Third Session, 42nd Parliament

(2022) OFFICIAL REPORT

OF DEBATES

(HANSARD)

Tuesday, October 25, 2022

Afternoon Sitting

Issue No. 238

ISSN 1499-2175

The HTML transcript is provided for informational purposes only.

The PDF transcript remains the official digital version.

CONTENTS

Orders of the Day

Second Reading of Bills

Bill 36 — Health Professions and Occupations Act

(continued)

M. Bernier

A. Olsen

T. Shypitka

C. Oakes

D. Davies

Hon. B. Ma

R. Merrifield

Hon. N. Cullen

E. Sturko

M. Morris

E. Ross

B. Banman

TUESDAY, OCTOBER 25, 2022

The House met at 1:32 p.m.

[Mr. Speaker in the chair.]

Orders of the Day

Hon. R. Kahlon: I call continued reading of Bill 36, Health Professions and Occupations

Act.

Second Reading of Bills

BILL 36 — HEALTH PROFESSIONS AND

OCCUPATIONS ACT

(continued)

Mr. Speaker: Member for Peace River South.

[Applause.]

M. Bernier: That applause was almost as long as the applause for the Minister

of Health during question period, but not quite as long. I do appreciate

the opportunity to get up and stand and speak to Bill 36.

It’s an important day in a lot of ways, when we see a bill of this

magnitude and this length. I’ll discuss some of the merits and that in a

few moments. It’s a bill, which has been brought forward, that’s

significantly going to impact our health care industry in many ways and

right now, obviously, in a very critical time, a time that we’re

watching a lot of stress and a lot of challenges that we’re seeing,

provincially, in our health care system. Many are calling it a crisis

that we’re seeing right now in the province of British

Columbia.

Although it’s important to modernize and bring forward

legislation…. I know there was a lot of work done on this. I think it’s

also important any time we do this, though, that we remember the crisis

we’re in right now and frame it around that, reminding ourselves of that

as we work on any health care legislation or any change that we’re

bringing forward in this House for consideration.

As I said, a lot of work was done by all members in this House on

all three parties in this House. I know the steering committee that was

put together, co-chaired by the MLA for Kelowna–Lake Country…. The

Leader of the Third Party was part of that as well as the Minister of

Health. It was really important work, I would say. That’s taken place

over the last quite a few years — work that was done collectively to try

to bring forward ideas and recommendations on how we modernize and

change, specifically referring to the Health Professions and Occupations

Act that we have in front of us today.

There were significant recommendations that were made by this

committee, including cultural safety and humility, which was really

important, improving our governance of regulatory college boards,

reducing the number of regulatory colleges, which I’ll speak about in a

moment, then the oversight of the colleges, which has been talked about

for quite a while, and establishing an independent disciplinary process

while revising the complaints process as well.

[1:35 p.m.]

We need to remember around this…. It’s supposed to be around

transparency. It’s supposed to be around patient safety. Through that

process, we need to ensure, as we’re modernizing any of the health acts

that we have, especially in a time, as I mentioned, of crisis that we’re

in here…. It’s about bringing trust and ensuring we have trust in our

health system.

Again, when we have a crumbling health care system, as we have

right now, it’s really important to make sure we have that broader

context of everything that we’re talking about. I think it’s fair to

say, though, as well, that this bill — acknowledged by pretty well

everybody in this House — is not seeking to solve, specifically, the

health care crisis that we find ourselves in. In fact, it’s around

something that’s been working for a long time, as I

mentioned.

Actually, the work for this started before we started talking

about the pandemic. The COVID-19 pandemic, obviously, has consumed a lot

of the discussion not only inside this House but outside the House. The

work on the steering committee started before that.

Again, I think it’s really important…. Because of that,

recommendations were made and work was done without having the COVID-19

lens brought into it at that time. So I think it’s really important, now

that we have this bill in front of us, that we remind ourselves of

that.

I know we’re going to get to some very pointed, frank and

important questions and discussions during committee stage. It’s really

important, as we’re making changes, that, because a lot of these

recommendations and discussions took place before COVID-19 and before

the crisis that we see ourselves in right now in the health care system,

we don’t make it actually worse.

I understand and acknowledge, obviously, the intent of this bill

and the work that’s been done is to try to improve a portion of the

health care system governing the health professions. But again, we have

to ensure we’re addressing it and looking at it holistically with all of

the other challenges that we’re faced with right now in the province

around health care.

Again, I want to acknowledge the work that was done. I understand

this is not something that happens overnight. Obviously, it’s not only

the work that took place for a couple of years of putting forward

recommendations but the behind-the-scenes work that would have taken

place by staff — staff in the Ministry of Health, Health staff and the

legislative review committee behind the scenes.

In all of the years that I’ve had the privilege of sitting in this

House, I don’t recall seeing a bill of 645 sections that pretty well

takes up the bulk of the binder underneath my desk here in the

Legislature.

[S. Chandra Herbert in the chair.]

Again, it’s important. We’re looking at a bill that’s going to

affect around 100,000 health care workers, in one way or another,

through the different colleges.

It’s important work. It’s important to ensure, for these colleges,

for these health care workers, that we talk about transparency, that,

through the colleges and the professions, we have people who are

qualified, that we have people who are competent to do this work and

that we have people who are, obviously, following the standards of

practice that are required in health care in the province of British

Columbia.

I think it’s important to note…. You know, this is not just about

the public. That should be paramount in all our thought processes, yes,

but it’s not just about the public as well.

I’ve talked to many doctors and nurses over this issue who also

say that they want to ensure that those codes of conduct, the standards

of practice, the discipline requirements…. The professionals themselves

want to see this. They want to know, when they go to work every day,

that not only themselves but their co-worker, the person working next to

them, is also that same professional who is governed under the same

standards of practice.

We’re ensuring, for not only public safety, again, that the trust

in the system is there. We all want to see that, not just in this House

and the public but the health care professionals themselves.

[1:40 p.m.]

As I said, 645 sections of this bill. One thing I should say

surprises me…. But in all fairness, it doesn’t, after I have seen so

many pieces of legislation that have been presented in this House. Once

again, this is enabling legislation. For those many, many people who are

watching right now on TV from home, enabling legislation…. Obviously,

what that does is enable government and cabinet to make decisions at a

later date, without bringing it back to this House.

That there, in itself, should be raising concerns in a lot of

ways, when we have 645 sections of a health care change, a brand-new

bill, a brand-new act that’s coming in. Time and time again, throughout

this legislation, it says that decisions will be made at a later date by

Premier and cabinet, without having to bring it back to this House for

debate or discussion, without having to go through the scrutiny of

public consultation. Things like that obviously have to raise flags and

concerns for the opposition.

Now, of course, we’re going to ensure that we are doing our part

to vote this through second reading to committee stage so we can ask

those very important questions of the minister and staff, ask why some

of the details are not in here — or the intent, in the future, of what

government’s plans will be. With enabling legislation, I think that’s

important around transparency. We talked about the transparency for the

colleges in this act, but I think it’s also just as important, if not

more so, for government to show that transparency so the public knows

what they can expect when pieces of legislation are put into this

House.

Again, I want to thank the steering committee that did all that

work over that time. A lot of the discussion was around public

confidence in the system, around patient safety. I think a lot of the

discussion, as well, around this bill — for members of this House that

are going to talk to this bill and through committee stage — again, is

making sure we get it right.

When you see 645 sections in a bill, obviously, there’s a lot to

digest. There’s a lot to go through, and I know this is probably going

to take us some time. It’s important work that has to be done. But we

also, again, need to make sure, in the context of these tough questions

that we’re going to be asking at committee stage — that’s our job — that

we’re having those discussions to make sure we get it right.

Right now there are 25 regulated health professionals that are

being governed by 15 colleges, 15 different bodies. Their job really is

around setting standards, registration requirements, maintaining a

register that people can search, which is very important for the public

and transparency. They help recognize education programs. And again,

it’s all around the governance of their professionals, but looking

through the eyes of building on a public health care system, public

safety and trust, as I mentioned.

One of the things that I flagged in here, though, when we look at

the colleges, specifically…. I think we will talk about this more in

committee stage, when the minister has a chance to address this. Right

now colleges have the right to elect their own board members amongst

their peers. They decide who they want representing them — whether it’s

nurses, College of Physicians, any of the other colleges. They decide

who their board of governors — if you want to say that term — is in that

college representing them.

One of the things that’s going to change, as I’m reading through

this legislation, though, is that those positions now appear to be

appointed by the minister. So of course, we’re going to have some

specific questions around that, for him, when we get into committee

stage.

[1:45 p.m.]

As I mentioned, this has been ongoing for quite a few years. The

committee’s work began — again, as I said — before the pandemic, so it

really didn’t take into consideration, I would say in all fairness, the

crisis that we see right now in the health care system.

Over the last five or six years, we’ve seen us get to the point

where we have one million British Columbians who are being wait-listed

to see a specialist. We have some of the worst walk-in clinic wait times

in the country. We’ve talked about the hundreds of thousands of people

right now who are unable to get timely medical imaging that they

require. Nobody is disputing the fact that we have almost one in five

people in British Columbia who do not even have a family

doctor.

These are issues that need to all be addressed. We have hospitals

right now that are in chaos.

Interjection.

M. Bernier: I appreciate the heckling from the minister. We’ll have lots of

time, I think, in committee stage to do the same thing, back and

forth.

The minister, I think, would also acknowledge — because he’s heard

me stand in this House and talk to him, even personally — some of the

challenges we’re facing in parts of British Columbia. I think we all

share the concern, and we need to fix that. So even though I think we

all acknowledge…. By no means am I trying to say that this bill

presented is not important work to look at, but it’s also important,

again, to remember it’s not going to solve all of these other issues

that I’ve just brought up.

I mean, we even have daily commentary that comes to, I think, most

of our offices of people who are struggling right now in the province of

British Columbia — and, I would argue, have lost a lot of faith and

trust in the health care system. I want to emphasize the word “system,”

because this isn’t the lack of trust in our health care professionals

and workers. I know that they are doing what they can in this crisis,

and we thank them for that.

We’re going to look at all of these different pieces that came

forward in this bill. You know, many changes…. The main intent, I think,

is to protect the public and streamline ways that we are operating

within the colleges, within government, in the health professions as

well. These are goals that we can support. Any time a piece of

legislation is going to come forward that looks to improve a system,

especially one that’s crumbling right now, that’s something that we are

going to definitely look at and want to be able to be supportive

of.

But before we can get to that point, I’m looking forward to

committee stage, where we’re going to have a lot of questions that we

have to ask of government and the minister. They’re important things

that we need to be considering.

The health care system…. I mean, it’s evolving. It’s always

changing, and in the time that it took this government to put this bill

together, the system has changed yet again. By the time that we finish

passing this bill — if that’s what government intends, which I assume it

will be, obviously — there’s going to be more crisis. There are going to

be other issues that we need to be dealing with.

We need to be remembering that even though we want to move this

forward from second reading to committee stage, we need to acknowledge

continually the challenges that we’re seeing in B.C.

I want to go back to the health care professionals for a minute,

because this bill is really addressing a lot of them, their colleges.

It’s about streamlining. It’s about the profession itself. When I talk

about the challenges, we shouldn’t be losing sight of the stresses that

our health care professionals are under, though, right now.

I had a very long talk, an unfortunate discussion, while I was

home over the last couple of days before we came back to this week’s

sitting, with some of the health care professionals in my riding to hear

about the challenges and stresses they face, to talk about how things

are working or not working within their profession. And again, we need

to remember that that needs to be a part of our thought process as we

bring this forward, because the last thing we want to do is make things

worse in an already crumbling situation.

[1:50 p.m.]

I talked with a couple of nurses. I don’t want to say I had the

privilege, but I was in the hospital last Friday, and while I was in

there, I talked with the nurse that was treating me. I said: “How is

your day going? How are you doing today?” His comment to me was: “You

know, my first 12-hour shift was tiring, exhausting. I’m glad that’s

over.” I said: “Why are you still here?” He goes: “I’m just starting my

second 12-hour shift, because we don’t have enough staff. If I don’t

stay on, we have to shut down the surgical ward, because I am the only

nurse that was able to stay on to keep it open today in Dawson

Creek.”

We need to remember that those are the stresses that our

front-line health care workers are under right now, and we need to

applaud those heroic efforts that they’re being faced with.

There’s also the other side of that. The same day, I spoke with a

nurse who is from one of my smaller communities — I’ll leave the

community’s name out of it, but one of the smaller communities in my

riding — that I’ve formed a very good relationship with over the last

couple of years as we’d talk about the crisis and the challenges in my

communities. I asked the same question: “How are things going with you?

I know you’re under a lot of stress right now with the shortage of

nurses, all the diversions, all the hospital closures that we’re having

to face. How are you coping? How are you doing?”

Her comment to me was one I wasn’t expecting, and she said:

“Actually, I regret to inform you that I’ve just gone on stress leave.

I’m no longer working at the hospital, because I’ve had a minor

breakdown because of all of the stresses and challenges. I just can’t

cope, and I need a break. I need to recharge, because I love the

profession. I love helping people. I can’t be my best, and I can’t focus

and support and help people, when I no longer can help myself because of

the stress I’m under.”

We need to remember that as we’re working on this bill, as we’re

framing Bill 36 and talking about the Health Professions and Occupations

Act. We’re also remembering in this bill those kinds of stories, the

stresses that people are under.

I spoke with a doctor in my riding, who had to tell me that in the

last three months — think about this, in the last three months — he has

not had more than eight consecutive hours of a break. That’s not a

partisan thing that we need to be talking about. This is something that

I think collectively, in this House, we need to be addressing. Even

though this bill is talking about the governance model of the

professions that I’m talking about, we need to, again, always be

thinking of the work that they’re doing, the stress that they’re under

and the supports that they need from us at all times.

I think as we talk about modernizing the governance models here,

we need to be doing so with the understanding that we need to be

recruiting, because of the comments that I just made. We need to be

recruiting more people to these professions. When they hear the stories

of how hard it is, when they hear the stories of the stress that people

are under, under this collapsing system right now…. I don’t know about

you, Mr. Speaker, but it’s not a good sales pitch for a recruitment

strategy when people are hearing that.

We need to figure this out. I’m hoping, as we get into more

discussion on this bill in committee stage, that some of those points

will be addressed, because we need to ensure that through this bill,

there are no unintended consequences that are going to make it more

difficult or less inviting for people to enter into the health care

profession.

As I mentioned, Bill 36, when we talk about it, is really

expanding on the previous duties of the college and establishes a series

of guiding principles that will be applied under this act, principles

that, we need to remember, include procedural fairness, respect for

privacy, promotion of a holistic healthcare system.

[R. Leonard in the chair.]

Kind of back to my point: we need to be promoting a system and

have a system that we know is strong, that is inviting for people to

move into. We need to make sure that we’re removing any barriers,

really, that might actually make it harder for these professions to act,

and also, barriers for extra-jurisdictional practitioners.

[1:55 p.m.]

A lot of that is referring to those who are internationally

trained and educated. We need to remember that…. Something we’ve been

calling on, on this government, is really recognizing the amount of

internationally trained professionals that we have. A lot of that is due

to the challenges right here in British Columbia.

A very close friend of mine…. His son graduated high school and

wanted to become a doctor — tried and tried and tried, numerous times.

They showed me all of these emails that he had, trying to get in, in

British Columbia, so he could become a physician. We always talk about

“train them here” and “keep them here.” But in this situation, and I’m

sure we all have stories if we went looking for them, where somebody’s

child, somebody who wants to become, let’s say, a doctor, has been

unable to get into a training facility here in British

Columbia.

In this case, because he was passionate about becoming a doctor,

he finally went to London. He did all his schooling in London, and

wouldn’t you know it? Now, because he’s internationally trained — and

from what I’m told, graduated top of his class in London — he can’t get

into British Columbia but got poached by the United States to go down

there. But could not get regulated to come back to British Columbia, the

place he was born and raised, somewhere where we could have used him in

small communities like Dawson Creek and Chetwynd and Tumbler Ridge in my

riding, who are all struggling right now.

You know, we had a call-out. Actually, the former mayor of Dawson

Creek…. I can’t take credit for this. The former mayor, Dale Bumstead,

and I were talking about the amount of people in our region that were

internationally trained but were not working in the health care system.

So he put the call out…. He did that as mayor, and I thank him for

including me in it. He put the call out and said: “Hey, is there anybody

here in Dawson Creek, internationally trained, who’s not working in

health care that would like to? We’d love to hear from you.”

Just by putting a simple post, basically, on Facebook, he had a

coffee talk a week later. Twenty-eight people showed up to this, mostly

from the Philippines and a few from South Asia, who were living in my

riding, who were not working in the health care system at all, but all

had international credentials. In fact, I talked with one of the people

who was registered as a nurse in the Philippines, and she told me that

she worked for 12 years in emergency as a cardiac specialist in nursing

and right now is working in a restaurant in Dawson Creek because she

can’t get accreditation to work here in British Columbia.

All 28 people that showed up, and I’m sure there are lots more, in

Dawson Creek are trying to get back into the profession they loved, the

profession of helping people, the profession that, in their countries,

they went through all of the scrutiny, training and experience…. All

they’re asking for is the opportunity to prove themselves. They want the

opportunity to be able to go and be approved, do whatever is required,

so they can get back in the emergency room to help.

I mean right now, in Dawson Creek hospital alone, we have almost

30 vacancies for nursing. So I put that out there and said, “Well, I

know enough people that can fill that gap tomorrow, if we only would

give them the certification,” if we ensure — obviously, ensure for

public safety that we talked about — that they meet the requirements and

credentials to operate and serve in that field in British Columbia. They

need that chance. Something that we’ve been calling for on this side of

the House is that we need to figure out a system to allow them to get

back into what they were doing.

Part of this bill is also seeking to create a clear path for

unregulated health professionals to apply and receive

designation.

[2:00 p.m.]

Bill 36 is actually creating a new office of a

superin­ten­dent as an oversight body. This superintendent

is going to be appointed by cabinet and would have a number of duties,

including the ability to conduct an assessment of an unregulated health

profession or occupation if regulation is needed or possibly if

different regulation is needed.

The bill is putting in motion, really, a process on how an

assessment would be conducted. However, once again, the parameters

around this are being left to the minister to decide. That’s, again,

something I want to highlight with some of my closing few minutes that I

have here: why we want to ensure that we bring that scrutiny and those

questions forward during committee stage. Because, time and time again,

we see, not only in this bill but most bills that this government brings

forward, that decisions will be made by the minister and cabinet at a

later date.

This is an important piece of legislation — as I said, something

that all three parties worked on a lot of recommendations for. But they

weren’t part of the entire legislative creation, just recommendations

that were brought forward. We need to ensure that we ask those questions

of the minister at committee stage.

We know this bill is bringing forward new rules, regulations and

provisions around the disciplinary tribunal and how that’s all going to

look. Again, this is important, because we want to ensure that that

process is fair and, at the end of the day, public. If there’s

discipline that was required….

As we’re looking at this bill, it’s really about gaining and

building a system that’s going to have public trust. We’re going to

ensure that the policies are put into place that work for the health

professionals themselves, obviously. But it’s something that’s going to

help, in its small way, to start working towards fixing a crumbling

health system that we’ve seen under this government.

Obviously, I’m looking forward to committee stage. There are a lot

of questions we’re going to have of the minister. I know, as he smirks

at me, that means he’s ready for all these questions. I can see the

smirk behind his mask.

Deputy Speaker: Thank you, Member.

M. Bernier: But we’re ready and excited to ask those questions in committee

stage and appreciate the time to speak to this bill. Thank you very

much.

A. Olsen: Thank you for this opportunity to speak to Bill 36, the Health

Professions and Occupations Act. It’s dense work, from what it looks

like, from the Minister of Health — indeed, the largest, I think, piece

of legislation that I’ve seen in my days here in the Legislature. As has

been mentioned by the speakers previous, it’s going to take some time to

get through this as we do the second reading and, as well, the committee

stage on this bill.

This particular act repeals and replaces the former Health

Professions Act. It’s building on the work of a steering committee that

was created from the 2019 Cayton report. This goes back to when we were

in the confidence and supply agreement with the B.C. NDP

government.

Interjections.

A. Olsen: I was about to get there. They’re really wanting to make sure that

there’s full and broad all-party support on this.

Interjection.

A. Olsen: Everybody’s got their opinions and arm-waving that’s going on.

Thanks, Madam Chair, for keeping the decorum in this place.

Deputy Speaker: Serious.

A. Olsen: Anyway, this goes back to a time when the Leader of the Third

Party, the member for Kelowna–Lake Country and the minister worked

together in a really good way to bring forward the recommendations into

this legislation that we are debating today. This is a good piece of

collaborative democratic work, and everybody was very eager for me to

get to that point.

[2:05 p.m.]

But I think that it should be held up. It should be held up as to

how work in this Legislative Assembly can happen across party lines.

Despite the differences of opinion that happen here — frequently or

infrequently, depending on your perspective — the reality is that there

is a lot of agreement that happens in this assembly.

Yes, we do like to highlight the areas that we may not agree with

each other. However, I think that it is important to recognize that when

we sit around the committee table together, when we look at the work

that needs to be done on behalf of creating legislation and regulation

that works for British Columbia, there is a lot of agreement on all

sides, in all seats, of this House.

I think that what we see here in Bill 36, as a result of work that

was done — collaborative work, proactively collaborative work — that was

undertaken by the Minister of Health…. He didn’t need to take this

approach, but chose this approach to be one that was going to give the

outcome the greatest chance of success.

As the member who spoke previously to me mentioned, there is a

role that the opposition plays in going through, clause by clause, in

the legislation, to ask the minister why this choice or why that choice

was made when the bill was being drafted. That’s the work that we do

here on this side of the House.

It doesn’t mean there’s disagreement on the bill overall. There

might be some different opinions about how we would approach certain

aspects of this policy work. How­ever, overall, I think what

you’re hearing and what the people are hearing about this important

legislation is that broad support out of that 2019 steering committee

and the Cayton report from before that. This bill is taking those

recommendations and bringing them into law or providing the regulatory

ability for the government, the minister, to regulate.

The bill creates an oversight role, the superintendent role, which

currently doesn’t exist, as well as a reformed complaint process and

independent discipline tribunal and changes the structure of the boards

from elected to appointed on these colleges. It continues to reduce the

number of colleges, in a process that the minister has been undertaking

in advance of this bill, from 20 colleges that currently exist in the

province down to six.

The regulatory colleges hold a register of all of the

professionals working in a field, in a sector. They set standards of

practice. They set and maintain standards of education and training and

hold professionals to account through complaints, investigations and

discipline processes.

These bodies are really critical to ensure that the people who are

treating British Columbians, who are assessing their health and

well-being and administering the treatment, are professionals, that

they’re accredited, that they’re educated and that there is a process to

hold those individuals accountable should they make mistakes in the work

that they’re doing.

There are currently — or there were, and in the process of

reducing — 20 regulatory colleges in the province that were established

under the Health Professions Act. That now, as I mentioned earlier, is

being reduced to six. Reducing the number of colleges makes for more

efficiency, specifically from a government relations

perspective.

I can imagine the Ministry of Health and ministry staff are going

to be quite happy to have fewer bodies and to be able to relate to

larger cohorts of health care professionals and occupations.

It also creates more efficiency for smaller professions like

podiatrists, for example, and to be able to set consistent standards

across professions as people move towards team-based care.

I think as the province…. It’s been a project that I know the

minister, when he visited my riding shortly after the 2017 election….

The minister visited my riding, and we talked with my constituents about

the move to team-based primary care. I think that this is a process that

is underway. It continues to be underway. I know that many people in my

community and communities across the province really yearn for a time

when we see the fruits of that labour and can benefit from

it.

[2:10 p.m.]

However, I think that as we’re taking a look at the regulatory

side of the colleges, the consolidation of these colleges from 20 to six

will really help in that work environment on the ground, in communities,

in that team-based environment. You can just imagine having 20 different

colleges involved and the complexity that that brings.

The six new colleges that will exist, as the minister continues

the work, will be the College of Physicians and Surgeons, the College of

Oral Health, the College of Allied Health and Care Professionals, the

College of Pharmacists of B.C., the College of Nurses and Midwives, and

the college of complementary and alternative health care

professionals.

As I mentioned earlier, this bill will create a superintendent

role to act as the oversight over the colleges. The superintendent is

responsible for setting and guiding principles of the colleges;

supervising their conduct, and in­vestigating when necessary;

running an independent discipline office, for when that’s needed; and

running disciplinary panels, as they’re required. It creates an

independent discipline tribunal and a reformed complaints process that

increases accountability and transparency.

Really, I think what is important to highlight here is that when

it comes to people and their health care, when it comes to people and

their relationship with those who are delivering that care, these are

some of the more sensitive conversations that we have with professionals

— our personal health and well-being, the state of our health. I think

that what’s important is that the outcome of this process is to ensure

that people who are in these vulnerable states are protected and, as

well, that we’re ensuring that the most qualified people are working in

the field.

This bill distinguishes between a “profession” and an “occupation”

and creates a regulatory program for lower-risk occupations to be

regulated but not designated. I think an example of this would be health

care assistants versus counsellors. It expands the regulation of service

providers; in the next steps, the minister is going to be regulating

counsellors. Then, following that, diagnostic and therapeutic

professionals.

I know that since my election in 2017, I’ve had some regular

advocacy, in my constituency office, requesting that the provincial

government regulate counsellors. I’m very pleased to see that advocacy

has turned into a process where that will be undertaken. As well, it

streamlines the process for designating new health professions and

occupations. This gives, I think, a pathway for this minister and future

ministers to be able to recognize and acknowledge new health professions

or occupations that may emerge as time passes.

We know that in October of 2020 B.C.’s three nursing colleges were

amalgamated into one college. In September of 2021 the nursing college

was amalgamated with the College of Midwives, and the College of

Physicians and Surgeons was amalgamated with the college of

podiatrists.

As I mentioned, this is a process in which, even as this bill is

being developed, the minister has been proactively working towards the

consolidation of these colleges, the simplification of this. In

September of 2022, just a few weeks ago, B.C.’s four oral health

colleges, which included the dentists, dental assistants, dental

therapists, denturists, dental hygienists and dental technicians, were

all amalgamated into one regulatory college.

Also in this bill, I think it’s important to acknowledge here a

few of the recommendations from the In Plain Sight report. This

has been an unfortunate part of our history, with respect to how

Indigenous people can access health care in our province and the

experience that they have.

[2:15 p.m.]

Just a year or so ago we had a report that highlights the

experience of the many thousands of Indigenous people in British

Columbia who courageously shared those experiences. Those have been

identified and published in the 2020 In Plain Sight report.

Well, it’s not one year ago; it’s two years ago. It just goes to show

how quickly time passes in this place. This bill is beginning to take

some actions on that report. There are a number of recommendations, but

specifically, there are four recommendations that are highlighted here

and that may be addressed with this bill: recommendations 4, 5 and

I think it’s important to acknowledge that in committee stage of

the debate, I’ll be taking some time to talk with the minister about

just exactly how this bill addresses the report that the government has

in front of it. It might give some opportunity to ask the minister, on

the record and for his purposes, the progress that’s been made overall

on that report and how the government will work with these new colleges

to ensure that anybody who is a registered professional or working one

of these occupations is implementing, through their colleges, all of the

recommendations from the In Plain Sight report. That will be

something that I’ll be asking the minister about.

It’s important to acknowledge that this will be going from a

process of where the members of the boards of these colleges will no

longer be elected from the membership. Rather, they will be appointed

from the government. There’ll be some questions about that and the

choice to move from an election process to an appointment process from

the government. Overall, I think what I’d like to highlight in this

debate, really, are the first remarks that I made as I’m speaking to

second reading here — on the collaborative process.

So often we can land on the disagreements and the differences of

opinion. Also, we need to stop, pause and recognize the areas of

collaboration. If we’re just passing over them and not reflecting on the

areas where we’ve been successful together, then it’s going to feel

fleeting. It’s important for us to recognize that the member for

Kelowna–Lake Country, the member for Cowichan Valley and the Minister of

Health have really worked together over the last number of years to get

this very substantial reform in how the health care professionals and

occupations are governed — their oversight, transparency and

accountability and how that’s managed.

I look forward to asking and to engaging the minister in

questions. I look forward to the questions from our colleagues here and

from the members of the official opposition, and I appreciate this

opportunity to speak to second reading today.

HÍSW̱ḴE

SIÁM .

T. Shypitka: I’m pleased to respond to Bill 36, Health Professions and

Occupations Act — a very hefty bill, as we’ve highlighted here a couple

of times. Just looking at the bill itself, it’s — I don’t know — 645

sections.

Is that what it is?

Interjection.

T. Shypitka: Yeah, here’s what we’ve passed through the House so far this year,

and here we’ve got this as number one. It’s beautiful. I want to

compliment the minister on supporting the forestry industry. There’s

lots of paperwork there; it’s awesome. He’s double-dutying

here.

I want to highlight first, before I go into my debate on this

bill, and recognize the importance of health care in B.C. It’s critical,

as we know. It touches every single one of us. We’re having some

troubling times right now in British Columbia. I really want to thank

those health care workers and health professionals that are in the

trenches right now, as we speak. It’s been a long haul for these folks,

especially in the last couple of years through the pandemic and

everything else that has been going on in British Columbia. It touches

all of us.

[2:20 p.m.]

I know we all have stories of friends, family and colleagues that

know health care professionals. We understand the stresses they go

through every day. It’s heartbreaking, to tell you the honest truth,

some of the stories I hear. I just want to make clear that they have

supported not only members on this side of the floor but, I know,

throughout the whole Legislature. We really…. You know, our hearts are

with them all the time.

It’s a multilayered issue. There’s no single solution to our

health care crisis. I think the minister has highlighted that, and he

has recognized that. This is just one piece of what we need to see in

British Columbia to address our health care issues.

Access to health care, for example, in my region of British

Columbia…. We’re close to the Alberta border. We used to have a really

good relationship with Alberta in getting that access to health care.

We’ve seen even the crumbling effects in other provinces, and then those

ties — that access to other jurisdictions — have been

severed.

That’s been making it tough for places where I live. We see wait

times being extended due to the fact…. We don’t have the boots on the

ground that we need to have to address some of these issues, for

sure.

Long-term care. I know in my region, as well as many others, our

seniors…. We have an aging demographic right now that is putting

additional strain on the health care system. Those long-term-care

facilities need the support that they’re not currently

getting.

The labour shortage is another issue that we’re facing. It’s tough

to get good help these days. All ministries from all sectors of our

economy and our governance here in British Columbia are feeling the

effects of the labour crunch.

We look at additional stories that I hear of vaccine mandates that

are in place right now.

Deputy Speaker: Member, if you can speak to Bill 36, please.

T. Shypitka: Absolutely, Madam Chair. I just wanted to lay the groundwork on

this. Bill 36 isn’t just going to solve all our problems right now.

We’ve got many other issues we have to deal with, for sure.

Speaking to Bill 36, then, Madam Chair, and how this bill came

about. It’s a good story. It’s a story of collaboration. It’s a story of

all parties coming together, sitting down at the table and modernizing

and changing the regulatory framework around health care in British

Columbia.

There were significant recommendations. I want to stress the word

“significant.” They’re very game-changing, as far as I’m concerned,

anyways. I’m sure a lot of other people in the House feel the same

way.

There were several recommendations that were made. Include

cultural safety and humility. Improve the governance of regulatory

college boards. We’ve heard debate from other members of the House on

the variety and diversity of those college boards across the

province.

This is an attempt to improve the governance of those regulatory

boards, reduce the number of regulatory colleges to make it more

streamlined, strengthen the oversight of the colleges. This is to bring

more accountability, more transparency to those board and establish an

independent discipline process while also revising the complaints

process with the aim to make it more transparent and focused on patient

safety.

I think it’s absolutely critical right now, when we’re talking

about a system that is strained, that we are focused on what’s right for

the patient and ensuring that patient safety is at the

forefront.

In short, I guess, this bill is a complete redesign of the Health

Professions Act. It follows several guiding principles. The bill

significantly expands on the previous duties of a college and applies

these principles to all under the act. This is the colleges, the office

of the superintendent, the director of discipline, and so on.

These principles include acting in accordance with the United

Nations declaration on the rights of Indigenous peoples, or DRIPA. We

heard my colleague from Vancouver-Langara speak, in quite detail, on the

importance of how this act will act in accordance with UNDRIP and the

importance of that.

We’re seeing examples of systemic racism through­out our

health care system. I think this act attempts to rein that in and to

bring more accountability and transparency to that.

[2:25 p.m.]

The steering committee that was set up to bring this act forward,

as we see it today, was done in a time, I believe, before DRIPA was put

in. They did support the principles and the guidelines of DRIPA during

that committee. So that is reflective in this piece of legislation that

we have here today.

Other principles include procedural fairness, respect for privacy,

promotion of a holistic health care system, identifying and removing

barriers for extrajurisdictional practitioners. I think that’s super

important as well.

As I mentioned earlier, in my preface there, the labour shortage

is one of those other barriers that we’re having here in British

Columbia. The member for Peace River South, I believe, made mention of

examples of some of these internationally trained professionals that are

having a hard time getting into our system or those that are even

domestic that want to get trained and are not finding the spaces to do

so. This bill will happen to, hopefully, bring some more transparency to

that process. We can get the spaces or we can get that accreditation

transferred in a streamlined way into British Columbia so we have those

extra resources.

I know, just myself…. As we travel back and forth to airports here

and there, we get engaged with our rides to and from. I’ve talked to a

couple of taxi drivers, as a matter of fact, that are trained and that

have been trying to get into our system and trying to get accredited in

British Columbia to be a physician. They’ve been here for years trying

to get that accreditation.

Hopefully, this will bring the oversight to where it needs to be.

We can make that streamlined, and we’re not waiting for these folks that

deserve their shot here in British Columbia. They’re going to do

everything they possibly can to meet the standards. And they should be

high. We’re not talking about lowering standards. As a matter of fact,

we’re probably talking more about tightening them up and putting the

proper control measures in place so that the streamlined process that we

all quest for is recognized.

It’s a shame, when we’re talking about one in five British

Columbians that don’t have access to a family doctor, me being included

in those statistics — I don’t have a family doctor anymore — to know

that some of these physicians are out there waiting, wanting to do the

right thing and wanting to help British Columbians with their health

care needs. It’s heartbreaking to know that they’re sitting and waiting.

We need them desperately.

Designation assignments. Previously, under the Health Professions

Act, an unregulated health professional could apply to the minister for

designation, or the minister could investigate a health profession to

determine whether it should be designated. Bill 36 would enable the

newly created office of the superintendent to conduct an assessment if

regulation is needed or different regulation is needed, if it was

required by the minister or if the superintendent determines an

assessment would be in the public interest. He would be required to

notify the minister if he chooses to do so.

The bill sets this process for how an assessment would be

conducted. However, much of the parameters, scope, conduct, timeline,

etc., are left to the minister to decide. We’re setting up another

supervisory role, the office of the superintendent, to do that and to

provide oversight to the process we’re looking to change. I think that

could work.

We’re going to have to dive a little deeper into the bill itself

in committee stage to understand exactly the scope and practice of what

the office of the superintendent will do and what that relationship with

the minister is going to be like. I think it’s a good start, and I think

nobody on this side of the House really opposes that.

The superintendent will be required to make a report with

recommendations, which will not be made public until the minister makes

a decision. So once again, a process that streamlines what we’re trying

to get to.

[J. Tegart in the chair.]

New oversight bodies. The bill establishes a new oversight body,

as I mentioned, the office of the superintendent of health profession

and occupation oversight, that consists of the superintendent, the

discipline tribunal and other employees, as required.

[2:30 p.m.]

It is setting up a large forum of different professions’ oversight

bodies that will help in this process. They say two heads are better

than one. Sometimes we get lost in the bureaucracy. These are some of

the things we’ll be exploring in committee stage, to be sure.

The purposes of the office are outlined in

section 435 and include

providing advice and recommendations to the minister on the

administration of an amendment to this act and the regulations, the

performance improvement of regulators and other matters as requested by

the minister, to promote awareness and adherence to the guiding

principles, to develop guidelines for regulatory college board

appointments, to promote regulatory consistency, to report on regulatory

performance and make recommendations for improvement, to publish

information records that are deemed to be of public interest and other

duties as set by the minister.

Once again, another function in this act will allow that type of

transparency that we really need to see when we’re talking about health

care in British Columbia — how the process works, how the disciplinary

actions work. If there is a complaint, if there’s a safety issue, if

there’s a discriminatory issue, if there’s a racist issue, then the

office of the superintendent will look at all these and will decide

whether or not disciplinary action will be warranted.

I believe it will still be with the colleges to hand out that

disciplinary action. There still is a tie-in with the colleges and with

the office of the superintendent, and I think that’s probably a good

thing. All working for one common goal here.

Licensed duties among the duties established in this bill. There

is a requirement for a designated health profession licence to practise

ethically, which includes a requirement for a licence. To quote in the

bill here, “practise a designated health profession in an ethical manner

and in accordance with ethical standards,” as well as for a board to

make bylaws respecting ethics standards. This latter includes

requirements for a board to make bylaws respecting providing false or

misleading information to patients or the public. So once again bringing

more oversight to the health care issues we have here in British

Columbia and how we get there.

As I said, it was a good act of collaboration between the member

from Lake Country — I believe that’s what it is, Lake Country — and the

leader of the Green Party and the Minister of Health to bring this

forward, their steering committee. But the times have changed. When this

bill was first brought out and was worked on…. We’re not seeing some of

the issues that we’re seeing here today.

So as I mentioned at the onset, we need to be aware, and we need

to be alive that this isn’t going to be the save-all. And I think, in

all fairness to the minister, he’s not saying this is the save-all. This

is just one big piece that we need. We see huge wait-lists in British

Columbia. This will not solve that. Walk-in clinics — some of the worst

in the country right now. This will not save this. Like I said before,

one in five without a family doctor, me being one of them. This will not

immediately save this.

But what this will do will bring a more streamlined process

forward so that physicians, colleges can do the work that they intend to

do with the proper oversight that the office of the superintendent will

provide.

With that, I’ll see what happens in committee stage. As I said,

this is a huge bill: 645-some-odd sections, and it will take some time

to wade through it all. But with that, I have the best hopes that this

will be the best thing for British Columbians.

C. Oakes: I’m glad to have the opportunity today to stand and speak to this

very important bill before the House — speaking of the Health

Professions and Occupations Act.

[2:35 p.m.]

I think it’s fitting for me to start my comments today on this

specific act to reflect on my riding of Cariboo North and what I have

been hearing from the constituents. I’m so incredibly grateful that they

have reached out and they’ve engaged. In fact, I just finished a meeting

in our caucus room with one of the constituents from Quesnel.

The comments that I regularly hear from the constituents are a

significant concern about the challenges that we currently have in our

health care system. There isn’t a day that goes by, I imagine, for all

MLAs in this Legislature, where we have people that come to us in our

offices and express their incredible concern and the challenges that

they’re having.

It is my hope that as we go through this bill, specifically in the

committee stage, perhaps this act provides some certainty or opportunity

for our constituents to have that engagement with our health care system

and raise the concerns that they’re having in our community. I commit to

the constituents that I’ll continue to keep our constituents updated on

how this piece of legislation moves through the House.

I think it’s also critically important that I take a moment to

recognize all of the incredible health care professionals in Cariboo

North for the work that they’re doing every single day. I don’t know if

it’s unique to, maybe, our more rural or remote ridings, but everything

seems a little bit more personal. When we have a health care

professional that we reach out to and we talk to…. The challenges, the

patients that they’re serving, in so many respects….

I reflect on many of the conversations I’ve had with the nurses

and care aides and health care professionals and doctors in my riding.

We know the families. Often that relationship goes back, in many

respects, many generations. I understand that when the health care

system is in the crisis that we’re currently experiencing, it just has a

compounding effect on people. We’re seeing that play out in our

communities.

I also want to take a moment to recognize some of the

extraordinary changes, positive changes, that I’ve seen that have been

evolving in Cariboo North. I want to take a moment to recognize the work

that our First Nations are doing. As we’ve seen an increase in

challenges in our health care system, I applaud the leadership of our

First Nations, who have come together and said: “Is there a better,

holistic way that we can improve health care outcomes in our

communities?”

They have gathered the leaders in our community, and they have

talked about a holistic approach from health care to housing, to social

services, to the Ministry of Children and Family Development. They’re

having those conversations right now, every month, in our community.

When I see bills that come before this House that are critically

important, I always want to make sure the lens of the constituents of

Cariboo North is seen in the legislation before this House.

I reflect on what I have read in this very hefty piece of

legislation. I think all members of this House understand and support

the critical needs to make sure that everyone who accesses the health

care system can do so with the utmost respect and humility and that we

should ensure we have a trauma-informed system of care. But I want to

make sure that legislation that is being brought forward — that our

First Nations are heard in this. I want to make sure that we’re not

forgotten about, and that is critically important.

[2:40 p.m.]

When I look specifically, now, at divisions of the bill, as we go

into division to the guiding principles, I discussed a little bit about

the anti-discrimination clauses that we will be going through in

committee stage and the principles that are being put forward in this

legislation.

Of course, I support fostering meaningful communication between

patients and the regulated health practi­tioners.

For members, MLAs in this Legislature, I know that some of the

most difficult conversations we often have are with constituents who

come to our offices and have experienced some extraordinarily tragic

events. Any opportunity to improve upon meaningful engagement and

communication and look at how we can improve and do things better is

critically important.

Again, as we look through the committee stage, I’ll be paying

close attention on that examination of communication between patients

and regulated health practitioners. How will our First Nations be

included in that process, and specifically, how will they be seen in the

guiding principles set forward in this act?

As we move into division 3 of this bill, when we talk about the

actual licensing, this is where we get to whole bylaws of this

legislation. As for so many people who have, certainly, had experiences

on other boards, reviewing bylaws and regulations, or perhaps

experiences with WorkSafe or other institutions, this can have a

critical impact on the ground and can have a critical impact on

people.

What was clearly identified in the bylaws in this legislation are

the eligibility standards, education, training, experience and other

qualifications, including the continuing professional development. I

want to take a few moments to talk about this critical aspect of this

bill.

I think a foundational piece that may be missed in this bill —

I’ll certainly have the opportunity as we go through committee to review

it — is that the foundation of every­thing that we’re talking

about right now is: where are the people? How are we training? What

types of investments are we making? Before we even start talking about

the Health Professions and Occupations Act, let’s start talking about

our labour shortages, and let’s start having these conversations across

British Columbia with how we are investing in training.

How are we making sure that in our world-class post-secondary

institutions, we’re meeting the demands today of what we need to provide

the important professional labour and professional services and the

health care and the social services? The list goes on and on. All of

that is going to require an educational system that is invested in, that

is supported so that we have the tools in place so that our graduate

students, once they come out of the education system, have every chance

of success.

I was at a rally a few weeks ago with the nurses in Prince George.

One of the things that stood out to me — well, a number of things stood

out to me — was the incredible pressure and the demands nurses are faced

with every single day. I saw it at the rally. An individual came up and

was hurling incredibly insulting words at the nurses. To be in that

environment and to see that firsthand was incredibly troubling. I hope

that the measures that the government has put in place recently will

have an impact on that.

I also heard from the nurses the critical challenges with just the

shortage we have of nurses — shortages in every part of this province.

Right now in the health care and social assistant professions, there are

142,900 job openings. That’s what is being projected. Of that, what we

heard was that there are 4,265 vacant nursing positions and that

there’ll be a requirement of 26,000 new nurses by the year

[2:45 p.m.]

Equally as troubling, I learned that UBC has over 800 people on a

wait-list for nursing spaces — 800 people on a waiting list. And that is

just one of our post-secondary institutions.

While we have bills that come forward in this House and we debate

important pieces of legislation, I cannot help but reflect on the

challenges that are happening on the ground in our constituencies right

now. Are we spending the time and the investment of the dollars to make

sure that we’re solving those problems?

Further, what I’ve heard from students who graduated from nursing

and are finding their way into the health care system is that they’re,

unfortunately, being put into situations, because of such low staffing

levels, that may not necessarily be getting the necessary staff support

that they require. What we’re hearing clearly is that many of the recent

graduates who are graduating from professional programs in British

Columbia find themselves in incredibly challenging experiences on the

floor in health care, and they’re making the decision to leave the

profession.

While we discuss the important needs of making sure that we are

setting up rules and authorities and disciplinary structures to make

sure that there is that professional level for a variety of the

professions in this piece of legislation, I wonder. At the heart of it,

what does this bill do if we don’t actually have the people on the

ground to do the jobs? What does that stress look like to that nurse who

is put into such extreme circumstances — shortage, multiple shifts

requiring overtime after overtime, the abuse?

Then layer what this bill says and what it’s setting out for

requirements. How does that nurse who has just put in double overtime

shifts and knows at the end of the day…? Or those other professionals

who are so struggling — what does it mean now when, all of a sudden,

there’s another additional body that says: “Now you have to carve out

this amount of time to make sure we’re doing X, Y, Z”?

I think it’s all critically important. But at the heart, if we do

not figure out how we manage the severe labour shortage that we have in

British Columbia, this crisis that we are experiencing in our health

care system is only going to get worse.

Then I look at the 645-plus sections of this bill. I look at all

the bylaw requirements, and I look at all the challenges. Look, I’ve

been in an organization. I’ve designed bylaws. I’ve had to do that work,

and I think: “Well, where are the people that are going to actually do

the work to design this?”

How many hours, how many people are going to be required to

develop one of the most significant bills that has come before this

Legislature? Where are the people to do that work? Are we going to be

pulling nurses off the floor to be a part of what this looks like? Are

we going to be leaning more heavily on health care professionals that

are already deeply struggling?

So I wonder that. I wonder about the paralysis — that potentially

this could happen in the system. Look, I think we need oversight, and I

think we need to streamline, and the elements of this bill I certainly

support. Again, I worry about the foundation of our health care system

and every single one of our communities right now.

We recently received an incredibly troubling letter from the

radiological society that rang the alarm bells about the estimated one

million patients waiting to see a specialist physician in

B.C.

“Radiologists see this crisis unfolding every day, with hundreds

of thousands of patients waiting for medical imaging in B.C. We know

that timely access to medical im­aging saves lives and helps

prevent disease progression. We fear the tsunami of cancer cases that

may be coming in B.C. because of delayed access to medical

imaging.

[2:50 p.m.]

“We’re asking for urgent action to address this issue, and we want

to work with you on the specifics of the solution.”

What goes further in this letter that was sent to minister Dix on

September 26 is that the health human resource strategy identified that

there’s a critical shortage of medical imaging technologists — X-ray,

sonography and other modalities — in British Columbia and that nearly

every facility in the province of B.C. is trying to recruit, with little

success.

Many technologists are working excessively long hours to try to

keep up with demand. Innovative solutions must be explored immediately

to recruit and retain experienced technologists to increase short-term

capacity, and more needs to be done to develop and train new

technologists for the long term.

That does lead into division 3 of the guiding principles, around

licensing in this bill and around some of the bylaws that are being

developed, specifically around the extrajurisdictional credentialing

issued by a person or body outside B.C. with the evidence of

qualifications.

We’ve been calling on that. We certainly recognize we’ve seen a

softening of a lot of the domestic students through post-secondary

institutions in British Columbia. We have a recruitment challenge right

across the board in all of our communities. And yes, we have been

looking at ways that if we have trained professionals in our

community….

The member for Peace River South talked about the 28 health care

professionals in his community that they’ve identified who, if we could

find a way to support their credentialing, would be in our health care

system, and that would be an extraordinary win for the

community.

I’m hoping that this bill, this piece of legislation, will help

streamline that and will help provide the oversight to make sure that

that’s happening, because what I’ve heard, to date, is a repeat of

communications out there from the government that say: “Look, we

recognize this. We’re going to streamline credentialing, and we’re going

to streamline all these processes.” We just haven’t seen that play out

in action.

When you have 28 professionals in a community that are waiting for

credentialing so that they could help support a health care system in

crisis, we have to do better. We have to find a better way to make sure

that this happens. What I worry about is that sometimes when we look at

a 645-section bill…. Is this going to create so much bureaucratic red

tape?

Again, I support the process of making sure we need to streamline.

I support the process of why we got to this bill. I just want to make

sure it doesn’t make things worse. I want to make sure that all of the

challenges that we are experiencing in our communities…. I want to make

sure that I’m raising the concerns of my constituents here in the

Legislature. Are we making things better?

I want to spend a moment to acknowledge the incredible work of our

post-secondary institutions, our colleges, right across the province of

British Columbia. I cannot imagine what the health care system in my

community, in the region of Cariboo North and specifically in G.R. Baker

Hospital, would be like if we did not have the nursing program, that

partnership between the College of New Caledonia and the University of

British Columbia in our community.

When I think of things that, as a Caribooer or as somebody that we

can hold up as an extraordinary win in our communities, making sure that

we have post-secondary education, colleges and training in our

communities is incredibly important. What we’ve been asking for is: let

us look at the LPN program. Maybe there are other things on the training

side that could help. Does this bill help us understand the needs

assessments in our communities? Is there an element of that within this

bill?

[2:55 p.m.]

I certainly read through the bill. Information always can inform

good governance. I’m looking for the type of information in this

legislation that really sets forward what we require in our communities.

I think it’s also critically important…. As I was going through the

legislation in this bill, under division 5 of the duties of the

licensing, I’m glad that informed consent was identified in the piece of

legislation.

I want to spend a moment now to talk about students. Last week it

was student advocacy week in the B.C. Legislature. We had the

opportunity to hear from student associations right across this

province. I always appreciate what they’ve been bringing forward and the

concerns that they’ve raised.

One of the elements that I think is critically important that we

have to start wrapping our minds around and listening closely to young

people and the work that they’re doing right across the country is: as

we look at informed consent and what that means, do we have a specific

set of criteria across institutions, across government, that looks at

what that means?

I applaud the students for pushing both the government and the

opposition on looking at what consent looks like and how, as we do that

training in our public institutions, there is a measure that is

consistent across the board, and the sexualized violence policies

incorporated to meet the minimum standard of care that’s

necessary.

What I heard currently from the students is that while we tend to

write in legislation that there are needs for policies in things such as

having consent culture or what sexualized violence policies look like

within our legislation, is that consistent? How does that get

interpreted across the board in institutions? I want to thank the

students and recognize and hope that they’re listening so that they know

that the work that they’re doing is brought forward into this House.

They’ve been doing important work with the Students for Consent Culture

Canada, again talking about what is happening across Canada.

I also just want to take a quick moment, because I think it’s

critically important, to read into Hansard and to have on

record. One of the other fundamental challenges that I’m paying close

attention to — it’s not just in British Columbia; it’s happening across

Canada, and I know that in February and March in 2022, the House of

Commons Standing Committee on Citizenship and Immigration have certainly

been looking at that — is around the false expectation and dreams of a

Canadian education and what that looks like.

How this ties into this bill is that whether it was the

government’s announcement of the health resource strategy or the

requirements, which we all certainly understand, that we need to look at

international professionals to come into Canada, and specifically to

come into the province of British Columbia, to help address our health

care challenges…. What we have been hearing, especially in that House of

Commons standing committee, is that there is a rapid rise in

international student recruitment that really does spark a call for

rules and standards to govern this.

What we’ve seen is a lot of promises about employment, housing,

cost of living and what kinds of supports there will be. Are we making

that more difficult here? When we embed into legislation the significant

requirements that we certainly understand and know that we need to be

leaning on international professionals to come into our system, do we

have the rules and standards and levels of care to make sure that

they’re being supported?

I think that’s something that we certainly need to investigate and

understand. Are we making the decision more challenging when we start

embedding things in legislation? That’s something for us to reflect

upon. Because at the end of the day, this very lengthy piece of

legislation…. I applaud the members that have been working on this for a

long time. Look, things change. Things in our commu­nities

certainly have changed. I mean, they change right now by the

month.

Like I said, I started talking about there’s some great

opportunities that we’ve seen. Is this an opportunity in British

Columbia to seize our opportunities? Is this an opportunity for the

government to say: “Look, we recognize that we have crises, and we have

challenges, but is this the time that we can come together and look for

opportunities”?

[3:00 p.m.]

Are there ways that we can improve systems? Absolutely. Is this

the way to make sure that we’re solving the labour shortage? I am

looking forward to seeing the Future Ready plan come forward.

I am looking forward to that funding review for post-secondary

education because I think that’s a critical component to making sure

that we’re solving the labour shortages, to making sure that we’re

supporting the people of British Columbia, to making sure that they get

access to health care, to making sure that when people have to find

their way into the health care system, there are the necessary health

care professionals to meet those services, to meet those demands. At the

end of the day, I know that the health care professionals are such a

caring group of individuals, specifically in my community.

I guess, at the end of the day, I want to make sure that my

constituents are seen in this piece of legislation. I want to make sure

that when the minister appoints a board, our communities have a voice in

that. I want to make sure that when decisions are being made in

Victoria, the Cariboo is reflected in that.

I want to make sure that when decisions are being made by a

minister, they understand that the unique dynamics of rural British

Columbia are often different than our urban counterparts. I want to make

sure that when we’re talking about legislation, we’re talking about the

challenges every day on the ground. Sometimes things look a little bit

different in some parts of our great province of British

Columbia.

I want to make sure that there’s an opportunity, not just through

the minister appointing people on the boards. I want to make sure that

our people have their voices heard. I will never apologize, and I will

never stop fighting to make sure that the constituents in our rural

communities have a voice in the legislation that we bring forward before

this House, especially when a bill such as this has such significant

impacts on their day-to-day lives.

So I’m calling on my constituents. If you have concerns about this

bill, if you have ways to improve this piece of legislation, if you have

ideas on how we can make things better — please reach out. If it’s not

to me, please reach out to other members in this House, because the only

way we’re going to improve and get better and get out of this crisis is

if we’re listening to British Columbians.

Enough is enough. I’m tired of hearing story after story of people

that just feel disenfranchised, people who just feel that they’re not

being heard in this Legislature, that feel that they’re being ignored,

that they’re raising alarm bell after alarm bell after alarm bell.

They’re trying their absolute best, on a day-to-day basis, and they’re

being ignored. It’s not good enough.

Every single member in this House has a lot more work to do. I

want my constituents of Cariboo North to know that you have my

commitment that as long as I’m here, I’ll continue to fight on your

behalf.

Deputy Speaker: Thank you, Member.

Recognizing the member for Peace River North.

Interjection.

D. Davies: Thank you to my fan club that surrounds me here today.

Interjection.

D. Davies: Including the Minister of Health. I’m just getting started,

Minister.

Thank you, everyone.

I’m glad to have the opportunity here to speak on Bill 36, the

Health Professions and Occupations Act, and how it significantly does

and will and could impact the health care system at a very critical

moment in time. We talked, and many of the speakers before me have

spoken to the size of the bill. It is quite large, to be honest, and I’m

going to talk about it in some regards. I’ll weave, throughout my

remarks, the unique impacts that it has on rural British

Columbia.

Of course, I represent an area that is almost 175,000 square

kilometres, which poses many challenges, just by the sheer size of our

riding. Health care, as I’ve said in this place many times before, is

probably the number one issue that I receive at my office. I have two

offices. I have an office located in Fort St. John, as well as one 4½

hours north in Fort Nelson.

[3:05 p.m.]

It is the number one issue that my office faces, and a lot of it

is around access to health care. I know Fort Nelson has been really

advocating. In fact, I’m going to be doing a statement in the House here

later this week, looking at some of the great work that Northern

Rockies, Fort Nelson is doing around a committee they’ve formed to deal

with some of these unique challenges around health care in that small

community that is so removed from larger centres. Even calling Fort St.

John a larger centre, it is quite removed from us.

Interjection.

D. Davies: Yeah, we have a nice pool. We do have a nice pool. They have a

nice pool in Fort Nelson. They have a beautiful rec centre.

I think most British Columbians would agree that we are, if not

already, at a collapsed health care system in this province. The system

is broken. We’ve heard it for weeks in this place, talking about the

changes that need to happen. Something needs to change.

I can’t remember. I think it was…. Yes, it was Einstein, I think,

who said that if we continue to do the same thing over and over again

expecting different results, it’s a sign of insanity. This is where I

think we really do need to change, and Bill 36 is obviously looking at

some of those changes. As mentioned, we will definitely have a lot more

to say as we dig into it during committee stage over the coming

days.

It’s not only British Columbians, the general public, that are

saying that our system is broken and needs to change. We’re hearing it

from people within the system. I’m trying to think. I think I was at a

hospital getting some blood work done a week and a half ago. It doesn’t

take much just to sit in the waiting room and listen to the

conversations around, listen to the other health care workers, to hear

that we’re in trouble. Our system is in trouble, because they’re also

talking about it as people that work in our health care

system.

But the legislation that is before us today, Bill 36, does not

seek, I guess, to move towards solving the crisis that we’re in, and it

has been in the works for quite some time. The minister, the Leader of

the Third Party and the member for Kelowna–Lake Country started this

work, and I recall back when this first started and we were talking

about it.

The collaboration, I think, is something worth recognizing — the

working together. Obviously, there are a lot of emotions that happen in

this room. This room is for that healthy debate. But people outside

these walls often focus on the negative side, the fiery debates —

question period and such. But I think it is important, also, to

recognize that there is collaboration, much more collaboration back and

forth than there is this presumed “we’re always at each other’s

throats,” because that is not the case. I certainly want to thank all

three of those members for the time that they put into this

committee.

But we really need to be careful. As I mentioned, our system is

very fragile at this moment, and we want to make sure the last thing we

do, moving into Bill 36 and what it is looking at doing — that it will

not make the problem worse. Obviously, these are going to be some of the

questions that we’re going to be looking at during committee stage. The

last thing we want…. I think Peace River South, my colleague, had

mentioned these unintended consequences. We need to make sure that there

are no unintended consequences down the road that are going to make the

problem or our health care system worse off than it already is right

now.

I should follow my notes. I have already said a few pieces. I’m

just skipping ahead.

[3:10 p.m.]

I also think it’s important to look at the work, again, that those

three members of this House began working on. The system, the climate

around health care, was much different when they started working on this

and looking at where the health system was. Even when they met, we were

starting to see some cracks in the system. Staffing shortages were

starting to become more prevalent throughout the province.

Of course, this committee definitely started prior to the

pandemic, when we saw definite, clear pressure that was put on the

system, obviously propelling us into the complete chaos that we see our

health care system in today. When this committee first started looking

at these challenges, it was in a very different place than where we are

now in health care in British Columbia. I think that’s really important

to keep in mind as we move into the committee stage on this

bill.

The main purpose of the committee is to make a series of

recommendations to modernize. There’s nothing wrong…. We always need to

be looking at different regulations, acts, legislation generally and

making sure that it is modernized. But I would bet that if you were to

talk to the average British Columbian around the framework that the

Health Professions Act is, most British Columbians wouldn’t have a clue

how the health care system is set up: the colleges, how they work, the

regulation. I would say that most British Columbians would not know the

inner workings of that.

In fact, I could probably say that I, myself, would be one of

those that does not know the finer details of how all of these pieces

work. I, like many other British Columbians, at the end of the day just

want a system that’s going to be there when I need it — a system that is

transparent and that each of us, as British Columbians, can put our

faith and trust in and know that we are going to get the absolute best

care we can have in our health care system, a system that is focused on

patient safety.

I’m sure there are others in this House…. I can speak from a

personal story that happened to me in 2018. I think anybody that was in

the House obviously recalls that I got into a little bit of a run-in

with a front-end loader and was crushed. This happened in the city of

Fort St. John. I was rushed into the trauma room, the emergency

room.

I’ll say that I never thought for one minute that I was not in

good hands. The service that I received, the care that I received, was

incredible. Everyone was where they needed to be. I will say, though,

that there was one issue — I have talked to the minister about this: our

air ambulance was the one letdown that caused me stuff that’s happening

still, today. Because it was not in place, I had to sit for almost ten

hours, waiting for an aircraft to medevac me over into

Vancouver.

When I was in care in the hospital in Fort St. John, even during

the medevac process on the airplane with B.C. Ambulance, transferred

into Vancouver General Hospital, and the whole time I was in the general

hospital, through my surgeries, I felt that I was receiving very good

care. I never questioned it once. I was never worried that I was not

getting the care that I felt I deserved.

I don’t know if I can say that today. I really don’t know if I

could say that today. If I were to experience the same accident that I

did in 2018, I believe I would be a little bit more nervous now about

the level of service and care that I would get. It’s not based on the

individuals. The doctors and nurses all do incredible work; the staff

give it all. We’ve heard stories here today on the unbelievable work

that our health care professionals are giving, working double

shifts.

[3:15 p.m.]

Again, the member for Peace River South talked about two

back-to-back 12-hour shifts. You know, these are heroes — nobody

questions that — but it’s the systemic breakdown of B.C.’s health care

that worries me. It worries, I know, many British Columbians right now,

around: can they get the service? Can they get the health care that they

need?

Will Bill 36 fix that? Well, no. Will it get us to a better place?

We hope so. These, again, are going to be the things that we need to be

focusing on during committee stage on this bill. The main intent of this

bill is to look at the regulation of the health professionals that are

working in our health care system. One of the things that we’ve looked

at is to streamline that system. There are lots of things that we,

obviously, agree on, and we don’t argue that. We will have many more

questions moving forward as this is discussed.

As we move forward, we need to be looking at what started out in

2018, when this process started, to where we are right now in 2022.

Things are really different, and we need to be almost dissecting this

bit by bit and asking the questions that are now more prevalent today

than they might have been in 2018 or in 2019. The pandemic has obviously

had an impact on our health care system in showing these cracks and

challenges, as has our opioid crisis. A lot of pressures are on our

system right now, which is starting to show some of the

issues.

As we’ve all alluded to on this on this side of the House, we are

supportive of many of the goals and the direction of this bill, but it

is a long and complex bill. I know it has been held up a few times. If

you compare it to all of the bills that we’ve had in this House, it’s

thicker than all of them so far this session. It will take some time. It

is going to take a lot of patience, I’m sure, with the minister and his

staff and the members on this side of the House. It’s a complete

redesign of the Health Professions Act, something that one cannot take

lightly.

The current Health Professions Act deals with the 26 regulated

health professions, of which 25 are governed by 15 regulatory colleges.

We can see, just by that sentence, the complexity of the system that we

are presently in. Looking at ways that we can improve, looking at ways

that we can streamline and looking at ways that we can make it more

transparent are obviously some things that we are supportive of and that

we’ll be looking at as we move forward with this Bill 36.

All of these colleges I have just mentioned have a legal

obligation to protect the public, and I think it is something that they

take very seriously. Questions have been raised around the transparency

piece. Again, these are the pieces, I think, that British Columbians

want to see. They don’t want to know the inner workings. They just want

to know that the system will be there, that the system is transparent

and that it’s a system that they can trust in.

Bill 36 expands much on the previous duties of the college and

establishes a series of guiding principles that will be applied under

this act — colleges, office of the superintendent, director of

discipline, among a few.

[3:20 p.m.]

It was talked about earlier this afternoon — the creation of more

layers, and I use the term loosely, of bureaucracy that have been

identified so far in this government. My worry is that this is just more

layers and will become something bigger and more of a barrier than it

might be of something that will improve, at the end of the day, the most

important thing, and that is the level of care that individual British

Columbians will receive.

At the end of the day, this is about removing barriers, and it

could easily become the opposite of that, and that is one of the things

that does worry me moving forward. Again, a lot of these questions,

hopefully, will be answered as we move into committee stage.

We’ve heard a few stories about internationally trained and

educated health care folks that come from all over the world that work

in our province. In fact, I think almost every speaker has probably

mentioned a story.

Again, the challenges are much more prevalent in a smaller

northern rural community, and I know many of us have identified people

that are working in the service sector or working in different sectors

that have years of experience in their country, years of university in

health care professions that British Columbia needs. There is a

breakdown in the system and the regulatory piece around getting these

individuals that are already here living in British Columbia into

something that they should be doing, and that is supporting in our

health care system.

In fact, a few years ago the city engineer in Fort St. John and

his wife had both moved up from I think it was Chile, and he was hired

by the city as the engineer. His wife was an obstetrician-gynecologist,

world renowned. She would go on speaking engagements all across the

world. You can imagine, to our elation: “My goodness, we’ve got a city

engineer that’s come in. Now we’ve got something….” In fact, the timing

was perfect. The obstetrician was just retiring out of Fort St. John, so

the timing could not have been better.

However, she was told: “You need a few more years of X, Y and Z.

You need to do this. You need to do that, and then reapply to us.” It

was a bit of a back-and-forth, and then she found that there was another

way. If she were to go to the United States and practise, to move into

B.C. would be much easier, so she did that.

Remember, her husband stayed in Fort St. John the whole time. She

moved down to Pennsylvania and practised in a hospital, without an

issue, by the way — just walked in and started. I’m presuming there were

a few loops to go through to make sure that she met the requirements,

but she started practising. Came back to British Columbia, as she was

told to, and was told: “No, you need another year and a half, a bunch of

these courses that you are missing.”

Anyway, unfortunately, we lost, because of that…. Both of these

individuals went to Grande Prairie. She’s now running an entire

department in Grande Prairie. Her husband now works for the city of

Grande Prairie. British Columbia lost two incredible professional people

because of, hopefully, some of the issues that we might get to in this

bill.

I think it’s important to tell these stories, and I think it’s

important that all of us share these stories in our communities of

people just like that, just like the member for Peace River South spoke

about in his community. These people are out there. These people are in

every single community across British Columbia, that love serving

people. They love being in health care. That’s what they got into it

for. We need to find ways to expedite these folks. Hopefully, this is

something that Bill 36 will look at a little bit deeper in regard to

regulating and the colleges and how they look at that.

[3:25 p.m.]

We need to have a clearer path, and this is something that’s been

spoken to I can’t even remember how many times. Over and over again, it

comes up. Here, throughout the province, we read stories about it. I

know that even in our Alaska newspaper, there have been stories that

there needs to be a clearer path for health care professionals from

other countries to apply and receive their designation here in British

Columbia.

As I mentioned, Bill 36 does create a new position, the

superintendent, as an oversight body of these colleges and these

regulatory groups. But again, as I mentioned, I worry that this is just

another barrier that could be created, as opposed to reducing barriers.

And we want to make sure that that is the last thing that we do. It’s to

be reducing the barriers, not creating more barriers.

There are also some funding challenges regarding funding of this

office and the fees. What does that look like? We’ve already heard from

family physicians across the province that they’re going broke. They’re

unable to keep their offices over due to the general costs of just doing

business in the province of B.C. This is…. It doesn’t matter if you’re

looking at utilities, your rent. All of these things add up and now,

potentially, an increase in fees. Is this something that could have

these unintended consequences down the road? It’s now more money that

we’re going to be asking our doctors, who are already strapped, to be

making.

We want to make sure we do identify what this looks like moving

forward. Is this another cost that’s going to be passed on to our

doctors? Another cost that’s going to potentially…. When we look at our

doctors and health care professionals, it’s a very competitive field. We

have Alberta looking at us. We have Saskatchewan looking at us. It’s a

very competitive field, and everyone is looking at trying to attract

doctors. It’s not just here in Canada. It’s going international to the

United States because these shortages are everywhere.

We want to make sure that these alluded-to unintended consequences

don’t in fact become real, because the last thing we want to do is make

ourselves less competitive when we’re trying to attract health care

professionals to the province of British Columbia.

I mentioned earlier…. Around my office, the number one call we get

is around health care. But another piece is we get a lot of people that

are calling about the ability to lodge a complaint. The ability to

complain, the ability to be heard in our system.

One of the pieces in here is to look at creating a new independent

discipline tribunal. It is something that I’m going to be definitely

looking at closely to see what it looks like because, at the end of the

day, we definitely want a system that is responsive to people that, when

they have a complaint, they know that they’re going to be heard and

there’s going to be follow-up. I think that is something worth

highlighting that is in Bill 36 to make sure that it is something,

again, that’s not more of a barrier, but is going to have a good outcome

for British Columbians if they do need to pursue a complaint within the

system.

Bill 36 is largely enabling legislation. Much of what this means

is, down the road — will come out of regulation. I’m not sure how many

bills we’ve seen go through this House in the last few years that leave

a lot up to regulation. That is one thing that kind of sets a flag off

in my mind.

[3:30 p.m.]

We’re going back to the transparency piece here. British

Columbians want to know, as do people that are working in the health

professions — their boundaries, what they’re allowed to do, what they’re

not allowed to do, the direction they need to go.

When you bring this big umbrella — this is a big um­brella,

630-some pieces — of enabling legislation, it leaves it open to an

incredible amount of regulation that can happen around the cabinet

table. That, again, raises some flags for me around where this could go,

how this could go and the long-term implications that it could have on

our already crumbling — I’ll say fragile — health care system that we

have in this province.

Hon. Speaker, I’ve noticed that my time is almost up. Everything

that I do, since I’ve been elected to this place, is to make sure I

represent the constituents of Peace River North. I’ve mentioned a few

times now that health care is probably one of the biggest things — not

one of; it is the biggest challenge that we have — in my riding.

Whenever we see any piece of legislation that comes through on health

care, we need to make sure that we are not just doing a cookie-cutter

approach, which is often done by…. It’s every level of government, I

will say. This isn’t just one government.

Cookie-cutter approaches do not work. This province is much too

diverse when we look at…. Vancouver is not Victoria, as it is not Fort

St. John or Prince Rupert. We need to make sure that when we are coming

forward with solutions, they are going to be solutions that are going to

work in these areas or that we have the ability within the legislation

to make sure that we recognize the uniqueness and the challenges in all

four corners of our province.

With that, and in closing, I will make sure that we’re going to be

very engaged over the next little while on the committee stage, making

sure that these hard questions are asked.

In closing, I do want to again thank our front-line workers, our

health care workers, our doctors — those people that are doing two

back-to-back 12-hour shifts. They really are heroes, and I know all of

us in this chamber, obviously, do want to thank all of them for the

incredible work that they do. With that, I’ll take my place. Thank you

for the time.

Deputy Speaker: Recognizing the Minister of State for Infrastructure.

Hon. B. Ma: Hon. Speaker, I was worried that maybe I needed to be a bit taller

for you to see me. Thank you for recognizing me.

It’s my pleasure to rise and speak in favour of Bill 36, Health

Professions and Occupations Act. I will try not to take up too much

speaking time. I know that there are a lot of members who want to speak

as well. It is an important piece of legislation, a massive piece of

legislation — 645 sections. My goodness.

[S. Chandra Herbert in the chair.]

For those who are watching the second reading here, we have a

first reading. We’re in second reading right now, and then we’ll go into

Committee of the Whole, where we will debate every single one of those

645 sections, one by one. Then there’ll be a third reading, and then a

final vote. We’ve got lots of time on this piece of

legislation.

I do want to take the opportunity to recognize the incredible work

that health care professionals have been doing, not just over the last

few years of the pandemic but for decades, my whole life. In the entire

time that we have had a public health care system here in British

Columbia, we have relied on the professionalism and expertise of

doctors, nurses and other health care professionals. They have been

doing incredible work, supporting us and taking care of us, helping us

when we need them the most.

[3:35 p.m.]

Of course, I also want to acknowledge that although the challenges

are not new, a lot of different, overlapping crises have brought us to

the place where we are today, where lots of people are challenged in

terms of accessing health care, and that’s important to acknowledge. Of

course, we have brought in and hired tens of thousands of net-new health

care professionals over the last several years — 38,000 new health care

workers in the public health care system. We’re signing up new family

doctors. We have more family doctors than ever before. Yet the demand

and the strain on the system, the need, is so great, and there is still

lots, lots more to do.

I’m so grateful to the Minister of Health for his work on the

health care workforce strategy that was released a few weeks ago. Of

course, the release of a strategy in and of itself is not enough. We

must implement it. So all of that work is happening now.

Of course, this is part of the overall work. It is not all of it.

It is just one small, important — well, I wouldn’t say small; I mean,

645 sections of the bill is not small — part of all of the different

types of work that we need to do in order to build up a stronger public

health care system that can provide services to people and their

families and communities when and where they need it, because that’s

what British Columbians deserve. That’s what Canadians expect. And

that’s the work that we need to do in order to get there.

This particular act, though, is very interesting. It’s about

adapting to the changes in our health care system and ensuring that

regulated health professionals are keeping up. We’re looking to improve

patient safety and public protection, efficiency and effectiveness of

B.C.’s regulatory framework around health care professionals and public

confidence through transparency and accountability.

Some of the changes that this piece of legislation will bring in

include — just very high level, because again, 645 sections of the

bill…. We are looking to a streamlined path to reduce the number of

regulatory colleges through amalgamation. There are currently — oh, man

— 15 colleges, and we’re going to be reducing that down to six through

two major amalgamations.

One of these amalgamations will combine the colleges for

dietitians, occupational therapists, opticians, optometrists, physical

therapists, psychologists and speech and hearing professionals into one

regulator. The other amalgamation would combine the colleges for

chiropractors, massage therapists, naturopathic physicians, traditional

Chinese medicine and acupuncturists into another college.

I will note that I’ve been hearing from a lot of therapists in

British Columbia that they’re also looking to become a regulated health

care professional. I think the reasons for doing so are…. They’ve made

their case very strongly, and my understanding, as well, is that by

streamlining the regulatory framework for the regulation of health care

professionals it actually provides a more streamlined path for more

health care professionals to also become regulated, so that’s really

important.

This act also enables the creation of an oversight body. Now, this

is something that’s familiar to me through our previous work on the

Professional Governance Act. A couple of years ago — maybe, my goodness,

was it three years ago now? — we actually brought in the Professional

Governance Act that sought to streamline the oversight of…. How do I say

this? It sought to streamline and standardize the oversight of

professions that are regulated through professional reliance.

As an example, the Professional Engineers and Geo­scientists

of B.C. and four other professional regulatory bodies were brought in

under an umbrella legislation called the Professional Governance Act,

and a new superintendent’s office was created to provide oversight

there. So the creation of an oversight body that promotes

accountability, transparency and consistency across regulatory colleges

at the health care professional level makes a lot of sense to

me.

[3:40 p.m.]

The legislation also seeks to improve transparency around

complaints. What particularly interests me about that piece is the

creation of a safer complaints process. When patients go to a health

care professional, they’re putting themselves in an extremely vulnerable

position. They put themselves in a place where they are, basically,

putting all of their trust in this health care professional to provide

them the best care possible. The vast, vast majority of health care

professionals absolutely do.

In those cases where something goes wrong, where something has

happened to create cause for a legitimate complaint…. I have had

constituents come to me with those complaints but refuse to actually

submit a proper complaint out of fear of retaliation. They’re worried

that if their health care provider found out that it was them that made

the complaint, they might not be able to access a doctor or that health

care professional in the future, even though the complaint that they

have to raise is very legitimate.

Those kinds of scenarios really concern me. Some re­cent

examples have been…. A constituent was very worried about a very unusual

charge they were being charged. They’d never seen this charge before,

and they really wanted my help, my office’s help, to help them

understand what the charge was. But in order for them to do so, we would

actually need to know the name of the health care provider. They were

very worried about providing us the name of the health care provider,

because they didn’t want to have it found out that they were asking

these questions out of fear that this health care provider wouldn’t see

them anymore.

We also have heard from some patients who have had their primary

health care provider refuse to see them in person, insisting that they

would only see them virtually. I recently learned from the College of

Physicians and Surgeons that they actually have a standard of practice

around doctors seeing patients when the patient feels they need to be

seen in person. They expect doctors to see patients in person when the

patient feels they need to be seen, not only when the doctor feels they

need to be seen in person. Apparently, refusing to see a patient in

person is grounds for a complaint to the College of Physicians and

Surgeons.

This is something I did not know until very recently, when the

College of Physicians and Surgeons — representatives from the college —

made it very clear that that’s grounds for a complaint. But if you are a

patient who is worried about being able to access medical care at all,

let alone virtually or in person, you might not feel comfortable

actually making that complaint in the first place, in which case it

might never be resolved or dealt with.

So the safer complaints process, which allows an ability to

protect the identity of complainants, is very important. I think that

that’s an important part of the improvements that this legislation will

bring in.

The commitment to cultural safety and humility is also very, very

important. The In Plain Sight report that was commissioned

during the pandemic brought to light some very serious concerns around

discrimination and, in particular, systemic racism against Indigenous

people. We are all learning. Nobody is perfect in this. Our government

is learning; our communities are learning. We’re all learning what it

means to reconcile with the systemic racism of societies past and how

that influences the ways that we behave and the ways that our system

operates.

With that, part of that work, of course, is to ensure our medical

system is also doing better each and every day. So this commitment to

cultural safety and humility is so important.

Last two changes I’ll note. It improves information-sharing. Of

course, we have to be careful, in terms of privacy and protection of

personal information, but allowing colleges to be able to share

information more easily between one another and with other agencies will

hopefully help enhance public safety and protection and, of course,

improve governance. Shifting away from the election of board members and

instead creating a board system where all of them are appointed, based

on competency and through a process, will make sure board members of

these colleges do not feel beholden to the people who elect

them.

[3:45 p.m.]

That’s important, because the purpose of a health profession

regulatory college is that they are responsible for ensuring that

regulated health care professionals provide health care services in a

safe, competent and ethical manner. They’re there to protect the public.

They are not a lobbying or advocacy group on behalf of their members;

they’re there to protect the public.

These are all, I think, very important things that we need to do.

None of it is to suggest that this is all that we need to do. There’s

more, of course.

Before I give up the floor to the next speaker, I do also really

want to thank not only the Minister of Health for the work that he and

his team, of course, have put towards this piece of legislation but also

the collaborative efforts of members from the opposition as well. The

MLA for Kelowna–Lake Country played an enormous role in making sure that

that this piece of legislation took into account all the different

perspectives of the House, along with the member for Cowichan Valley.

Having an all-party approach on this piece of legislation, I think, was

really, really important. I’d like to see a lot more of that

collaboration happen in this House.

You know what? I would be remiss if I didn’t throw one more thing

in there before I sat down. When it comes to improved transparency

around complaints, it reads pri­marily that we’re talking about

complaints from patients. But improved transparency, I think, could also

benefit in a number of other areas. Actually, the member who spoke

directly before me had mentioned international medical graduates. If we

can streamline processes, if we can make the process for helping

internationally trained medical graduates get licensed to work here in

British Columbia — if we can make that process more transparent, I think

it would benefit all of us.

There’s enormous expertise and value and experience that comes

into Canada from elsewhere around the world. We need to be making sure

that they’re given the best opportunity possible to utilize their skills

safely and effectively, of course, here in British Columbia in order to

support our population but also to support their families.

I know so many internationally trained medical graduates who have

made very difficult decisions to bring their whole families over here to

Canada in hopes of being able to build a better life. They really want

to be able to contribute to the communities that they now call home. I

think that it would benefit all of us to be able to find ways to allow

them to get trained up and get up to speed on the expectations of

practice here in Canada so that they can contribute to the solution on

behalf of all of us in our communities.

I will take my place and hand over the floor.

R. Merrifield: I’m going to agree with the minister, who spoke before me. This is

a monumental bill. This is truly a huge piece of legislation, and a

tremendous amount of work has gone into it. In fact, she mentioned the

645 different sections, and the Speaker will recall the riveting

committee debate on the one

section of the environmental bill. I

couldn’t even get the right

section at that point, so the Speaker gave

me aid and actually helped to adjust how we were going.

I do recognize how heavy and how weighty a piece of legislation of

this nature is. I’m really happy to be able to have the opportunity

today to stand and to speak to the House about this bill, because I

truly believe that this bill will impact our health care industry at a

very critical moment in history.

We’ve heard a lot of conversations in this House, just as of late,

about our two health care emergencies. First, we had the opioid crisis

that began back in 2016 and that still, to this day, rages out of

control, with more deaths this year than ever before.

[3:50 p.m.]

Then there was the second health care emergency, with the

pandemic. It was just before the pandemic that this piece of legislation

and the committee were struck so that we could actually figure out a new

way to do health care.

I don’t think any of us could imagine this third health care

emergency that we’re in the middle of right now. I don’t think any of us

could imagine how monumental this piece of legislation is in the middle

of a deadly health care crisis, with a collapsed system being hobbled

together by truly extraordinary front-line workers, whether it’s the

nurses and the doctors, whether it’s the care aides, whether it’s those

that work to keep our hospitals moving forward, like the cleaners or the

cooks or the facilitators.

I would rather have those nurses on the front lines than marching

with signs. I’d rather have those doctors performing surgeries or

diagnoses than on the front steps of this building.

I think we all agree that something needs to change. I do think

that this piece of legislation is part of that change. If we look at

this bill through the lens of how the system could shift, I do think

that it could be a part of the solution.

In evaluating this legislation…. Obviously, I’m going to approach

it from the perspective of my riding and those amazing citizens who have

elected me and have put me here. I’m going to evaluate it from an

Okanagian or from a Kelowna resident and their perspective.

In as far as this is a piece of reformation of our health care, I

don’t think that this bill will do what we need it to, to solve our

health care crisis. I don’t think it was actually imagined or struck in

committee with such a crisis in mind. I do believe that it can still

have a positive influence. I do believe that this can still move the

dial slightly forward. But I don’t think that we can look at this bill

as somewhat of a cure-all. It just won’t.

As with any piece of legislation, we need to approach Bill 36 with

a critical eye to make sure that there are not things that we need to

change within it and to ensure that we don’t have negative indirect

consequences. Speaking of the earlier environmental bill, in that one….

That was directly to change something that had been inadvertently placed

inside of a bill that shouldn’t have been changed then that was. We

don’t want Bill 36 to go through that same process. We want all 645

sections to truly be what they need to be without indirect consequences

that are negative.

This bill is not going to address the loads that our hospitals

face on a day-to-day basis.

In the Okanagan, we are incredibly short-staffed. Our Kelowna

General Hospital…. I just want to throw huge kudos out to everyone that

works there on a daily basis. They fluctuate between 120 and 140 percent

occupancy daily. That’s monumental, heroic, the efforts of those

individuals working there. Our operating rooms try to stay open but

routinely have only two-thirds of the nurses that are necessary to truly

run efficiently or effectively. Oftentimes patients are sent home, even

sent home to rural and remote communities from which they’ve driven to

the Okanagan.

[3:55 p.m.]

It would be great if this bill sought to fix some of those issues.

It would be great if somehow this bill could bring light to some of

those staffing issues. But this bill has been in the works for many

years and doesn’t address this aspect.

Now, what are the successes? I think there are successes inside of

Bill 36. The first one I would laud is the democratic process of

collaboration. I know many, who have been here for longer than me, will

roll their eyes and say: “Yeah, it’s great, when you’re in opposition,

to say that you want collaboration. Much harder when you’re in

government.” I do believe the best processes and the best legislation

and the best decisions come through a collaborative process and come

through disparate opinions that will conflict in fierce conversations

and bring to light unanimity.

I am proud that this work was done in collaboration, prior to the

snap election of 2020, prior to when this government no longer needed

our collaboration. Previously, when the NDP were forced, without a

majority, to work together, they did collaborate, and I would argue that

better work ensued.

As mentioned before, this piece of legislation has been borne out

of the recommendations of the steering committee that was co-chaired by

the MLA for Kelowna–Lake Country, part of Team Okanagan, the Leader of

the Third Party as well as the Minister of Health.

As I mentioned before, the committee’s work began before the

pandemic and before our system was showing the explicit outward signs of

crisis. It was before the health care system collapsed, before we had a

million British Columbians without a primary doctor and before we had a

million B.C. patients waiting for specialist care.

The other day I was driving with my spouse. I hap­pened to

get a phone call from someone that I knew and knew fairly well, a

constituent. Recognizing the number, I answered it. I said: “Hey, you’re

on speaker phone with me and Carlos. So just to let you know that you’re

going to be heard by both of us. I can give you a call back if you need

privacy.”

They went on to say: “No. It’s pretty immediate. I need to talk to

you.” They had just learned their family doctor was retiring. They went

on to say that they needed help finding one, that they have medications

that need to be refilled. When I got off the phone, my spouse looked at

me and said: “He sounded really scared.” British Columbians are

scared.

This bill is addressing how we are actually going to regulate the

doctors, but it’s not addressing the fact that we need more doctors.

With this constituent…. I didn’t have the heart to tell him that he is

one of the 35,000 residents of Kelowna without a family physician. I

didn’t have the heart to tell him that we have 16 family docs retiring

in 2022.

The minister before me indicated that we’ve hired all these new

doctors. I don’t know where they’re going, but they’re not going into

family practice. It’s like a war analogy, where you’ve got the infantry

and the front-line soldiers. We keep telling them: “Help is coming.”

We’re hiring and developing soldiers that we’re now employing as

strategists or as administrators or as anything but the soldiers who are

on the front lines of health care.

The main purpose of this committee was to actually make a series

of recommendations to modernize the health profession regulatory

framework. They debated. This was not a quick process.

There was also a lot of consultation. From that, there were these

recommendations that were made by the committee to include — I’m going

to read the list, because I think it’s quite phenomenal — cultural

safety and humility, improve the governance of regulatory college boards

and establish an independent discipline process while revising the

complaints process with the aim to make it more transparent and focused

on patient safety.

[4:00 p.m.]

That’s extraordinary. That’s amazing. It’s also through that lens

that we critically approach this bill to make sure that this bill does

what it was intended to do, that this bill was written with those

changes in mind.

As I read through…. Don’t read it late at night, because all 650

sections get a little bit dry. I read it late at night. But reading it,

it does seem to include many of these changes. The main intent is to

protect the public and streamline the way we currently regulate health

professions. Well, that’s a goal that I think most would support. Of

course the public needs to be protected. It’s one of the reasons that

this side of the House has been sounding the alarm bell about the state

of our health care system. It’s because we’re trying desperately to

protect the public.

As the Minister of State for Infrastructure was speaking earlier,

she inadvertently mixed up some words and said: “The public perception.”

But she’s right. I would argue that since this committee was struck over

3½, four years ago, public perception has shifted.

Inside of this bill, there is this creation of greater

transparency and greater protections. I want to believe that this bill

will achieve that. But I have to say that there is very little trust for

health care out there. There is a lack of public confidence.

We heard other members of this House stand up and talk about their

stories of: would the ambulance be there if they called today? I just

spoke of talking with a constituent and telling him that I didn’t have a

fast-track system to get a new family doctor. I’m working with another

constituent. He’s actually talking about going out of country to get a

surgery that he desperately needs. The public has a real lack of

confidence right now in our health care system.

This bill actually sets up that the minister and cabinet will be

appointing many of these positions. I would argue that we don’t need to

look further than the firing of an entire B.C. Housing board to see how

sometimes that can backfire. I say “sometimes” because I still remain

hopeful. But right now, we don’t have that level of detail articulated,

even though we have 645 sections.

When we talk about transparency…. Well, the most secretive

government in Canada award doesn’t go to those who are transparent and

open.

Where’s another success? Well, I believe that the aspect of mental

health…. This bill could actually pave a way forward for counsellors to

become accredited and to be professionally regulated. This could be a

way to bring that oversight forward.

Previously when they submitted their desire for professional

designation and oversight, well, they were told they had to wait for

this legislation. Actually, Bill 36 could make that way forward. We know

that with mental health where it is today in British Columbia, these

positions are desperately needed. But again, we need to protect the

public and make sure that this is a regulated profession, that there’s

excellence and that there is a way for public to actually hold to

account.

I hope that Bill 36 actually is that paved road forward. But there

are still other designations that are still waiting, other professions

that are still waiting: physi