Orders of the Day

Hon. R. Kahlon: In the main chamber, I call second reading of Bill 20, First Nations Mandated Post-Secondary Institutes Act.

In the Douglas Fir Committee Room, I call Committee of the Whole for Bill 16, Housing Statutes Amendment Act.

In the Birch Committee Room, I call Committee of Supply for Ministry of Labour, followed by the Ministry of Social Development and Poverty Reduction.

[S. Chandra Herbert in the chair.]

Second Reading of Bills

BILL 20 — FIRST NATIONS MANDATED
POST-SECONDARY INSTITUTES ACT

Deputy Speaker: All right. Let’s start the second reading, Members.

Hon. D. Coulter: First Nations in British Columbia have worked for decades to build a First Nations education system for First Nations learners. First Nations–mandated post-secondary institutes are part of that system. These institutes were created by First Nations to meet the unique needs of their learners and communities. The work they do contributes to building capacity for communities and revitalizes First Nations languages and cultures.

Creation of this legislation reflects the important role First Nations–mandated institutes play in B.C.’s post-secondary education system and provides ongoing funding so they can ensure that First Nations learners can access post-secondary education, skills training and economic opportunities in their communities. It is a critical step in reconciliation and meets a commitment in our province’s Declaration Act action plan.

The legislation will establish a framework for funding that recognizes that the First Nations–mandated institute sector will evolve over time. It will provide assurance of ongoing operational funding and capacity funding to eligible institutes.

[2:55 p.m.]

We haven’t done this work alone. The Ministry of Post-Secondary Education has worked closely with the First Nations Education Steering Committee and the Indigenous Adult and Higher Learning Association for many years to advance First Nations post-secondary education and training. We worked closely with them on this legislation. We’ll continue to work together to develop policies and procedures that support implementing this legislation.

Last year government provided $6.45 million through the StrongerBC future-ready action plan to support eligible First Nations–mandated institutes. This legislation provides assurance that this funding commitment is ongoing. This is an important first step on a journey to support and build this important sector and to continue the critical work of reconciliation in post-secondary education. I ask that all members of this House lend their support to this, the new First Nations Mandated Post-Secondary Institutes Act.

I would like to now move second reading.

C. Oakes: It is an honour and a privilege today to have the opportunity to rise and take part in a very important discussion about working towards our commitments to reconciliation and the betterment of educational outcomes for First Nations British Columbians.

Earlier today, I just wanted to acknowledge, we had some young leaders in the gallery. I had the privilege to spend a few moments with them to talk about leadership; our paths for each of us, our journeys, to come to this place; and the comments I made on what got me involved in politics. Particularly, my hopes were around education, around the fact that at the time, in my community, we didn’t have the availability to continue on with post-secondary education in the North.

I reflected to the young people — who, I know, have just left the gallery to go to another presentation — on the meaningful work to ensure that everyone has access to quality post-secondary across this province. Today is an important step as we look at supporting our First Nations communities on that journey.

This legislation establishes a framework for providing ongoing operational and capacity funding for First Nations–mandated institutions. I know, as anyone who has worked in the sector, how critical it is to have that assurance of ongoing operational funding. It is really difficult to drive the type of change all of us hope and want in our communities when we do not have access to that ongoing, stable, consistent operational funding. This is an important step forward in that.

It also supports capacity-building in our First Nations communities and the mandated institutions. We all know how difficult it is, often, to meet the call of proposals when you don’t have the capacity available to even put the grants forward. I’m hopeful, as we continue on and review this legislation, that we’ll have the opportunity to do an in-depth look at how that will work — with the hopes, at all times, that we find ways to better prepare First Nations, and all people in our province, to follow their hopes and their dreams of giving back to their communities.

I want to reflect on a few personal stories, on people that have had a meaningful impact in my life, and on how this bill, and the hopes I have for this bill, reflects on communities like mine. The first is a significant part of the work of the First Nations Education Steering Committee and the Indigenous Adult and Higher Learning Association. I want to recognize and thank the leadership in both these organizations for their efforts on the steering committee.

[3:00 p.m.]

We had the opportunity back, I think, in 2015 to work with the B.C. Aboriginal post-secondary education and training partners group to have an MOU to facilitate the collective efforts to improve levels of participation and success of Aboriginal learners in post-secondary. So the member who spoke before me is right. This has been decades of work that have led up to this.

What is critical and so important right now, especially with a strong focus on the urgent need for language learning and revitalization, is that we need to ensure that our Elders’ voices are reflected. When I was home this past weekend, two important conversations happened for me.

The first is Doreen Patrick. Doreen attended residential schools, and it’s had a significant impact on her life. She talks openly about the needs, as part of feeling safe in their communities and the cultural significance — how language has played such a vital role.

The second call I had this weekend, as we try and bridge and bring people together in our region, is Ellie Peters, another Elder impacted by residential schools. Both of these incredible Elders are leaders not just in our community but in our region. They are teaching the Carrier language, the Dakelh language.

[An Indigenous language was spoken].

They’ve been doing such an admirable job of not just providing the language in our…. First, they were passionate in our K-to-12 system and now in our post-secondary. But they’ve also reached out to all members in our community and have offered important courses.

I think language revitalization should be for all of us. We should all take the important efforts to learn the languages. I’m hopeful that, led by our First Nations and our Elders and the people who I have such incredible respect and admiration for, we’re going to see significant change. I’m hopeful for this bill, that this will provide the opportunities for people in our communities to do that important work.

I looked at some of the mandated institutions, and we’re a little bit left out in our area. Perhaps as we’re going through the committee process, there’s an opportunity to gain better information, so I can carry that back to our communities, because I think we have so much to give. Our Elders have so much to give to supporting this. I think all members of this House come with a strong sense of hope for our next generation and making suhre that our community members and our young people all see a path forward.

I know, coming from a smaller, rural, remote riding where there are many Indigenous communities, that often that pathway towards hope and that pathway towards post-secondary or advanced education seems awfully far away. It is difficult, coming from our smaller communities, when our only access to education sometimes is hours away, without the structures, without the support and without the cultural support that we’re used to in our communities. For First Nations, it is so much more than that.

[3:05 p.m.]

As the fastest growing population in British Columbia, it is paramount for all of us to make sure our young Indigenous First Nations have every opportunity to follow their dreams and to find success in whatever pathway they look towards.

I am hopeful that with this bill, which I do believe is an important step in recognizing the important role of First Nations–led post-secondary institutions, we ensure that at all times our students are protected. I think that is something…. All sides of this House know how critically important that is and that the accreditations and the credentialing ensure that they have absolutely every access to continue on and follow their pathway.

I also wanted to take a moment, if I may, to reflect on a couple of young people I recently had the opportunity to connect with. We had our Aboriginal cultural days two weeks ago at the College of New Caledonia at the North Cariboo Community Campus in my riding. I walked in the door hopefully. I was so excited to purchase some of the incredible crafts that the artisans had brought forward. Two young people came running up to me, who I had not seen in a while.

Celestine, who had worked as a co-op student in my office, said: “Look. I’m so excited. I picked up my nursing package. I am so excited. I want to be a nurse, and I want to go back into my community.” The Lhtako councillor was with her, and I just thought that that’s, to me, what success looks like, where that young, bright, intelligent, hopeful person sees a pathway towards post-secondary education and to follow their dreams. To take that back into community to build incredibly important capacity, I think is so critical.

Celestine, I am so cheering you on. You know that both myself and Jackie at our office, whatever we can do to help support you, we’re just incredibly proud of this step that you’re taking on this journey.

Another young lady, who was with her, was looking at becoming an early childhood educator, both also in the Lhtako First Nations. I thought: “Wow, that’s incredible.” I talked to the councillor, Tim, after, because I really, really appreciate the approach that Lhtako chief and council are looking at, their support of post-secondary education and what that can mean in supporting their community members to get access to that.

When we talk about building capacities, especially in our First Nations communities, it’s so critically important that we have the teachers and the nurses and the social workers that are in those communities, and they see a pathway towards that.

There are all still significant barriers, and I think the organizations, the First Nations steering committee and the Indigenous adult learning association have done an important job of identifying that it is often very difficult. There are gaps to learning in order to access that. Whether it’s getting courses for entrance preparation or transfer courses, that is the type of…. Security of operational funding, to make sure that those efforts are available, I think is critically important.

I talked last year during the estimates process about the student transition project, transitions of B.C. high school graduates into B.C. public post-secondary education. That was prepared in June of 2023. We’ve seen a significant decline in students transitioning from K to 12 and into post-secondary, in particular Aboriginal and males. I’m hoping that with this bill and under the First Nations leadership, we look to find new ways to support success in that transition. Having that focus of First Nations led by First Nations in First Nations–mandated post-secondary institutions I think is really important.

[3:10 p.m.]

Another key area that we will focus on when we get to the committee, just to give staff that heads-up, because we always want to talk about the key areas, is how learners will move into the post-secondary education system. It is critical.

We really do need to be paying attention to what’s happening with post-secondary institutions. I have raised, multiple times, my significant concerns that we have to look at the funding model. We have to look at how we are doing things, because we need to make sure everyone has access to very critical, important training.

I know in government there’s often language that is discussed around whether it’s 80 percent of jobs in the future that are going to require some kind of post-secondary. I think it’s easy for us to get caught up in the rhetoric of numbers and stats and forget about what those numbers represent. They’re people. They’re people that we care deeply for in our communities.

How do we make sure that there’s equity and make sure that, whether you live in Nazko, Kluskus, Dene Tha or Stellat’en — I could list communities across this province — there’s equity and there’s the ability for everyone to have access to training in a safe and culturally respectful way?

B.C. United stands ready to ensure that this legislation is not just a promise but something that’s practical and that’s really going to change the lives of people in our communities, because our communities are hurting. I think this is a strong path forward.

A. Olsen: It’s wonderful to be able to stand in the Legislature here today and speak to Bill 20, the First Nations Mandated Post-Secondary Institutes Act.

I remember back when government first started to make serious investments in Indigenous language revitalization and recovery. It feels like so long ago now. I was having a conversation at lunchtime about how quickly the calendar moves and how slowly government moves and how these are necessary polarities. The calendar moves very quickly when we’re elected officials moving from one session to the next, and then into constituency work. The pace of government is necessarily a lot slower.

In fact, in some cases, as this bill was tabled yesterday and here we are today debating second reading, I may have wished that it would have been a little bit slower, as I would have prepared more thoughtful and more detailed comments just to the impact that this bill has the potential for when it comes to Indigenous communities across the province.

I would say that limiting this to the impact to Indigenous communities would be wrong. The impact of fully understanding who we are — fully realizing and actualizing who British Columbia is, what British Columbia is — is only going to be achieved once we have a more complete picture of the really, really beautiful, diverse cultural mosaic that we have in this province.

When we look at British Columbia from an ecological perspective, we would celebrate it as one of the most, if not the most, biodiverse ecosystems in the entire country. In terms of species, in terms of different types of landscapes, British Columbia is recognized for its environmental biodiversity.

[3:15 p.m.]

The people in the land aren’t too different. In fact, when it comes to Indigenous people and the connections, rather than a sense of ownership of land — it is a sense of belonging to that land — it should not be surprising that we can also celebrate having one of the most culturally diverse jurisdictions in Canada and, probably, most culturally diverse jurisdictions or territories in all of North America, if not the world.

The number of languages, just in linguistic groups here — over 30 linguistic groups that exist in this province. The number of dialects — in the hundreds, low thousands maybe, of different dialects that come from those different linguistic groups.

If you look at the territory that I’m from, W̱SÁNEĆ territory, and the linguistic similarities between our relatives here in the lək̓ʷəŋən area where we do our work every day, to the south of the W̱SÁNEĆ people, and then the linguistic diversity just to the north of us, with the Quw’utsun and the Hul’qumi’num’-speaking people…. Of course, these languages are very similar but different. We can understand each other, yet the language is just slightly different — different accents, different pronunciations. It’s just an indication of how culturally diverse our beautiful province is.

It struck me when I was up in the Wet’suwet’en territory a couple of years back and was talking to one of their hereditary leaders there, Namoks, and talking about how linguistically different they are from the Gitxsan people that they share a border with but remarkably, distinctly different languages, different cultures. It really is what makes this province so unique geographically. It might make us unique economically as well, but that’s probably for a different speech. But unique geographically here in North America.

As I’ve highlighted several times in the Legislature, in a variety of different speeches over those seven years that I’ve had the honour of representing W̱SÁNEĆ here in the Legislative Assembly, I’m proudly from the W̱JOȽEȽP community, proud to be connected with my relatives and the families throughout W̱SÁNEĆ.

We talked about and I’ve talked about how language is so key to the understanding of the world views that the Indigenous people of British Columbia have, the connections that we have to our territories, the reasons why we are there, the relationships that we have to all the living and non-living, the inanimate and inanimate in our territories. Locked in language.

It makes the original acts of these Crown governments that we are here to be elected to represent and be representatives in…. It makes those original acts both understandable from the perspective of those Crown governments, in that their whole entire goal was to displace the Indigenous connections to those lands that were being….

As I’ve talked about on a fairly regular basis in here, the displacement was so that the Crown governments could take control of the lands and the resources, and, as we have learned and as we are learning about the history of this province, done without the appropriate legal agreements for the vast majority of the lands here in British Columbia.

The displacement, the destruction of language, the destruction of cultures, the separation of family members from their children, the erosion and undermining of Indigenous mothers’ ability to look after and raise their children, of our families to look after and raise our children are all part of the same policy framework that had an intense target on language.

[3:20 p.m.]

As we passed the Declaration on the Rights of Indigenous Peoples Act in 2019, an important policy change and an important philosophical change that we made in our province, I was quite proud to stand with all the members of the House.

I was quite proud to work with the former Minister of Indigenous Relations and Reconciliation, Scott Fraser, and his team as that was navigated — a very tricky, very complex bit of policy work — as it changed the focus from rights denial to rights recognition — a key shift, a key change in our province, which we can all be proud of.

It was not just a piece of policy work that former Minister Fraser did or just a piece of policy work that I worked on with the ministry. In the end, it was a piece of policy work that we all engaged in together, in that vote.

Many of the members in this House didn’t have the benefit of having been raised on an Indian reserve, understanding the history of the relations between Crown governments and Indigenous peoples, in a way that I was introduced to it, as a kid who was brought home to an Indian reserve in the mid-1970s and who was really informed by the things that I witnessed and experienced, and more deeply than that, by the things that I hear my family experienced but that I never did.

We know of the displacement of people from territory, the displacement of people from their homelands, from the places that they belong to — moving families around, intentionally creating policy that generates poverty rather than the ability for people to create wealth — the residential schools and the day schools.

Before I move on from that, the residential and the day schools were used as a way to separate people from their languages, with children being forced not to speak their language. Terrible, terrible things were done to children who just wanted to speak their Indigenous language. Terrible things were done to families whose kids were in day school. The parents had fear that teaching their Indigenous language to their kids might lead to their kids being taken away.

These really challenging relationships evolved between children and their parents, parents and their children — and they still live in the same house. Often overlooked when it comes to the day school experience is this tension between the parent and the child and the real, intense desire to protect the child from all the awful things that they heard about and to protect the parents from losing their children to residential schools. There was this belief: “At least they’re coming home.”

Residential schools were used to separate language and culture from a people, in order to begin to undermine and erode the people’s sense of identity, the people’s sense of place, the people’s sense of belonging and the people’s world view. As we have debated in here on a regular basis over the last few years around Indigenous language revitalization, one of the key acts that this government can do is invest in that language revitalization.

My daughter goes to ȽÁU,WELṈEW̱ school. “Place of refuge” is what ȽÁU,WELṈEW̱ means, a place of refuge. The name ȽÁU,WELṈEW̱ comes from a sacred mountain in our territory, just between Central Saanich and North Saanich, as you head out to the ferry.

[3:25 p.m.]

It’s that mountain that has the navigation ball on the top of it. That’s ȽÁU,WELṈEW̱, the place of refuge. That’s the place that our ancestors tied our canoes to in the time of the great flood. When the flood waters receded, they gathered at the top of the mountain and they said: “This is the place that we’re going to name ȽÁU,WELṈEW̱.”

It’s the place where we received our name, W̱SÁNEĆ, as the emerging people, the emerging lands, the people of the emerging lands, where we could gather as the floodwaters receded. So W̱SÁNEĆ stayed as the name for the Saanich Peninsula and eventually the name for the people that lived there, the W̱SÁNEĆ people, emergent.

[J. Tegart in the chair.]

In the 1970s and 1980s, our Elders, my grandfather, my great-uncles and my great-aunties made a dedicated commitment to preserve our language. They knew that the stories — the culture, the sense of belonging, the world view that was captured within the stories of our language — were really about identity. They were really about preserving an identity that the government had done everything that it could to try to destroy and remove from Indigenous peoples, not just in W̱SÁNEĆ but in communities across the province.

They made a concerted effort to protect that language, and our Elders, my grandfather, my great-uncles — my grandfather Ernie Olsen, my grandfather TELQUILEM; my late great-uncle PENÁĆ, David Elliott Sr.; and many others — each had their own way of doing that. They worked very, very hard to preserve the language, to protect it, to build a little nest for it and to hold it for another time, so that it could be picked up and carried further in the next generation.

That’s exactly what happened at that school at ȽÁU,WELṈEW̱. The Saanich Indian school board became this little place that that language was protected. When we built a new school for our elementary in the 1980s and 1990s — I can’t remember the exact date now, but a long time ago, when I was just a young man….

Interjection.

A. Olsen: Thanks. That’s what I was waiting for, was that. I appreciate that.

There was a discussion amongst the Elders in our community about what we should name that school. I’ve heard that story a few times now. It’s a moving story of a debate that happened amongst those language protectors, about what name we should put on this school. It’s an important part of our culture: the naming and the passing of a name from one to another. It’s a very deliberate and a very honourable thing to carry a name.

My name is SȾHENEP. It’s an honourable thing for me to carry that name. It’s an important thing for me to protect the honour of that name. That’s the responsibility that I have. SȾHENEP, it’s my job to look after it. So that when another SȾHENEP is identified, then they will also understand the role and responsibility.

Just last year two of my nephews, my nieces got that name, SȾHENEP. It was important for us to share the responsibility, which they now carry, in order to hold that name in a good way. Others got versions of SȾHENEP, because they are all connected to that individual name, SȾHENEP, that we received that name from.

Now we carry it together, and we have a collective responsibility. Even though they’re not my brothers and sisters, my kids, my children, they’re my nieces and my nephews, they’re my cousins, and we together have this collective responsibility now to carry this name.

So they had this discussion about what they were going to name the school, and they decided to bring the name, ȽÁU,WELṈEW̱, the place of refuge, down and put it onto that elementary school, that little language nest that they had built. That’s what they were going to name it, ȽÁU,WELṈEW̱. It was going to be….

[3:30 p.m.]

As the story is told, there was a very strong argument that was made — or a very strong point that was made, maybe — in the discussion, that that mountain already had that name. And it was important that that name be brought down from that place and be brought to the school to be shared.

I’ve heard this story a couple of times now. It’s a very moving story, because the place that protected us in the great flood…. As the story was told, there was a new flood in our territory that has impacted our culture, the worldview, the ability of the W̱SÁNEĆ people to self-realize, to self-determine. A lot of those things were taken away in that new flood.

What we needed was a new place of refuge for the culture, for the language, SENĆOŦEN, that has been spoken many times in this House now. It’s a great honour. Those words that Her Honour our Lieutenant-Governor speaks in here are from our language as well.

Much respect to Hansard, who really honour the languages, those words that are spoken in here. When they don’t have access to it, they work really hard to make sure that they get it right on the record, because they recognize how important that language is, that they capture it. They should be acknowledged for the work that they do to try to ensure that our record is a good one.

But they brought that name down, and they put it on the school. Now the beneficiaries of that are our children, who are actually in a language nest program, an immersion program. My daughter, Ella, is now in grade 6. She started when she was in grade 1. She’s now got six school years of SENĆOŦEN language learning. She is this beacon for our family.

Her dad doesn’t know that language. I can say a few words. I can make them sound pretty good. I think I have pretty good pronunciation for a person who can’t speak it to any great extent. I think I understand the concepts that are being taught through the language, that are being explained through the language. I’m getting pretty good at sitting at events and really being able to follow along and understand what our speakers are saying, just from listening and experiencing. But my daughter gets taught the language and the stories, and they become a part of her worldview in a way that only her great-grandfather could have imagined.

My son, Silas, is at Stelly’s high school. He was one year ahead of that first language immersion program. He missed it by one year, so he was in the public school system. He’s now at Stelly’s high school. School district 63 has recognized SENĆOŦEN as a second language, part of the second language curriculum, so he gets picked up by a van, he gets taken over to the campus at W̱JOȽEȽP with his peers, and they get to learn SENĆOŦEN as their second language. That’s very meaningful to him.

It’s the best that we could do for him in his education. One year younger and he could have been on the front edge of that learning. I see those kids that have been on that front edge of the learning. They’ve learned a lot about how to learn, and the school has learned a lot about how to learn. As the provincial government stepped up and put that first $50 million on the table to preserve language, and they found a mechanism to distribute that money, there was always the fear about how it was that they were going to be able to maintain this.

There’s a cultural teaching in W̱SÁNEĆ that once you start something like that, you have to continue. You have to follow through. You can’t stop this now. So how do we preserve that? How do we make that happen? I was wondering how it was…. When I heard the story of how our relatives in the urban communities at the Victoria Native Friendship Centre have a linguistic program….

[3:35 p.m.]

Of course, as I was talking about the beautiful diversity of this province, nowhere is that cultural diversity more recognizable than in the friendship centres in communities right across the province. Nowhere is the linguistic challenge more difficult than in the urban centres in those friendship centres. They are also the little cultural nests within the urban centre for our relatives who’ve been displaced from their territories and have moved into the urban areas to go and connect with their friends and their family and their extended family to celebrate culture together.

When I heard that that funding was cut, it was very sad to me and very devastating that this program that was giving a space for language learning and growth was at the whim of government funding.

I look to the way that this bill has been described, this bill that’s in front of us here, Bill 20, and about an attempt to create a more stable and more secure environment for Indigenous language learning, Indigenous language preservation and, more importantly, Indigenous language revitalization, as so many Indigenous languages are right on the brink of extinction. We saw that here as the words of the lək̓ʷəŋən language are now out in front of this building in perpetuity, and we celebrated that together, all four parties standing together, blanketed with my relatives from Esquimalt and Songhees.

As we see that that preservation is happening, we know that those fluent speakers are fewer and fewer every day, and there are languages that now have no fluent speakers alive anymore. So the revitalization, the language rescue project, needs a committed government. It needs a committed source of funding, and it needs a model that’s sustainable. If we can create, through these post-secondary institutions, a model for that so that language can be taught and preserved and taught across the province, then that’s a very exciting thing.

As we get through to the committee stage of this bill, some of the questions that I’m going to be asking are just around that stability, just around the ability for this program to get started. I note that while we are celebrating this today, we are still a few years, or a year and a bit, away from actually being able to see this realized. I’m searching now for the date, but I think that it’s 2025, so maybe a year away from it coming into effect. I think it’s important that we understand that the timeline of Indigenous languages is very short — very, very short for some languages.

I want to raise my hands to the minister. I want to raise my hands to this provincial government, who has seen and heard the need for Indigenous language preservation and Indigenous language revitalization. I want to acknowledge the comments of the speaker before me, who talked about the importance of education and post-secondary education and the importance that that is accessible to Indigenous learners.

I haven’t talked a lot about this, but I’ve just recently gone back to school. I’m doing it in this context as well. Lifelong learning — the ability to learn and grow and work and be a part of the community. That should be something that we can all aspire to. The creation of Indigenous institutes, First Nations post-secondary institutions that can partner with all of these other post-secondary institutions in the province and really create a strong fabric of learning for Indigenous people in this province is not just a benefit to Indigenous people; it’s a benefit to all of us. It’s that rising tide that lifts all boats.

I want to raise my hands to the Union of B.C. Indian Chiefs and the Assembly of First Nations, who have both made this a priority through their resolutions and their initiatives.

[3:40 p.m.]

I want to raise my hands to the First Nations Education Steering Committee, FNESC as we know it as, and the Indigenous Adult and Higher Learning Association. These are organizations whose job it is to ensure that our students and our learners have access to the programs that are meaningful to them and that they’re well-funded.

I look forward to seeing this program grow from this small number of institutions to institutions right across the province. I look forward to…. In maybe some of those smaller communities, maybe a full school is not something that can be done, but there can be places that people can go and get learning that’s connected to a broader, larger institution.

I really see the potential of this, and I hope that this model grows, and that, more importantly than anything else, government is clear. Once we start this work of Indigenous language revitalization, it is a pathway that we need to remain committed to. It is not a pathway that we can abandon.

As these programs grow and become more solid in our communities, no doubt that the Indigenous communities are going to pick them up and carry them. However, there has been so much investment in tearing Indigenous languages down, it is incumbent upon this Crown government institution, to invest, to ensure that we’re on stable footing and that we’ve got a good foundation.

I see this bill as something to celebrate. I know it moved a lot of emotions in our office, and we feel that. I feel that here today. It’s very powerful. I raise my hands to the minister, and I raise my hands to the government for moving this initiative. I look forward to engaging on it in committee stage.

HÍSW̱ḴE SIÁM.

Hon. D. Coulter: I’d like to thank the two members opposite for their comments on this important legislation. I can see that it’s personal to both of them. I’d like to particularly thank the member for Saanich North and the Islands.

I think it’s really important to hear your stories and have your perspective on this bill, so thank you very much.

As we know, First Nations in British Columbia have worked for decades to get to this day. They’ve worked tirelessly to build a First Nations education system designed specifically for First Nations learners.

In the post-secondary sector, First Nations mandated institutes are a critical part of this system. This is why it is so important to support institutes that are created by First Nations and that will meet the unique needs of their learners and communities.

Once again, I want to thank the First Nations Education Steering Committee and the Indigenous Adult and Higher Learning Association for their work to advance this legislation and First Nations post-secondary education and training in British Columbia.

With that, I know we look forward to the committee phase of this bill, and I will…. I don’t know. Can I say take my seat? That’s what we’ll do.

Deputy Speaker: It’s my understanding from the acting Government House Leader that the minister will not be making closing remarks.

Members, seeing no further speakers, the question is second reading of Bill No. 20, First Nations Mandated Post-Secondary Institutes Act.

Motion approved.

Hon. D. Coulter: I move that Bill 20 be referred to a Committee of the Whole House to be considered at the next sitting of the House after today.

Bill 20, First Nations Mandated Post-Secondary Insti­tutes Act, read a second time and referred to a Committee of the Whole House for consideration at the next sitting of the House after today.

Hon. D. Coulter: I call second reading of Bill 19, child, family and community service act, No. 2.

[3:45 p.m.]

BILL 19 — CHILDREN AND FAMILY
DEVELOPMENT STATUTES
AMENDMENT ACT, 2024

Hon. G. Lore: I move the bill be now read for a second time.

I am pleased to speak to the amendments to both the Child, Family and Community Service Act and the Adoption Act. These amendments build on our government’s work to support and recognize inherent jurisdiction of First Nations over their children and families. It builds on the work that started with Bill 38, the Indigenous Self-Government in Child and Family Services Act. It builds on the Declaration Act action plan, and it builds on recent amendments regarding the definition of an Indigenous child.

All of these legislative amendments reflect steps forward on this path that we are walking together.

Indigenous children remain overrepresented in child welfare. We know that it will take meaningful and intentional work and collaboration to strengthen our systems and supports. Work, we must do together.

As I did when speaking to Bill 5, I want to reflect on the importance of this work and its relation to the calls to action from the Truth and Reconciliation Commission and the calls to justice from the inquiry into missing and murdered Indigenous women and girls. These calls demand recognition of self-determination and inherent jurisdiction. They demand change in our child welfare system to address the historic and ongoing impacts on Indigenous children, youth, families and communities.

The Minister’s Advisory Council on Indigenous Women always reminded me that the process that led to these calls was sacred work, as is the work to answer them. These calls and the leadership and wisdom of First Nations and Indigenous organizations have continued to shape how we do this work together. It’s truly an honour today to speak to these amendments as we continue to take steps forward.

We know that Indigenous jurisdiction is inherent, and the path to resuming jurisdiction is important and unique for each nation. For nations not yet exercising full jurisdiction over children and family services, these amendments will create new opportunities for increased authority over decisions affecting their children and families. It does this by broadening the scope of joint and consent-based decision-making agreements between the Ministry and Indigenous governing bodies to capture the decisions, duties and powers of the director under the CFCSA and the Adoption Act.

It is the powers of an MCFD director that are among the most meaningful and impactful for children, their families and nations, and it is these powers that nations have told us they want to share in. For example, the director and an Indigenous authority will be able to jointly develop an agreement related to a child’s plan of care. In addition, changes to the process will mean that such an agreement about the child’s plan of care will not need the approval of Lieutenant-Governor-in-Council, since they are powers contained in the CFCSA and Adoption Act, not statutory powers of decision. These amendments bring to life what has been a shared vision with partners.

We continue to learn from the wisdom, advocacy and collaboration with Indigenous rights and title holders, Indigenous governing bodies, modern treaty Nations, Indigenous partners and First Nations Leadership Council. These conversations, this collaboration and the opportunity that I’ve had to learn have guided us and allow us to learn better how to take these steps forward.

Just as Bill 38 considered jurisdiction and the exercise of Indigenous law, it also contemplated dispute resolution, including enabling the use of the provincial court for nations who choose to use it as a dispute resolution mechanism. This bill includes expanding the pathways for dispute resolution by conferring the jurisdiction of the appellate courts, the B.C. Supreme Court and the B.C. Court of Appeal.

We know that many nations resolve disputes through their law, tradition and customs. For those nations who choose to use the provincial courts, this amendment is important to expand the pathway of the full court model if their law provides for it. In doing so, it will create an equal pathway to justice for Indigenous children, youth and families, and non-Indigenous families under the CFCSA.

[3:50 p.m.]

These amendments to both the Child, Family and Community Services Act and the Adoption Act are vital to the continued work to uphold inherent Indigenous jurisdiction over child welfare in ways that make sense for communities.

It remains at the heart of this ministry and this government that every child in B.C. has the opportunity to thrive, to be safe, to belong and to be connected to their community and culture.

I look forward to the committee process, as well as continued support for this bill.

N. Letnick: Thank you to the minister for second reading comments.

Bill 19 proposes vital changes to the Adoption Act and the Child, Family and Community Service Act, aiming to strengthen Indigenous communities’ authority over child and family services.

By expanding joint decision-making agreements and establishing a pathway for dispute resolution under Indigenous law, these amendments align with the Declaration on the Rights of Indigenous Peoples Act. This signifies another crucial step towards enhancing Indigenous self-determination and ensuring that decisions affecting their children and families honour Indigenous cultural, social and legal traditions.

Central to our discussions today is Jordan’s principle, which ensures that no Indigenous child faces delays in accessing necessary services due to jurisdictional disputes. This principle reflects our collective commitment to equity and justice, highlighting the importance of putting the well-being of children above all else.

As we review this bill, our ultimate goal is to uphold the best interests of Indigenous children and families. We must ensure that this legislation is not only well-intentioned but also practical, effective and transparent.

In the committee stage, we will examine each proposed change thoroughly, making certain that all stakeholders fully grasp the amendments and their implications for our children, for Indigenous communities and for our shared future.

A. Olsen: I rise to speak to Bill 19, the children and family and community services amendment act No. 2.

So many times, acts have been opened multiple times. This is the second time that this act gets opened this session, and amendments get made, in amending both the Adoption and the Child, Family and Community Service Acts.

This indeed is one of the, I think, most tragic chapters. If there was a book of British Columbia, the child welfare system is the saddest chapter of that. It’s the chapter that causes our province the most embarrassment out of them all.

As I spoke to in the previous bill around Indigenous language preservation and the responsibility that the Crown government holds in making sure that there is an ample amount of resources available to restore and protect Indigenous languages that are seeing fewer and fewer fluent speakers — indeed, as I mentioned, some have no speakers — the child welfare system in this province is where much of the work of previous generations of elected officials that sat in these seats is visible today.

To think that this is a past problem that we have in our province would be a mistake. The problem is current, and it’s ongoing. It’s built on the premise that, basically, you can’t trust Indigenous people to look after their own children. That’s what the whole system was built on.

The absolute devastation and destruction that the residential and day schools caused in our communities…. The result of it has been crushing poverty in our communities, broken families, intergenerational trauma, intergenerational struggles. So often, when a child welfare worker shows up to a place, they confront that reality every time — the result of a series of policies has the Ministry of Children and Family Development with little options, frankly.

[3:55 p.m.]

Failure of providing adequate housing for First Nations. I just read an article the other day about the infrastructure gap. We’ve got an infrastructure gap in communities across the province. The infrastructure gap in First Nations communities is far wider, far deeper, far more problematic.

First Nations communities in urban areas haven’t had access to proper drinking water. There’s no doubt in those scenarios that legislated poverty, poverty by policy — which is what we see in First Nations communities — that federal government decisions have led to this.

The Ministry of Children and Family Development has been on the front line separating children from their families, sending them to group homes, sending them to foster care, breaking families down, breaking communities down. That is the challenge — breaking identity.

As I talked about, there are a lot of connections between the bill that just passed second reading and the one that we’re debating here. A lot of the same policy tools were used to separate Indigenous peoples from their territories. They’re hard topics to discuss.

As we, as a province, begin to follow the lead of the courts…. The Crown governments have been scrambling to keep up with the decisions, what governments are forced to do.

We see the bill last year, Bill 38, and now we see these amendments here. This bill that’s in front of us today will expand the scope of joint consent-based decision-making.

Legislative changes will allow for Indigenous governing bodies to enter into the power or duty agreements with the minister. Requires any agreements and amendments made be public. Removes requirements of the Lieutenant-Governor-in-Council to approve the agreements and requirements under the Declaration on the Rights of Indigenous Peoples Act. Provides for further appeals to the Supreme Court and the Court of Appeal, if the provincial court has jurisdiction in relation to a legal dispute arising under Indigenous law.

Today we are building upon the changes that were made through Bill 38 through the fall of 2022, the Indigenous Self-Government in Child and Family Services Act.

It’s a result of requests that were made from the minister from Indigenous governing bodies to broaden the scope of joint and consent-based decision-making, to encompass most decisions taken by a director — as the minister stated — under the Child, Family and Community Services Act and the Adoption Act. Indigenous governing bodies were seeking to sign agreements such as developing care plans, voluntary agreements, similar to the duty of directors, rather than the statutory powers regarding procedures.

We’re just in the process of understanding the deeper implications of what this bill will do. But just as I talked about, at great length, in the previous bill, the resources in order for the rebuilding, the reconciliation, the reconstruction need to be available. The mechanisms in which those communities who are taking back the control of child welfare in their communities need to follow those communities.

These Crown governments were responsible for that destruction. The source of it is here. We often blame Indigenous communities for being in the position that they’re in, but the reality is, is that it’s because of Crown government policy that that crushing poverty exists.

[4:00 p.m.]

For the vast majority of the decades that Indigenous people have been facing this policy decisions, the poverty that has resulted is because of a lack of ability to generate own-source revenue in an effective way.

We had a bill earlier that…. Soon, it will be the first time that First Nations can hold land under the name of the First Nation. There are lots of laws around how Indian reserves and First Nations can hold land. From everything that I’ve been told about this….

We see here the Crown government that played a major role in breaking, in disrupting First Nations, handing the responsibility back with not the resources in place to be able to properly administer it. This potentially facilitates another situation where Indigenous people will be blamed for the failure of not being able to manage the child welfare system that we gave back to them. Is that where we’re at?

Are we at a situation where Indigenous communities have gone through this process — have gone through all of the changes that were made in Bill 38, the Indigenous Self-Government in Child and Family Services Act, have taken back the jurisdiction of child welfare in their communities — yet been given none of the resources that the provincial government’s child welfare system previously used to support those children? We’ll be asking many questions about this. It’s not good enough to simply break the system, cause the damage and then say: “Here, it’s yours. Good luck.”

We need to see from the government that’s passing these legislations — this one here today, the one two years ago in the fall of 2022 — that the resources that were initially set aside for the children that come from those communities, the responsibility for which is now going back to their home communities, are following the children to the administrators within their community, so that the administrators of the child welfare services and the child and family services in those communities are not constantly moving money around and trying desperately to do the things that are needed.

We know that this government spends $160,000 a year per child in the child welfare system, up from $135,000 a year. Is that money following? Is that money now available for kids that are no longer in the system? Does it stay in the system, or does it follow the children to the communities? I think that it’s really important to note that this ministry is not just handing the jurisdiction back with none of the resources in order for those communities to be successful. My understanding is that that’s the case, and I certainly hope that by the time we get to the committee stage, that can be made clear.

I really hope that when I look back at this part of this speech, I can be reassured that everything that I just said was a moot point, that I was misinformed. That would be the best day for me, to learn that I was misinformed about this whole part of this speech.

We do need to acknowledge that there have been people in our communities who have been fighting to get the responsibility of the child welfare system back within our communities and look after our children. We’ve been fighting with this government to get information about our children who are no longer in our communities but who are in the system. This government has been hoarding the information: “We can’t give it to you. It’s private information.”

[4:05 p.m.]

We hope that the information follows, as well, so that the administrators of our child welfare systems are not fighting this government to ensure that we know who all our kids are and where they are, our youth, so that we can maybe get them to that language that I was talking about just a few minutes ago — so that they can start to understand who they are and how they’re connected and who their families are and how they’re connected to these communities.

I’m happy that this policy is beginning to take shape. I’m really thankful for the First Nations in the province that are at the front end of this and all of the people who have worked to move this forward. I’m really thankful for them. I just want to acknowledge that there are some serious resourcing issues that need to be addressed, that the jurisdiction isn’t going back lacking resources and that now it’s not just, “Oh, here you go,” so that then the government can stand up and say: “We’ve never had fewer.”

I think successive Ministers of Children and Family Development…. The numbers have been getting better and better. From the first Minister of Children and Family Development under this B.C. NDP government to now, the numbers have been consistently getting better.

The current minister and the future minister are going to be able to say: “As First Nations communities, it’s gotten so good under us, under our government. There have never been fewer Indigenous kids in care, never been so good.” Yet when you go to those communities and you say, “How well resourced are you?” are they going to be able to say: “Yeah, we’re good; we’ve got the money that we need in order to be able to deliver the service”?

The situation is not a utopia, right? The damage has been done. The policies have been in place for decades. The intergenerational impacts are well known. I’m not going to repeat them again here. We’re not handing over an untroubled situation. We’re handing over a situation that is most desperate, in many cases. It needs to be linked with the housing policy. It needs to ensure….

At the rate of $160,000 a year that those children currently get in our system, and if there are multiple children in the system from the family, that would be more than enough to really, really well house that entire family, to super well house that entire family, especially in the reserve scenario.

Are those resources going to ensure that these children who have now come under the jurisdiction of their communities…? Are those resources going to go to ensure that those families have access to the money to build, to maintain and to have a home that can house everybody?

That would be remarkable. My sense is that it’s not, but I’m hoping that in committee I learn that I’m wrong. We know a lot of these child welfare cases are as a result of other health and social concerns. There needs to be a coordinated effort that looks at that.

Coming from a First Nations community, I know the thing that our leaders struggle with the most. It’s the most challenging file for any newly elected chief and council member: “You get child welfare.” There’s no support for those people.

You know, when I look across the street to my municipal council colleagues, nobody gets child welfare as their portfolio. They get sewer and water, or they get parks. That’s a good one. They get development, planning. They get all the things in a municipality. Nobody in municipal government gets child welfare when the child welfare person calls up.

That’s a commentary to our society. It’s a commentary to the systems that the Crown governments have built and maintained over decades — that when a chief and council get elected, they appoint someone to the child welfare. That’s not on them. Society is more inclined to blame First Nations for that scenario. That’s on us.

[4:10 p.m.]

The housing situation is on us and on the federal government. I know the government is going to say: “Well, the province has invested more in on-reserve housing than ever. In fact, it’s a federal issue.” So I celebrate that. How­ever, the reality is far greater than the resources that have flown to the First Nations communities.

We cannot fix what has been broken over decades. We cannot fix it by simply handing jurisdiction back. We cannot simply fix it by focusing only on child welfare. It needs to have a full breadth and scope view that health and well-being include a good home. It includes a good education. We talked about that in the last bill. It includes connection to your identity, to who you are and to your family.

It requires a government that respects the relationship between parents and their children. That has been part of…. The deliberate attack of Crown governments, over decades, is to undermine that and to erode it. That was, to a great extent, what the residential and day-school system was about.

I will take my seat on this. I will, actually, make one mention,. This is something that I think…. I’m going to put this on the record, because these are the types of things that need to change.

We got a briefing from the government on this. In the briefing documents, there was a rationalization that was made under the engagement with Indigenous partners. Due to the technical nature of this amendment, minimal feedback has been received. The reason why there was minimal feedback received to this consultation was due to the fact that it was too technical.

What am I to read into that comment? I don’t understand it? The people who are working in child welfare in our communities don’t understand technical things? Perhaps it was not intended to come off that way. I can tell you the feeling that I had when I read it was that I’m not able to navigate…. My relatives in communities across the province who have been working on the front lines of child welfare didn’t engage with this because they were confused.

There’s nothing in this about the timeline to engage. There is an acknowledgment here, quite thoroughly, that Indigenous governing bodies approached the government wanting these changes to be made. I assume that those were Indigenous governing bodies that were further in the process. We’ll hear about that as well.

I did want to make sure that this was on the record in my second reading speech. It is the kind of language…. Well, frankly, it’s the kind of language that we’re talking about. It’s the kind of way that the Crown government frames Indigenous people. It’s the kind of thing that needs to change.

It could have been that the notification went out, and 20 minutes later it was closed. I don’t know. It could be that it’s very technical in nature. However, I can tell you that whatever the intention was and how it landed…. I’m hoping the intention of it was very different. What it left was…. These changes were so bewildering. Nobody understood what they meant. So nobody engaged in the process.

We know the reality. In most of the notifications and engagements…. The pile is this high on the desk. There’s one person sitting there, two people sitting there, toiling away, working through the notifications of a Crown government that’s moving quickly, that wants to get on with the business, that wants to get moving, whose timelines are tightly controlled in the ministry and not the timelines of First Nations.

I’ve raised this a number of times. We’ve entrenched a number of times — 30-day notifications, 90-day notifications, the right to self-determination. You’ve got 90 days to respond, if you can get through the pile.

[4:15 p.m.]

I think every one of us that has relationships with First Nations communities in our province knows that they are absolutely overwhelmed with the number of notifications and the lack of resources. And this is the reason why. When the jurisdiction and authority for child welfare gets handed from one Crown government to an Indigenous governing body, the resources need to go along with it. There are adequate financial and human resources available to be able to coordinate with the provincial government, the federal government, when needed.

I’ll ask this question in committee stage. I certainly hope that something completely other than what the feeling in our office was when we read through this, when we sat down and reflected on what this felt like…. I certainly hope that the ministry meant something entirely different and that it was just…. We were reading it incorrectly.

With that, I will take my seat and look forward to the opportunity to engage with the ministry in committee stage.

HÍSW̱ḴE SIÁM.

Deputy Speaker: Seeing no further speakers, I call on the Minister of Children and Family Development to close debate.

Hon. G. Lore: Thank you to my colleagues for their initial thoughts on this bill in the second stage.

I do look forward to having the conversation further, during committee stage, on the important amendments that are in this legislation. Again, amendments that are aimed at bringing the changes that were made in Bill 38 in closer alignment with DRIPA and the action plan.

I did want to reflect on my colleagues’ comments just briefly. I heard the member for Saanich North and the Islands talk about the impact of a disconnection from family, community, culture and identity. I share that concern with the member and know the impact that that disconnection, through our ministry, has on Indigenous children, youth, families and communities.

Getting at that is so much of what these amendments and the increased scope for section 6 and section 7 agreements is meant to do. I actually increased the scope of that joint and consent-based decision-making. The things that matter for care planning, for connection, for a tie to community and family are the things that we are able to do that joint and consent-based decision-making work on.

Also, I heard the member on the question of resources. It’s a conversation the member and I have had and know we will continue to have. It’s my commitment to that work on resources. It’s not spoken to specifically in this bill or these amendments, but it is work that is active and work that I am undertaking now. In fact, it’s very active.

Next week I’ll be going to Vancouver, where we’re having a significant-sized in-person conversation. We are co-developing. We’re doing the work together on the question of resources, on the question of a funding model, what it looks like to resource jurisdiction.

It’s work we’re doing directly with rights and title holders. It’s also work that’s happening with the First Nations Leadership Council and the province and the federal government through a tripartite working group. I heard the member on those concerns as it relates to the opportunities in this legislation and just want to share that that work is active.

The last piece I want to reflect on…. Some questions were raised around information and access to information. The ministry has been working on and sharing accountability statements. That’s what we call them. What it means is information to nations about their children and youth that are in care, statements that are shared directly with nations.

The First Nations Leadership Council asked me to think about the role of regional accountability statements, how we think about this more generally. So to the members, an important point on information and what nations know about their kids and families. That is also work we’re taking. It was raised to me as an important factor by the First Nations Leadership Council.

[4:20 p.m.]

I will close there, except to also share the gratitude for the Indigenous governing bodies, for the advocates, for the folks who have led this work where some steps and changes were made as we went down this path together and we learned how we needed to do it better, learned how we need to make those additional changes to scope so that it’s actually accomplishing that shared vision.

Again, thank you to my colleagues for speaking to the bill, and I do look forward to continuing this conversation in committee stage and beyond.

With that, I move second reading.

Deputy Speaker: Members, the question is second reading of Bill 19, Children and Family Development Statutes Amendment Act, 2024.

Motion approved.

Hon. G. Lore: I move that the bill be committed to a Committee of the Whole to be considered at the next sitting of the House after today.

Bill 19, Children and Family Development Statutes Amendment Act, 2024, read a second time and referred to a Committee of the Whole House for consideration at the next sitting of the House after today.

Hon. G. Lore: I call second reading on Budget Measures Implementation (Residential Property (Short-Term Holding) Profit Tax) Act.

BILL 15 — BUDGET MEASURES
IMPLEMENTATION (RESIDENTIAL PROPERTY
(SHORT-TERM HOLDING)
PROFIT TAX) ACT, 2024

Hon. K. Conroy: I move that Bill 15 be read a second time now.

This bill enacts a residential property short-term holding profit tax. Families should not have to compete with wealthy investors when they are trying to buy a home. With this tax, the government is deterring speculative behaviour by taxing the income on quick flips to make the housing market work better for people, not speculators. This new tax will apply to income from specified residential property in B.C. sold on or after January 1, 2025.

Part 1 of the bill sets out definitions and interpretation rules for the tax. The definitions provide what is considered to be residential property for purposes of this act and what is considered a taxable property. The tax will apply to income from the disposition of a beneficial interest in either property with a housing unit or property zoned for residential use, and the right to acquire such properties. This part also includes rules on how the holding period of a taxable property is determined.

Part 2 of the bill outlines the calculation of the tax. Taxable property held for less than 730 days, or two years, will be subject to the tax. The tax rate will be 20 percent if a person held the property for 365 days or less. The tax rate that applies if a person held a property for more than 365 days will decline based on the length of time greater than 365 days the property was held, reaching zero by day 730.

The tax payable will be based on this tax rate and the net taxable income from the disposition of the taxable property. The calculation of net taxable income is equal to the proceeds of disposition of the property minus the cost of acquiring the property and certain costs of improving the property. There is also a deduction of up to $20,000 available for individuals who use the property as their primary residence but who do not qualify for any of the available exemptions.

Part 3 of the bill provides for exemptions from the tax. These include exemptions for those selling property due to life circumstances, such as death, divorce, family growth, job relocation or job loss. Persons selling taxable property to a related person will also be exempt from the tax. In order to help ensure this tax does not impede housing construction, this part includes exemptions for people who add to the housing supply.

Parts 4 through 8 establish the rules to enable administration and enforcement. In particular, they set out rules on tax returns, including timing and when payments are required; how taxes will be assessed and reassessed; the administrator’s power to undertake audits; the penalties and offences to enhance compliance; the appeal process if a taxpayer disagrees with their tax assessment; rules on interest on unpaid taxes; steps a commissioner can take in collecting unpaid taxes; and how taxpayer information can be used, including safeguards to ensure this information is kept confidential.

[4:25 p.m.]

These provisions are very similar to corresponding provisions in other tax statutes administered by the province.

Part 9 of this bill provides the ability for the Lieutenant-Governor-in Council to make a variety of regulations necessary for the operation of the act. Part 10 of this bill establishes transitional regulation-making authority and amends an appeal provision to align with changes being made in the first budget measures bill to other tax acts that will come into effect by regulation.

Finally, part 11 of this bill sets out consequential amendments to the Special Accounts Appropriation and Control Act to provide that amounts received by the government under this act are allocated to the housing priority initiatives special account.

Housing should be used as homes for people. With this tax, we will require speculators to pay their fair share on speculative transactions, and government will use these funds to make investments in affordable housing. Using housing to make a quick profit drives prices up for everyone else. This tax is part of our plan to stabilize the housing market and provide affordable homes for people.

P. Milobar: It gives me pleasure to rise to Bill 15 and speak to what is referred to as the flipping tax out there in the broader public. I’ll just have a few words to speak on this.

It does make one wonder what’s next after this bill comes in. I think we need to take a step back and look at what’s happened when other tax measures have come in under this government’s watch on housing.

It wasn’t that long ago that the Premier had a condo as well as his residence in Vancouver. Nothing wrong with that. Many British Columbians had similar situations. Magically, for family reasons, wanting to liquidate to pay off some other outstanding loans and things like that for his education and everything else, as other families in British Columbia are prone to do, the Premier sold that condo for a $150,000 profit. Yet a week or two weeks later the government comes in with a speculation tax which that would have actually met the definition of: having two residences sitting empty.

Interestingly enough, when that condo was put up for sale, it was marketed as an Airbnb opportunity for the next purchaser, with an on-site Airbnb concierge. In fact, with the changes to the rules of Airbnb regulations, I think a full-time Airbnb concierge would still make that building eligible to be an Airbnb, given the changes that the government is talking about. So that’s very convenient as well.

Those Airbnb changes have come in and impacted tons of different investors. Thankfully for the Premier, he avoided all that by making sure he had his place sold and cleared before any of these rules came in.

You know, I don’t take issue with somebody making a few dollars if they’ve held the property for a few years. The Premier seems to have a big issue with that. It’s interesting.

I note that he didn’t sell the condo in Victoria for what he paid for it. He made sure that when it sold for $150,000 more than he paid for it, he sold it for what the market wanted to pay for it, not out of the goodness of his heart, to make sure that he wasn’t profiting off it or just what the rate of CPI was over the years that he owned that condo. No, he sold it for full market value and made sure he profited the full profit from it.

It really speaks to: “Do as I say, not as I do.” That’s perhaps the worry here. It does make one wonder.

We do know that the NDP caucus is rife with investment properties across this province and in other parts of the world, so it does make one wonder if they’re getting ready to liquidate their extra properties to not be charged flipping tax in the next couple of weeks or not, before this bill becomes law. I guess we’ll stay tuned to that to see if there’s another “do as I say, not as I do” moment coming from this Premier and his government, as we’ve seen on housing.

The problem is that right now that’s what we see: we see performative pieces of legislation. We’ve been calling for a true flipping tax for the better part of five years now. In fact, we’ve introduced private members’ bills that did not get debated by this government. It’s been slow-walked by this government over the years.

[4:30 p.m.]

Although we agree with the concept, as we get into committee stage on this, it will be interesting to get to the root of some of the calculations of what this will actually mean, in a real sense, to housing. Because make no mistake about it. This bill will not create affordable housing for British Columbians.

Now, I can understand that the government won’t want to take my word for it, so I’ll quote their housing economist that they use all the time — I believe he works out of UBC — Tom Davidoff. This is what he had to say about this tax: “Not important at all for long-run affordability, but it may be important to provide political cover.”

He said that on February 25, 2024, three days after the budget was announced, three days after this concept was announced. Obviously, we didn’t have the bill ready to go when the budget was announced. That took a few days later, a few weeks later for it to come to the House so we could see the details of it. That’s the housing economist that this government likes to use to evaluate and validate their housing policies. So I think it’s important that we do look at that.

[S. Chandra Herbert in the chair.]

When we get into committee stage and fully investigate this bill…. There are almost as many pages in this bill of exemptions as there are of the rest of the bill. It is important to have exemptions, because people have lives, and their situations change, just as the Premier’s family situation changed and he felt the need to have to sell his second property, his one that was vacant for most of the year. He felt the need to sell it, again, conveniently right before the speculation tax came in. His family situation changed.

But so does everyone else’s. In British Columbia, family situations change on a regular basis. So we are happy to see there’s a litany of exemptions. The problem is every time you have more and more exemptions, you have fewer and fewer people that will actually trigger something like a flipping tax.

In the backdrop of the lack of the bidding wars that we saw back in 2018, when we first were proposing a true flipping tax, which was ignored by this government…. We don’t see that in the market right now. That might change again. We’ve seen interest rates frozen again today at 5 percent by the Bank of Canada. There’s every indication they will probably start to come down. Undoubtedly, there is pent-up demand in real estate, and you will see people, maybe, getting back into the market very quickly if rates come down half a percent or something like that over the next short term.

That’s understandable. So there may be more value to this bill in the longer run. We’ll wait and see. But to think it’s going to deliver affordability…. It simply is not. The numbers bear out, and I will certainly dig into this more when we get to committee stage. Hopefully, this is a heads-up to the minister for her staff to come prepared with lots of background calculations of how we got to the $43 million projected revenue for next year and only $11 million in this year.

I say that because this is a retroactive bill. One would think that given that it will take effect on people that have just purchased over the last while, the $11 million this year would actually be a higher amount. So why it quadruples next year is interesting, given that you would still have the same timelines in place in terms of the 730 days and working backwards.

The other problem is just doing the rough math. Even assuming all the properties paid the full 20 percent, which very few in B.C. would actually trigger, it starts to become a very interesting calculation to get to $43 million, especially when you figure out the 4,000 homes the government is trying to tout that this is going to create and free up on a yearly basis.

This isn’t actually freeing anything up. This is simply selling you that if you bought a house and you need to move and you don’t happen to qualify for one of the 2,900 different exemptions out there, you’re going to have to pay a bit of tax. But you can still move, and the house still exists. All that it’s making happen is the person moving is going to pay a bit more tax. It doesn’t create more space.

When people hear a flipping tax, they assume it’s because somebody is making, I don’t know, like, $150,000 on a condo sale. The reality is that in a two-year window, in the current market, there’s not that type of movement, unless you’re into the properties that are worth tens of millions of dollars. Even then, the movement is questionable.

[4:35 p.m.]

It will be interesting to see how the government has calculated the projected revenues on this, because with my first quick calculation, it would appear that they’re hoping to tax, at the max, at 4,000 homes to get the $43 million, $53,000 profits on sales. It doesn’t sound like the flipping people are thinking about, when they were back in the heady days of the rush to get in and people spending hundreds of thousands of dollars over assessed value.

It sounds like the government, based on the numbers they’ve used to explain this bill — both number of units and revenues and the calculation they use to generate those revenues — are talking about going after people that literally have just sold a home that went up by $40,000 or $50,000 over a couple-year period and are just trying to move. That’s not what the average person out there considers a speculator.

Even if it jumps up significantly in price, this bill has the very real unintended consequence. We’ve already heard from people in the industry that people will just hold the property for an extra six or ten months to avoid the tax but also slow down any potential redevelopment, then, of the sale and the flip.

The concept, I want to be clear, we agree with as the official opposition. We’ve been calling for something similar to this. We believe our proposal would have been more effective. But our bigger worry is the overselling of this by government to the public, because we’ve seen that time and again on their housing issues that they’ve brought forward.

Then, after the bill gets passed and a little time goes by, people realize that, in fact, the bill is not going to accomplish what it was stated and oversold as by this government. Then the government scrambles to come up with a different announcement or a new regulation or a new piece of legislation to try to cover up for the fact that what they previously announced isn’t actually working.

That’s the bigger piece that we’ll be diving into on committee stage. It’s trying to get to the root of how the numbers have been developed, how realistic they are, what it actually will truly mean to the people on the ground and how it’ll impact people in their daily lives that are just simply trying to buy and sell a piece of property, if they don’t happen to fall into one of the reasons, but it still just was needed. For whatever reason, they decided that they needed to move to a different place.

That’ll be the challenge for the government, I think, to try to help walk us through, as we go through the bill, this piece of legislation.

We’ll also be curious, because I think what most people hear of the flipping tax…. Again, you need to have exemptions. But when you talk to people, the number one thing when they talk about people flipping are people that make a living flipping or acquiring and doing renovations and then reselling and things of that nature. At the first cursory view of the exemptions, all of that type of activity is actually exempt by this bill. What the public expectation may be of this bill and what the reality of this bill is, we strongly feel, are going to be two different things.

Ultimately, I think that’s where you need public buy-in when you have pieces of legislation like this. We don’t need, after 7½ years, yet more overselling by this government on a piece of legislation of what it’s magically going to do. We just need straightforward understanding of how they’ve calculated the numbers in this bill, so that people have a clear understanding of what it will or will not actually do. Then they know what to expect in their own neighbourhoods and within the broader housing market.

As their own economist has pointed out, it’s not important at all for long-run affordability, but it may be important to provide political cover. That’s a very interesting statement to make in an election year, that’s for sure.

I thank you for the time, Mr. Chair. I look forward to committee stage on this bill where we can get into those numbers and just see how realistic any of these numbers actually are, especially given that it’s a retroactive timeline on this bill — the fact that somehow we’re going to collect a quarter of the money in this year that we would next year, even though the clock is already ticking for people to have to actually pay this tax on properties that they ‘d already purchased over the last year and a half.

[4:40 p.m.]

S. Furstenau: I rise to speak to Bill 15, Budget Measures Implementation (Residential Property) Act.

On behalf of the Third Party, we support this legislation and the province’s desire to address speculation and profiteering in the housing market. Indeed, my colleague and I have long raised the issue of the financialization of housing in this province and the need to rein that financialization in.

We are in a real housing affordability crisis. I always talk about how nobody wakes up one day to say: “You know, I think I’m going to decide to be homeless.” But to look at the level of homelessness that we have in this province right now…. We have to recognize that it is policy decisions, investment decisions and legislative decisions that get us to a place where we’re in this kind of affordability and homelessness crisis.

The province announced the flipping tax in the 2024 budget, and during his run for the leadership in 2022, the Premier promised to enact an anti-flipping tax. I confess that every time I think about flipping tax, I just want to flip the table. I just want to toss the table. I will try to resist that while I am speaking to this. His government subsequently announced the anti-flipping tax several times in 2023. It didn’t accompany the government’s housing legislation in the fall with all the massive upzoning, which was passed last November, but it is better late than never.

However, and as my colleague from the official opposition was pointing out, there are some, many, who say that it won’t make a huge difference because there isn’t a lot of speculation occurring in the market at this time. The B.C. Real Estate Association has said there isn’t much flipping happening, but it does come in cycles. So the next time there’s a spike in flipping activity, this could potentially discourage that speculation in flipping.

This is how we can look at policy as being a way of shaping the future, of recognizing that you want to put in place incentives for what you do want and disincentives for what you don’t want. That’s an example of what this legislation is proposing to do.

The province has estimated that 4,000 properties per year will be impacted by this tax, which is a small percentage of all property transactions. They estimate that it could generate up to $43 million. I recognize, as I was pointing out, the symbolic nature of this legislation. It sends a signal. It sends a message. I think we need the message more loudly that we need to see housing not as an investment but as a human right. Right now for a lot of people in B.C., that human right to housing is not guaranteed.

Past and current policy has encouraged treating home and land ownership as an investment and retirement strategy, with many new households now expecting or depending on home value increases for their financial security and wealth. But in B.C., we support whole industries, including TV shows based on improving homes, ultimately trying to push the prices up of homes, making housing more and more unaffordable for low- and middle-class British Columbians.

What I would very much like to see — in addition to this kind of legislation, anti-flipping legislation — is a crackdown on real estate investment trusts and the rise of investor ownership of housing, which is a very significant problem, particularly when it comes to the cost of rentals.

Newly built condominiums in Victoria are 64 percent investor-owned, and this is a problem that’s found across B.C. There is a huge need for policy mechanisms to deal with this, because as long as housing is seen as a form of investment or as a safety deposit box or as a means to extract profit in the form of ever-rising rents, then that goal that I think we all share, that goal of housing being a human right, is going to remain out of reach.

[4:45 p.m.]

I was just in the other chamber talking about a different housing bill with the minister. We hear from him very often: the market, the market, the market, supply, supply, supply.

That seems like a really simple way to address this crisis that we’re in. But unfortunately, supply alone is not going to solve the crisis we’re in. That is not going to guarantee affordable housing. That is not going to guarantee the goal of housing as a human right. There is such an enormous amount of wealth and capital that supply can just be bought up or used as an investment; 64 percent of newly built condominiums in Victoria are investor-owned.

Unless we put some parameters around that supply, unless we insist on affordability, unless we insist on there being enough non-market housing…. The market, which has gotten us to this place that we’re in, this crisis we’re in, is not going to deliver us from it with the same conditions that got us here. I would very much like to see the province move to more effectively regulate real estate investment trusts and other financialized landlords and recognize that trickle-down economics are never going to make housing more affordable in this province.

It does appear that the flipping tax applies to REITs, real estate investment trusts, and to bare trusts, which we’re happy to see. It’s good that assignments are included, but it appears that bare trust sales, for example, of residential development sites are not included. I look forward to committee stage to better understand this.

I also wonder how the exemptions will be proven. I’ve seen some speculation and vacancy tax when the home where they had lived for decades was not empty, for example. It’s always a challenge how these regulations are effectively both proven and enforced. Hopefully, a few years from now someone who faced challenging life circumstances isn’t having a hard time proving that they didn’t flip their house or that they are not subject to these conditions that are in here.

I know that there were stipulations in here for change in family status, for divorce. I think it’s going to be important that the capacity for people to demonstrate these conditions is not made too complicated, particularly given that these can be in times of people’s lives that are already very challenging and very difficult. I think another thing that we could consider could be a provincial capital gains taxation of all sales of development sites on a much longer timeline than two years.

I appreciate the opportunity to speak to this bill and to have the recognition that speculation and profiteering in our housing market, the financialization of our housing, is a problem that we need as many tools as possible to solve.

Deputy Speaker: Seeing no further speakers, does the minister wish to close debate?

Hon. K. Conroy: I move second reading of the bill.

Motion approved.

Hon. K. Conroy: I move that the bill be referred to a Committee of the Whole to be considered at the next sitting of the House after today.

Bill 15, Budget Measures Implementation (Residential Property (Short-Term Holding) Profit Tax) Act, 2024, read a second time and referred to a Committee of the Whole House for consideration at the next sitting of the House after today.

Hon. G. Lore: I call estimates for the Ministry of Health.

Deputy Speaker: We will take a short recess to allow the appropriate parties time to get here in place, and we will then resume with the estimates for the Ministry of Health.

Thank you, Members. We are in recess.

The House recessed at 4:49 p.m.

Committee of Supply

ESTIMATES: MINISTRY OF HEALTH

(continued)

The House in Committee of Supply (Section B); S. Chandra Herbert in the chair.

The committee met at 4:55 p.m.

The Chair: All right, Members. Let’s call this committee to order. We are here at estimates with the Ministry of Health.

On Vote 32: ministry operations, $32,710,062,000 (continued).

S. Bond: Thank you, and good afternoon, hon. Chair.

Good afternoon to the minister and his multitude of staff, and the minister would know what we were referring to.

Interjections.

S. Bond: Yeah, that’s hilarious. Thank you to my colleague. We’re starting off really well. Thanks for being here to support me. I totally appreciate it.

All right. I’d like to begin by…. The minister and I had a chat yesterday, with a question that apparently I could not make intelligible to the minister and his staff. I want to try it again, because it’s an important issue for me, and we had a challenge attempting to explain it. Let me try again.

This is related to, obviously, family-paid home support. While regional health authorities deliver the vast majority of publicly funded home support services, private or family-paid home support providers do have a role to play in our system. These are companies that deliver publicly funded home health services to clients via surge contracts — hopefully that helps with the explanation — with the five regional health authorities. They also hold contracts with many Crown corporations, including WorkSafeBC and ICBC, as an example.

My question was: what measures is the government considering to ensure that contracts with family-paid home support providers are structured in a way that aligns with the actual cost of delivering those essential health care services and make sure that we have long-term sustainability of those providers? I’m hopeful that that is more clear.

Hon. A. Dix: I think the answer is maybe…. When we talked about Crown corporations, we were thinking yesterday of WorkSafe and ICBC. Those were the two mentioned that might, because of the nature of the services that are sometimes supported by those two agencies. We can certainly engage with them.

With respect to the surge funding, which relates more directly to these estimates and this thing, we will take a look at the contracts for our surge providers to make sure that they compare appropriately with health authorities.

[5:00 p.m.]

It’s an interesting issue, and what I’ll do is directly ask the health authorities to engage with those providers on the very question of those contracts and address the issues. Then what I’ll hopefully do, as well, is report back to the House and to the hon. member at a later date.

S. Bond: Well, thank you very much.

Obviously, I had probably left a key word out of the question yesterday, because I appreciate the minister taking that away and taking a look at it. And it’s really about sustainability. They do play a really critical role, and there’s a concern that there isn’t an appropriate alignment with the actual cost. So I’m very appreciative of that.

I want to move on now. I know the minister, because I’ve heard the answer many, many times.… I’d like to spend some time actually figuring out exactly where and how this is working. Obviously, I want to talk about the primary care strategy. We’re going to move away from long-term care and seniors specifically. We’ll move into acute care, primary care, and have those conversations. Then we have a pathway for several more days.

The government released some figures in February, following…. It was the first anniversary of the longitudinal family practice payment model. The first statistics that were provided — and the minister, certainly in question period and elsewhere, repeats this — say 708 new family doctors. I want to ask some very specific questions about that, because I think British Columbians deserve to know. They don’t feel like suddenly there’s a swarm of new family doctors in our province. In fact, probably every MLA in this House has people coming to them saying: “I don’t have a family doctor.”

First of all, could the minister clarify for me: are all 708 doctors full-time in family practice?

Hon. A. Dix: I made it very clear, and I’ve said this many times. The member will know this because we know a lot of doctors, and they’re working, often, in different circumstances, not just in family practice. The number was, I think, just under 5,000 when we made that announcement. It’s now 5,054. This is the most significant one-year increase in the number of people practising what’s called longitudinal family practice, which is a way of saying they are family doctors that take patients.

This is the direct result of the changes that we developed with the Doctors of B.C. in the payment model and all the work that’s been done on new-to-practice contracts, both for doctors and for nurse practitioners. We’ll get into some of the details of this.

We are talking about an increase in family doctors of, at the time, 708. It’s more than that now. We’ll get into those numbers, because we’ve just had a month or two passage in time. That is the number of people who are practising as longitudinal family doctors.

Now this has been a period of years that we’ve seen the increase in the number of doctors, so we’re also seeing an increase in the number of specialist doctors. And we’ll share those numbers, I’m sure, during the estimates. The numbers are straightforward, counting numbers by the College of Physicians and Surgeons. They’re something that has been done over a period of years, and comparisons can be made. But that’s the number of doctors practising as family doctors in B.C.

I might say that the existing 4,200 that were there before, they were also not all practising full-time as longitudinal family doctors. They were often doing other things in their medical practices, but it’s, apples-to-apples, a very significant increase. And it was a one-year increase of 16 percent, which is something we’ve never seen before.

S. Bond: All right. Well, perhaps it’s late in the afternoon.

My question is this. I appreciate all the other information. The minister announced that there were 708 new family doctors. My question is…. I think the answer is: “No, they are not all practising full-time in family practice.” Would that be accurate?

Hon. A. Dix: It’s not an increase of 708 FTEs, if you know what that is, which is full-time, but it’s an increase of 708 family doctors, period. That’s what we put forward in February. The number is larger now.

Now we’re up to 5,054 family doctors, and basically, at the start of this, it was around 4,200. So it’s a major increase in the number of people practising longitudinal family practice, and it’s an exceptional thing.

So yes, there are, to use those numbers, 708 more family doctors in B.C. But, and I said this at the time and was very clear, that’s not FTEs; that’s 708 more doctors practising longitudinal family practice.

The Chair: Just noting that…. Yes.

Hon. A. Dix: My apologies. Sorry. We’ll do this quickly. I get to read the motion again.

I move that the committee rise and report progress and ask leave to sit again.

Motion approved.

The committee rose at 5:05 p.m.

The House resumed; the Speaker in the chair.

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

Report and
Third Reading of Bills

BILL 16 — HOUSING STATUTES
AMENDMENT ACT, 2024

Bill 16, Housing Statutes Amendment Act, 2024, reported complete without amendment, read a third time and passed.

Hon. G. Lore: In the Douglas Fir Room, I call Committee of the Whole on Bill 18, the Vancouver Charter Amendment Act.

In the main chamber, I call continued estimates debate for the Ministry of Health.

Committee of Supply

ESTIMATES: MINISTRY OF HEALTH

(continued)

The House in Committee of Supply (Section B); S. Chandra Herbert in the chair.

The committee met at 5:07 p.m.

On Vote 32: ministry operations, $32,710,062,000 (continued).

S. Bond: I appreciate that answer from the minister.

He would obviously anticipate my next question, which is: how many of the 708 doctors are FTE?

Hon. A. Dix: Doctors are individual practitioners. First of all, two things happened last year. Doctors joined the new longitudinal family physician model. It’s a very different model of care than had previously been provided, which was largely in a majority fee for service care. But what I would say is that, really, in terms of the type of work that doctors do, it’s similar to before. So this is a real increase of 16.6 percent in the number of people practising.

Significantly…. I’ll just take the member through the numbers, and we’ll talk about the longitudinal family practice model a little bit, maybe, in a second. The numbers are significant both by types of doctors but, in particular, the addition of new-to-practice doctors and new-to-practice contracts, which have dramatically increased the level of attachment.

[5:10 p.m.]

Obviously, when you have new-to- practice doctors, they’re not adding work, or they’re not rejoining the profession. They’re adding new groups of attached patients. We’ve seen, and we have, in those categories, 246 new-to-practice doctors. And they are a part, obviously, of that increase in the number of doctors. This is a change from the last number of years. It’s built up.

In a number of years before that, new-to-practice doctors were not joining longitudinal family practice. They were doing other things, and now they are joining. But the overall number of doctors has increased. And obviously the number of family doctors has increased significantly as a direct result of the work that we did with the Doctors of B.C.

S. Bond: Let me try the question another way. How many of the doctors are serving a full patient panel, which would be approximately 1,200 patients?

The minister has said that out of the 708 new family doctors that are called, in fact, 246 of them are new-to-practice, which would mean, obviously, we could have additional attachment. But my question is: how many of the doctors that the minister refers to, regularly, are serving a full patient panel, which is about 1,200 patients?

Hon. A. Dix: Typically, panel sizes are around 1,150. But what’s important…. A number of changes happened that were critical, and we’ll be talking about those over the next couple of days. We will, I’m sure, be talking about the health connect registry but also the registry of panels.

What happened in the doctors’ agreement that was significant was that we asked doctors, for the first time ever in B.C., to submit their panels of patients, to understand who they were serving and who they weren’t serving. One of the challenges with the fee-for-service system is it was happening out there without that kind of detailed information.

Part of our agreement with the doctors was to change the way we paid family doctors, and this was something that, as the member will know and the Legislature will know, doctors have been calling for. We worked through those changes, and they were significant. Part of that agreement was for them to provide, in their own registry of panels, who’s got a family doctor and who doesn’t. This is an important question because it means we can figure out who’s serving 1,200, who’s serving 1,150, who’s serving 1,050 but is negotiating at 1,200. In other words, where the spaces are to attach new patients.

I’ll speak of three groups. First of all, the new-to-practice group. The new-to-practice group…. Naturally, we didn’t ask them to take 1,200 patients on day 4 of their new family practices. They had two years to build up their practice to meet that test.

Of our new-to-practice providers, both nurse practitioners and doctors, that’s a significant number. They have currently 246,845 patients, and their target, because they’re in their first two years of practice, is 452,000. This means that they have, within their target, as they build up their patient load for them, a remaining target capacity of 205,000, which is pretty significant for people around B.C., given the numbers of people that don’t have a family doctor.

[5:15 p.m.]

For the rest, what we’ve done…. About 86 percent of doctors have submitted their full patient panels now. Now we can determine, in that group, who would have access to take more patients.

This is very helpful. It helps you determine if patients are attached to multiple family doctors, which is not the most important question but an interesting question. But it tells us who has room to take patients, who has room to be connected to a family doctor. What we’ve discovered in those categories, and what we’ve done, is that about 800 doctors and nurse practitioners, in that range, are able to take more patients, which is really good news.

Our task now will be to connect those people without a family doctor to those doctors taking patients. This isn’t a theoretical notion. When you join the new practice contract and you’re on full-time, essentially, you want to fill out that patient load as your part of the work you’re doing. This is a real opportunity to find family doctors for people who don’t have them.

You can only do that if you have more family doctors. It’s not a discussion. We often, I think, in legislatures, get into the discussion of FTEs. People don’t know what they are sometimes, but this is 708 more doctors. And we can speak about the need of nurse practitioners and those numbers, which have also grown significantly. What that tells us is you can only increase your attachment levels if you have more doctors, and we have more doctors. In fact, this has been the best year ever for the recruitment of family doctors.

As members of the House will know — because they review these statistics; they’re national statistics that are publicly produced — when I started as Minister of Health, I think we were sixth in Canada in the number of family doctors per capita. We’re now first, and that’s good news.

But I don’t think people in Prince George or Valemount or in my constituency, in Vancouver-Kingsway, care whether we’re doing better than Alberta or New Brunswick. They want a family doctor here, and that’s what having more family doctors will assist with.

S. Bond: All right. Thank you to the minister. I can understand. I think all of us would understand that a transition to full practice for a new-to-practice physician is important, but so is knowing whether people who are being counted as net new family physicians are carrying a full panel of patients or not.

What we need to be doing is adding substantive capacity. We also need to look at the puts and takes, because while we’re adding, there are practices closing as physicians are aging, and we have patients that are suddenly unattached because their doctor has retired. We hear from them every day.

I am surprised that we are not able to actually articulate how many of the 700…. And actually, I disagree with the minister. I actually think British Columbians do want to know if family docs are working full-time and how many patients they’re carrying. Heaven knows, the Ministry of Health has reams of data. We have a provider registry.

I am very concerned about the generalization, when there is a discussion about new family doctors, because what it does is raises hopes for people, and then they’re still waiting. We’re going to get to health connect all right, because people that we’ve talked to have been on that for 2½ years.

So I want to go back again. I have some very specific questions about…. How many people are on a physician’s panel? How many physicians of the 708 are full-time?

I just want to clarify something, because the minister continues to interchange…. I fully understand the role of nurse practitioners. We actually did a lot of work with that when we were in government. Does the 708 include nurse practitioners?

Hon. A. Dix: No.

S. Bond: Thank you for clarifying that. I didn’t think so, but the minister has sort of been interchanging that number.

Let me just move down a list. What I’d like to do is walk through the health authorities and have the minister provide me with as much specific detail as possible to understand whether or not physicians that have been attributed to a particular health authority have a full panel or are working full-time.

The numbers that we have are 211 family doctors in Vancouver Coastal Health. Can the minister tell me how many of those are full-time?

[5:20 p.m.]

Hon. A. Dix: Maybe I’ll go through the numbers by health authority — because I know the member asked for Vancouver Coastal Health; that would take us to the 708 — so that we know where they are and what the increase was in different health authorities.

In the Vancouver Island Health Authority, it went from 775 to 954. That’s an increase of 179, on a base of 775. That’s over 20 percent.

In Vancouver Coastal Health, we went from 1,179 to 1,390. That’s an increase of 211.

In Northern Health, we went from 246 to 281. That’s an increase of 35, on a base of 246.

In Interior Health, we went from 766 to 904. That’s an increase of 138.

And in Fraser Health, we went from 1,308 to 1,440. That’s a net increase of 132.

Those are the numbers that we provided in the February briefing. Those numbers were April 1 to December 31, 2022-23 to 2023-24. The overall numbers were 4289 to 4997 at the time. As I say, those numbers have increased since then, but we were talking about the 708, so we’ll stay with those numbers. What that tells us is: significant, double-digit increases in every health authority.

The member was asking: “Well, how do we know who can take patients?” That’s important. That’s why we’ve done something that never had been done before. Well, it seems absolutely logical that we would have a list of patients for doctors in the province, who do outstanding work and are well remunerated and everything else. That never happened — to be non-partisan — in the nine years of NDP government followed by the 16 years of Liberal government, up to now.

That was so important to us because having that list allows us to find where there are openings and refer people to those openings. What we discovered in this process is that there are close to 800 doctors and nurse practitioners, and I can give the breakdown of those, who have spaces available now for new patients, in order to get to the number that they need to get to, the 1,200 — or if they were working half-time, less than that — the number of spaces they have to take new patients on.

[5:25 p.m.]

The health connect registry — that action for the provider registry, that action for the clinic registry — allows us to do that, which is something that the stats have never done before, because they’ve always been surveys in the past: to refer real patients to real doctors and get them attached.

S. Bond: Thank you to the minister.

Again, today I’m going to resist the urge to have a debate about what we disagreed on in the past. What I am asking the minister to answer today….

There are big press releases, big announcements. I can read out the numbers of doctors, which add up to 708. There are 211 in Vancouver Coastal, 179 in Island Health, 138 in Interior Health, 132 in Fraser Health and 35 in Northern Health. That’s great, but what matters is: how many patients…? How many of these doctors are full-time?

It’s a pretty straightforward question. The minister has an entire ministry of people. The data wasn’t collected, but the minister marched out and said we have 708 net new doctors. No one in British Columbia is rushing around saying: “We suddenly have found a new family doctor.” These numbers actually matter. It’s not about being partisan; it’s about being factual.

Let’s try one more time. Of the 211 doctors added in Vancouver Coastal, how many of them are full-time?

Hon. A. Dix: Well, the numbers are pretty straightforward. There were 4,289 doctors practising before the practice model. They worked a variety of schedules. Some worked in different circumstances. Some might spend days or regular days working in the hospital and do their own practices. Others were nearing retirement. They would work part-time. That was the group before.

It’s an absolute apples-to-apples comparison. There are 708 more people doing that now. That’s the situation we’re in, and it’s a very positive one. It doesn’t answer all of the questions, of course.

Of the 4,289 before, those were a variety of different doctors. The 708 that have now been added are 708 more doctors practising in the province. When we say that close to 800 doctors and nurse practitioners have room to take more patients, it means that we can close the attachment gap. That’s important.

It’s also the case that we know about the attachment gap, which is not through just the Canadian community health survey. The opposition has used them dozens and dozens of times in the House. We can go through what those numbers are.

These numbers matter to people. People are registering now. They want a family practice doctor. We have hundreds of doctors and nurse practitioners able to take new patients, and we’re able to match the two. That is, I think, only possible when you increase the number of doctors.

[5:30 p.m.]

S. Bond: Well, pure and simple, the minister didn’t answer the question, because he can’t. There are 211 new doctors, according to the numbers that the minister uses regularly. I think that most reasonable British Columbians would expect to know how many patients they are serving and how many of the physicians are full-time. I’ve asked: 211 — how many are full-time? We didn’t get an answer. Let’s try this one. Of the 179 in Island Health, how many are full-time?

In order to maximize the amount of time that I have in estimates, I’m going to give the minister the other numbers. I’m going to ask the questions. It’s obvious that the answers are not here or in this room, or we don’t have them.

The minister and others in the House look skeptically at me. British Columbians have been told that there are 708 new physicians. It is a basic question. How many of them are full-time? There are no answers.

Let’s go down the rest of the list. It actually matters to people in these members’ constituencies. They may think it’s humorous. It’s not.

The Chair: I don’t think we need to engage in this back-and-forth with members. Let’s just ask the questions.

Interjection.

S. Bond: I’ll let you know.

Of the 138 in Interior Health, how many are full-time? Of the 132 in Fraser Health, how many are full-time? Of the 35 in Northern Health, how many are full-time? And given that the Northern Health Authority covers two-thirds of the geography of British Columbia, can the minister tell me today what health service delivery area these new doctors are in?

Hon. A. Dix: The members of the House and the member know this well. She knows about health care. Our doctors aren’t employees, so how you judge them…. We’ve had, to date, in the submission of panel size, which had never been done before…. It’s excellent policy. It allows us to attach people, family doctors…. It allows us to know who has a full panel size and who doesn’t.

[5:35 p.m.]

Of the 4,011 family doctors who submitted panels — so that’s not the full group; that’s the ones who submitted panels as of December 31 — the average panel size was 1,100, so close to full-time.

S. Bond: Well, thank you for that. I’m assuming that if we know what the average panel size was, and we had 4,011 panels represented, the ministry could break them down to say how many of those are in Island Health, Interior Health, Fraser Health and Northern Health.

I fully understand that the data hasn’t been collected before, but the reason it matters now is because the minister and this government marched out and used this number as demonstrated success for a new payment model. That’s great. No one’s going to criticize adding new doctors. But the fact that the minister can’t provide the context today is concerning.

It’s not enough to just march out and say there are 708 new doctors if we don’t know how many patients are attached or how many of those patients are new patients. Where those doctors are matters, especially if you look at a region like Northern Health, which is gigantic. If they’re all in Prince George, that doesn’t help Smithers, Prince Rupert, Fort St. John, all of the places with ER closures. It matters.

Frankly, I know the Ministry of Health pretty well. I’m pretty surprised that we can’t answer simple questions like: “How many are full-time?” Even using the number of the average panel size of 1,100 means there are a whole lot that aren’t 1,100.

Let me ask another question then. The other question that I would like an answer to at some point is: in Northern Health, which health service delivery area are the doctors in? It’s a big, big health authority, and it matters where they are. Why? Because every time we hear about an ER closure or a hospital closure or a something closure, it’s a staffing issue.

Lining up this announcement against what it’s actually doing matters. I don’t think it’s that unreasonable to try to understand how many new attached patients there are when this is the big signature announcement every time the minister answers a question.

Let me ask this question: are each of these doctors working in a team-based care model? If not, how many are, and where are they?

Hon. A. Dix: Again, the number of people practising longitudinal family practice has increased dramatically, and it’s because of the actions taken not just by the government. This is good news for everybody — that there are more people practising in B.C. and that we are, in fact, number one in Canada in the number of family doctors per thousand. That doesn’t mean that everyone has a family doctor and that we don’t have lots of work to do, which we clearly do.

[5:40 p.m.]

Just to be clear to the House, the Fraser Health number, as of December 31, 2023, was at 1,440. Interior Health was at 904. Northern Health was at 281. Vancouver Coastal Health was at 1,390. Vancouver Island Health was at 954. In the report, there were 28 that hadn’t been defined as a particular health authority. Those are the numbers of doctors practising longitudinal family practice.

Their average panel size is a pretty good subset of that. So 4,011 is more than a subset of that. It is 80 percent of those. The average panel size is 1,100, meaning that the average panel size is close to a full panel size. But the good news for us is that there is significant room for more people to be attached and that we have identified both the room to be attached and the people in the health connect registry who want attachment. We’re now going through the process of connecting one to the other. That’s what we’re doing.

I think that’s a pretty detailed survey based on the actual panel size of the work being done by health care providers who are professionals and not FTEs, in that sense, in the public health care system and family practice. Obviously, you can do quite a bit more with 5,000 family doctors than you can with 4,289 or the much smaller number of family doctors who were practising in previous years.

S. Bond: The minister and I are both experienced legislators. The bottom line is that he hasn’t answered a single question related to full-time capacity, additional capacity for patient attachment. I’ve asked where the doctors actually are in terms of which health service delivery area. We haven’t got an answer to that. Don’t know if they’re working in a team-based care model. We don’t know how many are and where they are.

Let’s try this one. Are any of the doctors that have been announced as new working to provide episodic care within urgent primary care centres?

Hon. A. Dix: Just to be clear, first of all, this information is available — the detailed information we provided and will be providing in the course of these estimates on patients, on average panel sizes. None of this information was available before — I mean, for decades. This is information that’s very useful to legislators. It’s very useful to people managing the public health care system. Certainly, as Minister of Health, it’s very useful to me. What it shows is, in terms of both our panel size, in terms of our attachment, having 708 more doctors is good news in B.C.

[5:45 p.m.]

The member asked how many physicians work at UPCCs. This is an FTE number because it’s different, in general, in the community. Doctors, in their own practices, are different than this. We do measure by FTE in the urgent and primary care centres.

On the number of doctors working in urgent and primary care centres, the actuals are 108.71 — the 0.71 meaning a doctor, in that case, who would be working 3½ days a week if that was the 0.71. It’s 108.71 physicians working in urgent and primary care centres across B.C. Of course, they have been working in those centres for some years.

S. Bond: Just to clarify, then, none of the new doctors referenced in the 708 are providing episodic care in UPCCs.

Hon. A. Dix: Well, doctors who are providing longitudinal family practice do other things. Sometimes they work in ERs, and we know this. In many communities, in fact, it’s the community of family doctors that staffs the ERs. That has been the historic situation in B.C.

Some physicians who work, conceivably, a day or whatever in a week at a UPCC also practice as longitudinal family practice doctors. Some UPCCs do attach, but principally it has been episodic care in UPCCs. That’s the situation as covered.

This is a perfect moment for this. I move that the committee rise, report progress and ask to leave to sit again.

Motion approved.

The committee rose at 5:47 p.m.

The House resumed; the Speaker in the chair.

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

Report and
Third Reading of Bills

BILL 18 — VANCOUVER CHARTER
AMENDMENT ACT (No. 2), 2024

Bill 18, Vancouver Charter Amendment Act (No. 2), 2024, reported complete without amendment, read a third time and passed.

Hon. D. Coulter: I call continued estimates of Health in the chamber.

In Committee of the Whole in the Douglas Fir Room, for Bill 17, Police Amendment Act, 2024.

Committee of Supply

ESTIMATES: MINISTRY OF HEALTH

(continued)

The House in Committee of Supply (Section B); S. Chandra Herbert in the chair.

The committee met at 5:49 p.m.

On Vote 32: ministry operations, $32,710,062,000 (continued).

S. Bond: I’m going to move ahead with another series of questions. I will simply say this, though. The minister talks about 708 doctors as good news. No one is arguing that. But what is important? The minister talks about how that information is important for the minister, for the ministry.

[5:50 p.m.]

It’s actually really important for patients to understand how many new people have a physician, after all of the press releases that have been pumped out the door about the 708 new doctors. What we’ve discovered this afternoon is that we don’t know. We have average numbers for panel size.

Typically, a panel is almost 1,200 people. The average number is 1,100. We don’t know where they are; at least, we aren’t able to explain it this afternoon. That matters to people. If you’re sitting in Smithers or in Cranbrook, you might want to know if there are new doctors specifically in your community and how they’re taking patients. No answer to whether they’re in a team-based care model or not. We don’t know how many are and where they are.

So let’s try this one. Can the minister tell me specifically: are the 708 physicians new to British Columbia, or were they previously registered with the college?

Hon. A. Dix: Maybe I’ll go through some more data. Again, the data on the number of doctors is consistent over time. We know that, and it’s very good news for the people of B.C. It’s very good news because it means there are more people serving people in community.

Let me give the members some of the information about doctors in B.C. We have, in the 2023 calendar year, 938 new physicians newly registered in B.C., in all categories. We have 793 international medical graduates registered in B.C. Obviously, we have more than 4,000, 4,054, doctors that are joining the longitudinal family practice model.

With respect to the new-to-practice contracts, the providers have taken on both new-to-practice doctors and new-to-practice nurse practitioners that have taken on 246,845 patients. For those 246,845 individual people, that’s good news. They have an adjusted target of 452,594, meaning that they have, for those new-to-practice doctors and nurse practitioners, a remaining target of 205,749.

With respect to the health connect registry, and we’ll be talking about that, we have 64,745 patients getting attachment through that means. So if you add those to the new-to-practice, you can see the significant impact it has for people.

At the same time, there are real challenges, right? In the calendar year of 2023, we also saw, in the neighbourhood of an increased number of people in B.C., the largest population growth I think we’d ever seen — at that point, 180,000. There are more people in B.C., so we have to continue to increase the number of doctors and those participating.

The member asked about the longitudinal family practice model. We’ve seen significant increase in international medical graduates, in new graduates. More of our new graduates, through new-to-practice, are taking up longi­tudinal family practice.

Some people in that category would be people moving back to longitudinal family practice from other work they’re doing, and that is certainly included in that category. But if you look at the LFP numbers, those 4,100 in the LFP model, a full 530 of those are fully new to MSP.

[5:55 p.m.]

That tells you that the majority of those new doctors are new to MSP and the system. And that’s, again, another example of really good news.

S. Bond: Thank you to the minister.

Again, can the minister tell me how many of these doctors came from other provinces in the country?

Hon. A. Dix: This isn’t the full 5,000. We know more than 80 percent have joined the new payment model, but there are still many doctors working on fee-for-service. So let’s just talk about the new-to-practice contracts.

Of those, as I mentioned, 530 are new to MSP. That’s not of the whole number; that’s not the whole 708. That’s the number that have joined the longitudinal payment model. And 530 full are new to MSP. That would include new doctors. That would include international medical graduates and people who have come from other jurisdictions.

As you know, since on all the national statistics we are doing much better than other jurisdictions in this area, it doesn’t mean that that matters. I think the member makes this point. I make this point. She’s heard me make this point all the time. I don’t think it matters that we’re doing dramatically better than Alberta in this area, dramatically better than Saskatchewan in this area, or Ontario. I don’t think that matters to someone in Smithers or in any community who doesn’t have a family doctor. They want a family doctor. That I fully accept.

In the longitudinal family practice model, what makes it so significant is that if you look at those 4,000 doctors, 3,008 were in existing family practice, 313 were previously locums, 238 were previously non-LFP, and 530 were fully new to MSP — just of those 4,000 of the 5,000 total longitudinal family practice doctors. What we’re seeing is more doctors, more specialists.

What makes B.C. unique, and you see this in the national statistics, is that 80 percent of our undergraduate and 90 percent of our graduate doctors from B.C. universities stay in B.C. — from the University of British Columbia, stay in B.C. That number in Alberta is 60 percent. In other words, we’re keeping our doctors in B.C. we train in B.C., and that’s why there’s an argument to train more doctors here, and that’s what we’re doing.

Whereas in Alberta, only 60 percent stay in Alberta. Of the doctors trained in Alberta, a very significant portion, 18 percent, come to B.C. The number of B.C. doctors that goes to Alberta is under 10 percent.

You can see that we do very well in every category. We do very well in holding doctors that we train in B.C. in B.C. and having them work here. That’s good news.

[J. Tegart in the chair.]

Our distributed model, much of which started under the previous government…. I would say that. Our distributed model is working well in that respect. We’re doing well in terms of international medical graduates. We’re doing well in terms of the net movement of doctors from other jurisdictions to B.C. The result of that is the result we see, which is more in longitudinal family practice but also more doctors, period.

S. Bond: I want to just go back over a couple of categories here. I am talking about the 708, the new family doctors, the big announcement. How many of the new family doctors came from practising in hospitals, long-term-care homes or walk-in clinics?

Hon. A. Dix: We’re not talking about the 708. That 708 is the net increase. So it’s better than 708.

[6:00 p.m.]

If it was just 708, then we were losing doctors. That’s the net increase in doctors, which is something that, I would just say, in longitudinal family practice doctors…. I assure you, the actual increase in doctors is larger than that. That’s the increase in longitudinal family practice doctors.

Now, what we have is some detail, which I’ve described, of those that are in the LFP model. That’s not all the doctors, but it’s a significant number of them, and this was as of December 31, 2023.

As I noted, 530 were new to MSP, and 238 were previously non-longitudinal, which is identified by their billing data in previous years, and 313 were longitudinal but locums. We saw a switchover of locums to taking patients, which is overall a positive thing in the LFP model. And 3,008 were previously longitudinal physicians. That’s in the 4,100, roughly, people who’ve joined the LFP model.

S. Bond: The point of the last hour has been to try to sort out, when we talk about the information the minister continues to share with British Columbians…. I don’t have to read out the press release because I’ve pretty much got it memorized — 708 new family doctors. What British Columbians want to know is: where did they come from, and where did they go? And how many patients are they attached to?

For the last hour, we haven’t been able to get a single detail about where they came from. From my perspective, if they came from practising in hospitals or long-term-care homes, who’s going to fill those gaps? No one is arguing that the compensation model, looking at longitudinal family practice and how we better compensate them, is important. We actually called for that as well.

The issue is there are zero details about where they came from, how many patients they’re attached to, new patients. And that matters. A headline — British Columbians deserve the details behind it. So my question perhaps should be more simplistic.

Where did the new doctors come from? I am talking about the headline. The minister can talk about 5,000 and 4,000. I am talking about 708 new family doctors. Over and over we hear that. Where did they come from?

Hon. A. Dix: The member says we have no information. We’ve had detailed information by health authority. We’ve talked about new-to-practice doctors and how many patients are registered. We haven’t talked about nurse practitioners yet. I’m sure we will. How many patients have been registered through the health connect registry and how many patients are with those family doctors we’ve gone through in detail. Those who are new LFP registrants — I just gave those numbers.

Of those numbers — which is apportioned 530 new to MSP, which I think is exceptional — others have done other work in the health care system, the largest group. That doesn’t include those that were practising as longitudinal family physicians before, were practising as locums and have switched over. This is an area where there was a concern that we weren’t having doctors choose longitudinal family practice. That concern has changed in a dramatic way, and that is good news for everybody.

Where did they come from? I went through in detail the number of international medical graduate doctors, the number of U.S.-certified physicians, the change in the longitudinal family practice plan, and in detail the number of new doctors. So that is the information that’s required that is important to people who want a family doctor.

[6:05 p.m.]

They want us to have more family doctors. We do. Now they want us to connect them to a family doctor in their community and neighbourhood, and that is what the health connect registry and our other efforts are intending to do.

It was required. The information we gave in detail about panel sizes, for those that have joined our panel registry…. That information was never available before, and we shared it in this House. This is unprecedented information about family practice. It’s not about….

In terms of the 708, I just want to remind people. The 708 is net. It’s not 708 doctors. It’s net new doctors. We went from in the 4,200 range to 4,996 by the end of the year. That’s 708 more doctors who are practising and taking patients. It’s called longitudinal family practice.

We’ve gone through the detail of the information here in every category. I appreciate that the hon. member might want comparisons from the past in some areas. Well, we are establishing the baseline here for people. Also, we have more family doctors working in B.C.

All of that is good news for people in the province. And it’s not just in some regions. It’s double-digit percentage increases in every health authority in the province for longitudinal family practice.

It doesn’t solve all our problems, but the detail of information that has been provided here demonstrates, I think, the strength of those initiatives. They’re strong not because I did them but because we did them together. People advocated for them, including members on all sides of this House.

Again, I’ll go back over the LFP model registrants: 530 new to MSP, 238 previously non-longitudinal, 313 longitudinal physician locums and 3,008 longitudinal physicians. There are further people who are not in that model who we would call community longitudinal family physicians. That number is 1,115. Those aren’t in the longitudinal family physician model, but they’re very important. They’re fee-for-service doctors who are providing services around B.C.

All of this shows the strength of the initiative. In terms of the recruitment of new doctors, of people coming from outside of British Columbia and of graduates in British Columbia, across the board, I think, it supports the changes that were made to make things better for patients and for family doctors.

S. Bond: Well, the really discouraging part of this conversation is…. What matters most is patients. I’m not sure who the minister is hearing from, but there’s not a flood of people celebrating the fact they have a family doctor that they didn’t have before.

I think it is absolutely reasonable that this government should be able to explain how many newly attached patients there are. The headlines are repeated, and the minister talks about 708 net new doctors and then repeats the information. The bottom line is…. We don’t know how many new patients have been attached. We don’t know if it’s….

Obviously, it’s good news when we have people choosing family practice, but if they’re coming out of long-term-care homes or they’re hospitalists or they’re coming from somewhere else, it’s simply exposing gaps in other parts of the system. That’s the heart of this issue. It’s one thing to talk about net new. But the most important thing is: who’s got a doctor today that didn’t have one six months ago? It’s pretty hard to tell from the lack of specific answers that we’ve had.

My time is limited over the next number of days. I am, basically, on page 1 of my gigantic binder full of questions.

[6:10 p.m.]

Let’s talk about the last year. The minister had a briefing note that said this: “The introduction of the LFP payment model has destabilized care and existing compensation arrangements in some communities and areas of family practice not currently covered by the model. The ministry and DOBC are working to address these issues as part of the next phase, which will include rural practice, team-based care, virtual care, emergency services, maternity care, palliative care and facility-based services. In the interim, mitigation strategies are being explored and implemented.”

Can the minister detail what specific compensation arrangements and which communities and areas of family practice are not currently covered by the model? How were they destabilized?

Hon. A. Dix: The member is a former Minister of Health, so she knows this; the Family Practice Services Committee is a joint venture between ourselves and Doctors of B.C. Four areas that we looked at were areas of concern. Several of these, as we worked out the details of payment methods, were supported by stabilization funds.

The four key areas that we looked at — there’s agreement — are in-patient, long-term care, palliative and maternity. All of them have been dealt with in the past year with stabilization funds, and we expect all of those to be signed off by June 10.

S. Bond: That briefing note was a year ago. I appreciate knowing what areas of practice are not currently covered. The word used was “destabilized,” which is concerning.

Given the reported destabilization of care and existing compensation arrangements — not my words but those of the briefing note — in communities and areas of family practice not covered by the current LFP model, what are the immediate measures being taken to ensure that the regions and practices do not suffer from reduced access to health care in the period before the next phase is implemented?

[6:15 p.m.]

Hon. A. Dix: For people watching this who might be interested, the Ministry of Health and the Doctors of B.C. are leaders in working together in a collaborative partnership. It’s called the Family Practice Services Committee. It didn’t start yesterday. It actually started some years ago, in the time of the previous government. A key focus of that committee is to improve the quality and sustainability of primary care.

As we did this historic agreement, which has had such a positive effect, we saw those four areas — palliative care, long-term care, maternity care and in-patient care for people who are in acute care — all things that family doctors do. So we provided, in addition to stabilization funds from the FPSC, over the two years, $72.2 million to stabilize those services as we work through the issues involved, which we are successfully doing.

In the new circumstance, the new payment model will be extended by June 10 and put in place. It requires billing codes to be put in place and other such things. That has happened.

When you do something as historic as this — to go from the one jurisdiction in Canada that was the most fee-for-service to the jurisdiction in Canada that’s the least fee-for-service — there are going to be consequences to that. We ourselves and the Doctors of B.C. work together to address those situations with stabilization funds and to work through the issues, issue by issue, to make sure that people get the care that they need.

S. Bond: Thank you to the minister.

I just want to clarify for the record that this discussion isn’t about being critical of relationships between the Doctors of B.C. and the work that’s being done. One would expect the minister and the ministry staff to be able to answer these questions. This is a flagship promise, and it’s out every day, in front of British Columbians, talking about this historic agreement.

Well, historic agreements are great, but what matters are results and making sure that people are in fact getting attached to family physicians. We have zero ideas of how many new attached patients there are. Yes, new to practice — those numbers were provided.

I’m interested in knowing how the minister and the ministry in this payment model acknowledged, first of all, that there were going to be issues in rural practice, emergency services and other critical areas. Could the minister explain the justification for an initial rollout of the model, knowing full well that there were going to be challenges in other significant areas of practice? They were excluded from the initial implementation.

The minister has talked about stabilization funds. Maybe just a better understanding. The decision was made, recognizing that there was going to be, potentially, destabilization in other areas. Can the minister explain how he rationalized rolling out one section while others were excluded?

[6:20 p.m.]

Hon. A. Dix: This is doing the work. On the model that had been in place, the head of the Doctors of B.C. at the time, and others, said that the fee-for- service model didn’t work. I can tell the member that younger doctors, the resident doctors that we would meet — they’d come here — and students that we’d meet were not choosing family practice and that significant action was required.

We negotiated a new physician master agreement that addressed compensation issues for family practice in a significant way. On top of that, we worked together to change the payment model. You do that by doing the work. Sometimes you do the work in pieces. The idea that we would wait and not proceed is, I think, not the right approach.

You see doctors — I meet them all the time, and I meet patients all the time — who were worried about the continued existence of their practice. Instead of being stabilized, they see their practices growing and growing in size and adding doctors, and that’s a good thing everywhere in B.C.

Why did we act? We felt the previous model wasn’t working any longer for patients or for doctors or for other health professionals or for team-based care. We didn’t decide on our own. We sat down with doctors, and we worked out that situation. We did the work together, and we’re continuing to do that work. It doesn’t end the day you sign an agreement. We’re continuing to do that work.

In terms of its impact on patients, we’ll just go through…. We can go through this again. In terms of the health connect registry, that’s 64,745 patients. In terms of the unique patients for new-to-practice doctors, 243,000. Overall, as a direct result of primary care initiatives — not solely that — 408,926 people have been attached to a primary care provider since the primary care strategy was launched.

Those are specific numbers. Because we changed the way that we have a relationship with the Doctors of B.C. and we have more and better information shared, we can now specifically target those who need a family doctor and target those family doctors who have space available. That’s what we’re doing now, and those are the results.

One can argue that the 64,745 attached through the health connect registry isn’t enough, and I would agree. I want it to be more. I want it to be done more quickly, and we have space to have it done more quickly. But for those 64,745 people, that’s still significant, just as the 243,000 unique patients of the new-to-practice doctors is significant.

These are significant changes. We made a decision to move. That decision has been justified by what has happened. At the same time, we provided stabilization funding and continued to do the work in long-term care and in other areas to make sure that we finished and completed the project together. That’s what we’re doing.

S. Bond: I want to move on to a backgrounder that was provided in early February. There are a series of attachment numbers provided under the heading “Primary care attachments.” That document stated that there have been 391,282 attachments since 2018-2019.

Can the minister clarify for me what the definition of “attachment” is? Is it an event, or is it the establishment and subsequent continuation of a relationship between a patient and a primary care provider?

Hon. A. Dix: There’s a fee code when a patient and a doctor come together. That’s how we do it in B.C.

It would be easier, if one were concerned just with numbers, to assign people. We don’t do that. It’s a real relationship between doctor and patient. When an attachment occurs between a doctor and a patient or a nurse practitioner and a patient, then that fee code is put in place, and they’ve established their attached relationship.

[6:25 p.m.]

Prior, obviously, to the LFP model, that was defined by fee-for-service billing. Now it’s defined differently. It’s a specific fee code.

When we give the specific number…. The 391,000 was a month earlier. It’s now 408,726. That’s the new number that I have here. That number represents people who were attached — and recognized to have attached, through a fee code — with a family doctor or nurse practitioner.

S. Bond: Perhaps the minister could just answer the specific question.

They get a fee code. Is it an event, or does it mean that there is an ongoing, continued relationship with that physician? Longitudinal care. Is there an ongoing relationship, not simply an event where the patient connects with the doctor?

Hon. A. Dix: The fee code reflects…. If I were a family doctor and the member were coming to see me about something, that wouldn’t be that fee code. The fee code reflects and supports the attachment of that patient to that family doctor. That’s what it is.

It’s not just going in and seeing a doctor, wherever you want to do it, in a walk-in clinic or a UPCC. That’s not attachment. Attachment is a specific code that reflects attachment between that doctor and that patient to provide longitudinal care.

S. Bond: Well, thank you. That’s what I want to determine — that people actually have the opportunity to have longitudinal care with a family physician.

Can the minister tell me how many people, in total, have accessed the health connect patient registry?

Hon. A. Dix: The number is 308,209. That’s the number that are registered with the health connect registry. Of that number….

These are up-to-date numbers, so they’re slightly different than I gave the member earlier. These are up-to-date numbers. We’ll be doing some work and bringing some people up to date on some things we’re doing on this issue tomorrow.

We’ll use the number…. It’s close to 310,000. It’s 308,209. The number of people attached is 66,000.

S. Bond: At some point, I was going to reference the fact the minister is going to update on the primary care plan tomorrow publicly. I’m hopeful that…. Let’s just say I will listen with interest after the discussion today.

I want to go back to attachment for a minute. I appreciate being reminded that…. One of the points of the question is…. Sometimes people are attached to a family doctor. For whatever reason, they don’t have that family doctor for long. By some stroke of luck, they get a second family doctor. Is that considered one attachment or two?

[6:30 p.m.]

Hon. A. Dix: This is part of what’s exciting — it’s maybe it’s not generally exciting, but maybe it’s just exciting to me — about the panel registry that’s taking place. It’s that we’re able to look at everybody’s relationship with a family doctor and then conceivably see someone who might be attached to more than one family doctor. Certainly, that’s possible that someone is. In fact, I’m sure that happens all the time. It allows us to clean up that list and also potentially create more space, say 1,200 spaces, for new people to be attached.

That’s what’s unique about what we’ve done compared to the past decade, since we had MSP and fee-for-service system. We now have the list of most of the doctors that have been submitted. We’re able to see who is attached to multiple family doctors, if that’s the case. It’s certainly the case, and clearly we found some of that. That will allow us to clean that up for patients and also to create more space for even more people to be attached.

That information had not been available and wasn’t available on the previous fee-for-service model, where we essentially just got the individual person billing over time. This allows us to have even more impact on attachment, potentially, and allows us to have an actual list, which we’ve never had before, which allows us to target attachment and ensure that people get appropriately attached to a family doctor.

S. Bond: Can the minister tell me what the budget was for education awareness and how they got information out about the new patient registry, and were there metrics in place to determine the outreach or success of that campaign?

Hon. A. Dix: We went live with the health connect registry, and we told people to start to register on July 1. Since that time, we’ve added 178,545, of which 154,235 added online and 24,310 added on the phone. We do keep detailed information about how people are attaching online and on the phone. I’ll just give the member an example of this. In the seven days leading to April 3…. That’s some of our most recent information. In that week, an additional 3,279 joined the health connect registry online and 344 on the phone.

What that tells us is that people have heard of the registry, and they’re joining in significant numbers. This is a group of people that’s providing information to us about their need for a family doctor and specific requests about that. We believe we need to expand out, and part of what we’ll be talking about tomorrow is expanding out the information people provide us so we can deal with levels of vulnerability and need. That’s where we’ve been at since July 1. That’s the number of people.

[6:35 p.m.]

It’s roughly 178,500 in that time, and that tells us that we have reached people. People are seeing the health connect registry, and obviously, a significant number are being attached to a family doctor. Now that we have the second portion of that, the panel registry, which was critical to the success of the initiative, we can really start to attach people, doctors and nurse practitioners and others who have space for new patients with people who want a family doctor. That’s the number I listed before.

S. Bond: Last year when asked, the minister said there would be a gap analysis regarding patient attachment following the introduction of patient and provider registries. Can the minister share the results of that analysis? Or perhaps that’s what he’s going to talk to the public about tomorrow.

Hon. A. Dix: Essentially, we have about 4,500 doctors who have provided their panels now, I’m informed. That leaves about 600 or 700 doctors to go. We’re at 87 percent now of participants — I mean doctors and nurse practitioners. We obviously want the remaining 13 percent, which will give us the fullest possible picture. We’ll, obviously, be continuing to publish information.

I assure the hon. member that I would never call a press conference about a gap analysis. What we’re doing tomorrow is providing more information to the public about this attachment process with the health connect registry, about the panel registry and some actions we’re taking to make it easier to get people who need a doctor to those doctors who have space available to people. I think that’s a very positive and continuing step.

The process up to now of that attachment is somewhat laborious, because it’s individuals. We have about 70 people working on the attachment process. The relationships are often over the phone, and that’s not a fast enough process for people. So what you’re going to see tomorrow is going digital with that process so we can really move even more people towards attachment more quickly. And we have the opportunity to do this because, of course, we have significantly more people practising family practice in B.C.

S. Bond: The minister may well call a press conference on gap analysis rather than talk about rampant drug use in hospitals. I think that, considering the alternative, I can imagine which one he’d prefer to talk about.

One of the concerns that patients have expressed to me is that the registry provided them with some sense of more immediate hope, and that hasn’t happened for a lot of patients. We have families that have been on that list since its inception. I think talking about the success needs to be discussed in the context of what people feel like when they’re still on the list years after they’ve been on it.

I appreciate improvements in technology and trying to speed up the transition to getting a family doctor. But today we’re having a semi-frustrating discussion, probably from both our perspectives, about attachment and numbers, where the new docs went and who are they and where did they come from.

[6:40 p.m.]

The reason we’re doing that is because people are desperate. The minister can say, “Well, we’re doing better than everywhere else,” and whatever. If you don’t have a family doctor, we know the implications of that in terms of long-term quality of your life, your health. By the time you find out you have something wrong with you, for many British Columbians, it’s too late. But if they had a family doctor, maybe that wouldn’t have happened with longitudinal care.

These questions matter, and the details matter, and where those doctors are matters and how many patients they’ve taken on matters. It’s not about me standing up here and asking prickly questions. It’s about people who have come to us and said: “We are desperate.” The same is true with health connect — people who have been on the registry for far longer than they anticipated they would be.

The minister is going to provide a report tomorrow on primary care attachments, I’m assuming. The minister had committed to doing quarterly reporting. I’m assuming that this would be one of those. And obviously, there will be an intervening election at some point here.

Can the minister confirm that he has a schedule of quarterly briefings planned?

Hon. A. Dix: Yes. I would say that — I think I said it earlier and the member said almost exactly the same thing — when people hear that we are leading the country in family doctors, they say, legitimately, if they don’t have a family doctor: “Well, what about me? What about my family? What about my mom?” I think I said that earlier. The member just said that. We agree on that.

That’s why we’ve taken, I think, these exceptional actions together with our doctors and nurse practitioners. And I’ll talk about team-based care and primary care networks — I know the member will have questions about those things — and be able to report on all the work that’s being done in communities led by communities of practitioners and teams across the province.

I absolutely agree with that, and that’s why we’re taking these actions. What’s very positive, on the issue of attachment…. What has always frustrated me — it frustrated me when I was the Health critic for the opposition and frustrates me now — is the main issue, the main thing that’s used. It’s the Canadian community health survey. The opposition used it when they were asking questions in the question period. It’s the main way we use it, but it’s a survey of Canadians.

What it shows is there are fewer people needing a family doctor today than there were in 2017, but a lot of people need a family doctor. That’s what the survey now shows. And there are a lot more people in B.C.

I agree with the member. We need more family doctors. We need more nurse practitioners. We have more family doctors. We have more nurse practitioners. We need more team-based care. We have more team-based care, especially through primary care networks. People have to feel the results of that. And the 60,000-plus people who have been connected to a family doctor or nurse practitioner through health connect probably feel pretty good about that. Those that haven’t been connected yet don’t feel as good.

We said, on July 1, we were setting up and opening up the system to everyone. We said that the key moment would be the registration process for doctors and nurse practitioners, but principally family doctors after that, where they upload their patient panels, so we could see who they actually had in their patient panel and where space was available. That has happened, and now we’re moving forward.

What we’re going to do tomorrow is just talk about how we can move more quickly to attach those patients to the doctors. We’ll be doing it, obviously, together with the Doctors of B.C. and with nurse practitioners as well, just to show the continuing work together.

I think doctors are enthusiastic about this work, and they’re enthusiastic, again, about family practice as reflected in the numbers, especially the numbers of people who weren’t billing MSP last year or billing MSP as family doctors. It is exceptional. We’re pleased about that, but we’ve got to continue to do more. We’ve got to add family doctors this year and next year and the year after, because hundreds of thousands of people are coming to our province, and they’re going to need family doctors too.

[6:45 p.m.]

S. Bond: The minister mentioned the growing population, and I actually wanted to raise that, so it’s a good segue.

If you use the numbers and years over which patients have been added as MSP registrants…. If you look at the years that the minister typically does, it’s probably about half a million new MSP registrants or so. At the same time, if you look at the population growth, the actual growth in population has been 498,034 people since 2018. It’s one thing to be adding docs. We’re adding people at an extraordinary rate.

It is clear that the strategy is not keeping pace with population growth, in addition to the other challenges that we have. That is particularly true in areas like Surrey. When you think about the overall increase in B.C.’s population…. There is a significant gap between the number of people successfully attached and the number of people that have actually come to British Columbia.

Maybe the minister could comment on that. It’s one thing to talk about MSP registrants. When you do that without the context of half a million more people being added to British Columbia at the same time, it changes the degree of success. I think that needs to be a realistic discussion with British Columbians. It’s one thing to say: “We’re doing great, but by the way, there are half a million more people in this province.” Maybe the minister could speak to that.

Hon. A. Dix: I’m happy to speak to that, because I’ve been speaking to that quite a bit. I think one of the challenges in Canada is the challenge of federalism. I won’t be too philosophical. We’re getting towards the end here.

The decisions made about things such as immigration policy, and the demands that those place on a place where people want to come like British Columbia, are significant and somewhat disconnected to provincial governments that provide health care and have a principal responsibility for housing and education and other areas.

I’ll just share with the member the information. While the number of people without a family doctor grew dramatically between 2009 and 2017, the population wasn’t rising as quickly at that time, which is actually not good news for that period. What we’ve seen in the Canadian community health survey is that there are fewer people today needing a family doctor — according to the Canadian community health survey, which has been used approximately 100 times by the opposition, so I think they believe in it — than when I started as Minister of Health.

This is in spite of the following. MSP registrants: 2016-17, 4.939 million; 2017-18, 5.033 million. That’s an increase in that year of 94,000.

In 2018-19, 5.132 million. That’s a net change of 98,887.

In 2019-20, 5.250 million. That’s a net change of 117,428.

In ’20-21 — that was a lesser year because of COVID — 5.317 million. That was a net change of 67,000. That was a year more like 2009, 2010 and 2011, during which the economy wasn’t growing as quickly.

In ’21-22, 5.466 million. That’s an increase of 149,000.

In 2022-23, an increase in one year of 3.44 percent of the population of MSP, or 187,939.

The estimate for ’23-24 — this is as of March 8 — is 174,823. We would expect to get close to last year. That’s an increase in the first 11 months and eight days of the fiscal year of 174,823 to MSP. That’s just a count.

We’ve gone from, for 2017, 5.033 million to 5.829 million. That’s what’s happened to B.C.’s population. A lot of that has to do with factors, obviously, different from health care, but all of those people need to be treated in the health care system.

[6:50 p.m.]

I agree with the member that it presents an extraordinary challenge — not just for our doctors, our nurses, our health sciences professionals, our health care workers but everyone in the province — to ensure that we’re providing services to a lot more people. It’s why we went from 9,200 base beds in acute care to 9,929 this year. It’s because we’re seeing that significant increase in population, unlike anything we have ever seen before in our province. So I think in that sense, it’s good.

I don’t know if the member has another question. I’d like to finish, because I’ve got the motion, but I’ll hand it back to her.

S. Bond: I understand the need to wrap up. I appreciate the opportunity. We’ll move on with some other aspects of primary care tomorrow and over the days ahead.

I would just implore the minister…. We’re going to have a press conference, and we’re going to talk about all the excitement, about partnerships and all of those things. That’s laudable. But I would just remind the minister how many British Columbians feel when they wake up in the morning every day, and they don’t have a family doctor, or they’re going to line up at a walk-in clinic at six in the morning to actually get in. By the time they get to the front of the line, the thing is full.

People don’t feel the headline of 708 doctors, and we’re adding all this capacity…. They don’t feel that on the ground. The minister knows it, and I know he’s sensitive to it. I would just like to make sure that we have appropriate context around the numbers, the statistics and the programs.

People are feeling lost without medical care. They’re concerned. I would hope that…. We’ll certainly hear that part of the discussion tomorrow. I will listen with interest to the minister’s press conference and may well have questions about that when we get back here tomorrow.

Hon. A. Dix: I just say that that’s what drives us all, I think. It’s what’s driven these initiatives, the need of people to get a family doctor, to get a nurse practitioner, to get team-based care.

With respect to the announcement tomorrow, it should be more technical than, shall we say, poetic. I’ll look forward…. What we’ll probably arrange, if that works for the hon. member, is a briefing for her, should she wish, with the deputy minister tomorrow in advance of us discussing it in the House. That might be helpful to our discussions.

With that, I move that the committee rise, report progress and ask leave to sit again.

Motion approved.

The committee rose at 6:52 p.m.

The House resumed; the Speaker in the chair.

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

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

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

Hon. M. Rankin moved adjournment of the House.

Motion approved.

The Speaker: This House stands adjourned until ten tomorrow morning.

The House adjourned at 6:54 p.m.