First Session, 43rd Parliament

Official Report

of Debates

( Hansard )

Wednesday, April 9, 2025

Afternoon Sitting

Issue No. 38

The Honourable Raj Chouhan , Speaker

ISSN 1499-2175

The HTML transcript is provided for informational purposes only.

The PDF transcript remains the official digital version.

Contents

Routine Business

Introductions by Members

Statements

Vancouver Canucks

Korky Neufeld

Introductions by Members

Members’ Statements

Reconciliation with Indigenous Peoples

Amshen / Joan Phillip

Passover

Claire Rattée

Canadian Unity and Values

Paul Choi

Gurdwara Sahib Sukh Sagar

Steve Kooner

Lapu-Lapu Day

Mable Elmore

Battle of Vimy Ridge

Tony Luck

Point of Order (Speaker’s Ruling)

Oral Questions

Safety of Nurses in Health Care System

Elenore Sturko

Hon. Josie Osborne

Kiel Giddens

Supply and Training of Specialized Nurses

Harman Bhangu

Hon. Josie Osborne

Government Action on Homelessness

Rob Botterell

Hon. Ravi Kahlon

Medical Assessment Fees for Seniors

Heather Maahs

Hon. Josie Osborne

Safety of Nurses in Health Care System

Claire Rattée

Hon. Josie Osborne

Safety of First Responders

Brennan Day

Hon. Ravi Kahlon

Violent Incidents in Hospitals and Safety of Health Care Workers

Misty Van Popta

Hon. Josie Osborne

Korky Neufeld

Lorne Doerkson

Steve Kooner

Hon. Niki Sharma

Trevor Halford

Orders of the Day

Government Motions on Notice

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

Hon. Mike Farnworth

Motion 13 — Membership Change to Finance Committee

Hon. Mike Farnworth

Motion 15 — Membership Change to Children and Youth Committee

Hon. Mike Farnworth

Committee of Supply

Estimates: Ministry of Health (continued)

Peter Milobar

Hon. Josie Osborne

Anna Kindy

Sheldon Clare

Jeremy Valeriote

Rob Botterell

Proceedings in the Douglas Fir Room

Committee of Supply

Estimates: Ministry of Environment and Parks (continued)

Trevor Halford

Hon. Laanas / Tamara Davidson

Jeremy Valeriote

Dallas Brodie

Estimates: Ministry of Forests

Hon. Ravi Parmar

Ward Stamer

Gavin Dew

Donegal Wilson

Larry Neufeld

Wednesday, April 9, 2025

The House met at 1:33 p.m.

[The Speaker in the chair.]

Routine Business

Prayers and reflections: Ward Stamer.

[1:35 p.m.]

Introductions by Members

Hon. Jennifer Whiteside : How lucky are we today. It’s another New Westie day today. It is such a pleasure

for me to introduce a whole team from New Westminster who are here advocating on education

issues. I think it’s unique, because I think this is the first time that we’ve had

representatives from the whole sector coming together.

We have Maya Russell, from the New Westminster school board; Cheryl Sluis, the vice-chair

of the New Westminster school board; Karrie Andrews, the president of CUPE 409; Laura

Kwong, New Westminster DPAC chair; Mark Davidson, the superintendent of New West schools;

Kristie Oxley, the president of the New West Teachers Union; Ken Millard, president

of the New Westminster Principals and Vice-Principals Association.

I just have to say that I am personally so impressed and grateful all the time for

their extraordinary advocacy for kids in New Westminster.

I have one more introduction after this, but if the House would please join me in

making folks from education in New West very welcome to the House.

As if that wasn’t fabulous enough, I also just want to give a pre-welcome to the New

Westminster students from École Glenbrook Middle School, grades 7 and 8, who are on

the precinct and who will be in the gallery this afternoon. I’m so grateful to the

staff who have accompanied them here today, grateful for the weather.

Would the House please join me in welcoming the students from École Glenbrook as well.

Steve Kooner : Today we have some representatives from Gurdwara Sahib Sukh Sagar who are in the

gallery today from Queensborough–New Westminster. They include Sukninder Singh Senghar,

treasurer and acting president; Jagjit Singh Sal, secretary; and Senthok Singh Sal,

senior volunteer group member.

Please make them all welcome.

Hon. Christine Boyle : I have two introductions I’d like to make today.

The first I made yesterday mistakenly. They have joined us today, so I want to again

ask the House to join me in welcoming, in the gallery, leadership from Doig River

First Nation, including Chief Trevor Makadahay, Councillors Justin Davis and Starr

Acko, as well as Shona Nelson. I’m looking to make sure they’re here, but maybe I

can’t see them.

I had the pleasure of meeting with Chief Makadahay and team yesterday as well as last

week. I also again will mention that Doig River is joined here today by someone familiar

to this House, former MLA Dan Davies. I understand he received a number of text messages

after I introduced him yesterday. He was, in fact, not here and was very confused

by it.

I am glad to have all of them joining us here today.

Will the House join me in making them feel welcome.

I have one more introduction, if you will allow.

Joining us in the gallery today also from my riding of Vancouver–Little Mountain is

my constituent Bobby MacDonald. Bobby is here representing Union Gospel Mission, an

incredible organization with an 80-year history of serving our most vulnerable neighbours.

Bobby and the dedicated team at UGM work every day to meet people where they are at,

providing essential services such as supportive housing, nutritious meals and addiction

recovery. My colleague next to me here wanted to make sure I mentioned that they are

also providing incredible services in New West, Vancouver and across the region, as

well as here in Victoria.

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

House.

Harman Bhangu : I’d like you to give a warm welcome to my family that’s joining me here today.

My wife, Courtney, who’s been a rock — a lot of us have our significant others; they

play a key role for us to do our jobs in here; my daughter, Audriana, who will be

turning five tomorrow; and my son, Bal. They are having a blast here.

Please give them a warm welcome.

[1:40 p.m.]

Hon. Josie Osborne : It’s my pleasure to introduce staff from the Heart and Stroke Foundation, along with

some of their partners, volunteers and guests, who are all joining us in the gallery

today. We met them earlier for lunch, members from across all sides of the House here,

and learned a great deal about heart failure and how it affects the lives of over

137 British Columbians who are living with this diagnosis.

Now, that includes Mayor Doug Kobayashi from the city of Colwood, who shared his own

personal journey and his work to improve health care access in his community.

It also included Dr. Nathaniel Hawkins from Vancouver Coastal Health, who shared the

work that he is doing in research and driving change to lead to earlier diagnosis

and care.

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

Statements

Vancouver Canucks

Korky Neufeld : Something that’s very close to all of our hearts is that the Vancouver Canucks made

NHL history last night, and very few outlets picked it up. So here it is.

Last night, versus the Dallas Stars, they were down three goals in the last minute

of the game, 5-2. In that last minute, they scored three goals — the first time in

the NHL’s history. And then to top it off, they won in overtime.

Introductions by Members

Hon. Laanas / Tamara Davidson : My mother raised a strong woman, and I am very proud to say that I raised an even

stronger woman. This is what we do as Indigenous women.

Today I’d like to have the House welcome my daughter Samantha, who is here on the

precinct, wish her well today and hope that she is safe in this place.

Ian Paton : Today I can see in the gallery two of the most fun, well-known government relations

people that are here all the time. I think there’s a B.C. Gaming luncheon tomorrow.

Please welcome Shiera Stuart and Chuck Keeling.

I’m sorry. There’s a gentleman in between them.

I welcome all three of you here today.

George Anderson : As we recognize the 108th anniversary of Vimy Ridge, I would like to recognize one

of my constituents, Cierra Robinson, an elementary school student who placed second

in the B.C.-Yukon Remembrance Day poster contest that was held by the Canadian Legion.

She placed first in her school, first in the district and first on the Island, second

overall in B.C. But she says next time she’s going to get first for British Columbia.

I would hope that the House would, essentially, say congratulations to Cierra for

the great work that she’s done in remembering our veterans.

Bruce Banman : I have two introductions. The first one is quite quick and easy. That would be former

MLA Dan Davies, who actually joins us.

Would the House join me in making him feel welcome.

Secondly, it comes as a shock to many of us, I think, as to how much the public sits

and prays for us and looks after our well-being. Today we were reminded of that. There

was a breakfast meeting that was put on by Jason Goertzen. Many of the members were

here. It’s a non-partisan breakfast, and it gave a message of acknowledgement to us

and for us to get together. It was great to actually break bread with one another.

A special shout-out goes to the member for North Vancouver–Seymour, who joined me

in actually singing our national anthem at said event. I do want to thank that member

for standing with me and helping lead us in that national anthem.

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

They had a wonderful speaker by the name of Stacy. During his speech, do you know

what he said? “Let’s be childlike, not childish.”

Let’s follow Stacy’s advice.

[1:45 p.m.]

Members’ Statements

Reconciliation with

Indigenous Peoples

Amshen / Joan Phillip : Today I’d like to talk about the importance of the work being done by this government

to advance reconciliation, particularly when there are certain voices that wish us

to go backwards.

Indigenous rights, sovereignty and liberation are causes I’ve fought for my entire

life and are now entrenched in the Canadian constitution and supporting laws. As a

political and politicized person, there has been no other option.

We know how much Indigenous peoples have lost through colonization. At Kuper Island

school, in one year, 269 students registered; 107 died, a whopping 40 percent. And

I see it every day in the constituency of Vancouver-Strathcona, the pain and trauma

felt disproportionately by Indigenous peoples. I see the issues today as continuations

of the same colonial problems that existed when I was a kid.

In spite of the generational trauma and ongoing racism, because of the work being

done by this government things are improving. I encourage all governments to join

us to continue this important work while lifting everyone up.

I’d like to end with a quote by my grandpa Dan George. “Like the Thunderbird of old,

we shall rise again out of the sea. We shall grab the instruments of the white person’s

success, their education and skills, and with those new tools, we shall build our

people into the proudest segment of society.” We are his dream come true.

Huy ch q’u siem.

[Applause.]

Passover

Claire Rattée : Today I rise to recognize that this weekend marks the beginning of Pesach, or Passover,

a sacred holiday in the Jewish faith that commemorates the Exodus, when the Israelites

were freed from slavery under pharaoh in ancient Egypt.

This is a time of remembrance, renewal and reflection. Around Seder tables here in

B.C. and around the world, Jewish families will gather to tell the story of liberation

and reflect on a story as old as our people, a story of faith under fire and of the

enduring fight for freedom.

But Passover is more than just a historical remembrance; it’s also a call to action.

In the wake of the horrific attacks on October 7 and amid a rise in antisemitism that

many believed we would never see again, the story of Exodus is a timeless reminder

that freedom is not something to be taken for granted, that justice, dignity and human

rights must be defended in every generation and that silence is never an option. Passover

is a time to celebrate the resilience of our people.

Freedom is not just a concept but a sacred responsibility. In an era where governments

are seeking to exert even more control over our lives, the message of Passover is

clear. Liberty is fragile, and we must protect it with courage and vigilance.

One of the most powerful teachings in the Haggadah tells us that in every generation,

each of us is obligated to see ourselves as though we personally came out of Egypt.

That message challenges all of us to stand against oppression wherever we see it and

to work toward a world where no one is left behind. Let us honour our ancestors by

standing firm in our faith, proud of our heritage and unafraid to speak the truth,

even when it is unpopular.

As someone who represents communities facing real hardship — whether it’s homelessness,

addiction or the lack of access to basic services — I find the themes of Passover

particularly meaningful. The struggle for freedom and dignity is not ancient history;

it’s ongoing. We as legislators bear the responsibility to ensure that hope and liberation

are not just symbolic ideals but lived experiences for the people we serve.

To all who are observing, chag Pesach sameach.

May this Passover bring peace, healing and renewed strength to the Jewish people and

light to a world that needs it now more than ever.

Canadian Unity and Values

Paul Choi : I rise today filled with gratitude for this House, for the people we serve and the

extraordinary nation we are privileged to call home.

[1:50 p.m.]

At a moment when turbulence echoes beyond our borders, Canadians from every province,

every faith and every walk of life are drawing closer together. We are rallying behind

Team Canada, not merely a slogan but a promise we make to one another that, shoulder

to shoulder, we are stronger than any storm.

I stand here as a proud Korean immigrant who found, on these welcoming shores, a country

that turns diversity into strength and kindness into second nature. Where else in

the world is “sorry” both a punchline and a badge of honour? Only in Canada do courtesy

and courage walk hand in hand.

Team Canada means breaking down the walls that divide us, whether it is interprovincial

trade barriers, languages, cultures or misinformation. It means harnessing B.C.’s

unique position as a Pacific gateway, not just for the province but for the whole

country, so the prosperity that flows through our ports lifts families from St. John’s

to Saskatoon. It means forging bold partnerships across Asia-Pacific, diversifying

our markets and future-proofing our economy for the generations yet to come.

So we celebrate because we have much to celebrate: our hockey triumphants that unite

living rooms coast to coast, our vast glacier lakes and towering forests that still

take our breath away. These are not just points of pride. These are reminders of who

we are and when we are at our best — the true north strong, free and unafraid to dream

big.

Yet pride must walk with humility, and we cannot speak of Canada without honouring

the First Peoples who have stewarded this land since time immemorial. Reconciliation

is not just a

chapter we visit. It is the spine of the book that we are still writing

together.

Together let us carry this torch of hope, compassion and unbreakable resolve. Let

us stand up for each other, for reconciliation and for prosperity for Team Canada.

Gurdwara Sahib Sukh Sagar

Steve Kooner : During Sikh Heritage Month and in honour of Vaisakhi, I’m proud to recognize the

amazing work of Gurdwara Sahib Sukh Sagar in Queensborough, New Westminster. Gurdwara

Sahib Sukh Sagar is much more than just a place for prayer. It’s a place where people

come together to help others through seva, which means selfless service, a core part

of Sikh faith.

Since it opened in 1919, this gurdwara has been giving back to the community. Every

week the kitchen at Sukh Sagar prepares over 4,700 meals, 200 of which are delivered

to people in need in the community.

Moreover, Gurdwara Sahib provides education classes to more than 200 kids each week

involving Punjabi language, Sikh martial arts and music. Throughout the year, the

gurdwara provides youth camps for over 1,000 children and also runs a summer internship

program for more than 20 students to gain real-world experience and mentorship.

Moreover, Gurdwara Sahib Sukh Sagar also has a seniors centre where elders come together

to give back and guide others. This gurdwara initiative sets the standard that service

has no age limit.

Gurdwara Sahib Sukh Sagar has become a true community hub, a place where people feel

supported, respected and empowered. I commend Gurdwara Sahib Sukh Sagar for its great

community service.

Lapu-Lapu Day

Mable Elmore : Across the world and throughout history, Indigenous peoples have fought to protect

their land and preserve their culture.

From Canada to Brazil and Australia and elsewhere, Indigenous peoples have been rising

and battling colonization, dispossession and suppression. Theirs is a long line of

stories of resistance, resilience and renewal. It’s a legacy that endures to modern

times in different forms of activism in pursuit of justice, dignity and survival.

[1:55 p.m.]

Among those who etched their names in this proud heritage was Lapu-Lapu, a warrior

chief from the Philippines. Lapu-Lapu lived at a time when European colonization started

in Asia during the 16th century, leading to the disruption of Indigenous societies

and cultures.

In 1521, Ferdinand Magellan, a Portuguese navigator serving Spain, arrived in the

Philippines to lay claim to native territories. Lapu-Lapu was not going to bow to

a foreign master.

On April 27, 1521, Lapu-Lapu and his warriors faced off with Ferdinand Magellan and

his forces in the historic Battle of Mactan-Cebu. Lapu-Lapu prevailed in this early

act of defiance against foreign rule, thus inspiring future generations of Filipinos

to fight for their freedom and independence. My family legend has it that my mother,

Maria Tabotabo, shares lineage with Lapu-Lapu.

On April 26 this year, the legacy of this Indigenous hero will be celebrated in a

block party in my riding of Vancouver-Kensington, organized by Filipino BC in partnership

with the Sunset on Fraser Business Association and the Hogan’s Alley Society and the

Black community. It will be a day-long festival that features music, dance, art, displays,

culinary offerings and family-friendly activities.

I’m inviting everybody to join the 2025 Lapu-Lapu Day block party. Everyone here in

the House is invited to join a great celebration in South Vancouver, Saturday, April

26. I hope to see you all there.

Battle of Vimy Ridge

Tony Luck : On April 9, 1917, 108 years ago today, under grey skies and bitter wind, Canadian

soldiers rose from the frozen trenches at Vimy Ridge in Northern France. They were

miners, clerks, farmers and sons, ordinary men asked to do something extraordinary.

For the first time, all four divisions of the Canadian Corps, drawn from every province

across our young country, fought side by side.

They faced a formidable enemy. The Germans had fortified the ridge for years. Both

the French and the British had tried and failed to take it, suffering heavy losses.

But the Canadians brought something different: innovation, preparation and a deep

sense of unity. They trained tirelessly, rehearsing their movements on full-scale

mock-ups. They used creeping artillery barrages, an advanced tactic for the time,

and relied on detailed maps carried by even the lowest-ranking soldier.

On that Easter Monday morning, they advanced through mud, gunfire and wire. And they

took the ridge. Brig-Gen. Alexander Ross would later stand on that battlefield and

say: “In those minutes, I witnessed the birth of a nation.”

He was right. Vimy Ridge wasn’t a military success; it was a coming of age. It showed

the world that Canada was no longer just a colony of the British Empire. We were a

proud, capable nation — resilient, courageous and united in purpose.

This victory came at a heartbreaking cost. More than 3,500 Canadians lost their lives.

Over 7,000 were wounded. The land they claimed was paid for in blood. As historian

Pierre Berton once wrote: “Vimy was the place where the nation took root. The fighting

may have created a sense of unity, but the price was unimaginable.”

Today we live in the freedom that they helped secure. We speak our minds, pursue our

dreams, raise our families, all because they believed in something greater than themselves.

“Take up our quarrel with the foe:

To you from failing hands we throw

The torch; be yours to hold it high.

If ye break faith with us who die

We shall not sleep.”

We owe those brave souls a debt we can never truly repay, but we can honour them by

remembering, by living with purpose and by upholding the values they fought so hard

for. At Vimy Ridge, Canada found not only victory but its voice; not only courage

but its soul.

Mr. Speaker, a request: may this House rise united for a moment of silence to honour

these brave souls who sacrificed so much for Canada and for us.

[The House observed a moment of silence.]

Point of Order

(Speaker’s Ruling)

The Speaker : Hon. Members, yesterday after the oral question period, the member for Kelowna-Mission

rose on a point of order, stating that the Minister of State for Trade used unparliamentary

language.

[2:00 p.m.]

As the minister in question did not rise to respond to the point of order, the Chair

took the matter under advisement. Having not heard the remarks in question, the Chair

reviewed the record of oral question period proceedings.

Pursuant to practice, Speakers have ruled that if the Chair did not hear the offensive

word or phrase and if the offensive language was not recorded in the Debates , the Chair cannot be expected to rule in the absence of reliable record. In this

instance, the unparliamentary remarks are not captured in Hansard .

However, the Chair will take this opportunity to caution the House that all hon. members

bear responsibility for their remarks in this place and the overall civility and decorum

of proceedings.

Further guidance is available in the order and decorum booklet circulated to members

yesterday.

Oral Questions

Safety of Nurses

in Health Care System

Elenore Sturko : Fraser Health recently had two incidents where nurses were severely hurt and may

never be able to return to work. But when WorkSafe investigated, they blamed the nurses.

One nurse was even suspended and made to do her violence prevention training.

Staffing shortages put nurses in situations where they are forced to make a choice:

treat a patient on their own, or delay care. This is a failure to meet care standards.

Both scenarios leave nurses in jeopardy of losing their licence.

B.C.’s nurses are being placed in impossible situations. Imagine how demoralizing

it must be to be blamed for getting hurt because of a no-win situation created by

this government.

When will the Premier look in the mirror, stop blaming nurses and stand up for their

safety?

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

Hospitals and health care facilities are places where people go to get better, to

get well. Violence has absolutely no place in any health care workplace, in any workplace

in British Columbia. That is why we take this so seriously and have worked so closely

with the Nurses Union, the health authorities in establishing relational security

officers and bringing in people who are specially trained in helping to create safer

workplaces.

If we are going to attract and retain more nurses, which we know we need to strengthen

our health care system, creating a safe workplace is an absolute requirement. I’m

absolutely dedicated to this initiative: to working with the Nurses Union, to working

with the health authorities, to continuing that work to ensure that our workplaces

are free from violence, that health authorities are following policies in place, meeting

our expectations for those safe workplaces for patients, for workers, for all British

Columbians.

The Speaker : Member, supplemental.

Elenore Sturko : Our health care system is losing nurses because they’re becoming injured and they

can’t work, and sometimes even worse.

Last month 33-year-old nurse Roseanne Wallace took her own life. She was attacked

twice in the psychiatric unit where she worked. Roseanne’s father said he would like

the people in charge to spend a day shadowing a health care worker. He said: “I’d

like one of those higher-ups to come and spend a shift in a facility like that. I’m

sure they wouldn’t believe it, and I’m sure they wouldn’t feel safe.”

Perhaps the minister should listen to Mr. Wallace’s suggestion and spend a shift working

in the dangerous conditions Roseanne was subjected to before she took her life.

How does the minister expect nurses and health care workers to follow her rules when

NDP staffing shortages are making it impossible for nurses to meet care standards?

Hon. Josie Osborne : What happened with this nurse is absolutely devastating, and I know that this loss

is felt across her workplace, in her community and by her family and her friends.

It is absolutely tragic what took place.

[2:05 p.m.]

That’s why we have to continue the work that we are doing to create safer workplaces.

That’s why we’re going to continue the work that we’re doing with relational security

officers, people who are specially trained to help de-escalate situations, to help

identify aggressive behaviours. That’s why we’re going to continue with this work

on bolstering curriculum around violence prevention in the workplace, because we know

that it takes everybody.

We have to do this work. We’re going to continue working with the union, with the

nurses. I’ve had the opportunity to hear directly myself from front-line nurses. Any

of us putting ourselves in their shoes and understanding how frightening these situations

are will help bolster all of us in the work that we need to do to continue to attract

nurses to safe workplaces.

Because we know that nurses are an absolutely essential component of B.C.’s health

care system, and part of strengthening that health care system is creating safer workplaces.

Kiel Giddens : The B.C. Nurses Union reports an estimated 46 serious assaults per month. A nurse

in Langley was assaulted with a weapon after the patient she was treating got into

an altercation with another patient who pulled the weapon.

The union’s president said that the health care system needs to keep weapons out of

hospitals and health care settings. Yet last year a leaked memo that members will

remember from Northern Health instructed: “Staff do not remove personal items from

the patient’s room, even if there is a knife or weapon.”

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

Hon. Josie Osborne : Weapons are banned in hospitals — full stop. We’re working to strengthen our policies

and to ensure that this rule is enforced, the policies and procedures that must be

in place. That includes expanding the use of weapons screening at hospitals that are

at the highest risk.

That’s a very serious step to take. Weapons screening is currently in place in certain

places like St. Paul’s Hospital. The security staff there are trained to look for,

to watch for, to address weapons that someone might have on their person. Conversations

regarding the feasibility of implementing more weapons detection are underway.

It is a sad place to be where we have to recognize this, but it’s important that we

take action, and that’s why we’re going to continue to do that.

The Speaker : Member, supplemental.

Kiel Giddens : That answer isn’t good enough for today’s working nurses, and it’s hampering our

ability to recruit the next generation of nurses because it’s not the reality in our

hospitals. Weapons are in our hospitals.

In November, a student nurse in her first clinical placement was attacked by a patient

with a knife at Vancouver General Hospital. Nurses from the health region told the

opposition: “We see weapons on a regular basis — knives very frequently, box cutters,

machetes, hammers, guns and, more recently, a crossbow.”

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

Hon. Josie Osborne : Once again, everybody deserves to feel safe and to be safe in their workplace, which

is why we have taken action in creating safer workplaces through the establishment

of security officers and have had conversations with the Nurses Union, with health

authorities around the highest risk sites, getting input from the Nurses Union directly

on where these officers should be.

I’ve outlined the steps that we’re taking around weapons detection and ensuring that

they are kept out of hospitals, because again, they are banned from hospitals — full

stop, as I said.

Interjections.

The Speaker : Shhh, Members.

Members, let the minister finish.

Hon. Josie Osborne : We are going to continue this work. We do have specialized teams of police officers,

mental health–trained nurses around B.C. to help respond to incidents outside the

hospital, to try to prevent events like that from taking place in a hospital.

We can all imagine just how frightening, how scary that would be to be a patient,

a nurse, any health care worker in a facility like that, in a setting like that. That’s

why we’re going to continue to listen to nurses and take action.

[2:10 p.m.]

Supply and Training of

Specialized Nurses

Harman Bhangu : In Langley, the shortage of specialized nurses has reached a crisis point. Nurses

are being asked to work outside their legal scope of practice, a reckless move that

endangers lives.

To meet the bare minimum for safety, specially trained nurses are constantly having

their shifts changed without notice, throwing patient care into chaos. This isn’t

just mismanagement; it’s a dangerous failure of leadership.

When will this Premier stop risking lives and take action to train and deploy the

specialized nurses that our health care system desperately needs?

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

Again, nurses are an absolutely essential part of our health care workforce, and they

deliver front-line care that everybody depends on.

We are facing a global shortage of health care workers, and that includes nurses.

That’s why we have taken steps to hire and train more nurses here in B.C., expanding

the number of seats for training nurses, bringing in nurses from international destinations

who are internationally educated, making it easier for nurses to come from the States

to British Columbia.

British Columbia is a fantastic place to work and to live. We’re going to do everything

we can to continue to build our nursing workforce here in British Columbia.

Government Action on Homelessness

Rob Botterell : For the past two weeks, forceful evictions have taken place in Kelowna. Residents

of Kelowna’s outdoor sheltering 4, known as OS4, experienced harmful and continuous

displacement. Bylaw and police officers created an exclusion zone barring anyone from

entering, including media, community advocates and cultural support workers.

As we’ve seen in cities across the province, residents of OS4 were dispossessed of

their belongings and survival gear. We know that for many of our friends and neighbours,

displacement equals death. These cycles of violence are unacceptable.

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

Hon. Ravi Kahlon : Having encampments in any community is unacceptable. That’s why we’ve been working

so hard with our partners to be able to rapidly deploy supportive housing, different

forms of housing, in communities throughout the province.

We have been working closely with Kelowna — 120 homes within a year; 80 of them are

up. We’re seeing success. People are moving in. They’re getting the supports they

need. In fact, 40 people have already moved into supportive housing and moved into

stable housing, either with family, on their own — found employment.

I appreciate the member’s question. We certainly know that there are some challenges

that Kelowna is facing. I would advise the member that there’s a lot work happening

from all partners to try to get every individual into housing.

There is a criminal element that also is going into situations and preying on vulnerable

people, and that also is unacceptable. So it’s important that the work that Kelowna

does ensures that they’re following laws, which…. My understanding is that they’re

following the rules. If not, of course, they’ll have to address those challenges.

We’re going to continue to work with Kelowna and all communities to be able to ensure

that people can get indoors to get the supports that they desperately need.

The Speaker : Member, supplemental.

Rob Botterell : It’s been two years since the massive Hastings Street decampment. Since then, several

of these displaced residents have died alone, and many more suffer from injuries and

trauma incurred during these sweeps. From the Downtown Eastside to Kelowna, spring

cleaning should not involve the violent displacement of our neighbours and violation

of their human rights.

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

To the Minister of Housing: will you work with all levels of government to implement

the federal advocates’ recommendations for upholding dignity and human rights in homeless

encampments?

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

I had the opportunity to meet with the advocate when I was in Ottawa just over a year

ago to discuss what British Columbia is doing to address encampments. In fact, I would

share with the member that we were praised for our leadership, for deploying housing

and providing wraparound supports for individuals.

[2:15 p.m.]

These are complex situations. Encampments are not safe for the people living in them.

They’re not safe for the community at large. We need to ensure that we’re getting

people indoors.

A member mentioned Crab Park. The member would know that there was close to 100 people

in encampments there. We found housing for all those individuals. The encampment no

longer exists. It’s not because they were moved out; it’s because we found housing

opportunities. We got people indoors.

We’re doing the same in Prince George, where Moccasin Flats had close to 100 people,

working closely with council. We have now four people left at that site, and we’re

going to find housing for those last four people as well. That work will continue

in all communities that need housing.

Medical Assessment Fees for Seniors

Heather Maahs : While nurses are being attacked, seniors are being shaken down when they struggle

to put food on their tables.

A constituent of mine in her 80s contacted me to tell me she was being charged almost

$300 to get a health checkup so she could keep her driver’s licence.

Why are seniors on fixed incomes being forced to pay out of pocket instead of being

covered by MSP?

Hon. Josie Osborne : Seniors are such a valuable part of our society, and they’ve put so much work into

creating the place that we have here. That’s why this government is committed to continuing

to support seniors by increasing their access to health care services, increasing

rent supplements for seniors living with low incomes and taking so many steps to keep

costs down.

I appreciate the member’s question very much. Our Medical Services Plan provides for

medically necessary procedures and for services that people require for their good

health. I appreciate the member’s question.

Safety of Nurses

in Health Care System

Claire Rattée : Last month a nurse new in her career was strangled unconscious and had to be dragged

to safety by her colleagues. This attack happened in the psychiatry in-patient unit

at VGH. The person that strangled her was a patient.

The B.C. Nurses Union deserves an answer to the question that their president asked:

“What is it going to take? Is it going to take one of my members actually being killed

on the job in order for some substantive changes to take place?”

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

that has taken place.

I want to assure the member and all members of this House just how seriously this

government takes workplace safety. Every patient who walks through a hospital door,

every nurse who starts a shift, deserves to be safe. Nurses are trained to help people

with their health care problems. They’re not trained to be security officers.

That’s why we’ve taken steps, adding over 750 relational security officers in hospitals

and sites across B.C. That’s why we’re going to continue this work and ensure that

there are people who have specific training in trauma-informed practices who are able

to identify these behaviours. And it’s why I’ve made it clear to all health authorities

that we need to see that all policies and procedures are being followed.

We have more work to do to build our nursing workforce; to ensure that we have the

minimum nurse-to-patient ratios — we’ve made this commitment to the B.C. Nurses Union;

and to build this in acute care sites to start with. We’re going to continue that

work and ensure that workplaces are safe for everybody.

Safety of First Responders

Brennan Day : Members of this House will remember what happened just a few steps from here. While

responding to a call, a paramedic was violently beaten trying to provide care on Pandora

Avenue. Health care workers and front-line responders are speaking out.

This side of the House hears you.

How has this government allowed violence against first responders to become just another

part of the job?

Hon. Ravi Kahlon : I thank the member for the question.

Certainly, encampments are a challenge. I mentioned that in a previous question as

well. I can share with the member that we have been, again, rapidly deploying housing

opportunities in Victoria.

Interjection.

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

[2:20 p.m.]

We’re working closely with stakeholders, with local businesses, with our first responders

on Pandora. We actually have a working table that has the city and has our not-for-profit

partners all sitting together so that we can identify where challenges are, to make

sure that when first responders are responding, they’re able to do so in a safe way,

and also so that our not-for-profit partners that are going in to provide supports

can be safe as well.

We have seen some progress because of that table. Work continues. I certainly hope

that we’re able to get the last few folks into housing so we can address that encampment.

But it is work that is ongoing.

Violent Incidents in Hospitals

and Safety of Health Care Workers

Misty Van Popta : At Eagle Ridge Hospital, a nurse opened a curtain and found herself face to face

with a man waving a machete, screaming, threatening, forcing staff to evacuate patients

from the ER.

Nurses’ lives are on the line, and this NDP government has turned a blind eye to the

safety hazards they encounter daily.

Can this government please tell this House how many days, weeks, months, years until

nurses can consider B.C. hospitals safe workplaces?

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

Interjections.

The Speaker : Shhh, Members. Members.

Hon. Josie Osborne : This government, like all governments of any political stripe should, takes workplace

safety incredibly seriously and understands that nurses and all health care workers

need safe places to be able to deliver care to British Columbians.

That’s why we’re taking action to increase our nursing workforce. That’s why we’ve

made a commitment to the Nurses Union around minimum nurse-to-patient ratios. That’s

why we’ve added security officers, specially trained security officers, in these sites.

That’s why we’re going to continue this work to ensure that nurses are able to deliver

the care for people that they need to be able to deliver, without fear of violence.

Nothing could be more serious, when people are seeking care, than to know that the

people who are there to deliver it are able to do that, are able to be focused, are

able to stay focused on those patients and deliver that care.

We’re going to continue this work to increase our nursing workforce. We’re going to

continue this work to create safer workplaces. The entire House needs to understand

that this government is entirely dedicated to that.

Korky Neufeld : Well, what we’ve heard here this afternoon is: “We will continue to work. We will

continue to work. We will continue to work.” The only thing that we’re certain is

continuing are the major incidents in our hospitals. We have had three major incidents

at Eagle Ridge Hospital in just the last few months.

Nurses, the public and even a police officer were attacked. Health care workers are

sounding the alarm, but this government continues to treat these assaults as isolated

incidents instead of systemic failures.

How many more attacks will it take before this NDP will wake up and admit to its own

failed policies that are fuelling the chaos unfolding in our hospitals today?

Hon. Josie Osborne : Each and every one of these incidents needs to be brought to light, and we need to

know about them, and we need to take serious action. When these incidents do take

place, health authorities investigate. They ensure that the proper steps are taken,

and they take action to make improvements.

That’s what this government will continue to do: address the systemic issues behind

violence in the workplace, address issues of mental health and substance use and sickness

in people to ensure that we are doing everything we can to support people.

We’re going to continue to support nurses by establishing these security officers

in hospitals, continuing to listen to the Nurses Union about those highest-risk sites,

encouraging and ensuring that health authorities are taking every action that they

need to.

We’re also facing a systemic issue in the shortage of health care workers, which is

why this government continues to take so much action, creating new nursing seats,

training nurses who will stay here in British Columbia.

[2:25 p.m.]

Every nurse deserves a safe workplace. Every health care worker deserves a safe workplace.

Every patient deserves to have that. We will not give up.

Lorne Doerkson : I can’t believe for a minute that the answers we are hearing today are providing

any comfort for front-line workers that are afraid to go to their workplace.

After these three attacks at Eagle Ridge Hospital, staff were told to plan escape

routes. Only now, after multiple assaults, has Fraser Health increased security. The

Nurses Union says it is not enough, calling the situation alarming and saying: “It

isn’t the environment that nurses should be expected to provide care in, and patients

should not have to be concerned about being exposed to violence.” Well, no kidding.

Why on earth has it taken three major incidents and serious injuries for this NDP

to finally act?

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

been adding nurses…

Interjection.

The Speaker : Please continue.

Hon. Josie Osborne : …making a serious and important commitment around minimum nurse-to-patient ratios,

part of ensuring that the staffing is there to help ensure a safe workplace for nurses.

We know just how critical nurses are, and that’s why we’re adding nurses to B.C.’s

health care workforce at a faster rate than any other major province. We registered

over 10,400 new nurses last year.

But there is more work to do, and we know that. That’s why we are going to continue

to do that. We are going to continue to train nurses here in British Columbia. We’re

going to continue to attract nurses from other workplaces to come — from the States,

for example. We’re going to continue to support the Nurses Union, to listen to the

issues, to listen to the incidents that are happening, to learn from every single

one of them and to create the safest possible workplace.

Steve Kooner : Eagle Ridge Hospital has seen a series of violent incidents in just a few months,

leading to serious staff injuries. The B.C. Nurses Union says that people often get

away with harming and assaulting health care workers.

Why isn’t this Attorney General making it a priority to hold violent offenders who

harm our health care workers accountable?

Hon. Niki Sharma : We take all violent incidents extremely seriously. The Minister of Health has gone

over a series of measures that we’re taking in the hospital to make sure that nurses

are safe.

I expect our justice system to deal with every instance of violence appropriately,

and we have put better resources in the system to deal with repeat violent offenders

to make sure that our bail policy is strong when it comes to people that are offending

and reoffending. We will continue to do that work to keep everybody safe in B.C.

Trevor Halford : Here’s the problem. These questions to the government aren’t new. The bigger problem

is that we’ve got a minister that’s answering these questions now the exact same way

the former Minister of Health answered those questions. We have a government that

continues to put politics before people. We’re hearing stories….

Interjections.

The Speaker : Members.

Please continue.

Trevor Halford : We’re hearing stories after stories of nurses having to battle through the bureaucracy

of WorkSafe. We’re hearing stories of the minister handing out seven-figure severance

packages to a failed health executive.

[2:30 p.m.]

The gaps in the system aren’t sustainable, and they’re clearly not safe. But even

worse than all that, days ago this Health Minister confirmed to my colleague the MLA

for Skeena that there is no new money for increased security in our hospitals —none,

zero.

We’ve had minister after minister stand up and talk about the importance of keeping

our front-line workers safe, but they don’t walk the walk. They fail time after time,

story after story.

My question to the Minister of Health is a very simple one. Why can she not make it

a priority to actually fund and protect our front-line workers instead of failing

them day after day?

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

workplace…

Interjections.

The Speaker : Members, shhh.

Hon. Josie Osborne : …safety seriously.

Interjections.

The Speaker : Members. Members. Come to order.

Hon. Josie Osborne : This is a government that takes workplace safety so seriously that we are funding

750 security officers across B.C.

Interjections.

The Speaker : Members. Members, shhh.

The question was asked, and the question was very clear. I think the minister understood

your question. Let her answer now. There is no need to continue to heckle.

Please, finish it.

Hon. Josie Osborne : This is a government that understands just how important nurses are to our health

care workforce and why we are taking so many steps to increase the number of nurses

that are working on the front lines delivering health care to people.

Adding more nursing training seats, making it easier for nurses to be licensed to

practise here in British Columbia when travelling, coming from other locations. That’s

why we’re continuing to do this work to ensure that we are going to meet minimum nurse-to-patient

ratios in acute care centres, for example. That’s why we’re going to continue to listen

to the Nurses Union and work with them.

Interjections.

The Speaker : Shhh. Shhh. Take it easy.

Member, please conclude.

Hon. Josie Osborne : That’s why we’re going to continue to take action and continue to strengthen B.C.’s

public health care system for all British Columbians.

[End of question period.]

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

Leave granted.

Introductions by Members

Hon. George Chow : I am very happy to welcome a group of grade 10 students in the gallery who are leaving

right now. I’m sorry. They come from David Thompson Secondary School in my riding,

and they are here to tour the building as well as learn about the building’s history

and the democratic process.

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

Orders of the Day

Government Motions on Notice

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

Motion 14 — Appointment of

Special Committee on

Democratic and Electoral Reform

Hon. Mike Farnworth : I move Motion 14, of which notice has been given in my name on the order paper, to

appoint a special committee on democratic and electoral reform.

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

1. Examine and make recommendations related to:

a. increasing democratic engagement and voter participation, and

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

representation

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

2. Review the administration of the 43rd provincial general election, including consideration

of the Chief Electoral Officer’s report on the 43rd provincial general election, and

make recommendations for improvements for future elections, and report to the House

thereon by May 14, 2026.

That the Special Committee have the powers of a Select Standing Committee and in addition

be empowered to:

a. appoint of its number one or more subcommittees and to refer to such subcommittees

any of the matters referred to the Special Committee and to delegate to the subcommittees

all or any of its powers except the power to report directly to the House;

b. sit during a period in which the House is adjourned, during the recess after prorogation

until the next following Session and during any sitting of the House;

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

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

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

That during a period of adjournment, the Special Committee deposit its reports with

the Clerk of the Legislative Assembly, and upon resumption of the sittings of the

House, or in the next following Session, as the case may be, the Chair present all

reports to the House.

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

Motion approved.

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

Motion 13 — Membership Change to

Finance Committee

Hon. Mike Farnworth : I move Motion 13, of which notice has been given in my name on the order paper, regarding

the membership of the Select Standing Committee on Finance and Government Services.

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

Motion approved.

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

Motion 15 — Membership Change to

Children and Youth Committee

Hon. Mike Farnworth : I move Motion 15, of which notice has been given in my name on the order paper, regarding

the membership of the Select Standing Committee on Children and Youth.

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

Motion approved.

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

In the Douglas Fir Room,

Section A, I call continued debate for the estimates on the

Ministry of Environment and after that for estimates for the Ministry of Forests.

[2:35 p.m.]

The House in Committee,

Section B.

The committee met at 2:38 p.m.

[Lorne Doerkson in the chair.]

Committee of Supply

Estimates: Ministry of Health

(continued)

The Chair : Thank you, Members. We’ll call this House back to order, where we’re going to contemplate

the estimates of the Ministry of Health, and we’ll call on the minister to move the

vote.

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

Peter Milobar : Just a couple questions for the minister. I’m sure it won’t come as a surprise to

her that I’ll be asking a couple questions around the proposed Kamloops cancer centre,

and I’ll explain why I’m saying the word “proposed” shortly.

There’s been a lot of discussion about the design of the Kamloops cancer centre. The

minister made herself available to myself and the member for Kamloops–North Thompson.

I know she met with the hospital board delegation shortly after that.

This has been canvassed in this chamber now for a couple of years around the overall

design of the Kamloops cancer centre. The fundamental problem is that the Kamloops

cancer centre will be the only one in the province, if not Canada and certainly North

America, that is designed as a site with two different locations.

[2:40 p.m.]

The ministry is now having to figure out how to have their information software of

Interior Health talk with the information software of B.C. Cancer. Part of cancer

services in Kamloops would be run inside the hospital by Interior Health, where they

don’t have the same expertise per se, necessarily, as B.C. Cancer does.

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

across North America.

We’ve heard lots of different reasons and excuses from the government, back to this

minister’s predecessor, for why this design has to be this way: anywhere from the

site’s constriction, to cost, to the building footprint, to a height variance being

needed for something. Like a critical cancer centre in a building that’s going to

be built into a hillside — that it needs about a three-foot variance to add a floor

to it.

As a former mayor, I can assure the minister it’s a completely ridiculous argument

to think that a city council would not give that type of a variance in a city that

does not protect view lines when rezonings come forward. We are a city of valleys

and hills, so we’ve never protected view to begin with.

All that said, the most recent comments by the minister again indicate that not only

will we have the only cancer setup like this, despite the urging of local medical

professionals and cancer medical professionals that this is a system and a design

that was not workable and will make it next to impossible for proper recruitment….

We’ve had positions unfilled for the better part of a decade in Kamloops already.

We now find out we won’t have a PET-CT scanner as part of this new building either

— yet again, substandard compared to any modern cancer centre being designed. I would

point out that there are actually more people from the Kamloops area that go to Kelowna

for PET-CT scans, and Vancouver, than for radiation treatments.

Yet this new centre — brand-new build, it hasn’t even broken ground yet; it’s still

at the drawing stage — cannot be accommodated with the changes to actually make it

a modern cancer centre on par with everyone else. Kamloops isn’t asking to be treated

differently. We’re asking to be treated the same when it comes to cancer care, of

all things.

The last piece, which is perhaps the most offensive piece, frankly, to the people

of Kamloops, is that cost keeps getting flung out by the minister and previous ministers

as another reason why not. While there’s already money being budgeted for the interior

renovation that could be moved over to the new build, there’s the new-build budget

as well.

I would point out to the minister that of 15 hospital projects under construction

right now in British Columbia, they are a cumulative 16 years behind schedule. A cumulative

14 of the 15 are over budget, to the tune of $4.3 billion. So it seems if you’re a health care facility in any other part of this province,

it’s okay to go $1.2 billion or $1.3 billion over budget. But if you’re the Kamloops

cancer centre, you better be held to the exact dollar figure or you’re not going to

be approved.

We can’t find any extra dollars for a cancer centre that’s supposed to have a 30-

or 40-year lifespan, at least, in it to build it properly on the front end. We’d rather

have a 40-year recruitment problem in Kamloops instead. It’s not acceptable. It needs

to change.

The last piece is that we get told: “Well, we don’t want any further delays.” Actually,

they don’t say “further.” The government says: “We don’t want delays.” This was a

cancer centre promised by the late John Horgan in 2020 that would have its doors open

by the fall of 2024, and the drawings aren’t even completed on it yet. Now this government

says if they can’t get building immediately, they won’t build it at all. It’s already

delayed, and it’s going to be built improperly.

When will this government, this minister, commit to actually designing the B.C. cancer

centre in Kamloops to the same standard and the same design specs of every other cancer

centre in British Columbia and provide people of Kamloops the same access to cancer

care as people in Victoria will have with their centre, people of Nanaimo, people

of Surrey with the one under construction, people in Prince George, people in Vancouver

and people in Kelowna?

We are not asking for something other than already exists. It would be like saying

you are building a tertiary hospital, but you’re not going to have a bunch of tertiary

services in it. You are not building a full-fledged B.C. cancer centre if it’s designed

the way the one in Kamloops is.

[2:45 p.m.]

Why is Kamloops the only project that is deemed to be okay to be built under standard

to every other cancer centre in the province and the only one that this minister and

this government seem to be worried about going cost overrun?

[2:50 p.m.]

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

Yes, he accurately references the fact that I have had the opportunity to sit down

with him and his neighbouring MLA. I’ve had the opportunity, on behalf of myself and

the Minister of Infrastructure, to sit down with the regional hospital district representatives

and have a really good discussion about this project.

First and foremost, this is about delivering better cancer care to people, closer

to home. This is about…. I know that the member has advocated strongly for years,

as have local representatives, about just how important it is to deliver cancer care

closer to home. The travel that people have had to go through, from places like Clearwater

or Barriere down to Kelowna, for example, has been very challenging.

That’s why this government has been so committed to expanding the amount of cancer

centres across British Columbia and reducing some of those barriers, hiring more oncologists,

more radiation therapists, bringing in the equipment that’s necessary for people to

get that cancer care.

Now, I think the member inaccurately references the amount of work that is needed

to happen in order to redesign a project, and I don’t think the people of Kamloops

and the surrounding area want to see delays in having that care come to them.

We are in a situation now where a ministry responsible for this has undertaken this

work, so I will direct the member to that ministry for the specifics around those

questions. But the costing and design and procurement — that is done. Construction

is expected this summer.

I know that the member has been out in the media and has told me that he could tolerate

up to a one-year delay. But this would be longer than a one-year delay, and this is

not necessary in order to deliver excellent cancer care to the people in Kamloops

and the surrounding region.

B.C. Cancer has been working with Interior Health, has been meeting with physicians

on site. Some of the things I can confirm for the member are that the information

technology systems will come together by the time the cancer centre is open. That’s

important. That’s addressing a major concern that has been heard from physicians.

Of course, I know the member is very familiar with what will be in the Kamloops cancer

centre: the three linear accelerators and the bunkers that are required for that;

radiation therapy planning, including a CT simulator, which is new technology that

is making it easier for physicians to precisely locate tumours and be able to treat

them; an outpatient ambulatory care unit with ten exam rooms and two consult rooms.

Most patients do not receive chemotherapy and radiation therapy on the same day. B.C.

Cancer and Interior Health and staff at the hospital are working together to make

it easy for patients to travel from one part of the campus to another part of the

campus, should that be necessary. But I would point out that there are other places

in British Columbia where people do travel much longer distances in order to receive

treatment in the same day — for example, receiving one form of treatment at Lions

Gate Hospital and then needing to travel to downtown Vancouver to receive the other

part.

We want to do everything we can to make cancer care easier to access for people, to

make it simpler for people to access, but we have to have a cancer centre in Kamloops

to be able to do that. And I don’t think the people in Kamloops want to wait years

to get that cancer care.

As I mentioned, the project is in the final stages of procurement. The construction

will begin this summer. We are going to be delivering excellent cancer care for the

people of Kamloops and the surrounding region.

I thank the member for his advocacy, and I thank, especially, the local leaders for

their advocacy in coming down to Victoria to meet with me, to understand this, to

talk about the fact that the PET-CT scanner is not part of the project right now.

[2:55 p.m.]

The former Minister of Health was clear about that when the business plan was released

in February 2024 last year — that that was not going to be a part of the centre at

this time.

Peter Milobar : Well, it’s this government’s stubborn adherence to a poorly designed cancer centre

that is causing the delays. I absolutely have said if it takes this late in the game

to get the government to finally listen to reason, yes, I would publicly…. I have

publicly said that of course if there’s a bit of a delay, I’d rather see it built

properly for the next 40 or 50 years of serviceable life than to have it rushed through

and designed improperly.

This isn’t myself saying…. I’m not a medical professional. My father was a specialist.

I’m certainly not. But if, god forbid, I get a cancer diagnosis, I’m going to rely

on the cancer professionals to tell me how I need to be treated. I’m relying on their

opinions and their advice on what they see as the shortcomings of this centre.

This is directly from the medical staff in Kamloops. This has been raised in this

chamber three times now at budget estimates and been ignored by…. The community has

been ignored repeatedly by this government.

Although the government has chosen to create a whole other minister responsible for

infrastructure now, it’s only been the Minister of Health that’s ever answered questions

about this facility, and it’s only been the Minister of Health that does media about

this facility in Kamloops. I’m going to keep asking the Minister of Health about the

medical aspects of this facility, and the government can figure out who wants to actually

manage the actual construction of the project.

The Surrey cancer centre was announced at the same time. It’s not being designed like

this. It’s being built from scratch. If this was such a superior model, why is that

not the case? If this was the new way to provide top-line cancer care for people,

why are the new cancer centres in the ten-year cancer plan not being designed like

this? Why is the update to the equipment in Kelowna not necessitating a redesign of

the Kelowna cancer centre to replicate what’s going on in Kamloops or in Prince George

or in Victoria or in Vancouver?

The minister conflates travelling from one part of Vancouver to get downtown to the

full cancer centre as somehow different or the same as people having to travel between

two buildings within Kamloops. I’d point out to the minister that people are travelling

from Williams Lake once this centre gets built. People are travelling from Blue River

once this centre gets built.

They’re currently having to travel to Kelowna. They’re going to have to continue to

travel in greater numbers to Kelowna for PET-CT scans because the government refuses

to put that into this. Just because it was announced by a minister a couple of years

ago that it won’t be part of this building doesn’t make it right. That is the underlying

problem with this whole process — the government’s stubborn refusal to acknowledge

what the medical professionals in Kamloops have been calling for, for years.

That is a properly designed cancer centre at the same level as other cancer centres

and not being sold a bill of goods about how superior this will be because of one

piece of equipment with a design that doesn’t even match up with other cancer centres

literally being designed at the same time. Then the community is made to feel potentially

guilty about any possible delays in a design that this government has stubbornly clung

to despite repeated requests by those same community members.

The hospital board has wanted this redesigned the whole time. The MLAs have wanted

it redesigned the whole time. The medical staff have wanted it redesigned the whole

time. The only people that haven’t has been this government. And now our understanding

is it gets ratcheted up a level where the government is alluding to…. If there are

any further delays, the project will be scrubbed completely.

Now, Kamloops has a long history of distrust with NDP governments and cancer centres.

They’re not going to relitigate the original decision that got yanked away from Kamloops

by then Premier Harcourt. But the community is still angry about that. So a simple

request. We’re going to keep fighting to have this designed properly — to the minister.

[3:00 p.m.]

Can the minister confirm that the Kamloops cancer centre is not under threat by this

government in any way, shape or form for cancellation? If there’s any delay, if the

community keeps advocating for a properly designed cancer centre in the first place,

and if, by some weird fluke, the government finally starts to listen to reason and

actually delivers a properly designed cancer centre, that is not suddenly the excuse

for this government to cancel the cancer centre, as we are starting to hear has been

now threatened to our community.

Hon. Josie Osborne : We clearly value this project. Despite all the economic uncertainty that we’re experiencing

and that members of the opposition bring up consistently in this House, this project

is going ahead. This project is in the final phases of the procurement process, and

construction will start this summer.

This project will address the needs for people to get cancer care closer to home,

and that is far superior to a situation where they are not getting that care. The

project is moving ahead.

Anna Kindy : To the minister: I’m just going to give you a bit of an overview and then some questions.

On reviewing the StrongerBC service plan for the upcoming three….

[3:05 p.m.]

Actually, let me premise first, just secondary to the member for Kamloops Centre’s

comment regarding the PET scan. There is a track 1 and track 2 for referrals. Track

1 is for cancer care. Once you get cancer care, you get treatment.

The issue, and I’ve had quite a few letters and people complaining of that, is that

unless you get your PET scan, often you do not get to see the cancer care because

they need the results of the PET scan. So I think not having a PET scan available

locally defeats the purpose a little bit. Just a comment to maybe take into consideration.

On reviewing the StrongerBC service plan for the upcoming three years, I have many

concerns, which we’ll eventually get to. But I have some overriding, specific concerns,

and they are the lack of legislated health standards, meaning acceptable wait times;

nursing ratios…. I think they’re 4 to 1. Also, one that’s never mentioned is laboratory

turnaround time and, also, the lack of transparency and clear data showing the progress

in the area of concern.

We need to know where we’re going, hence the health standards. How can we move forward

without that data? And just to put it in context a little bit, unfortunately with

the health authorities, many of the rural ridings have lost services.

I’ll just take one, for example, the lab services. Locally in Campbell River, we were

able to do Gram stains. A Gram stain is a very basic test. It’s done around the world,

in Third World countries — very standard test.

The reason we sometimes need the result right away is, for example, if somebody comes

in with necrotizing fasciitis, or flesh-eating disease, sometimes you’re not quite

sure. The way you can actually diagnose it is to see what kind of bacteria grows.

And to actually wait for a result when a young person comes in with flesh-eating disease….

And if you wait too long, that below-the-elbow amputation becomes above-the-elbow

amputation, which can become actually a life-threatening issue.

We’ve lost that service in Campbell River. We went from 14 lab techs, and at one point

we were down to three lab techs. What that meant was that if one lab tech took a holiday,

and we got to that point, the hospital was going to close. What I mean by close is

that we would not have been able to give or take blood. That’s why, sometimes, centralizing

services, which was done with the health authority, works against the rural background.

Coming back to my questions, having given you context, does the minister plan to create

standards in wait time for diagnostics, consultations and treatment so that the population

of B.C. clearly knows what is acceptable, and how will the minister share this progress

with the public and this government?

[3:10 p.m.]

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

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

Thank you for the question around wait-time targets or benchmarks or standards around

lab services and diagnostic imaging, for example.

[3:15 p.m.]

I am going to talk first about the standards and the question that the member asked.

I’m going to talk a little bit, too, about the need to train and recruit more health

care workers who perform these important tasks and the equipment that’s required to

do them.

First of all, I think it’s good to note that currently there are no nationally agreed-upon

wait-time targets for medical, diagnostic or MRI, CT and ultrasound imaging, and there

is a wide variation with respect to the collection and assessment of medical imaging

data.

Here in British Columbia, the suggested wait times are aligned with the Canadian Association

of Radiologists national designation five-point classification system, and they’re

based on medical urgency — for example, priority 1, immediate to 24 hours; priority

2, maximum seven days; priority 3, maximum 30 days; priority 4, maximum 60 days; and

priority 5, scheduled exams. Those are timed follow-up exams that take place on a

specified date.

The B.C. prioritization guidelines were developed to provide imaging departments with

a provincial approach to prioritizing the commonly ordered medical diagnostic and

imaging tests. In B.C., these priority levels can be assigned by the referring practitioner

or other roles in health authorities — for example, booking clerks, technologists,

radiologists. It depends on the health authority. There’s a bit of variability there.

Given that the prioritization levels might not be consistently assigned across the

province, right now the ability to ensure standardization and compare across health

authorities, for example, of the priorities is limited. But I take the member’s point

and understand what she is seeing. That’s why there is work underway right now in

the ministry and in the health authorities to ensure that there is greater standardization

of the implementation of these priority levels across the health authorities, and

that will ensure consistency. That takes care, I think, of the question around standardization.

I want to talk a little bit about diagnostic imaging access and all of the supports

for laboratory medicine services.

First of all, we recognize that there is a growing demand on medical imaging services,

of course, as the health care demands grow with an aging population, with a growing

population. That’s why we launched a diagnostic imaging strategy to help catch up

and to keep up with the demand.

There’s still work to do, but I’m going to talk a little bit about some of that work.

We are making progress. That’s around ensuring that more people have access to the

diagnostic imaging services that they need.

Since 2016-2017, since we formed government, we have increased the total number of

MRI units to 44 from 25 and the total number of CT units to 74 from 63. There are

11 net new CT units and 19 net new MRI units that have been added across B.C. because,

of course, as machines age, they need to be replaced. This is helping to both increase

capacity and also improve geographic access, improving access for people who live

in rural and remote areas, for example.

Additionally, since we formed government in 2017, health authorities have significantly

increased exams. Last year — these numbers are not finalized, but these are the estimates

— over 340,000 MRI exams, which is 95 percent more than when we formed government,

so almost a doubling in the number of MRI exams performed over the last eight years.

In the case of CT exams, over one million CT exams. That’s 45 percent more, compared

to the 2016-2017 year. Two years ago, in 2023, B.C. ranked second out of seven reporting

provinces for MRI exam wait time. Nine out of ten people in B.C. waited 159 days or

less for their MRI exam, compared to a national average of 167 days. That’s in accordance

with last year’s Canadian Institute for Health Information, or CIHI, report.

[3:20 p.m.]

We’ve made tremendous access on increasing the capacity for these services. We just

wouldn’t be able to achieve that kind of access without the collaboration and partnership

we’ve seen with health authorities and everybody who’s been involved, of course, too,

from the Ministry of Health in increasing this access and delivering these services.

Just to talk a little bit about the technologists who run the MRI machines. We launched

a direct-entry MRI technologist training program at BCIT in 2023 to help build the

workforce, and we certainly…. As I have said many times in this House, we’re experiencing

a global health human resource shortage, and we need more workers in practically every

part of the health care sector to help deliver the health care for British Columbians.

This program at BCIT is allowing high school graduates to apply instead of requiring

an existing medical imaging certification.

Any high school students out there interested in becoming an MRI technologist? Just

saying; it’s a great career.

This is an example of how we are increasing access to seats and training more people.

We know that when people are trained in health care jobs, professions here in British

Columbia, they tend to stay in British Columbia, and that’s a really important point

to make.

When it comes to the allied human health supports that are needed for laboratory medicine

services, so talking about the lab service side of things, this has very much been

a focus of our health human resources strategy and doing the work to support the medical

laboratory assistants or MLAs, the medical laboratory technologists, MLTs, and the

combined laboratory and X-ray technologists, the CLXTs.

A couple of examples. I won’t go too exhaustive on this, but action 34 in the health

human resources strategy points to the memorandum of agreement that GoHealth BC has.

Now, we’ve talked about GoHealth BC before in the House and how nurses working for

GoHealth BC, for example, have the opportunity to travel out to those communities

that are experiencing some of the most severe shortages.

In this case, GoHealth BC has a memorandum of agreement with the HSPBA, and that includes

medical laboratory technologists in that program. We’ve got five MLTs now as part

of the GoHealth BC program that are available to some of those communities, for example,

in Interior Health and in Northern Health.

There’s a cohort of 15 students that’s been supported to complete the combined lab

and x-ray technologist training program, improving access to the kind of training

that’s needed to do this specialized but very rewarding profession.

There are students enrolled in both the medical lab assistant and the medical lab

technologist programs at post-secondary institutions who are eligible, if they’re

enrolled between September 1, 2023, and October 2025, for tuition credits. Again,

trying to incentivize and bring down some of the barriers and the costs associated

with that.

Currently one thing I want to talk about is the education and training that’s offered

here in B.C. as well. We have 149 medical lab assistant training seats. There are

three public and seven private post-secondary institutions that are approved by the

B.C. Society of Laboratory Science, and they offer this six- to ten-month MLA certificate

program.

In Budget 2021 — again, just remembering that as budgets go by and investments are

made, these are sequential investments into the health care system — we added 16 new

MLT seats at BCIT, 12 ongoing MLT seats at the College of New Caledonia.

That’s an example of the kind of work that’s being done to increase the number of

people working in this critical part of the health care sector, increasing the number

of pieces of equipment that are available, and health authorities, too, working with

their staffs and their staffing rotations to expand the hours of access to these critical

exams that are needed for people, as well as some words at the beginning there around

the need for standardization and the work that’s underway in the ministry right now.

Anna Kindy : Again, I think comparisons are very important, because sometimes we compare provinces

to provinces. Other provinces are having issues as well with wait times.

[3:25 p.m.]

Just to give you an example of medical technology outside of our borders, Canada is

27th out of 31 OECD countries — again, Europe, Australia, New Zealand. We’re 27 out

of 31 for MRIs. We have 9.5 per million. We’re 28 out of 31 for CT scanners at 38.8

per million.

I think we need to sometimes look for solutions outside our border, especially right

now. It’s our understanding that there are currently over 500,000 patients waiting

for CT scans. We’re way beyond the recommended targets for CTs, MRIs, ultrasound and

mammography, as well as image-guided procedures such as biopsies.

You mentioned training seats for techs, which I think is great. The numbers I have

here from radiologists are that they need at least 100 new training seats for technologists

and 20 new training seats for ultrasound people. One of the key factors, like you

mentioned, in terms of wait times, is the medical imaging portion of it, because there

are extreme shortages of medical imaging technologists. So the sooner we address that….

I think we need to address it appropriately.

There’s a massive deficit of medical imaging equipment in B.C., and a significant

portion of the existing equipment is beyond its useful life, as determined by the

Canadian Association of Radiologists’ equipment life expectancy guidelines, and they

need to be replaced. In addition, net new equipment is needed to keep up with medical

imaging demand.

Could the minister please provide details on how much funding is required to replace

existing medical imaging equipment that is beyond replacement guidelines? What specific

plans and funding are in place to accomplish this?

[3:30 p.m.]

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

The member is asking around plans for the future acquisition of technologies like

CT units and MRI units, for example, and how government will be investing in that.

Not to repeat myself, but I will say that one of the things we did in forming government

was recognize that we had a lot of catch-up to do. And the replacement of equipment

and the acquisition of new equipment, net new equipment, to be able to increase access

for people has been a really high priority.

Again, increasing the number of total units to 44 from 25, which is 11 net new; CT

units to 74 from 63, which is 19 net new. And of course, it’s always important to

stay on top of what the latest technology is available in terms of MRI and CTs, for

example.

What’s the real rate limiter right now are people to run these machines and to perform

these exams. That’s why it’s very important, I think, that to be the most financially

responsible, it’s also to time those investments in the equipment with the investments

in recruiting, and training more people to run those.

The last thing we would want to do is purchase a machine that sat idle too much because

there weren’t enough people to run it, and then it became outdated over time and needed

to be replaced. We want to use every piece of equipment as efficiently and effectively

as possible, so that’s the right combination of acquiring these units and having the

staff to run them.

We’re also aware that with innovations in technology, things like artificial intelligence,

there’s an opportunity to begin augmenting the staffing that does exist and providing

that kind of assistance as well. I’ve certainly had this conversation with the radiologists

recently, myself. Maybe we met with them on the same day. Who knows?

Then not to frustrate the member, but I will say that the actual purchase of these

major pieces of capital equipment has moved out of the Ministry of Health and into

the Ministry of Infrastructure. So it’s important for our two ministries to work together,

of course. Looking across government, the Ministry of Post-Secondary and Future Skills

is an important partner here too.

We have stood up a working group between the Ministry of Health and the PSFS Ministry

to make sure that we’re staying on top of what the projections are in terms of the

staffing that’s needed to run diagnostic equipment and that the seats that are invested

in and the availability of new training seats for people are matching there too. It’s

really important for the three ministries to work together very closely on that, and

that’s the approach that we’ve taken since forming government.

We’ll continue to do that, recognizing, like the member has so accurately described,

just how critical these diagnostic tests are and how physicians and specialists need

them in order to be able to do their jobs well and that we are doing it in a way that

delivers the best health care for people, including to expand the availability over

all hours of the clock if we can. As well, increasingly in smaller centres, making

it easier for people who live in rural and remote communities to access these important

services as well.

I really appreciate the question.

[3:35 p.m.]

Anna Kindy : Word of mouth is that in Vancouver, for example, the cost of living is so high, and

the salary of a CT scanner tech is quite a bit less than an MRI tech. That’s part

of the difficulty of attracting enough CT scan techs. So just to take that into consideration.

Now, in terms of a community imaging clinic, it’s an important provider of publicly

funded out-patient medical imaging in B.C. For some of them, the fees aren’t quite

covering the overhead as they used to, and some are finding it financially difficult

to stay viable.

I’m just wondering. When will this government be implementing the permanent changes

to overhead fees for CICs? They did institute some changes, but they were not permanent,

and to keep those clinics going, they need a helping hand.

[3:40 p.m.]

Hon. Josie Osborne : First of all, for the folks at home, to acknowledge that community imaging clinics

are publicly funded and privately owned outpatient diagnostic facilities that perform

an incredibly important function here in British Columbia. That can’t go unnoted.

I want to acknowledge just how important they are. In some regions, they are performing

up to 60 percent of the services that people need.

In Vancouver Coastal region, for example, CICs provide 70 percent of diagnostic breast

imaging. It’s a really important part of the entire health sector ecosystem.

We acknowledge this and the challenges that these clinics are facing. We’ve heard

clearly from them that they are struggling financially and that some are concerned

about their ongoing viability. They have expressed some serious concerns around the

cost of overhead and administration, for example.

That’s why, in January 2024, we established a provincial ultrasound working group,

we call it. This has membership from the Ministry of Health, from health authorities,

from the B.C. Radiological Society, from radiologists who are directly affiliated

with the CICs themselves and from the Provincial Medical Imaging Office. The purpose

of this working group is to address these issues, including other issues, but it’s

primarily to look at the issues around financial sustainability and to look at some

of the disparities that exist.

I want to acknowledge the member describing the difference in pay rates, for example,

and that we are aware of that issue as well.

The discussions that are taking place at the working group meetings are enabling the

collective membership of that group to understand the extent of services that CICs

are providing and to understand more fully the financial sustainability issues that

they are facing and to explore options for how we can all work together to continue

to support patient access to medical imaging and ensure that it remains this important

part of B.C.’s health system.

In this work, we’ve advanced kind of a twofold plan to address some of the disparities

that are there. As the member noted, we’ve undertaken some stabilization payments

for CICs. Those go from September 2024 through to the end of August of this year.

That is continuing to provide the space and the time for us to work, through this

working group, to better understand these issues and then come up with a solution

that can last longer than the stabilization funding.

Thank you very much to the member for the question.

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

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

What is the current revenue from hospice palliative care fees by health authority?

Is there a variation in the hospice palliative care fee rate by health authority,

and if so, what are the average fee rates by health authority?

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

Hon. Josie Osborne : Thank you very much to the member for the question and an opportunity to talk about

just how important palliative, hospice, end-of-life services are and how lucky, fortunate,

we are in British Columbia to have such a strong network of hospice and palliative

care providers.

I really want to honour the people who do that incredibly important and challenging

work. It is so important for people reaching the end of their lives to know that they

have the peace and comfort and choice that is related to their own health. Of course,

that’s incredibly important for their families as well. And I appreciate the member’s

question.

Palliative and end-of-life care services are provided across a variety of different

kinds of settings here in B.C., and, of course, they all share the goal of improving

the quality of life for people who have life-limiting illnesses, for example, and

of supporting their caregivers as well. There are currently 474 palliative and hospice

beds in B.C., and that includes 345 community hospice beds and 129 acute beds.

Again, I just want to pause here and really express gratitude for those community-based

organizations that provide these services. I know, certainly in my community of Tofino,

we are very fortunate to have a very active hospice organization. I know that many

other communities benefit from the services that they provide beyond those end-of-life

care services for people. Also, the supports for their families through counselling

and grief supports, through vigil sitting, for example — these are really important

services.

Palliative and end-of-life services are charged differently based on the care setting,

but to the member’s question, there is a daily client fee. It is $48.20 for an in-facility

or short-stay hospice care.

[3:55 p.m.]

It is important to know, too, that no client is ever refused services. Should a family,

a person, be in a situation where this is not a fee that is feasible for them to pay,

there is a process in place to receive a waiver for that.

I want to acknowledge, too, that that’s a challenging situation for some individuals

and families to be in at that time, to have to contemplate having to go through that

process of, essentially, applying for a waiver.

The member has also asked about the differences between health authorities. I can

confirm that the rate is the same, the $48.20, but that the collection of this fee

by health authority…. Those records lie with the health authority, and we don’t have

that data at our fingertips, so I’m sorry to tell the member that I don’t have that

data.

I want to also reflect that we do have a bilateral agreement with the federal government

that was signed 2023-2024. Through that, we are receiving $52 million over five years

to improve access to palliative and end-of-life care, and we’re going to continue

to invest in other services like B.C. palliative care benefits. This supports palliative

care at home for people in B.C., for residents that are reaching the end stage of

an illness.

Again, it is part of our government’s commitment as part of a public health system

to continue to offer a full range of palliative care options for people in their homes,

in their communities and, when required, in community-based facilities or in acute

care settings.

I really appreciate the opportunity to talk about the good work that so many people

are doing there, and I appreciate the question from the member.

Anna Kindy : Just to clarify, with CICs, you mentioned that the contract ends August 2025 and

that right now there is no plan to extend it. We have 500,000 patients waiting on

a list for medical imaging exams.

You have to remember that the CICs, like you mentioned, are privately run. As a business,

it’s difficult to plan if you know you’re not…. It would be easier to plan, knowing

now, for August. Is there a plan in the works to come up with a solution in the immediate

future? I’m going to leave that as a question.

Hon. Josie Osborne : Yes. To be clear, the stabilization payments are not contracts. It’s an agreement

to provide stabilization funding, which ends on the 31st of August, 2025.

I’m extremely sympathetic that as private businesses, the sense of predictability

and needing to know about financial sustainability is, first and foremost, something

that they’ll be thinking of in addition to, obviously, the care and the services that

they provide for people. We really value those services.

Having the working group that has stood up to talk about this…. The intention of the

working group is to find a permanent solution. That work is underway right now. It

needs the space and time, but I take the member’s point that time is of the essence

and that it’s important for clinic operators to understand what the future will look

like. I’m grateful to them for being participants in the working group.

[4:00 p.m.]

I’m looking forward to learning more from my staff, as the working group proceeds,

about what kind of solutions can come forward. I appreciate the question.

Anna Kindy : Another key driver for long wait times for medical imaging is a shortage of radiologists.

Data provided by the BCRS shows that B.C. currently has a shortage of 58 radiologist

FTEs and this shortage will grow by 157 FTEs by 2030. If urgent action isn’t taken,

this shortage of radiologists in breast imaging, interventional radiology and image-guided

procedures such as biopsies will be significant.

In terms of recommendations, I have talked to multiple specialists, and I hear the

same thing through all the specialties. For example, neurologists in Vancouver — I

think they graduate five neurologists per year, and because of the cost of living,

as well, the retention rate isn’t what it should be. Looking at the demographic of

the physicians, the specialists, in terms of retirement, and looking at the numbers

produced by residency programs, it’s totally inadequate overall.

If we’re looking at increasing medical school enrolment for GPs, what are we doing

about specialists? Consider that to become a specialist takes ten years. If we don’t

increase medical school enrolment now — we’re already in trouble — we’re going to

be in huge trouble ten years from now.

I’m just wondering if the minister is actually collecting the data to that effect

per specialty. What is the cost of increasing residency positions, which I know is

taken into consideration? When you look at the effects on health care, the wait times

for….

I’ll go back to neurology. For example, if you have Parkinson’s disease, in terms

of seeing a neurologist in Vancouver, it takes a year now.

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

[4:05 p.m.]

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

Just to start by acknowledging the obvious and important role of specialists and the

length of time that it takes to train them. First of all, in order to go into a specialty,

of course, you need your basic MD, and the undergraduate training is a really important

component of that.

[4:10 p.m.]

I just want to give a nod to the fact that through our health human resources strategy

— again, where all of this effort is really focused on a strategic approach to ensuring

that we are training undergraduates, providing residency spots for postgraduate medical

education, looking at all the other health care professions within the sector that

are needed….

Through the HHR strategy, we have funded 40 new undergraduate medical school seats,

and of course, the new Simon Fraser University medical program will be welcoming a

first cohort of 48 students in fall 2026.

Specifically, though, the number of medical residents — I want to talk a little bit

about that. Here in 2025, now, B.C. is going to have a total intake of 613 medical

residents, which is a 35 percent increase since 2017. I’ll give a little bit of a

breakdown there: 205 of those will be family medicine residents, and that includes

31 that have been added since 2023 through the HHR strategy; 219 first-year specialty

residents; and 189 residents in a combination of sub-specialties, so re-entry into

medical residency, family medicine enhanced skills.

Between 2022 and 2028, UBC will add more than 160 new residency positions. There is

a resident allocation committee that meets on an annual basis between UBC, the health

authorities and the ministry, and they use data directly from the health authorities

to determine an appropriate allocation of how residency seats should be divided up

and how they should be allocated.

In addition to what I just talked about, medical imaging residencies have also increased

from eight to 12 between 2017 and now. I don’t have a direct cost per residency because

the length will differ for different specialties. I know the member understands that

very well.

I will just talk a little bit about the global budget for health education expansions:

Budget 2021, including $96 million over three years for health education expansions; Budget 2023, just over $302

million for three years for 19 of the focused actions in the HHR strategy. I’ll also

note that much of this funding is managed by the Ministry of Post-Secondary Education

and Future Skills.

I’ll just talk a little bit more about the actually filled residency seats and how

they have grown over time. For example, in 2022, in specialty, we had 260 specialty

and 65 residencies for family medicine enhanced skills — those family medicine practitioners,

for example, who want to gain specialization in oncology or in anesthesiology, and

an important feature for some of the smaller centres in B.C. where family physicians

with that extra training are able to provide services in those settings.

Then increasing in 2023 to 277 specialty seats and 64 family medicine enhanced skilled

seats in…. Sorry, that was 2023 that I just read. In 2024, it was 297 specialty seats

and 58 family medicine enhanced skills; and then now, in 2025, 314 specialty seats

and 84 family medicine enhanced skills seats residencies. I think it’s a demonstration

of the commitment to expanding the number of residency seats that are available to

train the specialists that we need.

I also want to note that in addition to training doctors and specialists here in British

Columbia, the work that we are doing to attract physicians to move to British Columbia

is an important part of this. With launching a recruitment campaign, for example,

specifically targeting the United States and attracting American, or Canadian but

American-trained, physicians who are working there to come back to British Columbia

or to move to British Columbia.

I recently met with a specialist who made that decision, having lived in the U.S.

with his wife for a number of years. She’s American. They made the decision to move

back to B.C., and I don’t think he could be happier, which is really good to hear.

We need to do more of that, so we’re going to continue the work that we’re doing to

fast-track the credentialing of doctors who come in from the U.S., for example, and

working with the College of Physicians and Surgeons on that work right now so that

we can make it as easy as possible for specialists coming from the States to come

here, practise in British Columbia and enjoy the fantastic province that we all enjoy.

[4:15 p.m.]

Anna Kindy : I think the important thing is to actually collect the data to see what the need

is. I think part of the data are the wait times. It gives a sort of indication of

what’s needed and the demographic of the physicians.

Again, word on the ground in every specialty is there’s going to be a wave of retirement.

People have been working. Second is also the different numbers needed. For example,

in general practice, you need to take into account how people work. The numbers in

general practice are not that much different than they were a few years ago, but the

need has, for some reason, exponentially increased.

Part of the reason is…. For example, in general practice, like you mentioned with

specialties, they sidetracked into different specialties. They’ll do either addiction

or sometimes skin care, or they’ll work solely in emergency. But how many of the old-school

doctors did it all, working 80 hours a week? Those days, I think, we have to count

as maybe not…. We can’t count as much on that. I think we need to take that into account

as well.

I think number one is the data collection in terms of the wait times and if we are

actually increasing or decreasing. Looking back to neurology, in terms of wait times….

I mentioned it’s one year in Vancouver. But if you’re from a rural area, to see a

movement disorder specialist, it takes anywhere from two to three years. So there’s

a real discrepancy.

We see that discrepancy, as well, coming from a rural area for cancer care. The issue

with cancer care is that the longer you wait, the worse your outcome.

I’m just wondering. Is the province measuring access to specialist care, measuring

the difference between rural and city?

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

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

First of all, I want to acknowledge that specialists actually maintain their own wait-lists,

and the Ministry of Health does not have a direct line of sight into that.

We do rely on the allocation process, the committee that I described, with the ministry,

the health authorities and UBC, using the data that health authorities are able to

provide and anecdotal information to make the allocation decisions about residency

seats. Absolutely aware of how important data like that are and acknowledge and agree

with the member opposite that that’s really important information.

I think that this is the right kind of conversation to take to the Specialist Services

Committee under the physician master agreement. The Specialist Services Committee,

for those folks at home…. Under the physician master agreement, this is a committee

that facilitates collaboration between government, the Doctors of B.C. and health

authorities on the delivery of services by specialist physicians, and it supports

the improvement of the specialist care system.

This committee has a specific mandate around enhancing and expanding the programs

that support delivery of high-quality specialty service to British Columbians to identify

projects that have measurable patient-centred goals that are focused on two key areas:

a health system redesign and expediating access to care. We’re talking about this,

I think, expediating access to care, absolutely. Also, the committee supports engagement

between facility-based family practitioners, between the specialist practitioners

and health authorities.

Another project that I’m aware of that the Specialist Services Committee has been

undertaking is around expanding team-based care for specialists, bringing nurses and

allied health professionals into a specialist clinic and enabling new ways of managing

wait-lists and supporting specialists and the management of those wait-lists.

Evaluation of that has been undertaken. What we know about it is that in every facet,

every objective that this pilot study had saw positive results, particularly around

patient satisfaction and in provider satisfaction — that specialist satisfaction as

well. That is a promising, I think, development and, again, exactly the kind of conversation

that needs to continue to happen. I would suggest that the Specialist Services Committee

is a good place for that conversation.

In the meanwhile, we will, of course…. The ministry participates in that and will

continue to work with those partners. I’ll just take the point that the member is

making around taking every action that we can to reduce wait times for British Columbians

to be able to access specialists.

[4:30 p.m.]

While I’m not able to provide information on the difference between rural and urban

residents, for example, I’ll just point to the importance of data, as the member has

stated, and our commitment to continue to do this work together with specialists and

our other health care partners.

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

very much.

Anna Kindy : I’m not an administrator by trade, but to me, to make a decision, you need data.

I’m assuming that data collection has been happening through the years. I think part

of having a health authority and having such a big bureaucracy….

[Mable Elmore in the chair.]

There should be data available as to what the needs are today and what the needs will

be five years from now and ten years from now. I think if we had actually looked at

that data and collected that data and implemented strategies, we wouldn’t be in the

situation we’re in right now. I can’t emphasize enough to collect data, and also comparative

data — rural versus non-rural areas, wait times, etc. — and make those data public.

I think, as well, sticking a little bit to the rural aspect or non-rural aspect, community-based

decision-making…. I just met, at lunch, the mayor from Colwood, who is initiating

a community-driven primary care centre. He has pledged not to take physicians from

other areas of B.C. He wants not to have one community lose while he gains. Again,

that’s a community-driven initiative. I think the community knows what it needs.

If we look at a community that is having a lot of issues right now, it’s Kamloops.

They have very poor access to cardiology, rheumatology, psychiatry and maternity care.

You’re mentioning maybe tying…. You mentioned that you’re bringing in U.S.-trained

doctors and maybe tying in, bringing in, foreign-trained physicians to the needs of

the community. If there’s a need for maternity care, and knowing that there’s a need

in Kamloops, that would be prioritized. I think that would be a good way of actually

moving forward.

In terms of psychiatry, there’s a provincewide lack of access to out-patient psychiatry.

In my community, we basically have no access to out-patient psychiatry whatsoever.

We don’t have psychiatric beds. Again, looking at a community-driven solution as opposed

to a health authority–driven solution…. I think it’s important.

Part of the reason we are in Campbell River was that the community opened its arms

up to having a plastic surgery program, looking at there being a resource industry

and the type of injuries that happen in that kind of community. Now it’s a very viable

program that has attracted more plastic surgeons, and the call group goes from Nanaimo

north.

The idea, and I’m just going to say it, is…. At some point, the previous minister

said that, well, if people need to travel, they just have to travel. I don’t think

that’s an adequate answer. We need to look at…. Every community needs to form its

own strategy, and maybe the health authority needs to open its eyes to that community-driven

solution.

We know there’s a general lack of specialists, and the numbers quoted in terms of

residency spots opening seem to me very inadequate. Again, looking at not saying the

point that there’s a global shortage, because there isn’t a global shortage in terms

of wait times and in terms of number of physicians per country.

I think we need to, again, look at true numbers, because the decisions we make today

will impact what is happening in five years. This will not change. I don’t foresee

it changing quickly. But if we don’t change now, we’re going to be way worse off in

five years and looking at other systems of model.

[4:35 p.m.]

I’m just going to go to primary care a little bit. In terms of primary care attachment,

I’m just wondering how the minister tabulates attachment to primary care.

[4:40 p.m.]

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

Thank you to the member for the question around primary care, the importance of primary

care and for people to be attached to a family doctor or nurse practitioner and receive

that important longitudinal care especially, as well, and how attachment is measured

and reported.

First of all, just a little bit of history. In the past, we relied on a Canadian human

health survey and also looked at utilization patterns, so some information around

the number of visits a person would make to a provider.

Now, this is imprecise, and you need to do some extrapolation to guesstimate how many

patients are out there seeking doctors and how many people are attached to a family

doctor or nurse practitioner. The lack of precision in this approach led to the development

of the provincial attachment system that we are developing and using today.

In this case, what we’re doing is working towards getting the records from every primary

care practitioner about their panels and how many patients they have. Then we have

an understanding of who is attached. Combine that with the health connect registry

that any British Columbian can and should, if they’re seeking a primary care practitioner,

sign up to.

[4:45 p.m.]

The health connect registry gives us a good line of sight into how many people want

to be attached to a primary care provider. Then we can accelerate the attachment with

the patient attachment coordinators that we have and have hired who do that work.

For the first time ever, now we actually have primary care providers telling us that

they want patients. They can tell the system that they want patients. This is a really

important move, I think, away from the burden for people seeking a doctor or a nurse

practitioner, primary care provider, from having to sit through the telephone book

— maybe we don’t use telephone books anymore — or go through the internet and find

as many local clinics as they possibly can and start calling every single one of them.

This is a system that’s helping make much more informed decisions. In the case of

new-to-practice family doctors, for example, using this system to help slowly load

their panel as they become accustomed to being full-time family doctors and enabling

them to practise before…. They might move away from a new-to-practice contract, for

example, into the longitudinal family payment plan model that’s here.

We have a lot of work to do, we know, in terms of continuing to train and attract

family doctors and nurse practitioners. Year after year we are attaching more and

more people to a primary care provider in their community. Since the launch of the

primary care strategy in 2018, more than 695,000 people have been attached to a family

doctor or nurse practitioner. In 2024, during that calendar year, 248,000 people were

attached to a primary care provider, compared to 186,000 the year before that and

130,000 the year before that.

You can see that the rate of attachment is accelerating, and last year, 2024, on average,

680 people a day attached to a primary care provider. That’s a 33 percent increase

in the attachment rate from 2023. It’s work that we have to continue.

In terms of how many family physicians we have here in British Columbia, again, we

are trending in the right direction, with more work to do. B.C. was the first province

in Canada for physicians per capita of 138 family physicians per 100,000 people and

134 specialists per 100,000 people.

We are attracting more out-of-province physicians than any other province, with the

highest positive net inflow, meaning that more physicians come to B.C. from other

countries and provinces than leave B.C. for other countries and provinces. In 2023,

for example, we had a net international inflow of 27. Second place was Alberta at

five. That same year we had a net interprovincial flow of 122. Second place goes to

Quebec with 33.

This is, really, around building on the successes of the initiatives that we’re taking

in showing that B.C. is an attractive place to live and to work, and the work that

we continue to do to incentivize people to move into rural and remote communities.

I’m so glad that the member mentioned specifically the mayor of Colwood. And of course,

we got to visit with him today at the Heart and Stroke Foundation lunch and hear a

little bit more about his inspiration behind standing up a community clinic. I think

this is really worth talking about because of the initiative that the city of Colwood

has shown in trying something different, a different model.

I’m proud that our government, the Ministry of Health, supported the city of Colwood

in the development of what they decided to do in standing up a municipally owned clinic,

essentially attracting physicians. Again, in his commitment to attract physicians

from outside of the province, he didn’t want to have an impact on the flow of physicians

and the need of physicians in existing communities and has hired from places like

Ireland, for example, in bringing physicians to the city of Colwood and working as

municipal employees.

I think this is exactly the kind of innovation and partnership that we continue to

need and need to see more of. When a municipality like Colwood…. I’m aware that not

every single municipality is able to put in the kinds of investment and work that

Colwood has, especially smaller places, and it’s really important that we continue

to do everything to support them.

I do want to just briefly highlight a few other communities around British Columbia

that are standing up to lean into this work of attracting physicians to their communities.

[4:50 p.m.]

I think of places like the Cariboo regional district that has set up a service inside

the regional hospital district, I believe it is, to pay for recruitment coordinators,

people who are working with local communities to attract physicians; to help welcome

physicians and nurses into their communities — to help them land well, to arrive into

a home that has a fully stocked fridge and to have toys for the kids; and who have

an understanding of what the interests of a physician or their family are and being

able to match them there.

I believe that in Burns Lake recently, they’ve just stood up a recruitment coordinator

as well, and other places like the Comox Valley have put an incredible amount of work

into attracting primary care providers.

We will do everything, and I will do everything that I can, to continue to support

communities in making these kinds of steps and trying innovative new models and standing

up clinics.

I recently had the opportunity to visit Shoreline clinic up in Sidney, just north

here of the Legislature, and was really inspired by the forward thinking of the team

of people leading that clinic in understanding that, as the member has referred to,a

wave of retirements…. It might be five years, might be ten years, but it’s going to

impact a community, and that’s why they stood up and have developed what looks to

me like a fantastic team-based facility.

When I toured it recently, with the member for Saanich North and the Islands, I was

given to understand that they practically have a waiting list of doctors who want

to join their clinic because they’ve created such a fantastic work environment. That’s

exactly the kind of thing that we need to continue to see.

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

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

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

shortly.

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

[Mable Elmore in the chair.]

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

of Health.

Anna Kindy : When we institute a program, there are potentially unintended consequences. For example,

having urgent and primary care centres or PCNs in a smaller community can draw the

physician out of the private practice and into the urgent and primary care centres.

Some of those private practices have significant patient attachments. We’re talking

maybe two physicians with 5,000 patients attached.

[5:00 p.m.]

What is the plan for the unintended consequences, from setting up UPCCs and now PNs,

for the private practice physicians?

[5:05 p.m.]

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

Yeah, the plan for unintended consequences and how sometimes thinking of the health

care system…. Let’s just talk about the primary care system, for example. It is a

little bit of a spider’s web, and it feels like you can make adjustments here and

they’re going to reverberate throughout the web. We have to be aware of what those

impacts might be and do our best to plan for them.

I think, also, in an earlier question, we were talking about the changing nature of

work and the changing nature of the way family doctors, nurse practitioners, are practising.

There was reference to the old-style family doctor that worked 80 hours a week and

coming to terms with different ways of practising medicine.

Certainly, something I think we are seeing amongst family physicians is the need for

choice and that people are looking to find workplaces and settings that work best

for them in the stage of life that they’re at. Maybe they have a young family. Maybe

they’ve been in practice for quite a while. Maybe people are moving towards retirement.

Some people want to live in an urban environment. Some people are looking for a rural

lifestyle. It’s important that the work we do with family doctors in those different

settings, whether hospitalists or those entrepreneurial doctors who want to set up

their own private clinics, for example….

Those who are choosing to work in places like UPCCs and those who have wanted to move

into the longitudinal family physician payment model…. I want to talk just briefly

a little bit about that because I think that’s a place where a lot of work has been

done that’s been very helpful in answering the concerns that we’ve heard from doctors

about improving the way that family doctors are compensated and supported for the

time that they spend with patients.

When the longitudinal family physician, the LFP, payment model was brought in, we

did that in collaboration with, of course, the Doctors of B.C. and B.C. Family Doctors.

It was part of a response to an urgent need that all British Columbians are feeling

around retaining and attracting family doctors, and the ongoing requests that were

coming forward to really revolutionize or modernize the long-standing fee-for-service

model that for many doctors wasn’t working anymore.

It’s a model that recognizes the complexity of long-term patient care and helps to

compensate family doctors for their time and for their patient interactions, and then

the number and complexity of patients that they have in their panel as well. As of

December 31, 2024, there were 4,418 family physicians actively working under the LFP

payment model.

[5:10 p.m.]

Of course, assessing other models and other ways that family doctors, primary care

providers, are working and how the system is working for British Columbians is really

important as well. That’s why I’m glad to see that