectly clear — and I suppose we’ll find that out during the committee stage — that my First Nations have been properly consulted with, without question.

As we go through the bill, we need to keep in mind that it’s largely enabling legislation. Much of what this bill seeks to accomplish is not done in the text of legislation but through regulation at a later date and, of course, at the discretion of the minister. Now, I can appreciate why that’s there, and that is definitely something that, I think, I and other people will want to fully understand at the committee stage when we do have opportunities to ask questions about that. There are other areas where it sort of falls back to the minister to make a decision, even noting that, in the bill itself, the director would be an independent person. I will certainly have questions about that.

With respect to how Bill 36 will, I guess, play out in the Cariboo…. I mean, I guess I need to draw a little bit of a picture of what the Cariboo looks like. You know, we have a number of facilities in Cariboo-Chilcotin. We have Cariboo Memorial Hospital in Williams Lake. We have another hospital in 100 Mile House. We have a station at Tatla Lake, another one at Anahim Lake. We have a new First Nations Health Authority clinic that is opening, actually, this week, and we have, of course, a variety of supports around that.

Honestly, the system is…. I mean, I’ve said the word “crisis,” and I don’t think that’s wrong. We have had some very, very serious situations in the Cariboo, and going back to the “transparency” word in Bill 36, I think that that will, obviously, help to answer questions that so many residents have, whether it was a loved one that was in a serious situation or perhaps themselves. I’ll get to those situations, but frankly, some of them have been very serious.

Rural B.C., of course, is a challenge to get to appointments…. I don’t think it would be misunderstood that when you drive from Anahim Lake in the West Chilcotin and you have to see a physician or a surgeon or whatever in Kamloops, that that could be a seven- or eight-hour drive. The concern is that we’ve had a number of missed opportunities, cancelled appointments, etc. Of course, people have questions about what’s happening in the system. Right now, it’s difficult even for an MLA to get a clear answer on that, so that’s why I think this will be helpful with respect to the transparency that the bill touts.

[3:50 p.m.]

Again, I don’t think that anything I’m saying is shocking or earth-shattering. One million British Columbians are wait-listed in this province right now to see specialists. I cannot believe that people don’t have questions about that. We have some of the worst walk-in clinic wait times in the country. Hundreds of thousands are unable to get timely medical imaging. One in five are without a family doctor, and many of those people were on the front steps of the Legislature lawn on Saturday, seeing doctors under tents.

To me, if we’re not all alarmed by this, then I am even more frightened. I really hope that Bill 36 — with respect to the other actions that it will, of course, tout — will have ripple effects through the entire health care system. I hope that there will be cascading success, honestly, for all of the people in the province.

In 100 Mile House, our emergency department has been closed multiple times. Again, I can’t put in perspective just how serious that can be.

We have had one serious situation where one of our residents had their father visiting from the Lower Mainland. He fell and had a very serious injury, and he could not get into this hospital. He was sent home, on a day when he had an extremely serious health situation happening. Fortunately for him, those kids were able to bang on the front windows of the hospital, loudly enough that someone finally came to their aid. By the time they talked to me, they had already talked to Canadian Mental Health. They were reaching for help from anybody that was willing to help.

I’ve got to say that they have multiple questions. Bill 36 will help to clean some of that up. The minister and the health authority itself will have questions as to what happened in that situation. Some of that we did work through with Interior Health. I want to give kudos to them, because they realized that it was a serious situation. I think some of that got fixed, but there was also a period of time when it was very difficult to get some of that information.

We’re not alone. Ashcroft, of course, has seen a number of closures. I can certainly explain to you that on December 2 a young lady that I know very well pulled upon the front door of the Ashcroft Hospital. Again, it was December 2. It was a very cold, snowy evening. They pulled on the front door of the Ashcroft Hospital, and it was closed. Quite feverishly, they packed up their car and drove to Kamloops to deliver my granddaughter. It was a pretty harrowing evening for them, I can assure you. With those types of events, there are often questions around them.

I’ve got lists and lists of hospital closures. Our residents question those decisions. When those hospitals are closed, that traffic has to go somewhere. Ultimately, it’s putting pressure into places that are already pressurized. When 100 Mile closes, you have to make a decision. In an emergency situation, by the way, you need to make a decision as to whether you’re going to go to Williams Lake, which may be at capacity, or to the Kamloops Hospital. That pressure, of course, is happening all the time. It’s not just in Ashcroft and 100 Mile House.

[3:55 p.m.]

Rest assured that people have questions about this. It’s hard to get answers around these closures, specifically Barriere, Blue River, Clearwater, all of them — some of them significant closures, for two and three days at a time, sometimes longer than that. Some are just diversions. I have a massive list of closures for Clearwater, which is extremely significant because, obviously, they have to go to Kamloops, and Kamloops is already under an unbelievable amount of pressure.

I guess I don’t really want to belabour that point, but it is happening throughout the entire province, with so many questions about what is happening there, in Grand Forks, Kamloops, Keremeos and all throughout the north, in Chetwynd, Dawson Creek — all serious closures. Those are happening on the Island as well. It’s a significant issue that does, obviously, require some answers.

Bill 36 is a complete redesign of the Health Professions Act. It has been preceded by recommendations, of course, from August 2020. The bill significantly expands on the previous duties of the college and applies these principles to all under the acts, as I said: colleges, offices, office of the superintendent, etc.

I do want to just speak a little bit about the bill, the way it establishes a new oversight body, the office of the superintendent of health profession and occupation oversight, which consists of the superintendent, the discipline tribunal and other employees as required. The superintendent is to be appointed by cabinet. My concern is that much of the direction, of course, would be coming from the minister and that the minister can simply, I guess, issue orders, etc.

That, to me, is a little bit concerning because it does mention that this individual is to be somewhat independent. I think that that, as I say, is a little bit concerning. I will definitely have questions around that. The superintendent will be able to utilize consultants, experts, specialists and others exercising this duty. This is extremely important to me. This is where I want to relate a couple of fairly serious stories that I’ve talked about in this House and that are currently at that stage of being questioned, for a better understanding of what happened during these events.

I can tell you that people are involved in a situation that developed at Cariboo Memorial Hospital with respect to a 90-year-old gentleman who was taken to the hospital for a number of concerns. He was taken there late in the evening. Because of the capacity of the hospital, he was left on a gurney in a children’s playroom, covered up with his own coat. Behind him were exterior windows of the hospital, and in order to give him privacy, the staff there duct-taped sheets on the window.

Now, I’ve talked about this gentleman, this person, a time or two in this House. I can say that Joanna, who is this now deceased fellow’s daughter, has, sadly, tried to understand what happened. Now, I want to be clear; I don’t want to introduce false information. This person did not become deceased in the hospital; that happened after this event. But this constituent has very significant questions about what happened that evening and that ultimately required getting an MLA involved, getting the highest levels of the hospital involved, because decisions were made there that were not beneficial to her father.

Under the regulation that we’ve seen before us…. I certainly hope I’ll have an opportunity to ask questions to the minister directly about, perhaps, this situation or how Bill 36 will help that individual. I want to point out that this is an individual that, I think, is owed an answer. She removed her father after, about 5½ or six hours, out of frustration, because he hadn’t even been given water in that time.

[4:00 p.m.]

The cascading effect that I hope that happens…. I can tell you that the secrecy…. Maybe that’s not the right word. The reluctance, I suppose, to answer questions about serious situations is frightening.

Last year in my riding — this past year, I guess — a very good friend of mine lost his son. He was a 14-year-old. He went into cardiac arrest in the Chilcotin, near the area of Redstone. We had an ambulance. That ambulance was just a short distance away, really, but it wasn’t staffed. Of course, the ambulance that responded to this call — a desperate call, by the way…. A 14-year-old in cardiac arrest. I don’t think I have to explain how serious a situation that is.

The situation unfolded where people from the health unit did their level best to help this child. But as I said, there was an ambulance just a half-an-hour away that could have responded, but it wasn’t staffed. The ambulance that did come came from two hours away. By the time the ambulance arrived there, this child, sadly, was deceased. I can assure you that this family has multiple questions around that.

In fact, even the staff of B.C. Ambulance have questions around that, because they have reached out to me and asked to push that issue, to ask: “What happened? Why wasn’t that staffed? What are the staffing levels?” To that point, I filed a freedom of information to get that information, and this is what I’m suggesting. The concern is how long it takes to get that information, in a moment where a friend has lost a…. It doesn’t matter if it was a friend. It doesn’t matter. It’s a 14-year-old child that died of cardiac arrest while waiting for emergency responders to get there.

Certainly, Bill 36 does talk about disciplinary action and things that could certainly happen to employees. But I want to make it very clear that I have questions around the different levels of management and the people that are making those decisions, who made the decision not to staff that ambulance that day. I hope that constituents like this can get the information, get the answers that they are so desperately seeking — if nothing else, to get closure.

Right now I have a constituent who has undergone…. You know what? We’ll maybe come back to that. That one’s a little bit raw to discuss.

I want to come back to the independent body. While the office of the superintendent is an independent body, there is a provision in the bill that requires the superintendent to comply with any orders of the minister. That again…. I just want to talk a little bit about that, because I do have concerns about that.

These are supposed to be…. Certainly, the bill has convinced me that this individual should be independent and that they should not be necessarily taking that direction from the Minister of Health. It actually goes as far as saying that the superintendent must act, in some circumstances, on a request of the minister. I’m not exactly sure what that will entail, but again, as I’ve mentioned before, I guess we’ll get into that in committee stage.

I want to lend my support to the suggestion of internationally trained and educated health professionals. Certainly, we’ve talked much about that in this House. Certainly, we’ve talked about it much as residents of the province.

[4:05 p.m.]

I can assure you that just months ago — I think this individual actually met with a number of people from government and from opposition — I had a ride from a fellow, from the airport to this Legislature, who was a cab driver. He was a doctor. Unfortunately, he couldn’t practice here in in Canada.

Sadly, he had mentioned that he had been hired in the UK, but his credentials were not acceptable here. With respect, he basically laid out his plans and how he would be leaving British Columbia, not only himself but certainly with his family as well. That is extremely concerning, because while we’re trying to, obviously, get people into the country, not just doctors and nurses and care aides…. Again to my earlier reference of cascading effect, we’re having the same problem in other areas — veterinarians and everybody else.

Bill 36, in a lot of ways, if it’s going to deal with that, may be a catalyst to help in other areas in our province. I am really hopeful that somehow we can understand that more clearly. Certainly, I hope that people in our province that are licensed to be able to do some of this important work ultimately can be hired, particularly if they’re already Canadian residents.

In this case, we’re actually talking about hopefully speeding up that process and bringing those individuals into the province. I know that there are certainly ways that that can be done, because we’re seeing it with residents that are fleeing the Ukraine. We’re seeing the process being sped up, of course, for those folks as well.

Finally — I guess I’m a little bit short on time — I want to just make a quick reference to our health care workers. I know that a number of health care workers are concerned about this bill, and rightly so. I think we have concerns. It’s not that we’re opposed to it at all. I think that it’s a very large bill, and I think many of us have significant questions. I certainly look forward to getting a chance to ask some of those questions.

Honestly, on behalf of our front-line workers and our medical providers…. I mean, I just can’t…. Thank-you is just not enough, honestly. Some of the stories they’ve told…. We met with the B.C. Nurses Union the other evening, and some of the stories that they told are simply heartbreaking as to what they’ve had to deal with.

Certainly, in my riding, that is the case too. I’ve heard from nurses — in fact, I heard from one that evening — that had been assaulted. I’ve heard from others that have been assaulted and just a lack of respect, in general terms. So for all of our front line health workers — all of our front line people, to be honest — I’m extremely grateful, from the bottom of my heart. I know that I probably speak for many people in this House when I say: “Thank you very much.”

Indeed, I do hope that Bill 36 will be helpful not just to our folks that are in the medical profession. Certainly, I hope that we will have an opportunity to make things so much better for the residents of British Columbia, the residents in Cariboo-Chilcotin.

Without question, I would like things to be better for them and, certainly, people in rural B.C.

B. Stewart: It gives me great pleasure to stand today before this House and speak on Bill 36. The opportunity to stand up…. This type of legislation is significant in terms of the fact that it increases the impacts on the health care industry at a very critical moment in time.

We know that we’re already in the midst of a deadly health care crisis. We hear it every day. It isn’t just the professionals that are in our hospitals but in our clinics and general practitioners. I know that I hope that this is going to help address some of the challenges that they face by streamlining and making regulatory issues around the professions more streamlined.

[4:10 p.m.]

The legislation, Bill 36, before us today does not seek to solve the health care crisis. In fact, it has been in the works for quite some time and deals mainly with the regulation of health professionals, but that does not necessarily mean that it won’t have an impact on the system as a whole. Therefore, we must be extremely careful, as we make changes, to ensure that we do not exacerbate the existing problems.

I think that with a bill of this magnitude — as my colleagues have mentioned, it has some 645 sections along 276 pages, compared to the previous bill in existence right now, which is 55 sections — it’s quite a reach in terms of its breadth of expansion and powers of the new superintendent. It also is full of rules. With rules comes the fact that people don’t necessarily know…. They have to get familiar with it.

I mentioned that when we go to make these changes — I’m sure that we’ll get into this in committee stage, in the implementation, the timelines — I think that it’s so important that we don’t do things that are going to disrupt or delay getting new people into the marketplace to fill the vacancies. As my colleagues have mentioned, more than a million British Columbians are without a family doctor. We do have a lot of people that are looking for solutions and not necessarily barriers.

This legislation has been a work in progress for quite a long time — multiple years, actually. The Minister of Health yesterday corrected the MLA for Kelowna–Lake Country in talking about Harry Cayton, who came out with a report in 2018 that talked about what could be done in this particular case. Of course, I’m sure that this very carefully follows some of those recommendations, but it also is based on the hard work of the Minister of Health, the member for Kelowna–Lake Country and the Leader of the Third Party.

The committee’s work obviously started well before the pandemic, when our system wasn’t showing some of the challenges that we face today. Members here, all around this House, could talk to you about the shortcomings and the challenges for people that are in the system. As I mentioned earlier, we don’t want Bill 36 to all of a sudden become a barrier to solving those problems. I do see that there’s some encouragement also, in the minister’s mandate to streamline regulatory procedures, in making certain that we can get professionals in here and that those barriers are reduced.

The main purpose of the committee, the one working on recommendations for redesign of the Health Professions Act, was started, as I mentioned, after the 2018 report of Harry Cayton. This bill introduces two distinctions: health professions and health occupations. I think that that’s a good way to describe things. I’m sure that as a professional, I wouldn’t want to be labelled as just a health occupation, etc.

I think that there are certain professionals that have worked long and hard. We all know how long it takes to become accredited as a GP, let alone a specialist and a further specialist in that. It is a very demanding and complex area of work. I think one of the things that is necessary is to make certain that we don’t diminish the importance of what might be considered to be a regulatory issue or an issue of competence for any one of the many professions that are governed by this new Bill 36.

There has been a long period of consultation and significant recommendations by the committee that include cultural safety; humility; improvement in governance, regulatory boards and college boards; and establishing an independent discipline process while also revising the complaints process, with the aim to make it more transparent and focused on patient safety.

[4:15 p.m.]

Transparency is a huge part of this. I hate to say it, but I think there’s a belief that professional regulatory groups sometimes don’t either tell the facts or feel that they can’t share them. I think that this is an important aspiration. It should be, hopefully, an outstanding goal of this particular legislation, in Bill 36: increasing transparency.

Its main intents are to protect the public and to streamline the way we regulate health professions. Both goals we are supportive of as the opposition. This bill expands on previous duties of the colleges and applies these principles to all under the act — the colleges, the office of the superintendent, the director of discipline, etc.

I think another thing that’s important is the principle — especially today, where we’ve recognized some changes in Indigenous child protection — that we are trying to use the lens of UNDRIP and DRIPA to make certain that those principles are respected. I think the steering committee previously supported the Declaration on the Rights of Indigenous Peoples Act and the requirement that they align with UNDRIP.

Other important things that I mention are procedural fairness, respect for privacy, promotion of a holistic healthcare system, identifying and removing barriers for extrajurisdictional practitioners. I’ll go into the part about internationally trained and educated practitioners. I think one of the things that I touched on — we talk about a health system that, hopefully, is not always in crisis. There are always challenges, right? It’s a big system. It’s a huge portion of the provincial budget.

We need to make certain, with this legislation we’re bringing forward in Bill 36, that we find a way of making it clearer, more streamlined and effective, in the sense that people know how it will work — not just in being more transparent and that it has an UNDRIP kind of respect and all of those kinds of conditions but, more importantly, that we work on the principle that this legislation is going to make it easier for health professions and people that are in health occupations to know where they stand and their obligations.

I mean, we’re paying them. There’s an obligation that patients, as well as the citizens of British Columbia, expect from this group. We need to make certain that this bill does everything it can and that we don’t end up tripping over ourselves because of all 276 pages and 645 sections — in the sense that that’s a lot, I know, having looked at it briefly.

I’m hoping that by the time we finish committee stage on that, all of us as legislators will be much more educated and briefed on the answers that I know that the Minister of Health will have on Bill 36. As I mentioned, we’re supportive of the many goals and efforts of this bill. It is long, and it is complex. It needs to have serious scrutiny before we can be fully supportive. It doesn’t mean we don’t support the idea.

In our questions and the scenarios that we play out, I hope that the consultation process with Harry Cayton and the others have made it clear to the people that are in these professions that this was going to be an improvement, and streamlining was going to occur. There are bound to be people that…. It’s not within our control or bailiwick as it is currently, but I think it’s really important that we make certain that that’s the objective of what we try to understand in the committee stage of this.

[4:20 p.m.]

It’s important that we establish, from the beginning of this bill, that this is a complete redesign of the Health Professions Act. Currently that’s 55 sections — versus the 645, just a little bit more — and 82 pages. The Health Professions Act deals with the current 26 regulated health professions, of which 25 are governed by 15 regulatory colleges.

I think that in terms of groups that were perhaps unregulated, there is an opportunity for groups under the previous act to apply to the minister for a designation, or the minister could designate and investigate a health profession to determine if it should be designated. I’m quite certain that Bill 36 is very comprehensive in trying to group all of those people together and making certain that it’s very streamlined and that the integrity of the act is upheld.

Bill 36 is going to enable a newly created office of the superintendent to conduct an assessment of unregulated health professions and occupations. If regulation is needed or different regulation is needed, the minister can determine if an assessment would be in the public interest.

The bill sets out how the process of assessment would be conducted; however, much of the parameters in terms of scope, conduct and timeline are left to the minister to decide. I know how much extra time the Minister of Health has. I’m sure that this will be an important addition to his work duties. But anyways, I look forward to, in practice, how practical Bill 36 will be to deliver on these objectives.

As part of the assessment, the superintendent will be required to consult specific people or bodies more broadly than is required under the current process, including regulated health practitioners who provide similar types of health services, Indigenous persons, post-secondary institutions and the public. And the assessment process also includes public hearings as well as risk assessment.

There’s a long list of rules. I think that we know what rules bring, right? It brings added cost. We’ll get to that in a minute. I think that it’s important that we figure out who’s going to pay for all of these regulations and the benefit, ultimately, to British Columbians and the citizens of British Columbia.

The superintendent will be required to make a report with recommendations, which will not be made public until the minister makes a decision. So I think that those are important points. We want to make certain that these rules that we’re talking about are something that are clearly understood by us in the House here when Bill 36 goes through. Secondly, I think that the public needs to comment on that and make certain that they’re informed and that they’re not disenfranchised by these changes.

These principles, as I mentioned, include acting in accordance with UNDRIP. This is an important piece of legislation and is something I know that my colleagues and I will discuss in greater detail in this debate.

Other principles include things like procedural fairness, respect for privacy and promotion of a holistic health care system, which I have a little bit of experience in in terms of trying to find the balance between things that are maybe coming of age or becoming more common. Whether it’s….

I wouldn’t say that they’re unusual, but naturopaths, Chinese medicine and people that are practising in areas that are not maybe understood by all of the other professions that might either not understand or maybe not even agree. But I think that there is a degree of procedural fairness needed across the spectrum of treatment and care, identifying those challenges and removing barriers for extrajurisdictional practitioners.

I think that the last part that I just wanted to touch on here was that one of the things that we talked about is the internationally trained and educated professionals — well, both occupation and professionals; we need both.

[4:25 p.m.]

I don’t think that there’s a place in our health care system that is without a shortage currently. And the fact is that it is one of the objectives in Bill 36, to make certain that there’s more respectful treatment of those people that are coming in internationally trained. I know we’ve heard it many times. I know it myself, as an MLA for a number of years, that people who were not accepted in British Columbia and went outside of the system and trained in, maybe, another country, and are accredited and assumed to be recognized under the international standards of medicine, that those people cannot necessarily easily get back in because we don’t provide adequate residency spaces.

I think that the bottom line is that we need to welcome people back, especially if they started in British Columbia. We educated them all the way along, and then we said: “Oh, no, we don’t have space for you in British Columbia.” They go elsewhere. That was their goal, they pursued it, and they were successful. I think in Bill 36, we do want to make that one of the things that is an objective.

As a matter of fact, I just happened to have a discussion with my doctor a couple of weeks ago. I was asking him about some of the issues. I know he’s got a big sign up on his door that he’s not accepting any new patients. I know that even today, looking on the Health website…. There’s a portal to go and find a doctor.

In this discussion with my own physician, he said that he and other physicians in the Kelowna area accept and adopt new families. I’m not exactly certain. But anyway, these people, this particular couple with children, came here from, I believe it was, Sudan. She practised medicine in Egypt, in Cairo. They came to Canada. She’s written all of the exams, and she’s been waiting two years for a residency spot. Yet she’s practising, in Kelowna of all places, as a care aide. To be honest, that just doesn’t seem logical, the fact that we have these.

This is one of, I’m sure, hundreds and maybe even more stories of people. There’s a barrier, and part of that is the fact that we don’t have the space. But second, it may be a regulatory matter. So I did pass this on to the minister, and I’m hopeful that there will be a positive outcome and that this particular constituent will be able to practise.

I’m looking forward to Bill 36 and adding to the contributions to make it easier to welcome foreigners. I think that that’s consistent with some of the numbers we even heard today, talking about the numbers of people that are working in British Columbia and in Canada. A large majority are immigrants. We certainly don’t want to have barriers to groups that we need here. I know that regulating them is one thing, but welcoming them is another thing that we need to do.

We talk about the office of the superintendent as an oversight body. The 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 different regulation is needed, of an already designated profession or occupation if required by the minister or if the superintendent determines an assessment would be in the public interest and would be required to notify the minister if so. This bill sets out how that assessment would be conducted. However, such parameters, the scope and contact timelines, are left to the minister to decide.

When I read that section of Bill 36, I do ask the question about costs. These are new. The current regulatory bodies do have costs. Those are usually paid through membership fees of the profession that’s being regulated, as are CPAs and lawyers — the legal society of B.C. I’m probably misquoting that. But I do want to think that when it comes to this new superintendent and the fact that they have the ability…. It says under section 440 that the superintendent requires colleges to pay a general administration fee to be set by the superintendent.

[4:30 p.m.]

In light of all of the questions that we’ve heard about costs, this particular one is an additional cost to both the colleges and the people that are members of those colleges. I do wonder, in terms of what those numbers are going to be.

[S. Chandra Herbert in the chair.]

Mr. Speaker, on Bill 36, I’m asking about the introduction of the costs that are going to have to be borne by the superintendent and the office and the broad scope of the number of people that can be added into their control.

Currently discipline matters are under the jurisdiction of regulatory colleges. The legislation introduces a new discipline process, separated from the regulatory colleges. However, the investigative stage will remain with the college as recommended by the steering committee.

A discipline tribunal would be established within the superintendent’s office and would include a director of discipline and discipline panel members.

When I read that, I immediately think it’s going to take a fair amount of additional financial resources, as well as the people that have to sit on these panels, to resource them. I think in Bill 36…. I know that we’re trying to streamline and reduce some of the overlap, but the part about this is that there is an increased cost in that.

It says that the director of discipline may be appointed by the minister and that they must be a lawyer, currently or formerly, in B.C. or elsewhere in another province.

I immediately go back to some of the work in terms of the Finance Committee. I’m looking at the Office of the Police Complaint Commissioner, in terms of their process, in terms of what it costs to have a person of that calibre doing a review of particular questions that are asked of police forces in British Columbia that are not part of the national police force. It costs a considerable amount to have these adjudications run by these people.

This jumps out at me as a significant cost. Although it may be necessary and it may increase the transparency and the fairness of it…. I think that the question, really, at the end of the day, is: how are the costs going to be covered? There’s certainly…. I know that it says the colleges are going to be responsible for some of these costs.

I do think that those are important questions. When it comes time for committee stage on Bill 36, I know that the minister will be all over that with answers. I know that he has the solutions or the answers to these things.

In creating the office of the superintendent…. This bill creates the new independent dispute tribunal, which I’ve just brought up. The tribunal brings out, from the jurisdiction of the regulatory colleges to this independent body…. However, the investigation still remains with the colleges.

It’s also important to highlight the impacts that this bill could have on internationally trained or educated professionals. I did mention that earlier. This would appear to respond to the minister’s mandate letter, which required him to improve the province’s credential recognition process and licensing.

In addition to the guiding principles piece, division 3, section 50 of Bill 36, regulatory colleges would be required to create bylaws specific to the processes and requirements for licensing extrajurisdictional applicants, including the issuance of provisional licences. This would appear to respond to the minister’s mandate letter, as I said previously, which required him to improve the province’s credential recognition process of licensing.

We welcome that. I think that’s one of the things that is definitely needed here in the province — to make certain that we’re properly supported with the health professionals, as well as the health occupations, and that we meet the needs in British Columbia.

[4:35 p.m.]

Speaking about the needs, I can’t help but think…. Although Bill 36 talks about regulatory issues….

There has been a flurry of new urgent and primary care clinics opened up across the province. The minister and I have spoken about two that are in the vicinity of my riding, one directly involved. The whole basis of these clinics is that they need to be staffed by professionals, and we need them.

The current one — I just checked today — if you can believe it, is open Monday to Friday, 4:30 to 8:30 p.m. I’m thinking: “Four hours a day.” What happens with that is…. The recommendation is…. Patients that require attention within 12 to 24 hours but that are not emergent are welcome to go there. What they do is…. They direct people to call 911 or present themselves at the hospital in Kelowna or maybe Penticton, if the traffic is what it often is in crossing Lake Okanagan.

I look forward to the fact…. All of this, under Bill 36, is going to open up people wanting to come to British Columbia — the professionals feel valued, they feel important, and they’re properly rewarded, the same with the occupations — so that we have the supports and the people that can deliver. Clearly, this one urgent and primary care clinic is demonstrating that there is a significant shortage. That community that I’m referring to has almost 50,000 people, and it takes a good 30 minutes, under regular traffic, just to get to the hospital.

We want to make certain that this bill, Bill 36, improves the government’s ability to be nimble in situations where flexibility is necessary, but it also raises some questions because of the regulatory regime that’s going to be imposed on health professionals. With Bill 36, we support the idea of nimbleness, but we don’t want to burden the system with undue regulations and a process of slowing things down so that people can’t get to…. I mean, taking a health professional out of service, disciplining them or temporarily suspending them would be something that would be terrible, considering the situation that we find ourselves in.

While some of the regulation-making powers make sense, there is still much that we don’t know about this bill, what this bill will do and how it will impact our health care system. As such, we will be examining this bill, Bill 36, closely and thoroughly in the committee stage, particularly as to what to look for or what this will look like in practice with our health care system in its current state.

We cannot forget that we are still in the middle of this crisis. I say that meaning…. I don’t think anybody would describe it differently. We’re dealing with a long, long list of closures, especially in rural and remote communities. I don’t know if it was the intention of Bill 36 to try to help bring professionals or health occupations into rural and remote communities, but by the current status of what many of those communities are facing, I would say that there’s a high degree of need to make certain that we attract and bring people into these rural communities.

On top of that…. Then we’ve got the other stress of ambulance delays and things like that. They’re a significant problem if you happen to be in rural areas and stuff like that.

We want to support the government in making certain that they can make the improvements to health care that will streamline and make certain that we have adequate health care professionals here in the province.

M. de Jong: I will begin my submission to the House by making this confession. I hadn’t actually anticipated speaking to Bill 36.

[4:40 p.m.]

I think it’s no surprise to people that we tend to divvy up responsibilities with respect to legislation. My attention had been focused on some other legislation that the government has tabled relating to the provision of health care and the collection of health care–related costs. That is legislation that’s yet to be debated.

As I have discovered over the years, there are times when one is persuaded by the subject matter and the issues being dealt with that it is prudent to become involved in the debate. And there are other times when one is persuaded by one’s caucus officers to become involved in the debate, and this is perhaps a combination of the two.

I hope that I can offer something useful in terms of observations around the legislation before the House. I would say this — begin by saying or suggesting that the importance of the bill is reflected in the breadth of the activities and health-related professionals that it will impact. That is something that others in the debate have commented upon and I think have commented upon accurately and fairly.

The provision of health care services in the province is far more than just doctors and nurses, though there is no way to overestimate the importance of the work individuals in those professions and vocations undertake. But whether it is occupational therapists, respiratory therapists, people providing dental care, dentists, eye care, optometrists, opticians, these are all aspects of our interwoven health care services that we, in this province and in this country, to a certain extent, take for granted and, I think, in many cases, have a measure of pride in.

I think it is certainly true that Canadians continue to have a measure of pride in the provisions of our publicly funded health care system, though it is worth noting that a number of the health care services that I’ve just mentioned are not covered by that publicly funded system. I would say this and make this observation: that level of pride in British Columbia, at least, I feel is on the decline, for reasons I’ll allude to later in my commentary with respect to Bill 36.

It is also, I think, appropriate, in the course of this debate, to pay tribute to the people, the folks that dedicate themselves to providing those services, and acknowledge, as others have, some of the challenges they have faced, unique challenges, as it relates to the period of time we’ve come through in the past number of years beyond anyone’s control, but also some of the challenges they are now encountering in areas where it falls to this chamber and, ultimately, the government to try and respond, to try and anticipate and respond to those challenges and, in some cases, respond in a more effective way than we have seen thus far.

At the heart of the legislation before us, I think it is fair to say, is the desire to achieve a professional regulatory model that protects the public interest. And that notion of the public interest is, I think, something that needs to be at the forefront. We need to ensure people understand.

[4:45 p.m.]

Frequently, I think there is confusion about what bodies like a college are charged with responsibility for, versus other professional representative bodies that have a different mandate.

By way of example, the profession that I was involved with before coming to this place, the legal profession, has a public regulatory body that is charged with protecting the public interest. That’s the Law Society. It’s populated by — it’s a unique term, I guess — benchers, and that is their mandate. Now there’s another body that has a different function. It’s an advocacy group for lawyers called the bar association, and that exists in various formats. But the roles are very different, and sometimes people confuse them.

In the same way that the Law Society is charged with protecting, first and foremost, the public interest, so too would the College of Physicians be charged with protecting the public interest. This is different than the Doctors of B.C., which, I will say happily, accepts as a very important part of its role advancing the public interest. But it is an advocacy group for its members, for the doctors of practice in B.C. That similar distinction exists throughout the health care professions and occupations and vocations.

This bill focuses in on a significant reinvention of the bodies that exist to protect the public interest with respect to the practice of various health-related professions, vocations and occupations. One of the things that the opposition will do throughout the course of the debate and the discussion and the examination of the bill is to explore the degree to which the model being proposed in Bill 36 effectively does that.

By now, it’s become clear that whilst the opposition is anxious to facilitate the committal of the bill to the committee stage for a closer examination of many of the clauses contained within this very lengthy piece of legislation, it will also be exploring in detail some of the issues that arise.

I’m going to focus on three or four of those issues, as an indication of where some of those more detailed questions and critiques and examinations might take place when we do move into that committee stage of debate.

The first thing that I think it is appropriate to observe — and many others during the course of the debate have — is the fact that the bill provides for the creation of a new oversight body: the office of the superintendent of health professions and occupations oversight. It’s a new office. It’s a new body with new responsibilities. The superintendent of health professions and occupational oversight is an appointment that will be made by the Lieutenant-Governor-in-Council, which is the fancy word for the cabinet.

[4:50 p.m.]

I don’t say that to necessarily provoke argument. I say it only to observe that, as is always the case with the creation of these bodies, the tension is between ensuring that the officeholder — in this case, the superintendent — possesses sufficient independence to discharge the responsibilities that this legislation would presume to grant to her or him, and measure that and ensure that independence exists in ways that can’t be compromised by political interference by those who make the appointment or possess some lingering authority or jurisdiction over the conduct of the person who occupies the office.

The superintendent is appointed by cabinet, and then the responsibilities or the mandate for the superintendent are contained in the legislation itself in, I think, section 435. There may be some other sections that are relevant to this. Where the minister, I think, will be anticipating some lines of inquiry is the degree to which the ability for the Minister of Health to provide specific direction to the superintendent, where the minister retains or acquires the right to direct certain activities on the part of the superintendent….

To what degree does that compromise this notion of independence? Are there safeguards in place to ensure that that authority isn’t abused? As I say, it’s a common tension that exists. Someone has to make the appointment. I don’t think the minister or the government should anticipate a line of inquiry or an argument that says that there is absolutely no role thereafter, but the question is whether this legislation has been drafted in a way that preserves and protects and safeguards the superintendent’s independence of action. We’ll see, as we go through the bill in further detail.

The second thing I wanted to comment upon briefly is the creation of a new independent discipline tribunal. This, I think, is fundamental to protecting the public interest and ensuring that the public can have confidence in the discharge of that responsibility to ensure that health care professionals are conducting themselves appropriately and, where they’re not, that they are being held to account and that there is appropriate sanction.

All of that, I think, is fundamental. But again, one needs to ensure that in the discharge of that responsibility by what will be the independent discipline tribunal, there are procedural safeguards in place for the member of the profession that might find themselves on the receiving end of a complaint to ensure that they have an appropriate opportunity to provide their explanation and to provide their defence, as it were, in response to a complaint — again, ensuring that there is, in the construct being proposed here and in the new structure being proposed here, sufficient balance.

Again, I can only draw on the experience from my profession. I will say this about the disciplinary provisions of the Law Society. Lawyers live in fear.

[4:55 p.m.]

I have to say, they take very seriously the reporting of or the filing of a complaint and understand that on a monthly basis, under something called the discipline digest. There are lists made public of lawyers who have been disciplined, with a description of what they have been found to have done wrong and a report of the sanction, everything from disbarment to fined.

I am not an expert, nor do I purport to be, on what the model has been for each of the health professions and occupations that exist in the province, what their colleges have done. My sense is that they, in each case, have been a little bit different, and in some cases are not seen to have been adequate. This represents an attempt to bring some consistency across the fold.

I do note, as several of my colleagues have observed, that there is likely not to be elected representation from the various health care professions in the way that, for example, exists with the Law Society. There are certainly appointments to the Law Society, to the Benchers, but there are elected members, as well, from the profession.

To the extent that that is problematic, I would only say this. As others have observed, in considering a complaint, it will be important that the discipline tribunal also understand and have the perspective of the profession, whether it is a doctor, a nurse, a dentist. When we are considering concepts such as the reasonable discharge of responsibility and reasonable care, having people who are familiar with what that represents with respect to each of the health care professions that this is going to cover, will be important — there again, an issue that I’m sure will be the subject of discussion when the bill moves to committee stage.

Similarly in this, and I’ve just touched upon this, the changes to the board appointment process, the college appointment process itself, insofar as they will now, as I understand it, all be ministerial appointments, is something that the opposition will be canvassing with the Health Minister, to at least explore the rationale for eliminating the opportunity that some of these professions heretofore have had to select from amongst themselves people who can participate in the body charged with protecting the public interest.

The government, it would appear, has chosen to eliminate that as an option or an opportunity for practising members of these occupations, vocations and professions. Determining the wisdom of that decision and exploring the potential problems associated with that decision, I think, is a legitimate exercise of the opposition’s responsibility when we move to committee stage.

Another area that has attracted some commentary in this discussion, and I’m pleased that it has, is the attention that the legislation focuses upon the opportunity and ability for internationally trained and educated health professionals. We have heard a series of examples. I will add my own and then maybe go a little bit further, if time permits, and presumptively offer what I hope is a direction that the government will move in and the colleges will move into, in taking advantage of the legislative focus that Bill 36 seems to include.

[5:00 p.m.]

At a time when we were facing, and are facing, severe shortage in areas like nurses, I was surprised this past summer to receive a phone call from a woman who had returned from the United States. This was a former resident of my community in Abbotsford who had taken her nursing training at a university called Brigham Young — I think, in the annals of post-secondary education, a fairly well respected university in the United States, in Utah.

She had done her degree, graduated with all the credentials necessary. She had then passed the equivalent of the college examinations in the state of Utah and had been certified as a registered nurse. At that point, she decided that she wanted to come home to Canada, to B.C., to Abbotsford. She came here and actually secured an offer of employment at Royal Columbian Hospital, where they were in desperate need. After almost a year had passed of trying to get her credentials recognized, she contacted my office.

I’m not going to suggest that this is an issue that has suddenly arisen in the last six months. I must say, in all fairness, that this has proven to be a challenge for a number of years. It was a challenge back in the day when I sat in the Health Minister’s office.

I will say this. I failed to understand then and fail to understand now what it is that prevents us, in this prov­ince, from acknowledging that there are a vast number of training facilities and schools, outside of our borders, that produce qualified medical professionals. Why we wouldn’t take the step of accrediting them beforehand and simply stating, “If you are a graduate of this program, we accept that you are a qualified professional for the purposes of operating in British Columbia,” is a question I couldn’t get a satisfactory answer to when I sat on that side of the House. Apparently, we still can’t get a satisfactory answer to it.

When someone graduates from the UBC teaching program and gets hired on by a local school district, they don’t test them to see if they know how to teach. They accept that they are a qualified teacher. Why wouldn’t we get to the point in this province where, if you are a graduate of any number of U.S. schools, any number of schools in the U.K., any number of schools in France, any number of schools in Germany — I could list other countries — we would say: “We accept that you are qualified”?

Now, the trade-off is that we may have some procedural issues in how we do things in B.C., and you’ll be obliged to take a short course to ensure that you’re familiar with that or be attached to a professional that has been operating here, but this arrogance that seems to exist — and to preclude us from accepting that there are institutions all over the world that train people as well as we do in B.C. — defies any explanation.

To the extent that the focus this legislation gives to that issue can be used to poke, prod and provoke a more realistic response, a more effective response, I hope that is the case. Again, it’s something that we will want to explore with the minister, to find out how the tool can be used to address that issue.

[5:05 p.m.]

It is frustrating beyond description, as I say, that our colleges, our professional bodies and other agencies continue to harbour this notion: “We are the only people on the planet that know how to train a registered nurse. Everyone else has to be dealt with in a suspect manner.” We can’t afford the delay. We cannot afford to make people wait one, two or three years in circumstances where they clearly possess the training and the knowledge to go to work more quickly.

I said at the outset that at the heart of this is the notion of protection of the public interest. I have to say that we’re having this conversation in the context and at a time when, I think, the public interest and public confidence in our health care system are at an all-time low. It doesn’t make me happy to have to say that.

Colleagues of mine, from across the province, have pointed to situations that they are confronted by: hospitals and health clinics that are closed. Some of them are just closed; others are on diversion; others have emergency rooms where, if you’re going to be in a car accident, it had better be on one of the three days a week that they’re open, because in many cases, they’re not. That’s not acceptable.

When we talk about protecting the public interest, yes, there is a regulatory component to that — and this act attempts to address that in a fairly comprehensive way — but all of that will be pretty thin gruel to people that can’t get into a hospital in their community because it’s closed, that can’t get into an emergency room or that can’t get a doctor. There are now apparently one million British Columbians that don’t have a doctor.

In my community, announcements don’t cut it. We had an announcement a few years ago in my community about an urgent care centre that was going to ease all of the pressure that people were facing in Abbotsford. Two years after the announcement of its opening, it was still only open one day a week.

That’s not good enough. That’s not protecting the public interest. That’s not instilling confidence in members of the public who want to know that they can rely upon our health care system. By the way, it’s ultimately not good enough for the health care professionals, who want to provide those services and are equipped to do so.

Having said all that, having fulfilled my abiding interest in the subject matter and desire to make submissions on the bill, I will say that I’m pleased and supportive of the opposition, my colleagues and me facilitating the committal of this bill to committee stage. It is certainly worthy of closer examination. I know that the government and the Health Minister would expect nothing less on a bill of this magnitude, of this importance, than to have the opposition spend the time necessary to explore in detail how these statutory provisions will translate into better management, better oversight and better protection of the public interest.

[5:10 p.m.]

G. Kyllo: It certainly gives me great pleasure to speak to Bill 36, the Health Professions and Occupations Act. It’s surprising, though, that despite the two health care crises that we have in the province right now, the magnitude of this particular bill, the importance of this bill at this particular time and, I think, in light of the increasing concern of British Columbians about the state of health care in the province, we are not seeing government members actually speak to this piece of legislation.

But having said that, a number of my colleagues have gone at great length to talk about the specifics of the bill. I think it’s definitely much needed. I do appreciate and support the work of the minister, along with my colleague from Kelowna, who did considerable work on the consultation and drafting of this. It believe it was initially prepared and ready in 2018. So it is great to see this coming forward now.

Now, having said that, we do have a number of challenges before us in the province. As my colleague the member for Abbotsford West shared with this House, the confidence in our health care system is at an all-time low. It has never been worse than it is currently. I certainly appreciate that some of this legislation may provide additional confidence to British Columbians, but as the member for Abbotsford West shared with this House, the confidence of British Columbians is about access, timely access, to health care. The number of issues and concerns that have been raised, even in the riding of Shuswap, with respect to ambulance delays, ambulances not showing up, some of the challenges that we’ve had, emergency room closures in and around the region certainly give great cause for concern.

Now, having said all of that, and the challenge that we’re faced, I think it’s definitely worthwhile to give appreciation to the amazing work of the health care professionals and support staff in and around the province. As has been shared, the COVID crisis put an immeasurable amount of strain on our health care system, and our nurses are absolutely burning out. We’ve got a real shortage. We have a significant number of nurses that otherwise would have worked full-time who, just due to stress levels, are moving to part-time work, and that just exacerbates and puts even further challenges on the province.

In addition to that, we have a number of nurses that are not able to actually practise due to the COVID mandates. I know the number I’ve heard is around 2,400 nurses that have actually been suspended from performing. I appreciate that with the significant backlog and shortage of nurses, anything that this government may be able to do in order to provide an opportunity for those nurses to retake their roles and responsibilities in the province would be most appreciated, I know, by other nursing staff and, certainly, the residents of British Columbia.

Now, the backdrop that this bill is being presented…. I will speak a bit on the specifics of the bill. But I think it’s definitely worthwhile noting that 1 million British Columbians currently — 1 million British Columbians — do not have access to a family doctor. We have some of the worst walk-in clinic wait times in the country. Hundreds of thousands of British Columbians are unable to get timely access to imaging, and we know that that only exacerbates and postpones potential life-saving surgeries and likely will also result in very unfavourable outcomes for those patients that are on those wait-lists.

We have hospitals in absolute chaos, with hospital closures….

Deputy Speaker: If I might, Member, just to draw you back to Bill 36. Thank you.

G. Kyllo: Thank you very much, hon. Speaker.

I certainly do intend to talk about some of the specifics of Bill 36. But the importance of Bill 36 is also…. It needs to take into context the monumental challenges that we see within our health care system currently around the province. As I was just referencing the number of hospital closures, I was provided with a significant list of the monumental hospital closures and ER closures around the province.

[5:15 p.m.]

It has been stated that British Columbians that might be involved in a motor vehicle accident or may be injured on a worksite don’t have the privilege or opportunity to wait for an ER room to be open in order to get that life-saving care. It is the ability of this government to actually provide timely access to services and care in this province that is largely what’s on British Columbians’ minds.

Now, as we look at the specifics of the bill, it’s interesting to note that this bill, and a lot of the work leading to the creation of this particular piece of legislation, has been ongoing for a significant number of years, and it’s very timely that it’s finally coming forward now.

What I would like to share with this House is that some of the key areas that this bill actually speaks to have been evidenced with respect to the Steering Committee on Modernization of Health Professional Regulation. This was co-chaired by both our Minister of Health and our MLA for Kelowna–Lake Country, as well as the official Leader of the Third Party. The 2018 report by Harry Cayton considered many of these changes in the Health Professions Act.

The bill introduced two main distinctions, both with the health professions as well as the health occupations. Some of the guiding principles were to identify that the bill significantly expand on previous duties of the colleges as applies to the principles under the act. That’s for the colleges and the office of the superintendent and the director of discipline.

These principles include acting in accordance with the United Nations declaration on the rights of Indigenous peoples. This House heard earlier today of some of the other monumental changes that are being undertaken with respect to the delivery of the services of the Ministry of Children and Families and the opportunity for First Nations communities to have direct access and control over the care of their children and families.

Now, the steering committee also provided a set of principles which included concerns around procedural fairness, respect for privacy, promotion of a holistic health care system and identifying and removing barriers for extrajurisdictional practitioners. These are extremely important, with the latter speaking to those who are internationally trained and educated. My colleague the member for Abbotsford West posed a very interesting potential solution when it comes to the credentialing of our doctors and health care professionals around the province.

I think that is definitely an area where government should be putting additional resources to have a look at what we can do in expediting the opportunity for the credentialing and accreditation of health care professionals that may receive their training in other jurisdictions around the globe. We definitely have a shortage. That has been very evident. The minister himself has indicated that we’ve got a significant crisis in our health care system. Anything that can be done to help expedite and increase the number of health care professionals working in our province is certainly work that should be embraced by the government.

Now, over the last number of months, I’ve had a significant number of concerns raised within my riding of Shuswap. As we know, probably not much unlike other areas around the province, a lot of the work of constituency offices is both to better understand some of the health care needs of our constituents and also to better understand what opportunities might exist for them to get timely access to care.

The list of concerns that have been identified recently, just in my riding of Shuswap, is definitely of extreme cause for concern — one specific reference to a young mother, whose son was in respiratory failure and having to wait in an emergency room for over nine hours before being admitted into the actual emergency room and then waiting a further three hours before her young son received the attention of a medical doctor.

These delays are something that I think he should be ashamed of in our province. It’s something that certainly causes great concern for many constituents across B.C.

[5:20 p.m.]

I also have a reference to a concern that was raised from a constituent. It was identified and shared in an emergency room that the surgery that they were anticipating or that was actually needed to remedy their current situation was deemed to be elective. Now, what the medical professional shared with my constituent is that there has been a change in the classification of what is deemed to be necessary and mandatory surgery versus what might be classified as elective. In this particular case, what was deemed to be an elective surgery, just a few short years ago would not have been classified as elective.

The concern that was raised to me is that for them, it should be information and communication that’s being shared through the Ministry of Health with respect to wait-lists. If the rules by which those actual criteria are established for this wait-list are being changed, it starts to manipulate the numbers.

Deputy Speaker: Excuse me, Member. Could the member help the Chair understand the connection to Bill 36, the Health Professions and Occupations Act?

G. Kyllo: Yeah, absolutely, Mr. Speaker. The bill that’s before us represents a significant amount of work that was undertaken by the minister, with the assistance of other health care professionals, to try and address some of the substantive need for modernization of the health care act. With that, I think it’s also imperative as part of this legislation that government is open and transparent and that the medical profession actually shares with British Columbians — that if there are changes that are being evidenced with respect to how they’re monitoring the successes or failures of the health care system, those are actually communicated with the general public.

In this particular instance, the concern that was raised by my constituent shared that they do not have that same confidence — that some of the criteria by which the elective surgeries are being identified are being changed, modified, without any opportunity for public disclosure. So I think I’m just providing that as a bit of evidence that with respect to some of the outcomes that are being touted by government, the devil is in the details, and if you can’t measure it, you certainly can’t manage it. Where the statistics and the criteria by which they are identified are being changed, it does cause a considerable amount of concern with respect to the confidence that British Columbians have in the health care system.

Now, with respect to the office of the superintendent, which is an independent body, there are also provisions of the bill that require a superintendent to comply with any orders the minister makes. In addition to creating the office of the superintendent, this bill also creates a new independent discipline tribunal. The tribunal brings discipline out from the jurisdiction of the regulatory colleges to this independent body. However, the investigation stage will still remain with the colleges.

It’s important to highlight the impacts that this bill could have on internationally trained and educated health care professionals. This would appear to respond to the minister’s mandate letter that requires him to improve the province’s potential recognition process and licensing. This piece, again, speaks back to the level of accreditation and the opportunities that we have in this province for bringing internationally trained health care professionals, to expedite their opportunity to actually take their place in our hospitals, in our care facilities, to provide the very important health care services that British Columbians rely on.

Now, in addition, this expediting of the approvals for the internationally trained health care professionals is something that the official opposition has been calling for, for many months. So if this bill can be implemented quickly and processes identified, it will certainly be beneficial to help with the shortage of health care professionals we currently have practising in British Columbia.

[5:25 p.m.]

As we go through the bill, we also need to keep in mind that it’s largely enabling legislation. Much of what the bill seeks to accomplish is not done in the text of the legislation but will be undertaken through regulation at a later date, at the discretion of the minister. It’s imperative that as those regulations are identified and developed, British Columbians are provided the opportunity to fully understand the reasons, the rationale, as they come forward, because there’s much of the regulation that’s going to be developed after the fact — largely developed and determined by the cabinet — without, necessarily, the scrutiny of this House.

Now, we certainly appreciate that moving things into regulation definitely allows government to be more nimble in situations where flexibility is necessary, but it certainly also raises questions. While some regulation-making powers make sense, it also means that there is still so much that we don’t know about what this bill will do and how it will potentially impact our health care system. As such, we certainly will be examining the bill very closely through committee stage, particularly as to what the bill and what the regulations will actually look like in practice with our health care system in its current state.

Again, when a lot of the work in the development of this particular bill was undertaken, it was before COVID, in a very different set of circumstances. With the crisis that we’re in now, I’m sure the government is going to be giving significant consideration to the health care crisis that we’re in at the moment. Many of the actions that are identified in this monumental piece of legislation…. How the implementation of further changes in the midst of a crisis can be implemented effectively without just adding unnecessary additional administrative burden and concern on the health care professionals….

Now, as we note the significant number, one in five, of British Columbians that don’t have access to a family doctor, we have heard lots of the additional work that’s been undertaken with the urgent and primary care centres. I can share with this House that there are not any urgent and primary care centres in the riding of Shuswap, but there are some in adjacent ridings.

What I’m hearing is some of the challenges with respect to the low staffing levels. These urgent and primary care centres were identified and largely put in place to take some of the pressure off, to provide access to medical care for constituents that don’t have access to a family doctor. A significant amount of capital costs in developing these leases…. The long-term expenditures that were undertaken are leasehold improvements. So when you have all of this capital being expensed and actually providing these facilities that are running at a very small capacity of what their intended capacity is, you have to have a look at what the actual cost is and where the value-for-money proposition is to British Columbians.

As we know, family doctors in British Columbia provide their facilities out of their fee, yet we have government, on the same hand, going out and spending considerable amounts of money on long-term leases and facilities with all the leasehold improvements. And if those facilities are operating at anything other than full capacity, the administrative costs, the overhead costs associated with that per-patient visit is sky-high.

That’s something that I think British Columbians are concerned about. Yes, we need access to care, but we also have to have respect for the taxpayer and seeing that efforts that government is undertaking are actually providing good value for money.

I know a number of doctors that I’ve talked to question that — whether they have an opportunity for increasing fees in order to increase access for family doctors around the province. Some of the initiatives of government are not actually achieving what the intended outcome was.

Now again, speaking back to Bill 36. Some of the further changes that have been identified with respect to the bill…. It’s also looking to make a clear path for the unregulated health care professionals to apply and receive the appropriate designations.

Bill 36 would create a new office of the superintendent as an oversight body. The superintendent would 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 the regulation is needed, if different regulation is needed of an already designated profession or occupation, if required by the minister or if the superintendent determines an assessment would be in the public interest.

[5:30 p.m.]

The bill sets this process for how an assessment will be conducted. However, again, much of the parameters — the scope, the conduct, the timeline — are left up to the minister to decide. So again, not a lot of detail provided in the specific legislation.

Now, as per section 440, the superintendent may require colleges to pay a general administration fee, again, to be set by the superintendent. This, again, is subject to regulation.

As has been shared by myself and my colleagues, there’s much of this particular piece of legislation that is left to be determined in further regulation. So as we go through committee stage, I know my colleagues will be going to line items with some very specific questions to try and get a better sense of where government is going and what we might see as those regulations are further developed.

This particular piece also indicates that this would pass…. The cost of funding the superintendent’s office would actually be moved on to the actual regulators.

Now, while the office of the superintendent is an independent body, there is certainly a provision in this bill that requires the superintendent to comply with any orders that the minister makes.

In addition to creating the office of the superintendent, the bill also creates a new independent discipline tribunal. The tribunal brings discipline out of the jurisdiction of the regulatory colleges to the independent body. However, the investigation stage will still remain with the college.

It’s important to highlight the impacts the bill would have on internationally trained and educated health care professionals. It would appear to respond to the minister’s mandate letter, again, which required him to provide the province’s credential recognition process and licensing.

We talk about the training that’s actually required for health care professionals. We have many health care training facilities around the province. There has been work undertaken to increase the number of trades training seats both for nurses and for doctors. Yet with our aging population, we still don’t seem to be getting ahead of the curve. It will be interesting to see what further work is undertaken with respect to bringing in the significant number of health care professionals that we are going to need in this province to meet the growing concern with the lack of access to health care.

As we look to the other health care crisis in the prov­ince, the opioid addictions…. I received a report earlier today that 80 percent of those that have actually succumbed to opioid overdose deaths are young men largely between 19 and 54 years of age. That is definitely of significant concern.

We’ve seen our neighbouring province of Alberta see a significant decline in the number of opioid deaths last year. Unfortunately, we’re seeing a continued rise here. It’s even impacting families here in the Shuswap, just within the last month and earlier — the number of individuals that have actually overdosed on account of the opioid crisis.

While we do have a minister with responsibility for mental health and addictions, we have not necessarily seen the outcomes, I think, that all British Columbians are looking for. A lot of it comes down to, again, the access to a family doctor, the access to psychiatric care. Again, many of those that are relying on opioids do have other underlying psychological and health care issues that unfortunately, sadly, lead to the use and reliance on opioids.

I do want to say, with respect to the health care professionals working in the riding of Shuswap…. I have had a significant amount of experience with the Shuswap Lake General Hospital.

[5:35 p.m.]

Four of my grandsons…. Grandsons, apparently, seem to be a little bit more rambunctious than granddaughters. I can actually say that I’ve been in the emergency room with four of my grandsons in the last three months, with everything from head injuries to respiratory illness and others. I have to say that the experience…. The work, the care, the concern that was provided both by health care staff and the doctors within the medical facilities is absolutely first class. So I definitely have much appreciation for the work that they’re doing under absolutely dire and increasingly stressful situations.

With that, I certainly appreciate the opportunity to speak to Bill 36. I certainly look forward to further clarification from the minister during committee stage of this debate.

J. Sturdy: I am pleased to rise to speak to Bill 36. It is a bill that has…. Its time is certainly due. Much work and consideration and collaboration have gone into what comes before us today. It reflects the mosaic of health care that we have in this province.

My colleague earlier started listing off some of the occupations within that health care mosaic that I hadn’t really thought about. And it’s true. It is truly a fabric. You instinctively and naturally think of doctors and nurses, but it really does move far beyond that, be it opticians or podiatrists or dietitians or massage therapists. It is a continuity — and a need for that — in order to deliver to people of this province what we honestly need and have built over many years.

There has long, I think, been confidence in our system. We have historically had significant, very positive outcomes in a variety of different sectors and have been recognized globally for those outcomes. I also think it’s fair to say that that confidence, over time, has waned.

What we’re looking at here in Bill 36 is, essentially, an overhaul of the health professionals writ large. The title is the Health Professions and Occupations Act. I’m understanding that that is going to encompass much more than what we traditionally believed to be the health professions.

This is an important and certainly weighty bill. I understand that 650 clauses is really something of a record for this House — or 646, something like that.

[5:40 p.m.]

Obviously, at the second reading stage, it’s really hard to be able to dig into it. That comes in committee stage. With the sheer number of clauses, it’s hard to imagine providing comment now that can be really anything more than superficial in many regards.

It impacts not just the professions that are encapsulated or the occupations that are included, the colleges and the registrars of each of those occupations, but it impacts every single British Columbian. I think there’s nothing that we hold more dear than our health care system and our health and our wellness. Certainly, my constituents and I hope that these issues and challenges that are faced on a day-to-day basis in interacting with the health care system are grappled with and, hopefully, impacted in a positive way by this very hefty piece of legislation. I suspect in committee, it will very much be looked into, as is its nature, on a clause-by-clause basis — and explore the impacts of each of these clauses.

I think we have to recognize or do recognize — it’s been acknowledged by many of my colleagues — that this is, largely, an enabling piece of legislation. That always raises concerns for the opposition. It’s interesting to sit on the government side of the House and say: “It’s all going to be good, not to worry. We have everybody’s interest at heart.” I do think that’s true.

I think that all of us are here for the right reasons. We’re here to serve our constituents, to serve the people of this province. I guess it’s natural to want to have that latitude to serve and to regulate as the government sees fit. Naturally, that can be concerning to those that aren’t affecting the levers of power — or are affecting them, influencing them in the way that the opposition can, but not directly, not writing the regulation, not appointing the individuals.

I think, certainly, as has been said, the devil is in the details. Unfortunately, what we’re seeing here in the way of Bill 36 — much of it is high level and is not specific and will be delegated to either other bodies or the regulation generated and drawn out in the back room, in the cabinet room, in the minister’s office.

[5:45 p.m.]

Transparency and an understanding of how we come to conclusions, how we generate regulation, how we administer the law — it’s important that it be understood and that people feel they’re participating in the development of these regulations.

Unfortunately, I’m not sure that the structure of much of this will engender confidence, because, really, much of what this is about is attempting to support or to reinforce — maybe “reinforce” isn’t the right word — the public in being confident that their interests are being served and their interests are being served broadly.

This is about the public interest. It’s about protecting the public interest and instilling confidence. But when the development of regulation is not done in an open and public way, I don’t think it necessarily serves the public interest. As I say, as always, the devil is in the details. It will be hard to assess some of the impacts. We may be literally years out in seeing how these regulations are developed, what they end up saying and whether the outcomes are what we would hope them to be. It is a frustration, clearly, to the opposition, as enabling legislation always is.

It will be hard to assess whether we will be potentially generating unintended consequences. That’s entirely possible. We have seen exactly that happen. We have seen the proposition of a solution. We see press releases. We see announcements. Often it sounds great. It does. It sounds great, but what actually happens? I hope the Speaker will give me a little bit of latitude in terms of providing an example of this with regard to the health care system — something that I know relatively well.

I did spend some 25 years as a B.C. ambulance paramedic and in all aspects of the health care system. I was a basic life support paramedic, but that gives you an opportunity to be, obviously, in the emerge constantly and regularly — but on a more routine basis, where you’re in long-term-care facilities or where you’re taking patients from wards to a cancer agency, for example, for treatments. Picking people up at doctors’ offices or clinics and transporting them to imaging — I had the benefit of seeing many of these facilities from the inside.

[5:50 p.m.]

I am glad that we are paying attention to this issue. It is one that does need an overhaul. It’s true. I’m glad to see that we had a cooperative approach. I hope that we’ll continue to see that going forward, with this particular piece of legislation.

This is impactful, and it is important. It’s also at a very critical time, where, as I mentioned, the confidence level in our system is waning. In fact, some would say it’s never been lower. I’m not sure how that’s measured, but it certainly is a dramatic statement.

Certainly, if we look at some…. All of us, I’m sure, get no shortage of correspondence in our offices with regard to these issues, with regard to health care, in particular. Others — forestry is certainly another big one, in my neck of the woods, and energy and transportation. All of these are important issues. I would like to take the opportunity a little bit later to read into the record, if time permits, some excerpts from some of the correspondence that I’ve received relative to accessing health care and people’s experiences when they are facing, oftentimes, a very, very difficult time in their lives.

The minister, I would say, almost daily references the two health crises that we’re all experiencing, some more or less. I’d say that there’s…. That’s fair. It’s true. When we were in government in 2016, we declared, or recognized, the fact that we were in an opioid crisis, and it was declared a state of emergency. Since then, obviously, COVID has impacted the globe in a way that I don’t think any of us certainly anticipated.

That does provide the context for the discussion that we’re having today around Bill 36 around the health professions. If no other industry, the health industry…. I hesitate to actually call it an industry, although clearly it is, but it’s much more impactful than the academic term or the business term of “industry,” because when we have a crisis, clearly it’s personal.

So yes, we’ve been dealing with COVID, and we’re dealing with the opioid crisis, as the minister constantly references, and rightly so. We’re also, on the health care side, dealing with the issue of doctor shortages, a critical shortage of physicians, specifically family physicians, but I’m sure that that’s true more broadly. That is very, very much an issue in West Vancouver–Sea to Sky — the access to physicians, from West Vancouver through each community in the region. Each community has a slightly different concern around those doctor shortages.

[5:55 p.m.]

We have the doctor shortage, but it also creates a crisis in other issues. It’s a knock-on effect around wait times, which is affected by what? By a shortage of nurses, by a shortage of doctors, the challenge around ambulance paramedics.

How does that relate to the health care professions? Well, it does because…. Just as a lived example, where there isn’t a doctor on site or there isn’t sufficient nursing staff available, a paramedic coming in to emerg will be forced to wait because our obligation…. It’s their obligation now, because I got exited.

I’ll have to tell you that story. I think I mentioned it to the minister once. I’m going to have a little sidebar now, if I can. I was a part-timer. There’s a distinction between a part-time paramedic and a full-time paramedic. The full-time paramedic is statutorily protected from termination if he or she serves as a provincial elected official. We’re in conflict, being elected officials and making decisions around….

Interjection.

J. Sturdy: The minister tells me they’re going to hire me back.

Could I have that in writing, Minister?

Well, it’s a gap. While I have this opportunity, before the Speaker shuts me down, I’m going to say there’s no reason that a part-timer is not protected while serving as an MLA, whereas a full-timer is.

I see that. “Dear Jordan, welcome home.”

Deputy Speaker: If the member is making a resignation speech, then I will give him extra time, but otherwise, we should get back to the bill at hand.

J. Sturdy: The shortage of physicians and nurses has knock-on impacts to a broad range of health care services.

We’re also dealing with the issue of delayed surgeries, and where I hope this bill can also provide or can be impactful is in that issue of accountability and responsibility and transparency.

[J. Tegart in the chair.]

I think the previous member said something that I have in my notes here somewhere — that if we don’t measure it, we can’t manage it. Ultimately, we want health outcomes that we can be proud of, and that takes measurement, that takes assessment and targets. Hopefully, that’s one of the things that can be incorporated or expanded throughout the system, because I certainly have some examples from constituents who don’t feel that there’s that accountability.

We are in a crisis which, of course….

Welcome, Madam Speaker.

[6:00 p.m.]

The legislation before us is not going to solve this list of crises, more than the two that the minister will regularly reference but the other crises, the collapsing health care system. It’s not going to solve these issues, but it can go some ways towards measuring things, towards creating accountability. I certainly hope it does, because it has been in the works for quite some time.

It will hopefully include parts of the system that are not currently considered. I have a constituent who is a thera­pist, who I actually introduced to and who met with the minister on the issue of being able to call yourself a therapist or a counsellor. As she described it to me, anybody can hang out a shingle and call yourself a therapist or call yourself a counsellor. They’d rather operate outside of the existing structures, and that doesn’t instil confidence.

I’m not going to name some of these therapies, because I’ll inevitably get myself into trouble. But I think that in some cases, hocus-pocus is not an exaggeration. To incorporate these practitioners into a college and have a registrar is, I think, a very important thing to do, because we’re ultimately trying to instil confidence of the public in the system that we have.

As we know, as I mentioned, this has been in progress for multiple years, based on the recommendations of the steering committee, co-chaired by the MLA for Kelowna–​Lake Country, the Leader of the Third Party and the Minister of Health. As described by our member…. He described it as a comprehensive and challenging but, to a large degree, rewarding experience — at least, to generate the recommendations. I take it that it was the ministry and the minister’s staff and drafters that helped come up with the 646 recommendations that will be…. I think that’s the right number. Is that…?

Interjection.

J. Sturdy: Sections, sections. So 646 sections — thank you, Minister — that we will be exploring in detail in committee stage shortly.

I think we do need to keep in mind that this work did begin some time ago, in advance of some of the dramatic changes or the impacts that we’ve seen in the health care system over the course of the last 2½ or 3½ years — certainly, since the spring of 2020.

The goal was to make recommendations to modernize the health care, health profession regulatory framework. I really want to thank the members of that committee for doing this work. I understand it was a very long and deliberate — deliberative — process with much conversation, engagement, consultation with many different sectors.

[6:05 p.m.]

The significant number of recommendations were put forward to include some pieces that, I think, are key. In the community of care that we all hope is robust, the issue of cultural safety is important.

A piece that jumped out at me, that I thought was unusual but valuable, was the term “humility.” That’s not something you often see in these types of recommendations and not something you often see…. You don’t see it as often in daily life or in the health care system as we’d like to see. It tends to be hierarchical. Humility, for all of us in this House and outside of this House and certainly in the health care system, is important.

I see my time is waning, as we say, and I didn’t actually get very far in my notes, but I look forward to committee stage of the debate.

T. Wat: I’m really pleased to rise in the House to speak to this bill in the next 30 minutes, a bill that is almost as big as the impact it seeks to have on our health care industry. As many of my colleagues have referenced already, this bill has 645 sections. It seems comprehensive, addresses various aspects and has been worked on for a long time.

In many ways, Bill 36 will address the crisis in our health care system now, perhaps address the shortages of staff resources and other adversities that bog our health care down. I’m sure, when the minister presented Bill 36 to this House, he definitely had in his mind that Bill 36 would at least help address the crumbling health care system.

I’m hoping, Madame Speaker, you will give me some latitude in the next less than 30 minutes now or so for me to read into the record the many correspondences that I received in my constituency so that the minister will understand how dire our health care system is right now and to take advantage of Bill 36 to really address the problem for the benefit of all British Columbians.

I do know that Bill 36 seeks to regulate health professionals and, therefore, can be connected to the benefit of the overall system. My biggest concern is ensuring that we, as legislators, have the time, the ability and the knowledge to properly dissect Bill 36’s content.

I wish that the minister could have made Bill 36 available to our reasonable members earlier so that we had more time to review and study and raise more relevant questions. It’s so complex that, even after reading it once last night, I think I could not understand some of the sections.

Bill 36 is on the steering committee’s recommendations, as co-chaired by my colleagues, the MLA for Kelowna–​Lake Country, the Leader of the Third Party and the Minister of Health. Thank you to the three of them for spending so much time in coming up with recommendations.

[6:10 p.m.]

To modernize the health care professional and regulatory framework, we must ensure this guarantees the most suitable changes with the highest standards. Change is essential. When I hear from my constituents in Richmond North Centre about how our health care system needs a change, Bill 36 may be a small part of the journey of renewing our health care system to one that works. I sincerely hope that this government will be truly committed to starting this journey, no matter how small it is right now, for the benefit of all British Columbians, as our health care system is in crisis.

Hundreds of my constituents have written to me to express their concern, their frustration, their anger and their fear that they themselves and their elderly parents are not having the proper health care as what they used to have six years ago. They urge me, they are asking me, to represent their voices at this Legislature so that the Health Minister will have a good understanding of what kind of problems they endure and how challenging it is for them now.

I’m sure every member of this Legislature is hearing the same stories from his or her constituents. It is really up to us, each and every MLA, to speak up and not just blindly support the minister as our health care system is crumbling. I do urge members on the government side to spend time to review and study Bill 36 to understand if this bill is truly addressing the dire health care problems our province is now facing.

I do hope each and every one of the government MLAs will stand up in this Legislature to speak about how they truly think about Bill 36, and most important of all, to speak up on behalf of their constituents. That’s why I’m sure we have taken up this call to run for elected office. This is what this Legislature is about: electing officials to speak their minds truly and speak on behalf of their constituents and have a thorough and constructive and meaningful debate of all pieces of legislation.

After a long period of discussion and consultation, significant recommendations were made by the committee that I referenced earlier to include cultural safety and humility, improve governance of regulatory college boards and establish an independent discipline process while also revising the complaints process to make it more transparent and focus on patient safety. Transparency is key.

Richmond is my riding, and it is home to many new immigrants who are professionally trained from abroad. Still, the need for more transparency from the industry has led to miscommunication and missed opportunity for people to get to work. We know how badly we need more support.

Bill 36, as written, includes many of these changes. Its primary intent is to protect the public and streamline the way we currently regulate health professions — both goals we support. We agree that these are significant matters to consider. However, we also have to recognize that our health care system looks different today than it did when these recommendations were first made.

[6:15 p.m.]

Every discussion about this legislation over the next few days and weeks, both here in second reading and later, in committee stage, must be done with the broader context of our now-crumbling health care system.

Bill 36, as many of my colleagues referenced, is long and complex, which is why I, along with my colleagues, need to exercise our responsibility of thoroughly analyzing and discussing Bill 36 — yesterday and today — in this House. We know there’s a shortage of health care professionals, and during difficult times like this, we must ensure that our regulatory and college systems are the best they can….

For example, this is what a constituent sent to me. Let me read this out. It’s from my constituent Shir:

“As a constituent in your riding, I’m urging you to use your voice to help address the dire nursing shortage in our province. B.C.’s health care system has been plagued by a critical shortage of nurses for years, but the COVID-19 crisis has compounded the shortage. Nurses have worked tirelessly to provide safe patient care to those in our community at the risk of their own physical and mental health. They care for patients who are our family members and friends, patients who are also your constituents.

“I’m deeply concerned that patient care is already being negatively impacted. Hospitals are at capacity, with patients in hallways. The wait-list for elective surgeries is long, and nurse-to-patient ratios are dangerously high.

“We have been living through two years of the relentless pandemic as well as B.C.’s extreme weather events of 2021 and the ongoing toxic drug crisis. Through all of this, nurses have been heeding the call to do more with less. Our nurses are working as hard as they can to provide care, but they are burning out. Thirty-five percent are considering leaving the profession by 2023, and that’s happening soon. Fifty-one percent of our ICU- and ER-trained nurses say the same.

“Our province needs more than 26,000 nurses by 2031 to appropriately staff our health care system. Without an actionable recruitment and retention strategy, we will not have enough nurses to meet the health care needs of British Columbians.

“Please use your voice to speak on my behalf at the Legislature in support of BC’s nurses. Prioritize health care by committing to hiring and retaining more nurses and addressing violence in the workplace. Our nurses are worth it. British Columbians deserve it.”

What I quote about is a correspondence addressed to me by Shir.

Let’s listen to another constituent of mine, William. I quote him:

“I went to emergency at Richmond Hospital a few weeks ago, and after more than seven hours, we haven’t got a chance to see any doctor. The nurse told me the doctor is busy, and the entire emergency department only has one doctor. The nurse also told that the new urgent care centre in Richmond closed earlier than their original proposed closing hour because they are short of doctors. We were there at 8 p.m. and stayed till almost 4 a.m. No doctor shows up at all.”

[6:20 p.m.]

Yet another, from my constituent Agnes To:

“I had a severe ear infection in July, and I tried booking an appointment with my family doctor. Unfortunately, my family doctor was too busy and could not take me in right away. He told me to go to the emergency if needed. I did not want to occupy a space in the hospital for those in need, and I decided to visit the UPCC in Richmond. It took me almost five hours to be seen by a doctor.

“I understand that the provincial government is trying to get more health care funding from the federal government, but when health care is so critical and as the crisis worsens, should the provincial government fund the system first to save lives? Why does the provincial government have funding for other programs and projects but not health care? Shouldn’t health care be a priority when so many people are not able to see a family doctor?”

Hopefully, the measures in Bill 36 will help us address the kind of issue that I just quoted from my constituent. I look forward to the member opposite explaining how so.

It is also important to establish from the beginning that Bill 36 is a complete redesign of the Health Professions Act. The Health Professions Act deals with the current 26 regulated health professions, of which 15 regulatory colleges govern 25. These colleges are legally obligated to protect the public by regulating their registrants. At present, colleges reveal all complaints about the professionals they regulate, including both current and former registrants.

Bill 36 significantly expands on the purest duties of a college. It establishes a series of guiding principles that will be applied to all under the act. Listening to our colleges is essential. In fact, I heard from the B.C. College of Family Physicians not too long ago, who wrote to me saying:

“Across British Columbia, almost one million people do not have access to a family physician. To make matters worse, physicians say that they are feeling burned out. Many are retiring earlier than planned or are planning to step away from their practices. Fewer family doctors are choosing to work in comprehensive longitudinal family practice, and more family doctors than ever before are considering leaving the profession.

“Today, 40 percent of British Columbians who currently have a family doctor say they are concerned that they will lose them. While this is a crisis, there is a path forward with the government’s help. We are calling on the government to ensure that family doctors have a seat at the table and that the solutions to strengthen primary care in B.C. include the input and advice directly from us family doctors.”

[6:25 p.m.]

In addition, the B.C. College of Family Physicians also pointed out that, in fact, B.C. is not short of family physicians. The actual root of the current shortage of family doctors for British Columbia is actually the environment that they are working in. The environment is not conducive to family physicians if the current model of running their own clinic continues.

Under the current model, family doctors do not finish work from 8 a.m. to almost 8 p.m. After 8 p.m., they need to bring all their administrative work back to their home after a full day of seeing their patients. You can imagine that the doctors hardly have any family time. It can happen once or twice or so. But if it’s every single day, how can any family doctor continue that way of operation? They will get burnout, even though they have a passion to serve British Columbians.

Family doctors’ business administration work is not compensated. Administration costs and rentals keep going up. If the current arrangements for family doctors are not changed, there’s no way we can retain family doctors in B.C. Training more doctors is a good option, but it will not solve this problem. At least, it will take six to seven years for the first batch of doctors working in B.C. Even if they are in the field, the young physicians might not be interested in taking up a family doctor position. The problem will get worse and worse.

The various colleges in our province clearly have been voicing their concern. I hope this NDP government has been listening to them, but unfortunately, it doesn’t seem to be the case, as I heard from many health professionals that their professional colleges have hardly been consulted, and they are not aware of the presentation of Bill 36. The minister is not a health professional by his profession. If he is sincere in his commitment to improve our health care system, the minister should listen to all the colleges and brief them before presenting Bill 36 to this House.

As a racialized person, I appreciate the special lens Bill 36 has undertaken, looking at it from a perspective that accounts for Indigenous peoples and their unique circumstances. These principles include acting in accordance with the United Nations declaration on the rights of Indigenous peoples. This is a critical piece of the legislation and something I know my colleagues and I will discuss in greater detail later in the debate. But I question the robustness of the consultancy involved in this, as highlighted by my colleague from Skeena earlier in this debate, who asked for a more comprehensive consultation with rights and title holders.

However, this bill, which has been a product of the recommendation of all three parties, includes more. Other principles include procedural fairness, respect for privacy, promoting a holistic health care system and identifying and removing barriers for extrajurisdictional practitioners. The latter speaks to those who are internationally trained and educated. Bill 36 also sets a more straightforward path for an unregulated health profession to apply for and receive a designation.

Bill 36 would create the new office of the superintendent as an oversight body. The superintendent will be appointed by cabinet and will have several duties, including the ability to conduct an assessment of an unregulated health professional occupation, if regulation is needed or a different regulation is necessary, if required by the minister or if the superintendent determines an assessment would be in the public interest.

[6:30 p.m.]

I do, however, note the danger that comes with in­creased bureaucracy, especially when we look at the last six years since the NDP government came into power. We have seen so much bureaucracy with no real action, no results. I know that my constituents who are still waiting for their promised hospital — a long time ago — would much rather see immediate results, like the promised shovels in the ground.

While Bill 36 also sets out how an assessment will be conducted, many of the parameters — such as scope, conduct, timeline, etc., — are left to the minister to decide. As per section 440, the superintendent may require colleges to pay a general administration fee to be set by the superintendent and subject to regulations. This would pass the cost of funding the superintendent’s office to the regulators.

Ultimately, our health care system and all the systems that play into it need overall change. Bill 36 has brought forward some necessary changes, and some, as my colleagues have mentioned, may need to be considered and debated further. Perhaps supporting the professional and occupational regulation overall may be the answer to fixing a few of the many issues that British Columbians face here at home.

The local newspaper in my riding city, the Richmond News, had a very impartial report a few months ago about the current health care situation, commenting on both the NDP government policy and B.C. Liberal policy when we were in government. I think it will help both sides to really understand the core problem. That’s why I’m going to read out this report into the record. This is a report dated May 11, 2022.

“Family doctors have long been considered the backbone of the health care system, providing primary care to most British Columbians for decades at privately run practices, but that backbone is strained, and thousands of Richmondites currently don’t have a family doctor. Many family doctors are carrying large caseloads and can’t take any more patients, despite daily calls from people desperate for a GP.

“Dr. Sharon Dodd, who runs two medical offices, wishes the government would listen to family doctors on the front line to find solutions, including modernizing the payment system, compensating for complexity of care and after-hours administrative work, bringing in team-based care, supporting the business side as well as looking at how other provinces are dealing with similar crises. ‘We just want to be able to sit down with government and come up with these solutions,’ she said. Patients are aging as their doctors age, requiring more complex care, and few young doctors are coming into the system, Dodd added.

“The fact that fewer young doctors are going into family practice has also been noted by the Health Ministry. While the Health Minister said that family doctors have been providing ‘great care for a long time,’ and the system has ‘real advantages,’ younger doctors don’t want to work in this kind of business model.

“Overwhelmingly, when you poll younger doctors, they tell you, ‘We don’t want to open our own business, take fee-for-service clients, and operate the way family practice in primary care was in the past,’ the minister said.

[6:35 p.m.]

“In 2010, the B.C. Liberals launched A GP for Me to get a family doctor for every British Columbian, but the doctor shortage remained. When the B.C. NDP won the election in 2017, they took a different tack by introducing an alternative to the traditional fee-for-service funding system.

“In fact, the minister recently called the private practice model a ‘very 1960s-style’ system. Instead, he touted solutions like ‘team-based’ practice, primary care networks, nurse practitioners and urgent and primary care clinics.

“The minister acknowledged ‘it’s not an easy challenge’ but added he feels the action the province is taking now will help resolve the family doctor crisis.

“The minister was recently in Richmond to announce the opening of the permanent location of the UPCC. When he became Health Minister, B.C.’s primary care system had more fee-for-service practices than other provinces, he explained at the opening.

“While UPCCs are currently set up to relieve pressure at hospital emergency departments and provide medical services to people who don’t have family doctors, VCH said the emphasis starting this fall will be on ‘longitudinal’ care, that is, looking after patients long term like a family doctor does.

“Since the temporary UPCC was set up in Richmond a year ago, it’s had 13,000 visits. The UPCC in Richmond has doctors, nurses and other health care professionals as well as X-ray services in a ‘team-based’ care environment.

“‘This is not addition by subtraction. This is in addition to all the incredible work done by primary care doctors.’”

That’s what the minister said. Unfortunately, I don’t think I have time to finish reading this article.

Deputy Speaker: Recognizing the member for Surrey–White Rock.

Interjection.

T. Halford: Riveting, yes.

I want to thank the Minister of Health for his rousing support here, and also a fellow basketball fan. Maybe one time we’ll be able to get out there and actually compete on a court.

Interjection.

T. Halford: Yeah? Well, it’s not…. I need a couple more inches.

Anyway, I’m thankful for the opportunity to speak to Bill 36, the Health Professions And Occupations Act. It’s a weighty bill. Some may call it thick. Some may call it husky. It’s a bill that is 645 sections. And I think it’s important. I think it’s important that we take the time and recognize the amount of work that went into this and the amount of work that went into it across party lines. I know that the Minister of Health was, obviously, instrumental in it, as was the Leader of the Third Party. Also, our colleague, the MLA for Kelowna–Lake Country, spent a fair bit of time in providing input on such an important piece of legislation that is before the House.

There have been a number of speakers that have spoken to this, and you have the opportunity here to really form relationships and an understanding and get a different perspective.

I want to point out my colleague from Skeena and the importance that he talked about. He’s somebody that I’ve really appreciated his friendship over the past while — and allowed to listen to him speak in this House and outside of it, on the importance…. I think he talked about the importance of collaboration and comprehensive consultation with First Nations communities and First Nations leaders.

I think that’s something that I know everybody in this House appreciates. We have those perspectives, obviously, from the government side, from our side and from the Third Party side, and that is immeasurable and it’s important and it’s something that I very highly value.

[6:40 p.m.]

The majority of my cases in my constituency work deal with health care. It’s important work. It’s work that we try and focus on every single day. I’ll say that when a constituent walks into your office and focuses on a health care issue, it’s your obligation to put the partisan politics aside and work towards a solution. Many times we’re able to do that through the minister’s office, and I thank him for that. Not all the time, but there are many times that we can do that.

Speakers have said before that the health care system is struggling right now. This is, like I said, a comprehensive piece of legislation, but it will not solve the health care crisis that we’re in. Obviously, the minister and others have spoken about the fact that we are in two pandemics. We’ve obviously, for the last number of years, been in the opioid crisis, where we’re losing six individuals a day — I will speak to that in a little bit — but we’re also dealing with the pandemic where it comes through, and we are making sure that we are taking care of all British Columbians and how we look out for their best interests, primarily in health care.

I will say this. One of the things that we have to look upon is: what does this legislation do in terms of removing barriers? I’ll speak to that now. Growing up in South Surrey, White Rock, we had had a number of doctors. My first couple of doctors were from South Africa. They had moved here. They were educated in South Africa, and then they came here to practise family medicine.

There weren’t just one or two; there was a handful. It was almost a community of family doctors from South Africa. That was absolutely immeasurable. The fact is that they chose Canada, they chose B.C., they chose Surrey to make their home and to focus on their practice.

I think it is something that we need to look upon in terms of foreign credentials and items like that. When we are seeing such a shortage and such an absolute struggle to retain, to have family doctors, it is important that we put the focus on how we make those changes to make it easier. How do we ensure that we are having people that want to stay here, live here, prosper here?

We’ve heard, we’ve seen on the front steps, we’ve met in our communities, we’ve attended rallies. We know the struggle that British Columbians are having when it comes to a family doctor. Bill 36, I think — I’m hoping — will try and address some of that through the colleges. But I’ll say this. We need to ensure that we are doing everything possible to make sure that we are putting forward ideas to have it where foreign credentials can be recognized if appropriate, where we are getting doctors in our community and doing work.

I recently got a letter from our family doctor, who I’ve been with for a number of years. He said: “If you are under a certain age….” The age was 40. People can guess if I’m under that age. But the age was 40. He said: “I would prefer it if you tried to seek out another doctor, because I’m not going to be here much longer. I’m looking at different things. I’m scaling back my practice, and I want to ease out of this, but I’m hoping that you can go off on your own and find a different family doctor.” That doctor sees thousands and thousands of patients each day.

It’s important to me. The fact is that we make sure that we are supporting our doctors and we are doing every­thing possible to ensure that they are thriving in this sector because of the important work that they do.

When I talk about the majority of cases that are coming in that are constituency-related, I think the fact is that we have seen ample closures in our hospitals. I worked with the minister in terms of Peace Arch maternity. Peace Arch maternity, where two of my three kids were born, is almost an institution in White Rock. It’s imperative that we have a thriving maternity. It’s actually almost….

[6:45 p.m.]

The majority of funding that has gone into Peach Arch Hospital has been through the Peace Arch Hospital Foun­dation. It’s been raised by members of the community. There has been funding from previous governments, current governments. But it’s important that we support local.

The fact is that we’ve got a maternity ward in White Rock that has been closed down a number of times. I’ll highlight that because what happens then is that when we see these closures happen, there’s panic. There’s panic that settles in with not only the health care professionals but also the families. It’s the parents. It’s the young moms.

We saw this extended maternity ward shutdown January 20. We saw another one from July 30 to August 9, 2021, and another one July 8 to 19, 2021. Bill 36, once we dive into it, will hopefully maybe address some of the challenges that I’ll illustrate in a second. But what that does is that puts pressure onto other existing hospitals. That’s Langley, that’s New Westminster, and that’s Surrey Memorial.

I’ll say that parents want to make sure that when they’re bringing the child in…. You know, there is a lot of stress that can be on a new mom, a new dad, and it’s imperative that we do everything we possibly can to try and alleviate that. A last-minute diversion or a last-minute closure does put it into stress for these parents.

I’ll say this. I know when we had to do this, when we had a diversion with our child, thankfully it worked out, and they were born at Langley. It can be a very stressful time. But I’ll also point out that it can actually impede what you’re trying to do. What we were trying to do at Peace Arch Hospital — I know the minister has spoken on this both to me and publicly — is recruitment. This is, hopefully, going to be addressed in Bill 36 — the recruitment of a pediatrician into Peace Arch Hospital so that we’re able to have somebody stable there that is thriving in the community, embraced in the community and somebody that is making sure that the maternity ward there is being kept open.

Part of the problem that we see is that when we do not have substantial pediatric care…. Doctors do need a vacation. Some of them go on leave. Some of them practise in other jurisdictions. That should not result in a full closure of a maternity ward, which is what we saw in White Rock. There was a lot of fear that if that maternity ward closed, it would not reopen.

[Mr. Speaker in the chair.]

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

T. Halford moved adjournment of debate.

Motion approved.

Hon. R. Fleming moved adjournment of the House.

Motion approved.

Mr. Speaker: This House stands adjourned until 10 a.m. tomorrow.

The House adjourned at 6:48 p.m.