Orders of the Day

Hon. R. Kahlon: In the main chamber, I call the Committee of Supply for the Ministry of Health.

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

In the Birch Committee Room, I call the Committee of Supply for the Ministry of Education and Child Care.

[3:55 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 3:57 p.m.

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

S. Bond: Good afternoon, hon. Chair and the minister and staff.

I’m going to take an opportunity this afternoon to allow some of my colleagues to ask their questions. It’s going to be a bit of a potpourri of issues, but with shrinking time in the House, I want to make sure they get the opportunity to raise issues that are important in their communities.

I am going to start with my colleague from Kamloops north.

P. Milobar: Just a couple of quick questions for the minister.

We have a bit of an issue brewing in Kamloops around ophthalmology. I’ll walk the minister through a very quick timeline here.

Essentially, late 2022, early 2023 Interior Health had identified that Kamloops required three ophthalmologists. They went out and successfully found another ophthalmologist. She does great work, and she happens to be a pediatric ophthalmologist as well, which added to capacity and services in the Kamloops area, which is wonderful.

However, in around January of 2024, so only a few short months later, one of the three ophthalmologists informed IHA that he would be retiring coming up in around August. He had located somebody to take over his practice — all fully board-certified, Canadian, coming out from Ontario, I believe it was — and he would take over the practice.

Now, this practice sees around 300 patients a week. It’s incredibly important, as only a year ago IHA had identified that Kamloops needed three ophthalmologists. So it was a bit of a surprise, both to the ophthalmologist and the community and his patients, that IHA immediately turned around and said: “Well, you know what? We actually don’t need three ophthalmologists in Kamloops anymore.”

Could the minister explain how, in the space of a few short months, in a city that’s one of the fastest-growing cities in Canada right now, with a patient load of 300 patients a week, it’s suddenly deemed to no longer be needed, and if so, is there not a way to have IHA reverse their decision, given that the system is already financially sustaining, within IHA, the three ophthalmologists?

[4:00 p.m.]

Hon. A. Dix: As the member knows, because he described it in his preamble to say that a new ophthalmologist was hired in the fall of 2023 in Kamloops. Dr. Jelfimow announced more recently than that that he’s retiring. There is, I think, as it appears, some difference of opinion between himself and those doing the work at the hospital, because there is some difference between his practice and a practice that would involve using hospital time. Those are the positions that are full.

What I would suggest, and I’m absolutely open to do and having our team do at Interior Health, is engage with Dr. Jelfimow. I think they’ve already made that offer, but we’d be absolutely prepared to have that offer to discuss the circumstances of his retirement and how he would continue to provide excellent service to the people of Kamloops.

These are issues, of course, that are management issues of doctors in the community. I think there is a difference between Dr. Jelfimow’s practice and the practice of the new doctor coming in. That’s something to be assessed and considered but absolutely open to having that discussion.

P. Milobar: Here’s the problem that patients in Kamloops are faced with. At a time where access to specialists and other doctors is critically short….

I recognize that IHA is essentially trying to dictate and control operating room time, but that is precisely the problem here. You have a catchment area that Kamloops serves, these three ophthalmologists serve, of 225,000 people. It goes all the way north to Williams Lake. In fact, one will travel up to Williams Lake to do some work up there as well occasionally. I think it’s once a week they rotate around.

So that’s the Kamloops catchment area, which is actually well below the ophthalmological standards, as I’ve come to learn, for ophthalmologists per population.

Let’s go down the road a little bit within IHA. Vernon, a population much smaller than Kamloops, has four ophthalmologists, all with IHA operating room times. Kelowna has ten. Penticton has four. So in an hour and a half drive in the Okanagan Valley, there are 18 ophthalmologists, and Interior Health is refusing to find the operating time for three in Kamloops.

Then I thought: “Well, where else does IHA cover? Oh, they cover the Kootenays.” The Kootenays has a much smaller population than the Kamloops area — the whole Kootenay region. The Kootenays have five, all under the Interior Health umbrella, all doing surgeries. These are all based on surgical wait times for ophthalmology, which means they actually are performing surgeries.

Will the minister be willing to intercede with IHA? This isn’t about qualification. This isn’t about the ophthalmologists having their own office and space and everything else like that. They have all that. They’re not looking for a different funding model. They’re simply saying it’s not reasonable that literally a few months ago Interior Health identified a need for three ophthalmologists, and then a few months later they’ve said: “Actually, we’ve recalibrated our assessment. We don’t need three anymore; we only need two.”

When we have a growing population, and when you see 18 literally just down the road from Kamloops and five over in the Kootenays, it simply does not make any sense that an area of 225,000 people that services people that live up to three hours away in Williams Lake is supposed to be served by two moving forward when the one that’s retiring has a patient load of 300 patients a week.

[4:05 p.m.]

Hon. A. Dix: I just want to put it in context. I think I answered in the first question that of course we’ll take a look at it. It makes sense, so we’ll take a look at issues when they’re brought forward, but just to understand that Dr. Jelfimow has consulting privileges but does not have allocated OR time. So that’s not a change. But all the positions at Royal Inland Hospital were filled after the recruitment of a new physician in the fall of 2023.

The Royal Inland Hospital has four privileged ophthalmologists at present. I appreciate the member may see there’s a debate about that and discussion about that in the community of ophthalmologists. My suggestion is that Dr. Jelfimow meet with the Royal Inland Hospital chief of staff and the chief of ophthalmology — I’ll certainly review the matter as well — and have a discussion about these issues, which are issues that arise when people retire.

Certainly, in Kamloops, the member will know this, we have shorter wait times for major ophthalmological procedures, including cataracts, than both the national and the provincial average and that we’ve, in fact, reduced those wait times in recent years. We’ve got to continue to do so as the community grows.

I’m not in dispute with the member. He’s raised this issue, and I’m interested in it. These are some of the facts that are involved. My suggestion is that the medical professionals get together and discuss it, but I will, of course, get involved in this, as I do in issues all the time.

T. Halford: I want to thank my colleague here, the member for Prince George–Valemount, for allowing me this time.

I’ll be brief. This is just on a subject the minister and I have touched upon. It’s regarding a local doctor, a family doctor in White Rock, that has unfortunately been diagnosed with brain cancer, or glioblastoma. He had put forward a letter to the minister dated March 8, 2024, and he’s writing regarding funding of a device that he believes could dramatically improve his quality of life, his quality of care.

Obviously, there’s a significant financial cost to this. But I do want to ask the minister directly if he’s had a chance to look at the request from Dr. Zayonc and if he can follow up at his earliest convenience, because this gentleman has been waiting over a month and a half now. It is something that I want to bring some closure to, if there’s ability to get funding for this device that will assist him and others that are dealing with this obviously tragic condition.

Hon. A. Dix: I appreciate the member’s question.

He raised this matter with me personally. We’ve discussed it on a couple of occasions. I have reviewed the matter, and we will be responding very shortly, both to the member and to the patient in question.

M. Lee: I appreciate the member for Prince George–​Valemount for giving me a little opportunity to ask some questions about health care in South Vancouver.

First of all, let me just confirm one point. On November 28, 2023 — on my birthday, as it is — I wrote a letter to the minister relating to the need for increased community health services in South Vancouver. I have a copy of the letter here. I don’t believe my office received a response. Perhaps if you have an opportunity….

You have lots of correspondence coming from members and other residents in British Columbia. I’m happy to hand over a copy of the letter, unless the minister tells me otherwise that the response is in the mail, or did I miss the response?

Can I just ask the minister to confirm? I’m also happy to hand this over to you so you can see it.

Interjection.

M. Lee: Well, I can ask the question, sure. I wanted to make sure that.… If I had the response, then I wouldn’t have to ask the questions.

[4:10 p.m.]

I know the minister, having spent some time, of course, in South Vancouver, knows the diversity of the peoples there in Sunset, Victoria-Fraserview, Killarney. We have over 100,000 people who live there: 80 percent of them identify as racialized; 55 percent are newcomers.

South Vancouver Neighbourhood House recently did an analysis on the social equity deficits in the South Vancouver area. I know that the member for Vancouver-Fraserview and myself were at the neighbourhood house discussing the results of the report. Marpole Neighbourhood House is also doing a similar equity deficit report for their community in Marpole.

I have, for some time, as the local MLA for Vancouver-Langara, been advocating for the need for additional community infrastructure supports, both for the growing population that we see along Cambie Street, Oak Street, Granville Street and across the community into Fraser Street, of course — more housing being built, including around transit and the Marine Gateway. We know we need to have additional supports for health care.

When I was elected in 2017, I joined many members of the community to talk about the move to centralize health care services at Pearson-Dogwood. That is something that is still unfolding. But that meant the closure of the community health centre at Knight and 49th, that community health centre where my mother, as a public health nurse, used to work.

I know the importance of that site — I’ve talked about it in the community — and also that there has been a proposal, including with the South Vancouver Neighbourhood House, a business case submitted for a new South Vancouver community health care centre to be built in South Vancouver and sites to be located in South Vancouver.

I know I had some discussion with the minister at one point, informally, about the need to identify a suitable commercial location for the community health centre. My letter back in November of 2023 was merely addressing the status of that possibility, recognizing, with the growing population of South Vancouver, the consistent need which is longitudinal care as opposed to episodic care — the importance of that through a community health centre grounded in the community in South Vancouver as a growing community.

I’d ask: have there been further updates in the work with the Ministry of Health to consider this proposal and the need for an additional community health care centre in South Vancouver, particularly in the face of closing that community health centre at Knight and 49th?

Hon. A. Dix: When the member asks me about health care in South Vancouver, it’s a subject that I have spent a lot of time working on, as a member of the Legislature and as the Minister of Health. I was working on it in 2013, I would say to the hon. member, when four primary care sites were closed by the previous government and centralized at one site. That’s the legacy of that time. I’m not going to say anything more about that, because that was 2013, and we’re in 2024.

What have we done? With respect to community health centres across British Columbia, we’ve provided sustainment support for community health centres, all of which were in trouble. We’ve supported the REACH Community Health Centre, which is on Commercial Drive, of course, and the Mid-Main and its relocation community health centre, which serves people all around Vancouver, as well, at their new location. We very significantly added support in both of those locations.

In terms of the primary care networks in Vancouver, this was new staff for primary care in Vancouver, net new 174 FTEs in cooperation with divisions of family practice in Vancouver. This includes an actual 41.73 more physicians, 48.74 FTE nurse practitioners, 22.1 nurses and 41.1 Allied Health professionals.

We’ve supported existing community health centres. We’ve added urgent and primary care centres, including the one at 43rd and Victoria that the member will be familiar with and a number of others in Vancouver. We’ve added a community health centre in South Vancouver, which is the RISE Community Health Centre, which is located at Joyce Street and Crowley Drive in southeast Vancouver.

[4:15 p.m.]

In addition to that, in that area of Vancouver, for Indigenous health, we’ve been supported by the new community health centre that was established by Lu’ma Housing, which was supported as well, which is really a remarkable project. I’d encouraged the member to look at it.

We have consistently supported the creation of new community health centres, and I think that South Vancouver would be a good location for one. That’s why we started one with the community.

In the case of the RISE Community Health Centre, it was formed out of work done by Collingwood Neighbourhood House. It has led to the attachment of thousands of people in the community, with a focus on people with high needs in the community as well.

Our primary care plan is founded on adding doctors, nurse practitioners and nurses. We’ve done that in Vancouver, building on the practices that are in place.

At RISE Community Health Centre, where a primary care centre was shut down in April of 2013, there’s now a community health centre operating there. I am enthusiastic about this project. I think I talked to the hon. member not long ago about it. I’m enthusiastic about building out more community health centres.

I actually think the new longitudinal family practice model will lead to more community health centres and the transition of some health clinics that are currently typical, and current doctors offices, to the community health centre model. I think South Vancouver Neighbourhood House is an excellent organization.

Just as we’ve added community health centres, added urgent and primary care centres, added primary care networks, added staff, added supports in the community in recent years, I think his suggestion and idea to do this, contrary to the position taken in the past — but that’s all good news; it shows the evolving situation around these questions, about which I’m very pleased — is a good thing. I am going to continue to work as a representative of South Vancouver to expand services there and everywhere else in B.C.

M. Lee: I appreciate the minister’s response and his reference points to the past. Obviously, I was a newly elected member of this Legislative Assembly in 2017 — proud to join my colleagues in that effort in the last seven years.

We have seen, of course, in the course of the last 11 years, in the period that the minister cited, a tremendous amount of change in neighbourhoods in South Vancouver. We’ve seen the oncoming development of River District in Vancouver-Fraserview. We’ve seen Marine Gateway, in my riding of Vancouver-Langara, at the foot of Marine Drive, the legacy of the 2010 Olympics.

The former Minister of Transportation, my colleague the leader of the official opposition, was able to lead in terms of building that Canada Line and the tremendous infrastructure investment cutting right through my riding, Vancouver-Langara, which has led to, of course, more housing density being built.

That same housing density has been built at Oakridge, also at the Pearson-Dogwood centre site, and Langara Gardens to come, at 57th and Cambie. I’ve been calling for repeatedly, in other ways, in terms of community infrastructure, greater transit supports, including the building of the contemplated additional Canada Line stations at 33rd and 57th. With the Oakridge development being a second town centre for Vancouver, we will see tremendous growth. That is now very much on the way, transforming the Oakridge area.

Heather Lands is another example of a development with MST — Musqueam, Squamish and Tsleil-Waututh Nations — as they come forward more. Across from the Jewish Community Centre, of course, we have the Grosvenor development and the Jewish Community Centre itself, with more housing and below-market housing to be built, including at the YMCA site at 49th and Cambie.

These are just a number of the examples of the growing population we’re seeing in South Vancouver.

Some of it, given their proximity, will be serviced by a more centralized hub at 57th and Cambie, Pearson-Dogwood lands. Some of it will be served, as the minister just cited, by the RISE centre, Joyce Street area, in partnership with Collingwood Neighbourhood House. I think that as the minister acknowledged, the South Vancouver Neighbourhood House is also another strong example of a neighbourhood house that’s doing good work.

[4:20 p.m.]

They obviously were there to help shepherd along the rebuild of the Marpole Neighbourhood House at 70th and Hudson in South Vancouver in my riding, but the leadership that they’re bringing to the table and the need that they’re identifying for another community health centre to be built in the South Vancouver area is also, I would suggest, in face of the growing population in South Vancouver, the growing diversity and the aging population, of course. This is where community health care centres on the ground are needed.

I attended, with other colleagues in this House and city councillors, a session that was held at Vancouver General Hospital with Vancouver Coastal Health. They provided the opportunity to give us an update on a regional basis. I also had the opportunity to ask, from leadership teams and members of that gathering, the status of this same question. They cited to me, as the minister just did, the ongoing development of services at the UPCC at Victoria Drive and 43rd.

All I’m suggesting, in light of the context the minister has again underlined, is that there still remains a great need for a community health centre to be built in South Vancouver, for the reasons I just gave. I would encourage the minister, as we go forward, that there is opportunity here.

There’s opportunity to partner with commercial developments. We saw that with South Vancouver Neighbourhood House itself, at Marine Drive and Fraser Street. They have a space there, a community hub, including for the child care that’s much needed in South Vancouver. That’s just an example of the kind of partnership we can see with commercial developments that are very much underway in South Vancouver.

I would encourage the minister, as he continues with his ministry, to look at the windows of opportunity here, as we see these developments come to light in South Vancouver. I would just ask the minister if he can provide any further comment about the process under which those sorts of partnerships can be considered, and the timing for consideration around the business case that has been provided by South Vancouver Neighbourhood House.

Hon. A. Dix: What we’ve done in the community…. The member will know this; we had a discussion on this last week. He’ll know that in the last two years, we’ve added, in British Columbia, in the neighbourhood of 375,000 people to the Medical Services Plan — in two years, unprecedented growth in B.C. because hundreds of thousands of people want to come here.

It’s a challenge — in housing and health care, in particular — to deliver services, but that’s why you’re seeing such extraordinary investment, led by my colleague the Minister of Housing, and why we’ve been so focused on improving primary care services such that, with the new LFP model, we’ve added 708 family doctors in the first nine months of the model.

With respect to community health centres, we’re enthusiastic about the prospects of more community health centres — led, obviously, by RISE and Collingwood Neighbourhood House, in our neighbourhood, and Lu’ma Housing Services, and a community health centre that recently opened in Rutland, British Columbia. We’ve given support in the expansion of other community health centres in Vancouver, such as Mid-Main and REACH.

There’s the new community health centre I had the honour to open last week on Bowen Island — not in South Vancouver, but a really extraordinary community effort. I know my colleague, the member for Vancouver-Fraserview, has talked to me. The member has talked to me. I’m always enthusiastic. In the case of the Rutland Community Health Centre and the one in Lake Country, I worked with one of his colleagues. The member for Kelowna–Lake Country worked very hard on those issues.

I am very committed to expanding out the model of community health centres. When people express interest in that model, we are there to work with them. That’s why we’ve gone in the opposite direction. The number of community health centres were declining, and they were all in trouble when I became Minister of Health. We made the investment in funding and in the association to support them, and we continue to engage. Whenever anyone comes forward with a proposal, we engage with them to see it happen.

[4:25 p.m.]

In the case of RISE, it took a little bit of time, and Collingwood Neighbourhood House is a formidable organization in Vancouver. It still took some time to put it in place, but it is an exceptional thing. Boy, is it a subject of pride in the neighbourhood. It had been closed down, but it reopened as a primary care centre, directed by a non-profit board, controlled by the community. That was a fantastic thing, something I’m personally very proud of and think it’s a model that can work in South Vancouver. I may even have answered the member’s letter with that answer.

With that, I’ll just say that I’m very committed to that. I think South Vancouver is obviously a growing area. We’re going to see growing density, whether it be in Joyce-Collingwood or in Marpole. The member mentions the Oakridge project. Really, the River lands project and all of those projects see an increase in demand, as we see in areas, for example, like Brentwood in Burnaby, which is significant and different. The community health centre will have a different approach than community health centres had in the past.

For example, the development of the REACH Community Health Centre back in the day, back in the late 1960s, early 1970s, continued to play a role in its time, and it has evolved over time. Now it’s the home not just of a remarkable community health centre but a community health centre–run urgent and primary care centre.

There are lots of options. I think this is the direction. Whether it was the direction of the past or not, it’s the direction of the future. It’s one that I strongly have supported as minister, and I agree that South Vancouver would be an excellent location for more community health centres.

M. Lee: I just have one last follow-up, and I’ll hand it back over to the member for Prince George–Valemount.

I want to make two sets of comments and ask that he confirm the last point that he just referred to, as we conclude here. The minister acknowledges the importance of growth in the community as we continue to welcome immigrants and others, to the extent that that is happening, back to our province. To the extent that that is happening, we need to have a plan for continued integration of community services. I say that beyond just health care. The minister recognizes that in South Vancouver, as he just described.

I also know the minister, in his role as the member for Vancouver-Hastings….

Interjection.

M. Lee: Ah yeah, Vancouver-Kingsway. Of course, the Attorney General is the member for Vancouver-Hastings.

I saw on social media that the member was there as a minister with an acknowledgment for the effort to save Bruce Elementary fields. That’s just an example of the need for school infrastructure, of course, for a growing community. We have that continuing conversation. My colleague the member for Surrey South is having that estimates discussion, I believe, right now, concurrently with this discussion.

I’m sure the minister knows about the situation at Sir Guy Carleton Elementary School as well, right? They had the fire. It’s an example of community infrastructure and how we continue to build for new population, a growing population, including in the east and south areas of our city of Vancouver.

On the transit front, I have had an effort, including with a petition, about a new bus service on 57th Avenue. The reason for that is to connect the health care resources, including at 57th and Cambie, so that people in South Vancouver can travel. There’s a bit of a zigzag around Langara College, but there’s a possibility to ensure that seniors, working people and their families can get to that health care resource.

In the absence of a new bus service on 57th Avenue, we also need this community health centre in South Vancouver that I’m speaking of, a site that would be east of Cambie Street and west of Joyce Street, of course, in that area, which is a large area below 49th. That integration of education, transit and health care is something I’m very focused on in the South Vancouver area, as the MLA for Vancouver-Langara.

Just to close off, the minister — tongue in cheek, so to speak — just said that he indicated that he may respond to my letter. I would actually appreciate the formality of that. I’m hearing, from the minister’s responses, that there’s a degree of willingness to have some involvement and cooperation with myself as a local MLA. I would welcome that opportunity.

[4:30 p.m.]

I know that the minister will acknowledge that at times, particularly for not-for-profit organizations or other members of the community, there’s a bit of sensitivity, let’s say, in terms of recognizing the roles that we all play. I’m obviously here as the local MLA for Vancouver-Langara to do the best for residents, whether I’m in the opposition or in government. I hope to have that opportunity someday soon. But on the opposition benches, though, I still play a role, as the minister well recognizes.

I would appreciate if the minister could at least give that indication to the community for whatever channel he does — including to his colleague, the member for Vancouver-Fraserview, the Minister of Citizens’ Services — because we can do more things in partnership. I believe I can bring more of that to the table, in terms of engagement with the community.

I ask if the minister could just confirm those two points.

Hon. A. Dix: I think that’s the point I was making. We were looking at the community of Lake Country, which is a very different community than the community of South Vancouver. It was looking at a community health centre at the time, a number of years ago. The opposition Health critic at the time was the member for Kelowna–Lake Country. I met him there, and we met with the people involved and got involved in that.

My friend from Peace River South is here. We’ve worked together on the hospital project since I’ve become Minister of Health — at the beginning, he was the Health critic and then afterwards, since then — to see that people get those services.

[J. Tegart in the chair.]

This has frequently been the case with other members — the member for Delta South, the member for Prince George–​Mount Robson. I work with people all the time. The member for Vancouver-Langara and I had a joint meeting at one time with people who had concerns in long-term care and issues there. I was happy to do that.

I’ll do him one better. After my session in estimates is over — which could be this week or could be next week; one never knows in this wonderful place — I would be happy to sit down and talk to him in person about it, rather than just the formality of a letter, and have a discussion about the way that happens.

Obviously, in the case of RISE, that’s one model to go forward with. It’s a good model if, say, a neighbourhood house would be involved in South Vancouver.

One of the challenges in South Vancouver historically has been, especially, not so much in the member’s riding but in the sort of Fraserview area, a little bit…. The lack of commercial space has always been an issue. Often people get served on Kingsway or on a street like Joyce, but less so if you go south of 49th, really, over between Boundary Road and Victoria Drive. This is a challenge.

This is changing now, of course, with development on the river and with other developments in the community. That historically was a problem and is why, often, primary care clinics, that are private clinics but public health care clinics that are run by doctors, weren’t in that area — because there wasn’t as much space, there wasn’t available space.

I think that makes the options in South Vancouver really positive. I would absolutely be happy to sit down with the member and talk about those.

M. Bernier: Thank you, first, to my colleague from Prince George–Valemount for allowing us a few moments. I just have what I think will be a fairly quick question for the Minister of Health, for the few moments that I have. I’m sure the question will be way shorter than the answer from the minister.

Again, let me set the stage. A young child has an accident. The mom puts them in the car and drives them to the Chetwynd hospital, only to find out that there’s a sign on the door that says that the emergency is closed and tells this family: “Sorry, we can’t let you in due to a shortage of staff.” I’ll get to that in a moment.

Then they have to drive over an hour, in good conditions, to the closest hospital. It’s what they’re told to do, or to phone 911. And all 911 will do is, if there’s an ambulance available, transport that child to the nearest hospital, which will be over an hour away. I know the minister probably thinks that this is not something that is suitable, but to have a sign on the door….

Let me also say one of the biggest challenges I’ve seen is the lack of communication from Northern Health. This is something I’ve addressed to them personally recently as well — with good response, I will say, from them.

[4:35 p.m.]

But to have a sign on the door that you don’t know about until you get to the hospital in a crisis; to be told that the only other place that you might have information is on a regional Facebook page — if you happen to look at that before you drove to the hospital, which of course the minister I think would acknowledge nobody would do in a crisis situation; not to have information on a Northern Health website or on a larger Northern Health site…. How is this a good treatment or fair treatment for the people in Chetwynd?

Dozens, I am told, of closures last year. In the recent little bit, I’m told there have been almost five closures already, diversions of the ER, this year.

I will acknowledge and thank — I know the minister would do the same — the doctors and nurses who are doing absolutely everything possible in the Chetwynd Hospital right now. If it wasn’t for them, there’d be even more diversions with the limited staff we have.

I’ve heard stories where nurses have finished a shift and stayed on to babysit children, so another nurse can come in and do a shift. This is all about making sure we don’t burn out the existing staff that we have there. I think the minister, again, can acknowledge that this isn’t something that we all want to see.

The minister just acknowledged that he and I worked together to ensure that we could continue to have the hospital in Dawson Creek. I thank the minister for that working relationship. That hospital is going to be a great contribution, a great asset for the people in Dawson Creek. But that’s not where I want to see the people of Chetwynd being shifted to in case of an emergency.

My very easy, I think, question to the minister is: how can we continue to work together? We want to make sure that we have the doctors and the nurses that we desperately need in our small rural communities — specifically, in this case, Chetwynd — to avoid any more closures of the ER. I know the doctors and nurses don’t want to see it. I know I don’t want to see it. Definitely, the families and the people in Chetwynd don’t want to see it.

What can we do to make sure this doesn’t continue?

Hon. A. Dix: I don’t want to see it ever. Sometimes it’s required. It is required by good practice, if we don’t have sufficient staff, to go on diversion. There have been enormous efforts made at recruitment, and there will continue to be.

I just want to put it in context. In Chetwynd — and I don’t consider this sufficient — we’ve seen now, after quite a bit of diversion at the end of last year, those numbers are going down. I think that’s good news, and that is a reflection on the work being done by Northern Health, in the community, by physicians and by nurses.

Let’s talk about what we can do together. We’re focusing on funding for physicians in Chetwynd to keep physicians at the primary care clinic, which is an important base for health care, in clinic, by reducing overhead costs. Chetwynd primary care is receiving funding for an additional physician to get on the physician side. It’s not just physicians; sometimes it’s physicians and nurses.

Let’s be clear. Northern Health is working with the district of Chetwynd in terms of housing for staff. That can sometimes be a problem. We have provided, for example, through the GoHealth program in Chetwynd, 4,964 hours since the beginning of that program. That’s very valuable. But to make those programs really work in communities sometimes requires housing, in order to make it a place where people want to go and come back and be there, even if on a temporary basis, to fill in in those critical moments, where we’re doing it.

We also established a steering committee in Northern Health, in March, to better address these issues of communication so that people know, understand when things are going to happen and what the circumstances are. And we’ve added very significant resources. We’ve added significant resources to both home support and to ambulance services in communities like Chetwynd.

I think one of the real achievements of the last period has been the real investment in ambulance services, especially in rural and remote communities in B.C. I’ll just make this point about Chetwynd.

[4:40 p.m.]

Purple and red call ambulance response: 13:34 two years ago, 8:26 this year to date. This past year, the year ending 2023, which was 12-31-2023, for orange calls, reduction in median response time from 13:29 to 9:50, and for yellow calls, a reduction from 18:36 to 12:05.

We are investing across the region in better ambulance response. That’s not the answer to the emergency room, but it’s important because there will be many patients who would have to go to another community for care. That investment in ambulance service, I believe, is a fundamental change in the way we do ambulance service in rural B.C.

So housing; our very significant incentive programs to nurses, and Chetwynd is a community that’s the subject of those; doctors working with community…. I’m absolutely happy to work with the hon. member as well on those issues.

D. Davies: This works out well. A bit of a follow-up with my colleague from Peace River South.

For a number of years…. The minister and myself and the mayor of Fort St. John, the mayor of Taylor, the president at the time of the BCNU were on a telephone call — it’s going back almost three years ago now — calling on an independent third-party audit of Northern Health.

I know since then those calls have grown. I know the Resource Municipalities Coalition wrote the minister a letter, which, again, included the mayor of Taylor, the mayor of Fort Nelson, the mayors of Mackenzie, Tumbler Ridge, Fort Nelson, Fort St. John.

We’ve had recently, at the last NCLGA, the North Cen­tral Local Government Association, “therefore be it resolved that the NCLGA and the UBCM lobby the prov­incial government to require review of the structure/management of health authorities,” so even broader than just Northern Health.

That was about three years ago when we first started calling for this audit. I think I told the minister that day on the phone that this isn’t trying to play gotcha or anything. We need to have those independent eyes looking at our health authorities.

My colleague was talking about the diversions. Chetwynd has seen nearly 50 closures or diversions in a little over two years. Fort Nelson has had numerous diversions. In Fort St. John, our emergency department was shut down recently. So things aren’t rosy. Things aren’t working well in Northern Health and…. We’ve heard the same stories, and I understand other local governments have called on reviews of their own health authorities.

First of all, I need to commend all of our front-line workers who have really stepped up. B.C. Ambulance — I know the minister mentioned B.C. Ambulance — has been really increased. In Fort St. John, my hat’s off. There were tons of ambulances there. Our nurses, our support staff and doctors….

But it does not negate the fact that things aren’t working well in our health authorities. We’ve seen it time and time again, whether we’re talking these diversions, we’re seeing wait times, transportation for specialist appointments. Something needs to be done.

I think, and many others believe, that this audit — and I’ll ask, specifically, as us — be done with Northern Health to find out how we can make things better. What is going well? What isn’t going well? Where can we make improvements?

I understand that they do fall under Accreditation Canada, but that’s a different piece than looking at the best way that we can manage our health authorities. To deliver the best results at the end of the day, we need to be patient-focused and what’s best for them?

Again, this has been called for a long time. I wonder if the minister can address that.

[4:45 p.m.]

Hon. A. Dix: Thanks to the member for the question.

I have spoken to him many times, and we’ve had this discussion. I had a discussion with the member for Vancouver-Langara. I don’t think people sometimes are aware of the extent to which we work together on these issues as members, especially in communities that are represented by members of the opposition. I’ve had the occasion to work with the member a number of times on issues involving long-term care, on issues involving acute care, on issues involving primary care in Fort St. John, for example, and other communities.

Just last week I had the occasion to meet with the mayor and council in Fort Nelson to discuss issues that they had, both with respect to diagnostic care, which is a real concern there, and the desire of that community to have a CT scanner, as the member will know, as well as issues around diversions and the recruitment of staff and the quite effective recruitment of staff that has occurred.

My own view, which is different than the hon. member’s, is that we’re having a lot of success in working with northern communities. I credit both Northern Health and the communities for the work we’ve done together. I’ll just give an example of the work we’ve done.

Northern Health set up for workers, to bring workers to community, child care support, so a prototype to support expanded net new child care spaces and expanded hours of operations to meet the needs of health care workers. It’s a really critical issue, in particular in the North in some communities where there is a lack of those spaces. That’s underway in Chetwynd.

In Fort St. John, in Kitimat and in Prince George — 36 spaces in Fort St. John, 24 extended-hours child care spaces; 21 spaces in Terrace; 32 spaces in Prince George; 12 additional spots targeted in Chetwynd, and so on. This is the case of communities working together with Northern Health on joint projects.

In terms of housing support, we’ve seen the same process that Northern Health, for the same reasons as discussed with respect to Chetwynd with the member for Peace River South, has obtained properties in Dawson Creek, in Fort St. John, in Chetwynd, in Valemount, in Kitimat, in Prince Rupert and others. These are partnerships, often with regional districts, for example. In the member for Prince George–Valemount’s riding, the Valemount regional district supported the purchase of a multi-unit home in the village of Valemount, for example.

All the work that’s been done with recruitment incentives, with the travel resource pool…. In fact, Northern Health has been leading British Columbia in terms of recruitment, because we have piloted initiative after initiative that’s now going provincewide in Northern Health. I think the Northern Health team…. We have strong representation throughout, including from the Peace country, on the Northern Health board, as we have since I’ve been here. They’re available and excellent people.

My view is that we do have to have a close relationship with municipalities, and that’s got to be working together on these issues of recruitment all the time, because what happens in a smaller community is that you can have a very stable group, and really there’s no space for a new health professional. Then suddenly someone decides to leave or retire, and suddenly, if that’s two people, it becomes a very significant situation. So I agree we’ve got to work very strongly and very closely with municipalities, not in the context of audits but in the way that we’re doing right now.

I could go through the workforce support programs. The member knows about them. We don’t need to go through them all. But a lot of those proposals are fundamental to the efforts we’re making in health human resources in communities, involve communities working with Northern Health on joint recruitment initiatives. And we’ve got to continue to do that.

[4:50 p.m.]

D. Davies: I have to disagree with the minister. Yes, there probably are a lot of successes, and I know the minister, during different parts of proceedings in this place, whether it’s question period or otherwise, talks about some of those. But the bottom line…. I negate it almost to that little meme that you would see on Twitter or whatever — or X now — of the dog sitting at the table and everything’s burning down around him. “Yeah, it’s fine. It’s all good.” It isn’t good. Things are not good.

I know the minister has been emailed and cc’d on the same emails that I get or my colleague from Peace River South gets. This is not my opinion that the minister had spoken about, that we have a difference in opinions. I listed off the municipalities that have called for this, that say that things are critically wrong. There are way more municipalities than I listed. The thousands of British Columbians across northern B.C. that are saying that it is not good health care in pretty much all levels….

I asked for a response, but maybe I should have made it a question, which I will do now. We do need to look at how things are being operated in Northern Health. How can we do them better? What are the gaps? Again, not having Northern Health looking inward and saying: “Yeah, we’re doing a good job….” This needs to be an independent audit, which is good for any large corporation, such as health authorities or even municipalities. Many municipalities undertake third-party, independent audits to find out those exact things. How can we do things better?

That’s all we’re asking, and this is all these municipalities are asking. This is all the NCLGA is asking. How can we do things better? That is going to happen, I think, through an audit, or maybe we call the Health Committee and do something on rural health care.

Will the minister commit today, or at least entertain committing, to an audit, or maybe striking the Health Committee, and getting something looking at rural health care?

Hon. A. Dix: I think that promoting rural health care is at the core of the changes that we’re putting in place. I don’t look one way or another at issues. There are issues in communities around B.C. when you have health human resources issues. Even when we’re seeing a dramatic increase in health professionals, that doesn’t mean they’re distributed in the way that we’d like all the time. That’s the case. That’s why we’ve taken action after action after action to support rural health care.

The difference…. I wasn’t disagreeing that there are issues. I’ve met with health professionals in Fort St. John in the past six months. I’ve met with health professionals in Dawson Creek. I met with them in Fort Nelson and communities across the North. My point to him is that we have, in Northern Health, on administration costs, one of the most efficient health authorities not just in Canada but across the world — a relatively low-cost administrative health authority.

The health authority model was put in place by the previous government, and I’ve maintained it. I’m not going to get into that discussion. It’s a model that’s in place. So on that basis, they meet the test.

There are real challenges in many communities in the North. It’s why we’ve taken such concerted action on ambulance service, because the system we had in place, which was a casual system, wasn’t working any longer. We made a fundamental reform to the way we delivered that service. It’s why we’re making so many parts of the health human resources plan focus on rural and remote communities and being modelled in Northern Health.

I think where I disagree with member is not that there aren’t issues. I acknowledge when there are issues. I go and see people when there are issues. We work to bring resolution to those issues.

In Fort St. John, for example, one of the issues is the need for more specialists in internal medicine. We need that at the hospital. We provide support to everyone in the hospital, and our recruitment efforts are in place. Some of those recruitment efforts are attached, and why we focus on issues like housing and child care in the community of Fort St. John is that we’ve heard from people in the community who said these are important issues in terms of recruitment.

I think we have to work together. Just take Fort St. John or Taylor or whatever the community would be. Northern Health has to work with communities closely to address these very real problems that exist because it’s critical in the community.

[4:55 p.m.]

If an emergency room is on diversion, it’s critical to that community. It’s not a small matter, even if it’s overnight, even if there’s a small number of patients affected on that given night. A hospital like Fort St. John has to be open, and we have to build out primary care. That’s why we’ve added primary care networks. We’ve added all these things to support those communities, and we’re going to continue to do that.

I always encourage an organization like Northern Health — because the member raised issues in the municipality — to work with municipalities on our joint priorities and communities. I’m just disagreeing about the mechanisms, that’s all. But of course, where there are issues, we have to face those issues head-on, and that’s what we’ve been doing.

D. Davies: Just for clarification, then, that is a no to the audit and a no to even striking the Health Committee?

Hon. A. Dix: I haven’t supported the idea of the audit when we’ve discussed it before. I’ve been pretty straightforward about that. I think we have a team in Northern Health that’s incredibly dedicated, that has an unusual challenge. Northern Health has to serve communities over wide geographic areas, and I think they’re incredibly committed to that. I know our Northern Health staff is.

But I’m not saying there aren’t issues. I think we have to work with them. I’m just saying that we have to work positively — with municipalities, for example, but many others; our unions and many others — to address those issues, and that’s what we’re working to do.

We’ve seen evidence of success that I think the member would have to acknowledge on the ambulance service, on BCEHS, on recruitment in general, on the initiatives around child care and housing and the recruitment efforts in the North. All of these efforts have shown significant progress. We’ve got to continue to do that. But what Northern Health faces are very real challenges that aren’t about Northern Health; they’re about the challenges. We’ve got to attack those challenges together with people who want to do so in good faith.

S. Bond: I appreciate that.

I think the minister certainly has a sense of the concerns that many of my colleagues have, many of whom are representing rural communities, and I really appreciate them. They do a lot of work. They spend time with their constituents. They listen to very difficult stories day after day after day, and I know the minister hears them too.

First of all, I want to thank them for the great jobs that they do in their constituencies, and I appreciate them stepping up and raising those issues.

I will just make this comment to the minister in reaction to his response to my colleague. I think that working together is actually really important. I think one of the things that, as elected officials, we feel often is that if we raise issues of concern, that is somehow seen as being critical of people. It has nothing to do with that. What it has to do with is people who feel like they can’t get the health care services they need.

I know my colleagues…. I’m sure members on the other side of the House experience this too. I’ve just spent the last week hearing from people across this province about how desperate they are. It’s not just that we come in here and ask a question because we think it’s a…. You know, here we are. It’s estimates, so let’s ask a question.

I’m going to raise a couple of issues today on behalf of people that I actually talked to. I’m diverting from my very large binder of carefully thought-out questions to raise some of the things that I heard from people this past week. I’m going to start with one that actually builds on the questions and the concept that my colleague from Peace River North raised, and the minister acknowledges that there are challenges.

I had a very constructive conversation with some advocates from northern British Columbia who are very worried about the lack of services for patients with neurological impairments in northern B.C. It might be one thing if you live in Surrey or Vancouver, but there’s a real challenge. These are a group of unbelievably dedicated advocates who, first of all, advocated for a physiotherapy program — which we now have underway — and occupational therapy at UNBC.

[5:00 p.m.]

Now what they’re interested in seeing is a community-based outpatient neurological rehabilitation clinic that will provide patients in the North with rehabilitation services, but it also provides clinical education for OT and PT students who have to complete their clinical training.

I want to simply point out that patients with neurological impairments have very limited access to specialized rehabilitation services. They often have to leave our communities, travel to the Lower Mainland or they go without service altogether.

I have brought with me a letter, and I would just like to send it over to the minister and the staff for them to have a look at and begin to have a conversation about the possibility of a student-led clinic. I gather that they’ve created a working group, and they’ve brought together Northern Health, UNBC and UBC department of physical therapy, department of occupational therapy — a very significant partnership. Part of the challenge is where to put a clinic. To me, that should be the least of our worries. For heaven’s sake, if it works, find a space, and let’s get moving.

I would just like the minister to indicate he’d be willing to take a look at this proposal and, perhaps, have staff reach out to the advocates that are noted on this paper. I really want to thank Terry Fedorkiw and Elizabeth MacRitchie for taking the time to meet with me about this.

With that, I will present that to the minister and, hopefully, he could just indicate he’d be willing to take a look at that very thoughtful presentation.

Hon. A. Dix: Where the member started was to talk about the work that we often do together, including the member and myself, on issues. I would be happy to look into this issue, to meet with the people that the member met with and to meet with the member as well. That’s an approach that, I think, is the best approach and that allows us to get….

The short answer is yes, of course. We’ll look at it, but do more than that. We’ve got a little bit of time in the Legislature together after we’re done with this, and we should be able to arrange a time where we can get together with people on Zoom and have such a meeting. I think that would be a great idea.

S. Bond: I am very grateful for that response, and I know that the people working hard on this would be as well.

I take every opportunity in this place to acknowledge this minister for the way he reaches out, talks to all of us, is willing, even after we’ve had a really tough question period and pretty feisty things happen, to try to work with members across the aisle, and I want him to know that’s deeply appreciated. I have said, continuously, that I wish it were replicated. But I digress.

I also had a meeting with a constituent, and he was really thoughtful about his presentation to me. He’s an older British Columbian, and his whole thinking was around: “How can I not be a stress on the health care system?” He wants to be healthy, well and cared for. His concern was about, from his perspective, the limitations that physicians have in terms of when a patient comes in to visit.

He laid this out for me, and I want to read a couple of the points and ask the minister to respond, basically, to him, but also so British Columbians understand if there are limitations of this nature.

His concern is that you go in as a patient, and you’re only allowed to discuss one thing with a doctor and that a patient can’t book an appointment to discuss several issues. Very rarely are things like: “Today I’d like you to look at my ear. Tomorrow I’d like you to look at my wrist.” Whatever that happens to be. His experience is that the time allotted for a patient to connect with a doctor is pretty much ten minutes or less.

His concern…. And I really appreciate it. By the way, he absolutely loves his family doctor, and I happen to know that doctor. He’s exceptionally good, and I’m very grateful that we had that conversation in the context of: “I have a family doctor and I’m grateful.”

Really, just the questions about time, and he says: “These time restraints are not a confidence builder. There is simply not enough time for a doctor to get to the core of what might be troubling a patient.”

[5:05 p.m.]

“I will also say,” he said, “unlike me, there are patients that feel intimidated just by the doc stepping into the room.” And I can assure you that he would not be intimidated by that. I, on the other hand, might feel differently about that.

I guess his point is, and I was wondering if the minister could respond to that, in the context of the changes made to the family practice model, and whether or not we are going to deal with issues like that so there’s a more holistic approach to a person’s health, and from a longitudinal perspective, so that when you go in, you don’t feel like you’re…. I’m going to get my $35, or whatever it is, and I’m marched out of there in ten minutes. I thought it was a really thoughtful series of questions. He obviously took the time, and I said to him that I would be in estimates with you and that I would raise those issues.

Really, maybe the minister could just speak very specifically about: can you only ask the physician about one issue? Do you get ten minutes? There was also a concern that the new family practice model that changes the payment compensation does not apply in rural B.C. for rural docs. That is really a concern for me, if that is the case. If the minister would just respond, I would be very happy to share this response with the constituent that came and spent some time with me.

Hon. A. Dix: I think I’ll just give the member my own example. Because, as people know, as I’ve said in the House, I have a chronic disease. I have type 1 diabetes, so whenever I go and see a doctor, which has been a while, I have to say, I have type 1 diabetes and whatever problem I have to see that day.

One of the reasons why some reforms were made around diabetes — when, interestingly, Penny Ballem was Deputy Minister of Health, and I think it was Colin Hansen; maybe I’m wrong — to the way that we paid around support for people with diabetes was just that question.

What would happen under the fee-for-service model is you’d have a patient with more challenges — let’s not call them a problem patient; let’s call them a patient with more challenges — who would not be wanted as much in that system. The doctor would have to balance off a 25-minute visit with a five-minute visit for two 15-minute visits.

One of the advantages of the change in model, as expressed by the Doctors of B.C., was just this. We could identify doctors with patient panels with a higher degree of need, so that would reduce the requirements of their patient panel, and that would be acknowledged in that model. As well, we need to, I think, in addition to that, build out team-based care. This is, to describe it again, for someone with diabetes, their problem may be one that requires a dietitian.

Say in the Prince George primary care network that we have in place…. I think we’ll be sharing a bunch of this information with a member. We’ve sent some responses today. That has basically 30 FTEs, almost none of them doctors, but all supporting and all part of a primary care network in a division of family practice efforts — nurse practitioners but also nurses, Allied Health professionals and pharmacists working with doctors in the community. Frequently what a person might need is not the medical training of a doctor but a nurse practitioner, a nurse physio or others in the community.

The response, I’d say, to the very thoughtful question is that we’ve got to build out team-based care. Because, for some things, having a doctor might be not the right qualifications to deal with a person’s care — for example, the management of blood sugar or whatever. Though where you might want someone…. Or a nurse might be able to handle that even better because of the time offered. So you’ve got to build out team-based care.

[5:10 p.m.]

I think the new payment model really works for that. It’s the intention of it to work better for it and not have this piecemeal payment process. I think it’s one of the strengths of that. One of the criticisms of the other model is that it meant that often doctors were reluctant to support things like extending scope of practice of other professionals, because the whole economics of the practice depended on those patients.

So you wanted to keep…. Let’s call them easier patients or single-problem patients. And even, for some doctors, you need a certain amount of them, not because you didn’t care for your patients but because you needed to balance off more complicated patients, which every doctor’s patient panel has. I think it’s very thoughtful, in a sense.

I think it’s team-based care. I think the new payment model will help.

In terms of rural B.C., frequently we work on service contracts. In rural B.C., it wasn’t a fee-for-service issue. The fee-for-service issue is much more Prince George than it is Valemount, I would say, just in a general sense. Those service contracts do work for hours, so they’re much less susceptible to the fee-for-service problem already. That was already a rural response in the broader primary care system.

I think the questions raised by the member’s constituent are really apt. That’s how we’re trying to deal with them, and I thank him for his question.

S. Bond: Thank you. What I appreciated most about the conversation was that his whole goal was for him to be healthy and not be a drain on the health care system. I really appreciated that.

He came with constructive ideas, but he is concerned that every time he has to go for a ten-minute appointment, it would be so much better to have that broader conversation. Again, it was really a pleasure to listen to him because he absolutely thought his family doctor was fantastic. That’s how most people feel when they have one. I think that’s really important.

In just a few minutes, I will let the minister know, I’m going to go back and ask some questions again about…. I feel extreme pressure about the time that we’ve been allocated, so I’m going to try to do my best. I have so many topics to cover off.

I would like to…. Yes, she’s here. Great. I know she’s running between estimates. I would like to give my colleague from West Vancouver–Capilano an opportunity to spend a few minutes with the minister about some issues that she’s concerned about.

K. Kirkpatrick: Thank you to my colleague for allowing me the time, and I appreciate your time also, Minister, and your staff.

Last year during estimates, I asked the minister very specifically about the number of licensed child care spots that we have in British Columbia. I was assured that would get to me right away. After three follow-up letters hand-delivered to the minister, we still have not received the information asked last year, which is the number of licensed child care spaces in British Columbia.

The minister is looking puzzled at this. It was provided to the minister, and the minister had confirmed he would be responding.

What we’re looking for is the ability to bring together what the Ministry of Health does and says with respect to licensed child care spaces and what Education and Child Care say with respect to licensed child care spaces. Those numbers should be the same. If they’re not the same, we just need to understand why that is.

So the question to the minister: how many licensed child care spaces are there today in British Columbia? And the second piece of that is: how many of those are infant-toddler spaces?

Hon. A. Dix: We’ve got the information, and I’m not sure what happened because we respond in detail after estimates to questions. I apologize to the member if we didn’t get the response to her.

What I’ll endeavour to do is get her the information before the estimates close here, so if she has follow-up questions, she can ask those questions at that time. Does that make sense? Then she’ll have the information in front of her, and then she can ask the questions that flow from that.

Because she’s been waiting for a while for the information, the good news is that it’ll be a year more up to date.

K. Kirkpatrick: Thank you to the minister.

Just to clarify, did the minister say that that information was provided after estimates last year?

Hon. A. Dix: I would ordinarily assume that it would be. I mean, we do a follow-up.

[5:15 p.m.]

We had questions last week that I was sending responses today from the member for Prince George–Valemount, so typically that would be the case. I don’t think there’s anything…. I’ll go back and take a look at that. I’m not sure what the reason for it might be.

In any event, what I’ll endeavour to do is to get the information done and set up and then send a letter to the member overnight so that she would have it before estimates would close here, if she wants to have more questions on that issue.

K. Kirkpatrick: Just to say thank you, I appreciate it. I’ll look forward to getting that, and then if I’m able to come back and ask a follow-up question, I appreciate the opportunity to do so.

S. Bond: Thank you to my colleague from West Van–​Capilano. I know she’s extremely busy, so I’m glad she could pop in and ask her question.

I know that we had a conversation. I’m going to go back to agency nursing for a little bit of time. I wanted to just…. We talked a little bit about it, I think. We’ve had a week break, so I’m going back and looking at all my scribbled notes here.

I wanted to bring up the issue again of travelling nursing agencies — basically, travel nurses. We absolutely understand the importance of making sure we have a full complement of nurses in British Columbia because heaven knows the system is under enough stress. I’m wondering if the minister could walk through for me…. I know that there was a…. Last year, the minister said that there was a moratorium on contracts for agency nursing.

I’m wondering if the minister could provide me with who the current contracts are with and what the total spend to date is for this fiscal year.

Hon. A. Dix: It’s my memory that’s failed me. I think I went through, at least, the costs in the previous estimates, but I’ve got it here, and I’ll just do that again.

There are 18 agency nurse groups that provide services in B.C. We went through it a little bit last time that the pricing agreements and the contracts are set to expire May 31, that there were 17 at the time of the moratorium, that we added one in Prince George that was needed for urgent reasons in that case, but otherwise the moratorium is on new organizations. We’ve had others expressing their interest in doing that, but we haven’t added anything since the moratorium was put in place.

I’ll just, maybe, give this by health authority if that works for the member. So $14 million in Fraser Health, $63.85 million in Interior, $43.33 million in Northern, $38.25 million in Vancouver Coastal Health, $2.5 million in Providence Health Care, $57.5 million on Vancouver Island and $1.08 million in the Provincial Health Services Authority.

This represents…. If you look at the overall nursing costs, I think I saw the number 3.4 percent of the overall nursing bill. Nonetheless, it’s a whole purpose of our work with the BCNU — of our contract negotiations, of our effort — to see this reduced.

Because regardless of whether it’s 3.4 percent…. It’s obviously higher, for example, in the Northern Health Authority because, even though the number is numerically less there, there are, obviously, fewer people in the north.

But the impact of agency nursing on particular workplaces is not positive, and that’s why we’ve made such an effort and detail all the efforts being made in the north and elsewhere to recruit nursing, why the nurse ratio proposal is so important, why we’ve put in incentives and support for long-standing nurses and others.

[5:20 p.m.]

We have moved, overall, in terms of nursing. There are more full-time nurses, more permanent part-time nurses and fewer casual nurses than there were, for example, in 2018 today. So that number has gone down, which is good news.

The demands, particularly during the pandemic, for agency nursing were significant and were increased. Those are the numbers of agencies. With respect to the names of the agencies, it might be more useful if I, as we’re ending here, maybe not today but before we start tomorrow, just provide that list. Reading them off wouldn’t be that useful.

S. Bond: Thank you to the minister. That would be just perfect. I appreciate that.

I’m wondering, though, if the minister can tell me. Contracts expire May 31. Is the intention to renew those contracts?

Hon. A. Dix: There will be a new contract with updated provisions, in terms of provisions to ensure that we continue to favour health authority nurses and Health Match B.C. nurses, who are health authority nurses. That discussion will happen and start after May 31.

We’re working with the health authorities to review the contract parameters now and ensure sort of a provincial approach to the delivery of safe, quality care. We’ll be putting a provincial team together to operationalize new contract terms. They haven’t been finalized yet, but they’re intended to ensure staff employed by agencies are delivering quality care and to limit the utilization of staffing agencies. That’s our intent in that process.

The criteria will be established to vet and monitor third-party agencies engaged with employers in B.C. There’s a series of things that are in place in B.C. or that will be in place in B.C. that ensure value for the taxpayer, a high quality of care but also support our efforts to have permanent nursing staff.

What I’m going to do, if I could, is…. I’ll just send over the list — I’ve got the list of vendors here as well — to the hon. member.

S. Bond: Thank you to the minister for the response and for sharing that information.

I want to talk a little bit about nurse-patient ratios for a moment. We did have some conversation about that. I think where we ended that discussion was really around any modelling that has been done by the government in terms of what the actual numbers are. From a conceptual perspective, we know that nurses are very supportive of the nurse-patient ratio. I certainly heard that this past week across the province.

I’m wondering. We know that we have a significant need for nurses by 2033. I think I used this number in our last conversation.

I’m just wondering. What type of modelling has been done by the government? When you make a decision, in partnership with the BCNU, for example, that we’re going to have ratios, which no one is arguing about here…. There must be modelling or detailed work that has been done that looks at how many nurses we need and where we’re going to get them from.

Would the minister just, perhaps, respond to…? Is there specific modelling that takes into account the number of nurses we already know we need? Does the modelling, for example, take into account population growth, an aging population? We’ve just talked about the complexity of patients.

I’m interested in getting a sense of…. We know we need nearly 25,000 nurses by 2033. What other factors are being considered, and has there been specific modelling done related to the ratios?

[5:25 p.m.]

Hon. A. Dix: Initially, in terms of…. This was on the acute side. As we went through the negotiations, as the member would expect, we were looking at: what do we need to do to implement this financially and in other ways?

We initially did some modelling based on about 10,000 beds — that is what we have, our base bed capacity now — and then 10,500 beds. We have a lot of hospital projects, all of which are increasing the bed base over the next number of years. So we did it based on those models.

Now we’re doing detailed modelling, now that we’re at the implementation phase, with nurses in the province. It’s really based on the number of beds. That’s a key aspect of the work. That is in acute care. Then, as we move to other categories of care, that will be in that case as well.

Yes. That modelling work is happening.

S. Bond: Anything that the minister can share with me around the modelling that has been done would be most helpful.

The minister mentioned implementation. As I understand it, the implementation begins this fall.

I’m wondering. What is the time frame of the work that has been done in terms of starting in the fall, beginning those ratios? Is there a projected, when we get to the end of meeting the ratios based on the bed count that we have today…? So implementation in the fall. Is there an end date that has been agreed to or considered?

Hon. A. Dix: The ratios are for the fall. The work is happening now, and the recruitment is happening now.

Really, this is about recruit, recruit, recruit, retain, retain, retain, whether it’s through additional nursing spaces in B.C.… We have a remarkable record of success of people trained in B.C. staying in B.C. It’s the envy of every other jurisdiction in the country.

If you look at the actions that I announced…. What I’ll do is maybe share the complete list with the hon. member. The actions that were announced when we announced the expenditure over the next three years, which is $750 million over three years, and the extensive bursary programs, recruitment efforts of all kinds that were put in place, supports for nurses, signing bonuses, new entrance programs, B.C. loan forgiveness, and so on — this is a massive joint effort to recruit nurses. That is on. We have to be doing it now.

[5:30 p.m.]

We had a very successful year recruiting nurses last year, maybe the most successful ever. We’ve got to do better than that and then better than that. That’s why we’re investing the $750 million in that and working with the BCNU and, obviously, the College of Nurses and others to support all that.

You see that in the very significant action that’s taken, in particular, in rural B.C. The challenge there is different than it is in urban communities.

We have very significant steps on internationally educated nurses. We have international recruitment that is part of that. We’ve been, as people may have noted, advertising in other jurisdictions, notably the U.K. and Ireland, and are making efforts to recruit nurses from there as well.

At its core, we’ve got to train more nurses here, and we’ve got to retain our nurses here and make the deal for nurses. This was the whole effort that the BCNU and ourselves jointly made in our discussions: to make this the best place to work as a nurse in B.C. That means a whole series of steps that are reflected in the actions we’re taking to recruit nurses. The dollars behind it are there; those dollars will be spent on nursing. That’s our commitment — that it will be spent on nursing. And that work is happening.

[S. Chandra Herbert in the chair.]

When the ratios start to come into effect, we’ll have made all that progress. But if we were starting the recruitment from a flat start in November, that would not be a good idea. We’re doing that right now.

S. Bond: The minister has actually given me a segue to the next section that I want to talk about, because it really is about retention and about how we are going to retain nurses. There are some enormous challenges at the moment.

I want to just end this section. If the minister can tell me…. I understand there’s a three-year plan, $750 million. Is there a number of how many new nursing positions will be advertised? How many are we looking for in the first phase of implementation? I’m assuming those positions have already started to be posted, or not. Maybe the minister could just give me a sense of how many new nursing positions will be posted and required to be filled in the first stage of implementation.

Hon. A. Dix: This is a partial number. The majority of beds are what are called medical surgical beds in acute care, and our estimate was 2,000 to 2,500 for those categories. To meet those — that was the original estimate.

Now we’re going through in a more granular way, and the beds and the ratios are not just for that. They’re for other types of beds. We’re going facility by facility on the acute care side to do just that. That was the initial estimate for what are called med-surg beds.

S. Bond: This next section is going to be difficult to talk about. We’ve talked about it in a variety of other places, including question period. But it’s really important, actually, to raise these issues on behalf of nurses that I met with in numerous communities over the last week in particular, but many weeks before that.

I want to start with the issue of security in hospitals. The minister always responds with: “We have 300-and-whatever-the-number-is of relational security officers, protection services officers.” I’m wondering…. Let me just think of where to start here.

Maybe the minister could start with the mandate of the protection services officers. What responsibilities are they tasked with? What I am concerned about is….

I will just say this to minister. He and I have very frank conversations, and I know he hears this too. I am deeply concerned about the safety of nurses in British Columbia. The ones who have had the courage to speak up are…. In some of the conversations this week, I literally had no words in terms of some of the situations they described that they face in hospitals on a regular basis.

[5:35 p.m.]

What I want to understand, and I think they want to understand, is: what is the mandate and responsibility of these types of protection services officers? Let’s suggest that there is an assault on a nurse or there is a violent incident in the hospital. What is the role of a protection service officer or a relational security person — however the minister would like to describe them? It’s important we understand. What do they do when something violent happens in a hospital?

Hon. A. Dix: With respect to the relational security officers, first of all, this was a proposal that was made not just by the BCNU. I think when the member is asking about nurses, she’s asking about health care workers as well, so I’ll just take that as given so we don’t have that discussion. Obviously, the issues around safety of workers are concerns for the BCNU nursing staff, the Nurses Bargaining Association, but also the HSA, the HEU, Doctors of B.C., ambulance paramedics, everybody who’s working in the hospital.

One of the reasons why we developed a relational security model was there was a view that security in health care, which had been privatized…. I don’t want to get into that discussion. There are private security services in health, but in addition to that, we needed a new model to build a safer workplace, more highly trained protection services personnel in workplace violence prevention and mental health.

The people involved in the relational security model, the 320 we’ve talked about in 26 designated health care settings — and I think the member has the list of facilities, but I could provide that as well — were intended to reduce workplace violence and psychological injury. They have been trained through an organization that is in part overseen by the BCNU and by the HSA and the HEU, which is SWITCH BC, which has also put in place an evaluation framework in consultation with those very organizations.

This proposal for relational security, a proposal I supported through and saw the funding for and have seen get into place, was very much a proposal by health care workers that they wanted to see in place in addition to other security that takes place in a facility. I’m happy to talk about…. Maybe we should talk about specific scenarios, but when there’s a code white of any kind, there is a response in the hospital.

The member, like me — I’m in hospitals a fair amount, meeting, amongst other things, with nurses on some of these questions. And you will hear code whites and the response of people to that. That includes response by clinical and security staff. If there’s obviously an issue of violence that leads and would lead, as you’d expect, in addition to that….

Relational security staff are trained in restraint and other things but also a response by the police if it was some form of violent attack, as I think was described by the hon. member. But all of that response is in place. When the code white is called in our health care system, there is a response to that from clinical and security staff, and certainly in the circumstances described by the hon. member — obviously, the police as well.

[5:40 p.m.]

S. Bond: I do appreciate the minister’s response, but there are some pretty big gaps in the protection and the feeling of safety that health care workers have. I hear from them every day, and I made a promise to them that I was going to come and tell some of their stories in this chamber. It is not accurate to say that if there is a violent situation and there’s a gap, the police are involved. There are not always police available to respond, and relational security models do not deal with violent issues that nurses and health care professionals are facing.

I hear the stories; the minister hears the stories. I spent time in Merritt this week, and I want Merritt nurses to know that I am raising their issues here in this House. They don’t have security in their hospital, but they have issues in their hospital, as every other hospital does. What I am concerned about are the gaps that exist between saying there’s a relational safety model and what’s happening on the floor of hospitals.

I had a young nurse tell me on Friday that she is a psych nurse. They have been asking for a relational protection service officer to be placed outside of the psych unit because of the circumstances they’re facing. No, that’s not what happens. They rotate. They’re in other parts of the….

I guess my question to the minister is this. It’s one thing to announce them. I am not suggesting for a minute that they are not in certain facilities across the province. How is this model being evaluated?

When a situation comes forward and nurses and other health care professionals say: “I don’t feel safe in my job….” The minister and I would agree that it’s not just about recruitment; it is absolutely about retention. If people don’t feel safe when they’re going to work, they are not staying.

Certainly, I would like a list of where exactly they are, and I would like to specifically have the minister respond to me about expansion. For example, when can Merritt expect to have some sort of protection in their hospital? I would also like to know about Quesnel. I’m sure there are lots of other ones.

For now, can the minister provide me with where they exist today? What monitoring is done, especially when it comes to ever-increasing violent behaviour in hospitals, putting not only health care professionals but other patients at risk?

Hon. A. Dix: On the relational security model, there’s security in place at hospitals across B.C. These 320 were in addition to that security. It’s a new model. We felt it important that people have a high level of training and that we would add resources to this. This was in direct response to the requests of our workers, not the least of which are the nurses.

This proposal came in place, and these first 26 sites were identified, in consultation with the B.C. Nurses Union, the HEU and others. The implementation of this model evaluation framework has been co-created by SWITCH BC, which also has on its board groups such as WorkSafe. The BCNU, the HEU and others have representatives, to ensure that the model is working effectively and is consistently assessed. This was an issue of adding significant investment into security in hospitals.

[5:45 p.m.]

This doesn’t mean…. Adding police officers, which we’ve done in lots of areas, doesn’t mean that everyone feels safe as a direct result of this. This is one measure to be put in place that makes things safer. On the model, the first 26, what I’ll do is to just share that with the member. I could read them off now, the first 26 sites, but I believe that this is the right model.

The BCNU, the HEU and the HAS, which were with me when I announced the model and had specifically requested this approach, are supportive of the fact that we’ve hired 320 people when we said we would, which we put in place. This was seen as a key part of the health human resources strategy.

I agree with the member that when people, who have lots of options — like our very talented nurses, who can work all over the place in the health care system — work in places which have very significant security challenges, they need to feel confident that they’ll be safe.

That’s why this initiative was taken. I never said, and I didn’t say at the time, that it was the only thing we needed to do. It’s just a significant thing we need to do, and it came from the very kinds of meetings that the member has had with nurses and, she knows, that I have with nurses on a very regular basis as well.

S. Bond: My point in asking these questions isn’t to question where it came from or to deny that health care professionals, more broadly, need security. It’s to make the point that there are gaps in the provision of safe working spaces for health care professionals. They exist. The minister doesn’t have to take my word for it, and he meets with health care professionals like I do.

I will digress. As the minister talks about visiting hospitals, I will just point out that it’s much easier for the Minister of Health to visit a hospital than it is an opposition critic. I will make that point, and it’s a regular issue. I think it’s time we shone some sunlight on this topic.

I’m not here to suggest this should be a partisan issue, but I’m here to say that 26 sites was the initial announcement. Even in those sites, there are gaps. I had a young nurse tell me she felt afraid and felt that the circumstance was such that it required an RCMP response. It took two hours for someone to come, because they’re busy, too, dealing with everything under the sun. If you’re a police officer in Merritt and you have to make a transport to Kamloops — the other situation didn’t happen in Merritt — you can’t respond quickly.

What I am saying to the minister today is that there needs to be monitoring. There needs to be an open dialogue about where the gaps are. There needs to be a conversation with health care workers in their own facilities about where those professionals need to be deployed. I think most people would think that the psych unit, when it is full to overflowing, is probably a place where there are some concerns.

My point is that we need to have the courage to say, “There are some gaps, and we’re going to have a conversation about how to make sure people feel safe,” because many people have said they do not feel safe in their places of work. I want to ask, then, again to the minister: will the model be expanded? Does it include Meritt and Quesnel? Will there be additional security, as the minister describes this model, provided to more than the initial 26 sites?

Hon. A. Dix: I believe that that should be the case. We started there. Those are the recommended sites. We worked with health care workers to define where they felt the need was greater, to start with, and that’s what we’re doing. I believe that the model makes sense. So yes, I expect that it will be expanded.

[5:50 p.m.]

The evaluation and the oversight really come from an independent, not-for-profit organization called SWITCH BC. It involves and it includes health care workers at the core of the oversight. This is independent of government, in that sense. There’s funding from different master agreements that have been put in place. There was a previous organization, the B.C. Occupational Health and Safety Agency for Healthcare. It was disbanded in 2010, and SWITCH BC was brought in.

The intention here is to have this initiative not assessed by the Minister of Health or the Ministry of Health, but to be assessed and overseen by SWITCH BC, where there is control and interest by health care workers themselves — so exactly what the member is talking about.

Just to say, finally, I was an opposition critic for Health too. It was the case, at that time, that sometimes it was difficult to connect. But if the member ever has any problems connecting or getting into facilities, she knows that she has my support in that. That’s something that I didn’t like then and I strongly believed I wasn’t going to repeat when I was the minister myself, to turn around and say that I wasn’t going to let people in.

I think the health care workplace benefits from an exchange of views and people having a chance to express those views. I strongly believe that. I strongly believed it when I was the Health critic. I believe it just as strongly as Health Minister.

S. Bond: Thank you for that. Again, I know the minister has a different approach than many other ministers in government, and I very much do appreciate that.

I’m often surprised when I find out ministers have been in my community and gone before I know they’re there. Let me just digress for a moment. When you are elected by people, it’s because they trust you and you know that community better than anyone else. Wouldn’t it be wonderful if we actually saw a collaborative way of serving the people that actually choose us to represent them? But I digress.

When evaluation work is done…. Did the minister just say, and I just want to make sure I understand this, that SWITCH BC trains people, and then they evaluate the success of the program?

Hon. A. Dix: SWITCH BC did the curriculum review for the training and does the training, and it will have oversight over evaluation. I think that’s an important distinction.

With respect to the broader issues, I agree with the member. I think when people who represent communities bring issues to me, I give them high, high interest, and that includes opposition members.

S. Bond: And I can validate that firsthand, and I’m always appreciative of that.

I want to then just ask, specifically…. We don’t have a timeline for expansion, which I know will be a concern for communities that do not have the additional security, because those hospitals, those health care workers are feeling the exact same thing that we feel in larger centres. Whether you’re in Quesnel or whether you’re in Merritt or whether you’re in Prince George or Burnaby, if there is violence taking place, they deserve the same kind.

Often my concern is that other services are stretched in rural and smaller communities as well, and when we expect the RCMP or the city police to respond, they can’t. What does that do? That leaves people vulnerable. I really want to ensure that the minister is looking at the evaluation process: what defines success? For me, success is that we actually are retaining people instead of losing them and we actually have people who feel like they can go to work and that somebody has their back.

I’m wondering if data is recorded on violent incidents or injury rates, those kinds of things.

Hon. A. Dix: Yes, it’s collected in…. I talked about code white, but in that white system. It’s also reported to WorkSafeBC.

S. Bond: I do think that there is an important role, also, for WorkSafeBC. I know this is not the Ministry of Labour. I will only dally briefly.

[5:55 p.m.]

I do think it’s an absolutely critical part of making sure that workplaces are safe. They have a job to do from that perspective as well.

I simply wanted to continue to raise these issues, because I literally…. I don’t know quite how to describe some of the meetings where health care professionals spoke out about how they are feeling. I literally had a hard time responding to them because they are frightened, they are overworked, and they deserve all of us to be working together to figure out how to make that workplace safe for them.

I want to move on to talk a bit about…. We’ve had this in the QP scenario, but I want to walk through it today with the minister. I want to talk about drug use in hospitals, but I want to start with this, because I heard this numerous times during the last week.

Will the minister today make a commitment to this House and to the health care workers who have had the courage to speak out about what they consider to be unsafe working conditions — and I think most British Columbians would agree with them — that they will not face any consequences if they speak up, if they have the courage to speak up?

There continues to be concern in the system that if they actually speak up…. We’ve had nurses and we’ve had the discussions about the memos that have been shared, things like that. I want to be sure that those nurses face no consequences for having the courage to speak up.

Hon. A. Dix: The answer is of course not. The member…. We talked about going to hospital, and let me acknowledge it might be easier, I think, when you go as Minister of Health. You often go in what you call more controlled circumstances. I can tell you in the dozens and dozens of meetings I’ve had with nurses, they are full and frank in their discussions with me, full and frank always, and I am with them. We have real exchanges, and I encourage that.

When I go to a hospital, I frequently will spend the whole day talking to different health, including health sciences professionals and HEU and BCNU and doctors and everyone, because you want to hear people’s perspective of what they’re going through.

I’ve had meetings on the home support side, which is a very different issue of security, and in which case you have to have a workforce that is very much trained in de-escalation. That experience for many people is a very difficult one, where they go into…. It’s not just violence in terms of workplace injury but sometimes the things that are requested of people, the moving people and everything else. Those are tough jobs. When something occurs and you’re working in the home care or home support field, you are out there without the infrastructure of the hospital behind you, although that can be very challenging in hospitals.

I want to hear all people speak about their concerns. I mean, the short answer is no. But also, I’d say to the member that when I meet with health care workers, they are extremely frank with me. I always encourage that, and I always take from that.

For example, we talked about relational security. This came from meetings with health care workers a couple of years ago and what they saw as required. Action followed the issues they’ve raised with me, not consequences. The only consequences should be that we be improving the health care system for everybody.

S. Bond: I thank the minister for that answer.

I know that health care professionals and nurses, in particular, who have recently felt heard about the issue of drug use in hospitals, are worried. I want to be sure that there is nothing that reflects on them. They have every right and responsibility to speak up, and I am grateful that they are.

That is why this will be one of the tougher parts of estimates, but it’s really important, because what’s happening in hospitals is not only impacting people who work there. It is a risk for patients. It’s also the cost of the things that we see happening in hospitals.

[6:00 p.m.]

The minister, I know, will disagree, but we hear almost daily now from…. In this case, the specific issues have been raised by nurses related to decriminalization and what it has caused to happen in hospitals.

I know that there’s been conversation about: “Well, it’s not allowed.” Well, it may not be, but it is happening. And I don’t need to repeat for the minister the concerns that we have expressed on numerous occasions.

As recently as Friday I met with another group of nurses who literally described a scenario that the minister or any other rational British Columbian would think is utterly unacceptable in a hospital or anywhere else: people dealing drugs in a hospital, in the bathroom. Nurses having to face people using drugs. Another nurse — Narcan, three times in one day inside the hospital because of ODs in the bathroom. Being asked to hand out supplies.

This, I would remind the minister, is not about me suggesting that people with mental health and addictions do not need health care or need treatment. That is not what this is about. And not one nurse has said that either. They know they need to be cared for. It is how we are allowing this to happen.

I would like to know what we are going to do. We need more than just better policies. We have people who are afraid in our hospitals. There are people sharing rooms that are using drugs in one bed, illicit drugs, and an 80-year-old on an oxygen machine in the next bed. That is not fiction, and it’s not…. It is the reality for many people in the health care system.

What I want to understand is: what is the minister and the ministry, the government, going to do to ensure that patients and health care professionals are safe and do not need to deal with this issue in our hospitals? It is unimaginable that this is going on.

I want to start there. How will…? The minister continues to say that there are policies and there are…. You know, we need better policies. How will we ensure that whatever is in place is enforced? I can’t imagine he thinks drug use and drug trafficking in a hospital is a good idea. So I would like him to, in this context, walk me through what on earth we are going to do about illicit drug use and drug dealing that is going on in hospitals in this province.

[6:05 p.m.]

Hon. A. Dix: I think at different times, this is an issue that faces hospitals in every part of the world. If you talk to the people at Kaiser Permanente, if you talk to the people in other health systems, if you talk to people in other countries, this is an issue everywhere. Some of the immediate challenges are related to change in the nature of the drug supply — not just its toxicity but the move away from injection to inhalation that we’ve seen.

This has occurred at different times in the health care system. It certainly occurred when I was critic, as the hon. member is now, with the rise of crystal meth and its impact in hospitals at the time. These issues are consistent and regular and need to be dealt with.

There are also some specific issues now that require specific actions to ensure that everybody who goes in the hospital, the mass majority of people in the hospital who are there because they have serious health issues…. They’re in-patient and have serious health issues.

They should not be facing secondhand smoke of any kind, ever, right? That’s not desirable. Not to say that it doesn’t happen, because the hospital is an open place, so sometimes these things can happen, but we have to ensure that our workers and our patients are safe.

In our mind’s eye, that includes all of the patients, all of the staff, whatever their role is in the hospital. That includes our relational security staff. All of them. But also those patients who are just in the hospital because they got into a car accident or they had some sort of health crisis or whatever. They’re in the hospital. Their interests matter to an equal degree of everyone else’s interests.

There are some specific steps we have to keep people safe in a time when, increasingly, those addicted are using inhalation products, and we have to deal with that.

Secondly, rules are important. But they’re only important, and I think the member would agree with this, to the extent that they’re understood and they’re followed.

One of the reasons why I’m looking at a task force and I’ve put in place a task force is to make sure that we put in…. We need to put in not just consistent rules so that you have the same rule in Fort St. John as you have in Delta or in Vancouver or in Victoria, but that they’re understood in the same way everywhere. That is the purpose of this process.

Nothing is more important to me than making sure, when people are admitted to a hospital and they are sick, that we do everything to keep them well and to make that very difficult stay…. They’re often staying in a room with other people, which is something they’re not used to, to begin with. It’s not just those issues.

When you’re in a health care setting — and I talk to a lot of people — the feeling and the fear that had happened during COVID when people just coughed in a room, never mind some of the issues being relayed by the member and were significant issues….

We’ve got to do everything we can to make sure people are safe, that they recover and that their experience is good. They deserve that, and they must have that. We have to ensure that our workers are safe, including, when there are changes in the challenge that they’re facing, that they’re protected in those changes.

Thirdly, I think we need to continue to take the actions recommended by our workers to make the health facilities safer and to extend that out beyond the 26 facilities we’ve talked about.

We need rules in place. We need actions to enforce those rules. We need everyone to understand what they are. And we need to take action with our patients, because as the member rightly says, we have people….

If you are addicted to an illicit drug in this province, you are much, much more likely to get to the hospital for any number of other reasons. It is a chronic disease, addiction. I don’t need to tell the member, who worked on this issue the year before last. I’ve worked on this issue. It is a vicious chronic disease, addiction.

We absolutely have to engage with our patients to ensure that they will come into the hospital when they’re sick, and not themselves be in some form of fear, but that they understand what the rules are and are supported in following those rules in the hospital.

[6:10 p.m.]

Those are the things that I, in many cases, have encouraged, have supported, but also we need to take even more greater action on, and I’m determined to do so.

S. Bond: Thank you to the minister for that response.

I do want to point out one differentiating factor. The minister says that this happens all around the world and in a variety of other places. The difference is that British Columbia decriminalized. That changes the scenario very dramatically, because, as the memo that was provided to me pointed out, they have no way of actually removing any 2.5 grams or less from a person.

So there is a dramatic shift in what’s happening in our hospitals because of the move to decriminalize. That has been linked…. Not by me. The memo actually talked about it. Nurses talk about it. The B.C. Nurses Union, for example, talked about it.

I want to move on just to talk a little bit about the task force. We have people dealing drugs and using drugs in hospitals. It’s not just the big ones. They are in other communities as well.

The immediate reaction is: “Okay, we’re going to have a task force.” Okay. I’m wondering if the minister can tell me who will be on the task force. Have they met already? Are there terms of reference?

Hon. A. Dix: Yes, they’ve met already. I don’t expect it to be a long process. I believe action is required. What you have on the task force is representatives of our workers. They’ve been involved in that in meetings and discussions already — BCNU; HAS; HEU; Doctors of B.C.; Ambulance Paramedics of B.C., CUPE Local 873; and others who have to be involved in it. Representatives of health authorities and addiction experts need to be involved in it as well, and the Ministry of Health. That’s what we’re doing.

I expect, though, the intention here isn’t to do some six-month review. I expect us to be taking action in days and weeks. Then the role of the task force would be implementing those actions, not in talking to everybody about what they should be.

S. Bond: Considering the anxiety and attention the issue has generated just about everywhere, I’m wondering if the minister plans to regularly report out in terms of what the expectations are of the task force.

I think that one of the things that’s interesting…. When we talk about the overdose crisis, one of the things, certainly, we hear is that when we were going through a pandemic, which was a crisis of another sort, there were people tuned in every day. Yet when it comes to the other crises we’re facing, we have to resort to question period, estimates, news releases and announcements.

I mean, I think the minister can understand that when British Columbians suddenly hear that, oh my goodness, there’s drug dealing going on in hospitals…. Wouldn’t it be refreshing to actually have the same kind of approach that was taken during a pandemic, where we wanted people to have confidence in what was going on and all of those things?

Would the minister at least consider and, I’m hopeful, agree that actually talking about this in public…? What changes will be made? What are the timelines? If action is required, what kind of action, and what are the timelines associated with it?

Hon. A. Dix: I agree with that, and that’s exactly what will happen. In addition to that, I think what’s required is around issues of…. Without drawing conclusions about what will come forward here, as I told the member, I expect that people will hear from us in this legislative session.

[6:15 p.m.]

I think we also need to be able to measure what’s going on. If you define some of these things as critical incidents, then you can do that very carefully. We measure, as was noted, violence. But violence is not often what we’re talking about. Often we’re talking about violence against oneself. So we have to do that.

Other measures. There was some discussion of particular incidents that happen. In one hospital, we did put in smoke detectors in different places, because you need to know things are going on so that people aren’t going to walk into, say, a washroom and deal with a situation that’s unacceptable. Some of these things that we put in place make sense in that regard.

I think we need to be able to measure. I think we need to be able to report. I think that’s my expectation. That’s what we did with the relational security question. That’s what we did with COVID. That’s what we did with surgical renewal. This is at that level. We have to do both those things. I agree with the member.

S. Bond: Thank you to the minister for that response. I think especially our health care professionals will be encouraged to hear that there will be an ongoing public discussion about that.

I will just say this. I think one of the other things…. I’m not an administrator in a health authority, but I think one of the things we actually need to be working on is a very much less defensive approach in work sites. Instead of worrying about what people are talking about and what that’s going to look like, it would be really great to actually have meaningful debate and discussion, welcoming and including staff at the health authority level, instead of a reactive, defensive position. That doesn’t help anyone, and most importantly, it doesn’t help patients who need health care support.

I can see crowds gathering. I would like to finish part of this section by asking the minister to clarify. He certainly was asked. He responded, and then he said, “No, that’s not what’s happening,” and we’ve seen sort of a back and forth.

I would like the minister to specifically clarify for me and constituents, particularly in rural and remote communities, whether or not there will be designated spaces where people are permitted to use. The question was: will there be a requirement to create one? The minister, at the time, said, “I think that’s the purpose of the effort, not just to standardize rules,” but the next day the minister said that was not the case.

Could the minister tell me: is the intention of the government to create designated spaces in hospitals across the province for people to use illicit substances?

Hon. A. Dix: The purpose of my first answer was to say: “Here’s what the task force is looking at.” That’s the question I was answering, and it was related to a piece of information we had provided. In any event, the next day I made it clear — and the day after, and the day after. We’re not going to be doing that. We’re not going to be saying there are designated sites in hospitals across B.C. In many cases, it wouldn’t make any sense at all.

The issue, though, and the significant issue…. Often we’ll go to a community — there was a member here earlier who I discussed this with — where the community wants an overdose prevention site, and they actually wanted it on the hospital grounds, for a whole bunch of reasons. They thought that would be a good idea, rather than…. We often have the discussion that you want it where people are, so they use it, so that it saves lives.

These are discussions that occur, but the answer is no. That was never an idea. I think when you’re seeing a huge amount of drug use being inhalation, it’s a whole different situation than what we used to call a safe injection site. It requires a whole lot of different standards. And you see, where there are inhalation sites, the degree of standards and equipment that are put in place for that. Not practical, not what we’re going to do. No, no, no.

With that, thanks to the members who participated today.

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

Motion approved.

The committee rose at 6:20 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 progress, was granted leave to sit again.

Hon. A. Dix moved adjournment of the House.

Motion approved.

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

The House adjourned at 6:21 p.m.