The House met at 1:32 p.m.

[The Speaker in the chair.]

Routine Business

Question of Privilege
(continued)

Hon. Brenda Bailey: I rise to respond to the question of privilege raised by the member for Kamloops Centre.

I take my responsibilities seriously to this House, to British Columbians and to upholding the long-standing rules, laws and conventions that govern the budgetary process in British Columbia.

The member for Kamloops Centre’s argument appears to centre on a claim regarding the applications of sections 5 through 7 of the Budget Transparency and Accountability Act. I have reviewed the member’s statement and written submission in detail.

Budget 2025 was tabled on March 4, 2025, in accordance with the legislative requirements outlined in sections 5, 6 and 7 of the Budget Transparency and Accountability Act. Section 5 lays out the process for what must be considered in the main estimates. Section 6 lays out when the estimates must be presented, and section 7 lays out documents that must be presented with the main estimates, including but not limited to the economic and fiscal forecasts, including a range of economic forecasts.

The tabling of Bill 6, the Supply Act, has also been done in accordance with that act. Like all budgets, it was prepared at a point in time based on the latest information available and inclusive of government decisions to date. There was no decision to remove the carbon tax at the time of the tabling of the budget on March 4.

On March 14, the federal government signed a directive to eliminate the carbon tax on consumers, and B.C. followed suit by introducing Bill 8 to eliminate the carbon tax at the very next sitting.

This was fully canvassed when you considered the Government House Leader’s application to consider Bill 8 through Standing Order 81. Mr. Speaker, you also heard the replies from the official opposition and the Third Party. Ultimately, you granted the application for Standing Order 81.

In the application for Standing Order 81, the government followed the practice and courtesy to this House to provide notice to this House. In the instance of this question of privilege, no such notice was given to this House.

[1:35 p.m.]

There is no requirement in the legislation or practice of this House to continuously update the budget after it has been tabled. Changes to forecasted revenue, expenditures and debt that arise after the budget is tabled are addressed in quarterly reports, as contemplated in section 10 of the Budget Transparency and Accountability Act. Otherwise put, there is no requirement in the act to table revised estimates or otherwise delay the consideration of the budgetary estimates process for the budget or ministerial service plans that were tabled on March 4.

Government plans to remain within the proposed Supply Act appropriations, which is the basis of the estimates debate. The economic and fiscal forecast is always subject to change. This is not unusual. The current fiscal plan notes heightened uncertainty caused by U.S. tariffs and the impact it’s already having on our economy.

This House is aware that there is an established process set out in legislation to provide quarterly updates that incorporate the latest information and forecasting that is based off government decisions and external factors. Section 10 of the Budget Transparency and Accountability Act sets out the quarterly reporting requirements, including the tabling of the first quarterly report on or before September 15.

We have publicly shared the financial impact of the carbon tax decision. The program review is also an ongoing process that is happening now. Decisions on specific programs have not been made at this time.

As I shared with the member opposite during Committee of the Whole, government intends to meet our quarterly reporting requirements and provide a report on the impacts of the carbon tax decision, including any offsetting mitigation strategies, at Q1.

Similarly, the member’s comments about the climate action tax credit regulation are inaccurate. The tax credit was eliminated through legislative amendments to the Income Tax Act in Bill 8, which has received royal assent. The regulation is not required to be amended to eliminate the climate action tax credit, as this was done through legislation.

Government does not hold that a prima facie breach of privilege has occurred. The government is following the relevant sections of the Budget Transparency and Accountability Act. Further, I recognize that this House has the right to scrutinize and consent to the main estimates, and the government has provided all relevant information to this House to consider.

In addition to the legislative requirements in keeping with past practice, each ministry has provided each recognized caucus critic the opportunity for a technical briefing with the public service as well as the allowance for a submission of written questions for any member of this House to ensure that the budgets and ministry service plan objectives are fully scrutinized.

As I have said before, I take my responsibility seriously and am committed to continuing to follow the rules, laws and conventions that govern the budgetary process in British Columbia. I have further documentation to submit to you, Mr. Speaker, to support the government’s position, including selected Hansard debate and sections of the Budget Transparency and Accountability Act.

Thank you, Mr. Speaker.

The Speaker: Thank you, Minister. Thank you for your submission. We’ll take it under advisement. If you have all the documents, please send them to my office.

Orders of the Day

Hon. Ravi Kahlon: In the main chamber, I call Committee of Supply for the Ministry of Health. In the Douglas Fir, I call estimates for Post-Secondary Education and Future Skills.

After the conclusion of Post-Secondary Education and Future Skills development, I call the Ministry of Environment and Parks.

[1:40 p.m.]

The House in Committee, Section B.

The committee met at 1:40 p.m.

[Lorne Doerkson in the chair.]

Committee of Supply

Estimates: Ministry of Health
(continued)

The Chair: Good afternoon, Members. We’ll bring the chamber to order, and we will encourage the minister to move the vote.

On Vote 32: ministry operations, $34,996,928,000 (continued).

The Chair: Thank you very much, Minister.

Carrying on with budget estimates of the Ministry of Health.

We’ll recognize the member for Courtenay-Comox.

Brennan Day: Chair, thank you for recognizing me. Good to see you again this afternoon.

Thank you to the minister and all of the staff behind the scenes that I know are working very hard over the last few days and will continue to work very hard on behalf of British Columbians.

I’ve pared my rural health section down a little bit, just due to the time constraints. Once we’re finished that, I will be moving into a few questions on perinatal and prenatal health, and then we’ll be moving on to seniors.

Minister, I think we all recall the case of Don Chamberlain, a resident of Courtenay-Comox, who faced severe barriers accessing his ultimately unsuccessful lung transplant. He reached out to me again and brought up the issues with pre-approval for the travel assistance program.

I know we’ve discussed it today, but reading about Don, another resident from my riding, Russell Vida, a veteran with ALS, who has to travel regularly to Vancouver, often on busy weekends, on B.C. Ferries, feels, and I quote, “neglected” by the lack of ferry travel priority and “like a second-class citizen.”

What measures in this budget ensure timely reimbursement and priority access for medically vulnerable Vancouver Islanders?

[1:45 p.m.]

Hon. Josie Osborne: Thank you to the member for the question and, again, raising the issue of barriers that people face to receive medical treatments and treatments important for their health.

I have actually been speaking with constituents of my own around issues like this to do with B.C. Ferries travel and in my capacity as an MLA have actually raised this directly with B.C. Ferries. Now I understand that B.C. Ferries does have a program for medically assured travel. That is not a Ministry of Health program, though, so I can’t really comment on it further.

What I would say, though, is I appreciate the question from the member, and I’d be happy to sit down with him and talk about this further, because, I think, again, this is an issue that we share in common. We’re hearing from our own constituents, and of course, there are many more British Columbians who are facing these kinds of challenges.

Brennan Day: Certainly it shouldn’t just be MLAs with priority boarding on the ferry. I feel that people under medical duress that are travelling should be prioritized. I would have got to that question yesterday, on Green Shirt Day, but we’ve only been doing about five questions an hour.

So I’ll close with rural health transport and the TAP program. The $5 million top-up is a bit of a drop in the bucket in a $35 billion budget that’s spending $4 million a quarter to park an air ambulance in a closed Port Hardy ER to ensure people can get to care. On that note, I will now move on to paramedic shortages and transport delays.

Initially this was going to be a 15-question set, but for the sake of time, I have condensed the questions. I do understand if the minister wants to get back to me, either written or later in the session, with these responses. I think they’re very critical to BCEHS and the many members that have reached out to me.

[1:50 p.m.]

I want to raise a serious concern about the ongoing crisis in emergency medical services across rural and remote British Columbia. I’ve heard directly from paramedics, patients and families in my constituency, many of whom have waited for hours, even overnight, for basic emergency transport. This is particularly acute in Indigenous and northern communities, which was brought to attention by the member for Skeena, where delays can stretch beyond 16 hours.

Despite repeated commitments, the on-call model remains broken. Full-time staffing is inadequate, and transparency continues to be an issue across the sector.

Given the long response times in this process, I will keep my questions brief.

For critically ill or injured patients in rural and remote communities, including many First Nations, the median transport time to hospital can range from two to four hours. In some cases, delays have exceeded 11, even 16 hours. Meanwhile, BCEHS reports a 25 percent vacancy rate for full-time paramedics.

What urgent measures is the minister taking to reduce response and transport times and to recruit and retain qualified staff? Does that vacancy figure include the driver cap classification, positions that require only a class 4 licence and minimal medical training, that are now being included in the numbers?

[1:55 p.m.]

Hon. Josie Osborne: Thank you to the member for the question. I couldn’t agree with him more in the sentiment that people need to have timely and reliable access to emergency health services. People need to know that when you call 911 in the event of an emergency, that paramedics are ready, willing and available to come and assist you.

That’s why we’ve taken the steps of increasing annual spending on emergency health services, including more than 475 million additional dollars since 2017, when we formed government, now reaching close to $1 billion a year.

What has this helped to do? Well, this has helped to increase B.C. emergency health services staffing, training, mental health supports for employees, as well as investing in more equitable access to ambulance services to support communities across B.C., large and small. The member specifically refers to rural communities, of course.

Now I would disagree with his characterization that the model is broken. In fact, an incredible amount of work has been done, in collaboration with the union itself, around changes to the staffing model and increasing those supports to rural communities.

Since 2017, we’ve added — or BCEHS has added — approximately 1,900 new full-time and part-time permanent paramedic emergency medical responder positions, with 700 of those individuals working in rural and remote communities around the province.

Since 2020, we’ve added 77 ground ambulances, five new air ambulances and 55 of the new ground ambulances. Five of the air ambulances were added as part of the Rural, Remote, First Nations and Indigenous COVID-19 Response Framework and represent an important investment into rural areas.

In November 2023, a year and a half ago, government announced that the scheduled on-call staffing model in 60 different rural and remote communities across the province would be converted, through to March 2023, to improve the overall coverage in rural communities.

Certainly, some of the rural communities that I represent as an MLA — places like Denman Island, places like Ucluelet — were involved in this. I’ve seen the difference that it’s made in my communities, and I know that this is making an impact in small communities around B.C.

Now 22 new communities have converted to 24-7 emergency response service, where staff are in the station and on duty 24 hours a day, seven days a week. As of April 1, 2024, as part of the schedule and call phase-out, an additional 55 FTE stand-alone community paramedics were added to provide dedicated community-based care and community outreach.

These community paramedics are an important expansion of service in rural communities. We piloted some of them on the west coast of Vancouver Island. Seeing the difference that community paramedics make in being able to visit people in their homes and really extend the services of the health care system in a way that they’re already being paid, they’re already on shift, they’re able to deliver…. If there’s an urgent emergent call, of course, then they respond to that.

We still have a lot of work to do, of course, but I think we’re making serious progress. It shows the commitment to an investment in rural and remote communities in ensuring that they have the services, the emergency services, that they need.

I’m not too sure where the member is citing his figures from, in terms of median wait times, so I do want to directly quote what we have for rural median response times.

The last full year that we have these data for, because we’re approaching the end of the next year and don’t have the data quite ready, is for the 2023-2024 fiscal year. The rural median response time for purple calls is seven minutes and 20 seconds; for red it’s eight minutes and 56 seconds. Purple and red, of course, are the most life-threatening situations.

For non-life-threatening situations, the orange and yellow, the median response time being ten minutes and 5 seconds, and 13 minutes and 54 seconds for orange and yellow, respectively.

Now, I understand those are median, so obviously that means half of the response times are greater than that, and half of the response times are lesser than that. But it does show an important investment in rural paramedic services and an investment of our government.

[2:00 p.m.]

We’re going to continue to work with the union and with BCEHS on recruitment and retention measures. We’ve been canvassing this quite a lot, of course, in estimates around the particular issues that rural communities face in attracting and retaining the high-quality health care staff that they need.

Paramedics are no exception to this case, where there is more work to continue to be done to ensure that the full complement of staff is available, that they have the training that they need and that we continue to work with them around scopes of practice and ensuring that they can provide the maximum benefit and improve patient care as much as possible.

Brennan Day: I thank the minister for the answer.

Again, we see the use of “new” here used interchangeably versus the “net new” staff levels, so if we could break that down by net new positions.

Also, given my experience with several friends that have been head of ambulance and also with new recruits dropping out after a short time, do you have the two- and five-year attrition rates in the Ambulance Service available?

Hon. Josie Osborne: In response to the first part of the member’s question, the figures that I cited, the addition of positions, these are positions. These are net new positions.

He asked a question around retention rates, two- and five-year rates. That’s information that we would have to get directly from B.C. emergency health services.

But retention is an important issue that the member raises. That’s why working with the union to understand and be able to support access to mental health services, for example, and supporting paramedics and the work that they do…. That’s why adding more positions to the paramedic complement around the province is very important so that the relief is there and that people have access to increased training to be able to develop their skills, practise their skills and stay in their job.

I know that paramedics are incredibly dedicated, professional people. These are people who put themselves right at the centre of some of the worst moments, the worst days that a person could experience. We all owe them a debt of gratitude, and I know that the member shares that sentiment with me, that these are individuals who work incredibly hard and help to keep people and communities safe.

Brennan Day: That’s the fastest non-response we’ve had yet, but it did clarify a couple of things. I would just seek clarification, then.

I cited a 25 percent vacancy rate which you did not deny. So all of the answers you said for created new positions, net new positions, not net new staff — and I asked the question wrong, so I apologize — we can round down by 25 percent since those positions…. You can create thousands of positions. If you have a 25 percent vacancy rate, you’re only getting three-quarters filled — so, again, slippery language. But I will move on to the next question.

In 2022, one in five interfacility transport shifts was understaffed. What was that figure last year? Will the minister commit to creating net new full-time paramedic positions and staffing them in rural and remote communities and to ending the province’s continued reliance on the broken on-call model?

Finally, will rural British Columbians receive regular public reporting on ambulance staffing and response times and be transparent with the actual numbers broken down by region, since the disparities are wide? Or will you continue to keep British Columbians in the dark?

The Chair: Just a reminder to keep those questions coming through the Chair, Member.

[2:05 p.m.]

Hon. Josie Osborne: I’m just going to start off my reply by repeating something I said a couple of days ago about estimates, and that is that it’s always my commitment to get the best information possible to the member, the House, in the shortest amount of time.

[2:10 p.m.]

But it does take time to confer with staff sometimes, and the level of granular detail that is asked for is not something that’s easily at our fingertips. You may have noticed we’re using binders. We don’t have access to devices where all these data are stored.

So I’ll continue to do that. But I think that it is unfortunate — the choice of words that is being used in some of the questioning here. If I do not agree with the data or the source, and the source of data that’s being cited is not disclosed, the fact that I don’t dispute it does not mean I agree with that. I’m going to continue to give the best data that I have, and that’s my commitment to you and to this House and to the members asking questions.

Now, B.C. emergency health services does have a centralized tracking system for vacancy rates. Again, as I noted, there is a level of data that we’re just not able to deliver within 30 seconds or three minutes here today. My commitment is to get the best information that I can to the member, after today and after these estimates are over, perhaps, because I think we only have a couple more days.

Brennan Day: Over the course of the last four hours, we’ve raised serious and pressing concerns around access, staffing, infrastructure and transparency in the delivery of rural health care across British Columbia. While I appreciate the time the minister has taken, I must note that many of the answers provided were exceedingly long to generate, as I noted before. I would be happy if the minister could defer if she can’t answer in a reasonable amount of time, just in that we have a limited time together here.

I would also like to acknowledge that I tend to have trouble speaking in the third person, as I noted to the minister last night. I appreciate the patience of this chamber as I find my parliamentary legs, so thank you very much for that space.

There remains a noticeable gap between what is being promised in this government’s mandate letters and budgets and what is being delivered on the ground in communities where emergency rooms are closing, paramedics are stretched beyond capacity and residents continue to wait too long for care — a budget, I will note, that is under threat from not only this government’s mismanagement but from factors south of the border at a national and international level that are out of your control.

Unfortunately, despite repeated questioning, there has been little commitment to timelines, minimal data shared and a concerning absence of measurable outcomes or clear accountability mechanisms. And this is just the known budget, which, eight days into this fiscal year, is, as this government has admitted, already not reflective of the current reality and challenges facing British Columbia.

With that said, I do sincerely want to thank the minister and her staff for their time today. This dialogue is important, even when their answers fall short of the urgency of the issues raised.

Before I get to our next section of questions, I would note for the record that we will be addressing the matter of perinatal and postnatal mental health funding, at the request of the member from Langley-Willowbrook, before turning our focus to seniors care. We will not be leaving our elders to the end, as is so often the case, because the crisis facing our seniors cannot afford to wait. Following my time, I will be turning the floor over to the member from North Island for general health questions, just so we can set the priorities.

During committee proceedings on Bill M204, government members stated that Perinatal Services B.C. and the Ministry of Health are developing a provincial perinatal and postnatal mental health strategy. However, there is no mention of this initiative in the ‘25-26 budget estimates or service plan.

Can the minister indicate the specific line item, budget code or program area where this work is funded? If this strategy is truly underway, where is it reflected in the current fiscal framework?

[2:15 p.m.]

Hon. Josie Osborne: Thank you to the member for the question raising the issue around perinatal and postnatal mental health, maternity and reproductive care, even as a larger issue facing people in British Columbia. It’s a key priority in the Ministry of Health. I’m glad to speak a little bit about this and then talk to the member’s question specifically.

First of all, I just want to note that it’s reflected in my mandate letter to improve the delivery of maternity and reproductive care for people across the province through targeted initiatives. The member asks why a specific initiative is not listed in the budget or does not appear in the service plan. The simplest answer for that is that the budget, as he knows, is not an exhaustive list of every single expenditure in every single ministry.

There are many different programs and initiatives, including the development of different strategies and plans that are embedded within the funding that is provided to a ministry. Ministries and cabinet and government make decisions about what rises in priorities and then tackles those issues. That’s exactly our intention here.

We’re committed to advancing perinatal mental health, substance use issues as well, as part of a broader commitment to improving maternity and reproductive care. The initiatives that are currently underway include focuses on expanded specialized services, on increasing accessibility, on integrating supports within the existing health care system as it stands.

We have requested, already, Perinatal Services B.C. to develop a refreshed maternity care strategy. That would be inclusive of perinatal mental health. It’s expected to bring forward an action-oriented roadmap to be completed. And to note the private member’s bill raises some very important questions and obviously has had the support from all sides of the House to get to the place where it is. I think that’s a very positive move forward, and I look forward to progress in this area.

[2:20 p.m.]

Brennan Day: Again, another “We’re working on it, and we continue to work on it” response. I hope that the minister could share with the public when that program will take effect.

Moving on to the next question. The Minister of Health’s mandate letter includes a commitment to improving maternal and reproductive care. Government members have repeatedly referenced this as evidence that perinatal mental health is a priority. However, no corresponding funding appears in the estimates.

If perinatal and postnatal mental health is indeed a mandate priority, why is there no specific budget allocation or measurable investment for it in this year’s estimates? When can we expect to have that information available publicly?

Hon. Josie Osborne: As previously described, perinatal and postnatal mental health care fall under a larger umbrella of maternity and reproductive care. That is an item specifically listed in my mandate letter. As I also previously explained, the fiscal plan does not provide a detailed line-by-line budget of every single expenditure, and there is, by necessity, an amalgamation of some of those programs. But it is clear to see from the overall budget that is provided and also the statement of government’s objectives through the mandate letters, for example, that these remain a priority.

Again, I appreciate the private member having brought forward the bill, and it has opened up the opportunity to have a lot of discussion around the services that are already in place that support women, families and children, particularly around perinatal and postnatal care and with respect to some of the biggest challenges facing certain individuals — for example, around addictions issues.

Just to be clear, I think that through the committee stage of the private member’s bill, there will be an opportunity for a lot more discussion there, and then this House will arrive at a decision on whether to move forward with a specific strategy as it’s laid out in the private member’s bill or not.

But in the meantime, programs do exist, and we will continue to invest in them. So for example, health care providers across British Columbia have access to a perinatal mental health and substance use specialist consultation service, and that supports patient care through the clinician-only RACE line and the perinatal addiction service from the B.C. Women’s Hospital.

The perinatal and newborn health hub is a clinical information resource system that’s provided by Perinatal Services B.C., through the PHSA, and it is an evidence-informed, up-to-date perinatal and newborn health information system that’s accessible for all health professionals in B.C.

There’s an education and training program called Not Just the Blues. This is a program for health care providers to support screening for perinatal anxiety and depression, and it’s available through UBC’s continuing professional development program.

[2:25 p.m.]

We’ve talked during these estimates about the longitudinal family physician plan and incentives and how these were extended, too, to family physician maternity providers back in June 2024; primary care, team-based care and nurse and practice resources that are available to maternity clinics; Family Practice Services Committee maternity programs; a number of different care programs, networks; and a care grant that’s available.

For people who are experiencing peri- and postnatal mood and anxiety disorders, there is the ability for those individuals to access professional supports through their primary care provider and other outlets and to access specialized reproductive mental health services. These services include assessment, treatment and referrals that are provided by a multidisciplinary team on an in-patient or an out-patient or a virtual basis.

The B.C. Women’s Hospital families in recovery program provides specialized supports to individuals who are pregnant or new parents that are navigating mental health and substance use concerns and, again — as we’ve canvassed quite a lot in estimates with the member for Skeena — substance use and treatment recovery beds. There are 415 female-only substance use and treatment recovery beds here in British Columbia.

These are all important services that are provided and many…. You can see how they cut across the different programs and services provided in the Ministry of Health and throughout our health care system here.

The private member’s bill, with its intention of really bringing a focus on a concerted strategy, is an important discussion that’s taking place in this chamber, and I look forward to the committee stage of that bill and continuing that discussion about this really important work.

Brennan Day: Just to clarify, the private member’s bill is about mental health and not substance use — the strategy surrounding mental health and trauma — as it stands. I’m sure the ministry is familiar with that act.

Moving on, if the ministry is actively collaborating with Perinatal Services B.C. on a strategy, as we just heard, can the minister table any operational documents, draft frameworks, memorandums of understanding or records of meetings that can demonstrate that this work is indeed in progress?

Hon. Josie Osborne: I can confirm that a perinatal working group was struck in July 2024, and it has a mandate to improve services for people who are pregnant or new parents who are navigating mental health and substance use concerns. That is part of the focus there of that working group.

I do just want to comment, though, on the member’s previous comment around the separation of mental health and substance use issues and note that often for people these are inextricably linked or mental health issues can lead to substance use issues. By being able to tackle mental health issues, provide supports for people, we can help avoid issues with substance use that could otherwise develop.

I think it would be inappropriate, perhaps, to divorce these two subjects entirely, and I think that the sponsor of the bill would understand that. Although the subject of the private member’s bill is specifically around mental health, there are aspects of substance use issues that, of course, we always want to be aware of and incorporate into that work so that we can ensure we are providing the very best supports for people who are experiencing issues, people who are pregnant or planning to have a family or have recently given birth.

[2:30 p.m.]

Brennan Day: In committee, government members suggested that a perinatal mental health strategy is being developed on the same timeline as Bill M204’s proposed one-year deadline, yet no public-facing documentation confirms this.

Again, can the minister confirm the specific timeline for the ministry’s perinatal and postnatal mental health strategy and whether the ministry intends to table or publicly release this within the next year?

Hon. Josie Osborne: As I previously explained, the Ministry of Health has already requested Perinatal Services B.C. to develop a refreshed maternity care strategy. I want to be clear that that is inclusive of perinatal mental health.

Now, that’s expected to bring forward an action-oriented roadmap, and that would be completed in a one-year time frame. So I actually think the attention for perinatal services, and the work that they are doing and will bring forward, is very congruent with what’s suggested in the private member’s bill.

Brennan Day: I’m going to just read this into the record. It was a late submission, but we want to make sure that we get some responses. This one, if you could just follow up with me after, or if the minister could send over written responses later, that would be excellent.

Can the minister confirm what analysis or stakeholder engagement was conducted prior to the March 12, 2025, decision by the College of Health and Care Professionals of B.C. to no longer accept the National Board of Examiners of Optometry, NBEO, for registration purposes?

Specifically, can the minister provide a copy of the review or summary that found the NBEO and OEBC exams not to be interchangeable; the number of optometry students impacted by this transition, particularly those enrolled in U.S. institutions; and what transition support was provided by the ministry, if any, to assist affected students navigating the shift to the OEBC exam requirements?

Hon. Josie Osborne: Thank you for the submission. Noted, and we will follow up.

Brennan Day: We’ll be moving now into seniors care. Obviously, everybody in this room is affected in some way with the severity of the seniors challenge.

In the mandate letter, it includes a commitment to improving seniors care and ensuring public investments are used efficiently and effectively, especially as B.C.’s senior population continues to grow. However, recent long-term care investments have overwhelmingly gone to health-authority-owned and -operated projects, with costs averaging $1 million per bed and, in some cases, as high as $1.8 million per bed.

Minister, can you please explain how spending $1 million per bed on each long-term care residence is proper stewardship of public funds? With the limited resources and increasing demand, what is the plan by this ministry to ensure that public funds are allocated strategically to maximize capacity?

[2:35 p.m.]

Hon. Josie Osborne: Thank you to the member for the question.

It’s good to move into a section of questioning around seniors care, because I couldn’t agree more with the member that this is one of the most important parts of our health care system and the responsibility and obligation that we have to care for seniors, who have done so much for so many of us. As the member says, it touches every aspect of our lives as well, too, with the people that we love in our families and in our communities.

The member is asking specifically around long-term care and the establishment of long-term-care facilities. As I know he is aware, we’re deeply committed to that and the work that we are doing to invest in new long-term-care facilities.

Now, provincially owned and operated long-term-care facilities are an important part of the equation. Noting the rising costs of infrastructure projects like this is one of the reasons why the Ministry of Infrastructure was created. The Ministry of Health no longer has the responsibility for the capital part of this part of health care and service delivery.

I would direct the member towards the Ministry of Infrastructure and just note that they will be undertaking some very important work, looking at how to reduce the costs, looking at procurement, for example, looking at how to streamline things and noting that we all share a responsibility to steward the resources that we are provided by taxpayers in British Columbia and other sources and to use those dollars as effectively and as efficiently as possible, while maintaining the quality and standards of care that people deserve and expect.

Brennan Day: I believe that response is going to come in very handy later as we talk about what we can do to deliver the overwhelming resources that are going to be required as our grey wave crashes over us and the lack of preparation multiple governments have made in addressing this issue.

Budget 2025 outlines that the province has committed $2.3 billion to long-term-care-bed redevelopment and replacement projects that will provide 2,297 beds, built to modern standards, in Vancouver, Colwood, Abbotsford, Richmond, Nanaimo, Delta, Campbell River, Kelowna, Squamish, Chilliwack and Cranbrook.

However, the Conference Board of Canada projected a need for over 30,000 new long-term-care beds by 2035. Meanwhile, other provinces, like Ontario, are making significant strides, with plans to build over 31,000 new beds and upgrade almost 39,000 by 2028.

[2:40 p.m.]

Minister, how many net new beds will be built within the next five years, and how does this align with the projected need for a net increase of 30,000 beds by 2035, as was forecasted all the way back in 2019, very close to the beginning of this government’s mandate?

Hon. Josie Osborne: Thank you to the member for the question and discussion around projections of our growing and aging population and the need for the supports and health care that people need to age well and to be well as they enter into their later years.

[2:45 p.m.]

The member has referred to the lack of investments in the past. I couldn’t agree more, in that we are faced with a situation — and were in several areas, forming government in 2017 — in making up for the lack of investments from previous governments. It’s a difficult place to be, and it requires us to not only continue to invest in long-term care and assisted-living facilities for people who depend on them but also an opportunity to be more creative, thinking of other solutions to help people age with dignity and to stay well.

One of the things that we know is that people are often healthier and happier by being at home. One of the ways that we are approaching this is through the long-term care at home initiative. I want to take a moment to talk about that. We know that these kinds of innovative models are needed to meet this growing demand for seniors health services. It’s incumbent on all of us to do this in a way that’s cost-effective and, again, really preserves dignity for valued elders in our lives.

This is a program that equips seniors homes with technology for virtual care that is customizable to an individual’s needs. A person is monitored by a care team that checks in if an alert is received. It also includes respite care for family members, to help alleviate the kind of caregiver burnout that can happen and really extend the ability for people to care for their loved one in their home for longer.

The program’s technology is pretty interesting. It can monitor for fall detection, activity levels, medication adherence, wandering and even vitals. By supporting people to stay at home in a way where it’s appropriate to do so, it’s very essential to reducing some of the pressures that the member is talking about in terms of physical spaces that are required in the health care system.

It helps us to improve care delivery and efficiency and often aligns with the preference of seniors themselves, of people themselves who want to stay home. They want to stay connected to their neighbours, to the places and the spaces that they are familiar with and comfortable in.

We have undertaken this as a pilot project, and we are collaborating with more health authorities now to implement sites across Island Health, Fraser Health and Vancouver Coastal Health this spring. By the end of the ‘27-28 fiscal year, the program is targeted to support thousands more seniors to age safely and independently in their homes.

Now, in addition to the 24-7 remote monitoring that can be provided through the long-term care at home program, it also provides an opportunity for connection to social activities and that predictable respite support that people need.

I want to talk, too, about the seniors programming helping people stay at home and age and a personal experience that I had visiting an assisted-living facility in Surrey several months ago where I had the opportunity to meet people who lived there but also to meet seniors who were living at home, who came in on a bus to the facility and undertook four-odd hours of programming there. They were able to socialize. They had a meal. They have opportunities to take seminars or education sessions. They do an exercise session.

I sat down and I talked with one woman in particular and asked her what she liked about the program. She explained to me how, for her, it was a perfect solution to getting access to some of the supports that she needed. She really, really appreciated the physical interaction with people and the ability to visit with people but that she was able to go home — she could watch TV on her favourite couch and her chair — and that she was able to sleep in her own bed at night.

Now, what the program providers told me during that visit was that their understanding is that, on average, people who are able to access those kinds of day programs can delay the need to enter into a long-term care facility by two years. That’s incredible — to be able to provide cost-effective supports for a person who’s able to stay home and stay healthy.

I use these examples as ways of saying that we have to be creative. We have to be innovative. We have to be willing to look at different models of care for people that work best for them, to help them age with dignity and to be the most cost-effective that we can.

[2:50 p.m.]

If the member has further ideas or insights, I certainly welcome them.

Again, these are the kinds of conversations that take place with the seniors advocate. I’m very grateful for the work that the office of the seniors advocate does in highlighting the need for innovative programs like these and continuing to urge government and this House always to do better.

Brennan Day: I suppose, then, we can just hold you to the 2,297 beds to be built to modern standards that are projected in this budget, and you’re not making any commitment or even attempting to reach the net increase of 30,000 beds.

Also, by your own conversation here, relying on telehealth…. I believe there is definitely a need for that in certain cases. It does not address personal care issues, feeding issues, meal preparation or any of the multitude of other tasks that family members do on a regular basis.

Given that response, can we presume that you’ll be issuing another projected number, revising that 30,000 projection, based on the investments you’re making in other areas? Or should we rely on the 30,000 number, and maybe we’ll get partially there?

The Chair: Through the Chair, Member, please.

Hon. Josie Osborne: By way of the ministry’s statistics, to share with the member opposite, and actually, as was highlighted in the news even as recently as this morning, B.C.’s senior population of people aged 75 and older…. We know that it’s grown by 26 percent from 2020 to 2025 and that it continues to grow rapidly.

In 2025, more than 517,000 people in the province are aged 75 years or older — that’s 9 percent of our population right now — but by 2035, that number is expected to increase to just over 772,000 people.

[2:55 p.m.]

As the member is pointing out, clearly the demand for long-term care in British Columbia is expected to increase significantly. Yes, the ministry does do projections, and our projection is that 16,300 new long-term-care beds will be required by 2035.

I will note too, though, and even the B.C. seniors advocate has been clear, that some of seniors who are in long-term care could potentially be accommodated in other settings, like in their homes, and that seniors need home support services in order to be able to stay at home.

I think this is the point I really want to drive home, which is that — as the member describes it, a silver wave — this growing and aging population demands some creativity and flexibility and innovative approaches in how we do things. And that is how we do two main things here.

First of all, treat people with dignity, provide the best care possible for people but also be responsible with taxpayer dollars. We’re in a situation where the thought of 16,300 new long-term-care beds being required by 2035 is a daunting figure. But we are making progress, and we have made commitments to building new long-term-care beds, and we need to continue to do everything we can to avoid people having to use long-term-care beds by providing services in a different way.

I have described one of those programs, being the long-term care at home pilot program, which shows a lot of promise for its ability to help keep people at home.

A second innovation that also leverages technology that supports healthy aging and aging in place is the HealthyBC self-assessment tool, a tool that’s designed for adults who are aged 50 and older, empowering them to reflect on and monitor their own health and wellness needs. Now, is this going to be a silver bullet? No. Is it perfect for everybody? No. But it is another tool to help people be well and to be able to undertake the things that they need to do to age well, to stay healthy and active.

It is work like that…. Again, I invite the member to bring forward his ideas and innovations too, because as our former Premier John Horgan used to say, good ideas come from everywhere, and we need good ideas to deliver services in the best way possible for people.

Now, with respect to the budget and its investments into seniors and the programs that can be used to help people age well and to, again, help to delay the need to go into long-term-care facilities, and perhaps even avoid the building of hundreds and hundreds and hundreds of long-term-care beds, I would note that in this year alone, ‘25-26, the budget contains $58.933 million for investment into community-based senior services. It contains $42.682 million to go into care management.

This includes the addition of full-time-equivalents, of about 400 FTEs in the health authorities to help undertake this kind of care management for helping people age at home, and $43.949 million in home support.

These investments continue and, in fact, increase in the following year to continue the kinds of programs and services that need to be developed — again, to help seniors age at home, help them maintain their independence and their quality of life, maximize the capacity of the health care system by diverting seniors care from acute care settings into homes and other appropriate places, and deliver what we all know that we need, which is a financially sustainable continuum of care.

Brennan Day: Thank you for the response.

I would be very interested to see what the model looks like that is bringing down that projection so dramatically and what that might look like. That’s a large change in demand over six years.

I’m going to move now onto long-term-care wait-lists. According to the office of the seniors advocate, there were 6,464 seniors waiting for a publicly funded long-term-care bed last year. The long-term care wait-list has more than doubled in the past five years, and the number of seniors waiting increased by 25 percent last year alone. The average wait time for people on the wait-list was 242 days. In 2023, 83 percent of alternate-level-of-care, ALC, days in acute care hospitals were for seniors.

[3:00 p.m.]

As the minister knows, there’s a trickle-down effect of that impact that plugs up the rest of the hospital system and the health care system. This represents seniors who are ready to be discharged but have no appropriate place to go. The reasons for that can be various: lack of family supports, the housing shortage and other care options that aren’t maybe available with home delivery. So I’m very glad to hear that the ministry is working on improving those.

Without significant investments in long-term-care beds, access challenges will continue to escalate, as older adults are denied appropriate care in the community and fewer beds are locally available for acute care patients requiring surgery or medical intervention.

The current state of ALC wait times and long-term-care waits in this province is unacceptable to British Columbians. What actions are being taken to ensure that seniors are not left waiting in the hospital beds but can access timely support in the community, whether that be through home health services, as you’ve described, or expansion of long-term care?

[3:05 p.m.]

Hon. Josie Osborne: Thank you to the member for the question and raising the issue around seniors — mostly seniors, but not exclusively — in acute care settings, ALC status and waiting for long-term care and the wait lists that people are experiencing.

Now, in previous questions, I’ve been talking a lot about some of the work that we are doing to ensure that people can age at home healthier and in a way that prevents them from having to enter long-term-care facilities. But despite this, we know that there are seniors in hospital settings, for example, who are waiting for long-term care.

Health authorities each have strategies to deal with what we call how people are decanted, how people are moved from ALC to long-term care, to LTC. I just want to talk a little bit about some of the actions that health authorities have been taking.

That includes — this is really to recognize the urgency of this problem; these initially were proposed as sort of interim solutions, if you will — prioritizing admissions to long-term care from acute care and community emergency settings; implementing a first appropriate bed policy for acute care ALC patients; enabling acute care patients to have time, to have 24 hours, for a consent or decision of admission to a long-term-care home; striving for seven-day admissions to long-term care; and implementing a 72-hour lost bed-day target for targeted facilities for admission of ALC patients.

Now, again, these are short-term solutions that are helping to make some progress. Of course, they’re not perfect in any way, and there’s more work that needs to be done.

Again, I want to emphasize the work that’s being done through the HealthyBC assessment tool, being piloted right now and to be rolled out, as one way of helping people think about their lives and where they are at and making plans for the future and understanding what their needs might be.

One of the incredibly important steps forward is the Age Forward strategy that we put out. This is B.C.’s 50-plus health strategy. It comes with a three-year action plan and really recognizes that with a population that is growing and aging and changing at an unprecedented rate, we really need a proactive and evidence-based strategy and action plan to enhance the health and well-being of older adults.

The plan focuses quite specifically on fall prevention and related health care challenges, focused on preventing and reducing falls and the associated health care challenges that result from that. As the member probably knows, this is a really serious issue for older adults. The prospect of entering into an acute care setting after experiencing a bad fall can often lead to a pathway where there is literally no alternative except to go into long-term care.

That’s why it’s so important to continue to take actions to prevent those kinds of incidents from happening. That’s exactly what the strategy is helping us to do.

Now, the goals of the strategy are to help expand people’s lifespan, their health span, if you will — health span as opposed to lifespan, the length of time in your life where you are healthy and well and able to function and hopefully be independent — but also to support aging in place, to reduce the preventable health care utilization through the kinds of programs and services that can be provided for people at home.

[3:10 p.m.]

These are all part…. With each of these answers, I hope I’m adding a little bit more of a layer of information in terms of a flexible and creative and innovative approach, not just assuming, for example, that nature is going to take its course.

There are so many ways that we can support people as we age and do everything that we can to prevent people from having to enter, obviously, into acute care settings but into long-term care if it’s not suitable or necessary and, again, doing it in a way that really supports the dignity and well-being of older adults and their families who are providing care for them.

Brennan Day: Thank you for the response. I think the more time we spend in this House, the less demand the members here are going to have for long-term care given the stress of the job.

I’m going to move over to hours per resident per day. The Health Standards Organization’s new national standards, although not prescriptive, cite 4.1 hours as the minimum level of acceptable care. The Ontario government is increasing the hours of direct care for each long-term-care resident to an average of four hours per resident day. Likewise, in 2021, the government of Alberta recommended increasing it to 4.5 hours over four years.

Currently, British Columbia provides an average of 3.43 hours of care, including allied health services. However, many care homes in the province are only funded for 3.36 hours of care, a target that was identified in 2016 when resident care needs were much lower than they are today. This raises concerns about whether the current level of care provided in the province is adequate to meet the needs of older adults living in care, and obviously the ripple effect that that has on staff burnout and satisfaction.

Minister, can you speak to what actions will be taken to ensure B.C. keeps pace with other provinces and moves beyond the minimal 3.36 hours of care per day? The B.C. Care Providers Association has recommended that the government of British Columbia invest $550 million over three years to meet staffing needs for a new minimum standard of four hours of direct care per day — which would still put us behind two neighbouring provinces — for each resident in long-term care.

Will the minister consider endorsing this recommendation and make these investments to ensure the quality of care for our elders?

[3:15 p.m.]

Hon. Josie Osborne: Thank you to the member for the question and for talking about the levels of care that are required in long-term care facilities to ensure that seniors, of course, are always treated with dignity and respect and get the care that they need.

The member cites the hours that are provided in British Columbia’s long-term care facilities. He cites 3.43. I am happy to provide an updated figure, which is that we are moving higher, and we are now at 3.61. I think that’s important to note, because moving forward with being able to provide more and better care is always a good thing.

It’s also very important for government to continue to monitor this very closely, taking into account the fact that we are seeing staffing challenges and, as we’ve discussed throughout estimates, a global shortage of health care workers. Despite best efforts in training new staff, in enabling them to work in excellent work environments, there’s more work to be done in order to attract more staff and meet some of the levels that the member is referring to.

Despite this, another thing that’s incredibly important to monitor and to have oversight over is the quality of care, so not just the number of hours of care that a senior would be receiving or a resident would be receiving in a long-term care facility but the quality of that care.

So a few things that we’ve undertaken. First of all, I’ll just point to the really amazing work of family councils, groups of caregivers and family members of residents in long-term care facilities that provide absolutely vital feedback into the ministry and into health authorities. It’s a line of sight coming from a perspective that’s really important here, and that is of the residents themselves and their family members.

The second is a reporting tool that we have established that gives the ministry a much better line of sight into long-term care facilities and the ways that funds are being spent. This is a really important tool to have so that we have the data that we need, too, to understand and to hold facility operators, of course, to account for the conditions of care and the standards and ensuring that they’re reaching those.

[3:20 p.m.]

The last thing I want to talk about is something that we have established called the long-term-care quality framework, again, with that emphasis on quality of care, an evidenced-based quality framework and policy directive that enables and formalizes comprehensive provincial-level reporting, monitoring and evaluation. That really supports continuous quality improvement within the long-term-care sector.

So this is a policy directive that came into effect just over a year ago, April 1, 2024. It requires the health authorities to report on and monitor and evaluate the quality of long-term-care services in their region, and they use 16 different indicators to do that. Those indicators are established in the framework, identified in the framework. They establish regional quality improvement initiatives that are consistent with the framework. They establish regional quality improvement leadership structures that monitor the quality and enable them to continuously and collaboratively participate in the quality improvement that health authorities need to undertake with long-term-care providers.

There is a report. The first annual report of this long-term-care quality framework will come out this fall. It will be a public report. We will all be able to see it and understand what we can learn from it and how we can evolve the framework, which we expect it to do. Again, we’re going to need the collaboration of stakeholders in doing that work. It’ll help us identify additional actions that we can take to enhance seniors care.

I’ll note, too, the recently announced aging with dignity funding from the federal government, which has been an important component of this. It’s to help really strengthen that access for people to high-quality and safe and dignified home and community care in long-term-care settings, for example. And it’s to help stabilize the long-term-care workforce, particularly with the impacts of the COVID-19 pandemic and what we saw taking place in long-term-care homes.

Our government’s commitment is to meet and exceed standards of care for people and ensure, again, that residents of long-term-care facilities are receiving the care that they need, that they are treated with the dignity and respect that I know the very hard-working workers in long-term-care facilities provide. Obviously, it’s to ensure that those workers, the people whose heart and soul really go into caring for seniors, are also treated with the dignity and respect and have the safe working conditions that they deserve, with the pay that is compensatory for the work that they do.

Brennan Day: I have a few comments to that response. I’ve definitely been meeting with many family councils, both at public and private facilities, and some of the concerns that they have are obviously very personal, and I don’t want to get involved in each individual dispute.

But it’s very clear to me from visiting those facilities that there’s a long way to go in terms of getting that transparency and that feedback loop closed. I’m hoping, perhaps, that myself and the minister could work on that process to give some more teeth to the legislation governing the family councils to ensure that we are holding whoever is managing those facilities, whether it be public or private, to account for the care that our elders are getting.

With that, we’ve seen many, many changes. COVID certainly changed the landscape around long-term care. We obviously had an outsized impact here with the seniors population that ravaged our long-term-care homes.

Even previous to that, under your predecessor and the predecessor of my riding, the Comox Valley Seniors Village had a crisis in care there and management under Golden Life. Much of that has been resolved, but the feedback I’ve got from the ground — from people that have been there over that entire duration with family in care — is that despite the attention that got paid early on in 2019, pre-COVID, to these issues and then the subsequent crisis in care over COVID, nothing actually changed.

There was a lot of talk and a lot of attention, but as usual, seniors came last. Unfortunately, I think there’s a long way to go. I do look to working with the ministry in advancing serious reform in the sector.

I’m going to move on now to the long-term funding model.

Minister: as I’m sure you’re aware, your predecessor committed to reforming the funding model for the province’s long-term-care sector. This work is of critical importance to delivering services efficiently and sustainably into the future, particularly as many long-term-care operators are experiencing significant fiscal pressures that were exacerbated during the COVID-19 pandemic we just spoke about.

[3:25 p.m.]

This funding model work has been in progress for quite some time. In fact, during last year’s estimates, your predecessor outlined timelines for this work to be committed. He stated the following: “The long-term-care funding model is targeted to be delivered in three phases: phase 1, direct care funding envelope, to be completed by the end of Q2 ‘24-25; phase 2, remaining operating expenditure categories, to be completed by fall ‘24, along with policy work related to the capital funding envelope; and phase 3, completion of the capital funding envelope, by spring 2025.”

Minister: can you please provide an update on the progress made on this work and when it is expected to be completed? Subsequently, can the minister outline what their consultant, PricewaterhouseCoopers, has actually done to move this file forward?

Finally, what actions are being taken to ensure that the new funding model reflects the true cost of the delivery of high-quality long-term care in B.C., including the true cost of compensating workers, building and operational supplies, capital costs, inflation and the increasing complexity of residents requiring far more hours of care as our hospitals are overwhelmed and they get shoved back into the system?

[Mable Elmore in the chair.]

[3:30 p.m.]

The Chair: Minister.

Hon. Josie Osborne: Welcome, Madam Chair. Nice to see you there.

Thank you to the member for the question. I’m going to answer first the component around PricewaterhouseCoopers, and then I’ll move into the funding model discussion.

The member asked specifically about the work that PricewaterhouseCoopers has been doing. They were awarded a contract back in December 2023 to support the advisory committee and the sub-working groups that had been pulled together. They have provided project management support, including the development of a detailed work plan to achieve key deliverables and track the key milestones in this project.

They’ve conducted a jurisdictional scan of capital funding approaches, and they’ve provided a report recommending an appropriate target profit surplus margin for contracted for-profit and not-for-profit long-term-care operators in British Columbia.

They’ve conducted a jurisdictional scan of environmental services standards and funding model considerations to inform the non-direct care funding envelope.

[3:35 p.m.]

I’m just going to speak a little bit about the progress of the project. Since the establishment of that long-term-care advisory committee and the sub-working groups that are part of it, the progress to date is around the policy sub-working group, which has produced draft policies on long-term care access and occupancy, long-term-care staffing models, long-term-care specialized populations, long-term-care innovation and long-term-care nutrition care and food services. This work is important to informing the broader work of the funding accountabilities and the funding methodology sub-working groups, two components of the larger group.

Now, the funding accountability sub-working group has focused on developing draft funding letter accountabilities that would be required to meet the policy objectives, like bed occupancy targets, direct care hours delivered, as we were previously talking about in another question, and the implications on funding allocations if those deliverables are not achieved.

The funding methodology sub-working group has finalized the direct care funding envelope, funding model input parameters, looking at things like staffing mix, compensation rates, the rates of overtime and agency staff utilization.

Where the project lies now is that previous to the election, there was a discussion that took place with partners in the sector and a request at that time to pause the work. An election took place, clearly, a transition into a new minister, and new leadership in the Ministry of Health. Since then, what I’ve done is direct staff to convene this table back again so that this project can continue into the next stages. The timing, I think, is good as we move into a new budget cycle as well.

But in the meantime, operators are experiencing cost pressures, so I have committed, and we will be providing, additional overtime and agency costs. Of course, coming out of the COVID-19 pandemic, we’ve seen a lot of impact on long-term-care facility operators, and it’s important to help keep them whole as much as possible while this important work around a long-term-care funding model takes place.

My commitment is to continue those discussions, and as I pointed out, to reconvene this table. Now seems absolutely like the appropriate time to do that.

Brennan Day: Thank you for the questions. I feel there are a few supplementals I would love to send over to you, but in the interest of time, I’m going to move on to nurse-to-patient ratios.

Last year the B.C. government committed to implementing nurse-to-patient ratios in the health care sector, which has helped improve staffing levels in hospitals. I’m sure you, like I, was approached for the 2-to-1 model. However, this has also drawn more nurses away from long-term-care and assisted-living facilities, where staffing shortages were already a challenge.

The government promised to introduce similar nurse-to-patient ratios in long-term care and assisted living but have yet to follow through. They’ve also committed to consulting with the affiliate care sector on how this should be implemented, but that consultation has not yet taken place.

Will this government commit to consulting with our affiliate care partners as your staff work to develop and implement minimum nurse-to-patient ratios in the long-term-care and assisted-living sector?

Could the minister please provide an updated timeline for this critically important work? When can the workers in this sector, who deliver critical care for our elders each day, expect to benefit from increased support and improved staffing levels?

Finally, the affiliate care sector has long suffered from regional health authorities poaching staff, an issue that’s been brought to my attention in multiple regions of the province. If nurse-to-patient ratios are only to be implemented in the acute care sector, what will this ministry do to prevent long-term-care homes and assisted-living residents from losing these critical professionals?

[3:40 p.m. to 3:45 p.m.]

Hon. Josie Osborne: Thank you to the member for the question.

I’m going to start with, for the folks at home, a little bit of information around the policy solution that we’re talking about here, minimum nurse-to-patient ratios, and dig into the member’s questions.

As a first jurisdiction in Canada to make this commitment, it’s a representation, I think, of government’s understanding and deep commitment to bolstering the workforce for nurses, ensuring that a quality and standard of care is delivered for patients and, so importantly, a quality of workplace and an environment where nurses are supported and are able to do the critical work that they do. In creating a better working environment for nurses, we enable the improvement of the quality of patient care.

We have worked very closely as a ministry with the B.C. Nurses Union to adopt these new minimum nurse-to-patient ratios. I think, again, this commitment, being the first jurisdiction in Canada to make this, is really saying that we want British Columbia to be the best place in Canada to be a nurse.

Now, the ratios represent the minimum number of nurses that would be required for care for a maximum number of patients on a unit. It is incredibly important that we do this work thoughtfully and that we do it collaboratively, in close partnership with nurses and operations leaders throughout the province, to ensure that the implementation of this achieves the greatest-possible impact with the best-possible outcomes, both for nurses and for patients. Implementation is ongoing.

Again, I just want to pause here to reflect on the fact that this work needs to be done thoughtfully and in deep collaboration with the Nurses Union and also with employers like health authorities. To do that and to achieve the commitments that we are making over the next years, we are also mindful of the fact that we continue to operate in an environment of a shortage of nurses. That’s why having minimum nurse-to-patient ratios will help to attract and retain nurses.

We have to find those nurses too. So a lot of work at the ministry, and as we’ve canvassed throughout estimates, is around the training of health care workers, including nurses, here in British Columbia; increasing the number of nursing seats; ensuring that incentives are in place and that we are reducing the barriers for internationally educated nurses to come to British Columbia and practise here; reducing the barriers for American nurses, for example, and attracting American nurses to come to British Columbia; and launching a new recruitment strategy right into the States, for example. And this is an important part of that work.

My mandate letter is also very clear about making progress on working collaboratively with partners to strengthen the nurse ratios and ensuring, of course, that we continue the actions that are outlined in the health human resources strategy. And this, specifically, is action 18 of that strategy: developing workload standards to balance workload and staffing levels and optimizing quality of care.

We have published a policy directive and implementation framework for hospital sector ratios that are to be used by health employers to support implementation. The directive and the framework are supported by the minimum nurse-to-patient ratio executive steering committee. That includes the ministry, the union, the Nurses Bargaining Association, the Health Employees Association of B.C. and health employers.

[3:50 p.m.]

The policy for MNPR outlines the necessary actions, the expected benefits and goals for introducing ratios. It provides a clear roadmap for improving care quality and nursing practice. It promotes safer, more effective nursing practices by improving supervision from other jurisdictions where similar ratios have enhanced patient outcomes and nurse satisfaction.

I’ll pause here, too, for a moment to reflect on the learnings from jurisdictions like Australia that have brought in minimum nurse-to-patient ratios, but I note that it took them about a decade to do that and to do it in a staged and collaborative way, and that they were able to achieve that at a time when they were not experiencing the same kinds of shortages in the nursing workforce that we are now.

That’s why, again, it’s important to continue to do this work very collaboratively, particularly with the Nurses Union.

The policy for mNPR also implements and evaluates the ratios to improve care. It’s an important part of that work as well.

We’re going to continue this. We are going through a process looking at minimum nurse-to-patient ratios in other settings. As the member mentioned, long-term care, community care — there is planning around that.

Again, I have to emphasize that no other jurisdiction has done this work. That’s why taking a phased approach to this…. That’s exactly what’s taking place. In fact, health employers are using a sequencing approach — and activation is currently underway for phase 1, as the member had mentioned — and doing this in a way that best aligns with the unit needs, the geography and the care-based needs of a different organization.

That’s why — again, I’m going to keep coming back to this — it’s really important that we do this in a very thoughtful and collaborative way. We’ve made this commitment. That commitment is, again, around creating a better working environment for nurses, creating a stable and safe working environment where nurses are supported and that enhances and improves the quality of patient care.

Now, we have not seen evidence of nurses leaving long-term care for acute care specifically due to minimum nurse-to-patient ratios. The member mentioned that. That’s not evidence that we have seen.

We will continue these efforts, achieving the minimum nurse-to-patient ratios; training, attracting and retaining nurses here in British Columbia; and doing everything here to really strengthen B.C.’s health care system and deliver the best possible, highest-quality care for people.

Brennan Day: That’s going to be my last question for this session. I’m going to hand it over to my colleague from Prince George–Mackenzie.

Before I do, I would like to take this time for all of you. We’ve spent some rather late nights here over the last couple days. I would like to thank everybody, including the minister, for their time and all the hard work I know you are doing and will continue to do in the coming months. I look forward to collaborating.

I do reserve…. I will try and get an update of the questions that I had as follow-ups, which I wasn’t able to ask in this session to you, read into the record prior to the end of session tomorrow so that we can get a follow-up on behalf of all the stakeholders and front-line workers, to make sure that they can get those answers.

Thank you very much, Minister, and I’ll turn it over to my colleague from Prince George–Mackenzie.

Kiel Giddens: Thank you to the Health critics for giving me this time and, of course, thank you to the minister and all of the staff for the work that you are doing answering these questions today.

There’s been some considerable discussion on long-term care. I wanted to add to some of those comments on behalf of residents within the Northern Health region. Of course, the community-based care and home support is all important, but those long-term-care beds are still absolutely critical for seniors when they need it.

Of course, the challenges are greater in Northern Health as seniors are on longer wait-lists for long-term care. According to the B.C. seniors advocate, from a hospital in the North, seniors are likely to wait approximately 239 days, or eight months. That’s a long time, and particularly, many of those seniors would be in a hospital setting.

I’m wondering if the minister could explain a little bit about what the ministry is doing specifically about addressing the challenges in Northern Health for long-term care.

[3:55 p.m.]

Hon. Josie Osborne: Thank you to the member for the question, the member for Prince George–Mackenzie, and raising, specifically, issues for people living in the North. We have spent a fair bit of time during estimates for the Ministry of Health talking about the unique challenges that people living in the Northern Health Authority, the northern half of the province, face. I am not a resident of the North, but I am a resident of a rural community and have some understanding of those kinds of challenges.

I want to, first of all, assure the member that my attention is very much paid to matters like this, and he has my assurance of that. I won’t cite again or canvass again the things that we’ve already talked about around the supports for people to stay at home as long as possible and to avoid care. Except to briefly just reiterate that all health authorities are implementing home and community care strategies to reduce the need for ALC beds and providing additional supports for people that help…. Having their care needs met in community is an important part of this, and certainly, Northern Health is absolutely no exception.

The community-based transitional care programs, similarly, that the health authorities are working on across the province provide people with that opportunity to maintain, or sometimes actually even improve, their functional status in a very supportive and non-hospital health care environment after an acute hospital stay — being able to be released into a setting where people’s needs are met and, hopefully, even see improvement.

[4:00 p.m.]

Now, across the province, there is a provincial access and flow committee. It’s working on standard provincial ALC categories and really helping in reporting, in service accountability and planning for those safe care transitions.

Despite this, as the member notes, we know that there are people who stay for a long time in that ALC, alternative level of care, and are waiting for admission into long-term care facilities or into a place that is more appropriate for them.

Specific to the Northern Health Authority, I’ll talk about some of the initiatives that are taking place there. First is around admission avoidance and the implementation of an emergency department admission avoidance team to reduce hospital admissions and support care in the community, an increase of day program hours and spaces.

The second initiative is around improved patient flow, so evaluating the current system tables and creating a strategic table to enable placement of ALCs beyond the current health service delivery area boundaries, evaluating system gaps for placement, which includes the hospital community and mental health teams, reviewing all of the ALC patients for the creation of a list of patients and barriers to movement that is then taken to the strategic table, and establishing a rehabilitative care model in northeast acute care facilities.

The third bucket, if you will, is around community transition. The work that the Northern Health Authority is doing here is around increasing sub-acute transition spaces by ten to 14, securing spaces and identifying staffing models, establishing these sub-acute beds in Terrace and Prince Rupert, as well as criteria for admission, and then opening new beds, opening beds specifically for dementia, for acquired brain injury, and establishing a family residence suite, as well, to accommodate families that are visiting ALC patients awaiting placement. This is taking place in Fort Nelson, for example, for people who had a home community that was not Fort Nelson.

These are initiatives that are specific to Northern Health Authority and some of the work that they are doing, again, to help move people out of acute care settings into a more appropriate care setting.

Again, I’ll just emphasize the importance of the home-based programs, and I’ve talked about the long-term care at home pilot program, for example, and other tools that are being used to help avoid admission into long-term care facilities but then, where it is required, again, to begin to reduce those wait times.

I thank the member for the question.

Kiel Giddens: I want to ask a little bit more of a specific question on long-term care, because some of it is obviously complex, including dementia care, specifically. The minister may be aware that Northern Health and the ministry are partnering on a dementia care facility in Prince George, a proposal. This is with land that was donated by the Catholic Church.

I’m wondering if the minister can confirm the timelines, costs and budget of this program and the capital program with it. Also, just if the minister could explain the long-term contractual arrangement with Providence Living to operate the facility.

[4:05 p.m.]

Hon. Josie Osborne: We’re digging around for the specific information, but the member can probably predict what I’m about to say, which is, first of all, with respect to construction timelines, although I can say the facility is scheduled to open in December 2026, the costing side of things is actually now being delivered by the Ministry of Infrastructure, so I’d direct the member to the Ministry of Infrastructure.

On the contractual side of things, that is a Ministry of Health responsibility, those relationships through health authorities or places like Providence Health Care on the operations side. I’m going to take the member’s question on notice and then provide him with information afterwards, because we just don’t have it at our fingertips right now. But I appreciate the question, and thank you for that.

Kiel Giddens: Thanks to the minister. I appreciate that. I would like to get the follow-up afterwards.

I just want to maybe go back, for my final question, to another specific question about long-term care in rural B.C. in particular. I appreciate the longer answer that the minister gave to the last question about Northern Health as a whole. But, really, there are 55 percent fewer publicly subsidized long-term-care beds per 1,000 population that are over 65, and the median wait times to access these publicly subsidized long-term-care beds is, really, twice as long in rural B.C. — so trying to see some improvements here.

I want to use Mackenzie as an example of this. I really want to thank the Williston Lake Elders Society for the important work that they’re doing to advocate for seniors health care and housing in Mackenzie specifically.

The latest census data in Mackenzie shows that there are about 1,150 residents over 55, and that’s about a third of the population. And it’s a growing number. A lot of seniors are moving to places like Mackenzie because of the affordable housing. It’s really a growing issue in some of these smaller communities.

There are currently only four long-term-care beds and one respite bed in Mackenzie. It’s just a challenging situation with a community that’s two hours away from Prince George as the closest centre.

I’m wondering if the government could explain a little bit more about — for smaller rural communities, not just the Northern Health region as a whole but smaller communities like Mackenzie — what the government is doing to provide more long-term-care beds if possible and more respite opportunities.

[4:10 p.m. - 4:15 p.m.]

Hon. Josie Osborne: Thank you to the member for the question.

Maybe a little bit of a joke, but I have to say, if the tables were turned and we were in the opposite seats, I would ask the exact same question. The reason why, I think, is because of my life growing up mostly in rural communities and in being the MLA for Mid Island–Pacific Rim, representing rural communities and being faced with these kinds of questions from my constituents all the time.

For example, where I live on the west coast of Vancouver Island, there is no long-term-care facility. We have talked for years and years about a dream of having a long-term-care facility that would enable people to stay on the west coast. In particular, we’ve long talked about the dream of a facility that really serves and honours Indigenous Elders.

It’s very challenging for communities when very much-loved members of our communities — especially small places where we’re so well connected — need to leave to receive an appropriate level of care. Myself, personally, I have lost community members, people who are now living in places on the east coast of Vancouver Island or in Port Alberni. And it’s really difficult. For the community of Mackenzie, for example, I would imagine it’s very much the same. It’s a challenging thing to do.

It’s important that we continue to do everything we can to invest in facilities in small towns. I would point to Fort St. James, which I will admit I’m being envious of, because it’s a town of about 1,300 people and has had a renewed long-term-care facility with some beds added and now has 18 beds there. That’s a fantastic and amazing thing for that community.

In the meantime, as I’ve been speaking about in some of my previous answers, it is so important to support seniors, elders, living in homes and being able to stay at home as long as possible.

I’m really glad that the member mentioned the Williston Lake Elders Society. I haven’t had the privilege of meeting with them or meeting them yet, but I can imagine how tenacious they probably are, how deeply committed they are. What they do is represent one of the very best assets we have in rural communities, and that is people. That is the non-profit sector — these community organizations that are driven to help people.

[4:20 p.m.]

I recently was on Hornby Island and had a round table with the Hornby and Denman Island Community Health Society. As I listened to them and the initiatives that they are undertaking to care for seniors in their community — there’s no long-term-care facility there either — and the way they are helping people who are leaving the hospital in Comox Valley to return home, the supports and their vision around, for example, purchasing a home or being bequeathed a home to be able to provide respite care for people who are caregivers living with seniors in their homes…. It’s really inspiring.

That’s why supporting community-based seniors services is a very important thing to do, and it’s a priority of government that we are investing in.

I do want to talk about how community-based seniors services for rural areas, particularly, are really integral to the plan to support seniors aging in place. Of course, they provide seniors with a very broad range of different supports, from non-medical home supports and health promotion programs and services that really address the social determinants of health, be it, for example, access to nutritious food, access to transportation supports that enable people to get out of home.

These kinds of services really demonstrated their value through the rapid roll out that took place during the COVID-19 pandemic of the Safe Seniors, Strong Communities program and the support that that program and these organizations provide during climate emergencies, for example.

A modernized community-based seniors services service delivery model is being implemented in phases. That is work that’s actively underway. Better at Home is the flagship program that many people have heard of — the member is familiar with it, I believe — providing non-medical support to seniors. There are 97 Better at Home programs in B.C.

What’s also exciting about this, as the program takes shape and develops in a more concrete way, is the creation of 90-odd community collaboratives, bringing together these organizations to coordinate program delivery. Instead of one program here and there and there, the organizations come together and understand the services that each of them are delivering and can coordinate them in a much better and focused way.

Forty-five of these community collaboratives were established in the last fiscal, ‘24-25, and there are more to come. Mackenzie, specifically, as part of a Mackenzie–McBride–Prince George collaborative, is being stood up. So that’s on the list for implementation.

These collaboratives have a community connector position that supports each collaborative and helps to coordinate care for at-risk seniors, in particular, to coordinate care with health authorities, to strengthen those partnerships within the community to really be able to deliver the best services possible.

Budget 2024 is where you can find the funding line for that. That was $127 million over three years to modernize community-based senior support services and expand and improve services and stabilize the workforce.

I hope that gives a little bit of insight We’re going to continue, obviously, to invest in home health and continue to expand community-based senior services support. I hope to have a lot more to say on that relatively soon.

In closing, I want to acknowledge the challenges that rural communities face with the economies of scale in having a full-blown long-term-care facility. That’s why it’s an achievement for Fort St. James to have the facility that they do and then to see facilities throughout the North. It is difficult. The geographical distances in the North really provide, I think, the impetus for us all to think very creatively and innovatively and to help build really strong, resilient communities where people support each other despite their political differences or their backgrounds.

We had a lot of very heartening stories during the pandemic, and we see it during climate disasters and emergencies, for example, of the way that people come together. I know that in my riding, I’m incredibly inspired by the Denman and Hornby Island Community Health Care Society, and it sounds like the member is equally inspired by the Williston seniors group.

I appreciate the opportunity to be able to talk about this during estimates.

I think, with that, that was the member’s last question. I’m going to ask for a ten-minute recess. Yes, I’m getting fingers up from the other side too.

The Chair: Okay, we’ll take a ten-minute recess. It’s 4:24, so we’ll see you back in ten minutes.

The committee recessed from 4:24 p.m. to 4:34 p.m.

[Mable Elmore in the chair.]

The Chair: Okay. I’ll call the committee back to order.

We are undertaking consideration of estimates for the Ministry of Health.

Recognizing the member for North Island.

[4:35 p.m.]

Anna Kindy: Thanks for the opportunity, Chair.

Just a quick note when I’m starting. I want to talk about the Medicare Protection Act from 1996. There’s a preamble and some of the principles of the Medicare Protection Act. I’m just going to pull out a few words just to give us context of how we’re doing: accessibility, sustainability, individual choice, transparency, accountability, reasonable access to medically necessary service, responsive to patients, value for money, fiscally sustainable health care system, individual access to necessary medical care solely based on need. That’s sort of the baseline of what we’re trying to achieve together.

I also want to put the context, as well, of our fiscal situation, because that does impact health care. In 2017, we had a surplus, and 2024-25 went up to $10.4 billion of debt. We’re up to $133 billion as of 2024, and projected is $208 billion. That’s without including the carbon tax, which will add $3 billion per year. And also on that we have to pay interest, which, if I recall, goes from $4 billion to about $6 billion in 2028.

Those are moneys that we don’t have, and it’s going to impact in terms of the contingency fund for health care. I just want to give that context to sort of see where we’re at, because we always have to begin with that when we start, I personally think.

With that in mind, this is a friendly question to the Minister of Health: what is the salary of the Minister of Health, translated to hourly wages, I mean number of hours that the Minister of Health works, and including the constituency office work?

[4:40 p.m.]

Hon. Josie Osborne: Welcome to my Health critic, the MLA for North Island. It’s good to be here, and I look forward to the questions over the next few hours.

Thank you for the question. I will state that compensation of MLAs in this House is, I would say, more a matter for the Minister of Finance. It’s not specific to the Ministry of Health. All remuneration is defined under the Members’ Remuneration and Pensions Act, where the base salary for an MLA right now is $118,532.72. Then, pursuant to that act, members who hold ministerial office or other offices do receive additional salaries. In the case of any cabinet minister, that is 50 percent.

Other questions of that nature, probably, are best directed to the Ministry of Finance.

Anna Kindy: My point to the question is that I think it’s a huge job and dramatically underpaid, and I just want people out there to know that.

Now going to the Ministry of Health…. The funding from the Ministry of Health to the B.C. Health Authority has increased from $12.3 billion in 2017 to $22.1 billion in 2024, an 80 percent increase, while the corporate expenditure has increased from $1.2 billion to $3 billion, so 140 percent. This is telling me that during a time of health care crisis, we’ve increased the spending for administrations over the front line….

The Provincial Health Services Authority saw an increase of corporate expenditure of 322 percent in that same time frame, from $283 million to $1.2 billion. If we look at comparing, for example, to Germany…. I’m just going to compare Canada to Germany and Alberta to B.C.

B.C. spends two times more on health administrators than Alberta, $350 million versus $180 million, according to an independent Canadian institute. I think we need to start looking outside our borders, just to improve our health care.

So if we look at Germany, Germany has one health administrator for — I’m going to round it out — 15,500 citizens, and Canada has one health administrator for 1,400 citizens. Basically, Canada has 11 times the health administrators that Germany does.

I know the minister is addressing this issue. In a sense, Penny Ballem has recently been hired. She stepped out of her role as a board chair, and she was a board chair at Vancouver Coastal Health from 2019 to 2025. We have to recall that during those years is when the health expenditure increased and the administration increased. She’s also a political insider.

My question to the minister…. And I think it’s an important question. Have you ever considered an independent, non-biased investigator for this review so vital for the fiscal success of health care delivery in B.C.?

[4:45 p.m.]

Hon. Josie Osborne: Thank you to the member opposite for the question.

I want to start out by addressing some of the mandates that the Premier has given to all cabinet ministers in his cabinet and the progress that he expects us to make over the mandate, specifically around protecting key services that British Columbians rely on. He has instructed every cabinet minister to work with the Minister of Finance to review all — in my case, Ministry of Health — programs and initiatives to ensure that programs support the health of British Columbians while keeping costs manageable. This is important in the context of current provincial budget constraints and our growing and aging population and emerging technologies.

Further, my mandate letter directs me to make progress in tackling the training, recruitment, retention and system redesign that’s needed to make sure our health human resources keep pace with the growing needs of people in B.C. and deliver better, faster care.

Now, we’ve been talking throughout the estimates process here about some of those measures and programs and initiatives that the Ministry of Health is taking. I think, especially in light of Trump’s unjustified tariffs, now more than ever is a time to protect those core services that British Columbians depend on, to ensure that we are working to strengthen our universal public health care system and ensure people have access to the health care that they need and deserve.

We’ve talked about a number of different challenges that we’re facing in the context of a global health care worker shortage, the challenges in delivering services in rural communities, for example, and needing to provide more equitable access for health care throughout British Columbia. Part of this work in ensuring that we are making the best use of investments into the health care system means that we are accommodating the needs of an aging and growing population.

As the member knows, the Ministry of Health has received a $4.2 billion lift over the next three years to ensure that that caseload growth, the growing population, is accounted for. But it’s incumbent on me and incumbent on our cabinet and this government to continue to do everything we can in reviewing programs and services to ensure that we are getting the best value for the investments that we’re making.

[4:50 p.m.]

Indeed, over my political career as the minister of four different ministries and, previously, as a mayor of a small town, that very much has been part of the drive, ensuring that the best use of precious public taxpayer dollars is being invested into the supports that people need and, at the same time, taking the steps that we’ve been talking a lot about in this House around growing and diversifying our economy, making sure that the assets and resources of British Columbia, both natural resources and the people of British Columbia, are being used and being harnessed in a way that supports an equitable society and provides those services and opportunities for all.

Part of the work that we’ve initiated in the Ministry of Health, of course, is undertaking a review of the Provincial Health Services Authority. I’ve spoken about that, and my mandate letter is very clear that we will not only undertake that review but also of the regional health authorities.

Again, the intention here is to really ensure that we are minimizing any unnecessary administrative expenditures and making sure that those are reprofiled and allocated to the front line, so delivering that direct health care that people depend on.

B.C.’s corporate services expense ratio — now, this measures administrative spending as a percentage of total health sector spending — was 3.5 percent, based on the latest calculations. That is the second lowest in Canada, behind one other major province. I say that to point out that it’s important to measure that, to monitor that, but it’s not a reason to not take that close look, which we are doing through program reviews and through the health authority reviews.

Now, as the member also indicated, Dr. Ballem has moved out of her role as the chair of Vancouver Coastal Health, and she’s moved in as the interim CEO of the Provincial Health Services Authority to be leading the review and working with an independent team. So there is an independent team of consultants whose expertise is in exactly this kind of work, and they are supporting Dr. Ballem and the program review team that’s been assembled by the Ministry of Health.

Dr. Ballem has my full confidence. She has been active in the health care sector for 35 years and held a number of sequential roles in management, in local government, in the health care sector and, as a deputy minister in a Gordon Campbell government, I’ll say, so not a B.C. NDP government, was responsible for overseeing the creation of the Provincial Health Services Authority in the first place.

Now, that was over 20 years ago, and so it is high time that the Health Services Authority had that review and that we are able to take a very thorough, careful look at the kinds of roles and responsibilities that are articulated as part of the health authority, looking at administrative spending, the different structures inside the PHSA and ensuring, again, that we’re minimizing administrative spending, putting those resources out on the front line.

I look forward to her recommendations, and I certainly will say that Dr. Ballem does not shy away from speaking her mind, and she will always bring me recommendations alongside the team, I think, that she and the team see fit and think are appropriate and that it is up to us as government to make decisions about those implementation pieces.

Together with the board of the PHSA, together with the program review committee, the steering committee and the assistance of these independent consultants, we expect to see progress with the first report coming to me, the first update of how the authority’s review is being undertaken and the initial scope and services and what it’s going to look like. And I’ll be able to speak then, too, more concretely about some of the questions that have been asked around timelines and steps that are to be taken.

It’s also important to ensure that the voices of employees, the people who are on the front lines who are delivering these services, are part of that review, so establishing pathways and processes for them to bring ideas forward and to share their experiences. Certainly, over the last four-odd months that I’ve been the Minister of Health, I have had the opportunity to hear from many, many different front-line workers, as I’m sure the member opposite has too. I know she takes her role as Health critic very seriously and is doing that work really diligently.

I hope that that helps to answer some of the questions from the member opposite, and I look forward to more dialogue.

[4:55 p.m.]

Anna Kindy: To the minister, I’m sort of glad you talked about global shortages. Because if we, again, compare apples to apples or apples to oranges or whatever, in terms of the OECD, which are 31 countries with universal health care — we’re talking Europe, Australia and New Zealand — we rank, in terms of number of physicians, 28th out of 30. So I think we can probably do better.

I think the global comparison is a good one because I think we need to start moving our health care towards a global comparison.

My question, and it comes out a little bit to what you’ve been talking about, Minister…. Two things. I’m going to ask two quick questions. As you review, I imagine, there’s accountability to running a health authority — meaning, if people do well, there’s a compensation somehow. If you don’t do well, there isn’t.

The two questions I have: are there any accountability measures in the contract of any of the people working in the health authority? It seems like there’s…. We were talking about Penny Ballem. She was in Vancouver Coastal as board chair from 2019 to 2025. We know from 2019 to 2025 the Vancouver Coastal Health, in terms of expenditure, went down, and their parameters actually worsened in terms of health care. So I’m wondering about accountability measures to the contract.

The other question is…. You talked about getting input from the front line. I know for a fact people in the front line and also in positions of leadership in hospitals seem to be afraid of talking, or they’re reprimanded for speaking out. I’ve got knowledge of that happening, so I’m wondering. Is there a non-disclosure as well with a health authority contract that adds to the censorship happening on the ground?

[5:00 p.m.]

Hon. Josie Osborne: Thank you to the member for the question and a discussion around accountability and measures in place and the health authorities.

I’m going to take a little bit of time just to describe the health authorities and the boards and chairs and the relationship that I have as the Minister of Health. The member mentioned specifically around non-disclosure — I have a lot to say on that.

First of all, as the member knows, the health authorities have been established under the auspices of the Health Authorities Act, and that really lays out a lot of the roles and responsibilities for the health authorities. I’d be very pleased to arrange for a detailed briefing for the member around the Health Authorities Act, if that’s something that’s of interest to her.

The board is appointed by the minister through ministerial orders. It is my expectation that the boards and their chairperson will always be acting in the best interests of people first and foremost in delivering the highest quality health care for people and also being responsive to government and government’s priorities.

[5:05 p.m.]

The relationship that I, as the Minister of Health, have with each of these health authority boards and their chairs in particular is incredibly important. I take those relationships very seriously and meet with board chairs on at least a monthly basis, with conversations in between. Having laid out my expectations there and building an understanding and a relationship between me, as the new Minister of Health, and them is incredibly important.

The boards are provided with mandate letters so that it is clear, as well, around government’s expectations of health authorities and their ability to deliver. I know in the initiation of the Provincial Health Services Authority review, for example, and in discussions with the health authorities and their board chairs that the participation of the boards in these reviews is also an incredibly important exercise.

They have responsibilities as boards around governance and the fiduciary obligations. I know that they take them very seriously. There’s a vetting process that is in place for selecting board members. It’s important, over the years as various Health ministers have appointed members to these boards, that people come from a variety of backgrounds and expertise for the most well-rounded board possible and ensuring that the voices of patients and community members are heard, as well, in addition to the skills and expertise that board members bring.

With respect to non-disclosure, I want to be very, very clear that no employee of a health authority should ever fear reprisal in bringing forward concerns that they have and that the input of employees at every level of an organization, be it a health authority or the Ministry of Health, these voices are valuable.

People feel a very big responsibility and understand that they are in positions of responsibility to do their very best in delivering health care services for people. I would expect nothing less than for matters to be brought forward and to be dealt with fairly, in the right time, respectfully, urgently and in accordance with any legislation and policy that guides that.

This government was the government that brought in the Public Interest Disclosure Act that came into force in December 2019 for government ministries and independent offices of the legislature to allow for confidential disclosures of serious wrongdoing that affect the public interest by employees of public sector organizations. The act protects employees who report concerns or participate in investigations from reprisal, such as demotion or termination, ensuring that employees under investigation are treated fairly. That is of utmost importance.

It applies to wrongdoings in or relating to a ministry, a government body or office and includes wrongdoings that occurred before the coming into force of the act.

The types of wrongdoings that it includes are: a serious act or omission that, if proven, would constitute an offence under an enactment of British Columbia or Canada; an act or omission that creates a substantial and specific danger to the life, health or safety of persons or to the environment, other than a danger that is inherent in the performance of an employee’s duties or functions; a serious misuse of public funds or public assets; gross or systemic mismanagement; and knowingly directing or counselling a person to commit a wrongdoing such as I have just described.

The public sector organizations, including health authorities and agencies, boards and commissions, were brought under the Public Interest Disclosure Act in a phased approach between April 2022 and June 2024. The organizations have specific obligations under this act, and that includes appointing one or more designated officers to receive reports, developing procedures for managing reports of wrongdoing, reporting annually about reports of wrongdoing in investigations and ensuring that staff are well informed about the act, including how to make an act of wrongdoing both internally to the organization and also to the Ombudsperson.

This is something that we take, and I certainly take, incredibly seriously, as I know the health authority boards do, as well as leadership in the Ministry of Health. It is my expectation, and I hope that does help to clarify the concerns and the questions that the member brought forward. I appreciate that question.

With respect to…. I haven’t gotten into and I won’t, unless asked, perhaps, but around the interests and rights of patients and the avenues that patients have to bring forward their concerns of patient care and quality, there is a rigorous system in place for that, as well, which I’d be pleased to talk about further.

[5:10 p.m.]

Anna Kindy: I want to thank the minister for that answer. As the minister has stated, a front-line health worker that is advocating for better care should not be reprimanded. So that’s fantastic to hear.

My next question is related to Doctors of B.C. They’ve been doing a health authority engagement survey report. The 2024 report is pending, if it’s going to happen, but I’ve got the 2023 report, which is the last one available. I’m going to just quote here from a physician that was quoted during the report: “We are prevented from speaking up or communicating frankly with patients about working conditions or the reasons for the long ER wait times as the health authority has previously threatened a response to the college.”

They’ve been doing this engagement report for the last eight years, and the average score for engagement questions has been trending down. The lowest was Vancouver Island Health Authority at 25 percent, and the highest was Vancouver Coastal at 42 percent. Of note is…. The question was: “Senior leaders seek physicians’ input when setting health authority goals.” The average was 19 percent. “This health authority values physicians’ contributions” was at 26 percent. “Physicians and medical leaders trust one another in my health authority” was at 33 percent. These are dismal, actually. I think we need to address that.

I’m going to ask the same question, in a sense, but I want something a little bit more concrete. What is the Minister of Health and the health authority’s plan to increase front-line engagement and reduce the fear of repercussion for speaking out? I think you’ve answered that, so I’ll move on.

One consideration would be regional elections for board members as opposed to appointments. I think maybe having half the board members coming from the front line somehow would be a very good accountability measure, so that would be a suggestion I would have here. Just wondering if the minister would take that into consideration.

[5:15 p.m.]

Hon. Josie Osborne: I’ll keep my answer quite short this time. First of all, I just want to say thank you to the member for the suggestion. I think, probably, if she’s interested, having a briefing of the Health Authorities Act and then reviewing the governance with the staff would be really helpful and a bit of a deeper discussion there.

I also want to point out, though, that part of the Provincial Health Services Authority review is an examination of its governance.

Again, I really appreciate the suggestion from the member.

Anna Kindy: Just wondering, in terms of efficiency of time for review of the health authorities, why are we just reviewing the PHSA as opposed to reviewing all the health authorities? We all know they have issues. I don’t see the strategy of reviewing one when we should be reviewing all when there is a health care crisis.

Hon. Josie Osborne: Thank you for the question. The intention is to review all of the health authorities, and that is clearly stated in my mandate letter from the Premier.

We chose to start with the Provincial Health Services Authority because of the provincial nature of that organization and the services and programs that it provides and the way they touch all British Columbians in all corners and communities, large and small — from providing direct services through facilities like Children’s Hospital and Women’s Hospital but also through their work with the B.C. emergency health services, B.C. Cancer, the B.C. Centre for Disease Control.

It makes sense to look first at a provincial organization with the kind of reach that it has, but the regional health authority reviews will form an important part of this. It wouldn’t make sense to complete a PHSA review without also initiating the regional health authority reviews in time, because as the recommendations come forward, there are a lot of dovetailing and opportunities there.

I’ll point to some of the shared services that regional health authorities already have and how they dovetail with the PHSA around things like procurement, information technology and lab services. That is, I think, a logical sequence of events, and those regional health authority reviews will be initiated in relatively short order.

But we’ll get underway with the PHSA review first. That will guide us in certain directions and, I think, give a lot of insight into the health authority reviews. Then, also, in the reverse, the results of the health authority reviews will provide a lot of guidance and insight into changes that may be made at the PHSA.

[5:20 p.m.]

Anna Kindy: I’m going to move on, but I just want to comment, because there is an engagement problem. Right now, as it’s structured, I’m not foreseeing changes happening, unless there’s true engagement with the front lines. I’m just hoping the minister hears this loud and clear.

I’d like to move forward to the Health Professions and Occupations Act. I’m just giving a little preamble here; this was one of the biggest bills ever passed in B.C. — 276 pages, 645 sections. It was passed without proper consultation — something that we’re becoming known for in this province. The Doctors of B.C. were given a two-week period over Christmas, and they got 56 responses, out of 14,000 doctors. It was also improperly passed, by this government invoking closure, when only 223 of the 645 sections had been reviewed and debated.

This bill, as big as it is, does not contain any measures to respect, protect or ensure the rights to deliver or receive health care that is timely, personalized, confidential and consent-based. It establishes two new offices, the discipline tribunal and the superintendent’s office, all appointed by the government, reducing self-regulation — again, government taking over.

The health colleges are reduced from 16 to six, with board members all appointed by the minister. Just to give context, previously to that, with the College of Physicians and Surgeons, half of the board members were elected and half appointed, and it seemed to work quite well.

I’m going to ask a question. What is the evidence that it was and is necessary or beneficial to health and safety? We’re abolishing a democratic governance of health professions and occupations and imposing governance by political appointees not required by law to be competent or accountable. It also authorizes the Minister of Health to make appointments of people without notice, consultation or oversight by the public, by the health care workers or by the Legislative Assembly.

Again, from these two points, what is the evidence that it was and is necessary or beneficial to health and safety to pass this bill?

[Lorne Doerkson in the chair.]

[5:25 p.m. - 5:30 p.m.]

The Chair: Minister of Health.

Hon. Josie Osborne: Thank you very much. Welcome back to the chair, Mr. Chair. Nice to see you again.

Thank you to the member for the question. I’m going to start out with some general comments and then provide a level of detail so that we all have the same understanding of the sequence of events that took place leading to the passing of this act. I will start out by saying it’s quite possible that the member and I will disagree on some matters, and I understand that and respect that, and that’s part of the estimates debate process.

But, first of all, I want to emphasize that in no way did this government undertake this act on a whim, that there is a sequence of events — and I will go through that — that led us to this place and that, first and foremost, we remain committed to ensuring that regulatory colleges always are acting in the public interest. The regulatory colleges are resourced to do the work that they need to do, and the changes made under this act provide a real opportunity to modernize the regulatory framework for health professions here in B.C.

We are the first province to undertake this degree of concerted effort and action to address concerns that were brought forward by both the public and by professionals. I do understand that there are some individuals who disagree, even vehemently disagree, but there are a great number of others who have been incredibly supportive of this work.

I want to go back to 2016 and the initiation of this effort that took place. I’ll recognize that this is in a previous government of a different political stripe. Now, at that time, the College of Dental Surgeons of B.C. held board elections, and a self-declared slate of six candidates stood with the intention of replacing the then president, the registrar, and bringing the then registrar under control while also committing to take back the college for the profession.

From 2016 to 2018, ministry staff and a consultant — again, recognize that this passed through two different governments from 2016 to 2018 — made numerous efforts to help the college board understand its legal mandate to protect the public. That included doing numerous full-day governance 101 sessions and getting the minister at the time to have dialogue with the chair, and none of this seemed to make a significant difference. But, in the meantime, the Health ministry continued to receive numerous complaints from the public.

In March of 2018, five new public members were appointed to the College of Dental Surgeons of B.C. board to try to stabilize the board and get them very focused on patient safety. This increased the board’s public members from 33 percent to 50 percent. At the same time, the Minister of Health also announced that he would appoint Harry Cayton to do an inquiry into the college as well as review the framework for professional regulation in the province.

I just want to pause here and note that Harry Cayton is the former CEO of the Professional Standards Authority of the United Kingdom and that he’s an incredibly well-respected leader in regulatory frameworks worldwide.

[5:35 p.m.]

In September 2018, the minister appointed Mr. Cayton under section 18.1 of the Health Professions Act to inquire into the college, and this really confirmed that the minister felt it was necessary to take this step and to do this in the public interest.

In April 2019, the following spring, the minister released the Harry Cayton report titled An Inquiry into the Performance of the College of Dental Surgeons of British Columbia and the Health Professions Act. It included 21 recommendations for the college to help make sure that it was acting in the public’s best interests. All of the recommendations were accepted, and the Health Minister directed the College of Dental Surgeons of B.C. to bring forward an implementation plan within 30 days, which the college completed.

From May 9, 2019, through to June 14, 2019, a consultation on the Harry Cayton report took place. There were over 300 written submissions received from a very broad cross-section of respondents, including approximately 190 members of the public, 50 health practitioners, 25 professional associations, 18 regulators and 30 other health sector stakeholders.

In May 2019, the same year, a steering committee was struck on the modernization of health professional regulation. This was led and formed by the then Minister of Health, and he did so alongside the two other parties in this Legislature: Norm Letnick, who at the time was Health critic of the official opposition, and Sonia Furstenau, who was the Health critic and House Leader of the Third Party. It was noted at this time that this was a non-partisan issue, that it was important for these three leaders from the three different parties to come together.

In November 2019, the steering committee released a consultation paper seeking public input on their proposal, Modernizing the Provincial Health Profession Regulatory Framework: a Paper for Consultation. Then from November through to January 2020, consultation on the paper and the survey was completed. Close to 4,000 people responded to the survey, and the Ministry of Health received over 300 written submissions. The survey had close to 70 percent of its responses from people who identified as health professionals.

It showed a number of things, but one thing I will note is that 92 percent of the respondents indicated that ensuring regulatory college boards are composed of members appointed on merit and competence was important or very important.

In August 2020, based on feedback from the consultation, the multiparty steering committee released its recommendations report to modernize the province’s health profession regulatory system and taking the next step to ensure that patient safety and improved transparency was at its forefront, leading us to the development of the act and to today.

I want to, again, just reiterate that this all stems from the need to ensure that, first and foremost, regulatory colleges are always acting in the public interest. Then in specific response to the appointments to colleges, the Minister of Health makes the appointments, but these are based on recommendations that come forward from an independent superintendent who undertakes that process, looking at merit and competence, and brings that forward.

The purpose here is to depoliticize on both sides — to depoliticize from membership of colleges, to depoliticize from political appointments made by governments. That is the development of how this act came into being and why it is important and why government will continue to carry forward with it.

Anna Kindy: I’m just going to take your last statement and move backwards, Minister.

The independent superintendent is Sherri Young, I believe — a career bureaucrat with no disclosed education in medicine, health or law.

Now, when we’re talking about the HPOA, we’re talking about all of health care. We’re talking about nurses, doctors, dentists, hygienists, massage therapists, physios — all of health care.

[5:40 p.m.]

You’re stating input from 300 people, 50 of which were identified as health care workers. I wouldn’t call that consultation.

This seems to be a repeated pattern. We’ve seen it with the health authorities and their engagement with the front lines, which is completely lacking and of censorship. And now we have the HPOA. To be fair to the minister, I did ask a question that wasn’t answered, but I’ll go to my next one anyhow. I asked what was the evidence that it was and is necessary or beneficial to health and safety.

The other point I want to make is…. The HPOA was years in the making. Consultation was minimal. It completely changed the parameters of how regulation was done. It’s a bit of an insult to mention that physicians should be regarded, really, with this bill, as potentially presenting “risk of harm to the public” — i.e., considered potential felons.

I’m going to go on to the next question. Hopefully we’ll get an answer with this one. Just to again give context, when this bill….

I’m new to politics, and I have to say that politicians are extremely busy. That was the premise of my first question — extremely busy, seven days a week, I would say, trying to keep up with emails and new bills and all the rest. This bill was one of the biggest bills ever passed in B.C. It was this thick, and for me…. I don’t quite understand how any MLA could have read this bill in a period of two weeks and come to any conclusion as to if it was a good bill to actually pass or not. I have to say that here.

My next question is, and again, I hope I get an answer: what is the evidence that it was and is necessary or beneficial to health and safety to delegate law-making powers to political appointees whose decisions will not be subject to appeal — i.e., challenge to the decision itself but only to a review of the legality of a decision-making process? Also, it shields appointees from accountability and prevents or restricts remedies for violations by appointees.

[5:45 p.m.]

Hon. Josie Osborne: I’ll just go back to a couple of the comments I made in the last answer around the evidence that was provided through public complaints that were received and through the work that Harry Cayton did in his report.

[5:50 p.m.]

Again, his report was looking really at three major objectives here around improving patient safety and public protection, improving the efficiency and effectiveness of the regulatory framework, increasing public confidence through transparency and accountability, and the work that was then undertaken by a non-partisan committee of legislative members to, again, review that and come up with their own report and recommendations.

Now, the member talks about 50 individuals providing feedback and that not being sufficient in her perspective. But I would point out that the 25 professional associations that provided feedback did so on behalf of their membership, so I think that gives a much broader voice to the health professionals who had their input into the act.

I’ll just come back to the initial action that inspired this or really led to this. When the College of Dental Surgeons of B.C. held their board elections and had a self-declared slate of six candidates standing with the explicit intention of replacing the registrar and bringing the registrar under control and committing to take the college back, that, I think, really opened up the possibility and the need to address this and to depoliticize this.

Again, regulatory colleges exist to protect first and foremost the public interest, setting the standards of entry into the profession of what safe and competent and ethical care is, receiving concerns, receiving complaints, having a disciplinary process in place and, again, acting first and foremost in the public interest. This is that intersection of politics and electoral politics and the need for objective standards that are developed in a way that protects first and foremost that public interest.

In the case of health care, of course, that is what we depend on health care professionals to do — to deliver safe, competent, ethical care for people, that we know and can trust where people are trained, how they are trained, how they are certified and come into a profession and are licensed to practice in British Columbia. That always has to be at the centre of this. The patient, the people, have to be at the centre of this.

Again, as I commented, I know that the member and I are not going to agree on all aspects of this, but I think that I’ve provided a thorough background. I would point the member into the Harry Cayton report itself to review the evidence that he also received and reviewed and point to his extensive experience in regulatory frameworks around the world and having been a key person in helping develop those recommendations that then came forward, expressed in the legislation as was presented to this Legislature.

Anna Kindy: To the minister, I asked for evidence, and Cayton did not provide the evidence that all these measures are necessary for health and safety. So if you report back to Mr. Cayton, this does not answer my question. He did not provide the evidence.

You mentioned about depoliticizing, right? Let me, again, give you context. Physicians are busy, and obviously, that two-week period, nobody was aware. When you get 56 responses out of 14,000, that’s not what we call consultation.

But physicians did become aware. As busy as they were…. Because there were so many emails sent to Doctors of B.C. regarding concerns about the HPOA, they had a Zoom in-service, I would call it, with two bureaucrats, health bureaucrats, to talk about the HPOA.

The bureaucrats gave sort of a superficial talk about the HPOA without going into the details of it. The 400 doctors, through the whole whatever it was, I can’t remember, half hour, continually asked questions, hard questions, expecting answers. To this day, there have been no answers.

I would argue, as well, that when you look at physicians as prospective felons…. We’re looking at a manpower issue, and the HPOA has driven some doctors away from B.C., and some doctors have retired early because of it.

[5:55 p.m.]

My next question regarding the HPOA, and it will probably be my last…. Again, hopefully we get an answer. We haven’t had an answer so far, and I will reiterate, going back to Cayton’s report does not provide answers to my questions.

What is the evidence that it was and is necessary or beneficial to health and safety to authorize adoption as law in B.C. of any law, made anywhere, by any state and any rule, adopted by any organization, anywhere?

What is the evidence that it was and is necessary or beneficial to health and safety to create acts of misconduct and criminal offences that violate the principles of legality and predictability? An example of that: providing false or misleading information to patients or the public is both an act of misconduct and a criminal offence.

I may add, who decides what is misinformation? Makes rules regarding informed consent, ethical standards, what health care services can be provided by who, to whom and in what location? Empowers appointees to mandate vaccination for transmittable disease as a condition of licensing and employment?

And we have to remember, this is all done by appointees without input from the front line, since there is no democratic process whatsoever in this bill.

[6:00 p.m.]

Hon. Josie Osborne: At the heart of this is the issue of public trust in health care professionals. Health care professionals — particularly physicians, but others too — are in positions of power and authority. They have extensive training that they undertake. British Columbians entrust their lives to professionals each and every day, not only the care of our own selves but the care of the people that we love. That’s why it’s important, always, that a patient’s interests are at the heart of this and that public interest remains paramount.

The tools provided in this act, and the consequences that the member is highlighting, are not an aspersion of all professionals or of any profession that they participate in. Instead, what this is about is, sadly, acknowledging that things happen that need to be dealt with.

[6:05 p.m.]

We need tools to go after those people who do not meet the standards of competent and safe and professional care, ethical care, that British Columbians deserve. Having those tools that are applied in a consistent and fair manner, doing everything that can be taken to depoliticize those processes, is absolutely important.

An elected board of members of its own profession, responsible for providing disciplinary decisions for its own profession, is not able to act in the best interests of the public in a way that would meet the expectations of British Columbians. Again, that’s really what is at the heart of this act.

Undertaking the advice of a well-respected professional in this field, who undertook an extensive report and undertook engagement, having a multiparty committee come together in a non-partisan way to come up with recommendations and then take their consultation report out and having almost 4,000 responses to that, 2,800 of which — almost 70 percent — were health professionals themselves….

This is not something that the public of British Columbia made up to express issues with. These were issues that came forward from health professionals themselves. Trust is at the heart of the delivery of health care — the relationship between the patient and the provider. Ensuring that health care is delivered in that safe, ethical, competent manner, ensuring that the processes that are in place protect the health care provider as well as the recipient, the patient, is of utmost importance.

I know that the member and I aren’t going to agree on everything, but this is an act that has had support, support that has come forward through every stage of its development to address serious issues that have been identified by both members of the public and health care professionals themselves. It makes changes that will make our health care system stronger and will enable the public to continue to have the confidence and trust in the system and in health care professionals that they deserve to have. It’s an act that I am glad that this Legislature passed.

Anna Kindy: I still haven’t had the answer. What is the evidence that it’s keeping people in B.C. healthier and safer?

But what I did hear was that health care workers are not competent to be objective in the protection of the public. Appointees are, but front-line health care workers are not. And I think that is why none of the other provinces are doing what we’re doing. It’s because you need context, and you need the outlook of a front-line health care worker.

I would argue that if the positions were all elected, you’d be right. I think there needs to be a balance, and we did have that balance, where half were appointed and half were elected. That balance has been removed, and to me, it’s government overreach, which makes people less safe.

I’m just going to ask one more, last question on this. What are the costs to date and the anticipated costs of amalgamation? Will these costs, or any of them, be billed to licensed health professionals and health occupations? What are the anticipated annual operation costs of the HPOA, and who will pay those costs?

[6:10 p.m. – 6:15 p.m.]

Hon. Josie Osborne: Thank you to the member for the question. I’m just going to run through the amalgamation of the colleges and then who bore the costs and what they were. Then I’ll talk about the annual operations budget like the member asked.

In 2018, first of all, the three nursing colleges came together, and the cost of that was borne by the colleges themselves, using the resources that they had.

In 2020, the College of Physicians and Surgeons and the college of podiatrists came together. Again, the costs were borne by the colleges themselves, although they were largely borne by the College of Physicians and Surgeons, because the low membership of the college of podiatrists prevented them from having sufficient funds.

In 2019, the three nursing colleges, also, then amalgamated with the College of Midwives. Again, the costs were borne by the college.

In 2022, the oral health college was formed as an amalgamation of dentists, dental hygienists, dental technicians, dental therapists, dental assistants and denturists. Again, the costs were borne by the colleges.

In 2024, the final two colleges came together. The first was the complementary college of massage, naturopaths, chiropractors and traditional Chinese medicine and acupuncturists. The second college that came together was the health and care professionals college with physiotherapists, occupational therapists, dietitians, optometrists, opticians, speech and hearing professionals and psychologists. Now, those two colleges were an amalgamation of very small colleges that didn’t have sufficient resources to undertake that work. So government provided a total of $5.2 million to enable that work to occur.

Then, with respect to the office itself and the independent superintendent…. Establishing that college in the first year, 2023-2024, budgeted for just under $2.5 million…. Then, as the superintendent’s office hires the staff that it needs, the annual budget is projected to rise to just under $7 million or around $7 million per year. That is funding that will be managed through the existing Ministry of Health funding envelope.

Anna Kindy: So as I’m hearing it, the colleges are bearing the brunt of the cost. Does that mean that the health care workers are? As far as I know, dues are paid by the health care workers. Is that what I’m hearing correctly?

[6:20 p.m.]

Hon. Josie Osborne: It’s important, I think, to note…. I spoke first about the three nursing colleges that came together in 2018. That was actually an initiative that the colleges undertook themselves because they recognized the economies of scale there. Rather than having three boards and three registrars and three disciplinary committees that they needed to operate, they took the decision to amalgamate.

Yes, the costs were borne by the colleges, and to the member’s point, colleges are funded primarily through membership dues. As I pointed out, the last two amalgamations that took place in 2024 — those colleges were so small and, in some cases…. In the other amalgamations as well…. For example, the podiatrists, with 77 members, simply did not have the funds themselves, so working with the other colleges with which they amalgamated, they used the resources that they had to undertake those amalgamations.

With the final two, the complementary and the health and care professionals colleges, coming together with some government assistance because they were not able to do that….

Hopefully that answers the questions. I know we’ve canvassed a lot today, and I appreciate the member’s submissions and questions.

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

Motion approved.

The Chair: This committee stands adjourned.

The committee rose at 6:22 p.m.

The House resumed at 6:22 p.m.

[The Speaker in the chair.]

Lorne Doerkson: Committee of Supply, Section B, reports progress of the estimates of the Ministry of Health and asks leave to sit again.

Leave granted.

George Anderson: Committee of Supply, Section A, reports resolution and completion of the estimates of the Ministry of Post-Secondary Education and Future Skills and reports progress on the Ministry of Environment and Parks and asks leave to sit again.

Leave granted.

Hon. Spencer Chandra Herbert moved adjournment of the House.

Motion approved.

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

The House adjourned at 6:23 p.m.