Third Session, 42nd Parliament

(2022) OFFICIAL REPORT

OF DEBATES

(HANSARD)

Monday, October 24, 2022

Afternoon Sitting

Issue No. 236

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 (Standing Order 25B)

Diwali

H. Sandhu

T. Wat

Library Month and School Library Day

K. Paddon

History of anti-LGBT campaign in public service and military

E. Sturko

Aspenwood Elementary fundraising for Terry Fox Foundation

R. Glumac

Kitimat Community Foundation

E. Ross

Oral Questions

Government action on repeat offenders and crime in communities

K. Kirkpatrick

Hon. M. Rankin

Action on community safety and role of incoming Premier

P. Milobar

Hon. M. Farnworth

Funding for disability benefits

S. Furstenau

Hon. N. Simons

Ambulance response times and service management

T. Halford

Hon. A. Dix

Government action on issues in health care system and role of Health Minister

L. Doerkson

Hon. A. Dix

S. Bond

Tabling Documents

B.C. Ferries Commissioner, annual report, fiscal year ending March 31, 2022

Orders of the Day

Second Reading of Bills

Bill 36 — Health Professions and Occupations Act

Hon. A. Dix

S. Bond

S. Furstenau

A. Singh

N. Letnick

Hon. R. Kahlon

K. Kirkpatrick

G. Lore

M. Lee

MONDAY, OCTOBER 24, 2022

The House met at 1:34 p.m.

[Mr. Speaker in the chair.]

Routine Business

Introductions by Members

A. Mercier: I’d like to introduce, at eight months, my son, Simon. As you can see,

he takes after me with hair. He’ll probably be going grey in the next week

or so, I think. I brought this burp cloth. I thought I’d get ahead of the

curve. He found a way around that, so he’s smart. He’s good at

problem-solving.

I’d like to introduce my wife, Kate, and my daughter, Charlotte.

Charlotte is very excited to come and meet Macey Hansard after question

period.

S. Chandra Herbert: Well, first, I want to wish a happy Diwali to my family, who are

celebrating today.

Happy Diwali to everyone celebrating across B.C.

[1:35 p.m.]

I want to introduce this House to two friends of mine, who are here in

Victoria, here in this chamber: Alex and Danielle Puttonen. Alex and

Danielle are incredible West Enders. They put community first. They’re out

volunteering, whether it be early in the morning, late at night. I think I

bugged them on their honeymoon. I think, in fact, they love politics and

helping people so much that they’re even here on a belated honeymoon — and,

in fact, also on Danielle’s birthday. So happy birthday to

Danielle.

Thank you for doing what you do for our community.

B. Anderson: I’m absolutely delighted to introduce Rebecca Brohman to the House.

Becky and I have been in school since grade 5. We have lived together and

moved up to the Yukon together. She is an incredible friend.

She’s also a nurse prescriber for the OAT program, so she is helping

people that are battling addiction every single day. She is extremely

compassionate. She’s also a volunteer firefighter.

I would like the House to please welcome Becky and thank her for

everything that she does for our community.

If I may, I also just want to say a very happy birthday to the

Minister of Forests, who is my Kootenay collaborator. She has been an

incredible mentor for me.

So happy birthday.

I. Paton: I’m pleased today to welcome a couple of guests from Tsawwassen, my

riding, including a young fellow from northern France who is here today.

Valerian Leignel is his name, and he’s from northern France. He’s here on a

Rotary exchange, and he’s attending South Delta Secondary in

Tsawwassen.

With him is a very well-known individual from Tsawwassen, a good

friend of mine, Garry Shearer. Garry Shearer has been past president of the

Tsawwassen Rotary club. He’s been the district governor. He’s been the

executive director of the Delta Chamber of Commerce. He’s been the president

of the Delta Hospice Society. A very community-minded gentleman, Garry

Shearer.

Please would the House make Valerian from France and Garry from

Tsawwassen welcome today.

A. Walker: On precinct today is the grades 10 to 12 class from Ballenas Secondary

School. I went to the school, and I was privileged to be able to visit Ms.

Jessylee Spence’s class. They will be coming up to watch question period

here when they arrive.

If we could give them all a wave and give them a round of applause

now, maybe they can hear us coming through security.

Hon. J. Horgan: Just under the wire. I would like to join the House in welcoming Susan

Sanderson, the execu­tive director of Realistic Success Recovery

Society, which is doing great work helping those who are vulnerable, helping

those dealing with mental health and addictions.

Susan is a dear friend of this place and has been working tirelessly

in her role to lift people up, particularly in their greatest hour of

need.

Would the House please make Susan very, very welcome.

Statements

(Standing Order 25B)

DIWALI

H. Sandhu: Today many people across the globe and in B.C. are celebrating the

Indian festival Diwali, which is the festival of lights. Lights are

symbolic of this festival, and people go overboard with sparklers and

fireworks to fuel their inner light that spiritually protects them from

the darkness.

As you know, Diwali symbolizes the spiritual victory of light over

darkness, good over evil, love over hate and knowledge over ignorance.

The Diwali festival is also a fusion of harvest festivals in India.

Diwali is a major cultural event for the Hindu, Sikh, Buddhist and Jain

diaspora. The beauty of Diwali is that it is not limited to the

celebration of just one historical event. Each religion remembers

different stories and historical events behind it.

Diwali brings with it happy tidings and a promise of a better

tomorrow. People light lamps in their houses and throw grand feasts to

celebrate happiness, good times and good fortune. I have many beautiful

memories of celebrating Diwali. One of those memories is my parents

encouraging us to share what we have with less fortunate people and to

donate generously.

[1:40 p.m.]

My parents reminded us that when harvest season and business

opportunity bring prosperity to many people, there are still countless

people who, despite working so hard, don’t have enough. Donation around

Diwali and other festivals was a big part of my family, so everyone

could celebrate with their loved ones. Therefore, Diwali, for me, is now

not only a fun festival, but it also instilled in me the values of

giving, sharing kindness and being thoughtful, which I will always be so

grateful for.

I wish everyone celebrating today a very happy Diwali and happy

Bandi Chhor Divas. May your life be as colourful, shimmering and magical

as the lights of Diwali.

T. Wat: I rise today to acknowledge and celebrate Diwali, also known as

the celebration of lights. We join Hindu, Jain, Sikh and Buddhist

communities across British Columbia, symbolizing the triumph of light

over darkness through Diwali and other related celebrations, such as

Bandi Chhor Divas.

While those joyous days may be celebrated differently, it is time

to appreciate the light around us, see friends, family and loved ones,

dance, play and feast, while supporting those in need. I would also like

to remind British Columbians to celebrate safely and per the regulations

wherever they are, especially regarding potentially dangerous displays

such as fireworks.

We are fortunate to live somewhere with as much light as British

Columbia. Besides the gorgeous landscapes, nature and architecture, the

sun shines brightly on us. Our light and glow also come from the

diversity and inclusiveness we enjoy and nurture in B.C. Diwali reminds

us of the many cultures, traditions, religions and ethnicities that add

so much more vibrancy to our province.

Cities across B.C. are hosting events to mark Diwali, including in

my constituency back in Richmond. I encourage all of you to join our

local celebrations in the spirit of togetherness and light.

On behalf of the official opposition, I wish every one of us who

celebrates the festival of lights a happy and healthy Diwali.

LIBRARY MONTH AND

SCHOOL LIBRARY

DAY

K. Paddon: October in B.C. is Library Month. B.C.’s public libraries ensure

people have equitable access to quality information, the Internet and

accessible public services. They foster inclusion and social well-being.

More than two million people have library cards in B.C., giving them

access to services at B.C.’s 71 public libraries and 250

branches.

I have the best memories of when the kids were little, bundling

them up and heading to our local library for storytime or searching for

our next picture book adventure or even signing up for summer reading

clubs with my teenagers, through Fraser Valley Regional Library. On

those days where things felt overwhelming, the library was a supportive,

fun and peaceful place to go together. For days when being there in

person was not an option, the digital collection was always accessible,

and there are resources online.

In May 2022, our government announced a one-time $8 million

investment of COVID-19 relief and recovery funding for libraries. We

know how important it is to keep people digitally and socially

connected.

Along with Library Month, today marks B.C. School Library Day. We

reflect on how school libraries inform and empower students in all

grades across B.C. School libraries foster critical thinking skills and

diversity. They provide stories for children, to inform their own

experiences and understand experiences different from their own. I love

the support my own kids and their friends have had from their

teacher-librarians, not only in being able to access an expertly curated

collection but in the guidance to individual students on materials that

foster interest, knowledge, awareness and growth.

To coincide with School Library Day, the Drop Every­thing

and Read Challenge is taking place. The celebration of reading is

promoted by the B.C. Teacher-Librarian Association and is designed to

remind everyone, young and old, to make reading a priority in

life.

Would the House please join me in celebrating this and make sure

that later today, you drop everything and read.

HISTORY OF ANTI-LGBT CAMPAIGN

IN PUBLIC SERVICE AND

MILITARY

find and eliminate LGBT members of the Canadian Armed Forces, the RCMP

and other federal agencies from the public service.

[1:45 p.m.]

Wrongly labelled a threat to national security, they were cast as

subversives and likely targets of blackmail by communist regimes seeking

classified information. During this period, known as the LGBT purge,

thousands of Canadians were subjected to investigations and

interrogations.

In 1989, a bright and talented military officer named Michelle

Douglas was released from the armed forces, told she was not

advantageously employable due to homosexuality. In 1990, she filed a

lawsuit against the Department of National Defence. In October of 1992,

Michelle Douglas was successful in her claim, and the federal government

stated it would abandon its policy of banning gays and lesbians from the

military.

This year October 2022 marks the 30th anniversary of that landmark

court ruling, which is considered to be the beginning of the end of the

LGBT purge. It was a case which set precedents for many other positive

changes in Canada with respect to equality and ending discrimination

based on sexual orientation.

Two weeks ago Michelle Douglas met with members on both sides of

the House and shared her story. It was a tremendous opportunity to

reflect on the history of LGBT people in Canada and here at home in

British Columbia. Thanks to the courage of Canadians like Michelle

Douglas, our country and our province have advanced human rights and

equality for LGBT people.

Canada’s purge is a dark

chapter in our history. How­ever,

as each of us reflects upon our past, we can also reflect with a sense

of the success that we’ve achieved together in seeing how far we’ve come

to be an inclusive society, from a time when LGBT people were purged to

a time where each of us has the codified right to serve our country and

our province.

I ask that members of this House join me in recognizing this

important anniversary.

ASPENWOOD ELEMENTARY FUNDRAISING

FOR TERRY FOX

FOUNDATION

R. Glumac: On October 15, 1979, Terry Fox wrote a letter to the Canadian

Cancer Society asking for support for his upcoming run. He wrote: “We

need your help. The people in cancer clinics all over the world need

people who believe in miracles. I’m not a dreamer,” he said, “and I’m

not saying this will initiate any kind of definitive answer or cure to

cancer, but I believe in miracles.”

From those inspiring words, today almost $1 billion has been

raised by the Terry Fox Foundation to help find a cure for cancer. Each

one of those dollars raised comes with a story of its own from thousands

of individuals and groups, elementary schools.

Today I just want to share a few words about Aspenwood Elementary

in Port Moody and its inspiring principal, Janine Close, who last year

motivated her students to raise $8,000 for the Terry Fox Foundation and

rewarded them, in true elementary school style, by dressing up as a

chicken and doing the chicken dance in every classroom of the school.

This year she had to top that, so she volunteered to be doused with

gooey green slime, to the delight of the elementary school students, who

once again raised $8,000 for the Terry Fox Foundation.

There are so many ways to make a difference, so many stories, and

we can inspire each other each and every day.

I want to say thank you to Aspenwood Elementary and Principal

Close for your incredible fundraising efforts and for putting a smile on

so many faces at the same time.

KITIMAT COMMUNITY FOUNDATION

E. Ross: The Kitimat Community Foundation serves and enhances Kitimat by

connecting donors to community needs and opportunities. By bringing

donors to the table, they are able to formulate and realize their

philanthropic goals, matching their interests and concerns with

community needs. The foundation takes a broad view of what a community

is and what it needs to succeed, using its grants to support everything

from shelters to sustenance and care for those most in need.

The success of the foundation is because they take the long-term

view of what it takes for community-building by assessing the needs for

the future and providing opportunities and investing in sustainable

solutions, helping the community to be a strong and resilient place to

live, work and play.

Just recently the foundation held its 43rd Aluminum City Telethon.

This year was another success, at the Mount Elizabeth Theatre, in front

of a full crowd that included food trucks and a grad car wash. The day

could not have gone any better, because they raised $55,000 to support

many local organizations and programs like the Tamitik Status of Women

or Delta King Place, which provides assisted-living services.

[1:50 p.m.]

The annual Aluminum City Telethon continues each year in October

as the main fundraising source for the Kitimat Community Foundation,

which enables continued support of immediate needs in the community

while building long-term stability funds for the future.

The volunteers who have spent months in setting up this telethon

truly deserve the thanks, and it benefits all walks of life, but they

could use more volunteers. So please reach out to this foundation and

help with their incredible work that they’ve been doing for 43

years.

On a side note, I’ve co-hosted this telethon twice. In my first

year, they asked me to do 30 push-ups as a fundraiser, which I felt sore

from after a few days. This past year they asked me to learn how to

waltz. I prefer push-ups.

Oral Questions

GOVERNMENT ACTION ON REPEAT

OFFENDERS AND CRIME IN

COMMUNITIES

K. Kirkpatrick: Every day there is another catch-and-release horror story. Tyler

Newton is a violent, prolific offender who was convicted in the

unprovoked fatal knife attack of an unsuspecting stranger on a bus. This

is a dangerous high-level criminal, a high-risk criminal, currently

facing charges for aggravated assault and assault with a

weapon.

Newton has, in the past, blatantly and repeatedly disregarded

release conditions, but shockingly, he was once again being released and

is out in the community. On the weekend, the government made it clear

that the Crown prosecutor agreed with his latest release, and there was

no attempt by this government to keep him in custody — a complete

indictment of the incoming soft-on-crime Premier’s broken

system.

To the Attorney General, why was Tyler Newton’s right to reoffend

more important to this NDP government than the right of the community to

be safe?

Hon. M. Rankin: We, obviously, share the member’s frustration with this horrific

act. We share the understanding that this cannot continue, and we are

taking concrete steps to address it — not just within the prosecution

service, which, as the member knows, is an independent branch of

government, making daily decisions. The 500 talented people who choose

what to do in certain circumstances are governed by the criminal law of

Canada and the Charter of Rights.

There are unintended consequences of the Bail Reform Act of 2019.

We’re working with our federal partners to address that. We’re working

with local governments, as well, to take the steps necessary to deal not

just with the crime but the causes of crime as well.

Mr. Speaker: Member for West Vancouver–Capilano, supplemental.

K. Kirkpatrick: That answer is simply not good enough. Newton has a long and

appalling criminal record, with 51 convictions. He’s described in parole

documents as someone with “consistent disregard for the law,”

pro-criminal attitudes and values and a high-risk and high-needs

offender who has not mitigated that risk.

He is a violent, prolific offender who has a history of blatantly

violating release conditions, yet he faces no consequences. He is being

released again because of the incoming soft-on-crime Premier’s

catch-and-release program. This is exactly why we have called for the

NDP to issue a directive to Crown prosecutors that puts the rights of

the community’s safety ahead of the criminal’s right to

reoffend.

To the Attorney General, when will the NDP scrap this incoming

soft-on-crime Premier’s catch-and-release system that keeps violent

prolific offenders like Tyler Newton out on our streets?

Hon. M. Rankin: Well, I thank the hon. member for the question. We are, of course,

examining all concrete measures, all programs that might make a

difference. As the member knows, we commissioned an independent report

that made 28 recommendations. Those recommendations are being examined

very closely to see if we can come up with a comprehensive

response.

It’s important that we know that social investments need to be

made so we can deal with the offenders as individuals. There was a

program called the prolific offenders management program that managed to

cut this repeat offending by 40 percent. The former government chose to

cut it. We have reinstated that program.

[1:55 p.m.]

In addition, there are a number of important programs that will

make a difference on the street — peer assisted care teams with mental

health experts to try to deal with those people who are suffering mental

health or the consequences of addiction.

We are spending up to $114 million in the last budget to have 500

people housed in complex care housing, which is something that was

recommended by the experts. We also are making sure that people who are

released from our penal institutions have wraparound services for not

just 30 days, in the past, but now 90 days. And for every single

correctional facility in the province, this program will be

applicable.

When they were in government, the opposition did none of those

things. We intend to continue doing that in partnership with local

government and with the federal government.

ACTION ON COMMUNITY SAFETY

AND ROLE OF INCOMING

PREMIER

P. Milobar: The incoming Premier spent much of his abridged leadership

campaign bragging about his work as a legal advocate at the Pivot Legal

Society. In fact, he even said that his work at Pivot Legal Society was

“formative” for his political career.

Let’s look at that legacy. Could it be the legacy of the book

How to Sue the Police that the incoming Premier wrote? Or

perhaps it was his legacy around suggesting that perhaps police forces

had too many tax dollars going for them, which continues on today in the

Pivot Legal Society. And the Attorney General just referenced the

prolific offender program that the Attorney General called aggressive

policing tactics. That’s what the incoming Premier referred to that

program as.

Well, last night we saw that legacy on full display when Meenakshi

Mannoe from the incoming soft-on-crime Premier’s own Pivot Legal Society

blamed the RCMP for the tragic murder of Constable Yang. I’m going to

quote, and it’s a bit of a tough quote to have to read out, but it’s

important. “Is it possible that this officer was killed because the RCMP

has a racism and misogyny problem that doesn’t protect young, racialized

women in their ranks? What does Stop Asian Hate look like inside the

oldest boys’ club in KKK Canada?” Some legacy.

Will the NDP government condemn these disgusting comments and

their connection to Pivot Legal?

Hon. M. Farnworth: I appreciate the question from the hon. member. Let me be clear.

That individual, whoever they are, does not speak for anybody on this

side of the House. In fact, I don’t believe they speak for anybody in

this House. Quite frankly, given those comments and other comments I’ve

heard from some of those individuals, they don’t represent anybody other

than a small group of people who are just completely, in my view, out to

lunch.

What I can tell you, though, is that we have an Attorney General

who, from the very day he was sworn in, started tackling some of the

challenges that we’ve been facing on the criminal front in this province

— whether it’s money laundering, which went on in this province

unchecked; whether it’s recognizing, after discussions with mayors, that

there needed to be changes; that what was happening in communities was

working together with the mayors to find solutions, which was the

LePard-Butler report, of which 28 recommendations, three of them are

already being implemented — including the one that he thinks the

Premier-designate does not approve of.

We’re all in support of those initiatives, every single one, every

single member on this side of the House. I just hope that that side of

the House will be in support of the work that we’re doing to stop the

challenges that are being faced by communities.

Mr. Speaker: Member for Kamloops–North Thompson, supplemental.

P. Milobar: But the reality is that the incoming Premier is incredibly close

to Pivot Legal, and he’s bragged about his work with them throughout his

very brief campaign, a brief campaign that he didn’t actually talk about

the LePard report in. In fact, despite what the Solicitor General says,

this side of the House and the public don’t actually know what the

Premier-designate thinks now about the prolific offender

program.

[2:00 p.m.]

We only have his work during Pivot Legal days to base that on and

his failed 5½ as the Attorney General, where crime and violent prolific

offenders spiked in this province. Just Friday he said that his work at

Pivot Legal was formative for his political career.

Now, as he is getting ready to transfer in as the Premier…. After

2,000 days as the Attorney General, all we saw was an ever-increasing

street disorder under his failed catch-and-release system. Now he’s

asking us to believe — the incoming Premier and, it sounds like, the

Solicitor General — that after 2,000 days of inaction, he will do

something in the next 100 days. Let’s hope it’s to do something more

than just release the second edition of How to Sue the

Police .

Why doesn’t this government act now instead of delaying yet

another 100 days for political reasons — while in Vancouver alone, four

people a day will be randomly assaulted in that same time frame — and

end the Premier-designate’s failed catch-and-release system?

Hon. M. Farnworth: I appreciate the question from the member. I’ll just make a few

brief observations.

This Attorney General took action on money laundering on the very

first day that he took office. He did not do what the opposition did

when they sat on this side of the House. One of their first priorities

was to close courthouses around the province. How does that help the

justice system? How does that help the justice system?

Did he cut funding to sexual assault centres, to community

organizations that bring supports to victims, like they did when they

sat on this side of the House? No. We saw the funding for those things

increased.

When mayors came and said, “We’ve got problems with social

disorder and increasing criminal activity in our streets,” he said:

“Look, we want to work with you on what potential solutions are.” That’s

why that report was commissioned. That’s why those recommendations were

put in place. That’s why recommendations are being

implemented.

One of the key things in that report is that there needs to be

changes at the federal level. We made sure that that was put front and

centre on the agenda in Halifax with Justice ministers from right across

the country.

I know one thing. I’ll put my money on the incoming Premier when

it comes to dealing with law and order and ensuring our streets are safe

than anything that side of the House would ever….

Interjections.

FUNDING FOR DISABILITY BENEFITS

S. Furstenau: Bill C-22 is making its way through the federal House of Commons

right now. The goal of this legislation is to ensure that people with

disabilities are not living below the poverty line. But the federal

minister of disability and inclusion, Carla Qualtrough, says it may be a

year or more before the benefits to people with disabilities start to

arrive.

In an interview over the weekend, Minister Qualtrough indicated

that she is encouraging the provinces to step up and fill the gap to

ensure that funding to people with disabilities is there so that nobody

has to be poor because they are disabled.

My question is to the minister of Social Development and Poverty

Reduction. Will he step up and immediately raise the rates for people

with disabilities so they are no longer forced to live below the poverty

line?

Hon. N. Simons: I truly appreciate getting a question to deal with issues around

poverty in this province, not because there’s not more work to do, but

it gives me an opportunity to say how much we’ve done already and show,

as an example, how much more work we plan to do to address the ongoing

issues.

As we all know, this is the government that introduced a poverty

reduction strategy that included a number of measures across government

to address the issue that had been ignored under the previous

government. When it comes to supporting people who are living with

disabilities, I’m proud to say that this was the government that

introduced the Accessible B.C. Act. This is the government that reversed

a trend from the previous government of not increasing disability

assistance rates. We’ve increased disability assistance rates three

times in five years.

[2:05 p.m.]

Yes, we have more work to do. With respect to the federal

government legislation, we have a lot of questions about it. We don’t

plan to do things differently. We plan to ensure that people who are

living in poverty get the supports they need, and we continue to expand

those supports.

Mr. Speaker: Leader of the Third Party, supplemental.

S. Furstenau: It’ll be cold comfort for people with disabilities to hear about

how much has been done already.

Let me speak really plainly. The current disability assistance

program undermines the human rights of British Columbians with

disabilities across this province. Many who rely on disability benefits

are living in abject poverty. In my constituency, we’ve heard dozens of

stories from people with disabilities who are forced to make impossible

choices on a daily basis, choosing between paying their bills or their

rent, buying groceries or buying medications.

When one of my constituents was evicted through no fault of her

own, she was unable to afford the increased market rental rates and

could not access timely support through B.C. Housing. She was forced to

seek shelter in local motels, quickly exhausted her insufficient person

with disabilities benefit, and she went for days eating only rice

because she could not afford groceries or access local food

banks.

The cost of living is breaking records — rent, food, fuel prices,

medication. People everywhere are struggling to stay afloat, and for

people with disabilities, they’re expected to live on $16,300 a

year.

My question is to the Minister of Social Development and Poverty

Reduction. Will he increase disability rates above the poverty line in

B.C.?

Hon. N. Simons: I thank the member for the question again. Our goal is to

continually improve the system of supports for people in this

province.

The increases that we implemented affecting people on income

assistance and disability assistance were welcomed. We did not claw back

any of the benefits that people received during the pandemic, unlike any

other province. We were well known to have provided the most support for

people in the province of any other jurisdiction in Canada. That is well

documented, and in fact, our approach will be to continue to take steps

necessary to address the gaps.

I acknowledge that there are challenges. People are living with

challenges because of worldwide inflation. We understand that that’s

impacting everybody, and that’s why we will be continuing to find ways

to ensure that people living on disability or income assistance have the

supports they need from this government.

AMBULANCE RESPONSE TIMES

AND SERVICE

MANAGEMENT

T. Halford: Over 15 months ago the Health Minister announced he would improve

ambulance response times. Things have gotten worse, not

better.

When Surrey resident Allison Dorchester suffered a spiral

fracture, she was forced to lay on the ground in excruciating pain,

waiting for an ambulance for four hours. She was lying in pain,

screaming in agony, while her family pleaded on the phone for

help.

Our health care system has collapsed, and stories like this are

happening every day. There needs to be accountability, and that

accountability needs to start at the top.

Will this Health Minister do the right thing and

resign?

Interjections.

Mr. Speaker: Members. Shhh, Members.

Hon. A. Dix: What we are doing is taking substantial action in urban B.C. and

in rural and remote communities to increase the number of paramedics, to

ensure we have full-time paramedics and not a system dependent on casual

staff, which it was in 2017, to give the largest increases of any area

of health care other than mental health and addictions to the ambulance

service — to add ambulance paramedics, to increase training, to increase

the number of ambulances, to increase the number of dispatchers, all of

which we have done.

What we are also seeing in this period of two public health

emergencies is a dramatic increase in the number of ambulance calls. In

fact, the increase in the last few years to what are called purple and

red calls and serious calls…. It has increased by 27 percent,

dramatically above and, indeed, four times more than what one would

expect with respect to the increase in population growth and an aging

population.

I think our ambulance paramedics do an extraordinary job, and we

need to continue to take action to address this situation everywhere in

B.C.

[2:10 p.m.]

I want to express, of course…. When people hear about cases where

people didn’t respond quickly enough, we appreciate that, and we

respond, and we investigate those cases every time. But I would

acknowledge the exceptional work of our ambulance paramedics and the

work we have to continue to take together to ensure we’re building the

ambulance service we need to meet increasing demand in the

future.

Mr. Speaker: Member for Surrey–White Rock, supplemental.

T. Halford: Nobody is disputing the job that is being done by the paramedics

in this province. What people are taking exception with is the job that

is being done by this Health Minister.

Minutes matter, and in British Columbia, when you need an

ambulance and call 911, you should be comforted by the fact that that

ambulance will show up in a timely manner. And that was not the case for

a woman who collapsed with a seizure in Surrey at the Shoppers Drug Mart

on the weekend. Instead, when her friend called 911 to report a stroke,

it took an ambulance over an hour to get her and get her to the

ICU.

Day after day, we hear stories about this health care system

collapsing. Accountability starts at the top. And I will say it again:

will this minister do the right thing, be accountable and

resign?

Hon. A. Dix: I would say that what we need is a government that supports our

ambulance service, and that’s what we have. In 2010, under a previous

Health Minister, now the Leader of the Opposition, they stripped away —

in an action, frankly, of political retaliation — the right of ambulance

paramedics to bargain and support one another. We restored

it.

In 2017, 30 percent of ambulance paramedics were full time. That

number is now 55 percent. We’ve dramatically increased resources and the

number of ambulances and the level of training, and we’re going to

continue to do it. We have been working hard with our ambulance

paramedics, with our dispatchers and with our team to do exactly

that.

I think what the public wants is action, and that’s what we’ll

continue to provide.

GOVERNMENT ACTION ON ISSUES

IN HEALTH CARE SYSTEM

AND ROLE OF HEALTH MINISTER

L. Doerkson: Certainly, the residents of this province are looking for action,

but what matters to British Columbians are results and outcomes. Every

single part of our health care system is in crisis, but there’s no

accountability from this minister.

And if he keeps his job, it’s obviously more of the same from the

soon-to-be Premier who has yet to have a single idea on health care. He

has been campaigning for months and hasn’t presented a single health

policy idea — not one. Meanwhile, the system collapses, and people are

suffering.

On Saturday, hundreds gathered on the front lawn of this

Legislature as people came to talk to family doctors and get advice,

providing field medicine under a tent like something out of a war zone.

That should not be the state of our medical system. It’s absolutely

unacceptable.

Will this Health Minister finally do the right thing, accept

responsibility for his government’s appalling failure to deliver the

health care that British Columbians need, and resign today?

Hon. A. Dix: I would say that what people require is the kind of commitment to

public health care that the government has shown. From the time I’ve

been Minister of Health to the present, there are 38,000 more people

working in the health care system — not, as the Leader of the Opposition

calls them, bureaucrats but nurses and doctors and health sciences

professionals delivering a high level of care and service.

We are in the midst of two public health emergencies in B.C. — the

overdose public health emergency and COVID-19 — which continue to

profoundly affect our system. In spite of that, for example, in the last

recorded week, the end of September, we completed 7,200 surgeries in

that week, which is a record for that week in the history of British

Columbia.

We continue to deliver a high level of service, and there are

challenges. That’s why in the area of primary care, because I think

that’s what the member was talking about in his question, that means

providing new-to-practice contracts that have been welcomed by Resident

Doctors of B.C. and signed in record numbers.

[2:15 p.m.]

It means working with the Doctors of B.C. to change the way in

which we pay doctors and remunerate doctors in B.C. so that patients can

get better access to care. It means raising standards in long-term care

from a record of abject failure to a record where we meet the standards

that we as a government set. It means treating health care workers with

respect, everywhere in B.C., and allowing health care workers — who have

worked decades in the health care system, in many cases — to again get

access to pensions.

That is a record of which we can be proud, and our determination

is to continue to make improvements to face the current challenges of

public health emergencies facing our health care system. That’s what I’m

going to continue to try and do.

S. Bond: Well, I’m sure the Health Minister knows that every day that he

stands up in this Legislature and fails to acknowledge that the health

care system in British Columbia has collapsed, it has an impact in the

field. We’ve heard story after story, day after day, of people who are

telling us — I know that members on the opposite side of this House are

hearing it too — that they have never seen it this bad. That’s under

this minister’s watch.

Let’s just look at some of the items on the list. We have one

million people in British Columbia who don’t have a doctor. Dozens of

specialists sent this minister a letter, and he was warned that there

are massive delays in patient referrals for specialists. Radiologists

then spoke up. Do you know what they said? I know the minister knows.

They are expecting a tsunami of late-stage cancer cases. Not my words.

The words of radiologists and specialists — not to mention nurses, who

are exhausted. They are burnt out, and they are demoralized.

Every single day, when this minister gets up and refuses to

acknowledge that every single piece of our health care system is in

crisis, that’s on his watch. That is his responsibility, and every time

he tries to look in the rearview mirror, he should look in the mirror.

It is up to this minister today to acknowledge the failure to deal, with

specific actions, in the health care system.

Will the minister have the courage to do the right thing today, to

stand up and acknowledge the mess that our health care system is in,

under his watch, do the right thing and resign?

Hon. A. Dix: I think I would say a couple of things. Firstly, as I’ve said — I

don’t know — a dozen, two dozen times in this House, our health care

system is in crisis. We’ve been in two public health emergencies — and

we have been, for six years in one case and 2½ years in the

other.

We have been responding, in British Columbia, with extraordinary

action in both cases: the largest increase in building out a system of

mental health and addictions, on the one hand, and on the other hand,

our collective response to the COVID-19 pandemic — which, by world

standards, was extraordinary.

The member talks about radiology. In 2016-17, there were 174,000

MRI exams in B.C. In the Northern Health Authority, where the hon.

member lives, there were 22 per 1,000. That was a third as much as

Ontario. That was their record. What have we done? Well, in that health

authority, we’ve more than doubled it. That’s what we did, and that

helps.

When radiologists say we need to do better, absolutely so. But

when you go from 174,000 to 296,000, when you increase the number of CT

scans by 200,000, those represent people getting care sooner and the

diagnosis they need sooner. We’re going to continue to do

that.

Mr. Speaker: Member for Prince George–Valemount, supplemental.

S. Bond: Well, I’m not sure what the minister, then, is saying to

specialists in British Columbia, who are concerned that people will die

on a wait-list.

[2:20 p.m.]

That’s what they said. Radiologists said that people will find out

too late that they have late-stage cancer and have the likelihood of

dying in British Columbia because they cannot access medical

imaging.

We have emergency rooms that have closed dozens of times with

short notice, sending people to communities whose hospitals are also

overflowing. We have hospitals on diversion. We have health care workers

that are absolutely at the end of their limit.

That is on this minister’s watch. Perhaps the organizer of the

rally on Saturday…. We’ve had nurses on the front lawn, doctors on the

front lawn, families on the front lawn, all trying to get this

minister’s attention. Here’s what the organizer of the rally said on the

weekend. The minister can stand up and simply pass the numbers along.

These are real people with real issues that he continues to ignore.

Here’s what the rally organizers said: “We are frustrated to continue to

see this crisis go unabated by this government. We need change

now.”

The change should start at the top. British Columbia cannot afford

more of the same.

Will the minister do the honourable thing? Stand up,

admit that it’s time for a change that starts with him and

resign.

Hon. A. Dix: More thoughtful comments from the opposition health

leader.

I just want to say that when we talk about the numbers of people

who’ve received more care since 2017, it’s made a real difference in

their lives. I understand the opposition would be uncomfortable with the

fact that on MRIs and CT scans, we were near the bottom of the province.

It’s radiologists. We’re talking about radiologists. They, and everyone

else, would acknowledge that when you go from near the bottom of the

country to the top of the country, in comparing with other

jurisdictions, when you go from 174,000 MRI exams to 296,000, when you

add 17 new MRI machines to the public system, when you add medical

imaging, radiologists….

All of that work done by our extraordinary radiologists in B.C.,

174,000 exams to 296,000, every one of those exams, every single one, is

important to patients, every one of them is important to radiologists.

We’ve delivered 120,000 more than there were in 2017. We went from near

the bottom to near the top, and that demonstrates our commitment to

public health care responses.

[End of question period.]

Tabling Documents

Hon. M. Rankin: I have the honour to present the Annual Report to the British

Columbia Ferries Commissioner for the fiscal year ending March 31,

Orders of the Day

Hon. M. Farnworth: I call second reading, Bill 36, Health Professions and Occupations

Act.

[S. Chandra Herbert in the chair.]

Deputy Speaker: Members. Members, we would like to get this business underway, so if you

have conversations, please take them somewhere else. Thank you.

Second Reading of Bills

BILL 36 — HEALTH PROFESSIONS AND

OCCUPATIONS

ACT

Hon. A. Dix: I’m moving second reading of Bill 36, the Health Professions and

Occupations Act, 2022.

[2:25 p.m.]

As noted, this is different from most of the bills that we will be

debating this session — indeed, in most sessions — in that it’s a new

act, and it’s a very significant one that reflects significant

consultation and input from the public; from members of this House,

including members of all parties in this House; from outstanding

international experts as well; and, of course, from our health

professions in our health colleges.

This legislation will enhance patient safety and improve oversight

of regulated health professions. But the new legislation this

legislation sets to do is to set a path forward to modernize the way

health professions are regulated in B.C. by replacing — and that’s what

we’re intending to do here — the former Health Professions Act with the

new Health Professions and Occupations Act.

These comprehensive changes will help ensure that health

professions are regulated more consistently and transparently in the

public interest, moving away from a system that is decades old. It’s a

task that we’ve done together.

The current framework, as you will know, hon. Speaker, for the

regulation of health professions was developed nearly 30 years ago.

Health care practices, professional oversight and public expectations

have changed significantly since then. Our health care system is

changing, and we need to ensure that regulated health professionals are

keeping up by improving public patient safety and public protection,

which are important; efficiency and effectiveness of B.C.’s regulatory

framework; and building public confidence through transparency and

accountability.

I want to talk a little bit about how we got here today and the

work that we’ve done together. What’s the recent history behind this

legislation? I’ll say, to the member opposite, that I will probably take

about 35 minutes overall for this — just because I know, having been in

opposition, that it’s good to know that as one prepares one’s own

remarks in this case.

In March of 2018, I decided, and the Ministry of Health decided,

to launch an inquiry into issues at the time at the then College of

Dental Surgeons of B.C. We appointed Harry Cayton, an expert in health

professional regulation, who conducted the inquiry. We also asked him,

as part of that inquiry, to review the Health Professions Act, which

sets out how health professionals are regulated in B.C. In response to

this request, Mr. Cayton wrote the report. It’s called An Inquiry

into the Performance of the College of Dental Surgeons of B.C. and

the Health Professions Act and was made public on April 11,

The Cayton report recommended approaches to modernize B.C.’s

health regulatory framework through legislative reform in the interests

of the safety of patients and the public. In response to the

recommendations outlined in the Cayton report, we did something that I

think is quite unusual and quite positive.

We established what was called the Steering Committee on the

Modernization of Health Professional Regulations. It was myself, as the

Minister of Health and representing the government side at the time; the

member for Kelowna–Lake Country, who was then the Health critic for the

official opposition; and the member for Cowichan, who was then the

Health critic and the House Leader for the B.C. Green Party, for the

Third Party, in the Legislature.

We, in principle, decided that we would review the report and do

our own report that would be based on a unanimous approach to our

recommendations. We worked for a very significant period together, along

with the public service and the public, on responding to the Cayton

report and the practical recommendations that were needed to form the

basis of regulatory reform. In that period, we consulted a lot of people

in the two sets of processes.

We received about 6,000 submissions in one form or another from

the public and heard from the public on those issues. The steering

committee joined to make, in fact, a unanimous recommendation — we

finalized them — for improving the model of health professional

regulation. Those recommendations of that report, made by the unanimous

members of the committee, who were representing their caucuses at the

time, form the basis of this legislation today.

The key recommendations dealt with six areas, and I want to talk

about that a little bit. Enabling cultural safety and humility — that’s

important in everything we do. Improving governance. Reducing the number

of regulatory colleges. Creating a new oversight body. Improving the

complaints and discipline process and improving information-sharing

across the board. After putting our initial recommendations forward, we

received a second phase, and then we established our final

recommendations on the same issues after those two phases of public

consultation.

[2:30 p.m.]

In addition to these two phases of public consultation, a very

significant amount of consultation was conducted with Indigenous

leaders, health regulatory colleges, regional health authority

leadership and several other stakeholder groups that are affected by

these changes. In short, we, if anything….

Ordinarily, a minister comes up and introduces the legislation on

behalf of the government. In this case, I think, because of the

exceptional work….

I want to acknowledge the exceptional work of the member for

Kelowna–Lake Country, the member from Cowichan and their successors,

including the member for West Kelowna, who is participating in this

process, and, indeed, the current Health critic for the official

opposition, the member for Prince George–Valemount. All have been, in

some ways, involved, although the primary work was done in the first

phase, together, by the three original members. I want to acknowledge

their role.

Again, when I became Minister of Health, this wasn’t my first

priority — to do a massive reform of the health regulatory colleges. But

circumstances required that we make changes — circumstances that came

from the public — and we responded to that.

I think people on all sides of the House, when invited, responded

to that in a spirit of generosity and good sense. We worked together on

that basis. I think we have to try to do that as much as possible. I

think when that happens and when that occurs. we should acknowledge it.

This is their legislation as much as mine.

In

summary, the new legislation does the following things. I want

to go through some of the details of that, to lay it out for people who

might not have heard of this debate.

I think when you consider the number of people regulated by health

professions — well over 100,000 — and the number of people who go to

health professionals, which is, one might say, five million to five

million plus…. Really, everybody in the province, at one time or another

in their lives….

It’s very significant legislation. It’s new legislation and,

therefore, will make some changes in the way we’ve historically done

business. This is very important legislation. These things are not

always reflected in media attention, which is sometimes guided by other

things. But this is some of the most important work that I think the

government and the opposition will do in these four years of legislation

that we’ll deal with in the Legislature.

In

summary, the new legislation addresses discrimination in health

care and requires cultural safety and humility to be embedded in the way

professionals provide health care. It improves governance to ensure the

regulatory colleges are governing the professions in the public

interest. It creates a path to reduce the number of regulatory colleges

for improved efficiency and effectiveness, establishes the creation of

an oversight body to ensure the regulatory framework is functioning in

the public interest, creates a new discipline process which is safer and

care. It improves information-sharing. This includes with the media but,

most principally, with the public for better transparency and

accountability.

I want to break down each element of that to show how the

legislation achieves each of these goals.

With respect to the proactive approach to eliminating

discrimination, the new act will now be clear that discrimination is a

form of professional misconduct and that a regulated health professional

who engages in discrimination could be subject to an investigation and

discipline. There will also be more clarity to ensure health care is

practised in a way that is consistent, with objectives for

anti-discrimination and improved cultural safety for patients, something

that was at the centre of the In Plain Sight report, which has

been published subsequent to our reports on health colleges.

Secondly, with respect to improved governance, the new legislation

clarifies that the role of a regulatory college board is to function

exclusively in the public interest. It shifts away from the election of

health professional board members, creating a system where all board

members are appointed by a competency-based process. It also establishes

smaller boards of regulatory colleges, with equal numbers of public and

health profession board members.

The third thing, a streamlined path to reducing the number of

regulatory colleges through amalgamation…. We’re reducing the number of

regulatory colleges to improve efficiency and effectiveness. It’s been

something we’ve been taking action on since 2017 and before. In that

period, we’ve reduced the number of colleges from 22 to 15.

[2:35 p.m.]

Members of the House will remember…. Early on in my tenure as

Minister of Health, we amalgamated the four nursing colleges, who now

have between 60,000 and 70,000 members, making them, by far, the

largest…. In fact, basically half of the regulated health professions….

It’s now, of course, the College of Nurses and Midwives.

This process was started under the previous Minister of Health,

Terry Lake, and concluded in this Legislature with legislation I’ve

introduced. Since then, other colleges have amalgamated as well. The

College of Podiatric Surgeons, for example, which had 87 members and had

to fund, through the fees of those 87 members, an entire college, has

joined the College of Physicians and Surgeons. That makes sense. We’re

seeing the coming together of the four dental colleges now, in advance

of the legislation, which I think will serve the interests of the

professions.

One of the interesting things in the Cayton report was the lack of

communication between those professions and, indeed, between those

colleges. Obviously, they’ll be working with each other closely now.

Team-based care in any area requires us to act as teams, and that’s

what’s happening.

We’re seeing a reduction in the number of colleges. It’s from 22

to 15 now. It will be six at the end of this process. That, I think, is

a valuable process, meaning that we have colleges that are strong

enough…. Some of the smaller colleges, in terms of numbers, also had the

members who earned the least amount of money and were required to pay

the most to sustain the college. It allows us to ensure we have

organizations capable of doing the investigations and doing the work

required without putting an undue burden on an individual profession for

that.

Coming together as six, as opposed to 24, and then adding to that

24, 26 or 28, is, I think, the right approach, meaning that we’ll have

six core colleges, several of which will have multiple, of course,

professional disciplines within them. We’re going to have that process

go through, in a streamlined process, and a reduction in the number of

regulatory colleges to six. This will also, I think, make it less

confusing for some patients as to which regulatory colleges they can

direct complaints to.

Fourthly, we create an oversight body to promote accountability,

transparency and consistency across regulatory colleges.” The oversight

body will conduct routine audits of regulatory colleges, set standards

for regulatory colleges on policy and practice, investigate regulatory

colleges when necessary and make recommendations to the minister

on…health professions or occupations to be regulated under the

act.”

Members of the public will also be able to engage directly with

the office to submit complaints about the governance activities of a

regulatory college or a complaint about this act or its regulations. The

office cannot pursue complaints that relate to matters involving health

professionals, as this remains a role of the regulatory college. By

having a dedicated place for members of the public to go, the new system

adds a layer of accountability on regulatory colleges to ensure they are

functioning at a high standard and continue to be laser focused on their

public protection mandate.

Next, a new discipline process with improved transparency. This is

an area of some concern and has been for members of the public, as

members of the Legislature will know from their experience through

casework. The complaints and adjudication system will have a new

complaints process that separates the investigation stage, which will

remain with the regulatory college, and the discipline stage, which will

be handled by an independent discipline body. Information about all

discipline imposed during a discipline hearing and about all agreements

made between regulatory colleges and health professionals will be public

in order to increase transparency.

Regulatory colleges will provide support workers for those who’ve

experienced sexual misconduct, sexual abuse or discrimination from

regulated health professionals to help navigate through the complaints

process in a safe and trauma-informed way. Regulatory colleges will also

fund counselling for people who have experienced sexual abuse, sexual

misconduct or discrimination from regulated health practitioners. The

regulatory college will be able to then recover the associated costs

from regulated health practitioners found to have committed….

Finally, greater information-sharing. Regulatory colleges will now

have new abilities to share information between each other and with

other agencies where necessary for public safety and protection.

Enhanced information-sharing will remove barriers to improving patient

safety, enable more transparency and improve public trust in the

system.

I think what is always important…. Sometimes these debates sound a

bit arcane. It’s about colleges and how they operate. At its core, what

we want are changes that will help people. I just want to go through, in

some detail, the connection between people who might be listening to us

today and the changes, and significant changes, we’re making

today.

[2:40 p.m.]

I think the new legislation helps people in four ways. It builds

stronger public protection supports, it creates a safer complaints

process, it enhances public safety measures, and it ensures greater

transparency and accountability.

Here’s some…. If you want some examples of how that does that,

when you think of stronger public protections, I think it protects the

public from the harms of discrimination in health care and promotes

anti-discrimination practices by doing the following.

The legislation addresses all forms of discrimination by

strengthening the response to discrimination when it occurs and

promoting anti-discrimination objectives. We noted that.

Health regulatory colleges will now be required to take action

against professionals who are found to have engaged in any form of

discrimination made against protected grounds under the B.C. human

rights code. Discrimination based on race, colour or ancestry is an

example of that.

Additionally, we are establishing a legal duty for health

professionals to report other health professionals who engage in acts of

discrimination and for employers to report to a regulatory college if a

discrimination incident occurred that may have resulted in a

termination.

Often, and occasionally — it’s not all the time, but when it

happens, we see it — there will be a case of someone who moves within

jurisdiction or within positions. It’s important that there be

transparency about that.

The safer complaints process helps the public in the following

ways. It opens the doors to complainants who are in a vulnerable

position. The new legislation enables such people to request that their

identity be protected during the investigation process of a regulated

health practitioner.

In the past, people may have avoided submitting a complaint or

providing information during an investigation process as it can be

traumatizing to do so and could lead to retaliation or the perception of

such retaliation. Offering identity protection will encourage more

people to come forward to hold regulated health practitioners

accountable for their action when required.

The new legislation reduces the potential risk of re-traumatizing

someone testifying during discipline hearings by allowing reasonable

steps to be taken to support them and to shield them from the health

professional they’re complaining about. For example, this requires

sensitive documents to be only be disclosed when relevant and

necessary.

Requiring patients to face the person who perpetrated harm in an

adversarial discipline hearing setting or having their sensitive

documents disclosed only to damage their credibility can be traumatizing

and prevent people who’ve experienced harm from coming forward. Allowing

the independent discipline body to take steps to prevent this is

intended to help people who experience harm feel more comfortable in

making complaints.

The Health Professions and Occupations Act is offering funding for

support. A new provision of the act creates a pathway to support people

through counselling services who have experienced sexual abuse, sexual

misconduct or discrimination by a regulated health professional. To

ensure people have prompt access to support services, support can be

provided before an investigation reaches a conclusion.

The Health Professions and Occupations Act creates a new role of

support workers and, in this way, creates a safer complaints process as

well. A new provision in the legislation creates a funded support worker

position for those who have experienced a traumatic experience of sexual

misconduct, sexual abuse or discrimination by a regulated health

professional. These support workers play a dual role. Firstly, they are

there to support the complainant through the complaint process.

Secondly, they’re there to make recommendations and monitor the

complaint process to help make it safer and trauma-informed.

The Health Professions and Occupations Act establishes clear

definitions for sexual misconduct and sexual abuse. The new legislation

defines sexual misconduct to include acts such as sexual manipulation,

harassment and communication. It also defines sexual abuse, which is an

attempted or realized sexual act or physical contact of a sexual

nature.

Defining these terms provides a clear understanding of what they

are, which will better hold everyone who commits these harms accountable

for their actions and help ensure that the discipline matches the

severity of the incident. Clear

definitions also enhance public

understanding of what is prohibited and the basis for which complaints

can be made.

Enhance public safety. There are a number of provisions of this

act, and I understand that we’ll be dealing with some of these at

committee stage, but I just wanted to lay out, in general, what we would

expect those to be.

The superintendent’s office, whose role is to monitor and assess

the performance of regulatory colleges, is a new body created by the

Health Professions and Occupations Act. Members of the public will be

able to engage directly with the office to submit complaints about a

regulatory college’s actions or policy, providing appropriate

oversight.

[2:45 p.m.]

The office can then choose to investigate the regulatory college,

complete a report on the findings and bring issues to the Minister of

Health’s attention when regulatory colleges don’t change or

improve.

By having a dedicated place for members of the public to go, the

new system holds regulatory colleges accountable to the public and

streamlines the complaint process, which enhances public

protection.

The Health Professions and Occupations Act creates a new mechanism

to regulate lower-risk health service occupations. The purpose of

regulating health service providers is to enhance public protection from

health services that may present a risk or harm. However, the current

Health Professions Act is binary, with only two options: become a fully

regulated health professional with their own regulatory college or don’t

get regulated.

The new legislation creates another pathway for regulation by

government. It enables health occupations to become regulated who may

not meet the threshold of a health professional where there is some risk

which requires a level of regulation commensurate with that

risk.

When health occupations are not held to the same regulatory

standards — well, they aren’t the same regulatory standards — as health

professionals, they must uphold anti-discrimination objectives and can

lose their authority to practise for committing emotional, financial,

physical and sexual abuse or neglect of a patient.

The Health Professions and Occupations Act enhances public safety

through regulatory college boards. Regulatory colleges get their

direction from a board. Under the current Health Professions Act, a

proportion of board members are elected by health professionals through

an election process. This system has created a misconception that health

professionals are members of a regulatory college and beholden to those

who elect them. However, a regulatory college’s goal is to protect the

public, not those that they govern.

The new legislation removes the election process and replaces it

with a merit-based appointment system. This is an issue of which we had

long discussions with people, of course. The new system will ensure

regulatory board members have the right skills and competencies to

effectively regulate health professionals with the goal of enhancing

patient safety.

Finally, greater transparency. The Health Professions and

Occupations Act enhances communications between employers and regulatory

colleges. The Health Professions and Occupations Act requires that

employers of regulatory health practitioners are notified when an

employee has been disciplined or has had their practice restricted for

any reason by the regulatory college. When an employer makes a decision

to let a health professional go due to sexual misconduct, sexual abuse

or discrimination, the employer will be required to inform the

regulatory college that regulates that health professional.

The Health Professions and Occupations Act streamlines the

amalgamation process, of course, in order to create fewer and stronger

regulatory colleges.

We are also, I think, in this process, acknowledging some of the

very significant challenges in new professions who are not currently

regulated health professionals but would wish to become regulated. In

the past, such processes have taken years and years and years. And often

the public demand for this, and even the professional demand for this,

wishes that to be significantly more.

The diagnostic and therapeutic professions, for example, are one

example of health professionals who wanted to be regulated in their own

college for some years. The process takes much, much too long, involved

their process and the government’s process and legislation. This process

will allow — and this is an important question for all members, I think,

of the committee and members of the public and members of groups such as

counsellors, such as the therapeutic professions, such as perhaps

potentially ambulance paramedics and others to get

regulated….

If it takes too long, then it’s almost impossible to move forward

in that way for many of them — or to deal with rapidly changing

circumstances. Just as if the only tool for overseeing health regulatory

bodies is for the minister to put them under administration, that’s a

strong tool, but it’s not a very subtle tool as well.

So we have changes here, and we are proceeding, in particular, in

those cases, with the diagnostic and therapeutic professions, who are

well along the road to be regulated by the allied health care

professionals college, and to equally move forward with counsellors.

That process is underway, and we are hoping that process will coincide

with the bringing into force of the legislation. In short, this is a

more flexible system as well.

So I wanted to, again, express my appreciation to the member from

Cowichan, to the member for Kelowna–​Lake Country, to members of

the House and to all of those involved in this process.

[2:50 p.m.]

We know that our health professionals and our health colleges are

committed to the public interest and do extraordinary work. We know that

when issues, such as some of the ones I’ve discussed here, come forward,

they are exceptions but important ones. We know that the standard of

health professional regulation is critically important in a society that

so depends on health professionals. It’s the public health care system,

and then there are a number of health professionals that are primarily

not in a public system but are in a separate system.

For example, naturopathic physicians and others are not

principally providing services within the public health care system but

are recognized as health professionals. They wanted to be recognized as

health professionals, were recognized as health professionals by

previous governments — either the previous Liberal government, the

previous NDP government or governments before that — and are regulated

and expected to hold, and to be held to, high standards. Regardless,

when you’re a health professional, we expect you to have high standards

in B.C.

These are, of course, challenging times, and there’s often

criticism of health colleges, I think, and I think the committee felt

this, an increase in transparency would and will allow, people to

understand more and will actually benefit those colleges by ensuring

that people see, when they act, what happens. They’ll see, when action

is taken based on a complaint, what happens — and understand that

there’s accountability and oversight for those colleges as

well.

That balance of ensuring more oversight but fewer colleges, for

not seeing us go forward from 22 to 24 to 26 colleges, as is necessary —

I think we regulate, for example, counsellors as a diagnostic

profession, potentially other professions — that we not keep simply

adding regulatory colleges but that we bring and make our system more

efficient and make these colleges stronger and working together…. In a

time of team-based care, ensuring that health professional colleges act

in teams, as well, I think is a positive approach.

I wanted to conclude by again thanking all of the people involved

in this process — I’ve noted the exceptional role of members of the

opposition, whom I’m very grateful to — officials of the Ministry of

Health, who have done some exceptional work and proceeded and pursued

this task with dedication.

I want to thank the health professional colleges and all of our

health professionals for being open to a necessary change — change is

always difficult — and being so open and so willing to participate in a

serious way in this process.

I want to thank everyone in B.C. for making this legislation

possible. I have to say, of course, that once the legislation is passed,

even a greater effort will be required in implementing that

legislation.

We’re putting legislation in place for the 21st century that

ensures accountability — I think the legislation is going to be followed

in other jurisdictions in the country — legislation that ensures greater

cultural safety and greater transparency; legislation that makes the

system more efficient and, I would argue, less expensive for many health

professionals; and legislation that allows us to expand the number of

regulatory health professionals in a more efficient way and integrate

those professionals when they come into colleges — not in their own

colleges, separate from all the others, but as part of broader colleges,

working with other health professionals, to put in place a high level of

professional regulation and responsibility.

Like I say, people are going to hear this debate over the next few

days — or however long it takes; it’s a long bill — and they’re going

to….

Sorry, the member for Skeena may not be listening to it as

carefully as other people in the last few days. He was just giving me a

hard time over there, which is fair enough.

I think we’re going to see…. Some of these issues may be seen as

narrow, but overall, there will not be British Columbians who are not,

in the course of their lives, affected by this discussion.

I expect that we’ll have a thorough discussion of this massive

effort to put the recommendations of the committee and of Mr. Cayton

into law. How they did that, and the clarifying questions, will be very

important for members of the opposition. I want to say, finally, that

I’m proud of this work. I’ll say that when I became Minister of Health,

I didn’t plan to bring forward a health professions act, but

circumstances required that.

[2:55 p.m.]

Instead of standing in the way of that, we shared

respon­sibility and accountability with other members of the

House, and they participated in good faith. We have today legislation

that reflects that effort. It reflects the 6,000 people who participated

in the process, reflects the views of members on all sides of the House

and, I think, will serve us well in this 21st century as we move forward

to regulating our existing health professionals, others who want to

become health professionals and, most importantly, protecting the

public.

S. Bond: Thank you to the minister for those comments. Certainly, one of

the words that I will agree with right off the top is…. He used the word

“massive.” I can honestly say that in my time in the Legislature, I

can’t remember seeing a bill that has 645 sections in it, so there is

going to be some substantive discussion about the bill that the minister

has tabled.

I think we actually need to, first of all…. I also want to say to

the minister that in many ways, it’s a sad commentary on the work we do

when the minister describes the process that was undertaken as unusual

and positive. Positive is the good part. Unusual is the fact that rarely

do we see the kind of effort that was made to actually be inclusive in

terms of the work that was done leading up to the creation of this piece

of legislation, and I think that’s something that will warrant further

discussion as we look at the processes in place here in the

Legislature.

I want to back up for just a minute, because today, as we speak,

British Columbians have, probably, no idea that this work has been

undertaken — or certainly are probably not aware that it’s on the floor

of the Legislature. One of the things that’s pretty important about this

bill and what regulatory colleges actually do in British Columbia is

make sure that when you have a relationship with a health care

professional in British Columbia, there are expectations about what that

relationship looks like.

I think most British Columbians assume what that looks like and

how that happens. I don’t think they particularly pay a lot of attention

intentionally to the regulatory colleges, but it’s a pretty essential

piece of what happens.

When you think about the mandate of regulatory colleges, their

mandate is to serve and protect the public at all times. So when you

think about the process that the minister has undertaken, that really is

the underpinning of the work that’s been done.

The work is twofold. One is about protecting British Columbians,

and the way that colleges do that is by ensuring that their registrants,

the people that are members of their colleges, are qualified, that

they’re competent, and that they’re following standards of practice and

ethics. Colleges are also in the position of responding to complaints,

both from patients and the public. So one of the things that’s going to

be critical in our discussion with the minister as we engage over these

645 sections is talking about an increase in transparency and what that

looks like.

The colleges today, if they must take…. They must take action.

There isn’t a question of whether they do or not. They must take action

if one of their registrants is incompetent, unethical, illegal or

impaired in some manner. I think those are pretty fundamental things

when we’re looking at the provision of health care in British Columbia.

What we want to know is that the health care professions that are in the

system in British Columbia meet all of those particular characteristics:

qualified, competent, following standards of practice.

We also know — and I’ve heard this, in fact, from one of my

colleagues, who has been in a regulated college — that members

themselves want to ensure that people who are their colleagues in that

profession are actually all of those things as well: competent, that

they are following standards of practice. So I think there’s a mutual

interest from the people who are regulated. As the minister pointed out,

there are about 100,000 people who are impacted by this particular bill,

but it impacts all British Columbians, so it is incredibly important

work.

[3:00 p.m.]

I want to let the minister know that when we engage in some

discussion through committee, obviously later today, he will Hear from

the our member who was engaged in the work along with the Leader of the

Third Party. The MLA for Kelowna–Lake Country will be participating.

We’re also going to have the MLA for Vancouver-Langara. He is the critic

for Aboriginal relations, and it’s an important element of this work

that was not the focus of the work done by the steering

committee.

Again, looking at the issue of humility and cultural safety,

looking at the aftermath of the report In Plain Sight… . My

colleague from Vancouver-Langara is taking a look at that. I have a

colleague that will look at, in particular, the issue of clinical

counsellors. We know that there is some intent to potentially look at

clinical counsellors. So the MLA for West Vancouver–Capilano will take a

look and have some conversation with the minister about that.

Then my colleague — actually from where I represent, Prince

George–Mackenzie — who was a member of the Health Professions Review

Board wants to have a better understanding of how that independent

structure is actually impacted by this piece of legislation.

Let’s talk a little bit about what, actually, the minister…. First

of all, we should begin by saying that bills of any size, but this one

in particular, don’t simply appear on the Legislature floor. It takes

the work of an incredible team of dedicated professionals in the Health

Ministry, drafting, looking at the content. I want the minister to know

that when he outlines the principles that are important in this piece of

legislation, those are things that we, certainly, as an opposition — the

Leader of the Third Party, I’m sure, will speak as well — have a good

sense of understanding about.

But we also need to recognize that when you take those policies

and turn them into law, we need to make sure that what we’re talking

about is the same thing. One of the concerns that I have, certainly, is

that this is an enabling piece of legislation. We have continuously

raised in this House, with the government, the fact that much of the

very specific detail about how this bill comes to life, how it actually

works in practice, is done in regulation. What happens — those details

and that work — is done behind closed doors. It isn’t done on the floor

of the Legislature, particularly in the case of a new bill.

We are not talking about minor amendments here. We are talking

about a brand new bill, and you make that decision based on how much of

it you have to amend. So there is a very significant shift in this bill.

I want the minister to know that, certainly, I think it is our intent as

opposition to allow this bill to pass through second reading, and then

we’ll have the opportunity to look in much, much more detail at the

sections that have been presented in the bill.

Our ultimate support, either for the bill or not, will be based on

the discussion that we have in committee stage as we ask those very hard

questions. That, of course, is despite the fact that there was a

collaborative process to get us to this place. We want to make sure that

if we’re making these changes, first of all, they are understood and

that there are as few unintended consequences as possible. We will

pursue that during committee stage.

The minister has walked us through some of the steps that were

taken. One of the things that struck me when I was looking back at the

history of this…. Of course, my colleague will speak to the work that he

did as part of the steering committee. But the steering committee was

actually guided by a number of objectives, and the number one objective,

of course, was to improve patient safety. We want to make sure that that

is captured in all of the changes that the minister is recommending

today. Of course, public protection, and improving efficiency and

effectiveness of the regulatory framework….

Probably most important is improving public confidence. One of the

ways we do that in legislation is by increasing transparency. There is a

very substantive change here when it comes to the disciplinary process.

We will look at what that looks like and how that will be accomplished.

I can imagine that there’s probably some concern on members of the

colleges about that shift in how discipline will not only be processed,

but what the end result is.

[3:05 p.m.]

The end result will be that if a person, after a fair process,

separate from the investigative process, that person…. Both the issue

that has been brought for discipline, and the discipline, as I

understand it, will be made public. Those are things that we’ll walk

through in terms of how we are making sure that that person is protected

until that point in time and we know that that is the ultimate outcome.

Those are the kinds of questions that we’ll be asking.

We should remember the history of what happened here. I think

there’s also an example to be made of the way the process worked. It was

an iterative process. The minister actually had a number of steps

involved in the process. When you look at the work that the Cayton

inquiry did, the report actually looks at two parts. The first

part is

that it makes recommendations specifically to the College of Dental

Surgeons of British Columbia, and secondly is possible suggestions to

look at modernization of the overall health regulatory

framework.

That was in the spring of 2019. The minister, then, in response to

that — especially

part 2, which was the public interest side and the

modernization overall — established and chaired the steering committee

on modernization and ultimately had a phase of public consultation,

where members of the public and health sector stakeholders were invited

to provide written feedback. The steering committee went through a

number of other steps, which leads us to earlier this month. Eventually,

the bill appears here in the Legislature.

We should point out that this bill, while core to making sure that

health care services and the provision of services, the people who

provide those services, are paramount, certainly — and I will wait for

the minister in committee — does little to deal with the current

situation in health care, in terms of many of the other challenges that

we’re facing.

That doesn’t mean it won’t have an impact, necessarily, on the

system as a whole, but it is not about fixing the specific challenges

that we’re facing in health care. We have to make sure that while this

is important work, we don’t want to see there be any unintended

consequences that further exacerbate the challenges we’re facing in the

health care system.

This has been a work in progress for literally years. Again, I’m

grateful to the people who participated in the process. You’ll hear from

the Leader of the Third Party and, obviously, our MLA for Kelowna–Lake

Country. The main purpose was to look at a series of recommendations, in

terms of how we modernize the health profession regulatory

framework.

There was a lot of discussion and consultation. Very significant

recommendations have been made, as I’ve mentioned, including cultural

safety and humility. I know that there’s going to be a need for us to

have a conversation about that, because the steering committee’s work,

actually, I think, concluded before that work was considered as part of

the legislation. That’s going to be an important discussion.

The bill that is written, certainly, as much as we’ve had the

chance to look at all of the sections, does include many of these

changes. Its main intent, of course, is to protect the public and

streamline the way we regulate health professions. Both of those goals

are things that I think most people, including us, would be supportive

of.

Again, it’s in the details. When you create law, it is very

difficult to change it, so what we want to do is make sure that we’re

getting it right, as much as possible, in the first iteration of this

law. Again, I do have concerns about the fact that it is enabling. There

will be a great deal of work that is done by regulation, and that

concerns all legislators. We raise that frequently in this

House.

We do want to recognize that it’s taken a lot of work to make sure

that the bill appeared here — dedicated staff and committee members who

literally took

part in years-long processes to get us where we

are.

I want to just talk about a couple of things as we think about

this. The Health Professions Act deals with, currently, the number of

regulated health professions. Twenty-five regulated health professions

are currently governed by 15 regulatory colleges.

[3:10 p.m.]

Colleges have a legal obligation to protect the public through the

regulation of their registrants. What they do is that they determine

registration requirements. They set standards of practice. They

recognize education programs. They maintain, literally, a register that

everyone can search. Critically, they address complaints about their

registrants. Currently, at the moment, colleges review all of the

complaints about the professionals they regulate, including both current

and former registrants.

Bill 36 significantly expands on the previous duties of a college

and establishes a series of guiding principles that will be applied to

all those that are governed under the act: colleges, the office of the

superintendent, and the director of discipline, which, by the way, are

new — the office of the superintendent and the director of discipline —

so that the guiding principles will be applied to everyone who is

governed by the act. It’s important to note that the principles act in

accordance with the United Nations declaration on the rights of

Indigenous peoples, or UNDRIP. That’s a very important piece of this

legislation.

I know that my colleague will be raising some of those issues and

discussion in greater detail later in the debate. Other principles

include procedural fairness, respect for privacy, promotion of a

holistic health care system and identifying and removing barriers for

extrajurisdictional practitioners. The latter part of that speaks to

those who are internationally trained and educated. As the minister

pointed out, the bill also creates a much clearer path for an

unregulated health profession to apply for and receive

designation.

One of the very significant pieces of this bill is the creation of

a new office — a new oversight body. That will be the office of the

superintendent. The superintendent would be appointed by cabinet and

would have a number of duties, which include providing advice and

recommendations to the minister on the administration and amendments of

the act and the regulations; the performance improvement by regulators;

and other matters that are requested by the minister. It’ll be

interesting to know how the minister expects to set up that relationship

with the superintendent’s office — brand-new to the act.

Also, the superintendent will be expected “to promote awareness

and adherence to the guiding principles” and to promote regulatory

consistency. In the work that was done by the steering committee, that’s

certainly one of the key things that was heard: that there were concerns

about inconsistency. The superintendent will also report on regulatory

performance, make recommendations for improvement, and publish

information and records that are deemed to be of public interest. Of

course, there are always the other duties as set by the

minister.

The superintendent will also have the ability to conduct an

assessment of an unregulated health profession. The minister spoke to

groups of health professionals that, previously to this, have found it

very difficult to find a pathway to regulation. The new act will give

the superintendent the ability to look at that assessment of an

unregulated health profession or occupation if regulation is needed, if

different regulation is needed, if required by the minister or if the

superintendent determines that assessment would be in the public

interest — again, always looking at what’s in the best public

interest.

The bill clearly sets out a process for how an assessment would be

conducted. However, again, parameters will be decided and left to the

minister to decide. For example, scope, conduct, timeline — all of those

things are not captured in this bill. The minister will have the

opportunity to make those decisions.

Section 440, the superintendent may require colleges to pay a

general administration fee, to be set by the superintendent — again,

subject to regulation. What that means is that the cost of the

superintendent’s office is going to be covered by the regulators. I

think it’s going to be critical, for the colleges and for us, to

understand exactly what the implications are of that decision to have

the superintendent’s office funded by the regulators — what that

means.

[3:15 p.m.]

While the office of the superintendent is an independent body,

there is a provision in this bill that requires the superintendent to

comply with any orders that the minister makes. That’s a relationship

that we will want to explore: what does the minister anticipate, or at

what point would he anticipate, that there would be specific orders he

might make — or she might make — to the superintendent.

The office of the superintendent is a significant creation in this

bill, but the bill also creates an independent discipline tribunal. The

tribunal brings discipline. It removes discipline from the jurisdiction

of the colleges, which the minister mentioned, to the independent body,

but the investigation piece remains with colleges, and the new tribunal

will deal with the disciplinary piece.

When we look at this concept, initially, it seems to make sense

that there would be a more independent and transparent process in the

final decision around discipline. Again, we’re going to have questions

in terms of what that looks like in practice and, of course, what it

means for individuals who might be part of that process.

Another very significant change in the act is the way that

regulatory colleges’ boards are created. Under the new system, one of

the office of the superintendent’s purposes is “to develop and implement

a merit-based selection process for the appointment of members to boards

of regulatory colleges.” Despite that, it is the minister who will

ultimately make the board appointments, based on the recommendations of

the superintendent. That is a very substantive shift.

I’m certain there must have been a great deal of discussion about

that with the colleges, because currently, colleges have the ability to

elect members to their board. It’ll be interesting to hear not only the

rationale but how the minister feels that will work in the practical

application of that.

The other area that we’re very interested is internationally

trained professionals. We will certainly be clear about the fact that we

think it needs to be easier, particularly when we look at the number of

Canadians who have gone and trained in other parts of the world with

very highly accredited institutions. We want to make sure that at a time

when we need them most, they’re able to actually work in British

Columbia. We’ll want to take a look at the piece that talks about it:

are their impacts on internationally trained and educated health care

professionals?

In addition to the guiding principles piece under

part 3, division

section 50, regulatory colleges would be required to create bylaws

specific to the processes and requirements for licensing

extrajurisdictional applicants, including the issuance of provisional

licences. That, from my perspective, doesn’t sound like it is an

expeditious way to make sure that we’re moving people who are

credentialed into the system.

This would, though, appear to respond to the minister’s mandate

letter, which required the minister to improve the province’s credential

recognition process and licensing. We’re going to want to make sure that

that isn’t adding another layer that’s going to take time and extra

regulation.

The expediting of approvals for internationally trained health

care professionals is something that the official opposition has been

calling for, for months. If the bill addresses that and actually speeds

that up — obviously, in an appropriate way — we would consider that

quite beneficial. Among the duties established in the bill, there is a

requirement for a designated health profession licensee to practice

ethically, which includes the requirement for a licensee to practice a

designated health profession in ethical manner in accordance with

ethical standards, as well as for the board to make bylaws respecting

ethics standards.

The latter includes a requirement for the board to make bylaws

respecting providing false or misleading information to patients or the

public. There’s also a new duty to practise in accordance with the

principles of protecting the public, as the minister mentioned, from

harassment and discrimination and to take anti-discrimination measures,

and so forth. That is a constant and interwoven theme in the

bill.

[3:20 p.m.]

There are also additional elements in this bill that respond to

issues that have arisen during the COVID-19 pandemic. For example,

provisions in

part 7 relate to public health emergencies and emergency

orders, specifically the duration of emergency orders, end dates and

consultations required for emergency orders.

As we go through this bill, we also need to keep in mind that it

is largely enabling legislation. Much of what the bill seeks to

accomplish is not done in the text of the legislation but through

regulation at a later date, at the discretion of the minister. While it

allows the government to potentially be more nimble where flexibility is

necessary, it also raises significant questions about how those

regulations will be determined.

There are very broad regulation-making powers affecting

designation assessments of health professions and occupations, including

the criteria to be used when deciding whether a health profession or

occupation should be regulated — what regulatory model should be used? —

and the powers and duties of a health occupation director when governing

a designated health occupation.

There are other reg-making powers regarding hearings as conducted

by a discipline panel or by the director of discipline; regulatory

complaints and restorative processes; monetary penalties, as well as

setting rates, tariffs and others to recover costs or expenses; support

programs administered by regulators; broadly defined general matters;

restructuring of regulators and the appointment of discipline panels;

and the superintendent’s office matters that relate to fees and

applications to court.

So as you can see, while some of these make sense as

regulation-making powers, it means that there is so much that we will

not know about what the bill will do and how there are potential impacts

on individuals governed by colleges, also how it will impact our already

burdened health care system.

We certainly will be examining the bill closely and thoroughly in

committee. As I said, a number of my colleagues will be participating in

that process. I think that it is very difficult to be critical of a bill

that is going to protect the public interest and make sure that health

care professionals are actually competent and following standards-based

practice. Those are important principles that I think any British

Columbian would think are essential. It is when you take those policies

and create law that the questions need to be asked and

answered.

I do want to thank the minister’s staff, in particular, for being

available to speak to us about the bill. We certainly…. It would have

taken days to walk through it line by line. As you can imagine, that did

not occur, but we do appreciate the efforts that have been made by the

minister, the minister’s staff and others, who have been engaged in

helping us prepare for the follow-up committee work, and by the steering

committee that worked hard.

I thank the minister for his comments. We will certainly be

supporting the passage of the bill through second reading. Again, we

will make our final determination about our support for the bill after

we have worked our way through committee stage.

With that, I’ll conclude my remarks.

S. Furstenau: I rise to speak to Bill 36 and thank the minister for his comments

and the member for Prince George–Valemount for hers.

It’s always interesting to listen to how the lens is, really,

through which we’re looking at a piece of legislation like this. I think

one thing, a starting place we can all agree on, is the importance of

public safety, public trust and public confidence when it comes to the

regulation of health care professionals in our health care

system.

[3:25 p.m.]

I just want to start from the perspective of a regular person, a

citizen accessing the health care system. I think all of us have this

sense of an expectation that there are rules in place. There are

regulations happening.

As a patient or a person accessing the system, there is a level of

protection that comes with that. There are bodies that are overseeing

and ensuring that my safety is considered to be paramount in the system,

and that is, absolutely, a situation and a scenario that we want to

ensure we have in British Columbia when it comes to the health care

system.

As has been noted, the member for Kelowna–Lake Country and I

participated as part of a steering committee with the Minister for

Health back in, what feels like a very long time ago, 2019, I believe,

and we were participating in reviewing the report from Mr. Cayton and in

working with the minister and his staff to produce a report that was

delivered.

I will add a clarification, however. We participated — and I won’t

speak for the member for Kelowna–Lake Country — in the production of

that report, but that’s where the participation really ended. I was in

no way involved in in the legislative process here. I saw the

legislation at the same time as my colleagues in the official

opposition, which was just a few days ago.

The minister talks about six key areas: cultural safety, improving

governance, reducing the number of colleges, a new oversight body,

improving the complaints process and transparency when it comes to the

public. I think these are all laudable aspirations and goals to have,

and I think the lens through which we would always want to be looking at

this is the lens of the person accessing the health care system. Do

these steps achieve these outcomes and how are we measuring that

success?

These are really significant changes, and I expect there will be

aspects and elements that different colleges, different professionals,

different stakeholders will have concerns about. As was raised by the

member for Prince George–Valemount, this will have to be an iterative

process. There will have to be a recognition that things won’t be,

necessarily, all perfect the first time around.

As we saw with professional governance, there were amendments to

that bill that have already come in, just a few years after that bill

was introduced, for a similar restructuring of governance and regulation

in the resource sector and the professionals that are involved in

that.

I want to talk a little bit about what has come up quite a bit in

both comments from the minister and the opposition member around

increased transparency and accountability. Absolutely, this is critical

for building that public trust, that sense of public confidence and

ensuring that what we are achieving is a sense, for the people of

British Columbia, that they can be assured when they’re accessing the

health care system that their safety and protection is

paramount.

There is some irony in this in that we have currently, in our

health care system, some pretty significant deficits when it comes to

transparency and accountability.

[J. Tegart in the chair.]

We have some ongoing concerns that are being raised with all of us

in here around accessing information, seeing data and understanding the

workings of the health care system and whether or not it is actually

meeting the needs of people in a really transparent and accountable

way.

So I would say that as we look at this legislation and consider

the outcomes that we’re trying to achieve with it, that lens should be

applied to the health care system writ large and not just to the

regulatory colleges and the health professionals. Are our health

authorities being transparent and accountable? Is the data being made

available to people? Is government being transparent and

accountable?

[3:30 p.m.]

We have to recognize that what we are expecting from health

professionals and health colleges — that same expectation should

absolutely be on government and the health authorities that are

delivering health care in this province. I don’t think it’s really hard

to dismiss the fact that this government and this province and this

health care system have had some pretty serious concerns raised around

that lack of data availability, lack of transparency and lack of

accountability.

I just want to speak — I have a few more notes here — to the

points raised by the member for Prince George–Valemount. The piece

around enabling legislation also speaks to this. Again, I’m going to

quote my friend Laura Colpitts, and I’m going to tell her to check

Hansard , that her name is there.

Laura Colpitts used to say…. In the days of Shawnigan, which was

really, in our efforts to protect our watershed there, very much what we

saw — a failure of regulation, a failure of government to protect public

interest and public safety, putting a permit for a five million–tonne

contaminated landfill site at the headwaters of our watershed…. But

Laura Colpitts, who was very involved in our efforts in Shawnigan, used

to say: “How you do one thing is how you do everything.”

We have seen a growing trend. I will acknowledge openly that it’s

not just in British Columbia, but we’ve seen a growing trend in Canadian

parliaments and legislatures across the country, the federal parliament

in other parliamentary systems, this growing tendency towards enabling

legislation. We had a piece of legislation in the spring session that

was essentially blank. We couldn’t debate it. We didn’t know what we

were debating. I recognize that this is a rather significant and complex

piece of legislation. There is a lot that is being done here.

There’s also that orientation that we want governments to have,

particularly in a democracy, towards shining a light as much as

possible, making that part of the process so that the public is not left

wondering what is happening behind closed doors, what kind of decisions

are being made. And when we see this increase in more and more details

being left to be brought in by regulation and we see this growing trend

of enabling legislation, there is an irony that goes along with a piece

of legislation like this that has embedded in it the goal of more

transparency and more data available to the public that…. As Laura would

say, how we do one thing is how we do everything.

I think that we, too, will be watching and participating in the

committee stage of this. And this is a…. I think the member for Prince

George–Valemount said maybe it’s the biggest bill she’s ever seen in

terms of number of clauses. It’s a huge bill. So there’s a lot in there

to get clarification on, to get details on so that it’s well understood

as it goes through the processes, which is one of the benefits of a

parliamentary democracy — that teasing out of what the intention is

here. How do we understand this legislation? What are the consequences?

What are the implications? What are the expectations? And, ideally. that

helps to inform how we’re measuring the success of this.

We will be, of course, supporting this at second reading and

watching very closely as it goes through. The goals are very laudable,

and we should be embracing all of these kinds of goals. The job of all

of us in here is to make sure that we are, ideally, going to be

achieving these goals with the legislative work that’s being

done.

[3:35 p.m.]

I appreciate the opportunity that I had to be part of that

steering committee in 2019, and I think that it was an example of the

kind of participation that we can see across party lines in here that

contributes to, really, a deepening of the legislative work and a

weakening of the partisanship that can often, so many times, be so

overwhelming in here, that partisanship.

We don’t have to be in a minority government to do that. We can

always look for ways to deepen that collaboration and that work across

party lines. There are perspectives to be brought that are so important.

The member for Kelowna–Lake Country was certainly one of the most

diligent and hard-working members of a steering committee that I’ve ever

worked on with, and I really appreciated what he brought.

From my perspective, it was really critical to raise issues and

concerns that had been coming into my constituency and notice trends,

particularly around the lack of regulation when it comes to counsellors

in this province, and also the lack of regulation of social workers who

work within the Ministry of Children and Families. They’re not regulated

by their own college in this province. I think that that remains an

outstanding issue that needs to be addressed.

I hope to see, again, that level of expectation of transparency,

accountability and public trust being put at the forefront of what we’re

doing.

A. Singh: I rise to put my support behind Bill 36. Members have spoken about

the luminous nature of this bill. I do not envy the minister’s time that

he’s going to have in committee stage, so I wish him luck there. And if

he needs any of our help, we are here for him.

You’ll often — and I’ll probably repeat it for the next few years,

as long as I’m here. — hear me say that government is all about choice,

and this bill reflects that as well. Really, a bill that has — I don’t

know — several hundred sections…. What’s really illuminating is that

after the

interpretation sections in the beginning, the first two

sections that you see are the sections on sexual misconduct and sexual

abuse and discrimination. So it really sort of shines light on the

perspective of caring for public safety and caring for the public.

That’s really a part of this bill.

The explanatory note that comes…. I’m not going to go through the

bill, thank god.

Interjection.

A. Singh: You will? At committee stage, yeah. That’s going to take a few

days.

What the bill does is it replaces the Health Professions Act. I

like the explanatory note because it really encapsulates what’s

here.

The primary objectives of the bill are “to prioritize protection

of the public and to facilitate good governance by regulators.” Again,

you see that reflected right in those first initial sections and in

direct response to the report In Plain Sight and other things

and what we’ve seen in our system.

What the bill does is it expands…. I’m going to just read out

this: “The Bill expands the regulation of health service providers.

While the practice of health professions continues under this Bill to be

fully regulated through self-regulating bodies, more flexible models of

regulation are available under this Bill for the practice of health

occupations that present a lower risk of harm to the public.”

Again, for many regulations out there that want to be part of a

regulatory structure, this allows them to be recognized as health

professions. It “streamlines the process for designating new health

professions and occupations. It also clarifies processes for creating

and combining regulatory bodies and transferring the governance of

health professions and occupations between regulators.”

It also establishes the office of the superintendent of health

professions, and my friends have spoken about it earlier. And it

establishes, within the superintendent’s office, an independent

discipline tribunal.

[3:40 p.m.]

That’s really important for regulators, because oftentimes the

colleges and regulators are set up as self-regulating bodies. What

happens is important, but public perception of what happens is far more

important. To have an independent discipline tribunal lends credence to

that. That’s Bill 36, the Health Professions and Occupations

Act.

What exactly, as I said, is being announced today? What is being

introduced today? This new legislation will enhance patient safety, and

it’ll improve oversight of regulated health professionals. It sets a

path forward to modernize the way that health professions are regulated

in British Columbia by replacing the former act with the new Health

Professions and Occupations Act. These are comprehensive changes, and

they’ll ensure that health professionals are regulated more consistently

and transparently and more in the public interest.

It moves away from a system that is decades old. The reasoning for

this being done: the current regulation is old, it’s outdated, and it

hasn’t moved with society. The current health regulation that exists

right now, before this bill, was developed over three decades ago.

Health care practices, professional oversight and public expectations

have changed significantly since then. What constitutes health care has

changed significantly since then. We’ve seen an expansion of the types

of providers out there.

Our health care system is changing. We have to adapt to that, and

we need to ensure that the regulated health professionals change with

the times. We need to be able to keep up to improve patient safety and

public protection, to make sure that B.C.’s regulatory framework is

effective and efficient. Again, public confidence, public perception, is

really key, so increasing public confidence through transparency and

accountability. Bill 36 does all of that.

Like in many pieces of legislation, there is a history. Not only

is it decades old and needs to be overhauled, but in March of 2018, the

Ministry of Health launched an inquiry into the College of Dental

Surgeons of B.C. Harry Cayton, an expert in health professional

regulation, conducted the inquiry, and what we see now is part of

that.

In response to the inquiry, Mr. Cayton wrote a report. That report

was made public in 2019. As my friends have spoken of earlier, Mr.

Cayton recommended that B.C.’s health regulatory framework be

modernized, through legislative reform, to improve governance and

regulatory performance in the interests of the safety of patients and of

the public in general.

In response to those recommendations, the Minister of Health

established and chaired the steering committee. My friend the Leader of

the Third Party was on it, as were others. I believe we’re going to be

hearing from our friend later on today. A public consultation on the

Cayton report, on its suggestions to modernize health regulation, was

held from May to June of 2019.

After reviewing this public consultation feedback and their

suggestions, the steering committee then developed a further

consultation paper to seek public feedback on the proposed changes to

the health professions regulation. That consultation was open for public

feedback from November of 2019 to January of 2020. The feedback from the

consultation assisted the steering committee to finalize

recommendations, which were finally finalized in August of 2020, to

improve the model of health professional regulations.

The six recommendations that there are — which is really,

essentially, what this bill breaks down to — are to enable cultural

safety and humility; improve governance of the health professions;

reduce the number of regulatory colleges — I think there are many, many

at this point; create a new oversight body that oversees all of the

regulatory colleges, including a disciplinary body; improve the

complaints and discipline process; and improve information-sharing in

the public interest.

[3:45 p.m.]

What does this new legislation do? It addresses discrimination in

the health care system and requires cultural safety and humility to be

embedded in the ways that professionals provide health care and take

care of the public. It improves governance to ensure that regulatory

colleges are governing their own professions in the public interest.

They’re still self-governing, but there is that overarching interest

that they have to accede to.

It creates a path to reduce the number of regulatory colleges for

improved efficiency and effectiveness. As I said earlier, there are

other health care professions out there that want to be recognized, and

instead of creating multiple, numerous colleges with their own separate

rules, this is a much more efficient and transparent system.

It establishes the creation of an oversight body to ensure that

the regulatory framework is functioning in the public interest. It

creates a new discipline process that is safer and accessible for

patients who have experienced harm while getting health care.

Again, for patients who have suffered harm, sometimes there is

that stigma of going back to the regulating body of that health care

profession, which is made up of the same people that would have possibly

caused that harm. Having an independent discipline process improves

public safety, improves public perception. Process also improves the

information-sharing for better transparency and

accountability.

The Health Professions and Occupations Act will now be clear that

discrimination — again, it is right in the first few pages of the

legislation — will be a form of professional misconduct, and a regulated

health professional who engages in discrimination will be subject to

investigation and could be disciplined. There will also now be more

clarity to ensure that health care is practised in a manner that is

consistent with the objectives for anti-discrimination and improved

cultural safety for patients.

The new legislation also clarifies the role of the regulatory

college board as functioning exclusively in the public interest. It

really breaks down the sort of mishmash that we had before of a

regulatory college and professional association. They were both sort of

the same thing. What this really does is that it creates that wall. This

is a regulatory college. It’s there exclusively to rule and govern in

the public interest. Health care professionals can have separate

associations that advocate for them and advocate for their interests,

but that’s not what a regulatory college board will be designed to

do.

It shifts away from the election of health profession board

members, creating a system where all board members are appointed by a

competency-based process, and it establishes smaller boards and

regulatory colleges with equal numbers of public and health profession

board members.

What we’ve done here is that we’ve streamlined the path to

reducing the number of regulatory colleges through amalgamating some of

them. Reducing the number of regulatory colleges to improve efficiency

and effectiveness has been something our government has taken action on

since 2017, when we passed the legislation to allow college

amalgamations.

Since then, we’ve reduced the number of colleges from 22 to 15.

Under this act, those amalgamations will continue but with a more

streamlined process. This will ultimately reduce the total number of

regulatory colleges to six. That’s down from 22 that there were in 2017

to, ultimately, six.

It will enhance our ability to regulate and make it less confusing

for patients as to which regulatory college they direct their complaints

to. It will allow for those health care professionals who are sort of

outside of the system to fit in, in one of those six regulatory

colleges, if they choose to do so. Most health professionals that are

not in the traditional health care stream will want to do so. It lends

credibility to their profession.

The oversight body that the legislation will create will conduct

routine audits of regulatory colleges. It will set standards across the

board for regulatory colleges on policy and practice. It also will have

the power to investigate those colleges, when necessary, and make

recommendations to the minister on health professions or occupations to

be regulated under the act.

Members of the public will also be able to engage directly with

the office to submit complaints about the governance activities of the

regulatory college or to make a complaint about the act or regulations.

The office cannot pursue complaints that relate to matters involving

individual health professionals, as that will still remain the sole

jurisdiction of the regulatory college itself.

By having a dedicated place for members of the public to go, the

new system adds another layer of accountability on regulatory colleges

to ensure that they’re functioning at the very high standard that we

require them to and to continue to be laser-focused on public protection

as their main mandate.

[3:50 p.m.]

There will be a new discipline process, with improved

transparency. The complaints and adjudication system will have a new

complaints process that separates the investigative stage, which will

remain with the regulatory college, and the discipline stage, which will

be handled, again, by an independent discipline body. Again, it’s not

just what actually happens. It’s also the public perception of what

actually happens. Having an independent discipline body gives

credibility to the actions and the results that come from that

discipline body.

Information about all discipline imposed during a discipline

hearing and about all agreements made between regulatory colleges and

health professionals will be made public in order to increase

transparency. Again, the crux of this legislati