The House met at 1:33 p.m.

[The Speaker in the chair.]

Routine Business

Prayers and reflections: Ward Stamer.

[1:35 p.m.]

Introductions by Members

Hon. Jennifer Whiteside: How lucky are we today. It’s another New Westie day today. It is such a pleasure for me to introduce a whole team from New Westminster who are here advocating on education issues.

I think it’s unique, because I think this is the first time that we’ve had representatives from the whole sector coming together. We have Maya Russell, from the New Westminster school board; Cheryl Sluis, the vice-chair of the New Westminster school board; Karrie Andrews, the president of CUPE 409; Laura Kwong, New Westminster DPAC chair; Mark Davidson, the superintendent of New West schools; Kristie Oxley, the president of the New West teachers union; Ken Millard, president of the New Westminster principals and vice-principals association.

I just have to say that I am personally so impressed and grateful all the time for their extraordinary advocacy for kids in New Westminster. I have one more introduction after this, but if the House would please join me in making folks from education in the New West very welcome to the House.

As if that wasn’t fabulous enough, I also just want to give a pre-welcome to the New Westminster students from École Glenbrook Middle School, grades 7 and 8, who are on the precinct and who will be in the gallery this afternoon.

I’m so grateful to the staff who have accompanied them here today, grateful for the weather. Would the House please join me in welcoming the students from École Glenbrook as well.

Steve Kooner: Today we have some representatives from Gurdwara Sahib Sukh Sagar who are in the gallery today, from Queensborough–New Westminster. They include Sukninder Singh Senghar, treasurer and acting president; Jagjit Singh Sal, secretary; and Senthok Singh Sal, senior volunteer group member. Please make them all welcome.

Hon. Christine Boyle: I have two introductions I’d like to make today. The first I made yesterday mistakenly. They have joined us today, so I want to again ask the House to join me in welcoming, in the gallery, leadership from Doig River First Nation, including Chief Trevor Makadahay, Councillors Justin Davis and Starr Acko, as well as Shona Nelson. I’m looking to make sure they’re here, but maybe I can’t see them.

I had the pleasure of meeting with Chief Makadahay and team yesterday as well as last week. I also again will mention that Doig River is joined here today by someone familiar to this House, former MLA Dan Davies. I understand he received a number of text messages after I introduced him yesterday. He was, in fact, not here and was very confused by it.

I am glad to have all of them joining us here today. Will the House join me in making them feel welcome.

I have one more introduction, if you will allow. Joining us in the gallery today also from my riding of Vancouver–Little Mountain is my constituent Bobby MacDonald. Bobby is here representing Union Gospel Mission, an incredible organization with an 80-year history of serving our most vulnerable neighbours.

Bobby and the dedicated team at UGM work every day to meet people where they’re at, providing essential services such as supportive housing, nutritious meals and addiction recovery. My colleague next to me here wanted to make sure I mentioned that they are also providing incredible services in New West, Vancouver and across the region, as well as here in Victoria.

Will the House join me in thanking them for their work and welcoming Bobby in the House.

Harman Bhangu: I’d like you to give a warm welcome to my family that’s joining me here today. My wife, Courtney, who’s been a rock — a lot of us have our significant others; they play a key role for us to do our jobs in here; my daughter, Audriana, who will be turning five tomorrow; and my son, Bal. They’re having a blast here. Please give them a warm welcome.

[1:40 p.m.]

Hon. Josie Osborne: It’s my pleasure to introduce staff from the Heart and Stroke Foundation, along with some of their partners, volunteers and guests, who are all joining us in the gallery today. We met them earlier for lunch, members from across all sides of the House here, and learned a great deal about heart failure and how it affects the lives of over 137 British Columbians who are living with this diagnosis.

Now, that includes Mayor Doug Kobayashi from the city of Colwood, who shared his own personal journey and his work to improve health care access in his community.

It also included Dr. Nathaniel Hawkins from Vancouver Coastal Health, who shared the work that he is doing in research and driving change to lead to earlier diagnosis and care.

Would the House please join me in making them all feel very welcome today.

Statements

Vancouver Canucks

Korky Neufeld: Something that’s very close to all of our hearts is that the Vancouver Canucks made NHL history last night, and very few outlets picked it up. So here it is.

Last night, versus the Dallas Stars, they were down three goals in the last minute of the game, 5-2. In that last minute, they scored three goals — the first time in the NHL’s history. And then to top it off, they won in overtime.

Introductions by Members

Hon. Laanas / Tamara Davidson: My mother raised a strong woman, and I am very proud to say that I raised an even stronger woman. This is what we do as Indigenous women.

Today I’d like to have the House welcome my daughter Samantha, who is here on the precinct, wish her well today and hope that she is safe in this place.

Ian Paton: Today I can see in the gallery two of the most fun, well-known government relations people that are here all the time. I think there’s a B.C. Gaming luncheon tomorrow. So please welcome Shiera Stuart and Chuck Keeling.

And I’m sorry. There’s a gentleman in between them, but I welcome all three of you here today.

George Anderson: As we recognize the 108th anniversary of Vimy Ridge, I would like to recognize one of my constituents, Cierra Robinson, an elementary school student who placed second in the B.C.-Yukon Remembrance Day poster contest that was held by the Canadian Legion.

She placed first in her school, first in the district and first on the Island, second overall in B.C. But she says next time she’s going to get first for British Columbia.

So I would hope that the House would, essentially, say congratulations to Cierra for the great work that she’s done in remembering our veterans.

Bruce Banman: I have two introductions. The first one is quite quick and easy. That would be former MLA Dan Davies, who actually joins us. Would the House join me in making him feel welcome.

Secondly, it comes as a shock to many of us, I think, as to how much the public sits and prays for us and looks after our well-being. Today we were reminded of that. There was a breakfast meeting that was put on by Jason Goertzen. Many of the members were here. It’s a non-partisan breakfast, and it gave a message of acknowledgement to us and for us to get together. It was great to actually break bread with one another.

A special shout-out goes to the member for North Vancouver–Seymour, who joined me in actually singing our national anthem at said event. I do want to thank that member for standing with me and helping lead us in that national anthem.

The Speaker: I, also, would like to thank Jason, Tim and Anna for hosting us this morning.

They had a wonderful speaker by the name of Stacy. During his speech, do you know what he said? “Let’s be childlike, not childish.” Let’s follow Stacy’s advice.

[1:45 p.m.]

Members’ Statements

Reconciliation with
Indigenous Peoples

Amshen / Joan Phillip: Today I’d like to talk about the importance of the work being done by this government to advance reconciliation, particularly when there are certain voices that wish us to go backwards.

Indigenous rights, sovereignty and liberation are causes I’ve fought for my entire life and are now entrenched in the Canadian constitution and supporting laws. As a political and politicized person, there has been no other option.

We know how much Indigenous peoples have lost through colonization. At Kuper Island school in one year, 269 students registered; 107 died, a whopping 40 percent. And I see it every day in the constituency of Vancouver-Strathcona, the pain and trauma felt disproportionately by Indigenous peoples. I see the issues today as continuations of the same colonial problems that existed when I was a kid.

In spite of the generational trauma and ongoing racism, because of the work being done by this government things are improving. I encourage all governments to join us to continue this important work while lifting everyone up.

I’d like to end with a quote by my grandpa Dan George. “Like the Thunderbird of old, we shall rise again out of the sea. We shall grab the instruments of the white person’s success, their education and skills, and with those new tools, we shall build our people into the proudest segment of society.” We are his dream come true.

huy ch q'u siem.

[Applause.]

Passover

Claire Rattée: Today I rise to recognize that this weekend marks the beginning of Pesach, or Passover, a sacred holiday in the Jewish faith that commemorates the Exodus when the Israelites were freed from slavery under pharaoh in ancient Egypt. This is a time of remembrance, renewal and reflection. Around Seder tables here in B.C. and around the world, Jewish families will gather to tell the story of liberation and reflect on a story as old as our people, a story of faith under fire and of the enduring fight for freedom.

But Passover is more than just a historical remembrance. It’s also a call to action. In the wake of the horrific attacks on October 7 and amid a rise in antisemitism that many believed we would never see again, the story of Exodus is a timeless reminder that freedom is not something to be taken for granted, that justice, dignity and human rights must be defended in every generation and that silence is never an option. Passover is a time to celebrate the resilience of our people.

Freedom is not just a concept but a sacred responsibility. In an era where governments are seeking to exert even more control over our lives, the message of Passover is clear. Liberty is fragile, and we must protect it with courage and vigilance.

One of the most powerful teachings in the Haggadah tells us that in every generation, each of us is obligated to see ourselves as though we personally came out of Egypt. That message challenges all of us to stand against oppression wherever we see it and to work toward a world where no one is left behind. Let us honour our ancestors by standing firm in our faith, proud of our heritage and unafraid to speak the truth, even when it is unpopular.

As someone who represents communities facing real hardship, whether it’s homelessness, addiction or the lack of access to basic services, I find the themes of Passover particularly meaningful. The struggle for freedom and dignity is not ancient history; it’s ongoing. We as legislators bear the responsibility to ensure that hope and liberation are not just symbolic ideals but lived experiences for the people we serve.

To all who are observing, chag Pesach sameach. May this Passover bring peace, healing and renewed strength to the Jewish people and light to a world that needs it now more than ever.

Canadian Unity and Values

Paul Choi: I rise today filled with gratitude for this House, for the people we serve and the extraordinary nation we are privileged to call home.

[1:50 p.m.]

At a moment when turbulence echoes beyond our borders, Canadians from every province, every faith and every walk of life are drawing closer together. We are rallying behind Team Canada — not merely a slogan, but a promise we make to one another that, shoulder to shoulder, we are stronger than any storm.

I stand here as a proud Korean immigrant who found, on these welcoming shores, a country that turns diversity into strength and kindness into second nature. Where else in the world is “sorry” both a punchline and a badge of honour? Only in Canada do courtesy and courage walk hand in hand.

Team Canada means breaking down the walls that divide us, whether it is interprovincial trade barriers, languages, cultures or misinformation. It means harnessing B.C.’s unique position as a Pacific gateway, not just for the province but for the whole country, so the prosperity that flows through our ports lifts families from St. John’s to Saskatoon. It means forging bold partnerships across Asia-Pacific, diversifying our markets and future-proofing our economy for the generations yet to come.

So we celebrate because we have much to celebrate — our hockey triumphants that unite living rooms coast to coast, our vast glacier lakes and towering forests that still take our breath away. These are not just points of pride. These are reminders of who we are and when we are at our best: the true north — strong, free and unafraid to dream big.

Yet pride must walk with humility, and we cannot speak of Canada without honouring the First Peoples who have stewarded this land since time immemorial. Reconciliation is not just a chapter we visit. It is the spine of the book that we are still writing together.

Together, let us carry this torch of hope, compassion and unbreakable resolve. Let us stand up for each other, for reconciliation and for prosperity for Team Canada.

Gurdwara Sahib Sukh Sagar

Steve Kooner: During Sikh Heritage Month and in honour of Vaisakhi, I’m proud to recognize the amazing work of Gurdwara Sahib Sukh Sagar in Queensborough, New Westminster. Gurdwara Sahib Sukh Sagar is much more than just a place for prayer. It’s a place where people come together to help others through seva, which means selfless service, a core part of Sikh faith.

Since it opened in 1919, this gurdwara has been giving back to the community. Every week, the kitchen at Sukh Sagar prepares over 4,700 meals, 200 of which are delivered to people in need in the community.

Moreover, Gurdwara Sahib provides education classes to more than 200 kids each week involving Punjabi language, Sikh martial arts and music. Throughout the year, the gurdwara provides youth camps for over 1,000 children and also runs a summer internship program for more than 20 students to gain real-world experience and mentorship.

Moreover, Gurdwara Sahib Sukh Sagar also has a seniors centre where elders come together to give back and guide others. This gurdwara initiative sets the standard that service has no age limit. Gurdwara Sahib Sukh Sagar has become a true community hub, a place where people feel supported, respected and empowered. I commend Gurdwara Sahib Sukh Sagar for its great community service.

Lapu-Lapu Day

Mable Elmore: Across the world and throughout history, Indigenous peoples have fought to protect their land and preserve their culture. From Canada to Brazil and Australia and elsewhere, Indigenous peoples have been rising and battling colonization, dispossession and suppression. Theirs is a long line of stories of resistance, resilience and renewal. It’s a legacy that endures to modern times in different forms of activism in pursuit of justice, dignity and survival.

[1:55 p.m.]

Among those who etched their names in this proud heritage was Lapu-Lapu, a warrior chief from the Philippines. Lapu-Lapu lived at a time when European colonization started in Asia during the 16th century, leading to the disruption of Indigenous societies and cultures.

In 1521, Ferdinand Magellan, a Portuguese navigator serving Spain, arrived in the Philippines to lay claim to native territories. Lapu-Lapu was not going to bow to a foreign master.

On April 27, 1521, Lapu-Lapu and his warriors faced off with Ferdinand Magellan and his forces in the historic Battle of Mactan-Cebu. Lapu-Lapu prevailed in this early act of defiance against foreign rule, thus inspiring future generations of Filipinos to fight for their freedom and independence. My family legend has it that my mother, Maria Tabotabo, shares lineage with Lapu-Lapu.

On April 26 this year, the legacy of this Indigenous hero will be celebrated in a block party in my riding of Vancouver-Kensington, organized by Filipino BC in partnership with the Sunset on Fraser Business Association and the Hogan’s Alley Society and the Black community. It will be a day-long festival that features music, dance, art, displays, culinary offerings and family-friendly activities.

I’m inviting everybody to join the 2025 Lapu-Lapu Day block party. Everyone here in the House is invited to join a great celebration in South Vancouver, Saturday, April 26. I hope to see you all there.

Battle of Vimy Ridge

Tony Luck: On April 9, 1917, 108 years ago today, under grey skies and bitter wind, Canadian soldiers rose from the frozen trenches at Vimy Ridge in Northern France. They were miners, clerks, farmers and sons, ordinary men asked to do something extraordinary. For the first time, all four divisions of the Canadian Corps, drawn from every province across our young country, fought side by side.

They faced a formidable enemy. The Germans had fortified the ridge for years. Both the French and the British had tried and failed to take it, suffering heavy losses.

But the Canadians brought something different — innovation, preparation and a deep sense of unity. They trained tirelessly, rehearsing their movements on full-scale mock-ups. They used creeping artillery barrages — an advanced tactic for the time — and relied on detailed maps carried by even the lowest-ranking soldier.

On that Easter Monday morning, they advanced through mud, gunfire and wire. And they took the ridge. Brig-Gen. Alexander Ross would later stand on that battlefield and say: “In those minutes, I witnessed the birth of a nation.”

And he was right. Vimy Ridge wasn’t a military success; it was a coming of age. It showed the world that Canada was no longer just a colony of the British Empire. We were a proud, capable nation — resilient, courageous and united in purpose.

But this victory came at a heartbreaking cost. More than 3,500 Canadians lost their lives. Over 7,000 were wounded. The land they claimed was paid for in blood. As historian Pierre Berton once wrote: “Vimy was the place where the nation took root. The fighting may have created a sense of unity, but the price was unimaginable.”

Today we live in the freedom that they helped secure. We speak our minds, pursue our dreams, raise our families — all because they believed in something greater than themselves.

Take up our quarrel with the foe:

To you from failing hands we throw

The torch; be yours to hold it high.

If ye break faith with us who die

We shall not sleep.

We owe those brave souls a debt we can never truly repay, but we can honour them by remembering, by living with purpose and by upholding the values they fought so hard for. At Vimy Ridge, Canada found not only victory, but its voice; not only courage, but its soul.

Mr. Speaker, a request: may this House rise united for a moment of silence to honour these brave souls who sacrificed so much for Canada and for us.

[The House observed a moment of silence.]

[2:00 p.m.]

Point of Order
(Speaker’s Ruling)

The Speaker: Hon. Members, yesterday after the oral question period, the member for Kelowna-Mission rose on a point of order, stating that the Minister of State for Trade used unparliamentary language.

As the minister in question did not rise to respond to the point of order, the Chair took the matter under advisement. Having not heard the remarks in question, the Chair reviewed the record of oral question period proceedings.

Pursuant to practice, Speakers have ruled that if the Chair did not hear the offensive word or phrase and if the offensive language was not recorded in the Debates, the Chair cannot be expected to rule in the absence of reliable record. In this instance, the unparliamentary remarks are not captured in Hansard.

However, the Chair will take this opportunity to caution the House that all hon. members bear responsibility for their remarks in this place and the overall civility and decorum of proceedings. Further guidance is available in the order and decorum booklet circulated to members yesterday.

Oral Questions

Safety of Nurses
in Health Care System

Elenore Sturko: Fraser Health recently had two incidents where nurses were severely hurt and may never be able to return to work. But when WorkSafe investigated, they blamed the nurses. One nurse was even suspended and made to do her violence prevention training.

Staffing shortages put nurses in situations where they are forced to make a choice; treat a patient on their own, or delay care. This is a failure to meet care standards. Both scenarios leave nurses in jeopardy of losing their licence.

B.C.’s nurses are being placed in impossible situations. Imagine how demoralizing it must be to be blamed for getting hurt because of a no-win situation created by this government. When will the Premier look in the mirror, stop blaming nurses and stand up for their safety?

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

Hospitals and health care facilities are places where people go to get better, to get well. Violence has absolutely no place in any health care workplace, in any workplace in British Columbia. That is why we take this so seriously and have worked so closely with the Nurses Union, the health authorities in establishing relational security officers and bringing in people who are specially trained in helping to create safer workplaces.

If we are going to attract and retain more nurses, which we know we need to strengthen our health care system, creating a safe workplace is an absolute requirement. I’m absolutely dedicated to this initiative: to working with the Nurses Union, to working with the health authorities, to continuing that work to ensure that our workplaces are free from violence, that health authorities are following policies in place, meeting our expectations for those safe workplaces for patients, for workers, for all British Columbians.

The Speaker: Member, supplemental.

Elenore Sturko: Our health care system is losing nurses because they’re becoming injured and they can’t work — and sometimes even worse.

Last month, 33-year-old nurse Roseanne Wallace took her own life. She was attacked twice in the psychiatric unit where she worked. Roseanne’s father said he would like the people in charge to spend a day shadowing a health care worker. He said, quote: “I’d like one of those higher-ups to come and spend a shift in a facility like that. I’m sure they wouldn’t believe it, and I’m sure they wouldn’t feel safe.” End quote.

Perhaps the minister should listen to Mr. Wallace’s suggestion and spend a shift working in the dangerous conditions Roseanne was subjected to before she took her life. How does the minister expect nurses and health care workers to follow her rules when NDP staffing shortages are making it impossible for nurses to meet care standards.

Hon. Josie Osborne: What happened with this nurse is absolutely devastating, and I know that this loss is felt across her workplace, in her community, by her family and her friends. It is absolutely tragic what took place.

[2:05 p.m.]

That’s why we have to continue the work that we are doing to create safer workplaces. That’s why we’re going to continue the work that we’re doing with relational security officers, people who are specially trained to help de-escalate situations, to help identify aggressive behaviours. That’s why we’re going to continue with this work on bolstering curriculum around violence prevention in the workplace, because we know that it takes everybody.

We have to do this work. We’re going to continue working with the union, with the nurses. I’ve had the opportunity to hear directly myself from front-line nurses. Any of us putting ourselves in their shoes and understanding how frightening these situations are will help bolster all of us in the work that we need to do to continue to attract nurses to safe workplaces. Because we know that nurses are an absolutely essential component of B.C.’s health care system, and part of strengthening that health care system is creating safer workplaces.

Kiel Giddens: The B.C. Nurses Union reports an estimated 46 serious assaults per month. A nurse in Langley was assaulted with a weapon after the patient she was treating got into an altercation with another patient who pulled the weapon.

The union’s president said that the health care system needs to keep weapons out of hospitals and health care settings. Yet last year, a leaked memo that members will remember from Northern Health instructed, I quote: “Staff do not remove personal items from the patient’s room, even if there is a knife or weapon.”

When will this government finally protect nurses and keep weapons out of our hospitals?

Hon. Josie Osborne: Weapons are banned in hospitals — full stop. We’re working to strengthen our policies and to ensure that this rule is enforced, the policies and procedures that must be in place. That includes expanding the use of weapons screening at hospitals that are at the highest risk.

That’s a very serious step to take. Weapons screening is currently in place in certain places like St. Paul’s Hospital. The security staff there are trained to look for, to watch for, to address weapons that someone might have on their person. Conversations regarding the feasibility of implementing more weapons detection are underway.

It is a sad place to be where we have to recognize this, but it’s important that we take action, and that’s why we’re going to continue to do that.

The Speaker: Member, supplemental.

Kiel Giddens: That answer isn’t good enough for today’s working nurses, and it’s hampering our ability to recruit the next generation of nurses, because it’s not the reality in our hospitals. Weapons are in our hospitals.

In November, a student nurse in her first clinical placement was attacked by a patient with a knife at Vancouver General Hospital. Nurses from the health region told the opposition, and I quote: “We see weapons on a regular basis — knives very frequently, box cutters, machetes, hammers, guns, and more recently, a crossbow.”

To the Premier, would he feel safe if someone came to his office with a crossbow?

Hon. Josie Osborne: Once again, everybody deserves to feel safe and to be safe in their workplace, which is why we have taken action in creating safer workplaces through the establishment of security officers and have had conversations with the Nurses Union, with health authorities around the highest risk sites, getting input from the Nurses Union directly on where these officers should be.

I’ve outlined the steps that we’re taking around weapons detection and ensuring that they are kept out of hospitals, because again, they are banned from hospitals — full stop, as I said.

Interjections.

The Speaker: Shhh. Members. Members, let the minister finish.

Hon. Josie Osborne: We are going to continue this work. We do have specialized teams of police officers, mental health–trained nurses around B.C. to help respond to incidents outside the hospital, to try to prevent events like that from taking place in a hospital.

We can all imagine just how frightening, how scary that would be to be a patient, a nurse, any health care worker in a facility like that, in a setting like that. That’s why we’re going to continue to listen to nurses and take action.

[2:10 p.m.]

Supply and Training of
Specialized Nurses

Harman Bhangu: In Langley, the shortage of specialized nurses has reached a crisis point. Nurses are being asked to work outside their legal scope of practice, a reckless move that endangers lives. To meet the bare minimum for safety, specially trained nurses are constantly having their shifts changed without notice, throwing patient care into chaos. This isn’t just mismanagement; it’s a dangerous failure of leadership.

When will this Premier stop risking lives and take action to train and deploy the specialized nurses that our health care system desperately needs?

Hon. Josie Osborne: Thank you to the member for the question. Again, nurses are an absolutely essential part of our health care workforce, and they deliver front-line care that everybody depends on.

We are facing a global shortage of health care workers, and that includes nurses. That’s why we have taken steps to hire and train more nurses here in B.C., expanding the number of seats for training nurses, bringing in nurses from international destinations who are internationally educated, making it easier for nurses to come from the States to British Columbia.

British Columbia is a fantastic place to work and to live. We’re going to do everything we can to continue to build our nursing workforce here in British Columbia.

Government Action on Homelessness

Rob Botterell: For the past two weeks, forceful evictions have taken place in Kelowna. Residents of Kelowna’s outdoor sheltering 4, known as OS4, experienced harmful and continuous displacement. Bylaw and police officers created an exclusion zone barring anyone from entering, including media, community advocates and cultural support workers.

As we’ve seen in cities across the province, residents of OS4 were dispossessed of their belongings and survival gear. We know that for many of our friends and neighbours, displacement equals death. These cycles of violence are unacceptable.

To the Premier: will your government adopt a human rights–based approach to homelessness?

Hon. Ravi Kahlon: Having encampments in any community is unacceptable. That’s why we’ve been working so hard with our partners to be able to rapidly deploy supportive housing, different forms of housing, in communities throughout the province.

We have been working closely with Kelowna — 120 homes within a year; 80 of them are up. We’re seeing success. People are moving in. They’re getting the supports they need. In fact, 40 people have already moved into supportive housing and moved into stable housing, either with family, on their own — found employment.

I appreciate the member’s question. We certainly know that there are some challenges that Kelowna is facing. I would advise the member that there’s a lot work happening from all partners to try to get every individual into housing.

There is a criminal element that also is going into situations and preying on vulnerable people, and that also is unacceptable. So it’s important that the work that Kelowna does ensures that they’re following laws, which…. My understanding is that they’re following the rules. If not, of course, they’ll have to address those challenges.

But we’re going to continue to work with Kelowna and all communities to be able to ensure that people can get indoors to get the supports that they desperately need.

The Speaker: Member, supplemental.

Rob Botterell: It’s been two years since the massive Hastings Street decampment. Since then, several of these displaced residents have died alone, and many more suffer from injuries and trauma incurred during these sweeps. From the Downtown Eastside to Kelowna, spring cleaning should not involve the violent displacement of our neighbours and violation of their human rights.

Last year the federal housing advocate released a report titled Upholding Dignity and Human Rights identifying six major calls to action.

To the Minister of Housing: will you work with all levels of government to implement the federal advocates’ recommendations for upholding dignity and human rights in homeless encampments?

Hon. Ravi Kahlon: Again, thanks to the member for the question.

I had the opportunity to meet with the advocate when I was in Ottawa just over a year ago to discuss what British Columbia is doing to address encampments. In fact, I would share with the member that we were praised for our leadership, for deploying housing and providing wraparound supports for individuals.

[2:15 p.m.]

These are complex situations. Encampments are not safe for the people living in them. They’re not safe for the community at large. We need to ensure that we’re getting people indoors.

A member mentioned Crab Park. The member would know that there was close to 100 people in encampments there. We found housing for all those individuals. The encampment no longer exists. It’s not because they were moved out; it’s because we found housing opportunities. We got people indoors.

We’re doing the same in Prince George, where Moccasin Flats had close to 100 people, working closely with council. We have now four people left at that site, and we’re going to find housing for those last four people as well. That work will continue in all communities that need housing.

Medical Assessment Fees for Seniors

Heather Maahs: While nurses are being attacked, seniors are being shaken down when they struggle to put food on their tables. A constituent of mine in her 80s contacted me to tell me she was being charged almost $300 to get a health checkup so she could keep her driver’s licence. Why are seniors on fixed incomes being forced to pay out of pocket instead of being covered by MSP?

Hon. Josie Osborne: Seniors are such a valuable part of our society, and they’ve put so much work into creating the place that we have here. That’s why this government is committed to continuing to support seniors by increasing their access to health care services, increasing rent supplements for seniors living with low incomes and taking so many steps to keep costs down.

I appreciate the member’s question very much. Our Medical Services Plan provides for medically necessary procedures and for services that people require for their good health. I appreciate the member’s question.

Safety of Nurses
in Health Care System

Claire Rattée: Last month a nurse new in her career was strangled unconscious and had to be dragged to safety by her colleagues. This attack happened in the psychiatry in-patient unit at VGH. The person that strangled her was a patient.

The B.C. Nurses Union deserves an answer to the question that their president asked: “What is it going to take? Is it going to take one of my members actually being killed on the job in order for some substantive changes to take place?”

Hon. Josie Osborne: Thank you to the member for the question and, again, identifying a tragic situation that has taken place.

I want to assure the member and all members of this House just how seriously this government takes workplace safety. Every patient who walks through a hospital door, every nurse who starts a shift, deserves to be safe. Nurses are trained to help people with their health care problems. They’re not trained to be security officers.

That’s why we’ve taken steps, adding over 750 relational security officers in hospitals and sites across B.C. That’s why we’re going to continue this work and ensure that there are people who have specific training in trauma-informed practices who are able to identify these behaviours. And it’s why I’ve made it clear to all health authorities that we need to see that all policies and procedures are being followed.

We have more work to do to build our nursing workforce, to ensure that we have the minimum nurse-to-patient ratios — we’ve made this commitment to the B.C. Nurses Union — and to build this in acute care sites to start with. We’re going to continue that work and ensure that workplaces are safe for everybody.

Safety of First Responders

Brennan Day: Members of this House will remember what happened just a few steps from here. While responding to a call, a paramedic was violently beaten trying to provide care on Pandora Avenue. Health care workers and front-line responders are speaking out. This side of the House hears you.

How has this government allowed violence against first responders to become just another part of the job?

Hon. Ravi Kahlon: I thank the member for the question. Certainly, encampments are a challenge. I mentioned that in a previous question as well. I can share with the member that we have been, again, rapidly deploying housing opportunities in Victoria.

Interjection.

Hon. Ravi Kahlon: I don’t understand why this question needs to be heckled. It’s a simple question.

[2:20 p.m.]

We’re working closely with stakeholders, with local businesses, with our first responders on Pandora. We actually have a working table that has the city and has our not-for-profit partners all sitting together so that we can identify where challenges are, to make sure that when first responders are responding, they’re able to do so in a safe way, but also so that our not-for-profit partners that are going in to provide supports can be safe as well.

We have seen some progress because of that table. Work continues. I certainly hope that we’re able to get the last few folks into housing so we can address that encampment. But it is work that is ongoing.

Violent Incidents in Hospitals
and Safety of Health Care Workers

Misty Van Popta: At Eagle Ridge Hospital, a nurse opened a curtain and found herself face to face with a man waving a machete, screaming, threatening, forcing staff to evacuate patients from the ER. Nurses’ lives are on the line, and this NDP government has turned a blind eye to the safety hazards they encounter daily.

Can this government please tell this House how many days, weeks, months, years until nurses can consider B.C. hospitals safe workplaces?

Hon. Josie Osborne: It’s absolutely untrue that this government has turned a blind eye. This government….

Interjections.

The Speaker: Shhh. Members. Members.

Hon. Josie Osborne: This government, like all governments of any political stripe should, takes workplace safety incredibly seriously and understands that nurses and all health care workers need safe places to be able to deliver care to British Columbians.

That’s why we’re taking action to increase our nursing workforce. That’s why we’ve made a commitment to the nurses union around minimum nurse-to-patient ratios. That’s why we’ve added security officers, specially trained security officers, in these sites. That’s why we’re going to continue this work to ensure that nurses are able to deliver the care for people that they need to be able to deliver, without fear of violence.

Nothing could be more serious, when people are seeking care, to know that the people who are there to deliver it are able to do that, are able to be focused, are able to stay focused on those patients and deliver that care.

We’re going to continue this work to increase our nursing workforce. We’re going to continue this work to create safer workplaces. The entire House needs to understand that this government is entirely dedicated to that.

Korky Neufeld: Well, what we’ve heard here this afternoon is: “We will continue to work; we will continue to work; we will continue to work.” The only thing that we’re certain is continuing are the major incidents in our hospitals. We have had three major incidents at Eagle Ridge Hospital in just the last few months.

Nurses, the public and even a police officer were attacked. Health care workers are sounding the alarm, but this government continues to treat these assaults as isolated incidents instead of systemic failures.

How many more attacks will it take before this NDP will wake up and admit to its own failed policies that are fuelling the chaos unfolding in our hospitals today?

Hon. Josie Osborne: Each and every one of these incidents needs to be brought to light, and we need to know about them, and we need to take serious action. When these incidents do take place, health authorities investigate. They ensure that the proper steps are taken, and they take action to make improvements.

That’s what this government will continue to do: address the systemic issues behind violence in the workplace, address issues of mental health and substance use and sickness in people to ensure that we are doing everything we can to support people.

We’re going to continue to support nurses by establishing these security officers in hospitals, continuing to listen to the nurses union about those highest-risk sites, encouraging and ensuring that health authorities are taking every action that they need to.

We’re also facing a systemic issue in the shortage of health care workers, which is why this government continues to take so much action, creating new nursing seats, training nurses who will stay here in British Columbia.

[2:25 p.m.]

Every nurse deserves a safe workplace. Every health care worker deserves a safe workplace. Every patient deserves to have that. We will not give up.

Lorne Doerkson: I can’t believe for a minute that the answers we are hearing today are providing any comfort for front-line workers that are afraid to go to their workplace.

After these three attacks at Eagle Ridge Hospital, staff were told to plan escape routes. Only now, after multiple assaults, has Fraser Health increased security. The nurses union says it is not enough, calling the situation alarming and saying: “It isn’t the environment that nurses should be expected to provide care in, and patients should not have to be concerned about being exposed to violence.” Well, no kidding.

Why on earth has it taken three major incidents and serious injuries for this NDP to finally act?

Hon. Josie Osborne: This government has been acting since the day we took office. This government has been adding nurses…

Interjection.

The Speaker: Please continue.

Hon. Josie Osborne: …making a serious and important commitment around minimum nurse-to-patient ratios, part of ensuring that the staffing is there to help ensure a safe workplace for nurses.

We know just how critical nurses are, and that’s why we’re adding nurses to B.C.’s health care workforce at a faster rate than any other major province. We registered over 10,400 new nurses last year.

But there is more work to do, and we know that. That’s why we are going to continue to do that. We are going to continue to train nurses here in British Columbia. We’re going to continue to attract nurses from other workplaces to come — from the States, for example. We’re going to continue to support the nurses union, to listen to the issues, to listen to the incidents that are happening, to learn from every single one of them and to create the safest possible workplace.

Steve Kooner: Eagle Ridge Hospital has seen a series of violent incidents in just a few months, leading to serious staff injuries. The B.C. Nurses Union says that people often get away with harming and assaulting health care workers.

Why isn’t this Attorney General making it a priority to hold violent offenders who harm our health care workers accountable?

Hon. Niki Sharma: We take all violent incidents extremely seriously. The Minister of Health has gone over a series of measures that we’re taking in the hospital to make sure that nurses are safe.

I expect our justice system to deal with every instance of violence appropriately, and we have put better resources in the system to deal with repeat violent offenders to make sure that our bail policy is strong when it comes to people that are offending and reoffending. We will continue to do that work to keep everybody safe in B.C.

Trevor Halford: Here’s the problem. These questions to the government aren’t new. The bigger problem is that we’ve got a minister that’s answering these questions now the exact same way the former Minister of Health answered those questions. We have a government that continues to put politics before people. We’re hearing stories….

Interjections.

The Speaker: Members.

Please continue.

Trevor Halford: We’re hearing stories after stories of nurses having to battle through the bureaucracy of WorkSafe. We’re hearing stories of the minister handing out seven-figure severance packages to a failed health executive.

[2:30 p.m.]

The gaps in the system aren’t sustainable, and they’re clearly not safe. But even worse than all that, days ago this Health Minister confirmed to my colleague the MLA for Skeena that there is no new money for increased security in our hospitals. None. Zero.

We’ve had minister after minister stand up and talk about the importance of keeping our front-line workers safe, but they don’t walk the walk. They fail time after time, story after story.

My question to the Minister of Health is a very simple one. Why can she not make it a priority to actually fund and protect our front-line workers instead of failing them day after day?

Hon. Josie Osborne: We have canvassed all of the actions that this government is taking because we take workplace…

Interjections.

The Speaker: Members. Shhh.

Hon. Josie Osborne: …safety seriously.

Interjections.

The Speaker: Members. Members. Come to order.

Hon. Josie Osborne: This is a government that takes workplace safety so seriously that we are funding 750 security officers across B.C.

Interjections.

The Speaker: Members. Members. Shhh.

The question was asked, and the question was very clear. I think the minister understood your question. Let her answer now. There is no need to continue to heckle.

Please, finish it.

Hon. Josie Osborne: This is a government that understands just how important nurses are to our health care workforce and why we are taking so many steps to increase the number of nurses that are working on the front lines delivering health care to people.

Adding more nursing training seats, making it easier for nurses to be licensed to practise here in British Columbia when travelling, coming from other locations. That’s why we’re continuing to do this work to ensure that we are going to meet minimum nurse-to-patient ratios in acute care centres, for example. That’s why we’re going to continue to listen to the Nurses Union and work with them.

Interjections.

The Speaker: Shhh. Shhh. Take it easy.

Member, please conclude.

Hon. Josie Osborne: That’s why we’re going to continue to take action and continue to strengthen B.C.’s public health care system for all British Columbians.

[End of question period.]

Hon. George Chow: I ask leave to make an introduction.

Leave granted.

Introductions by Members

Hon. George Chow: I am very happy to welcome a group of grade 10 students in the gallery who are leaving right now. I’m sorry. They come from David Thompson Secondary School in my riding, and they are here to tour the building as well as learn about the building’s history and the democratic process.

Would the House please make them all feel welcome and say goodbye.

Orders of the Day

Government Motions on Notice

Motion 14 — Appointment of Special Committee on
Democratic and Electoral Reform

Hon. Mike Farnworth: I call Motion 14 on the order paper.

I move Motion 14, of which notice has been given in my name on the order paper, to appoint a special committee on democratic and electoral reform.

[That a Special Committee on Democratic and Electoral Reform be appointed to:

1. Examine and make recommendations related to:

a. increasing democratic engagement and voter participation, and

b. models for electing Members of the Legislative Assembly, including proportional representation

and report to the House thereon by November 26, 2025.

2. Review the administration of the 43rd provincial general election, including consideration of the Chief Electoral Officer’s report on the 43rd provincial general election, and make recommendations for improvements for future elections, and report to the House thereon by May 14, 2026.

That the Special Committee have the powers of a Select Standing Committee and in addition be empowered to:

a. appoint of its number one or more subcommittees and to refer to such subcommittees any of the matters referred to the Special Committee and to delegate to the subcommittees all or any of its powers except the power to report directly to the House;

b. sit during a period in which the House is adjourned, during the recess after prorogation until the next following Session and during any sitting of the House;

c. conduct consultations by any means the Special Committee considers appropriate;

d. adjourn from place to place as may be convenient; and,

e. retain personnel as required to assist the Special Committee.

That during a period of adjournment, the Special Committee deposit its reports with the Clerk of the Legislative Assembly, and upon resumption of the sittings of the House, or in the next following Session, as the case may be, the Chair present all reports to the House.

That the Special Committee be composed of the following Members: Jessie Sunner (Convener), George Anderson, Rob Botterell, Sheldon Clare, Amna Shah, Ward Stamer and Qwulti’stunaat / Debra Toporowski.]

Motion approved.

Motion 13 — Membership Change to
Finance Committee

Hon. Mike Farnworth: I call Motion 13 on the order paper.

I move Motion 13, of which notice has been given in my name on the order paper, regarding the membership of the Select Standing Committee on Finance and Government Services.

[That Steve Morissette replace Harwinder Sandhu as a member of the Select Standing Committee on Finance and Government Services.]

Motion approved.

Motion 15 — Membership Change to
Children and Youth Committee

Hon. Mike Farnworth: I call Motion 15 on the order paper.

I move Motion 15, of which notice has been given in my name on the order paper, regarding the membership of the Select Standing Committee on Children and Youth.

[That Susie Chant replace Paul Choi as a member of the Select Standing Committee on Children and Youth.]

Motion approved.

Hon. Mike Farnworth: In this chamber, I call continued debate on the estimates for the Ministry of Health. In the Douglas Fir Room, Section A, I call continued debate for the estimates on the Ministry of Environment and after that for estimates for the Ministry of Forests.

[2:35 p.m.]

The House in Committee, Section B.

The committee met at 2:38 p.m.

[Lorne Doerkson in the chair.]

Committee of Supply

Estimates: Ministry of Health
(continued)

The Chair: Thank you, Members. We’ll call this House back to order, where we’re going to contemplate the estimates of the Ministry of Health, and we’ll call on the minister to move the vote.

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

Peter Milobar: Just a couple questions for the minister. I’m sure it won’t come as a surprise to her that I’ll be asking a couple questions around the proposed Kamloops cancer centre, and I’ll explain why I’m saying the word “proposed” shortly.

There’s been a lot of discussion about the design of the Kamloops cancer centre. The minister made herself available to myself and the member for Kamloops–North Thompson. I know she met with the hospital board delegation shortly after that.

This has been canvassed in this chamber now for a couple of years around the overall design of the Kamloops cancer centre. The fundamental problem is that the Kamloops cancer centre will be the only one in the province, if not Canada and certainly North America, that is designed as a site with two different locations.

[2:40 p.m.]

The ministry is now having to figure out how to have their information software of Interior Health talk with the information software of B.C. Cancer. Part of cancer services in Kamloops would be run inside the hospital by Interior Health, where they don’t have the same expertise per se, necessarily, as B.C. Cancer does.

Again, this is the only setup like this within the B.C. Cancer network and indeed across North America.

We’ve heard lots of different reasons and excuses from the government, back to this minister’s predecessor, for why this design has to be this way — anywhere from the site’s constriction, to cost, to the building footprint, to a height variance being needed for something. Like a critical cancer centre in a building that’s going to be built into a hillside — that it needs about a three-foot variance to add a floor to it. As a former mayor, I can assure the minister it’s a completely ridiculous argument to think that a city council would not give that type of a variance in a city that does not protect view lines when rezonings come forward. We are a city of valleys and hills, and so we’ve never protected view to begin with.

All that said, the most recent comments by the minister again indicate that not only will we have the only cancer setup like this, despite the urging of local medical professionals and cancer medical professionals that this is a system and a design that was not workable and will make it next to impossible for proper recruitment…. We’ve had positions unfilled for the better part of a decade in Kamloops already.

We now find out we won’t have a PET-CT scanner as part of this new building either — yet again, substandard compared to any modern cancer centre being designed. I would point out that there are actually more people from the Kamloops area that go to Kelowna for PET-CT scans, and Vancouver, than for radiation treatments.

Yet this new centre — brand-new build, it hasn’t even broken ground yet; it’s still at the drawing stage — cannot be accommodated with the changes to actually make it a modern cancer centre on par with everyone else. Kamloops isn’t asking to be treated differently; we’re asking to be treated the same when it comes to cancer care, of all things.

The last piece, which is perhaps the most offensive piece, frankly, to the people of Kamloops, is that cost keeps getting flung out by the minister and previous ministers as another reason why not. While there’s already money being budgeted for the interior renovation that could be moved over to the new build, there’s the new-build budget as well.

I would point out to the minister that of 15 hospital projects under construction right now in British Columbia, they are a cumulative 16 years behind schedule. A cumulative 14 of the 15 are over budget, to the tune of $4.3 billion. So it seems if you’re a health care facility in any other part of this province, it’s okay to go $1.2 billion or $1.3 billion over budget. But if you’re the Kamloops cancer centre, you better be held to the exact dollar figure or you’re not going to be approved.

We can’t find any extra dollars for a cancer centre that’s supposed to have a 30- or 40-year lifespan, at least, in it to build it properly on the front end. We’d rather have a 40-year recruitment problem in Kamloops instead. It’s not acceptable. It needs to change.

The last piece is that we get told: “Well, we don’t want any further delays.” Actually, they don’t say “further.” The government says: “We don’t want delays.” This was a cancer centre promised by the late John Horgan in 2020 that would have its doors open by the fall of 2024, and the drawings aren’t even completed on it yet. Now this government says if they can’t get building immediately, they won’t build it at all. It’s already delayed, and it’s going to be built improperly.

When will this government, this minister, commit to actually designing the B.C. cancer centre in Kamloops to the same standard and the same design specs of every other cancer centre in British Columbia and provide people of Kamloops the same access to cancer care as people in Victoria will have with their centre, people of Nanaimo, people of Surrey with the one under construction, people in Prince George, people in Vancouver and people in Kelowna?

We are not asking for something other than already exists. It would be like saying you are building a tertiary hospital, but you’re not going to have a bunch of tertiary services in it. You are not building a full-fledged B.C. cancer centre if it’s designed the way the one in Kamloops is.

[2:45 p.m.]

Why is Kamloops the only project that is deemed to be okay to be built under standard to every other cancer centre in the province and the only one that this minister and this government seem to be worried about going cost overrun?

[2:50 p.m.]

Hon. Josie Osborne: Thank you for the question from the member for Kamloops Centre.

Yes, he accurately references the fact that I have had the opportunity to sit down with him and his neighbouring MLA. I’ve had the opportunity, on behalf of myself and the Minister of Infrastructure, to sit down with the regional hospital district representatives and have a really good discussion about this project.

First and foremost, this is about delivering better cancer care to people closer to home. So this is about…. I know that the member has advocated strongly for years, as have local representatives, about just how important it is to deliver cancer care closer to home. The travel that people have had to go through, from places like Clearwater or Barriere down to Kelowna, for example, has been very challenging.

That’s why this government has been so committed to expanding the amount of cancer centres across British Columbia and reducing some of those barriers — hiring more oncologists, more radiation therapists, bringing in the equipment that’s necessary for people to get that cancer care.

Now, I think the member inaccurately references the amount of work that is needed to happen in order to redesign a project, and I don’t think the people of Kamloops and the surrounding area want to see delays in having that care come to them.

We are in a situation now where a ministry responsible for this has undertaken this work, and so I will direct the member to that ministry for the specifics around those questions. But the costing and design and procurement — that is done. Construction is expected this summer.

I know that the member has been out in the media and has told me that he could tolerate up to one year delay. But this would be longer than a one-year delay, and this is not necessary in order to deliver excellent cancer care to the people in Kamloops and the surrounding region.

B.C. Cancer has been working with Interior Health, has been meeting with physicians on site. Some of the things I can confirm for the member are that the information technology systems will come together by the time the cancer centre is open. That’s important; that’s addressing a major concern that has been heard from physicians.

Of course, I know the member is very familiar with what will be in the Kamloops cancer centre. The three linear accelerators and the bunkers that are required for that. Radiation therapy planning, including a CT simulator; that is new technology that is making it easier for physicians to precisely locate tumours and be able to treat them. An outpatient ambulatory care unit with ten exam rooms and two consult rooms.

Most patients do not receive chemotherapy and radiation therapy on the same day. B.C. Cancer and Interior Health and staff at the hospital are working together to make it easy for patients to travel from one part of the campus to another part of the campus, should that be necessary. But I would point out that there are other places in British Columbia where people do travel much longer distances in order to receive treatment in the same day — for example, receiving one form of treatment at Lions Gate Hospital and then needing to travel to downtown Vancouver to receive the other part.

We want to do everything we can to make cancer care easier to access for people, to make it simpler for people to access, but we have to have a cancer centre in Kamloops to be able to do that. And I don’t think the people in Kamloops want to wait years to get that cancer care.

As I mentioned, the project is in the final stages of procurement. The construction will begin this summer. We are going to be delivering excellent cancer care for the people of Kamloops and the surrounding region.

I thank the member for his advocacy, and I thank, especially, the local leaders for their advocacy in coming down to Victoria to meet with me, to understand this, to talk about the fact that the PET-CT scanner is not part of the project right now.

[2:55 p.m.]

The former Minister of Health was clear about that when the business plan was released in February 2024 last year — that that was not going to be a part of the centre at this time.

Peter Milobar: Well, it’s this government’s stubborn adherence to a poorly designed cancer centre that is causing the delays. I absolutely have said if it takes this late in the game to get the government to finally listen to reason, yes, I would publicly…. I have publicly said that, of course, if there’s a bit of a delay, I’d rather see it built properly for the next 40 or 50 years of serviceable life than to have it rushed through and designed improperly.

This isn’t myself saying…. I’m not a medical professional. My father was a specialist. I’m certainly not. But if, god forbid, I get a cancer diagnosis, I’m going to rely on the cancer professionals to tell me how I need to be treated. I’m relying on their opinions and their advice on what they see as the shortcomings of this centre.

This is directly from the medical staff in Kamloops. This has been raised in this chamber three times now at budget estimates and been ignored by…. The community has been ignored repeatedly by this government.

Although the government has chosen to create a whole other minister responsible for infrastructure now, it’s only been the Minister of Health that’s ever answered questions about this facility, and it’s only been the Minister of Health that does media about this facility in Kamloops. So I’m going to keep asking the Minister of Health about the medical aspects of this facility, and the government can figure out who wants to actually manage the actual construction of the project.

The Surrey cancer centre was announced at the same time. It’s not being designed like this. It’s being built from scratch. If this was such a superior model, why is that not the case? If this was the new way to provide top-line cancer care for people, why are the new cancer centres in the ten-year cancer plan not being designed like this? Why is the update to the equipment in Kelowna not necessitating a redesign of the Kelowna cancer centre to replicate what’s going on in Kamloops or in Prince George or in Victoria or in Vancouver?

The minister conflates travelling from one part of Vancouver to get downtown to the full cancer centre as somehow different or the same as people having to travel between two buildings within Kamloops. I’d point out to the minister that people are travelling from Williams Lake once this centre gets built. People are travelling from Blue River once this centre gets built. They’re currently having to travel to Kelowna. They’re going to have to continue to travel in greater numbers to Kelowna for PET-CT scans because the government refuses to put that into this. Just because it was announced by a minister a couple of years ago that it won’t be part of this building doesn’t make it right.

That is the underlying problem with this whole process — the government’s stubborn refusal to acknowledge what the medical professionals in Kamloops have been calling for, for years, which is a properly designed cancer centre at the same level as other cancer centres and not being sold a bill of goods about how superior this will be because of one piece of equipment with a design that doesn’t even match up with other cancer centres literally being designed at the same time. And then the community is made to feel potentially guilty about any possible delays in a design that this government has stubbornly clung to despite repeated requests by those same community members.

The hospital board has wanted this redesigned the whole time. The MLAs have wanted it redesigned the whole time. The medical staff have wanted it redesigned the whole time. The only people that haven’t has been this government. And now our understanding is it gets ratcheted up a level where the government is alluding to…. If there are any further delays, the project will be scrubbed completely.

Now, Kamloops has a long history of distrust with NDP governments and cancer centres. They’re not going to re-litigate the original decision that got yanked away from Kamloops by then Premier Harcourt. But the community is still angry about that. So a simple request. We’re going to keep fighting to have this designed properly — to the minister.

[3:00 p.m.]

Can the minister confirm that the Kamloops cancer centre is not under threat by this government in any way, shape or form for cancellation? If there’s any delay, if the community keeps advocating for a properly designed cancer centre in the first place, and if, by some weird fluke, the government finally starts to listen to reason and actually delivers a properly designed cancer centre, that is not suddenly the excuse for this government to cancel the cancer centre, as we are starting to hear has been now threatened to our community.

Hon. Josie Osborne: We clearly value this project. Despite all the economic uncertainty that we’re experiencing and that members of the opposition bring up consistently in this House, this project is going ahead. This project is in the final phases of the procurement process, and construction will start this summer.

This project will address the needs for people to get cancer care closer to home, and that is far superior to a situation where they are not getting that care. The project is moving ahead.

Anna Kindy: To the minister: I’m just going to give you a bit of an overview and then some questions. On reviewing the StrongerBC service plan for the upcoming three….

[3:05 p.m.]

Actually, let me premise first, just secondary to the member for Kamloops Centre’s comment regarding the PET scan. There is a track 1 and track 2 for referrals. Track 1 is for cancer care. Once you get cancer care, you get treatment.

The issue — and I’ve had quite a few letters and people complaining of that — is that unless you get your PET scan, often you do not get to see the cancer care, because they need the results of the PET scan. So I think not having a PET scan available locally defeats the purpose a little bit. Just a comment to maybe take into consideration.

On reviewing the StrongerBC service plan for the upcoming three years, I have many concerns, which we’ll eventually get to. But I have some overriding specific concerns, and they are the lack of legislated health standards, meaning acceptable wait times; nursing ratios — I think they’re 4 to 1; also, one that’s never mentioned is laboratory turnaround time; and also the lack of transparency and clear data showing the progress in the area of concern.

We need to know where we’re going, hence the health standards. How can we move forward without that data? And just to put it in context a little bit, unfortunately with the health authorities, many of the rural ridings have lost services.

I’ll just take one, for example: the lab services. Locally, in Campbell River, we were able to do Gram stains. A Gram stain is a very basic test. It’s done around the world in Third World countries — very standard test.

The reason we sometimes need the result right away is, for example, if somebody comes in with necrotizing fasciitis, or flesh-eating disease, sometimes you’re not quite sure. The way you can actually diagnose it is to see what kind of bacteria grows. And to actually wait for a result when a young person comes in with flesh-eating disease…. And if you wait too long, that below-the-elbow amputation becomes above-the-elbow amputation, which can become actually a life-threatening issue.

We’ve lost that service in Campbell River. We went from 14 lab techs, and at one point we were down to three lab techs. What that meant was that if one lab tech took a holiday — and we got to that point — the hospital was going to close. What I mean by close is that we would not have been able to give or take blood. That’s why, sometimes, centralizing services, which was done with the health authority, works against the rural background.

Coming back to my questions, having given you context, does the minister plan to create standards in wait time for diagnostics, consultations and treatment so that the population of B.C. clearly knows what is acceptable? And how will the minister share this progress with the public and this government?

[3:10 p.m.]

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

Good to see you again. We’ll have a good session today, I know.

Thank you for the question around wait-time targets or benchmarks or standards around lab services and diagnostic imaging, for example.

[3:15 p.m.]

I’m going to talk first about the standards and the question that the member asked. I’m going to talk a little bit, too, about the need to train and recruit more health care workers who perform these important tasks and the equipment that’s required to do them.

First of all, I think it’s good to note that currently there are no nationally agreed-upon wait-time targets for medical, diagnostic or MRI, CT and ultrasound imaging, and there is a wide variation with respect to the collection and assessment of medical imaging data.

Here in British Columbia, the suggested wait times are aligned with the Canadian Association of Radiologists national designation five-point classification system, and they’re based on medical urgency. For example: priority 1, immediate to 24 hours; priority 2, maximum 7 days; priority 3, maximum 30 days; priority 4, maximum 60 days; and priority 5, scheduled exams. Those are timed follow-up exams that take place on a specified date.

The B.C. prioritization guidelines were developed to provide imaging departments with a provincial approach to prioritizing the commonly ordered medical diagnostic and imaging tests. In B.C., these priority levels can be assigned by the referring practitioner or other roles in health authorities — for example, booking clerks, technologists, radiologists. It depends on the health authority. There’s a bit of variability there.

Given that the prioritization levels might not be consistently assigned across the province, right now the ability to ensure standardization and compare across health authorities, for example, of the priorities is limited. But I take the member’s point and understand what she is seeing. That’s why there is work underway right now in the ministry and in the health authorities to ensure that there is greater standardization of the implementation of these priority levels across the health authorities, and that will ensure consistency. That takes care, I think, of the question around standardization.

I want to talk a little bit about diagnostic imaging access and all of the supports for laboratory medicine services. First of all, we recognize that there is a growing demand on medical imaging services. Of course, as the health care demands grow with an aging population, with a growing population, that’s why we launched a diagnostic imaging strategy to help catch up and to keep up with the demand.

There’s still work to do, but I’m going to talk a little bit about some of that work. We are making progress. That’s around ensuring that more people have access to the diagnostic imaging services that they need.

Since 2016-2017, since we formed government, we have increased the total number of MRI units to 44 from 25 and the total number of CT units to 74 from 63. There are 11 net new CT units and 19 net new MRI units that have been added across B.C. because, of course, as machines age, they need to be replaced. This is helping to both increase capacity and also improve geographic access, so improving access for people who live in rural and remote areas, for example.

Additionally, since we formed government in 2017, health authorities have significantly increased exams. Last year — these numbers are not finalized, but these are the estimates — over 340,000 MRI exams, which is 95 percent more than when we formed government…. Almost a doubling in the number of MRI exams performed over the last eight years.

In the case of CT exams, over a million CT exams. That’s 45 percent more, compared to the 2016-2017 year. Two years ago, in 2023, B.C. ranked second out of seven reporting provinces for MRI exam wait time. Nine out of ten people in B.C. waited 159 days or less for their MRI exam, compared to a national average of 167 days. That’s in accordance with last year’s Canadian Institute for Health Information, or CIHI, report.

[3:20 p.m.]

So we’ve made tremendous access on increasing the capacity for these services. We just wouldn’t be able to achieve that kind of access without the collaboration and partnership we’ve seen with health authorities and everybody who’s been involved, of course, too, from the Ministry of Health in increasing this access and delivering these services.

Just to talk a little bit about the technologists who run the MRI machines, we launched a direct-entry MRI technologist training program at BCIT in 2023 to help build the workforce, and we certainly…. As I’ve said many times in this House, we’re experiencing a global health human resource shortage, and we need more workers in practically every part of the health care sector to help deliver the health care for British Columbians.

This program at BCIT is allowing high school graduates to apply instead of requiring an existing medical imaging certification. So any high school students out there interested in becoming an MRI technologist? Just saying — it’s a great career.

This is an example of how we are increasing access to seats and training more people. We know that when people are trained in health care jobs, professions here in British Columbia, they tend to stay in British Columbia, and that’s a really important point to make.

When it comes to the allied human health supports that are needed for laboratory medicine services — so talking about the lab service side of things — this has very much been a focus of our health human resources strategy and doing the work to support the medical laboratory assistants or MLAs, the medical laboratory technologists, MLTs, and the combined laboratory and X-ray technologists, the CLXTs.

A couple of examples. I won’t go too exhaustive on this, but action 34 in the health human resources strategy points to the memorandum of agreement that GoHealth BC has. Now, we’ve talked about GoHealth BC before in the House and how nurses working for GoHealth BC, for example, have the opportunity to travel out to those communities that are experiencing some of the most severe shortages.

In this case, GoHealth BC has a memorandum of agreement with the HSPBA, and that includes medical laboratory technologists in that program. We’ve got five MLTs now as part of the GoHealth BC program that are available to some of those communities, for example, in Interior Health and in Northern Health.

There’s a cohort of 15 students that’s been supported to complete the combined lab and x-ray technologist training program, improving access to the kind of training that’s needed to do this specialized but very rewarding profession.

There are students enrolled in both the medical lab assistant and the medical lab technologist programs at post-secondary institutions who are eligible, if you’re enrolled between September 1, 2023, and October 2025, for tuition credits. Again, trying to incentivize and bring down some of the barriers and the costs associated with that.

And currently, one thing I want to talk about is the education and training that’s offered here in B.C. as well. We have 149 medical lab assistant training seats. There are three public and seven private post-secondary institutions that are approved by the B.C. Society of Laboratory Science, and they offer this six- to ten-month MLA certificate program.

In Budget 2021 — again, just remembering that as budgets go by and investments are made, these are sequential investments into the health care system — we added 16 new MLT seats at BCIT, 12 ongoing MLT seats at the College of New Caledonia.

That’s an example of the kind of work that’s being done to increase the number of people working in this critical part of the health care sector, increasing the number of pieces of equipment that are available, and health authorities, too, working with their staffs and their staffing rotations to expand the hours of access to these critical exams that are needed for people, as well as some words at the beginning there around the need for standardization and the work that’s underway in the ministry right now.

Anna Kindy: Again, I think comparisons are very important, because sometimes we compare provinces to provinces. Other provinces are having issues as well with wait times.

[3:25 p.m.]

Just to give you an example of medical technology outside of our borders, Canada is 27th out of 31 OECD countries. Again: Europe, Australia, New Zealand. We’re 27 out of 31 for MRIs. We have 9.5 per million. We’re 28 out of 31 for CT scanners at 38.8 per million.

I think we need to sometimes, again, look for solutions outside our border, especially right now. It’s our understanding that there are currently over 500,000 patients waiting for CT scans. We’re way beyond the recommended targets for CTs, MRIs, ultrasound and mammography, as well as image-guided procedures such as biopsies.

You mentioned training seats for techs, which I think is great. The numbers I have here from radiologists are that they need at least 100 new training seats for technologists and 20 new training seats for ultrasound people. One of the key factors, like you mentioned, in terms of wait times, is the medical imaging portion of it, because there are extreme shortages of medical imaging technologists. So the sooner we address that…. I think we need to address it appropriately.

There’s a massive deficit of medical imaging equipment in B.C., and a significant portion of the existing equipment is beyond its useful life, as determined by the Canadian Association of Radiologists’ equipment life expectancy guidelines, and they need to be replaced. In addition, net new equipment is needed to keep up with medical imaging demand.

Could the minister please provide details on how much funding is required to replace existing medical imaging equipment that is beyond replacement guidelines? What specific plans and funding are in place to accomplish this?

[3:30 p.m.]

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

The member is asking around plans for the future acquisition of technologies like CT units and MRI units, for example, and how government will be investing in that. Not to repeat myself, but I will say that one of the things we did in forming government was recognize that we had a lot of catch-up to do. And the replacement of equipment and the acquisition of new equipment, net new equipment, to be able to increase access for people has been a really high priority.

So again, increasing the number of total units to 44 from 25, which is 11 net new; CT units to 74 from 63, which is 19 net new. And of course, it’s always important to stay on top of what the latest technology is available in terms of MRI and CTs, for example.

What’s the real rate limiter right now is people. It’s people to run these machines and to perform these exams. That’s why it’s very important, I think, that to be the most financially responsible, it’s also to time those investments in the equipment with the investments in recruiting and training more people to run those.

The last thing we would want to do is purchase a machine that sat idle too much because there weren’t enough people to run it, and then it became outdated over time and needed to be replaced. We want to use every piece of equipment as efficiently and effectively as possible, so that’s the right combination of acquiring these units and having the staff to run them.

We’re also aware that with innovations in technology, things like artificial intelligence, there’s an opportunity to begin augmenting the staffing that does exist and providing that kind of assistance as well. I’ve certainly had this conversation with the radiologists recently, myself. Maybe we met with them on the same day. Who knows?

Then not to frustrate the member, but I will say that the actual purchase of these major pieces of capital equipment has moved out of the Ministry of Health and into the Ministry of Infrastructure. So it’s important for our two ministries to work together, of course. Looking across government, the Ministry of Post-Secondary and Future Skills is an important partner here too.

So we have stood up a working group between the Ministry of Health and the PSFS ministry to make sure that we’re staying on top of what the projections are in terms of the staffing that’s needed to run diagnostic equipment and that the seats that are invested in and the availability of new training seats for people is matching there too. So it’s really important for the three ministries to work together very closely on that, and that’s the approach that we’ve taken since forming government.

We’ll continue to do that, recognizing, like the member has so accurately described, just how critical these diagnostic tests are and how physicians and specialists need them in order to be able to do their jobs well and that we are doing it in a way that delivers the best health care for people, including to expand the availability over all hours of the clock if we can. As well, increasingly in smaller centres, making it easier for people who live in rural and remote communities to access these important services as well.

I really appreciate the question.

[3:35 p.m.]

Anna Kindy: Just word of mouth is that in Vancouver, for example, the cost of living is so high, and the salary of a CT scanner tech is quite a bit less than an MRI tech, and that’s part of the difficulty of attracting enough CT scan techs. So just to take that into consideration.

Now in terms of a community imaging clinic, it’s an important provider of publicly funded out-patient medical imaging in B.C. For some of them, the fees aren’t quite covering the overhead as they used to, and some are finding it financially difficult to stay viable.

So I’m just wondering. When will this government be implementing the permanent changes to overhead fees for CICs? They did institute some changes, but they were not permanent, and to keep those clinics going, they need a helping hand.

[3:40 p.m.]

Hon. Josie Osborne: First of all, for the folks at home, to acknowledge that community imaging clinics are publicly funded and privately owned outpatient diagnostic facilities that perform an incredibly important function here in British Columbia. That can’t go unnoted. I want to acknowledge just how important they are. In some regions, they are performing up to 60 percent of the services that people need.

In Vancouver Coastal region, for example, CICs provide 70 percent of diagnostic breast imaging. It’s a really important part of the entire health sector ecosystem.

We acknowledge this and the challenges that these clinics are facing. We’ve heard clearly from them that they are struggling financially and that some are concerned about their ongoing viability. They have expressed some serious concerns around the cost of overhead and administration, for example.

That’s why, in January 2024, we established a provincial ultrasound working group, we call it. This has membership from the Ministry of Health, from health authorities, from the B.C. Radiological Society, from radiologists who are directly affiliated with the CICs themselves and from the Provincial Medical Imaging Office. The purpose of this working group is to address these issues, including…. Other issues as well, but it’s primarily to look at the issues around financial sustainability and to look at some of the disparities that exist.

I want to acknowledge, too, the member describing the difference in pay rates, for example, and that we are aware of that issue as well.

The discussions that are taking place at the working group meetings are enabling the collective membership of that group to understand the extent of services that CICs are providing and to understand more fully the financial sustainability issues that they are facing and to explore options for how we can all work together to continue to support patient access to medical imaging and ensure that it remains this important part of B.C.’s health system.

In this work, we’ve advanced kind of a twofold plan to address some of the disparities that are there. As the member noted, we’ve undertaken some stabilization payments for CICs. Those go from September 2024 through to the end of August of this year. That is continuing to provide the space and the time for us to work through this working group to better understand these issues and then come up with a solution that can last longer than the stabilization funding.

Thank you very much to the member for the question.

Anna Kindy: I am going to pass the question to the member for Prince George–North Cariboo.

Sheldon Clare: My question is about hospice fees. It’s really two parts and maybe quite detailed.

What is the current revenue from hospice palliative care fees by health authority? Is there a variation in the hospice palliative care fee rate by health authority? If so, what are the average fee rates by health authority?

[3:45 p.m. - 3:50 p.m.]

Hon. Josie Osborne: Thank you very much to the member for the question and an opportunity to talk about just how important palliative, hospice, end-of-life services are and how lucky, fortunate we are in British Columbia to have such a strong network of hospice and palliative care providers.

I really want to honour the people who do that incredibly important and challenging work. It is so important for people reaching the end of their lives to know that they have the peace and comfort and choice that is related to their own health, and of course, that’s incredibly important for their families as well, and I appreciate the member’s question.

Palliative and end-of-life care services are provided across a variety of different kinds of settings here in B.C., and of course they all share the goal of improving the quality of life for people who have life-limiting illnesses, for example, and of supporting their caregivers as well.

There are currently 474 palliative and hospice beds in B.C., and that includes 345 community hospice beds and 129 acute beds.

Again, I just want to pause here and really express gratitude for those community-based organizations that provide these services. I know certainly in my community of Tofino, we are very fortunate to have a very active hospice organization. I know that many other communities benefit from the services that they provide, beyond those end-of-life care services for people but also the supports for their families through counselling and grief supports, through vigil sitting, for example. These are really important services.

Palliative and end-of-life services are charged differently based on the care setting, but to the member’s question, there is a daily client fee. It is $48.20 for an in-facility or short stay hospice care.

[3:55 p.m.]

It is important to know, too, that no client is ever refused services. Should a family, a person, be in a situation where this is not a fee that is feasible for them to pay, there is a process in place to receive a waiver for that.

I want to acknowledge, too, that that’s a challenging situation for some individuals and families to be in at that time, to have to contemplate having to go through that process of, essentially, applying for a waiver.

The member has also asked about the differences between health authorities. I can confirm that the rate is the same — the $48.20 — but that the collection of this fee by health authority…. Those records lie with the health authority, and we don’t have that data at our fingertips. So I’m sorry to tell the member that I don’t have that data.

I want to just also reflect that we do have a bilateral agreement with the federal government that was signed 2023-2024. Through that, we are receiving $52 million over five years to improve access to palliative and end-of-life care, and we’re going to continue to invest in other services like B.C. palliative care benefits. This supports palliative care at home for people in B.C., for residents that are reaching the end stage of an illness.

Again, it is part of our government’s commitment as part of a public health system to continue to offer a full range of palliative care options for people in their homes, in their communities and, when required, in community-based facilities or in acute care settings.

I really appreciate the opportunity to talk about the good work that so many people are doing there, and I appreciate the question from the member.

Anna Kindy: Just to clarify: with CICs, you mentioned that the contract ends August 2025, and right now there is no plan to extend it. We have 500,000 patients waiting on a list for medical imaging exams.

You have to remember that the CICs, like you mentioned, are privately run. As a business, it’s difficult to plan if you know you’re not…. It would be easier to plan, knowing now, for August. Is there a plan in the works to come up with a solution in the immediate future? I’m going to leave that as a question.

Hon. Josie Osborne: Yes. To be clear, the stabilization payments are not contracts; it’s an agreement to provide stabilization funding, which ends on the 31st of August, 2025.

I’m extremely sympathetic that as private businesses, the sense of predictability and needing to know about financial sustainability is first and foremost something that they’ll be thinking of in addition to, obviously, the care and the services that they provide for people. We really value those services.

So having the working group that has stood up to talk about this…. The intention of the working group is to find a permanent solution. That work is underway right now. It needs the space and time, but I take the member’s point that time is of the essence and it’s important for clinic operators to understand what the future will look like. I’m grateful to them for being participants in the working group.

[4:00 p.m.]

I’m looking forward to learning more from my staff, as the working group proceeds, about what kind of solutions can come forward. I appreciate the question.

Anna Kindy: Another key driver for long wait times for medical imaging is a shortage of radiologists. Data provided by the BCRS shows that B.C. currently has a shortage of 58 radiologist FTEs and this shortage will grow by 157 FTEs by 2030. If urgent action isn’t taken, this shortage of radiologists in breast imaging, interventional radiology and image-guided procedures such as biopsies will be significant.

In terms of recommendations…. I have talked to multiple specialists, and I hear the same thing through all the specialties. For example, neurologists in Vancouver — I think they graduate five neurologists per year, and because of the cost of living, as well, the retention rate isn’t what it should be. Looking at the demographic of the physicians, the specialists, in terms of retirement, and looking at the numbers produced by residency programs, it’s totally inadequate overall.

If we’re looking at increasing medical school enrolment for GPs, what are we doing about specialists? Consider that to become a specialist takes ten years. So if we don’t increase medical school enrolment now — we’re already in trouble — we’re going to be in huge trouble ten years from now.

I’m just wondering if the minister is actually collecting the data to that effect per specialty. What is the cost of increasing residency positions, which I know is taken into consideration? When you look at the effects on health care, the wait times for….

I’ll go back to neurology. For example, if you have Parkinson’s disease, in terms of seeing a neurologist in Vancouver, it takes a year now.

What is the plan, with the minister, in terms of increasing medical school enrolment?

[4:05 p.m.]

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

Just to start by acknowledging the obvious and important role of specialists and the length of time that it takes to train them. First of all, in order to go into a specialty, of course, you need your basic MD, and the undergraduate training is a really important component of that.

[4:10 p.m.]

I just want to give a nod to the fact that through our health human resources strategy — again, where all of this effort is really focused on a strategic approach to ensuring that we are training undergraduates, providing residency spots for postgraduate medical education, looking at all the other health care professions within the sector that are needed….

Through the HHR strategy, we have funded 40 new undergraduate medical school seats, and of course, the new Simon Fraser University medical program will be welcoming a first cohort of 48 students in fall 2026.

Specifically, though, the number of medical residents — I want to talk a little bit about that. Here in 2025, now, B.C. is going to have a total intake of 613 medical residents, which is a 35 percent increase since 2017. I’ll give a little bit of a breakdown there: 205 of those will be family medicine residents, and that includes 31 that have been added since 2023 through the HHR strategy; 219 first-year specialty residents; and 189 residents in a combination of sub-specialties, so re-entry into medical residency, family medicine enhanced skills.

Between 2022 and 2028, UBC will add more than 160 new residency positions. There is a resident allocation committee that meets on an annual basis between UBC, the health authorities and the ministry, and they use data directly from the health authorities to determine an appropriate allocation of how residency seats should be divided up and how they should be allocated.

In addition to what I just talked about, medical imaging residencies have also increased from eight to 12 between 2017 and now. I don’t have a direct cost per residency because the length will differ for different specialties. I know the member understands that very well. But I will just talk a little bit about the global budget for health education expansions: Budget 2021, including $96 million over three years for health education expansions; Budget 2023, just over $302 million for three years for 19 of the focused actions in the HHR strategy. I’ll also note that much of this funding is managed by the Ministry of Post-Secondary Education and Future Skills as well.

I’ll just talk a little bit more about the actually filled residency seats and how they have grown over time. For example, in 2022, in specialty, we had 260 specialty and 65 residencies for family medicine enhanced skills — those family medicine practitioners, for example, who want to gain specialization in oncology or in anesthesiology, and an important feature for some of the smaller centres in B.C. where family physicians with that extra training are able to provide services in those settings.

Then increasing, in 2023, to 277 specialty seats and 64 family medicine enhanced skilled seats in…. Sorry, that was 2023 that I just read. In 2024, it was 297 specialty seats and 58 family medicine enhanced skills; and then now, in 2025, 314 specialty seats and 84 family medicine enhanced skills seats residencies. I think it’s a demonstration of the commitment to expanding the number of residency seats that are available to train the specialists that we need.

I also want to note that in addition to training doctors and specialists here in British Columbia, the work that we are doing to attract physicians to move to British Columbia is an important part of this. With launching a recruitment campaign, for example, specifically targeting the United States and attracting American or Canadian but American-trained physicians who are working there to come back to British Columbia or to move to British Columbia.

I recently met with a specialist who made that decision having lived in the U.S. with his wife for a number of years. She’s American. They made the decision to move back to B.C., and I don’t think he could be happier, which is really good to hear. We need to do more of that. So we’re going to continue the work that we’re doing to fast-track the credentialing of doctors who come in from the U.S., for example, and working with the College of Physicians and Surgeons on that work right now so that we can make it as easy as possible for specialists coming from the States to come here, practice in British Columbia and enjoy the fantastic province that we all enjoy.

[4:15 p.m.]

Anna Kindy: I think the important thing is to actually collect the data to see what the need is. I think part of the data is the wait times. It gives a sort of indication of what’s needed and the demographic of the physicians.

Again, word on the ground in every specialty is there’s going to be a wave of retirement. People have been working. Second is also the different numbers needed. For example, in general practice, you need to take into account how people work. The numbers in general practice are not that much different than they were a few years ago, but the need has, for some reason, exponentially increased.

Part of the reason is…. For example, in general practice, like you mentioned with specialties, they sidetracked into different specialties. They’ll do either addiction or sometimes skincare, or they’ll work solely in emergency. But how many of the old school doctors did it all working 80 hours a week? So those days, I think we have to count as maybe not…. We can’t count as much on that. I think we need to take that into account as well.

I think number one is the data collection in terms of the wait times, and are we actually increasing or decreasing? Looking back to neurology, in terms of wait times…. I mentioned it’s a year in Vancouver. But if you’re from a rural area, to see a movement disorder specialist, it takes anywhere from two to three years. So there’s a real discrepancy. We see that discrepancy, as well, coming from a rural area for cancer care. The issue with cancer care is the longer you wait, the worse your outcome.

I’m just wondering, is the province measuring access to specialist care, measuring the difference between rural and city?

[4:20 p.m. - 4:25 p.m.]

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

First of all, I want to acknowledge that specialists actually maintain their own wait-lists, and the Ministry of Health does not have a direct line of sight into that.

We do rely on the allocation process, the committee that I described, with the ministry, the health authorities and UBC, using the data that health authorities are able to provide…

[Interruption.]

…and anecdotal information to make the allocation decisions about residency seats. Absolutely aware of how important data like that are and acknowledge and agree with the member opposite that that’s really important information.

I think that this is the right kind of conversation to take to the Specialist Services Committee under the physician master agreement. The Specialist Services Committee, for those folks at home…. Under the physician master agreement, this is a committee that facilitates collaboration between government, the Doctors of B.C. and health authorities on the delivery of services by specialist physicians, and it supports the improvement of the specialist care system.

This committee has a specific mandate around enhancing and expanding the programs that support delivery of high-quality specialty service to British Columbians to identify projects that have measurable patient-centred goals that are focused on two key areas: a health system redesign and expediating access to care. We’re talking about this, I think, expediating access to care, absolutely. Also, the committee supports engagement between facility-based family practitioners, between the specialist practitioners and health authorities.

Another project that I’m aware of that the Specialist Services Committee has been undertaking is around expanding team-based care for specialists, bringing nurses and allied health professionals into a specialist clinic and enabling new ways of managing wait-lists and supporting specialists and the management of those wait-lists.

Evaluation of that has been undertaken. What we know about it is that in every facet, every objective that this pilot study had saw positive results, particularly around patient satisfaction and in provider satisfaction — that specialist satisfaction as well. That is a promising, I think, development and, again, exactly the kind of conversation that needs to continue to happen. I would suggest that the Specialist Services Committee is a good place for that conversation.

But in the meanwhile, we will, of course…. The ministry participates in that and will continue to work with those partners. I’ll just take the point that the member is making around taking every action that we can to reduce wait times for British Columbians to be able to access specialists.

[4:30 p.m.]

While I’m not able to provide information on the difference between rural and urban residents, for example, I’ll just point to the importance of data, as the member has stated, and our commitment to continue to do this work together with specialists and our other health care partners.

The Chair: We just heard why all devices should be on silent mode in this chamber. Thank you very much.

Anna Kindy: I’m not an administrator by trade, but to me, to make a decision you need data. I’m assuming that data collection has been happening through the years. I think part of having a health authority and having such a big bureaucracy….

[Mable Elmore in the chair.]

There should be data available as to what the needs are today and what the needs will be five years from now and ten years from now. I think if we had actually looked at that data and collected that data and implemented strategies, we wouldn’t be in the situation we’re in right now. I can’t emphasize enough to collect data, and also comparative data — rural versus non-rural areas, wait times, etc. — and make those data public.

I think, as well, just sticking a little bit to the rural aspect or non-rural aspect, community-based decision-making…. I just met, at lunch, the mayor from Colwood, who is initiating a community-driven primary care centre. He has pledged not to take physicians from other areas of B.C. He wants not to have one community lose while he gains. Again, that’s a community-driven initiative. I think the community knows what it needs.

If we look at a community that is having a lot of issues right now, it’s Kamloops. They have very poor access to cardiology, rheumatology, psychiatry and maternity care. You’re mentioning maybe tying…. You mentioned that you’re bringing in U.S.-trained doctors and maybe tying in, bringing in, foreign-trained physicians to the needs of the community. So if there’s a need for maternity care, and knowing that there’s a need in Kamloops, that would be prioritized. I think that would be a good way of actually moving forward.

In terms of psychiatry, there’s a provincewide lack of access to out-patient psychiatry. In my community, we basically have no access to out-patient psychiatry whatsoever. We don’t have psychiatric beds. Again, looking at a community-driven solution as opposed to a health authority-driven solution…. I think it’s important.

Part of the reason we are in Campbell River was that the community opened its arms up to having a plastic surgery program, looking at there being a resource industry and the type of injuries that happen in that kind of community. Now it’s a very viable program that has attracted more plastic surgeons, and the call group goes from Nanaimo north.

The idea, and I’m just going to say it, is…. At some point, the previous minister said that, well, if people need to travel, they just have to travel. I don’t think that’s an adequate answer. We need to look at…. Every community needs to form its own strategy, and maybe the health authority needs to open its eyes to that community-driven solution.

We know there’s a general lack of specialists, and the numbers quoted in terms of residency spots opening seem to me very inadequate. Again, looking at not saying the point that there’s a global shortage, because there isn’t a global shortage in terms of wait times and in terms of number of physicians per country.

I think we need to, again, look at true numbers, because the decisions we make today will impact what is happening in five years. This will not change. I don’t foresee it changing quickly. But if we don’t change now, we’re going to be way worse off in five years and looking at other systems of model.

[4:35 p.m.]

I’m just going to go to primary care a little bit. In terms of primary care attachment, I’m just wondering how the minister tabulates attachment to primary care.

[4:40 p.m.]

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

Thank you to the member for the question around primary care, the importance of primary care and for people to be attached to a family doctor or nurse practitioner and receive that important longitudinal care especially, as well, and how attachment is measured and reported.

First of all, just a little bit of history. In the past, we relied on a Canadian human health survey and also looked at utilization patterns — so some information around the number of visits a person would make to a provider.

Now, this is imprecise, and you need to do some extrapolation to guesstimate how many patients are out there seeking doctors and how many people are attached to a family doctor or nurse practitioner. The lack of precision in this approach led to the development of the provincial attachment system that we are developing and using today.

So in this case, what we’re doing is working towards getting the records from every primary care practitioner about their panels and how many patients they have. Then we have an understanding of who is attached. Combine that with the health connect registry that any British Columbian can and should, if they’re seeking a primary care practitioner, sign up to.

[4:45 p.m.]

The health connect registry gives us a good line of sight into how many people want to be attached to a primary care provider. Then we can accelerate the attachment with the patient attachment coordinators that we have and have hired who do that work.

For the first time ever, now we actually have primary care providers telling us that they want patients. They can tell the system that they want patients. This is a really important move, I think, away from the burden for people seeking a doctor or a nurse practitioner, primary care provider, from having to sit through the telephone book — maybe we don’t use telephone books anymore — or go through the internet and find as many local clinics as they possibly can and start calling every single one of them.

This is a system that’s helping make much more informed decisions. In the case of new-to-practice family doctors, for example, again, using this system to help slowly load their panel as they become accustomed to being full-time family doctors and enabling them to practise before…. They might move away from a new-to-practice contract, for example, into the longitudinal family payment plan model that’s here.

We have a lot of work to do, we know, in terms of continuing to, again, train and attract family doctors and nurse practitioners. But year after year, we are attaching more and more people to a primary care provider in their community. Since the launch of the primary care strategy in 2018, more than 695,000 people have been attached to a family doctor or nurse practitioner. In 2024, during that calendar year, 248,000 people were attached to a primary care provider, compared to 186,000 the year before that and 130,000 the year before that.

So you can see that the rate of attachment is accelerating, and, last year, 2024, on average, 680 people a day attached to a primary care provider. That’s a 33 percent increase in the attachment rate from 2023. It’s work that we have to continue. In terms of how many family physicians we have here in British Columbia, again, we are trending in the right direction, with more work to do. B.C. was the first province in Canada for physicians per capita of 138 family physicians per 100,000 people and 134 specialists per 100,000 people.

We are attracting more out-of-province physicians than any other province with the highest positive net inflow, meaning that more physicians come to B.C. from other countries and provinces than leave B.C. for other countries and provinces. In 2023, for example, we had a net international inflow of 27. Second place was Alberta at 5. And that same year, we had a net interprovincial flow of 122. Second place goes to Quebec with 33.

This is really around building on the successes of the initiatives that we’re taking in showing that B.C. is an attractive place to live and to work. And the work that we continue to do to incentivize people to move into rural and remote communities….

I’m so glad that the member mentioned specifically the mayor of Colwood, and, of course, we got to visit with him today at the Heart and Stroke Foundation lunch and hear a little bit more about his inspiration behind standing up a community clinic. I think this is really worth talking about because of the initiative that the city of Colwood has shown in trying something different, a different model.

I’m proud that our government, that the Ministry of Health, supported the city of Colwood in the development of what they decided to do in standing up a municipally-owned clinic, essentially attracting physicians. Again, in his commitment to attract physicians from outside of the province, he didn’t want to have an impact on the flow of physicians and the need of physicians in existing communities and has hired from places like Ireland, for example, in bringing physicians to the city of Colwood and working as municipal employees.

I think this is exactly the kind of innovation and partnership that we continue to need and need to see more of. When a municipality like Colwood…. I’m aware that not every single municipality is able to put in the kinds of investment and work that Colwood has, especially smaller places, and it’s really important that we continue to do everything to support them.

I do want to just briefly highlight a few other communities around British Columbia who are standing up to lean into this work of attracting physicians to their communities.

[4:50 p.m.]

I think of places like the Cariboo regional district that has set up a service inside the regional hospital district, I believe it is, to pay for recruitment coordinators, people who are working with local communities to attract physicians, to help welcome physicians and nurses into their communities — to help them land well, to arrive into a home that has a fully stocked fridge and to have toys for the kids — and who have an understanding of what the interests of a physician or their family are and being able to match them there.

I believe that in Burns Lake recently, they’ve just stood up a recruitment coordinator, as well, and other places like the Comox Valley have put an incredible amount of work into attracting primary care providers.

We will do everything, and I will do everything that I can, to continue to support communities in making these kinds of steps and trying innovative new models and standing up clinics.

I recently had the opportunity to visit Shoreline clinic up in Sidney, just north here of the Legislature, and was really inspired by the forward thinking of the team of people leading that clinic in understanding that — as the member has referred to — a wave of retirements…. It might be five years, might be ten years, but it’s going to impact a community, and that’s why they stood up and have developed what looks to me like a fantastic team-based facility.

When I toured it recently, with the member for Saanich North and the Islands, it was given to understand that they practically have a waiting list of doctors who want to join their clinic because they’ve created such a fantastic work environment. That’s exactly the kind of thing that we need to continue to see.

With that, I’ll wait for the next question.

Actually, can I ask for, like, a five-minute recess, please, so I can concentrate.

The Chair: Certainly. We’ll take a five-minute recess. It is now 4:51, so we’ll see you back shortly.

The committee recessed from 4:51 p.m. to 4:59 p.m.

[Mable Elmore in the chair.]

The Chair: Okay, I’ll call the committee back to order to resume the debates on the Ministry of Health.

Anna Kindy: When we institute a program, there are potentially unintended consequences; for example, having urgent and primary care centres or PCNs in a smaller community can draw the physician out of the private practice and into the urgent and primary care centres. Some of those private practices have significant patient attachments. We’re talking maybe two physicians with 5,000 patients attached.

[5:00 p.m.]

What is the plan for the unintended consequences, from setting up UPCCs and now PNs, for the private practice physicians?

[5:05 p.m.]

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

Yeah, the plan for unintended consequences and how sometimes thinking of the health care system…. Let’s just talk about the primary care system, for example. It is a little bit of a spider’s web, and it feels like you can make adjustments here and they’re going to reverberate throughout the web. We have to be aware of what those impacts might be and do our best to plan for them.

I think also, in an earlier question, we were talking about the changing nature of work and the changing nature of the way family doctors, nurse practitioners are practising. There was reference to the old style family doctor that worked 80 hours a week and coming to terms with different ways of practising medicine.

Certainly, something I think we’re seeing amongst family physicians is the need for choice and that people are looking to find workplaces and settings that work best for them in the stage of life that they’re at. Maybe they have a young family. Maybe they’ve been in practice for quite a while. Maybe people are moving towards retirement.

Some people want to live in an urban environment. Some people are looking for a rural lifestyle. It’s important that the work we do with family doctors in those different settings, whether hospitalists or those entrepreneurial doctors who want to set up their own private clinics, for example, those who are choosing to work in places like UPCCs and those who have wanted to move into the longitudinal family physician payment model….

I want to talk just briefly a little bit about that because I think that’s a place where a lot of work has been done that’s been very helpful in answering the concerns that we’ve heard from doctors about improving the way that family doctors are compensated and supported for the time that they spend with patients.

When the longitudinal family physician, the LFP, payment model was brought in, we did that in collaboration with, of course, the Doctors of B.C. and B.C. Family Doctors. It was part of a response to an urgent need that all British Columbians are feeling around retaining and attracting family doctors, and the ongoing requests that were coming forward to really revolutionize or modernize the long-standing fee-for-service model that, for many doctors, wasn’t working anymore.

It’s a model that recognizes the complexity of long-term patient care and helps to compensate family doctors for their time and for their patient interactions, and then the number and complexity of patients that they have in their panel as well. As of December 31, 2024, there were 4,418 family physicians actively working under the LFP payment model.

[5:10 p.m.]

But of course, assessing other models and other ways that family doctors, primary care providers, are working and how the system is working for British Columbians is really important as well. That’s why I’m glad to see that in our agreement for cooperation and responsible government, the accord that we’ve struck with the Third Party, the B.C. Greens, as part of that — I’m just going to read it right into the record here — one of our agreements with the B.C. Greens is that:

“Performance analysis of the health system is critical. Government will assess all elements of the primary care system, community health centres, urgent and primary care centres and family practices…. This will involve an analysis of the performance of CHCs and UPCCs.

“The Minister of Health’s special adviser will work with the B.C. Green caucus, the NDP caucus and Ministry of Health officials to develop terms of reference for this analysis. The resulting report will be made public within 45 days of completion.”

That’s a commitment we’ve made to the B.C. Greens, and a commitment we’re making to British Columbians, around this kind of performance analysis and being able to be open and transparent about what we find and, using those findings, to continue to adjust and improve the primary care model.

It’s not that that kind of evaluation, to different degrees in different places, is not happening. In fact, there’s a whole set of different monitoring, reporting and evaluation initiatives inside the ministry, looking at aspects of the primary care system — just a couple of them that I’ll list as examples.

For example, including the real-time virtual supports, the RTVSs, is an evaluation of this. This is a program that is looking to provide timely and efficient medical support to remote, rural and First Nations communities and other Indigenous peoples in B.C., looking at the use of those kinds of virtual supports and how they can augment access to health care.

Looking at team-based care evaluation. Again, we’re increasingly hearing from all kinds of health sector employees — family physicians, nurse practitioners, social workers, dietitians, physiotherapists, other allied health professionals, of course — that a team-based setting is desirable.

It’s a workplace setting that people enjoy having, and it’s delivering excellent care for people, enabling people who work in that kind of a setting to specialize in what they do, and ensuring that a family physician, for example, is able to focus on the things that they are trained to do. There might be somebody else, like a dietitian or a mental health worker, in that same clinic to be able to provide supports to people.

Included in this, as well, is a reporting program for the longitudinal family physician payment model. This is looking at things like physician registrations, model uptake numbers, the source of registrants into the LFP — were they locums, or were they new to MSP, for example? — the proportion by health authority, the age and gender, and the billings by fee item.

This kind of reporting, again, provides that line of sight into the LFP plan and helps us make better decisions around the way that model is being used and what changes might need to be made.

The member also mentioned primary care networks. A primary care network core attributes measurement system and performance metrics have been developed for these core attributes of a primary care network — including longitudinal care, coordinated care, timely access, extended hours, comprehensive care, team-based care, population and public health promotion, digital enablement, culturally safe care and equitable access.

All of this is to say, in addition to other reporting and evaluation that takes place, that it’s a really important part of being able to make informed decisions around things that may, as the member points out, have that unintended consequence. You know, you ping the spider’s web, and you see a reaction somewhere else.

Our commitment, of course, is to continue this kind of evaluation and reporting and to know that the work we’re doing with the Greens is important work. I look forward to this work. That reporting will become public, too. It’s a really important part of us all being able to work together in this House and across government to build and strengthen our universal public health care system.

[5:15 p.m.]

Anna Kindy: To the minister: with all due respect, you didn’t answer my question. This is an urgent matter. We’re talking of the small community of Cranbrook. I believe you got the same email.

This is a physician who’s been working in this town for numerous years. Because of the unintended consequences, he — and, I believe, one or two partners — is left with 5,600 patients, with the inability of attracting new doctors in his clinic because of the opening of the UPCC, or the PCN.

If there’s not something done immediately, he will leave. So the bureaucracy needs to move faster. I’m not sure why practice contracts can’t be issued for private practice, for example. They need help as well. We know that they have had many attached patients for many years. I’m not sure why these contracts are only available — or special contracts, potentially — to government-run clinics.

We have to look at the efficiency of the private clinic and how many patients they see, and the lack of GPs that they are able to attract at this point in time. Either something is done immediately, or this physician will leave. Is this something that the minister is willing to accept — the loss of a GP or couple of GPs? If he leaves, the clinic will close, and we’re talking about 5,600 patients attached to this clinic.

[5:20 p.m. - 5:25 p.m.]

Hon. Josie Osborne: Thank you to the member for focusing her question specifically on this particular clinic in the Kootenay-Rockies riding, in the community of Cranbrook. I am aware, and my office has been in touch with the member for Kootenay-Rockies about this specific situation.

Of course, any time a community hears that doctors may be leaving, it’s a cause of concern. We always want to make sure that everything is being done to recruit new doctors into a community like this, to be able to assume a panel of patients or be able to work amongst the complement of providers there. In case there’s any misunderstanding, I want to be very clear that all clinics have the ability to access service contracts, so that should not be an obstacle for this clinic.

Also, just to talk a little bit about — I mean, we talked about this before — the changing nature of the way people are practising medicine and the choices that are being made around community-led clinics versus private clinics. Physicians and other health care providers are finding the best fit for them and, ideally, finding the best fit with their community as well.

I recognize the struggles that some clinics face. We were talking about this before with community imaging clinics, for example — the cost of overhead and the cost of doing business, quite literally.

Part of the work in developing the longitudinal family physician payment plan was around, again, creating a more fair compensation plan for family physicians and recognizing those costs of their time and the overhead that they need to bear and then letting those physicians, and other providers they choose to partner with, choose the model that works best for them.

In the case of a clinic with multiple physicians, like this one, for example, obviously I know that they understand the work that needs to be involved in succession planning and recruitment. We spent a lot of time talking about the importance of recruitment and how there’s natural fluctuation and overhead in the operations of a clinic like that.

The clinic is already being supported by the Ministry of Health through the primary care network, with a range of nursing and Allied Health professionals and those salaries that are being paid for. It’s important that we continue to support this clinic so that they can continue to provide the health care services that people in Cranbrook and the area are depending on there. We’ll continue to do that.

[5:30 p.m.]

Also, I’ll just point out the difference I was observing before, as I’ve travelled around and met with family physicians and other care providers in different clinic settings — again, pointing to Shoreline clinic and my really interesting visit there and learning more about their model and the work that they are doing.

I’ll continue to work and support the member for Kootenay-Rockies in this, and I really appreciate the question from the member. Obviously, we want everybody to be attached to a family care provider of some kind, and we’re going to continue that work in the attachment and supporting communities like Cranbrook.

Anna Kindy: Thank you for that answer. But I think maybe the ministry needs to look at temporary relief for areas in need. I think this is just the beginning, to be honest. I think we need to still look at who is providing an effective service and try to support those that are in need. This can be temporary as well, but I think that needs to be looked at. That’s my two cents on that.

My understanding is that the ministry’s plan is to create 50 more urgent and primary care centres and 100 primary care networks across B.C. If we’re looking at the consistency in delivery of care, it has been variable from UPCC to UPCC — quite variable, actually. The cost per visit averages $129. But there is variability there. It’s twice as much as a longitudinal care visit, which I think is $59 per visit, and four times that of fee-for-service, which was $32.50 per visit. These clinics actually are failing to offload the emergency departments in many communities where they exist.

What are the accountability measures for these clinics to make sure that they are actually working as they should? What is the plan once we have the accountability measure to change what’s happening, the cost per visit?

[5:35 p.m. - 5:40 p.m.]

Hon. Josie Osborne: Thank you to the member for the question around urgent and primary care centres. I’ll take a little time just to quickly describe them and address the question and the assertions that she’s made.

These are clinics that provide access to same-day, urgent, non-emergency primary care. They help increase existing primary care capacity, enable new patient attachment in certain situations and are intended to reduce pressures on emergency departments. This, we know, is a priority in all aspects — and being able to provide care through a variety of different means.

Here, of course, we’ve got community health centres. There are private clinics. There are First Nations–led clinics. There are UPCCs. And different needs in different communities…. Also, as we continue to build up the primary care provider workforce here in B.C., we know that for people who are not attached to a primary care provider, or people who have a primary care provider but are not able to access an appointment on an urgent basis and need that help right away, UPCCs are there to help provide that care.

Now, it’s not consistent across all UPCCs, but some are often open on evenings and weekends, on statutory holidays, again providing access to care for people that can’t access it outside of regular business hours or who may be attached to a doctor but that clinic is not open to them during those hours. Really importantly, they provide a primary and urgent care option for people and families who might otherwise have gone to a hospital emergency department for issues that, frankly, don’t require emergency care. That’s really important in alleviating some of the pressure on our hospitals.

There are some UPCCs that attach people to primary care providers on a longitudinal basis and have the opportunity for that long-term health relationship with their primary care provider.

But a few statistics. We now have 42 open, and we are working toward 50 across the province. They are delivering more than three million patient visits since the first UPCC opened in 2018 as part of this primary care strategy.

In the first three quarters of last year alone, leading up to January 2025, they provided 648,964 patient visits and have attached almost 30,000 people to longitudinal care in the last fiscal as well, which is an increase of 1,811 patients.

Again, together with the work being done through primary care networks, community health centres, First Nations–led primary care centres, nurse practitioner–led primary care centres and UPCCs — all together, designed to help increase access to health care and provide a more comprehensive system across B.C.

The long and the short of it is that when we launched our primary care strategy, we did so because we recognized that we needed capacity. So we built capacity. We needed flexibility during the pandemic, and UPCCs helped to provide some of that flexibility that was needed.

I recognize that there’s variability across the UPCCs and, again, reflect back on the agreement that we have with the B.C. Greens to undertake the primary care review. And that work looking at UPCCs is an important part of that.

It’s not to say that monitoring and reporting on UPCCs doesn’t happen, because it does. There are a number of key performance indicators that are measured with UPCCs, and that’ll provide an important source of information for the work that we’re going to be doing with the B.C. Greens.

[5:45 p.m.]

We have stood up these urgent and primary care centres quickly because we know that the need is there. Continuing to monitor them, to evaluate them, to make the changes that are necessary so that they’re performing the way that they need to is, obviously, going to continue to be important.

I think it’s challenging to compare across different models of care directly on a cost-per-visit basis, in part because it does not always acknowledge the complexity of a patient. It does not always acknowledge the geography, and there is variability across different parts of British Columbia.

Ultimately, we all want to make sure that our health care dollars are going into a system that is providing as much efficiency as possible, but our expectation, of course, is to continue to deliver excellent care for British Columbians. We’ll continue to do that work in attracting the health care workforce that we need here, providing different options and ways for, for example, family physicians to be able to practise and ensuring that a community’s needs are being matched.

Again, this is where the primary care networks are such an important tool as well, because enabling that…. It isn’t a one-size-fits-all approach, and we’re talking about the needs of different communities throughout estimates and needing to recognize that different models will be more appropriate for some communities over others.

I think the work, especially the work that we will do with the Greens, will help to tease out and reveal more of that so that we know we’re making the best choices possible and really optimizing the use of our health care dollars. It’s never been more important to do that work, and that’s why we’ll continue with this work moving forward.

Anna Kindy: I’m just going to go back to the principles of the Medicare Protection Act. One was value for money, and you mentioned that. I’m not sure how we can assess value for money if we don’t collect the data and there are no accountability measures.

Going back to the cost per visit, you didn’t say that my numbers were inaccurate, so it seems to me the cost per visit is high. I’m just wondering again about the accountability measure. I think that’s something that the minister needs to look at.

The other question is just for my own knowledge — and I’m going to ask more than one question here. What constitutes a visit in the UPCC statistics? Can a single patient visit to a UPCC generate more than one visit? And the other…. It shouldn’t take too long to figure that one out, I think.

[5:50 p.m.]

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

I’ll never argue with her that value for money is an important metric and that we need to do everything we can to optimize our health care investments. But I would suggest that — and I don’t think she is suggesting this — to only measure dollars per visit would not be an adequate way to measure health outcomes and the actual impact of the health care system on people.

I don’t know the source of all of her numbers, so I’ll neither agree nor disagree with them, though I will counter that the figures that we have between different health authorities, in terms of the average cost per visit, are a little bit different than what the member has.

She’s asked specifically around a definition of visits, and I will tell the member that is one of the key performance indicators, of course, that is measured — total patient visits, the number of patients receiving clinical care in a UPCC on a single calendar day. Each patient is counted as one visit for that day, no matter how many people they see, how many direct care staff they see in that setting. So one patient, one visit.

But also, what is measured are patient encounters, and this is broken down by provider type. Encounters that patients have with direct care staff during their visit…. Within one patient visit, the patient may have encounters with different direct care staff — let’s say a physician and a registered nurse. All patient encounters are counted for each patient visit.

The statistic that I read previously — the 648,964 unique patient visits — is just that: one person, one visit. But if you look at encounters for that same time period, it would be 1,066,629, just showing that a patient in a team-based care environment like that can touch more than one provider, and so we count both the number of patient visits as well as the number of encounters that that person has.

Anna Kindy: Of course quality always matters, right? I always take that into account. Having been a physician myself, I think quality is as important, if not more important. That’s where longitudinal care allows GPs to spend more time with their patients. From a quality perspective, it is better care.

But there’s also a balance, because we do have limited funding, so we need to look at that balance.

Just a thought. I’m wondering if the minister has any contingency in place to incentivize family doctors to have after-hours clinics or to have more than 250 patients on their panels to receive…. Basically, if they have more, the payment goes up. Is that something that they would consider to incentivize?

[5:55 p.m.]

Hon. Josie Osborne: With respect to after hours, of course, the college requires family doctors, as part of their standards of practice, to be available to their patients literally 24-7, 365. Of course, in practice, that would be very challenging, which I know is why physicians, often in a community, for example, will work together to create call groups and share the workload, if you will, for that.

[6:00 p.m.]

Something that we have been doing in partnership with HealthLinkBC and the Family Practice Services Committee and the divisions of family practice is launch what’s called an after hours care program. This is a pilot program that provides after-hours care for attached patients of participating longitudinally primary care practices. It’s a program that that launched back in September 2023.

There are five participating divisions of family practice: Victoria, the South Island, Langley, Thompson and South Okanagan–Similkameen. Then, at the beginning of last year — January 2024 — it was expanded to include Shuswap–North Okanagan.

This is an interesting program and one that has some very interesting core strategic objectives, which is, I think, what we’re talking about here, in part. It is to reduce the burden on family doctors associated with meeting that college requirement for providing after-hours care, and, of course, like we’re talking about, to provide patients with timely access to care when their provider’s practice is closed.

It provides physician supports to attached patients of family practitioners and nurse practitioners when the community family practice clinic is closed, so 5 p.m. to 9 a.m. on weekdays and all day on weekends and statutory holidays.

The way it works is that during this after-hours period, attached patients from the participating longitudinal primary care practices are either transferred or provided with a dedicated number, a separate phone number from 811. They’re connected with the after hours care program team, who then can connect the patient with a doctor. Again, it’s a pilot program that’s addressing some of this need that we know that communities need around after-hours care.

Now, with respect to incentives in terms of panel sizes, the longitudinal family payment plan includes just that. Of course, it’s not just a fee-for-service model, which could be viewed, maybe, as a sort of a peer incentive in terms of panel size, but one that accommodates the factors of a doctor’s time that is spent, the number of visits and then the number of patients they have and their complexity.

Baked into the formula of the LFP model is an incentive around panel size. I think that, taken together with some of the work looking at after-hours care, is beginning to address some of the things that the member is bringing forward.

Anna Kindy: To the minister, thank you for that answer. I do think incentivizing is a good way to go. I think 250 is a relatively small panel, if you look at Alberta. I’m not saying that they shouldn’t get the longitudinal payment plan, but that maybe, again, an incentivization to increasing the numbers and would be important.

Can I ask the minister: just at some time in the future, could the minister provide me with the average cost per patient visit to the UPCC around the province, as well as the LFP and emergency departments?

My next question will be related to health authorities and number of hospital beds per 1,000 population per health authority.

[6:05 p.m.]

Hon. Josie Osborne: The number of base beds per thousand population in Interior Health is 1.89; Fraser Health, 1.32; Vancouver Coastal Health, 1.77; Vancouver Island Health Authority, 2.09; and Northern Health Authority, 2.10.

Anna Kindy: Is it divided by region served or hospital? For example, the Langley Memorial Hospital — What would be the number of beds per thousand? How do you guys figure out the needs?

Hon. Josie Osborne: This is all the beds in all facilities in a health authority divided by that health authority’s population. It’s an average over the entire health authority, but I’m not reporting on a facility basis.

Anna Kindy: How does the ministry decide on the number of beds needed? For example, for a new hospital being built or the number of beds that need to be added to a community in a health authority.

Hon. Josie Osborne: I appreciate the question from the member.

I’m providing the statistics on the number of beds per thousand population, which is often used to compare capacity across regions or across time, but the rates measure capacity without adjusting for factors that affect the needs of the population that they’re serving. So I think the member’s question is a really good one. Because how is planning undertaken? What factors are taken into consideration to project and to use as a basis for capital planning?

[6:10 p.m.]

I’ll talk about four main factors. One is the age structure of the population. A population, for example, with a large proportion of seniors would generally require more beds per capita than an area with a small proportion of seniors.

The health status of the population — a healthier population would require, generally, fewer beds per capita than a population of people with poorer health, and we know that there are regional disparities in terms of population health.

Third, interregional flows and the location of tertiary services. Of course, tertiary services are highly specialized places. They require highly specialized personnel and equipment, and they’re generally centralized in a single location. A good example is B.C. Children’s Hospital. That’s an important consideration to make when comparing this data or these statistics across health authorities in B.C.

Finally, isolation of the population. Because of the distance between communities, a province or a region that has many isolated communities will require often more hospital beds per capita than an urban region.

All of that taken together are factors that are used in capital planning. Of course, I have to note that capital planning for hospitals and health care facilities has come out of the Ministry of Health and now lies with the Ministry of Infrastructure. So further questions maybe around capital planning could be directed there. But, of course, the Ministry of Health continues to staff and operate hospital facilities.

Anna Kindy: Premier Eby promised Nanaimo during the 2024 election campaign that there was going to be a cath lab built for the region. You were talking about quality of care. Quality of care includes, as well, timely access to care. Considering that in ’23-24, some 4,000 caths were done in Vancouver Island and 60 percent of those were north of the Malahat and the current standard is…. If you’re from the north Island, that standard is unacceptable — the length of time before you get the cath.

What has happened to that promise? Where are we at?

The Chair: Just a reminder not to use names.

Hon. Josie Osborne: Thank you to the member for the question. It certainly is a question that has come up in conversation around Vancouver Island and Nanaimo, for example, obviously. Unfortunately, I have to defer that to the Ministry of Infrastructure because they are the capital planning ministry now that has taken on that. I know that the Minister of Infrastructure, she may have been asked questions on that in her estimates, and Hansard would reflect that. That ministry is the ministry that can answer that question.

Anna Kindy: Port Hardy Hospital is one of the hospitals where the emergency department is no longer accessible. Now it’s been for two years. It closes at five. There have been patients that have passed away travelling to Port McNeill. From what I hear on the ground, there is the staff needed to open it. I’m just wondering why, at this point, knowing that an emergency department is an essential service.

[6:15 p.m.]

The second question regarding Port Hardy Hospital is that the acute beds are taken up by long-term-care patients, so there are no acute admissions in that hospital. It’s basically gone from a fully functional hospital to an urgent care centre, in a sense. hat is the plan for Port Hardy Hospital? I would like timelines as well.

Hon. Josie Osborne: Thank you to the member for the question and, specifically, raising Port Hardy. It’s in her riding, of course. In fact, Mayor Corbett-Labatt, was the first mayor that I spoke to in my new role as the Health Minister, back before Christmas. I really appreciated the conversation I was able to have with her. Again, having been a former mayor of a small community myself, a lot of understanding about the kinds of impacts that this can have on a community. I appreciate the member bringing this up.

I want to just talk a brief bit about the history and the current issues that the region is experiencing. I know that the member has heard me speak many times about the work that we are doing and the work that we must continue to do to attract physicians and nurses and other critical health care staff to our rural communities, places like Port Hardy.

[6:20 p.m.]

Between the summer of 2022 and January 2023, the three emergency departments in the north Vancouver Island area — Port Hardy, Port McNeill and Cormorant Island Health Centre — were all experiencing frequent temporary closures due to staffing shortages.

That’s really difficult for communities to bear — the uncertainty that that creates, the anxiety that it creates for people. Of course we want emergency health care services to be available to people 24-7, and those are the intentions of emergency departments, and it’s really hard on communities.

As I’ve also commented in the House before, I’ve heard from a number of mayors now from around the province about impacts beyond just those that are felt by community members but also in attracting new businesses, new families, sports tournaments, things like that where people are depending on health care services to be there for people.

So in response to the challenges that this region was facing in the summer to the last half of 2022, in early 2023, the Ministry of Health and Island Health announced a plan that outlined some significant investments in the communities and included a predictable schedule for emergency department services in the region, again, bringing at least some peace of mind in the predictability and knowing what was and wasn’t open.

The number of temporary service interruptions at the Port Hardy emergency department then decreased significantly. That was, as the member has pointed out, a result of a reduction in the operating hours from the previous 24-7 to create that certainty in the hours of operation during the day, and evening and night emergencies going down to Port McNeill.

It is really difficult when one hears that people have passed away as a result of not being able to access care immediately, and I just want to express my condolences to the member and to the communities that have experienced that in the Port Hardy region.

Despite the staffing improvements that have been made, there are still not enough staff to operate all three sites 24-7. So by maintaining the hours that are in existence now, we are able to see a minimization of service disruptions and diversions and, really, to stabilize those services. The aim is to continue to do the work to mitigate unexpected or short-term coverage issues by keeping the hours as they are currently, for now.

Now, Island Health needs to sustain the current staffing and the ancillary support services — like community services, partnerships, support services, physician and staff recruitment and retention efforts, all the infrastructure and building improvements — to support Port Hardy, both with the hospital and with community services. And all three of these sites in the north Island are continuing to rely on agency nursing, on GoHealth BC and on Island Health staff, who travel from other sites to maintain the current operating hours.

I think what this is…. It gets to the heart of the matter again about the need to continue to train more physicians here in British Columbia, to attract them to move and live in our rural communities here in British Columbia and to recruit physicians from out of country and out of province to come to British Columbia. And as I’ve described in previous answers today, we are trending in the right direction, and we are adding physicians and nurses at good rates, but more work needs to continue to be done.

I know there was concern, as well, about a helicopter resource in Port Hardy, and I’m pleased to say that that resource has been extended, and that’s been communicated to the mayor. So I think the community, as well, understands that now.

But we’re going to have to continue to work. And so I cannot put a timeline on when resolution will be found because I don’t want to promise something that we can’t guarantee delivering. What I can guarantee is that we are going to continue to do everything we can in partnership with Island Health, in partnership with Doctors of B.C., the Nurses Union, other health care unions and workforces, with post-secondary institutions in creating seats, trying to attract high school kids like we had earlier here in the House today to choose a very rewarding profession in health care.

This needs to be done not just for communities like Port Hardy but for communities like Burns Lake and Merritt and Clearwater and Oliver and other places around B.C. that, all too unfortunately, have been experiencing these temporary service disruptions. It is a key mandate item in my mandate letter given to me by the Premier.

[6:25 p.m.]

I think particularly because of my rural background, it’s something that is a particular passion for me, and I can definitely commit to the member to continue working with her. Very happy to sit down and talk with her further about the north Island and her riding and to do everything we can to ensure that kind of stabilization and predictability is there and that the health care services are there for people when they need them.

Anna Kindy: If there’s a will, there’s a way, and that’s what concerns me, to be completely honest. We’ve turned a fully functioning hospital into an urgent care centre with no ability to admit, because of the beds being filled with acute ALC patients.

Rather than getting the roundabout answer, I’d much appreciate a commitment to reopen in Port Hardy a fully functioning hospital, meaning the ability to admit acute care patients as well as having an emergency department open 24-7.

Hon. Josie Osborne: I really appreciate the member’s sentiment that if there’s a will, there’s a way, and I absolutely share that. I think it’s the will of all of us to do everything we can to recruit the staff that we need, to invest in the facilities that we need, and to strengthen the health care system so that health care is there for people. And I want to assure the member that I have a lot of will, and I want her to be able to count on that.

I am aware that in Port Hardy there is a long-term care facility. I think it’s 21 beds, and clearly it’s operating at capacity, and the member is speaking about the number of people inside the hospital, a 12-bed hospital at the ALC stage.

My understanding is that currently there are seven people at that living in an alternative level of care and waiting for placement into the proper care in a long-term facility that they need, and that at the Port McNeill Hospital, being the one right now that has the 24-7 emergency department, beds are kept open so that they are there for those acute needs, and that’s an important part of it.

There is a long-term care facility coming to Campbell River that will add space for 153 residents, but yesterday — or it might have been the day before — we had a really good conversation around the fact that one of the challenges in rural communities is having to travel or move, effectively, out of your community to access long-term care, and that is really challenging.

[6:30 p.m.]

It was the member for Prince George–Mackenzie, I think. He and I were having that discussion, and I was reflecting that that has long been a desire in the place where I live, out on the west coast of Vancouver Island, and that there are no long-term-care facilities available there. Tofino General Hospital, where I live, has often had people there because that long-term care is just not available for them.

My commitment to the member is to continue to work with her and to continue to work with Island Health and support them, again, in providing the predictable, stable health care services that people need in that Port Hardy region and in the whole north Island region. I look forward to more discussions with her.

Anna Kindy: I’m not hearing a commitment here, and that concerns me. Port Hardy services four First Nations, and I’m not sure why we should be providing second-rate health care to four First Nations that live there. I’m just wondering how the health authority can explain that one.

[Lorne Doerkson in the chair.]

Shifting a little bit here, talking about First Nations, they have a managed alcohol program with the First Nations there. So there’s a van that goes to the First Nations and brings them alcohol.

So (1), I’m wondering what the evidence is behind doing that, and (2), if the evidence is so strong, why are we not implementing that provincewide?

[6:35 p.m.]

The Chair: Minister of Health.

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

Thank you so much to the member for this really important question.

In talking about the managed alcohol program that the member refers to…. Managed alcohol programs are evidence-informed harm reduction programs that support people living, particularly, with long-term alcohol use disorder and issues and is an important form of care for people as they are able to access other treatment and supports that they need.

These programs do run in other places in the province. I don’t have an exhaustive list at my fingertips, and so what I’d like to do is offer further information to the member after today’s estimates. But it is one of the innovative ways and one of the necessary ways to provide and work with First Nations and Indigenous peoples in supporting health and wellness initiatives.

[6:40 p.m.]

I’m really, really grateful that the member has talked about the importance of Indigenous health care, because I could not agree more that this is a place that is so incredibly important in the work that we are doing as a government, as a legislature, in ensuring that First Nations and Indigenous peoples across this province have equitable access to health care services that they deserve and need.

I want to speak just a little bit about the work that we are doing in Indigenous health funding, the partnerships that we have with health authorities, the First Nations Health Authority, the B.C. Association of Aboriginal Friendship Centres and the Métis Nation B.C. to support the advancement of Indigenous health and wellness initiatives, and, first and foremost, reiterate our government’s commitment to addressing and eliminating Indigenous-specific racism in health care and acknowledge that Indigenous health concerns and the experiences of racism continue to be reported as a barrier to accessing care in British Columbia.

That’s why we continue to invest in and support a range of Indigenous-led, culturally safe health and wellness initiatives, and I just want to list a few of those. That includes annual funding to health authorities, the First Nations Health Authority, the B.C. Association of Aboriginal Friendship Centres and Métis Nation B.C. It’s a commitment to open 15 First Nations-led primary care centres throughout B.C. Two of those are open, and the remaining 13 are in various stages of planning, implementation and completion.

It’s a commitment to renovating six and building two new First Nations-run treatment centres. With the member for Skeena, of course, we canvassed quite a lot around treatment and recovery options, both noting the importance of Indigenous-led solutions in that space and ensuring that culturally appropriate, culturally safe care is provided for people and that it is Indigenous-led and within the practices and the cultures of Indigenous nations and peoples around B.C.

This also includes establishing additional Indigenous patient support positions, Indigenous patient navigators and cultural competency training for health care workers. I’ve had the opportunity to meet some of these navigators — for example, in my riding in the West Coast General Hospital and also at the Road to Recovery centre at St. Paul’s Hospital.

I can see with my own eyes the obvious ease and support that they provide to Indigenous patients as they help them navigate a system that can be so scary for some individuals that they will not even walk through the front door of a hospital.

Living with the legacy of colonialism and residential schools and knowing the impact that I can only imagine a person might feel in walking into what is such an institutional environment and the feelings that that brings…. The importance of these navigators and of continuing to work with health care workers who have that trauma-informed training and that practice and commitment to supporting Indigenous patients….

Again, we are supporting virtual care through the First Nations Health Authority’s First Nations virtual doctor of the day and virtual substance use and psychiatry services. We are going to continue to do this work in partnership with Indigenous peoples, continue to invest in the time and the collaborative work that’s needed to help improve health outcomes for Indigenous peoples.

We know, and we have talked about in this chamber, the disproportionate impacts of the toxic drug crisis on Indigenous peoples. That is just one example of the disproportionate impacts of so many factors that have impacted the health and well-being of Indigenous peoples.

I want to, again, thank the member for the opportunity to talk about this and to reiterate our government’s commitment to do better and to continue to support First Nations and Indigenous peoples in leading the transformation of a health care system that needs to do better to serve Indigenous peoples.

Anna Kindy: To the minister: you’ve answered zero of my questions. I’m a physician and science-based. I asked for evidence for managed alcohol programs. As far as I know, alcohol use disorder is a medical issue. I’ve never heard before, for example, if you’re a diabetic, that you will treat a diabetic First Nations person differently than a non–First Nations person.

[6:45 p.m.]

Again to my question…. I’m going to ask again, and I’d like to have an answer this time. What is the evidence behind a managed alcohol program, in terms of implementing it, and what other jurisdiction is it being implemented in?

The second question is…. We know there’s diversion. There is diversion of safe supply, and I’m hearing on the ground that there is diversion of alcohol. So if a pregnant woman drinks alcohol that’s diverted, it affects her pregnancy, obviously. If a kid drinks alcohol, which is diverted…. And that’s what is happening in that community. I know that for a fact.

Coming back to my question…. In view of the fact that in March of 2024, in the course of two months, there were 11 overdoses and suicides, and we know that alcohol is a depressant…. It’s a depressant. People commit suicide when drinking.

So again to my question: what is the evidence for providing alcohol to a community managed alcohol program? And if the evidence is so strong, why are we not implementing it provincewide?

Hon. Josie Osborne: To the member’s question: I appreciate that she has asked it a second time, and I need to reiterate part of my previous answer. I’m not a doctor. I’m not a physician. I’m not medically qualified to talk at length about the evidence behind managed alcohol programs. That’s why my offer remains to the member to get her that information from the people that I know can provide it after estimates is over.

I do know these programs are used to support people who have severe alcohol use disorder.

Again, I just want to reiterate my commitment to get that information to the member. That is the nature of estimates at times, when we don’t have the information right at our fingertips. I just can’t get it to you this evening, but we will get it to the member. I appreciate that and hope that, as frustrating as that may be, the member will understand.

Anna Kindy: Yeah, I’d like to have an answer. I obviously am not getting one right now.

So again, I’ll reiterate the question. What is the evidence behind managed alcohol programs? If the evidence is so strong — there are other communities with severe alcohol use disorder — why is it not implemented provincewide? What is the diversion rate of the alcohol?

Again, looking at the data, we’re talking 11 suicides in a nation of 1,100 people. That’s almost 10 percent in two months that committed suicide and overdosed.

[6:50 p.m.]

I think this is something, as well, to consider: Port Hardy Hospital is associated with the GNN Nation, the same nation that had a full, functioning hospital with the ability of doing detoxes and maybe transitioning to a treatment centre, and now that ability is gone. With alcohol comes many illnesses, and now Port Hardy does not have the ability to admit. With the complexity of illnesses, Port Hardy Hospital is no longer a functioning hospital. I just want to leave it at that. To me, it’s completely unacceptable.

Going into hospitals in general, we know that a hospital that’s being run over-census is unsafe, in the sense of the data collection of.... So just wondering: what census does this minister consider a safe census for hospitals?

Hon. Josie Osborne: Thank you for the question around hospital capacity. Of course, ensuring that patients have timely access to emergency and acute care services in maintaining hospital capacity is absolutely imperative, and that’s especially during those periods of increased demand. We see that seasonal variation — for the winter respiratory illness season, for example — and combine that with shortages in human health resources.

It is absolutely a fact that hospitals here in B.C., and in Canada, are generally seeing higher volumes, not just in emergency departments but of higher-acuity patients.

[6:55 p.m.]

We are continuing to work with health authorities to address the risks and barriers and the supports that are required to manage these surges, the increased congestion that hospitals are experiencing and the escalation in delays in accessing care. That’s done through a daily provincial coordination call.

In the event of an increased demand, like the respiratory illness season that I just referred to, there are plans and processes in place at hospitals and within networks of hospitals in regions to add beds and to expediate patient flow as is required and to help ensure that hospitals are ready for periods of that increased inpatient demand.

There is a standard provincial seasonal surge response plan, and that’s been based, developed, on learnings of the past four seasons, for example. It’s based on partnership and learnings in the relationship with Health Emergency Management B.C. and the health authorities. We’re going to continue to work with the health authorities in managing hospital capacity and really standardizing practices across the health care system, increasing inpatient capacity wherever possible.

As we have talked about, the importance of…. It’s not only emergency departments and ensuring more stabilization there, but also in the long-term-care sector side, preventing people from having to have long hospital stays and to release those hospital beds for people that need them.

Then, of course, I have to point out the absolutely record level of investments that this government is making in new hospital facilities — opening, renovating, expanding hospitals and adding capacity across British Columbia and communities large and small.

With that, Mr. Chair, I would like to ask for a 15-minute break, if possible, just for some sustenance.

The Chair: Thank you, Minister. I anticipated that question coming forward, and I’ve already talked to our opposition critic. We will take a 15-minute recess, beginning now.

The committee recessed from 6:57 p.m. to 7:14 p.m.

[Lorne Doerkson in the chair.]

The Chair: Thank you, Members. We’ll bring the chamber back to order, and we will begin by recognizing the member from North Island.

[7:15 p.m.]

Anna Kindy: There seems to be a little bit of confusion as to how many hours I have, so I might be passing to the member sitting there. I’m potentially going to wrap up, potentially not, but I just have a question I want to ask as a wrap-up, maybe, and I will be emailing, if it’s okay, questions for response.

This question is regarding B.C. emergency health services. Particularly, I’ll just focus on East Kootenay hospital. I’ve received communication from them in the last few months regarding the issue with transport of pediatric patients. There’s a letter, as well, from the mayor, that there have been at least ten infants in pediatric transport cases that have not gone smoothly, and one has resulted in a death.

The pediatrician there was saying that prior to COVID, they had the STARS contract with Alberta. The contract, as compared to what…. The service they are receiving now is not comparable. With STARS, the turnaround was quick, and the outcomes were good. But with BCEH, because of the time to transport…. It puts the patients at risk.

I’m just wondering if the minister can commit to having STARS transport until the BCEH has the same level of care provided.

Hon. Josie Osborne: Thank you to the member for the question in raising this really important case or set of cases.

I have been in touch with the mayor directly on this, and my office is working with him to explain some of the situation of the way transfers work and the way the two provinces work together. Rather than get into a long answer right now, I just want to respect the time that the B.C. Greens have, that I know is diminishing, and I’m going to make the commitment to get that answer to the member in writing, after estimates.

[7:20 p.m.]

Anna Kindy: I’m going to pass on the questions to the member for West Vancouver–Sea to Sky, the Leader of the Third Party.

Jeremy Valeriote: Thank you to the minister and staff. I know these are the last two hours of a gruelling, multi-day session, so I will try and be brief.

I’ll apologize in advance. We’re a small caucus, so I have not heard all the questions that have been asked. There may be some repetition, but I will try to minimize that. A couple of broad questions, and then I’ll get into specifics.

First one — we’ve heard a lot in this chamber about emergency room closures impacting all parts of B.C. In my colleague’s riding, Saanich, the emergency room has been temporarily closed at night for almost two years. Recently, the Squamish Hospital has been struggling to retain consistent ob-gyn coverage, which could force expecting mothers to travel hours to deliver. Insufficient staffing has been an ongoing issue, as we all know.

Can the minister summarize what the government is doing to improve the level of doctors and medical staff? I’m specifically trying to focus on rural parts of B.C.

Hon. Josie Osborne: Welcome to the Leader of the Third Party. Good to have you in the room, and thank you for the questions. I’ll also do my best to try to give responsive answers and refer you, perhaps, in some places, to Hansard, where we have canvassed some of these questions before. Also, I’ll try to keep my answers relatively high-level, and I’m happy to talk with the member more after.

First of all, when it comes to the number of doctors and health care practitioners that we need to train and recruit and attract to live in our rural communities, this is one of my top priorities. I want to first say that as a former mayor of a rural community myself, the thought of having an emergency department temporarily closed, I can well imagine what that must feel like as a citizen of that community and knowing that you need to be able to count on medical services being there for you at your time of need.

Also, to put it in the context of the global health care worker shortage that we are experiencing not just here in B.C., of course, but across Canada, other provinces are experiencing emergency room closures in aspects with their health human resources that we are here too.

I’m just going to briefly go through some of the many different programs and steps that our government is taking but point out that this is a key deliverable in my mandate letter from the Premier — to make progress on attracting physicians, nurses and others that are needed to make sure that emergency departments are open and ready for people.

One of the ways we’re doing this, through the health human resources strategy, is through the expansion of the practice-ready assessment program, offering 96 seats. It’s a pathway to licensure for internationally trained family physicians, in exchange for a three-year return-of-service commitment into a community of need, as identified by a health authority.

[7:25 p.m.]

We are working with the UBC Faculty of Medicine to support international medical graduates through their postgraduate medical education training in family medicine, in psychiatry, in general pediatrics, in internal medicine.

In terms of rural recruitment and retention, there are several different programs that are underway through the Joint Standing Committee on Rural Issues for rural programs under the rural practice subsidiary agreement, and these support specifically the recruitment and retention of physicians.

There is the rural retention program. It provides financial benefits to encourage physicians to live and work in eligible rural communities. There is what we call the RRP flat fee. This includes a rural business cost modifier, which is paid to any physician who permanently resides and practices for at least nine months of the year in an eligible community.

The northern and isolation travel assistance outreach program provides funding for travel expenses and travel time honorariums to approved visiting physicians. They deliver medical services in rural and isolated communities when service isn’t available. A recruitment incentive fund provides up to $20,000 to a physician who’s recruited to fill a vacancy in an eligible community.

I want to talk a little bit about distributed medical education, the program at UBC. It’s the first fully distributed medical education program in North America, where there are over 1,000 medical students and over 1,500 medical residents who are learning and training in communities across B.C.

UBC now has the single-largest family medicine program in Canada, and this distributed medical education will continue to play a really pivotal role in creating more physicians here in B.C., expanding the number of family physicians who complete their residencies and transition into practice here in B.C.

We’ve expanded postgraduate medical education significantly. We’ve added 162 positions, including specialty positions, and we’ve been canvassing specialties in estimates today. In 2025, we have a total intake of up to 613 new postgraduate medical education residents, and that includes family medicine, family medicine enhanced skills, first-year specialties, subspecialties.

We have created new physician extender occupations. The member has mentioned the Saanich Peninsula Hospital. I’m really glad that he did because that is the site of British Columbia’s first two physician assistants in emergency departments. They’ve joined the team there. And the purpose…. They have been described as physician extenders, so people who work in that team-based environment in an emergency department and assist physicians working there.

Now, we’ve got two at Saanich Peninsula. Northern Health has four PA positions posted, two each in Prince George and Dawson Creek, and they’re hoping to fill that this spring. All of the health authorities are working to identify sites where they can introduce physician assistants.

We also have what’s called associate physicians. This is a route to meaningful employment in the health system for international medical graduates who are not otherwise eligible for independent licensure. So we have 78 of these associate physicians who are working in a wide range of different settings across British Columbia.

Then maybe lastly, I’ll just talk briefly about the work that we’re doing to reduce barriers, supporting bylaw changes to reduce barriers for U.S.-trained physicians and supporting bylaw changes to remove the Medical Council of Canada examination requirement for internationally trained medical graduates. Again, this is about, of course, meeting the test of the public interest and ensuring that physicians are qualified, have training that is equivalent to what one would receive in Canada and enabling them to come and work here faster.

So these are just examples of some of the many different kinds of programs, from creating new physicians to incentivizing physicians to move into rural and remote areas — and not just family doctors, which we know are so important, but also the specialties that are required.

The member had mentioned maternity services, for example — so ob-gyns and other essential members of the health care team.

Jeremy Valeriote: Thank you to the minister for that summary.

I’ll jump straight into some specific questions, some of them on behalf of my Green caucus colleague — this one, you’ll notice, definitely is. Will the ministry cover travel expenses for residents of the Gulf Islands who need to travel off-island for health care?

[7:30 p.m.]

I will just say that, personally, I became aware of the travel assistance program when my daughter was back and forth to Children’s Hospital from Gibsons. That worked extremely well on the Langdale–Horseshoe Bay ferry.

I gather that there’s some wrinkle with the TAP program on the Gulf Islands. So the question is: can those travel expenses be covered by the ministry?

Hon. Josie Osborne: Thank you to the member for the question and for mentioning your own youth and knowledge about the travel assistance program, which is a really important program supporting people, primarily travelling on B.C. Ferries, from the destinations that B.C. Ferries serves.

I’m really happy that last December we were able to announce an expansion to the travel assistance program to provide support for communities — I know this is not the Gulf Islands — like Bamfield, for example, which have ferry-supported routes but are not publicly run through B.C. Ferries.

We talked a little bit about the travel assistance program over the past couple of days, and I had mentioned that this is a program eligible to all communities that are served by B.C. Ferries. That does include Gulf Islands. Last year there were 16,291 medical travel trips, for residents of the Gulf Islands, which were approved.

In addition to the travel assistance program, I just want to mention for Gulf Island residents that they do have access to Island Health’s health connections program for assistance with travel for medical services. It’s a health authority–run program. It offers subsidized transportation options that help defray the costs. Of course, costs are just one of the barriers that people face, coming from small places like the Gulf Islands, to travel in for care. This program supports non-emergency, physician-referred medical care outside of somebody’s home community.

Through funding from the Ministry of Health, the health connections program really helps to meet some of the unique needs that selected communities have in regions. These funds contract transportation providers, creating a transportation network around the Island Health Authority area, supporting people, including multiple different Gulf Islands. They’re contractors who provide door-to-door, non-emergency patient transportation services.

I’ll also just briefly mention that there are targeted provincial travel supports for people, available through the Ministry of Social Development and Poverty Reduction and through the Ministry of Children and Family Development that some Gulf Island residents may also qualify for. In addition to all of this, some Island Health residents and some Gulf Island residents might qualify for the First Nations Health Authority medical transportation benefit. That helps to cover the cost of meals, accommodations and transportation to assist in travel to medical appointments outside of their homes.

[7:35 p.m.]

Jeremy Valeriote: Another Gulf Islands question: can the minister provide clarity on the state of a B.C. ambulance service on Saturna Island, so that residents there have equal access to emergency services when they need them?

Hon. Josie Osborne: Thank you for the question about B.C. emergency health services and how it works for an island as small as Saturna Island, a beautiful island.

B.C. emergency health services is a provincial service, and ambulances of both air and ground are always sent to the highest-priority calls when they’re needed. That’s regardless of community boundaries. So despite the fact that Saturna Island does not have its own, and it never has had its own, B.C. emergency health services station, it does receive services. It’s really important for residents to know that service is available by air, ambulance or water taxi when it’s needed.

Note that there are under a hundred events annually on Saturna. A couple of other ways that emergency health services provide support: one is by providing medical supplies and training to the Saturna Island Rescue medical responders group. The dispatch centre for Saturna Island is based in Langford, and it provides the 911 call assessment and the emergency assistance over the phone to local residents.

There is a local fire department, I will also note, but they do not respond to medical events, unlike some other communities where they are also trained to respond to medical events.

I really appreciate the question. I think it’s important for people living on the Gulf Islands to know how they are supported by B.C. emergency health services by air, ambulance and water taxi. That is the key ways that these critical life-saving services are provided.

The Chair: I would encourage members to turn off or silence their electronic devices during this conversation.

Jeremy Valeriote: Continuing on with the ambulance service, I’ve heard, in my riding, about advanced-care paramedics not being able to work to their designation in rural areas; these advanced-care paramedics are typically only funded for urban areas. In rural areas, this increases the need for nurse practitioners or other medical professionals to accompany ambulance transfers, which actually ends up increasing costs.

Is the ministry looking at increasing funding for advanced-care paramedics in rural areas? It’s my understanding that the $8-an-hour differential would be recovered in other ways by eliminating the use of other professionals to be on board in some of these ambulance transfers.

[7:40 p.m.]

Hon. Josie Osborne: Thank you to the member for the question. I think that’s exactly the kind of thinking that’s really important in determining different ways of being able to provide service in rural and remote communities.

My understanding is that B.C. emergency health services does have advanced-care paramedics stationed in specific rural communities. We are looking at that. I think there’s going to be a lot to learn from these placements. We can see how well they are working in the system of care that’s available in those communities and the specific work that they can do and, with that knowledge, look to recruiting, training and hiring more advanced-care paramedics as a solution for providing care in rural communities.

So far, the communities where advanced-care paramedics are stationed are Saltspring Island, Port McNeill, Cranbrook, Valemount, New Denver and Zeballos.

Jeremy Valeriote: A bit of a broader question. The 2025 budget allocates significant additional resources to increase the capacity of our health care system, which is good news. However, it’s our view that lack of access to a physician is not only the result of a limited number of doctors but also due to increases in administrative burdens that are eating up doctors’ time and resources.

What is this government’s plan, what is the ministry’s plan, to alleviate the administrative pressures for doctors that prevent them from providing more care for patients and less time for paperwork?

[7:45 p.m.]

Hon. Josie Osborne: Certainly, when I meet with doctors, one of the top issues they raise with me is around administrative burdens and all the steps and ideas that they have and that we are doing together — I’ll speak about these in just a moment — to reduce that burden so they can spend the most time possible with patients. I completely agree with the member. That’s one way that we can help maximize and optimize the best use of our health care resources by making sure that physicians and nurse practitioners, primary care providers, are spending the most time possible with their patients.

We’ve actually struck an Administrative Burdens Working Group that’s committing the Ministry of Health, the health authorities and Doctors of B.C. together to look at ways to reduce the current physician administrative burden and potentially shift some of that to other appropriately trained staff. That’ll, again, better enable physicians to focus their time on patients.

A few areas where the group has been discussing changes are around things like medical imaging — focusing on different processes and ways of undertaking medical imaging that will save time for physicians. Looking at the way special authorities are provided. That includes authorization renewals, drug listing reviews, the digital integration that is available there.

We have a campaign commitment that we have made around reducing the use of sick notes and eliminating that requirement, which family doctors especially have mentioned many times is an administrative burden that they feel is unnecessary. We’ve made that commitment to work with them, and so we’ll have more to say about that in the future.

A lot of this really is around replacing paper and fax with digital tools, using the technologies that are available to better connect health care systems. By digitizing referrals, consults and orders, it makes it easier for doctors and patients to share information with each other, and it means faster, more efficient and fairer access to care. Those are some examples of the work that’s underway.

The last thing that I’ll say to address this question is around the longitudinal family physician payment model and recognizing, through that model, the time that doctors need and needed to be compensated for paperwork that they are undertaking. We can report that family physicians on the LFP payment model on average are spending 76 percent of their time on direct patient care now, 23 percent of their time in indirect patient care and 1 percent of their time on administration.

I think that’s an important sign of the progress that’s being made and our continued commitment to use the technologies that are available, eliminating sick notes and taking more steps to digitize processes and make for faster, fairer care.

Jeremy Valeriote: A couple of questions specific to the Sea to Sky, the area that I represent.

The first one is a big one. The ministers and ministry staff are probably aware that Squamish needs a new hospital at some point. Rapid population growth and age means that Squamish is outgrowing its hospital, or has outgrown it.

[7:50 p.m.]

There has been some preliminary work on a health sciences precinct on a new site, very preliminary. I’m just wondering if the minister can say where this sits in the overall ministry’s capital financial plan, where on the horizon it might be and when Squamish might be able to expect a new facility.

Hon. Josie Osborne: I’ll be very happy to pass that question along to the Ministry of Infrastructure. They now have the responsibility for capital planning and building hospitals.

Jeremy Valeriote: Thank you for confirming that. I noticed the capital expenditure in Ministry of Health was $30,000, so it’s probably not enough. I will redirect to the Ministry of Infrastructure. Thank you.

In the Pemberton Valley, Sea to Sky Community Services is partnering with Vancouver Coastal Health, Foundry and the Líl̓wat Nation to address the crisis in youth and Indigenous mental health in the Pemberton area. Based on their effective and cost-efficient Foundry partnership in Squamish, the service would be co-located in a 63-unit affordable housing and community services development due to open in September of 2026.

The greatest challenge at a critical time for the project seems to be some internal decision-making from the ministry. If you bear with me for a second, I’ll just get a bit more detail.

Vancouver Coastal Health is supportive of the project. However, there seem to be some administrative issues, one about co-location and one about the formula for staff space. I’m recognizing this is pretty specific, but I’m hoping that the minister or ministry staff might be able to update where that….

Obviously, it’s been very successful across the province. Foundry has been successful in Squamish since it opened a couple years ago. I think, given the challenges…. The whole Pemberton Valley, including Mount Currie…. This would be a very beneficial service, and it seems to be most of the way there, with a little bit more support required.

Hon. Josie Osborne: Thank you to the member for the question inquiring about this specific project.

Foundry projects that are expanding across British Columbia provide really critical services for youth to access all kinds of health and mental health services, all under one roof. I know in a community like Pemberton and in the valley there, it’s just as essential for youth there as it is for youth living in any community in B.C.

What I’m going to ask is for the member to give us an opportunity to go dig into the specifics of this case so that we can report back to him and get him an update that he needs for the project.

[7:55 p.m.]

Jeremy Valeriote: Thank you to the minister. I appreciate that.

Continuing on with mental health, the Mental Health Act has been in desperate need for examination and update for years, yet despite two decades of increased knowledge and research into mental health, it has not been amended since 1998.

Will the minister and this government commit to an evidence-based analysis of the Mental Health Act to support improving mental health care in our province?

[Mable Elmore in the chair.]

The Chair: Minister.

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

Thank you very much to the member for the question around the Mental Health Act.

I want to start off by recognizing that it is important to review the evidence and implement changes to legislation and policy to ensure that we are providing the very best mental health and substance use care possible for British Columbians, and that includes amendments to the Mental Health Act.

It’s equally important that we undertake this work carefully, given that the Mental Health Act governs the treatment and care for some of the most vulnerable individuals in our society, in our communities, and in a very complex system of primary, acute, tertiary and community settings. Changes need to be done in a thoughtful way, to ensure that services continue to be provided to people always with their best interests at the heart.

Since the act came into force in 1998, as the member refers, there actually have been a number of changes to the act and its regulations, so I’ll just briefly run through a few of those.

For example, in 2005, the prescribed forms 13 and 14, which are forms that support patients who are being informed about their rights under the act…. These forms were rewritten in plain language and updated to be more patient-friendly.

In 2011, the definition of “near relative” in the act was updated to be more inclusive. And in 2022, our government passed amendments that introduced a right for involuntary patients to meet with an independent rights adviser. The independent rights adviser service is operated through the Canadian Mental Health Association. It’s run by Health Justice.

[8:00 p.m.]

This service provides free, confidential and independent support and information to people who are detained and experiencing involuntary treatment under the Mental Health Act here in B.C., to help them understand what their legal rights are and how they can act on those rights. The service is available at all 75 facilities that are designated under the Mental Health Act and for those who are in community on extended leave. It’s an important step that was taken to improve and modernize the process in the Mental Health Act for involuntary treatment.

In 2023, there was an amendment to allow nurse practitioners to assess and sign the first medical certificate for an involuntary admission under the act. This supports nurse practitioners to work within the full scope of their practice and supports patients, as well, by enabling a more seamless admission process during what very often is a time of crisis.

So we’re going to continue to review and make the appropriate changes that are needed to best support patients, to support their caregivers, as well, and the entire system of mental health services here in B.C.

Following on that, there are also two key documents that I want to talk about briefly. They support individuals and practitioners, mental health facility operators and the public in understanding the application of the Mental Health Act. They are the Guide to the Mental Health Act and the Standards for Operators and Directors of Designated Mental Health Facilities. These are two important, really cornerstone documents that seek to direct and inform people about how the act works for people who are most affected by it.

Updates to these documents are underway right now, and they’re being guided by the revisions of the act that I have just run through. They reflect the current-day understanding that we have around how to best deliver mental health services to those people who are in crisis.

As I said — work to revise this. It’s a 2005 edition, so it’s high time that we do this work. And we’re doing this based, in part, on recommendations that came from the Office of the Ombudsperson to help improve compliance with the Mental Health Act, to help people understand what the act encompasses and to ensure that there’s consistency between the guide and the standards, which are also being revised and updated. This is work that will be completed this year.

Jeremy Valeriote: On a similar note, access to mental health care is out of reach for countless people in B.C. Evidence shows that preventative care and access to mental health resources improve outcomes for those struggling with mental health–related illness.

Despite our work under the Cooperation and Responsible Government Accord to bring psychologists into the system, most mental health resources are not covered under MSP, blocking people from accessing the life-saving counselling and psychiatric care they need.

When will the ministry commit to a comprehensive approach to mental health that provides people with MSP coverage for mental health services to prevent the worsening impacts of mental health disorders?

[8:05 p.m.]

Hon. Josie Osborne: Thank you to the member for the question, and welcome to his colleague who has joined him as well.

I really appreciate an opportunity to talk about mental health care because I think, now more than ever, particularly with the pandemic, we have seen the growing impacts of mental health issues amongst children and youth, into adults as well. This government is committed to expanding the supports that are available for people and ensuring that mental health is treated as it should be, which is part of health.

I’ll note that we set aside mental health and addictions into a stand-alone ministry in 2017 and then took the decision just late last year to roll that back into Health. While I think a stand-alone ministry served a very important purpose, now was the time for more efficient and kind of expedient decision-making around mental health care and supports for people suffering from substance use disorders, for example, and that we roll that right back into the Health Ministry.

The member has asked specifically around mental health resources and the Medical Services Plan. I’m going to just talk briefly about what is covered under MSP or the eligibility there, and then I want to talk a little bit, too, about some of the rest of the work that’s done outside MSP to support mental health.

First of all, the services of psychiatrists are eligible for MSP coverage because psychiatrists are medical doctors and they have that training specifically related to psychological issues and they are eligible to prescribe medications and provide psychotherapy, a form of counselling.

Under MSP, coverage is provided for the services of psychiatrists, up to a maximum of one hour per day, up to two hours per week. Exceptions can be made to those limitations if the psychiatrist provides MSP with evidence that additional services are medically required.

For an appointment to a psychiatrist, you do need to be referred by your family physician. I acknowledge that there are a number of people in British Columbia, of course, that are not attached to family physicians. This presents a barrier, and we’ve canvassed extensively during estimates around the work being done to attach more and more people to primary care providers.

There are supplementary health care services that are not covered by MSP, like psychologist services. I just want to be clear that lack of MSP coverage for those services is not a comment on the value of those services, but it really reflects some of the limits of available public funding. Some people who have extended health care plans or employee assistance programs, for example, are able to access the services of a psychologist. They may have the coverage of those services.

As well, low-cost counselling may be available — I’m going to speak a little bit more about this in a moment — in the community, at clinics, at universities, at colleges. And there is a lot of information that is provided through the B.C. Psychological Association.

[8:10 p.m.]

In terms of mental health resources that are available outside the MSP system, I do want to talk a little bit about community counselling grants. This is an area that our government has invested in heavily in trying to create more access for people to community counselling, knowing that it is a key early intervention for people who have mental health and substance use challenges and for whom cost remains a barrier that will really limit access for people to timely support.

Beginning in 2019, our government, in partnership with the community action initiative, developed the community counselling grants program to fund low- and no-cost community-based adult mental health and substance use supports. These are grants that are intended to increase access to underserved or hard-to-reach populations and to make counselling more accessible, including in rural and remote and Indigenous communities.

The program began with grants to 29 different organizations. It was expanded to include 20 more in the year 2020 — that was a part of our response to COVID-19 and the pandemic — for a total of 49 providers. As of February 2025, there are 47 counselling services who are organizations that are receiving grants. We continue to support them and have recently committed to extending funding to the community action initiative to continue this program with an additional $6.7 million approved to fund for yet another year.

We’re continuing to build an integrated network of voluntary services to support children, youth, young adults and their families by promoting mental wellness. These are services designed to prevent the onset of mental health and substance use challenges and really identify those people who are struggling early and connect them to effective and culturally safe supports and services. In this bucket, if you will, are integrated child and youth teams, expanding those across the province, with 39 teams operating in or implementation about to begin in 20 different school district communities.

These are teams that work in an integrated way to deliver multidisciplinary wraparound mental health and substance use supports and services to children, youth, their families and caregivers and really connect them to the care that they need in a school setting or in a community setting. They include school-based counsellors, youth concurrent disorder clinicians, peer support workers, family support workers, Indigenous roles to provide that culturally safe service that’s so important, and further services that are available through the Ministry of Children and Family Development. The first phase of these teams are serving an average of almost 1,500 children and youth every single month, which is just fantastic to hear.

Of course, the expansion of the Foundry network continues to be a priority of this government, a network of integrated youth health and wellness centres and virtual supports. There are 17 of these Foundries that are established. There are 18 more in development, to bring the total to 35 once the whole provincewide network is complete. This really is a one-stop shop for youth, providing primary care, mental health services, substance use supports, peer family support and social services specifically targeted for people aged 12 to 24 and their families.

PreVenture is a provincewide program that includes licensing, training and implementation costs for school districts. PreVenture is delivered by the Foundry central office to interested school districts, and it’s a prevention program for youth aged 12 to 18 that uses personality-focused interventions to promote mental health and reduce the risk of substance use. They use school-based workshops that are designed to help students learn useful coping skills, set long-term goals and channel their personality traits towards achieving them so that they can thrive in all aspects of their lives.

There is an early psychosis intervention program. These are services that we have expanded through Budgets 2021 and 2023 by approximately 100 new full-time professionals, increasing the number of staff involved in these specialized services, which provide early identification and treatment for psychosis.

[8:15 p.m.]

That really aims to improve the outcomes and minimize the impact of the condition on a person’s life. These teams include a variety of different professionals like psychiatrists, community clinicians, therapists and other specialists to provide the comprehensive care that’s required.

The programs are very recovery-focused. They aim to help individuals really achieve and succeed with their goals at work and school and within their social networks.

I hope this provides an answer about MSP and the services that are provided with psychiatrists but also kind of an extensive look at a lot of the other mental health supports that are out there, available for people and for youth.

Finally, the member reflects on the agreement that we’ve made together, as two political parties, to work on the integration of psychologists into primary care teams. I’m excited by this work, enjoying the work that we’re doing together and the meetings that we’ve been having and discussing this, and I really look forward to making progress on this together.

Jeremy Valeriote: Thanks to the minister for outlining…. It does make me optimistic, the amount of prevention and intervention, especially with youth, that is going on.

However — it’s always a however — it’s our understanding that the province is struggling at the limits of public funding to find enough resources to support voluntary treatment beds for those who are already suffering from substance use disorders.

Research has proven the impacts of involuntary treatment can be detrimental to the health and recovery of those suffering. Will the government, and will the minister, commit to using an evidence-based approach to prevent involuntary treatment for those suffering from substance use disorders?

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

In opening on this, I want to say I really appreciated the discussion I had with the member for Skeena. We had a lot of discussion around supports for mental health and substance use and talking about the voluntary system of care that our government is so focused on — building out a seamless system of care for people, through programs like Road to Recovery, where people can access same-day medical assessments and be connected with the right level of support for what they need at that time; recognizing that continuing to build out the system of care with voluntary treatment and recovery beds is a key priority for this government.

[8:20 p.m.]

I won’t go into all of the investments there because I know the question specifically is around involuntary care. I just want to be clear, though, that the system of voluntary care is absolutely of the highest priority.

The toxic drug crisis is something we know all too well. It’s devastating families and communities and people. I think every single person in this House has been touched, and I think every British Columbian, for the most part, has been touched by this terrible crisis, and we need to continue to do everything we can to address it.

We know that there are some individuals who have very complex mental health and addictions issues. They may have acquired brain injuries as the result of repeated overdoses, and they are not able to make good decisions about their care. These people who are living with these concurrent disorders may benefit from involuntary treatment, in a way to help get them on a path to treatment and recovery.

I want to be very clear, though, that a person who is suffering from a substance use disorder as their only diagnosis is not a person who is eligible to be admitted involuntarily under the Mental Health Act. And I appreciate that there’s a lot of information out there, but I think that’s a really important clarification to make: that there are four criteria for admission under the act, and all four of these criteria have to be met.

So, in the plainest language: the person is experiencing a serious mental health issue that makes it hard for them to deal with situations or people around them in a safe way; the person needs treatment in or through a facility; the person needs care, supervision and control to stop their mental or physical health from getting worse or to keep themselves safe or others safe; and they will not get the treatment they need if they were a voluntary patient.

As the member knows, this government is being advised by Dr. Daniel Vigo. He is the chief scientific adviser for psychiatry, toxic drugs and concurrent disorders. And he recently released a clinical guidance document to support practitioners in determining when a person who has concurrent mental health and substance use challenges…. To help clarify for practitioners when it’s acceptable to treat a patient when their substance use disorder may be exacerbating a mental health disorder.

This is guidance that will help ensure that providers have the right information that they need to make the right clinical decisions for patients who are in crisis, and that decision may lead — for this very, very small subset of people who are experiencing concurrent disorders, who are a risk to themselves and to others — to their eligibility for involuntary treatment.

As we’ve discussed in this House before, there are two designated facilities being established right now. The first, at Surrey Pretrial, has ten beds there for people who are in the corrections centre. But second, a designated facility at Alouette has another 20 beds for people.

This is an important first step, and work continues with Dr. Vigo in this and looking for future sites, for example, up north. That’s probably the next priority — to provide involuntary treatment services like this in the northern part of our province.

Jeremy Valeriote: In this budget, $500 million was allocated for new funding for addictions and treatment recovery programs. From this, can the minister explain which portion is for treatment aftercare, and what does it look like for those when they emerge from voluntary care?

[8:25 p.m.]

Hon. Josie Osborne: Thank you to the member for the question. This probably has been extensively canvassed in the dialogue that I had with the member for Skeena, so I will just do a really light touch and then, if you don’t mind to touch on Hansard.

Specifically, over the fiscal plan, the $500 million that the member refers to, there is $70 million that’s allocated to sustain existing services, and that includes just over $47 million in the fiscal plan to sustain Road to Recovery. I’ve talked quite a lot about the importance of Road to Recovery and having that seamless system of care that connects people to the right services to meet their needs, all the way from withdrawal management through to treatment and recovery and aftercare supports.

I’ve spoken a lot with the member for Skeena around the importance of that seamless care system to avoid people falling through the gaps, the in-between, moving from withdrawal management into treatment, moving from treatment into aftercare, making sure that people have the supports they need at the stage that they are at in their journey to healing.

The budget includes $15.75 million in funding for aftercare regional community clinicians. It includes $10.936 million to expand community recovery centres. We have three recovery community centres operational in Vancouver Coastal Health right now, on the north shore in Vancouver and on the Sunshine Coast, and work is underway to expand this so that there is at least one in each health authority.

This budget also includes $102 million for Indigenous treatment, recovery and aftercare. I do want to spend a moment on this because of just how important Indigenous treatment, recovery and aftercare is in terms of supporting Indigenous people specifically who are struggling with substance use, mental health and concurrent disorders. These are Indigenous-led projects that are designed to offer cultural and land-based healing programming as part of a supportive recovery and rehabilitative continuum of care.

Some examples include Orca Lelum, the youth treatment centre. It’s a first of its kind in British Columbia and offers a ten-week cultural treatment program for youth. The Tsa̲kwa̲’luta̲n Healing Centre on Quadra Island, which will be opening soon, offers treatment and supportive recovery programming that integrates the withdrawal management services that are offered by Island Health in Campbell River. And the northwest legacy project, a project we’ve been speaking about in the House with the Northern First Nations Alliance, will include a new cultural treatment facility in the North.

The Indigenous fund also has included a grant to the Métis Nation B.C. to deliver on elements of their culturally distinct mental health and wellness programming and funding to the First Nations Health Authority to enhance their healing house program.

Jeremy Valeriote: In the ministry’s service plan, there is a stated goal of increasing access to opioid agonist therapy, which I will refer to as OAT. How many people are currently accessing OAT? How are these numbers being tracked?

[8:30 p.m.]

Hon. Josie Osborne: In December 2024, 23,414 clients received OAT prescribed by 2,029 OAT providers across B.C.

Jeremy Valeriote: How many people would the minister like to see receiving OAT in the next year, and what are the targets for the next four years?

[8:35 p.m.]

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

Two things — I’m just going to talk a little bit about the member’s question around what are the goals with respect to the number of people who are being prescribed OAT, but I also want to talk just briefly, too, about the difference between being prescribed OAT and staying on OAT, so OAT retention rates.

First of all, I think it probably goes without saying that we want to ensure that any person who needs and wants access to opioid agonist therapy has that access and is able to be provided with it. We have undertaken a number of efforts to expand access to OAT.

In fact, we’re the first jurisdiction in Canada to enable registered nurses and registered psychiatric nurses to diagnose opioid use disorder and to prescribe life-saving opioid agonist treatment. This is a transition into a permanent, certified practice. We worked with the College of Nurses and Midwives on this as part of that sustained commitment to expanding access to OAT in B.C.

We also launched the opioid treatment access line, and that allows people anywhere in the province to be able to call and get same-day care and a prescription for OAT medications. This is particularly important for people who are living in remote and rural areas. It’s important for people who may be living with the fear of stigma and need to reach out, and having a confidential conversation on the telephone is the best way for them to do this.

This work really aligns with our bigger provincial goals around increasing the available workforce for substance use care, connecting people with sources of care and increasing that initiation and retention in treatment. Ultimately, of course, it is about separating people from a toxic drug supply.

I read the number of people who are, as of December 2024, currently prescribed OAT. Of course, we’re going to continue to ensure that anybody who wants access has access, but it’s also important to monitor OAT retention rates and the ability of a person to stay on OAT.

Despite the benefits of OAT for people who use opioids, we have seen that retention rates have decreased over time. In ’23-24, the percentage of people on OAT who have been retained for 12 months was 44.4 percent, and that’s a slight decrease from the year before, where it was 44.9 percent.

The barriers to OAT access and retention are very multi-factorial. They are interrelated, and they really span across the health system. There are barriers to treatment access. People have mobility challenges. They may encounter lack of prescribers or pharmacies nearby. Medication availability can be a factor.

A fragmented system of care — we’ve canvassed this extensively during estimates around, again, the need to build a seamless continuum of care for people so they are not dropped through the gaps. Stigma and aspects of OAT provision that really limit people’s ability or willingness to continue engaging in treatment — these are all factors that can impact retention.

The ministry’s service plan does set goals for OAT retention, and they are outlined: 44 percent for ’25-26, 45 percent and growing in years beyond that.

I really appreciate the question from the member.

[8:40 p.m.]

Rob Botterell: In the southern Gulf Islands, there’s a lot of work being done right now to improve access to primary care. In rural areas, generally, there’s a need for flexibility because there are such unique circumstances in remote areas or rural areas of the province.

In the southern Gulf Islands, when doctors are, say, on Saturna Island or on Pender Island and are needed on another island, the current policy is that they’re required to take the least-cost form of transportation. The impact of that is that they take B.C. Ferries, which is great for B.C. Ferries, gets ridership up, but it also means that you could spend half a day getting from between islands that are actually very close together.

The question is: would there be consideration given to adopting a more flexible approach, which would involve water taxis as a way of ensuring the doctor can spend more time serving and helping residents of the islands with their primary health care needs as opposed to playing Wordle on the B.C. Ferries?

Hon. Josie Osborne: Well, as much as many of us like to play Wordle in our spare time, I know we want to make sure that doctors are spending the most time possible with their patients. I really appreciate the question.

I’m not aware of anything in the physician compensation framework that requires a least-cost form of transportation to be used. So it may be a health authority policy. I’m going to suggest to the member that we follow up to look specifically into this case and get an answer for the member.

Jeremy Valeriote: Back to our regular programming after that cameo.

Many communities don’t have access to life-saving services like supervised consumption sites or overdose prevention sites. I note that in Squamish the overdose prevention site is in some peril due to real estate exchange.

[8:45 p.m.]

What is the ministry’s plan to expand overdose prevention services to communities in need and/or to increase the operating hours for overdose prevention sites to allow more supervised drug use outside of the current limited hours available?

Hon. Josie Osborne: Thank you to the member for the question. I appreciate having an opportunity to talk about the importance of overdose prevention sites and services as one of the tools that are needed to address the toxic drug crisis and the importance of services like these in literally saving lives.

These services are often the first point of access for people to the health care system. They are places where people can connect and receive information and learn about the supports, treatment and recovery services that are available to them. They also enable people to use drugs in a place that is monitored, where naloxone, life-saving naloxone, is present and also where, sometimes, drug-checking services are part of it, but drug-checking services being part of harm reduction services overall. They are part of this seamless continuum of care that we need.

In order for people to access treatment and recovery, they need to be alive. Overdose prevention sites keep people alive. Over the last six years, over 12,000 death events have been averted through overdose prevention sites. We know that the people using them, the people working in them, the people in communities around them need to be safe, as well, that proper oversight and monitoring is required, and that’s why we are developing minimum service standards to ensure that this oversight is in place.

[8:50 p.m.]

With this, we continue to support OPS. Budget 2025 provides $48.7 million to support existing harm reduction initiatives at OPS throughout the province, support drug checking, support naloxone kit distribution. That includes $10 million annually over three years to support OPS.

With the release of the minimum service standards, health authorities will also have the guidance that they need and will make their decisions about the services that they will be providing within health authorities or at their sites.

Again, I just really want to emphasize how committed we are to building and expanding a seamless system of care for people who are experiencing mental health and addictions issues. Keeping people alive is the first step in connecting them to the system of care that they need for their healing journey.

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

Motion approved.

The Chair: The committee is adjourned.

The committee rose at 8:51 p.m.

The House resumed at 8:51 p.m.

[The Speaker in the chair.]

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

Leave granted.

Nina Krieger: Committee of Supply, Section A, reports resolution and completion of the estimates of the Ministry of Environment and Parks and reports progress on the Ministry of Forests and asks leave to sit again.

Leave granted.

Hon. Josie Osborne moved adjournment of the House.

Motion approved.

The Speaker: This House stands adjourned until 10 o’clock tomorrow morning.

The House adjourned at 8:52 p.m.