The House met at 1:31 p.m.

[The Speaker in the chair.]

Orders of the Day

Hon. Mike Farnworth: In this chamber, I call continued estimates debate for the Ministry of Health.

In Section A, in the Douglas Fir Room, I call continued committee stage on Bill 16.

The House in Committee, Section B.

The committee met at 1:32 p.m.

[Lorne Doerkson in the chair.]

Committee of Supply

Estimates: Ministry of Health
(continued)

The Chair: Good afternoon, Members. I’m going to call just a very brief recess while we get our teams in place for our estimates this afternoon.

The committee recessed from 1:32 p.m. to 1:33 p.m.

[Lorne Doerkson in the chair.]

The Chair: We’ll call the chamber back to order, where we’re going to contemplate the estimates of the Ministry of Health.

On Vote 32: ministry operations, $35,968,875,000 (continued).

Claire Rattée: Moving on with Red Fish Healing Centre, I just want to talk about this a little bit further, and I appreciate that update. I’m hopeful that we’ll hear some kind of an announcement coming forward soon.

With the current Red Fish Healing Centre, I’m wondering what the average wait time for admission at the Red Fish Healing Centre was for the fiscal year ’24-25.

[1:35 p.m.]

Jeremy Valeriote: I seek leave to make an introduction.

Leave granted.

Introductions by Members

Jeremy Valeriote: I’m pleased to introduce constituents Andrew Schultz and Susan Watkins. Both helped me get elected. They split their time between White Rock and Whistler, and they’re in the back here.

If you could all please make them feel welcome.

The Chair: Indeed, welcome to everyone in our chamber today. We are going to hear the estimates of the Ministry of Health this afternoon.

Debate Continued

Hon. Josie Osborne: It’s going to take a few moments to get that information, so I just wanted to give the member an opportunity to ask another question if she wishes.

Claire Rattée: While we’re at it, if we could also find out what the current occupancy rate is for that centre, that would be helpful. I don’t know if the minister would prefer me to move on to a different topic while that other information is being gathered.

Hon. Josie Osborne: It depends on the member. It’ll take a few minutes to get, so I’m happy to move on and come back to this when we get it.

Claire Rattée: I’ll wait.

I have one other one that might be useful to just tack on to this, if it’s helpful, because it’s in the same vein. Just generally, what is the current average wait time for authority-funded substance use treatment and recovery beds for the last fiscal year, please?

[1:40 p.m.]

Hon. Josie Osborne: All right. First, I’ll start with Red Fish Healing Centre for Mental Health and Addiction. Again, this 105-bed facility provides treatment for people with the most severe, complex mental health and substance use challenges or concurrent disorders. It has patients, clients from all over the province that come down to Coquitlam. The centre is really filling a service gap for clients who may otherwise end up in custody. They may end up in emergency departments instead of getting the help that they need.

The wait times vary by regional health authority, depending on the number of allotted beds in the centre and the volume of referrals. The program, it’s fair to say, consistently receives more referrals than it can admit annually, and it’s consistently full. So while there isn’t a precise tracking of occupancy levels such as the member may be asking for, because it is not tracked that way, I can say it is consistently full. So there’s a minimal amount of time that there would be an empty bed, as patients leave and new patients enter.

Of course, knowing that that volume of referral is higher than what the centre can currently accommodate, that’s why the program is expanding out, and we understand and recognize the need for that.

The wait-list data. I will read some information into the record here. As of December 31, 2025, there were 95 clients who were on the wait-list. I’ll break that down by health authority. Fraser Health had 20; Interior Health, 24; Northern Health, ten; Vancouver Coastal Health, 26; Island Health, 15; and the Provincial Health Services Authority, zero.

The average wait time to admission for clients admitted over the last calendar year, January to December 2025, was 97.9 days. If the member is interested, I can break that out further into regional health authorities.

Again, I just want to comment on the wide range of wait times that we do see between health authorities, primarily due to the volume of referrals that would be coming in from different regions. For example, Island Health refers a higher number of clients or patients relative to their population than some of the other health authorities, so that accounts for some of the difference. But on average, for all British Columbians on the wait-list, it is 97.9 days.

[1:45 p.m.]

The member also asked about wait times for substance use and treatment and recovery beds, and I can tell her. After estimates last year, we wrote to the member and followed up with the median wait time by different health authorities for ’23-24. The member is asking for the same data for ’24-25, so I’m going to read that into the record. I’m also going to add the first two quarters of 2025, because we do have that data as well, of the ’25-26 fiscal.

For Fraser Health in ’24-25, the median wait time was 38.3 days; in Interior Health, it was 26.5 days; Northern Health was 6.1 days; the Provincial Health Services Authority was 21.8 days; Vancouver Coastal Health was 43.5 days; and Island Health was 26.2 days. Overall, the provincial median wait time was 30.8 days, which is very similar to the information from ’23-24 that the member has, where the overall provincial median wait time was 31 days.

In the first two quarters of this fiscal, in Fraser, we see the median wait times have come down to 32.8 days; in Interior Health, 21.6 days; in Northern Health, 9.9 days; the Provincial Health Services Authority, 23.1 days; Vancouver Coastal Health, 27.1 days; and Island Health, 25.3 days, for an overall provincial median wait time of 25.6 days.

Claire Rattée: On the first piece, on the Red Fish Healing Centre, the ’23-24 fiscal year, it was actually 70 days that was the wait time for Red Fish. Going up to 97.9 now is a pretty significant increase in the number of days that people are waiting. No real question there, just pointing that out, but obviously, this is something that seriously needs attention immediately.

On the authority-funded substance use treatment and recovery beds, I am glad to hear that the wait times are coming down slightly, but in this first quarter, that is a significant increase for Northern Health. For obvious reasons, that concerns me. It directly relates to my riding. I would say that’s a very substantial increase and a confusing one, because we actually just had our first treatment centre that’s actually a proper bed-based treatment centre open. I don’t know if that has a role in more people maybe potentially seeking treatment, because there is finally an option and an opportunity that is available there, but I find that a bit concerning.

Budget 2023 promised another 375 new substance beds over the following three years, and those three years have passed. I just am wondering if those beds are currently in service.

[1:50 p.m.]

Hon. Josie Osborne: Just going back to the last question, the member commented that Northern Health is seeing a jump in the median wait time from 6.1 days to 9.9 days. I wanted to explain that one of the reasons why that number has changed so significantly is because there were a number of services in the Northern Health Authority that were not reporting in, and as of the beginning of last fiscal, they are reporting in. Having more services reporting in gives us a more accurate understanding.

It is not that the existing services that were reporting have seen an increase in wait times, but rather that the pool of data has changed, and the median wait time, therefore, has changed.

The member asked about the commitment around 375 substance use treatment recovery beds that was made in Budget 2023. As of January 2026, 272 of those have been built and implemented, and the rest are currently in active planning and development. As they are opened, then announcements will be made about that. So we are well on track to meet that commitment.

Claire Rattée: Just out of curiosity, though, that was a commitment that it would have been completed already. So what happened? Why didn’t we get to that number, if there’s specific reasoning around why we haven’t achieved that goal? What is the timeline for the rest of those beds to be completed?

[1:55 p.m.]

Hon. Josie Osborne: An update, even, from the number I gave, of 272 implemented as of January 2026: between January 2026 and now, another 50 — bringing the total to 322, which is just 53 shy of the commitment of 375. As I said, those remaining 53 beds are actively underway. So these are not projects or commitments that have been re-paced or slowed or cancelled or paused or anything.

To the member’s question, “Why haven’t you hit the mark exactly as of the end of fiscal?” I think there’s no extraordinary reason for this. It’s the typical process of the planning, the procurement, the construction. There are various reasons why sometimes capital projects will slow down a little bit, but we are very, very close. The announcements for those remaining beds are imminent, within months/ We know just how much those beds are needed.

So it’s an important accomplishment and, again, just builds on government’s commitment to expand the substance use and treatment recovery options that are available for people.

Claire Rattée: Thank you to the minister. I appreciate that.

I’m going to focus the rest of my time, probably, on treatment beds and similar types of issues, and then we’ll see where we’re at if I can get to a few other programs.

I want to start by just reading something into the record here, and I want to start by saying that these are not my definitions. These are definitions that came from government websites.

I’m going to talk about two different types of treatment beds that are outlined in the documents we referenced earlier — and I appreciate the minister getting those to me — around substance use and treatment beds that exist currently within our province. There are a number of different types of beds, but I want to focus on bed-based treatment versus supportive recovery services or supportive recovery beds.

Bed-based treatment refers to structured, live-in substance use treatment programs, often called residential treatment. These programs are time-limited and provide intensive, evidence-based therapy and support in a substance-free environment. According to Interior Health, bed-based treatment services provide you with a structured, live-in program where your treatment goals are supported through assessment, evidence-based treatment and skill-building. Similarly, Fraser Health describes them as time-limited treatment in structured, substance-free, live-in environments, addressing the physical, emotional, social and other needs of each person.

In practice, this means residents receive daily programming, such as individual and group counselling, educational workshops, life skills training and other therapeutic activities, all delivered by qualified professionals, counsellors, addiction specialists and often health care providers.

Now, the definition for a supportive recovery service or a supportive recovery bed is that it provides low-to-moderate intensity support in a live-in, recovery-oriented environment, rather than formal clinical treatment. In British Columbia, supportive recovery services are bed-based or live-in services that provide low-to-moderate intensity substance use services and supports in a communal and supportive environment. These are essentially recovery homes or residences where individuals can live temporarily while they work on their recovery goals, such as maintaining abstinence or transitioning to the next stage of treatment.

[2:00 p.m.]

Unlike intensive treatment facilities, supportive recovery houses do not typically provide formal clinical care or therapy on site. Instead, they offer a safe, substance-free living space with peer support, basic structure and links to community services.

A couple of important distinctions there between the two. Qualified professionals, structured, evidence-based intensive therapies and supports in a substance-free environment — there are a few distinctions there. I want to make it clear that I’m not making those distinctions because I am in any way not supportive of the concept of building out supportive recovery services, because I am. But I think they’re a second step for most people.

As somebody who’s lived through this system, I would have benefited greatly from that, but I still needed to go to a bed-based treatment centre.

The reason I ask that is because when I received that document last year, I was pretty surprised to see, and I’m hoping memory serves here, that there were only 806 publicly funded bed-based treatment beds in the province last year. When I’m looking at the new numbers that I just received today, there’s overall an increase of 47 beds versus the March update that I received in 2025. It’s good that there’s an increase, but the increase is in some strange areas in my opinion.

In adult supportive recovery beds, there was an increase of 28 — great. Adult withdrawal management, increase of 16. Adult transitional services, there was a decrease of eight. I understand that sometimes these things can happen due to contract issues, whatever. I’m not necessarily honing in on that one. Youth supportive recovery beds, an increase of eight. Sobering and assessment beds, an increase of five.

Then where it didn’t change at all is: adult bed-based treatment, no change. Youth bed-based treatment, no change. Youth withdrawal management, no change. Youth transitional services, no change. Tertiary substance use concurrent care, no change.

I have some concerns around that. I have some concerns that when we’re talking about those 375 beds, that maybe a lot of the focus has been put on supportive recovery beds rather than on bed-based treatment. I think that we need to make sure that we’re focusing on bed-based treatment and building that out.

I would appreciate the minister’s comments, just on that breakdown and, looking at those numbers year over year, why that wasn’t the focus, why we didn’t focus on bed-based treatment rather than supportive recovery services or “and”. But like I said, there was no change at all in the numbers apparently.

I do apologize. I had to do this very quickly, to compare the two documents. But if those numbers are correct, I do have some concerns that we didn’t place any focus there, so I’d just appreciate the minister’s comments on that, please.

[2:05 p.m.]

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

I want to approach this answer not talking strictly about a comparison of one year to the next year but, instead, about government’s approach to building out a continuum of care since 2017.

[2:10 p.m.]

I want to remark that at that time, in 2017, there were far fewer services available for people, and it has been a consistent and committed approach of this government to build out that continuum of care, again, using evidence and expertise that is provided to us by professionals in this space and listening to people with lived and living experience.

Over the last some years, eight years, since 2017, we have seen the addition of 829, in total, new publicly funded substance use beds of different kinds. The member broke it down very well between adult and youth, between detox or withdrawal management, sobering and assessment beds, to treatment and supportive recovery, transition beds. These are all different types of bed-based services that people can access.

But the system of mental health and substance use care is not just about those bed-based services. It is also about the provision of out-patient services. It is about a person who may go into a withdrawal management facility and then be able to transition to OAT and use those out-patient services and not necessarily need bed-based treatment. But there are many who do. So the system needs to constantly recalibrate itself based on the needs of what we are seeing.

As the toxic drug supply itself changes, we are seeing how those needs change. For example, as I know the member understands, recently decisions have been made in certain withdrawal management facilities to move from a very short-term stay of three to five days to a three-week stay because of the difference in what we are actually seeing in the toxic drug supply and the addition of benzodiazepines, for example, of medetomidine, other things.

As care providers are grappling with how to best medically assist and treat people who are going through withdrawal from some of those substances, it requires different lengths of stay, different forms of care.

I do want to stay away from directly comparing the number of beds just on one year to the next and say that we continue to follow the work that’s being provided by health authorities in their assessment of patients, of what treatment and recovery services are most appropriate for clients.

So when somebody asks for help with addiction services, the health authority will gather information about their recovery goals, about their substance use history, about the level of support, including the level of medication support that’s required by people — really finding a service that fits best for them. What is available. Clients then are referred either to treatment services or to bed-based recovery options or supportive recovery options if the more intense levels of treatment are not needed.

I also just want to speak, too, about Road to Recovery, this made-in-B.C. program using the evidence that we see before us to help a person quickly access services and assessment and then be able to be paired or matched with the right service for them at that time in a way that has them not experiencing the gaps that far too many people have faced in the past and they continue to do today.

By bringing down wait times, as we have seen in the St. Paul’s Hospital–based Road to Recovery program, from a median of 28 down to just eight or even one day for those who most, most urgently need withdrawal management, for example, and then ensuring that they are able to move through the system of care in a way that is most appropriate for them…. The success rates, the evidence that we are seeing coming out of the Road to Recovery program at St. Paul’s is incredibly promising, and that is why we’re expanding this model of care across the province.

I hope that that helps to answer some of the member’s questions. Again, I just want to point back to the importance of building out a continuum of care that provides different models — some bed-based, some not bed-based — and being able to adjust and recalibrate as is needed, as we move through time.

The underlying thing here, though, is that there is a need for more of all of these services, and we recognize that. The toxic drug crisis has not abated. We still see that, and we see the way that it is changing.

We know there is more work to do even outside of…. We are talking mostly here about treatments and recovery. But much earlier in the education, in the prevention, in the early intervention programs for people, whether it be helping people manage pain without opioids, whether it be working with children, especially those who are highest risk — identifying them and supporting them in the school system, in community settings — this is all part of the mental health and substance use continuum of care that British Columbians deserve and need.

[2:15 p.m.]

Claire Rattée: Thank you to the minister for that. I was going to continue to focus on this topic, but there was something interesting that was mentioned there around prevention and education. I know that the minister knows that that’s something that I’m very passionate about. I’m curious if the minister can point to how much in her budget is allocated for prevention and education for youth when it comes to substance use.

[2:20 p.m.]

Hon. Josie Osborne: Thank you to the member for the question. I appreciate the opportunity to talk about the required and much-needed emphasis on prevention and early intervention.

We know that the majority of mental health challenges often have that onset in childhood or adolescence. We know that youth today are facing some very unprecedented challenges. It’s not just stemming from the COVID-19 pandemic, although that certainly has had an impact.

The toxic drug crisis, climate-related emergencies in weather, pressures from school, bullying, relationship matters, issues with families — these are all things that place an enormous burden on children and youth today. So being able to support children and youth with mental health resources and that early intervention to prevent small problems from getting worse — and, potentially, even to the point of substance use — is a very important focus of the work that we’re doing. Again, just building out that seamless system of care.

I don’t have one specific number that I can provide to the member that encompasses all of the mental health and substance use education and prevention supports that are provided for children and youth, because the ministry undertakes most of its work in a program fashion. There are several different programs. I’m going to speak about those in a moment. Those have figures attached to them.

I know the member is very familiar, for example, with Foundry. With 20 Foundry centres open now, 15 more in development — that number might even be a little bit outdated — and satellite Foundry locations being announced as well, the ministry has provided $74.9 million, over three years, to enhance the Foundry services.

Foundry also receives $2 million every year in the base budget — that’s in base funding — for the provision of PreVenture in schools. PreVenture is an important program that is age-targeted and helps youth identify challenges and ways of managing and handling those challenges that help to prevent turning to substances to deal with issues that youth are facing.

In addition to that, we do undertake partnerships with organizations like the Canadian Mental Health Association of B.C. and Confident Parents, Thriving Kids, which is a service that is funded through the ministry, for children aged 3 to 12 experiencing behavioural or anxiety challenges. We do work with other partners like Child Health B.C. and the B.C. Healthy Child Development Alliance, funding them for social and emotional development programs in early years.

We have the early psychosis intervention program that provides some rapid and comprehensive treatment for youth and young adults aged 13 to 30, who are experiencing early signs of psychosis. This program was funded and expanded in 2021, adding approximately 100 new FTEs across the province, and received further investment in Budget 2023.

Again, this work continues through to today. The integrated child and youth teams that we’ve talked about in the chamber here before — these community-based multidisciplinary teams are focused on children that are identified and youth that are identified as being most at-risk and are helping to deliver these wraparound mental health and substance use services and supports for them.

Just a few more numbers here. With the Confident Parents, Thriving Kids program with the Canadian Mental Health Association, the ministry provides $6.818 million in funding. An additional program with Child Health B.C., called feelings first, has another $235,000 in annual funding.

The early psychosis intervention expansion through Budget 2021, $53 million, and increasing that funding to $75 million in ongoing funding through Budget 2023 for those 100 FTEs that I spoke of.

Then the province has committed $131.5 million, over three years, to implement the integrated child and youth teams in 20 school districts.

Again, I just want to point to the fact that this is not wholly within the Ministry of Health and that our partners in the Ministry of Education and the Ministry of Children and Family Development are an important part of this, too, in providing these kinds of mental health and substance use supports to children and youth.

[2:25 p.m.]

Claire Rattée: I appreciate that response, and I’m glad that the minister mentioned Foundry. I have a lot of questions on Foundry that I don’t know if I’ll have time to get to because I need to get through these ones around treatment beds.

Personally, I would actually categorize Foundry as not being that effective for the purposes of prevention amongst youth. I’ve had the opportunity to tour a few, speak to quite a few of the people that do program delivery, read through everything that is available online and on the app, and there’s very little in the way of prevention and education.

Most of the materials explicitly make mention of just trying to use safely and encouraging youth to, effectively, maybe curtail their use to a more reasonable level if it has become problematic. There’s very, very soft language being used, throughout all of the documents that I’ve read, that really downplays the dangers and the harms.

When this is being targeted at young children, I think that it’s extremely inappropriate, in my opinion, to do that. Hopefully, if we can get through these questions, I would love to get into some on Foundry.

I’m wondering if the ministry — and I hope they do — tracks how many people fall off wait-lists waiting for treatment or for withdrawal management without accessing any services.

[2:30 p.m.]

Hon. Josie Osborne: Thank you to the member for the question around whether the province tracks people who fall off wait-lists. First of all to say that’s a really important point. The intention here is to build out a seamless system so that people don’t experience those gaps in care.

Seeing the establishment of Access Central as part of Road to Recovery in Vancouver and now seeing Access Central roll out to three other regional health authorities, with Northern Health coming on later this year….

[2:35 p.m.]

That is absolutely the intention, to be able to provide that rapid response to people and then maintain a relationship with that person so that they do not fall off of a wait-list as they’re waiting for the care that they are assessed for as being needed at that time.

We don’t currently have a provincewide system of being able to track people in that manner, but that’s the work that we’re moving towards, and it’s an important part of building out the system. Working on this Road to Recovery, working with Access Central to ensure that active engagement and to reduce the number of no-shows, for example, we are already seeing the reduction in wait times to access withdrawal management. Very, very positive results coming out of Road to Recovery.

But at the same time, establishing other ways into the system — for example, the OAT line, the opioid therapy line and treatment line and the rapid access addiction clinics — to provide people with that quick access into the system. Then build out, as we’ve been talking about during estimates here, the different types of bed-based and outpatient-based care that people need as they move on that Road to Recovery and move through their healing journey.

I do want to come back to the member’s comments about Foundry.

I recently had a detailed briefing with leaders at Foundry, who showed me some of the results of their evaluation and the metrics that they are recording and seeing — noting things like 84 percent of the youth who use Foundry services, noting that it has a positive impact on their ability to cope, which we know is an important part of dealing with mental health challenges and preventing small problems, again, from getting worse and getting to places where we don’t want to see any youth, when it comes to substance use and the choices that they’re making.

I would like to offer the member a detailed briefing both on Road to Recovery and on Foundry services to bring her as up to date as I am on the really promising results that we’re seeing out of both programs and then give her an opportunity, too, to ask staff questions about that so she has the fullest understanding possible.

Claire Rattée: Thank you to the minister. I do appreciate that, and I would be happy to do that.

Just to clarify, too, that I think that building out youth centres is excellent work. I think it’s incredibly important work, and I support that. I think we need lots more youth centres. That’s not the issue I take.

The issue I take is with, for lack of a better term, the curriculum around substance use when it comes to what’s happening in these youth centres, particularly given the fact that it’s also aimed at children that are quite young in a lot of circumstances, who likely aren’t using substances. As somebody that started at a very young age, I do know it happens and it’s possible, but it’s not the norm.

Certainly, for ones that are using, I would hope that our goal would be abstinence for young people especially. Even if ideologically we disagree about whether or not people can safely use dangerous substances, I think most of us can agree here that youth cannot. Their brains are not fully developed. There is no safe amount of drugs for them to be taking. So I think that that just scientifically doesn’t make any sense.

The reason I made that comment was because I actually attended an information session when they were looking at putting a Foundry centre into my community. I don’t know the exact ages of all the kids and youth that were in the room, but I can tell you for sure that there were kids as young as ten, maybe younger.

The program coordinator said, and this is a direct quote: “We can help youth to have safe supplies when they use substances so they’re not being harmed, or we can help them to just decrease their use to a more manageable level.”

Nothing about encouraging them to not do drugs, nothing about educating them on the dangers of doing drugs, not to mention the fact that most of these children had probably never had conversations around drugs, because they were quite young. So that was putting it in their heads, and I didn’t much appreciate that, personally. If it was my children, I would have been pretty upset.

So that is why I had raised that, and like I said, I hope that maybe we can have — as the minister had offered, and I appreciate that — an opportunity to sit down and kind of talk through some of that.

Just again, as somebody that experienced that in my youth, I don’t think that those comments would have been helpful to me. I think they would have encouraged me to continue with some pretty destructive behaviour and know that I was going to have somebody on my side to back me up on it and encourage me to keep on that path. What I needed was very different from what that is offering.

I want to talk a little bit about the per-diem rates for treatment beds because they vary greatly by health authority.

Sorry, I don’t know. Maybe I’m not using the right term but….

Interjection.

[2:40 p.m.]

Claire Rattée: Oh, like the per-diem rates. Yes. For beds, right? For treatment beds, supportive recovery beds, that sort of thing.

My understanding at this point is that they vary by health authority. We had the opportunity very briefly to touch on this earlier in estimates, about some of the issues that we can see with a regionalized health authority model simply because, obviously, there is not consistency throughout the province, which can be a problem.

These rates do vary throughout the province, quite substantially in some cases. Different health authorities pay different amounts, and in not one of them does it actually cover the entire cost, the real cost of what it costs to operate that bed.

It has created a little bit of a problem for people that are on the public system, because it has forced a lot of recovery centres to actually have to prioritize private-pay clients, which they usually don’t want to do, unless they’re very much in it for profit. Typically, they want to be serving people that are underserved, but they’re forced to prioritize those private-pay clients because they can’t afford to operate their centre without that extra revenue.

I would like the minister’s comments on whether or not this is something that’s being addressed — trying to create a standard rate throughout the province — or if it’s going to be regionalized. And to be fair, I can see where that may be beneficial, because cost of delivery in a place like Northern Health is likely going to be a lot higher than it is in the Lower Mainland. But the reality is that it’s almost opposite what those rates are right now.

I would like to know if there’s work being done to address that discrepancy, to try and make some kind of a standardization of that and to actually look at making sure that it reflects the real cost, because in some cases it’s as much as half of the true cost of operating that bed per day.

As you can imagine, many of these providers are non-profits, so it has put a significant burden on them through fundraising and other sources of revenue and then, like I said, the need to prioritize those private clients, which does a huge disservice to some of the most vulnerable people that need access the most.

[2:45 p.m. - 2:50 p.m.]

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

As the member knows, and she’s rightly pointed out, there’s a complexity to the way that substance use treatment and recovery beds are funded with our partners at health authorities and not-for-profit facilities, for example.

I just want to start out by saying how important and valued those partners are in delivering this care for people and recognize that there are facilities that do have a mix of private and publicly funded beds. And then, of course, there are facilities that have solely run with publicly funded beds. Then, in those partners, some of them are both private-pay operators, and some of them are not-for-profit organizations as well.

So public funding for substance use beds is provided to the health authorities directly, to service providers, to First Nations through health authority funding, through contracts, grants and per diems. And the member is making the point around per diems. Of course, our goal is to provide equitable access to people and to ensure that people receive that standard of care that they expect and deserve.

The member spoke about per diems and pointed out some of the issues in how we support and provide those services to the province’s most vulnerable citizens. Funding is available to people who are receiving income and disability assistance via the Ministry of Social Development and Poverty Reduction and through those per-diem payments that the member is speaking of.

So SDPR per diems are paid directly to the treatment or recovery provider at a set rate on behalf of those recipients. The funding is available for people who are accessing publicly funded and non-funded beds, and the services have to be licensed or registered in order to receive that SDPR per diem funding.

Now, recognizing that there was a need to increase per diems, that was accomplished through Budget 2024. That increased the per diem daily rates from $35.90 to $60 for registered bed-based services and from $45 to $70 for licensed bed-based services. That’s the second increase that’s been undertaken in a six-year period. The previous per diem increase was in 2019 — the first one in ten years.

I also want to recognize and acknowledge that there’s more work to do in this place and also recognize that it’s important to continue to provide these services to clients who cannot afford, don’t have the ability to pay, and that’s why there’s a no-barrier hardship funding that health authorities also have processes for individuals to apply to.

And I think I’ll just leave it there and see if the member has a follow-up question.

Claire Rattée: Thank you to the minister for that. I appreciate that and the recognition, both, that this is something that needs to continue to be worked on. And I also recognize that it’s something that had been left for a long time. I’m completely alive to that.

[2:55 p.m.]

I just get a lot of complaints from treatment centres about the fact that they can’t actually operate a bed, based on what they receive in ministry funding, and this is not a small portion of the population that can’t afford treatment. I mean, private treatment is incredibly expensive. I don’t think most working British Columbians could afford it.

That was kind of more so what I’m getting at. Are we doing any work to try and find ways through the Health Ministry to ensure that the providers are properly being compensated for the service that they’re providing for the patients that are coming through there? It just seems that there is a pretty significant disparity. Like I said, in many cases, they are receiving less than half of what their actual cost to operate is. I will leave it there.

I have another question. I’m wondering if the minister could provide me with the number of how many patients last year were forced to leave their home health authority to be able to access services.

Hon. Josie Osborne: This is a tough question to answer because there can be some very individual circumstances, I think, that I want to speak a little bit about.

But first of all, to say that while the principle remains, we know that many British Columbians want to receive care as close to home as possible. To have the support of their community, their friends, their family and their colleagues is an important thing.

That’s why, as we are building out this continuum of care when it comes to mental health and substance use supports, be it bed-based or outpatient-based, it’s really important we continue to do the work to increase access, particularly for those communities who are remote, rural, Indigenous, northern.

I’m glad that this last month we were able to celebrate the fact that there will be new treatment beds opening up near Terrace, for example, including withdrawal management beds in a new facility, coming within the next couple of years, building out supportive recovery. This is important to provide, as we’ve been talking about through estimates here — the different parts of the care continuum and having that easily accessible as close to home as possible.

[3:00 p.m.]

I was recently speaking with a First Nation about access to treatment and recovery beds, and they were talking to me about the fact that some of their members travel to Vancouver Island from a northern community.

I said: “Oh, that must be quite difficult to do. That’s a big journey and can be a really tough time.” And I got an interesting answer, because in this particular case, it was described to me: “You know, that’s actually not the worst thing. We’re grateful to be able to send people to a facility that we trust, that we know, that we see the results of their program.”

And it is far away from home, but for some individuals, actually being away from some of the sources of challenges that they are facing and being away from some of those people in their lives has been a positive thing. So it is a very individual thing.

Further, there are some people, such as health care providers themselves, who are experiencing substance use challenges, for whom they would not want to be maybe even just in their own health authority receiving treatment but not even in the province of British Columbia, to retain the anonymity, really, that they’re looking at and making sure that the risk and the possibility of stigma that could be applied to their situation is reduced as much as possible.

Again, just coming back to the beginning of my answer, it is a difficult question to answer. I appreciate, I think, the intention of the member about being able to increase access to care in all parts of the province, which absolutely is part of our goal as we continue to build out the mental health and substance use care continuum.

Claire Rattée: I do appreciate those comments. I recognize that in some situations it is better to be able to leave your community. The reality, though, is that most of the time it’s not.

The main reason I asked that question was because I was curious to see, for example, how many patients from Northern Health last year had to leave the Northern Health region to be able to access care. I think everybody should have some choice.

Again, this is one of the issues, I believe, with the regional health authority model. Because, yes, if there is a treatment centre that’s excellent that everybody knows they really want to go to, I think they should be able to have that choice. But they should also be able to have the choice of something that’s close to home. Unfortunately, for a lot of people right now, that is not the case.

I’m not advocating that we put a treatment centre in every community. There are some that obviously will never be able to have access to that because they’re too small, but just something that’s a little bit closer. I know we’ve spoken about it before and throughout estimates here, but even Prince George, for example…. For somebody living in my community, that’s still an eight-hour drive away. It’s not a small distance to travel.

I’m wondering what percentage of individuals who complete detox or withdrawal management are able to immediately access a treatment bed right now. This is something we discussed last year and we’ve discussed throughout the year. There is a really deadly gap between withdrawal management and treatment. So I’m curious to see what that wait time is like currently between the two services, on average.

[3:05 p.m.]

Hon. Josie Osborne: Thank you to the member for the question. I think this really gets at the heart of government’s goal around making access to treatment and recovery as seamless as possible to reduce and eliminate the gaps that people experience.

Part of that, as we’ve been talking about throughout estimates, is around strengthening that full continuum of care. The addition of the beds that we’ve been discussing in estimates today is part of that. Again, there are the 829 beds that have been added over the past eight years or so, with planning underway for more.

But I want to come back to the Road to Recovery model and the work that it is doing to connect people with clinicians and specialists from the very first conversation that they have at Access Central.

Now, I’ve already talked about some of the success of the Road to Recovery model in Vancouver that has reduced the median wait time to get into withdrawal management from a median of 28 days down to 8 days, with even faster access for those who are most urgently needing it.

The member is asking specifically about the next possible wait time or gap in care, moving from withdrawal management or detox into some form of treatment. I want to be clear, again, that it is not always bed-based treatment that is needed, wanted or deemed to be the most appropriate in that relationship between a patient and their team.

The Access Central line. What it also helps to do is make sure that a person doesn’t have to navigate that system on their own or, as often is the case, a family member helping them to navigate it on their behalf. For example, if a person calls Access Central, they have that access immediately to clinicians and to specialists. If they have, through that process, a pre-booked treatment date that requires detox first, Access Central actually works to line up the withdrawal management date with the scheduled treatment intake. That is one way to reduce or eliminate a gap that a person might experience.

But again, not every person who enters withdrawal management has an intention, or goes in with a plan, to need a treatment bed. We don’t want that to be a barrier to accessing care, which, again, is why we provide other access into outpatient-based services, helping to prescribe OAT in that case for those individuals, and working with people to really identify what their recovery goals are and make a plan. That plan may include accessing bed-based treatment services if it’s needed or if it’s their choice.

Now, if there is a wait for treatment beds, the team does everything it can to make sure that a client continues to be supported. That might be accessing a stabilization or a transition bed. It might be connecting them with outpatient treatment care or services like OAT that I talked about and having teams who regularly follow up with the client.

[3:10 p.m.]

I want to acknowledge that there’s still a lot of room to improve this system and to continue building it out. That is exactly what we are doing through Road to Recovery and by continuing to invest. The progress we have made over the last eight years or so has been incredible when we compare it to what there was before.

The member…. We’ve already talked about this and acknowledged that there wasn’t enough then. There is more now, and there is still more work to do.

Claire Rattée: I appreciate the minister’s response on that, and I just quickly wanted to mention this because with Access Central…. I do understand that that’s something that’s really been touted as being a solution to a lot of these problems. Part of the problem I see with that, though, is….

Just recently my team was doing some constituency work helping a constituent outside of our constituency. I know we don’t have access in the North yet to Access Central, but this is somebody that was…. I don’t know. I don’t remember off the top of my head exactly where they lived, but they were in the Lower Mainland in general.

We told them to call Access Central. They called, they got their callback 24 hours later, and they were basically told: “We don’t line up treatment. You can call back every day, and we’ll let you know when a detox bed is ready.”

I do not, personally, see how that is any different from the system as it existed previously, as somebody that, again, had to navigate it. That’s always been the case. That’s why it’s been very hard, particularly for really vulnerable populations, those that are unhoused, for example, that are unlikely to have a cell phone. If they do, it’s likely to get stolen very frequently.

This has always been an issue with our system. We put a lot of the onus on a patient or a client to do the follow-up, when they are typically not in the right headspace to be capable of that. We should be doing everything in our power to make sure we get them in to access services when they are ready and they show voluntarily that there is a desire to do so.

So I have had a few experiences now with Access Central that have been less than stellar, I’ll say, compared to the way that this program has been sold. I’m happy to connect offline with the minister about that, but I do have some concerns about the way that this program has actually been rolled out.

I know that it’s newer, and I know that there will be things to work through. Maybe you get somebody on the phone one day that isn’t properly trained, I don’t know. But it was not helpful, and it actually really frustrated the family to the point where they’re feeling like they’re going to give up again because they just have not been able to access services.

With that, I have one more question that I’m going to ask and then after that will request a five-minute break, because my colleague is going to take over, so that the minister can switch out her staff.

But before I ask my question, I just want to say thank you. I appreciate everything that the minister and all of her staff have done over the last two days here and answering all of my questions. I appreciate that we always have respectful conversations, even though we disagree on some things. I know that we agree on more than not overall, because I think we both want to get to a place where we can get a handle on this crisis and my role is no longer needed.

The last question that I’m going to ask is around data collection. I think I touched on this last year, but I would really like to try and, one more time, circle around to this. I’m hoping this is something we’ve made some progress with. It’s around what kind of data the ministry collects on success rates of residential treatment programs that are funded by the government.

How are we tracking outcomes? How are we confirming that what we’re doing is working? How are we figuring out which treatment centres might be doing a better job than others? What kind of aftercare and follow-up is needed? What’s more successful? How are we tracking any of those data points?

[3:15 p.m.]

Hon. Josie Osborne: Just going back to the member’s accounting of the family, the person, that she and her office were trying to assist through Access Central, I’d be very happy to hear more details.

I do want to acknowledge that Access Central…. We know that that’s not a silver bullet. It’s not a single, stand-alone solution. But it certainly is helping people to navigate the system better. It won’t launch perfectly, but it is improving as time goes on.

Just one anecdote of my own. In speaking with people who are involved in the system and acknowledging that, yeah, not everybody has a cell phone and has the ability to be able to call back…. You know: “Next Tuesday, call at 1 p.m.” Acknowledging that the system needs to meet people where they’re at. So being able to say to somebody who doesn’t have a cell phone, for example, “I’m the person you’re going to speak with. I work these days. Try to call back next Tuesday, any time between 3 and 8 p.m. or in the afternoon….”

[3:20 p.m.]

The point of Access Central is to provide a single point of connection and to help somebody move through the system. That’s the intention, and I’ll be happy to hear from the member more about the particular case that she was talking about.

Now, moving on to tracking the success ratio of residential treatment and recovery programs. It is a challenging question to answer in a couple of ways. First of all, defining what success is and understanding that a person who undertakes a bed-based program may find themselves, some weeks, months or years later, in a position of wanting to access that treatment again, because of their addiction.

We discussed yesterday this being a disease, a situation that can be relapsing for people. That’s part of the journey. It’s not a straight-line journey for individuals. Defining “success” is challenging. It is very individual and depends on a person’s own recovery goals, where they are seeking to be and what “success” means to them.

There’s no single source of these data. We are working with five regional health authorities and a provincial health services authority and bringing those together with other ministries and services that are part of this picture, this big piece of the puzzle, too — for example, the corrections system, which actually is probably the place where we have the most data, because of the way individuals are tracked. Bringing together the corrections system, the health system, social services like housing, for example — this is all part of what’s needed to be done.

Now, that being said, since 2021, the ministry has developed a performance measurement framework to monitor access and service utilization, the number of clients in each health authority that are served by health authority–funded, adult, bed-based treatment and recovery services, for example. This is new. Before that, these data had never been collected, beyond just bed counts. So understanding the service use and how people are using them.

We also, on a program basis, monitor very closely some of those key investments that I’ve been speaking about today, including the CMHA beds program, the Road to Recovery program, recovery community centres and the opioid treatment access line. These all have regular monitoring, reporting and evaluation.

[Mable Elmore in the chair.]

Again, I’ve offered the briefing to the member around the evaluation findings from Road to Recovery in Vancouver, showing that treatment retention has improved by more than 25 percent and that most participants in the monitoring and research program were still on opioid agonist treatment 30 days after discharge, which exceeds provincial retention rates that are reported for methadone and buprenorphine.

[The bells were rung.]

I’ll wait for the bells.

A few more results that we’ve already seen: for the Road to Recovery program, their year 2 evaluation showed a 13 percent improvement in housing status, or stable housing, in the 12 months following Road to Recovery admission. CMHA B.C.’s grant-funded beds that are provided at no cost and that are prioritized for underserved populations are also making a really big difference.

Evaluation findings are showing that clients are reporting benefits like increased self-control and a sense of empowerment, increased optimism and hope for the future, reduction in anxiety, improved mental health and increased capacity to successfully transition out of treatment.

We also monitor treatment and recovery services through ongoing and strengthened oversight in these recent years. All licensed and registered sites are required to comply with the Community Care and Assisted Living Act and the regulations there.

In 2021, we introduced provincial standards for registered assisted-living supportive recovery services to really strengthen that safety and the quality and the oversight of supportive recovery services. Health authorities and the CMHA have been directed to incorporate these standards into their funding agreements for all publicly funded beds. The health authorities continue to monitor their contracted operators for compliance with the standards, and they report annually to the ministry on progress.

[3:25 p.m.]

I hope that explains a little bit more about some of the oversight, the monitoring and the evaluation that the ministry does undertake, recognizing the consistent need for improvements in the system and being able to better understand how, using the evidence and the research that we have, the advice and recommendations of experts and clinicians in this field, to provide the best services for people and, again, designing and developing and implementing a system that not only is seamless but that is able to provide people with the support and the care that they need, no matter where they are in their journey.

I, too, really appreciate the conversation, the dialogue that I’ve had with my critic for mental health and addictions, the member for Skeena. I want to say thank you very much for this — and my commitment to the ongoing dialogue that we regularly have outside of the chamber to be able to continue this work.

I also just want to take this opportunity to emphasize and once again reiterate this government’s commitment to building out a system of care that works for people. There has been a phenomenal amount of work that has been done. I have come to see and learn, in my last 18 months or so in this role as Minister of Health, to really deeply appreciate the work of those people on the front lines, in facilities, who are working with people every single day. It is difficult and hard work.

And there is so much more to do, not just to serve those people who are the most vulnerable and experience the most disadvantages but also to continue to improve the services we provide for people that are maybe thought of a little bit less when we think about substance use — that is, people who are using at home alone, people who face enormous stigma and fear in wanting and needing to be able to talk about issues.

We want to continue to expand the supports and have a conversation with society at large about reducing that stigma so that we can help more people and, again, so that one day this critic doesn’t need to have the role that she has.

So with that, I’ll say thank you and ask for a five-minute recess, please.

The Chair: Okay, we’ll take a five-minute recess.

The committee recessed from 3:27 p.m. to 3:35 p.m.

[Mable Elmore in the chair.]

The Chair: Okay, I’ll call us back to order from the recess. We’ll continue our conversation on Vote 32 with the Ministry of Health.

Brennan Day: Nice to see everybody again this year. I feel we’ve all aged in dog years over the past 12 months, but it’s great to see everybody back. I’ll jump right into it. The plan today is to do some general health questions, and then we’ll get into seniors and rural health.

My first question. Last year when asked for net new nurses, you provided gross registration numbers, so I guess I’ll re-ask the question again this year. How many net new nurses are practising today, compared to this time one year ago, after accounting for those who left the system?

[3:40 p.m.]

Hon. Josie Osborne: I know how much the member likes numbers, and so I am going to provide numbers.

First of all, just to say that nursing supply-and-demand challenges remain, as the member knows and as we’ve canvassed in question period many times. That’s why we are hard at work to make British Columbia the most attractive place for a nurse to work with fair pay, with modernized facilities and workforce models and really reducing the barriers for internationally trained nurses to come practise here in British Columbia.

I just want to quickly point out and say thank you for the work that the B.C. College of Nurses and Midwives has done around speeding up the credentialing of international nurses.

I’m going to give some overall stats and then dive into some of the details. The growth in B.C.’s nursing workforce has outpaced population growth since 2018. As of December 1, 2025, there were 76,594 nurses registered with the B.C. college. Registrations have grown by 29 percent since 2018. In that time as well, nursing full-time equivalents, or FTEs, have grown by 16 percent. That is net growth.

Specifically, from 2023 to 2024, which is the most recent year-on-year comparison that I can provide, we went from 53,059 FTEs to 56,193, which is a net growth of 5.9 percent.

I want to break down the different kinds of nurses that we have in our nursing workforce. Of those 76,600-odd nurses, LPNs comprise 17,164 who are registered. Of those, 16,214 are actually practising. That’s 94.5 percent. There are 55,490 registered nurses; 50,810 who are practising. That’s 91.6 percent. Registered psychiatric nurses: 3,940 registered, 3,716 practising, or 94.3 percent. We also have 2,141 employed student nurses or student psychiatric nurses.

We have a nursing turnover rate of about 4.6 percent here in B.C., which is actually the second lowest of all provinces, and our retention of early-career nurses is the highest in the country.

Earlier I referred to outpacing population growth. Just to add a little onto that, compared with population growth of 13 percent between December 2018 and December 2025, nursing registrants grew at 29 percent. From January 1, 2025, to December 1, 2025, the number of nurses registered in B.C. grew by 2 percent, compared with a projected decline of just under 1 percent in the population, over the same period. Again, I’m just making the point that the growth in the nursing workforce is outpacing population growth.

I think I’ll leave it there and see if the member has any follow-up questions on that.

Brennan Day: I think if it would be possible to see the net-change data across health authorities, that would be very beneficial. We don’t need to canvass that here, but certainly, for nurses entering the market, it would be great to encourage them to join our neighbours in the North. I know there are quite a few openings up there.

The second question that I have, just on general health care numbers: how many funded health care positions in British Columbia are currently unfilled?

Hon. Josie Osborne: If I could ask the member to clarify, is he speaking of all positions or any specific positions?

[3:45 p.m.]

Brennan Day: No, I’m referring to all positions. How many currently funded health care positions in British Columbia, under the Ministry of Health, are currently unfilled?

Hon. Josie Osborne: Thank you to the member for the question. I just want to start off describing a little bit about how these data are tracked and reported, again, with the five regional health authorities and the Provincial Health Services Authority.

[3:50 p.m.]

They report quarterly, to the Ministry of Health, the total regular positions and total vacant positions. That’s what’s tracked and reported by Island, Northern and Vancouver Coastal.

In Fraser, Interior, PHSA and Providence Health Care, they track this a little bit differently, as total regular employees and total job postings. I would note that total job postings and total vacant positions are not exactly the same thing. But if we look at total job postings as being a bit of a proxy for vacant positions…. The ministry then takes these data and presents an estimate of provincial vacancy rates by occupation and for the whole health care workforce that’s employed by health authorities.

I also want to be clear that vacancy rates are not necessarily directly indicative of workforce demand, so not all of the vacancies that are listed necessarily have to be filled in order to meet service delivery. But current vacancies speak to the present, and they don’t always speak to the future workforce dynamic, so I just think it needs to be interpreted with that lens in mind. We always expect a certain number of vacancies because people retire, people move, people go on leave. These things happen, and so there’s the constant filling of positions.

I will also note too that we all understand well that the workforce shortages we’re experiencing in British Columbia are most acutely felt in rural and remote communities. This is a place where we see vacancy rates, routinely, that are higher than in more urban areas.

When we look at regional data, it’s important to note that that can obscure that disparity, the situation that we’re experiencing in rural and remote areas, as well as there being fewer employees. So if, on a unit, two of a certain kind of position are required and one is vacant, it’s 50 percent, and the optics of that are different than the reality on the ground.

I also want to note too that the small size of workforces in rural and remote communities can, as I just outlined with that example, indicate the proportionality of the impact on service delivery, and that has been a real factor in some cases.

The overall vacancy rate for all health authority employees is about 10 percent as of the third quarter of the last fiscal, ’25-26. This equates to an estimated 15,070 total vacancies. This estimated vacancy rate is roughly two percentage points lower than last year at the same time, and almost all of the occupations that are tracked across the system have seen a decrease in vacancy rates over the past year, which is good in that there has been progress, but clearly there is more to do.

Nursing positions make up almost half of these vacancies, about 48 percent. In Northern Health, it’s a little bit higher; nursing vacancies actually make up about 51 percent of the total vacancies. And as professions, nursing and physiotherapy have the highest vacancy rates, followed by anaesthesia assistants, occupational therapists and respiratory therapists.

I can add more detail if the member wishes. I can actually run through the data for the different occupations. I am sure that we will get into this as we talk through estimates here.

But again, all pointing to the need for continued work around expanding training opportunities, as we have been doing, not just with building a new medical school for physicians and expanding nursing seats but also expanding training seats for allied health professions — like speech-language pathologists, like physiotherapists being now able to be trained on Vancouver Island here, something that has not happened before.

As well, the need to continue the efforts around recruitment and retention. One of the things I hear the most often when I’m out in communities, when I’m in facilities talking with people about the positive impacts of the recruitment efforts that are going on here in the province, is the importance of retention. That’s why that focus on workplace conditions is so incredibly important.

Health care workers in British Columbia are some of the hardest-working people I have ever met. To see the strain that people are facing right now…. Yet they continue to show up each and every single day, and they absolutely give their hearts into their job.

[3:55 p.m.]

Experiencing vacancies, experiencing workforce shortages is very, very hard on the health care workforce and just, again, reiterates the need and really cements the commitment that I have as Health Minister and that we have as a government to continuing to expand the workforce through every measure that we can.

Brennan Day: So 2 percent lower than last year — that’s a fantastic number. Are any of the 15,000 positions that are being cut in government affecting that number, artificially eliminating positions which would then pad the number? I guess that’s one question.

The other question is: would the minister be able to provide the breakdown regionally, in some sort of usable format for us, going forward?

Hon. Josie Osborne: Okay. I’ll read into the record vacancy information by health authority, as the member asked. I won’t read it by occupation but just aggregate.

The Northern Health Authority. This is as of Q3 of fiscal ’25-26. In Northern Health, there were 1,963 vacant positions for a vacancy rate of 19 percent.

[4:00 p.m.]

In Island Health, there were 3,196 vacant positions for a vacancy rate of 13 percent.

For Vancouver Coastal Health, there were 3,605 vacant positions for a vacancy rate of 14 percent.

For Fraser Health Authority, there were total job postings. Again, this is a proxy for a vacancy rate because the health authorities don’t report identically. For Fraser Health, there were 2,788 job postings for an estimated vacancy rate of 8 percent.

Interior Health Authority had 1,721 job postings for an estimated vacancy rate of 8 percent.

The Provincial Health Services Authority had 1,035 total job postings for an estimated vacancy rate of 4 percent.

Providence Health Care had a total number of job postings at 320 for an estimated vacancy rate of 8 percent.

Now, again, I want to reiterate that vacancy rates are not necessarily indicative of workforce demand, and not all vacancies need to be filled in order to meet service delivery requirements. But I also want to speak to the work that government is doing around minimum nurse-to-patient ratios and actually increasing the amount of nursing staff on the front lines. As the health authorities have been hiring, of course, they post those positions or they are listed as vacant positions until they are hired.

I also want to point to the work that we have done with the health authorities to eliminate duplicate or redundant administrative and executive positions, about 1,100 of which have occurred, at an estimated cost savings of $60 million a year for the health authorities — an opportunity to take that money and provide it directly to the front lines.

These are positions that are…. Sometimes they are left vacant purposefully, so, again, just taking the vacancy data into account there and understanding that as we move forward, an estimate like a 2 percent reduction in vacancy rates from one year to the next is….

When we’ve made that decision to keep those positions empty but they’re still listed for now, that is going to perhaps result even in an underestimate, understating the actual reduction in vacancy rates there and the work that we are doing, again, to do everything possible to re-profile the funding from those unnecessary positions into front-line care, like meeting minimum nurse-to-patient ratios.

Brennan Day: I guess the transition is perfect into the next section, and that’s ER closure hours in B.C. Last year you cited approximately 8,000 hours of ER closures. Unfortunately, when I checked the transcripts, you didn’t define the period. Through FOI request, we determined that in 2024, there were 10,300 hours of unplanned ER closures in the province of B.C., and in 2025 through to April 17, there were 2,690 hours of closures.

To the minister: could you please confirm the data, for calendar 2025 as well as 2026 year-to-date, for unplanned ER closures?

[4:05 p.m. - 4:10 p.m.]

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

Just before I go dive into the numbers, I do want to acknowledge how challenging it is to have emergency department diversions, unplanned obviously, and what an impact this makes on people and on communities. I also recognize that, despite the progress that is being made — and I will speak to that — there are certain communities and certain sites that have experienced more disruptions than in other places.

It is absolutely a government priority to provide sustained, reliable, predictable access to emergency care. I recognize, too, that emergency departments are very symbolic of the health care system and people’s faith and trust and confidence in the system.

This just another reason why we need to keep doubling down on the work we’re doing to fill gaps and address workforce challenges as well as look at new models of service delivery that can provide that access to essential life-saving services in a way that accommodates the changing nature of the delivery of medicine as well as accommodating what technology can provide us.

At the end of the day, keeping emergency departments open for people. We do have the highest number of physicians per capita in Canada here in British Columbia, and we are still experiencing some very severe systemic pressures in the system, like other provinces.

I do want to speak about other provinces, too, because British Columbia certainly is not alone in this issue. From January 2019 to April 2024, there were 38 percent of our emergency departments here in British Columbia that experienced a closure — at least one. But that number is 70 percent in Manitoba, it is 66 percent in Nova Scotia, and it is 57 percent in Saskatchewan. That just points to the fact that this is something that we are experiencing in communities, particularly rural communities, across Canada.

Now, the member asked specifically for our accounting of the number of hours that emergency departments have been closed. In 2024, that is 8,645. In 2025, it is 7,262.

[4:15 p.m.]

I will point out in 2025 that 87 percent of possible emergency department diversions or temporary closures were actually averted. That’s 4,090 events that were resolved.

In 2026, year to date, up to the end of March, March 31, 1,257 hours of emergency room closure. That’s a 28 percent reduction over the same period of last year, so from the first of January to the end of March 2026, compared to the same period the year before. That’s what I’m talking about, a 28 percent reduction. Clearly, a reduction from 2024 to 2025.

It’s progress. It’s tracking in the right direction. That’s exactly what we want to see.

I acknowledge, at the same time, that there are particular sites that haven’t experienced that progress and, in fact, are feeling even like there’ve been setbacks. In 100 Mile, Fort St. James — these are communities that come to mind as some of our smaller rural communities that experience frequent closures. That’s been very, very tough on those communities. That’s why the health authorities continue to do everything they can to attract locums to fill the vacancies and to work with pools of physicians.

It’s why Northern Health, as a health authority, for example, has an emergency department stabilization task force, essentially, within the health authority, looking at ways to continue to close those gaps.

It’s why Interior Health undertook the pilot program called LINK-ED, in which four Interior Health communities are now linked, with virtual care options being delivered at nighttime by a physician, staffed primarily in Nakusp, who is able to provide those services.

It is why we continue to explore other options and other service delivery models — to work with those communities but really to work with all communities as we move forward and do everything we can to stabilize emergency rooms, particularly in those remote and rural communities that are experiencing the worst of it.

Brennan Day: I’m very curious how we’re counting ER closures.

I think just for all the British Columbians out there that I know are glued to their TV sets watching this, could you please confirm that when an ER is not scheduled to be open overnight or on weekends, that that does not count as an unplanned ER closure. Those are planned closures and those are not reflected in the data presented today.

Hon. Josie Osborne: Yes, I can confirm those are unplanned closures.

Brennan Day: How many ERs in British Columbia, currently, are not open 24-7-365?

[4:20 p.m.]

Hon. Josie Osborne: There are currently six sites in British Columbia where emergency departments are not open 24-7-365. Four of them, I’ll start with: Saanich Peninsula, Port Hardy, Mount St. Joseph, and UBC. The other two are Tumbler Ridge and Mission.

Now, Mission is a temporary closure, as people know. That announcement was made around nighttime closure at Mission Memorial Hospital for the emergency department. Tumbler Ridge has had nighttime and weekend closures for the past months since last fall, but work is underway and ongoing between Northern Health and the district of Tumbler Ridge and the community there to re-establish 24-7, as it is in Mission, which is experiencing particular issues on its own.

I think it bears noting. Again, I talked in my last answer a little bit about the nature of delivery of medicine and emergency services, the incorporation of technology into emergency care and what we are also seeing around the increasing and strengthened collaboration on a regional basis between hospital care, primary care, ambulance services and specialized emergency programs, which together are beginning to work in a more coordinated and cohesive way to ensure that emergency care is sustainable, appropriate and delivered in a timely manner.

I make that distinction because what we traditionally have called an emergency department is not experienced in the same way in every site. I want to use Saanich Peninsula Hospital as an example. A person experiencing a heart attack, an urgent life-or-death matter, who calls 911, as anybody should do in the event of an emergency in any location in British Columbia, will be taken to the closest major hospital that is able to handle that — for example, Victoria General Hospital.

[4:25 p.m.]

Again, this is about the coordination of regional services and working together with paramedics and the ambulance system in a way that ensures people get the most timely and the most appropriate care.

I mention this because the conversations that are happening in communities and what people are experiencing in places like Princeton or Nakusp or Clearwater or Lillooet, where virtual care is being used at night in order to allow local physicians to be able to sleep unless they need to be called in, for example, for care that is needed to be delivered in person, is again part of that changing nature of emergency care.

The goal, always, is to provide the best, the most timely care and to do everything that we can to ensure that British Columbians can access that. As we address the workforce challenges that we’re seeing, it asks us to be more creative, to be more innovative and to be more open to looking at service delivery models that might not be the way that it was 40 years ago but is going to deliver the care that British Columbians need.

Brennan Day: It does seem like scheduling the closures is a way to avoid the inflated hours that we were seeing over the last several years in the ER closures, and it’s a bit of a bait-and-switch for British Columbians. Thank you for identifying that it’s not as widespread as we may have been led to believe.

Given those impacts certainly are very different…. Mission has adjacent hospitals that are within a reasonable driving distance — and certainly in cases like Tumbler Ridge, which shows up 19 times on the closure report, we discovered through the FOI, over a period of two years. It’s extremely concerning, because those driving distances and the weather play a concern.

I will move on to the next question. Last year in estimates, the minister confirmed that $240.6 million was spent on agency nursing. What is the total amount spent in 2025, and what is the total amount spent year to date?

[4:30 p.m.]

Hon. Josie Osborne: Just before I turn to agency nursing, I just want to close off the discussion we were having around emergency rooms and make it very clear that there’s absolutely no bait-and-switch that’s going on here.

[4:35 p.m.]

We have been reporting the hours where emergency rooms have been closed, very forthright about those sites where longer-term — dare I say even permanent — changes, in some cases, have been made, where emergency departments are not open 24-7 or 365 anymore. It’s explaining a little bit about the mitigations that are put in place and how it works, particularly as the member had spoken about certain locations that are in closer proximity to other places.

Now, Mission. We know that it is a temporary decision to have the Mission Memorial emergency department closed at night, and it is in close proximity, 15 to 20 minutes away, each, from Abbotsford General and Ridge Meadows Hospital.

Again, we’re working very closely with emergency health services to ensure that patients are transported quickly and, when 911 is called, that they are taken to the appropriate site. As well, Fraser Health is working closely with the district of Mission, working with the community, to make sure that they know about and understand what’s taking place with the emergency room closure there.

In sites like Tumbler Ridge…. I do want to return to the point that the member makes, which is very well taken, which is that in rural and remote sites where the next closest emergency department is literally hours of driving away, that’s a really serious issue. That’s why we’ve placed such priority on stabilizing emergency department staffing to the best of our abilities, together with the health authorities — innovating, incorporating technology, all the things that I’ve already talked about.

But what’s important in the case of a community like Tumbler Ridge is to be able to provide, again, the reliability, the predictability and the consistency. I certainly have heard this loudly and clearly from communities like Lillooet, which was experiencing intermittent closures, communities like 100 Mile House, which still continue to experience those closures.

We’re working with Interior Health to provide more advanced notice of when those diversions might take place so that people can plan more appropriately, when they are not in the case of needing to call 911 but do need to come in and use an emergency department for those services.

That’s a very serious issue, and I take it very, very seriously, as we’ve canvassed many times before in the House here. I, too, come from a rural community and can absolutely imagine how destabilizing it would feel to see the emergency department in my small community of Tofino go on diversion. Nobody wants that, and that is exactly why we continue to do this work in stabilizing and innovating and keeping that emergency care open for patients, for people in British Columbia.

When it comes to agency nursing…. I’m really glad to canvass this topic. First of all, I want to say that our utmost priority is to provide that stability and reliability in services. That means sometimes having to use agency nursing in order to fill those shifts and those vacancies in staffing schedules to ensure that the services are provided for people in acute care settings particularly.

But it is a priority to use non-agency staffing wherever possible. It’s a priority, I know, of every community that has health care facilities in their towns and villages and cities to have residents — people who live there, who work there, who raise their families there, who spend their paycheques there in those communities and volunteer and do all of the things that being part of a community means…. That’s why we are focused on reducing the reliance on agency nursing, but we will use it when we have to.

We have implemented competitive wage increases, premiums, incentives, policy approaches to attract and retain nurses, including the work that we’re doing directly with the B.C. Nurses Union around minimum nurse-to-patient ratios, which I’ve been addressing already.

I want to, as well, just compliment and thank the BCNU for working closely with us on the issue of agency nursing. It is something that we have regular discussions about — and about the work that the province is doing to decrease, together with the health authorities, our reliance on private agency nursing.

I’ll read some numbers into the record here in a moment, just noting that agency utilization has increased over the past years, but the rate of increase has slowed. We are now turning the tide, and it is trending downward from the peak in 2024.

[4:40 p.m.]

There are two key developments so far that have helped us to reduce that reliance on agency nursing. First is around the establishment of a standardized provincial contract with private agencies with language that improves the financial transparency, that prioritizes quality care, patient safety, Indigenous cultural competency — a new provincial application process to identify and limit third-party service providers rather than using local procurement or direct awards, for example.

The second is around the establishment of, effectively, our own kind of made-in-B.C. travel agency solution, GoHealth BC, a provincial travel resource pool that deploys health authority–employed nurses, and has expanded to medical laboratory technologists, to rural and remote communities to be able to assist with those staffing gaps, communities that have in other times relied on private agency staff. And again, it’s always about the overall goal of reducing or eliminating or avoiding altogether service disruptions.

I have had the opportunity to meet nurses on the floor in different facilities who have actually come to British Columbia as agency nurses, fallen in love with the communities that they’re working in and then taken permanent positions. So there are benefits. But again, as I’m saying, overall, the intention here absolutely is to drive down that need to use private agency nursing.

Now, the member asked specifically around costs and cited a number from last year, which was a preliminary figure. So what I want to do now is turn to some specific expenditure data on agency staffing and to note — because, as I was just talking about medical lab technologists, for example, being part of the GoHealth pool — that there are some other occupations where agency staffing is used.

So I’m going to report gross numbers for agency staffing altogether. In fiscal 2024-2025, that number was 295.049 million. The forecast for this most recent fiscal that ended just less than a month ago is 247.386 million. Now, that is a reduction of just over 16 percent. Again, as I said, trending in the right direction.

But I will point out that there is some regional variation in this as well. Some health authorities like Northern Health — again, they actually developed the GoHealth nursing pool — have really placed a focused effort on reducing their reliance on agency staffing. Between what was spent in 2024-25 and the forecast for 2025-26, we see a reduction of almost 33 percent, which is simply phenomenal. Now, that’s not exactly the same across all health authorities. But VIHA, another health authority, is seeing an anticipated reduction of 35 percent in that reliance on agency nursing.

So again, I’ve described some of the ways that we’re working to address this, understanding the importance of doing so, of requiring agency nursing where it’s needed to, of course, always prioritize patient care and keep those services open, meet minimum nurse-to-patient ratios where those ratios are being activated and implemented and established in different units, and ensuring that British Columbians get that care from our incredible nursing workforce that we have.

Brennan Day: So GoHealth is effectively now a stand-alone travel nursing pool. What was the spend last year on GoHealth and the attached nurses?

[4:45 p.m.]

Hon. Josie Osborne: The GoHealth BC agency was an action that was specifically delineated in the health human resources strategy. It’s action 34. Now, at that time, in ’23-24, it was budgeted for $113.680 million over three years and $42.97 million ongoing. The fiscal year 2025-26, the preliminary — and I will emphasize preliminary — actuals for the GoHealth BC program were $42.97 million.

Brennan Day: It seems like a bit of a wash in terms of actual savings on the ground between the agency nursing when you factor in the $42.9 million from GoHealth.

I’ll move along. The ministry’s April 1 press release states that more than 600,000 people have been connected to a primary care provider since 2023. How many of those 600,000 individuals represent net new patients attached to primary care after accounting for people who lost a provider or were reassigned?

[4:50 p.m.]

Hon. Josie Osborne: Just returning to agency nursing for a moment, I want to be clear that there’s no wash at all in those numbers when we talk about expense on GoHealth nursing and attempt to compare that to expense on private agency nursing.

I want to be really clear. GoHealth is an initiative that has been a real benefit for the health care system and for those nurses who choose to be part of it. Moving away from private agency nursing, which is more costly than a GoHealth position, a nurse on the GoHealth team is a B.C. resident, is part of a unionized workforce and is part of a team. That part of that health authority team is going around travelling the province and essentially pinch-hitting, going in to fill the gaps to keep units open, to keep those services reliable and consistent.

I don’t know if the member thinks we will ever get away entirely from agency nursing. I don’t think that’s possible. We wouldn’t want to, in the sense of having a mobile workforce, people who sometimes are new graduates who want the experience of moving around in big centres, in smaller centres, getting different experiences, but being able, again, to fill those gaps when there just aren’t enough nurses who are working in the community to be able to fill some of the gaps, particularly as we’re experiencing right now….

GoHealth has been, again, as I said, a real benefit to the province and a program that we’re going to continue to invest in and continue to work closely with the B.C. Nurses Union on being able to strengthen.

Now we’ll switch to attachments of people, British Columbians, who are seeking a primary care provider, be it a family doctor or a nurse practitioner. And yes, since 2023, more than 600,000 people have been attached to a primary care provider, which, obviously, is a huge thing for those individuals and can never be underestimated.

I really appreciate the stories that I hear directly. Every single week I hear from at least several people who tell me that they got the email, that they’ve been attached to a primary care provider. I have a constituent, for example, who hadn’t been able to see a doctor in a longitudinal fashion, in that direct relationship, for some years and just felt an enormous sense of relief in being able to go in and sit down with their primary care provider and talk about some of the health issues that they’ve been experiencing.

We know that that attachment is incredibly important, particularly around preventative health care, being able to identify health problems before they become worse, making sure that all eligible screening, for example, or diagnostics that are required are being undertaken and simply just the peace of mind of knowing that you have that ability to be able to be attached to a clinic, to a primary care provider and get that service.

[4:55 p.m.]

We know that primary care is absolutely the backbone of our health care system, and it really is that entryway for those folks who need more specialized services and who encounter diseases or situations where that specialized care is needed.

Now, we are not the first government to make the commitment to provide that attachment to a primary care provider. The government before us announced the GP for Me program, for example. Unfortunately, when they left office, they actually left the province with more people without a primary care provider than when they initially announced the program.

What we’ve done, though, as a first government to do this, is actually develop a framework and a system for measuring attachment and for registering people in British Columbia who want to seek that attachment to a primary care provider through the health connect registry. I encourage every British Columbian who is unattached and who wants to be attached to a primary care provider to register on the health connect registry.

The patient attachment system that we have — we are finally able to actually measure and report progress on this effort. There is one way of counting, which is how many patients have become attached, like the 600,000 number, the figure that we’re talking about. And then there’s also looking at the percentage of British Columbians that report or that we know are attached, again, through the patient attachment system.

In June 2024, 74.2 percent of British Columbians were attached, and in December 2025, 77 percent were attached. That is an increase, and that’s an important increase, because note the number of new British Columbians, the growth in our population here. Again, exceeding population growth in terms of attachment rate means that we are getting ahead. That’s why we’re going to continue to do the work to get ahead so that any and every British Columbian who wants that attachment with a family physician or a nurse practitioner has it and, in the meantime, continue to expand different models of care and access to services that still help people.

For example, being able to see your pharmacist and increasing the scope of practice for what pharmacists can do and the type of care that they provide, as with other types of health care providers, continuing to build out a network of urgent and primary care centres that not only will help people who can’t get an appointment with their family doctor quickly enough — who need that care within 12, 24, maybe 48 hours — but also those people who do not want or are not attached to a family practice doctor to be able to still have their episodic needs taken into account.

That’s probably enough for now, and I look forward to the member’s next question.

Brennan Day: I didn’t hear a clear answer there to the question, so I’ll ask in a different way. According to a ministry press release February 9, 2024, which has a convenient breakdown of attachment rates by year, in 2016, we had a population in B.C. of 4.859 million, and approximately 821,000 British Columbians did not have access to a primary — were without a family doctor.

In 2022, we had a population of 5.32 million, or approximately 883,000. This is from the Canadian community health survey, which was reprinted in the ministry press release.

The current population of British Columbia is 5.7 million people in 2026. The attachment rate in a press release from April 1 states clearly that 77 percent of British Columbians are attached, but that means that 23 percent aren’t attached. That’s 1.3 million British Columbians by my math.

Could you please confirm how many British Columbians today do not have a primary care provider in the province of B.C.?

[5:00 p.m.]

Hon. Josie Osborne: Let me try to address this question in a slightly different way.

The figures that the member cites are part of a previous way of estimating the number of people who were unattached through a survey. As I said in my previous answer, having a patient attachment system and actually having a framework to be able to measure and then report has been an important development in the way the Ministry of Health can track and report out on this.

The health connect registry, again, is a place where people can go to sign up for attachment to a primary care provider. As of March 2026, 345,000 people in B.C., approximately, are registered on the HCR. They’re waiting to get a primary care provider. We are seeing an average of just over 4,000 new attachments on a weekly basis.

We, of course, encourage everybody who is unattached and wants to be attached to register on the health connect registry. People can update their status on the HCR at any time if something changes — if they move, various reasons, if they have a child and want to add the child, etc.

As the member indicates, now knowing, with our ability to measure this, that 77 percent of British Columbians are attached to a primary care provider, and doing the math, as the member said, means that 1.24 million do not have a primary care provider who is attached to them.

But I want to note that not everybody who is unattached is actually looking for a family doctor or nurse practitioner. We do know there is a body of people that may be relatively transitory in British Columbia, here for a short time, who are young, who feel healthy, for whatever reason are not seeking attachment and are still able to access care when needed, for example, through an urgent and primary care centre.

So I think that helps to address the member’s question. Again, the work continues, because we know just how important it is for people who want to be attached to a primary care provider. That’s why we’re continuing to build the workforce. That’s why we’re opening a medical school here in British Columbia, the first new one in just about 60 years, taking in 48 students this fall. Now, it does take some time to grow a new family doctor, so four years later, we’ll have that graduating class. Two years later, they’ll complete their residencies in family medicine.

We’ll be adding at the same time, continuing to recruit physicians from other jurisdictions like the U.K., like the U.S., and doing everything we can to expand nurse practitioner training seats, tripling the number of nurse practitioners who are working in B.C.’s health care system over the last few years and expanding the ability for people to undertake that training in more of the regions of the province, not just in Vancouver, and that work will continue.

Brennan Day: Since I’ve heard the minister and the Premier both repeat the press release headline of 600,000, could you please confirm if the 600,000 measures people that became unattached, or is that just net new attachments? Or is that gross? What is the gross number? Because 600,000 people, by your own numbers, did not become newly attached, based on 2022 numbers, to a doctor in B.C.

So, what is it? Because it’s very unclear here. The 600,000 number — how many people over that same period became unattached from a primary care provider in B.C.?

[5:05 p.m.]

Hon. Josie Osborne: The 600,000 number and the numbers when we report attachment — those are newly attached patients. Now, there may be somebody who moves from, say, Vancouver to Fort St. John who leaves their physician or nurse practitioner in Vancouver and then is newly attached to a provider in Fort St. John. The system measures that as a new attachment.

I cannot break down for the member the precise number of that 600,000 that would be “I never had a family doctor before” to “I just haven’t had one for two years” to “I just moved and needed to find a new provider in my community.”

That’s why we have moved the ministry service plan to actually report out on the metric of percentage of British Columbians that are attached, because it is an accurate reflection of how many people are attached to a primary care provider. Again, knowing that in December 2025, we are now at 77 percent whereas in June 2024, we were at 74.2 percent means an increase in the rate of attachment, knowing that more British Columbians who want a primary care provider are able to access one.

Brennan Day: Again, I’ll need a little bit more explanation, then, about the difference between how it was measured in the Canadian community health survey — which says that in 2022, 16.6 percent of British Columbians did not have a family doctor — to the data today because that is a large drop in the data. If there is a difference in the data that I’m comparing, I’d be happy for you to set the record straight.

The second question is so that everybody can understand what is being considered an “attachment” under the health connect registry. How many times do I need to go into an urgent and primary care centre to be considered attached to that facility?

Could you please describe how you are counting attachments within the 600,000 number that you’re showing here so that we can understand the gaps?

[5:10 p.m.]

Hon. Josie Osborne: The Canadian community health survey is a tool that has been running since 2001. It covers populations across all provinces and territories in the country. It’s a useful tool for measuring comparatively — i.e., how B.C. compares to other Canadian jurisdictions.

The question that the CCHS uses to measure having a regular health care provider has changed over the years, so it’s important to note that. It’s also just important to note that as a survey, it is of course subject to the methodological constraints that all surveys have. So it is subject to the uncertainty in extrapolating the results out from a representative number of people.

I want to point out, too, that the survey only targets individuals who are 18 years and older. So it would not be accurate to say that it’s representative of the full population in British Columbia.

It’s exactly these kinds of problems that are part of the reason why British Columbia has developed a much more sophisticated tool for measuring attachment. And starting in 2024, our official reporting for primary care attachment is sourced from the provincial attachment system that I’ve been talking about. Again, the survey offers context in understanding how B.C. compares, but the provincial attachment system is the actual enumeration.

Primary care providers have…. A physician or a nurse practitioner has a panel of patients. For example, in the longitudinal family physician payment model that has been developed as part of that contract or arrangement with the province, a physician would upload the panel information actually through their electronic medical records into the provincial attachment system so that it’s registered in the system. And it’s an automated process, so that when a patient is attached in the panel that’s uploaded, it automatically removes that person from the health connect registry.

[5:15 p.m.]

I think that makes it easier to understand the precise enumeration of a person and how they are attached to that family physician, which is much more accurate and provides us with better data, better information, than the survey tool that was previously used.

I’ll leave it at that and see what happens next.

Brennan Day: For the attachment rates that were published in the April 1 press release, stating that 600,000 people have been connected to a primary care provider, with this new advanced tool that the ministry has developed, what are the net new attachments of those 600,000 people that were advertised as being connected to a provider?

I guess I can ask it another way, and we can go into doctor retirements and average caseloads and figure it out backwards from there. I’m just looking for a clear answer to clarify this government’s claim of 600,000 people being connected to a primary care provider since 2023, because that is not the reality that British Columbians are experiencing. Some clarification on that would be appreciated. If it is a gross number, that is fine. If you do not have the data on the net number of connections or what the total shift between people that….

We can look at ’23. What was the total number of people in 2023 that did not have a family doctor in B.C., and what is the total number today that do not have a doctor in B.C., per the new system?

[5:20 p.m.]

Hon. Josie Osborne: To try to answer this question again, this really goes back to having the reliable way of measuring attachment so that we have an accurate benchmark with which to measure progress. When we report 600,000 attachments since 2023, it is exactly that — new attachments.

As I referenced in my previous answer, some of those individuals could be people who have moved, who have left one provider and are seeking a new provider, and then they are attached. It’s why we can measure…. We have a sense of progress through that number, but to truly understand how many British Columbians have access, have that attachment to a primary care provider, the metric of measuring the percentage of population is a better way to measure progress.

That’s why we changed the metric in the service plan, for example. Because we have a provincial attachment system that provides that direct enumeration, that link between a patient and their primary care provider that is regularly updated as physicians and nurse practitioners upload information into the system and that can be compared against what the provincial statistics provides us with — our population — we have a way of being able to understand how many British Columbians are not attached but also the progress that we’re making in that rate of attachment.

Comparing the numbers today using the provincial attachment system against numbers previous to 2023 using the survey instrument doesn’t give us the accuracy into the insights that perhaps the member is looking for, because it is using the numbers from one methodology compared to another methodology. That is why drawing that line at the time of the provincial attachment system coming in and then looking and using the metric of attachment rates through percentage of population provides us with that understanding of the progress that’s being made.

At the same time, the 600,000 number is accurate in that those are new attachments. But again, just to reiterate what I’ve already said, breaking down exactly what a new attachment is — in terms of how many, how long somebody may have not been with the provider, when they moved communities, for example — is a level of granular detail that I don’t have at my fingertips here.

But again, that’s why I keep coming back to the increase in the rate of attachment, moving again from June 2024, with 74.2 percent of British Columbians being attached, to December 2025, 77 percent. Again, accounting for the fact that our population is changing and growing in that period, to see the rate of attachment increase at the same time is positive news. It is progress.

Then there’s still, obviously, an incredible amount of work to do to continue to encourage patients, people to register on the health connect registry as well as to increase the number of physicians and nurse practitioners who offer the primary care services that we all depend on and rely on here in B.C.

Brennan Day: Thank you, Minister.

I’ll ask this again, and I’ll ask it from 2023. On December 31, 2023, what was the population of British Columbia that this government was using as their baseline, and what was the percentage of patients attached? In 2024, December 31, what was the population of British Columbia that this government uses as their baseline, and what percentage was attached? On December 31, 2025, what percentage? Same question.

That’s what’s in your report, with the 77 percent. That should give us the number I’m looking for.

[Lorne Doerkson in the chair.]

[5:25 p.m.]

Hon. Josie Osborne: Let me read into the record some of the information that the member is seeking. I have been citing the numbers from June 2024 and December 2025, and I want to draw a distinction between 2023 and this month of June 2024.

The provincial attachment system was implemented in 2023 with over 6,000 primary care providers who needed to upload their panel information into this new framework, into this new system. That takes time. It is something that these providers had never done before. This is a system that didn’t exist before.

So we do not place confidence in the numbers until June 2024, because at that point there was confidence that all the information was fully uploaded and that we would have a very accurate picture of panel size and attachment. That’s why I’m using these months to compare.

[5:30 p.m.]

I’m going to read into the record the precise numbers for the member. In June 2024, the beginning of June 2024, the population used was 5,566,772. Of that, 4,129,334 persons were attached. That is an attachment rate of 74.2 percent. It means that there were 1,437,438 who were not attached.

But to be clear, again, that does not mean that every single one of those individuals is seeking to be attached. They are all people with personal health numbers who are not attached in the system.

In December 2025, at the end of that month, the population number used is 5,670,070 people, with 4,373,293 people attached, which is a rate of 77.1 percent, or 1,296,777 people — personal health numbers — who were unattached.

I can add, actually, that at the end of this most recent quarter, the most up-to-date information we have shows there are now 1,259,425 people not attached. When looking at the population and the attachment rate, we see 77.8 percent. So even in the three months since December 2025, we see an increase of 0.7 percent in the rate of attachment.

Brennan Day: Thank you, Minister.

What is the average wait time for people to spend on the health connect registry? If you could give me an average, median and maximum number, it would be appreciated.

Hon. Josie Osborne: Okay. First, before I get into a few numbers, I’ll say that it obviously is a priority to attach people as quickly as possible from the health connect registry to the primary care provider. In the system, there are attachment coordinators who work directly with clinics to assist with that attachment process, and we’re continuing to work with family physicians and with nurse practitioners to build up their panels.

We have different arrangements with, for example, new-to-practice contracts, with family physicians who are building up their practice and with nurse practitioners who are building up their practice as well. So attachment rates for providers can vary in the speed there.

[5:35 p.m.]

Nevertheless, having them update regularly their attachment data into the provincial attachment system is very helpful, obviously, so that we know the bigger picture of things and also that attachment coordinators know who has the capacity to take on new patients.

We’re certainly seeing evidence of that. We’ve seen advertisements, for example, in Maple Ridge and in North Vancouver, literally bus shelter ads that are advertising for patients, you know, doctors looking for patients, which is incredible to see. But it’s not like that everywhere, and that points to the variability between communities. Depending on the number of family physicians and nurse practitioners or the rate or the percentage of practitioners versus the population, it can take longer in some areas.

It also bears mentioning that there are people who require attachments sooner. People with more complex or urgent, serious medical conditions are prioritized for attachment, and that makes it difficult to interpret wait-list information on a more broad basis. We know that some people have been waiting for years to be attached to a primary care provider. We also know that some of the people who are now on the health connect registry were actually on smaller regional lists that were being used prior to 2023 and acknowledge that those individuals have been waiting longer.

Now, when the health connect registry was established, those regional lists were pooled. They were merged into the provincial attachment system, and again, we’re continuing to work with people to attach them as quickly as possible.

I can report the median time to attachment by health authority region, which I’ll do right now. Again, just to point out, obviously a median — half are greater, half are less than this — doesn’t report those intricacies or nuances that I just spoke to, particularly around availability of physicians and nurse practitioners in different areas and the capacity to take on patients as well as the medical conditions or complexity that some patients have and their need to be attached more urgently.

In Fraser, it is 241 days. In Interior, it is 477 days. In Northern Health, it is 198 days. In Coastal, it is 171 days. On the Island and coastal communities, Vancouver Island Health Authority, it is 388 days. Overall then, for British Columbia, the median time to attachment is 295 days.

The provincial attachment system is giving us data on attachment that just wasn’t possible before 2023. It is helpful because we can now look literally by city, by region, by health authority at where efforts are needed most to recruit primary care providers and to understand where the greatest number of patients who are unattached, who are sitting on the health connect registry wanting to be attached, are.

Again, that helps the attachment coordinators. It helps inform decisions around recruitment and working together with Doctors of B.C., with primary care networks, with the divisions of family practice to point to where the most urgent needs are and continue to do that work so that no matter where people are living in British Columbia, they have the opportunity to become attached to a primary care provider if they want one.

Brennan Day: Thank you, Minister.

I also asked for the maximum, and if you could give that to me by health authority as well.

Hon. Josie Osborne: I don’t have that on hand, but if we can get it, then I’ll get it to the member, absolutely.

Brennan Day: Thank you, Minister. You can certainly check the FOI records. It’s over 1,300 days in one case. But if she could take that on notice and get back to me on that, it would be much appreciated.

We’re going to move on now to U.S. health care recruitment. I support recruiting qualified health professionals. I know in our sparring in question period for the cameras that we often get accused of the opposite, but that’s not a time for answers, and hopefully we can get some today. The issue is not the principle of health care recruitment. It is whether the press releases match actual care on the ground.

[5:40 p.m.]

The government has celebrated more than 2,900 applications and more than 500 accepted job offers from U.S.-trained professionals. How many of those 500 recruits are actively practising in British Columbia today?

[5:45 p.m.]

Hon. Josie Osborne: I’m delighted to talk about the U.S. recruitment campaign that we’ve undertaken and talk about some of the results that we’re seeing.

To the member’s line of questioning asking about the job offers, I can report that the most up-to-date figure I have now is 581 job offers that have been accepted.

I think the member probably understands that there’s a process in the hiring of an individual and them moving, relocating their whole family from the U.S.

[5:50 p.m.]

But I want to back up and talk a little bit about the work that we have done that has made it possible for the U.S. recruitment campaign to be so successful. That really is around the policy work of streamlining and fast-tracking the credentialing system, the licensure system, primarily for physicians, nurses and nurse practitioners who can move from the States to B.C.

In working with the College of Physicians and Surgeons of British Columbia, the bylaw changes that they have undertaken remove some of the bureaucracy that is not required, in ensuring that U.S.-trained professionals have the experience, the qualifications, the comparable education, the competency to move to British Columbia and practise here, making it easier by removing the need for certain board exams, for example; bringing down the cost, in certain cases; and shortening the process from one that took months and months to now just weeks.

Similarly, the work we’ve done with the B.C. College of Nurses and Midwives around shortening that process, using a platform called Nursys, which enables the college to get easy access into information about U.S.-trained nurses and, literally within days, to be able to provide them with a licence to practise here in British Columbia.

I have heard from so many nurses, and from physicians now, about the fact that it is easier for them to move to B.C. and establish their licensure than it has been even to move from state to state. That’s an example of making the system easier.

Going out to advertise, to market, to campaign at a time when there’s so much turmoil and dissent in the U.S. and asking health care workers — people who have chosen to follow a profession, who feel drawn into a profession of helping people from a true values basis, wanting to provide health care to people not because of how much money they have in their bank account but because they are a human being that walks through the door and needs that health care — is a proposition that so many American health care professionals are choosing to follow.

Now, the member brought up discussions we’ve had in the House and my statements in question period that members of the opposition have been opposed to the U.S. recruitment campaign. I just want to read it into the record. The MLA for Chilliwack North called the campaign “an irresponsible, reckless and idiotic waste of taxpayer money.” The MLA for Kelowna Centre called the campaign embarrassing. The MLA for Prince George–Valemount said we don’t need a recruitment campaign. The MLA for Langley-Willowbrook asked: “Was this money well-spent?”

I would assert: this is money well-spent. Over 109 physicians have accepted job offers here in British Columbia. The taxpayer pays over $300,000 per physician that is trained here in British Columbia, but these physicians have come here. That is an incredible value, to have them move to our province and be able to practise here in British Columbia.

The change in the licensure system. We have seen 229 American-trained physicians register here in British Columbia between March 1, 2025, and February 28, 2026. That is a 141 percent increase from the same period a year earlier. And 1,028 nurses registered from the U.S.

This is an important step in the process. What I hear from these professionals is that usually they choose to go through the licensure process first. When they’re making the decision or they’ve had the thought, “I am going to move to British Columbia,” they do the licensing process. They know that they can now go through the recruitment process, look through BCHealthCareers and Health Match B.C., and work with our recruitment professionals to find a job that is a good match for them.

There is also the immigration process. Making the decision to relocate your entire family from somewhere into British Columbia is no small thing. So with 581 accepted job offers, that doesn’t mean that 581 people are now practising or delivering health care here in British Columbia at the moment, but they are on their way. Many of them are here.

[5:55 p.m.]

We know that the people who choose to do this, some come in advance of their families, and then they make the decisions about the communities they’re going to work in and live in. And they have a lot of questions around education for their children, recreational opportunities, employment for their spouses. Again, communities, Health Match B.C. and professionals are working with them to make sure that they have that information that they need.

I was up in Nanaimo on Saturday at the health care infusion, and it’s a pleasure to say, and to have Tod Maffin mentioned here in this House, because the work that he and his wife, Jocelyn, have done together is a real grassroots campaign to let Americans know that they are welcome here in British Columbia, that we want them, that we value them, that they can be a part of our health care system where those values of a public, universal health care system match the reasons why they went into health care in the first place.

We hear directly…. I’ve met with so many of these professionals who have moved here, who have told me directly that they spend less time on paperwork and have more time for patient care here in British Columbia, that they are accepted and welcomed by their colleagues and feel that sense of camaraderie and inclusivity from their work colleagues, but as well, even from the neighbourhoods that they’re moving into.

Now, Nanaimo has really benefited from the work that the Maffins have done and that people have gotten engaged in. On Saturday, talking with Island Health, we talked about some of the benefits that those American health care workers are providing to Nanaimo Regional General Hospital specifically.

Island Health is reporting that in 2025-2026, overtime hours have decreased by 24.3 percent, compared to the year before, while maintaining patient care hours. Across Island Health, hours of patient care have increased, while overtime rates have dropped 21½ percent. Vacancy rates have also improved. Agency hours have decreased by 22.9 percent in 2025-2026 over 2024-2025.

Throughout this past year, they have hired 27 new RNs, four physicians — that includes three hospitalists and one urologist — and a nurse practitioner for Nanaimo Regional General Hospital. These are American health care workers that have come to Nanaimo, that are part of the team and that are making a real difference on the ground.

I know that the initial question the member asked was: “Of these accepted job offers, how many people are working here in British Columbia now?” Some of them are; more of them are coming. I am confident that even more will come because, as these professionals who have relocated here in British Columbia reach back into their hospitals, into their clinics, into their communities, they are bringing more people with them.

We know it’s not just American health care professionals that are making the choice to move to British Columbia. We’re also seeing professionals come from the U.K. For example, there’s a family physician who has moved to the Interior who tells us that, again, reaching back to their community, they have enticed another 22 individuals to make the move to Canada, to come to British Columbia and practise medicine here, deliver health care here.

This, in my mind, is absolutely a success. It is not embarrassing, it is not a waste of money, and I am very grateful that we’ve undertaken this campaign. We’re going to continue to do this work while we still build out the workforce that we need by training British Columbians; inspiring high school kids and university kids today to follow a path into health care; opening up and expanding medical school seats, nursing seats, allied health professional seats.

There is a real future in health care for people in B.C., and being part of a system that we should all be so proud of is something, certainly, that I am entirely committed to, working in my role as Health Minister. I know the member opposite is going to do everything he can, too, to help make sure that this system is as strong as possible for all British Columbians.

Brennan Day: To the minister, there was no answer there. And I understand it’s a hard question, but trumpeting applications and accepted job offers versus people working on the ground is something I believe British Columbians are entitled to know.

I will also clarify that my caucus is not against U.S. recruitment. We are against stunts with coffee buses at $1,000 a cup. I believe if you look back at the full transcripts of the comments from my colleagues, those will show that.

[6:00 p.m.]

I guess, then, since we do not have a number of how many people are actively practising today in British Columbia from the now 581 accepted — which is excellent, thank you; I think that work is important — can we establish a baseline of how long it takes to go from application to practice in the province of British Columbia?

If we can establish a baseline pre this system, say, 2022…. I know when I first started, it was taking U.S. doctors, friends of mine, up to two years. So the minister’s statement that it was months and weeks…. Well, it was actually years to go from a U.S. practice to Canada, even for Canadian citizens who didn’t have to argue with immigration.

Can we set a baseline of what the ministry was seeing for the time from application to practice in 2022 and the time from application to practice today?

[6:05 p.m.]

Hon. Josie Osborne: The journey for each individual who makes the decision to apply for a position here in British Columbia to go through the steps of licensure, to go through the job application process, the interview process, to accept a job offer, to also go through the immigration process is highly variable. There isn’t data on the time that it takes for individuals to go through those processes. But again, that just simply isn’t tracked.

What we do know, though, is that the policy changes made here in British Columbia to streamline credentialing have made a significant impact on the time that it takes to undergo that licensure. I want to talk a little bit more specifically about what some of those changes are.

The College of Physicians and Surgeons of British Columbia, in July of 2025, implemented new bylaws. It makes it easier by removing certain steps from the process that were redundant or sequential in a way that added time. It does things such as eliminating the U.S.A.-certified class of restricted licensure and launching a U.S.A.-trained pathway for U.S.-trained doctors who hold certification from the American Board of Medical Specialties, the American Board of Family Medicine or the American Osteopathic Board of Family Physicians.

These changes also eliminated the requirements to pass general qualifying examinations of the Medical Council of Canada and to obtain the licentiate of the Medical Council of Canada.

Those were two very key steps that improved licensure timelines by bypassing two of the national certification bodies and by streamlining the process and reducing the time and costs associated with licensure.

[6:10 p.m.]

The member spoke about an individual for whom it took years, and yes, before these changes were made, there were cases where it took years. But now having reduced that to just several months has made it much faster, and the numbers speak for themselves. Once again, to see a 141 percent increase in the number of registrants, American-trained registrants in this case, with the College of Physicians and Surgeons of B.C. in the 11-month period that I cited before, is just a phenomenal result.

Knowing that there is more work to do, the college, in June last year, began public consultation on more proposed bylaw changes to allow internationally trained physicians to enter practice from select international jurisdictions. So beyond the work that they have been doing with American-trained physicians, under the proposed bylaws, internationally trained physicians wishing to practise would be eligible for the full or independent class of registration, provided that they meet the requirements.

That includes the completion of a minimum of two years of accredited postgraduate training in a foreign jurisdiction approved by the college of family physicians and surgeons of Canada for certification without examination, like the U.S.A., Australia, the U.K. and Ireland.

The College of Nurses and Midwives is examining similar kinds of changes to, again, reduce the timelines and the process for nurses choosing to immigrate here from similar jurisdictions — the U.S.A., Australia, the U.K. and Ireland.

Also under the proposed bylaws, internationally trained physicians would be eligible for this full or independent class of registration, providing they also meet the completion of postgraduate training and obtainment of the completion of a training certificate and certification in their particular specialty from a foreign jurisdiction that’s approved by the Royal College of Physicians and Surgeons of Canada. And those RCPSC-approved jurisdictions would include Australia, New Zealand, Hong Kong, Singapore, South Africa, Switzerland, United Kingdom and Ireland.

Again, the point being here that we do everything we can to, of course, ensure that internationally trained physicians have the skills, the qualifications, the comparable education, the competency to practise here, to meet public safety standards, of course, that we have and that we are beholden to, to ensure that patients are safe and are safely treated by physicians who are educated and trained elsewhere. But that work to streamline the process, make it faster, make it simpler, has enabled us to help more and more physicians be able to move to British Columbia and choose to practise here.

Again, just coming back to the individual timelines. I have sat down with different physicians who have made the move here. For some, it has been relatively simple and an easy decision. For others, it has been more complicated. It is about unwinding or ending a practice in their community in the U.S. It is about working with their spouse and their children to make a really big decision to relocate a family, about finding employment for that spouse and then about undergoing the immigration process.

It’s been in the media lately, Heather Gilchrist, the Scottish midwife who encountered some real bureaucratic glitches in the federal system that eventually ended up in her going back to Scotland. She has unfortunately made the decision, most likely, to stay in Scotland and not come back to practise midwifery here in Victoria, which is an incredibly difficult decision to hear about and really hard on the midwifery clinic that she worked with and, of course, on patients.

It’s the exact opposite of what we want to see, and that’s why I’ve written to the federal ministers. It’s why we need to continue to urge and push and work with the federal government on immigration processes to make sure that this is as simple and as easy as it can be for people working in a field for whom we are in urgent need of.

All provinces and territories across the country are working to attract and to bring in new health care workers. And British Columbia, I’m proud of the record that we have so far and the work that we’ve been doing. Again, there’s more to do, and we’ll continue to do that work.

While there may not be the specific data that the member’s asking for to be tracked, we do hear stories. There are plenty of anecdotes that are readily available on social media and in the mainstream media around the choices that people have made, how welcomed they feel when they come to their new workplaces and their new communities here in British Columbia and just how happy they are with the decision that they’ve made.

[6:15 p.m.]

Again, a really big decision for a person and their family to make. We welcome them here to British Columbia. We’re going to continue to do everything we can to make it as easy and quick as possible for those people to come here.

That includes consistently hearing from them and making improvements in the system, whether it be through the job application process, passing on feedback to the federal government around the immigration process, and working with the colleges to speed up the credentialing and licensure system so that people can practise here in British Columbia.

Brennan Day: I think we can probably finally take a victory lap on something good that RFK Jr. and Trump have done, which is to drive health care workers out of the U.S. into Canada. I think that should definitely be applauded. I think there’s a bit of causation and correlation effect there in the numbers of U.S. health care workers that want to move north of the border.

I would really like to hear what the minister’s targets are. If she doesn’t have a baseline to measure the improvements in the pipeline of getting people practising in British Columbia, what is the target? Is it six months? Is it a year? Is it two weeks? I’d love to know what the ministry’s goal is between both herself and — sorry — both the minister and the feds in terms of that goal and what coordination is going on.

My last question for today will be around the cost per acquisition. I come from the private sector. Headhunting and recruitment was a major problem that we had to deal with overseas — often five- or six-figure recruitment costs to get people practising.

What is the cost for a doctor? What is the cost for a nurse? What is the cost for a care aide through this recruitment package? How is the ministry tracking those costs? And what kind of value for money are we getting doing it ourselves versus outsourcing that recruitment?

Larry Neufeld: I’d like to request a five-minute recess, please.

The Chair: For what purpose, Member?

Larry Neufeld: I’d like to confer with my caucus members, my leadership, my House Leader.

The Chair: I’ll give you three minutes. How’s that sound?

We’ll have a three-minute recess.

The House recessed from 6:18 p.m. to 6:19 p.m.

[Lorne Doerkson in the chair.]

The Chair: Members, we’ll call the chamber back to order.

[6:20 p.m.]

Hon. Josie Osborne: Noting the hour, I’m just going to give a very short answer to the question, and then I’ll move.

Let me just speak about the cost only of the U.S. recruitment campaign. We invested $5 million into that campaign. With 581 accepted job offers, my math tells me that’s around $8,600 per recruit there.

As I cited previously, it costs over $300,000 of taxpayer money to train a family physician here in British Columbia. That would be upwards of $600,000 or $700,000 if we were looking at a specialty. Noting, as the member said, coming from the private sector, to hire a private recruitment firm and do the headhunting, we’re looking at tens of thousands of dollars per person.

This U.S. recruitment campaign has been absolutely demonstrating value for money with every job offer that gets signed because of the results of the campaign and the snowballing effects of people, again, reaching back into their communities, their clinics, their hospitals and telling their former work colleagues about the opportunities they’re seeing here in British Columbia and, to the member’s point, really feeling pushed out of the United States.

That is what I hear consistently, as well, from American health workers that are coming here to a place with a universal public health care system, where we believe in science, where we use evidence and research and results to inform the decisions that we make in delivering health care for people; where we believe in the autonomy of people’s bodies and the decisions that they make for themselves; where we believe in vaccinations; and where we don’t depend on what somebody has in their wallet in order to access health care.

Every single penny we have spent on that U.S. recruitment campaign has been money well spent.

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

Motion approved.

The Chair: This committee stands adjourned.

The committee rose at 6:22 p.m.

The House resumed at 6:22 p.m.

[The Speaker in the chair.]

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

Leave granted.

George Anderson: Section A reports progress on Bill 16 and asks leave to sit again.

Leave granted.

Hon. Mike Farnworth moved adjournment of the House.

Motion approved.

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

The House adjourned at 6:22 p.m.